- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $208.93 / $489.78
| Facility | | $50.12 | $208.93 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.00 / $10.72 / $13.18
| Facility | 26 | $10.00 | $10.72 | $13.18 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $30.90 / $199.53 / $467.74
| Facility | TC | $30.90 | $199.53 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $43.65 / $162.18
| Professional | | $33.11 | $43.65 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.91 / $12.02 / $44.67
| Professional | 26 | $8.91 | $12.02 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $38.02 / $38.02 / $38.02
| Professional | 50 | $38.02 | $38.02 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $23.99 / $32.36 / $77.62
| Professional | TC | $23.99 | $32.36 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $30.90 / $63.10
| Professional | | $24.55 | $30.90 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.94 / $8.32 / $15.14
| Professional | 26 | $7.94 | $8.32 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $64.57 / $64.57 / $64.57
| Professional | TC | $64.57 | $64.57 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $54.95 / $54.95
| Facility | | $34.67 | $54.95 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $38.90 / $66.07
| Professional | | $38.02 | $38.90 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.23 / $10.47 / $17.78
| Professional | 26 | $10.23 | $10.47 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $48.98 / $56.23 / $66.07
| Professional | 50 | $48.98 | $56.23 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $26.30 / $28.84 / $48.98
| Professional | TC | $26.30 | $28.84 | $48.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $69.18 / $204.17 / $676.08
| Facility | | $69.18 | $204.17 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $47.86 / $70.79
| Professional | | $31.62 | $47.86 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.12 / $13.49 / $19.05
| Professional | 26 | $9.12 | $13.49 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.39 / $35.48 / $52.48
| Professional | TC | $22.39 | $35.48 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.27 / $50.12 / $66.07
| Professional | | $0.27 | $50.12 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $0.09 / $12.88 / $16.98
| Professional | 26 | $0.09 | $12.88 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $0.18 / $37.15 / $50.12
| Professional | TC | $0.18 | $37.15 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.27 / $0.27 / $63.10
| Professional | | $0.27 | $0.27 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $0.09 / $0.09 / $15.85
| Professional | 26 | $0.09 | $0.09 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $0.18 / $0.18 / $46.77
| Professional | TC | $0.18 | $0.18 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $41.69 / $41.69
| Professional | | $39.81 | $41.69 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.23 / $10.72 / $10.96
| Professional | 26 | $10.23 | $10.72 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $29.51 / $30.90 / $30.90
| Professional | TC | $29.51 | $30.90 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $42.66 / $245.47
| Facility | | $42.66 | $42.66 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $40.74 / $67.61
| Professional | | $31.62 | $40.74 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.33 / $11.48 / $20.89
| Professional | 26 | $9.33 | $11.48 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.39 / $28.84 / $50.12
| Professional | TC | $22.39 | $28.84 | $50.12 |