- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.03 / $10.47 / $23.44
| Facility | 26 | $6.03 | $10.47 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $34.67 / $138.04 / $380.19
| Facility | TC | $34.67 | $138.04 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $41.69 / $104.71
| Professional | | $13.18 | $41.69 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.03 / $11.22 / $28.84
| Professional | 26 | $6.03 | $11.22 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $34.67 / $69.18 / $162.18
| Professional | 50 | $34.67 | $69.18 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $26.30 / $67.61 / $158.49
| Professional | 52 | $26.30 | $67.61 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $23.44 / $34.67 / $64.57
| Professional | TC | $23.44 | $34.67 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $38.90 / $56.23
| Professional | | $29.51 | $38.90 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.37 / $8.13 / $10.47
| Professional | 26 | $5.37 | $8.13 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $24.55 / $34.67 / $40.74
| Professional | TC | $24.55 | $34.67 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $23.99 / $57.54 / $954.99
| Facility | TC | $23.99 | $57.54 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $46.77 / $51.29
| Professional | | $39.81 | $46.77 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.51 / $8.51 / $10.72
| Professional | 26 | $8.51 | $8.51 | $10.72 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $91.20 / $128.82 / $186.21
| Facility | TC | $91.20 | $128.82 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $40.74 / $63.10
| Professional | | $37.15 | $40.74 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.61 / $8.71 / $15.49
| Professional | 26 | $6.61 | $8.71 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $74.13 / $81.28 / $125.89
| Professional | 50 | $74.13 | $81.28 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $30.20 / $31.62 / $52.48
| Professional | TC | $30.20 | $31.62 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $38.02 / $69.18
| Professional | | $24.55 | $38.02 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.25 / $8.13 / $13.49
| Professional | 26 | $5.25 | $8.13 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.78 / $30.20 / $56.23
| Professional | TC | $17.78 | $30.20 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $54.95 / $67.61
| Professional | | $40.74 | $54.95 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.76 / $9.12 / $10.96
| Professional | 26 | $6.76 | $9.12 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $33.88 / $44.67 / $56.23
| Professional | TC | $33.88 | $44.67 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $25.12 / $25.12 / $25.12
| Facility | TC | $25.12 | $25.12 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $39.81 / $75.86
| Professional | | $17.38 | $39.81 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.25 / $7.76 / $14.13
| Professional | 26 | $5.25 | $7.76 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $12.30 / $33.11 / $63.10
| Professional | TC | $12.30 | $33.11 | $63.10 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $123.03 / $239.88 / $416.87
| Facility | TC | $123.03 | $239.88 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $45.71 / $52.48
| Professional | | $25.70 | $45.71 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.92 / $7.94 / $11.22
| Professional | 26 | $6.92 | $7.94 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $16.22 / $87.10 / $97.72
| Professional | 50 | $16.22 | $87.10 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $38.02 / $38.02 / $45.71
| Professional | TC | $38.02 | $38.02 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $26.30 / $58.88 / $134.90
| Facility | TC | $26.30 | $58.88 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $46.77 / $56.23
| Professional | | $39.81 | $46.77 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.94 / $8.51 / $11.22
| Professional | 26 | $7.94 | $8.51 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.03 / $8.32 / $15.85
| Facility | 26 | $6.03 | $8.32 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $26.30 / $44.67 / $120.23
| Facility | TC | $26.30 | $44.67 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $41.69 / $79.43
| Professional | | $29.51 | $41.69 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.37 / $7.94 / $14.45
| Professional | 26 | $5.37 | $7.94 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.91 / $33.88 / $63.10
| Professional | TC | $22.91 | $33.88 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $37.15 / $75.86
| Professional | | $12.59 | $37.15 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.61 / $6.61 / $7.59
| Facility | 26 | $6.61 | $6.61 | $7.59 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.42 / $20.42 / $29.51
| Facility | TC | $20.42 | $20.42 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $16.22 / $46.77
| Professional | | $6.31 | $16.22 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.46 / $6.61 / $7.59
| Professional | 26 | $6.46 | $6.61 | $7.59 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.42 / $29.51 / $32.36
| Professional | TC | $20.42 | $29.51 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $36.31 / $77.62
| Professional | | $23.44 | $36.31 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.50 / $7.94 / $16.98
| Professional | 26 | $5.50 | $7.94 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $18.20 / $29.51 / $64.57
| Professional | TC | $18.20 | $29.51 | $64.57 |