- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $87.10 / $398.11 / $676.08
| Facility | | $87.10 | $398.11 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.94 / $8.51 / $10.23
| Facility | 26 | $7.94 | $8.51 | $10.23 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $57.54 / $204.17 / $446.68
| Facility | TC | $57.54 | $204.17 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $43.65 / $151.36
| Professional | | $14.13 | $43.65 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $14.45 / $48.98
| Professional | 26 | $7.08 | $14.45 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $33.11 / $114.82 / $199.53
| Professional | 50 | $33.11 | $114.82 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.39 / $41.69 / $117.49
| Professional | TC | $22.39 | $41.69 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $28.84 / $47.86
| Professional | | $23.44 | $28.84 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.46 / $6.92 / $13.18
| Professional | 26 | $6.46 | $6.92 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $34.67 / $44.67 / $45.71
| Professional | 50 | $34.67 | $44.67 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $29.51 / $43.65 / $52.48
| Professional | TC | $29.51 | $43.65 | $52.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $50.12 / $50.12
| Facility | | $31.62 | $50.12 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $34.67 / $57.54
| Professional | | $32.36 | $34.67 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.76 / $7.94 / $13.49
| Professional | 26 | $7.76 | $7.94 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $40.74 / $48.98 / $63.10
| Professional | 50 | $40.74 | $48.98 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $23.44 / $26.92 / $43.65
| Professional | TC | $23.44 | $26.92 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $169.82 / $501.19
| Facility | | $64.57 | $169.82 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $38.90 / $66.07
| Professional | | $27.54 | $38.90 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.92 / $10.47 / $14.45
| Professional | 26 | $6.92 | $10.47 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.95 / $29.51 / $51.29
| Professional | TC | $19.95 | $29.51 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.25 / $45.71 / $60.26
| Professional | | $0.25 | $45.71 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $0.09 / $10.47 / $13.80
| Professional | 26 | $0.09 | $10.47 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $0.16 / $35.48 / $46.77
| Professional | TC | $0.16 | $35.48 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.25 / $0.25 / $57.54
| Professional | | $0.25 | $0.25 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $0.09 / $0.09 / $12.88
| Professional | 26 | $0.09 | $0.09 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $0.16 / $0.16 / $43.65
| Professional | TC | $0.16 | $0.16 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $38.02 / $38.02
| Professional | | $36.31 | $38.02 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.94 / $8.71 / $8.71
| Professional | 26 | $7.94 | $8.71 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $27.54 / $29.51 / $29.51
| Professional | TC | $27.54 | $29.51 | $29.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $38.02 / $181.97
| Facility | | $38.02 | $38.02 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $35.48 / $57.54
| Professional | | $23.99 | $35.48 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.31 / $9.12 / $16.60
| Professional | 26 | $6.31 | $9.12 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $16.60 / $26.30 / $46.77
| Professional | TC | $16.60 | $26.30 | $46.77 |