- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.59 / $20.42 / $30.90
| Facility | 26 | $12.59 | $20.42 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $67.61 / $147.91
| Professional | | $38.90 | $67.61 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.96 / $16.98 / $36.31
| Professional | 26 | $10.96 | $16.98 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $30.90 / $45.71 / $109.65
| Professional | TC | $30.90 | $45.71 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $42.66 / $64.57
| Professional | | $42.66 | $42.66 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.76 / $7.76 / $7.76
| Professional | 26 | $7.76 | $7.76 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $40.74 / $40.74 / $40.74
| Professional | TC | $40.74 | $40.74 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $57.54 / $120.23
| Professional | | $46.77 | $57.54 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.77 / $12.02 / $28.18
| Professional | 26 | $9.77 | $12.02 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $70.79 / $85.11 / $169.82
| Professional | 50 | $70.79 | $85.11 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $37.15 / $44.67 / $89.13
| Professional | TC | $37.15 | $44.67 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $63.10 / $81.28
| Professional | | $19.05 | $63.10 | $81.28 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $3.24 / $15.14 / $21.88
| Facility | 26 | $3.24 | $15.14 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $77.62 / $199.53
| Professional | | $44.67 | $77.62 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.47 / $19.50 / $46.77
| Professional | 26 | $10.47 | $19.50 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $34.67 / $60.26 / $154.88
| Professional | TC | $34.67 | $60.26 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $81.28 / $131.83
| Professional | | $64.57 | $81.28 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $13.49 / $20.42 / $48.98
| Professional | 26 | $13.49 | $20.42 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $53.70 / $70.79 / $102.33
| Professional | TC | $53.70 | $70.79 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $79.43 / $141.25
| Professional | | $44.67 | $79.43 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.02 / $17.78 / $30.90
| Professional | 26 | $12.02 | $17.78 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $31.62 / $60.26 / $109.65
| Professional | TC | $31.62 | $60.26 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $57.54 / $79.43
| Professional | | $54.95 | $57.54 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $15.85 / $16.22 / $16.98
| Professional | 26 | $15.85 | $16.22 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $57.54 / $57.54 / $57.54
| Professional | 50 | $57.54 | $57.54 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $75.86 / $158.49
| Professional | | $64.57 | $75.86 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $15.49 / $18.62 / $34.67
| Professional | 26 | $15.49 | $18.62 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $48.98 / $57.54 / $123.03
| Professional | TC | $48.98 | $57.54 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $81.28 / $234.42
| Professional | | $50.12 | $81.28 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $11.75 / $17.38 / $77.62
| Professional | 26 | $11.75 | $17.38 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $38.90 / $63.10 / $186.21
| Professional | TC | $38.90 | $63.10 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.72 / $15.49 / $25.70
| Facility | 26 | $10.72 | $15.49 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $75.86 / $141.25
| Professional | | $44.67 | $75.86 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $11.48 / $17.78 / $33.11
| Professional | 26 | $11.48 | $17.78 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $31.62 / $57.54 / $109.65
| Professional | TC | $31.62 | $57.54 | $109.65 |