- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $151.36 / $389.05
| Facility | | $33.11 | $151.36 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $12.02 / $17.78
| Facility | 26 | $7.08 | $12.02 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.91 / $67.61 / $275.42
| Facility | TC | $22.91 | $67.61 | $275.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $35.48 / $134.90
| Professional | | $8.71 | $35.48 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $12.02 / $42.66
| Professional | 26 | $7.08 | $12.02 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $18.62 / $141.25 / $177.83
| Professional | 50 | $18.62 | $141.25 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.95 / $32.36 / $91.20
| Professional | TC | $19.95 | $32.36 | $91.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $109.65 / $109.65 / $109.65
| Facility | | $109.65 | $109.65 | $109.65 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $32.36
| Facility | 26 | $32.36 | $32.36 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $77.62 / $77.62 / $77.62
| Facility | TC | $77.62 | $77.62 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $85.11 / $107.15
| Professional | | $33.88 | $85.11 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.23 / $19.95 / $24.55
| Professional | 26 | $10.23 | $19.95 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.91 / $64.57 / $81.28
| Professional | TC | $22.91 | $64.57 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $61.66 / $141.25
| Professional | | $35.48 | $61.66 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.13 / $11.75 / $39.81
| Professional | 26 | $8.13 | $11.75 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $23.99 / $35.48 / $83.18
| Professional | TC | $23.99 | $35.48 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $83.18 / $346.74
| Facility | | $38.02 | $83.18 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $31.62 / $70.79 / $70.79
| Facility | 26 | $31.62 | $70.79 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $75.86 / $123.03 / $123.03
| Facility | TC | $75.86 | $123.03 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $56.23 / $223.87
| Professional | | $32.36 | $56.23 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.91 / $12.02 / $54.95
| Professional | 26 | $8.91 | $12.02 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $21.88 / $30.20 / $169.82
| Professional | TC | $21.88 | $30.20 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $75.86 / $117.49
| Professional | | $60.26 | $75.86 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $17.38 / $21.38 / $36.31
| Professional | 26 | $17.38 | $21.38 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $41.69 / $57.54 / $79.43
| Professional | TC | $41.69 | $57.54 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $109.65 / $109.65 / $109.65
| Facility | | $109.65 | $109.65 | $109.65 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $32.36
| Facility | 26 | $32.36 | $32.36 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $77.62 / $77.62 / $77.62
| Facility | TC | $77.62 | $77.62 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $69.18 / $85.11 / $117.49
| Professional | | $69.18 | $85.11 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $17.38 / $21.38 / $36.31
| Professional | 26 | $17.38 | $21.38 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $51.29 / $64.57 / $79.43
| Professional | TC | $51.29 | $64.57 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $109.65 / $2,187.76 / $3,090.30
| Facility | | $109.65 | $2,187.76 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $33.11 / $61.66
| Professional | | $9.12 | $33.11 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $109.65 / $190.55 / $245.47
| Facility | | $109.65 | $190.55 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $47.86 / $95.50
| Professional | | $32.36 | $47.86 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.33 / $15.49 / $60.26
| Professional | 26 | $9.33 | $15.49 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $21.88 / $28.84 / $57.54
| Professional | TC | $21.88 | $28.84 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $61.66 / $72.44
| Professional | | $61.66 | $61.66 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $14.79 / $14.79 / $17.38
| Professional | 26 | $14.79 | $14.79 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $45.71 / $45.71 / $54.95
| Professional | TC | $45.71 | $45.71 | $54.95 |