- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $117.49 / $537.03
| Facility | | $41.69 | $117.49 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.91 / $14.13 / $20.89
| Facility | 26 | $8.91 | $14.13 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $30.20 / $53.70 / $288.40
| Facility | TC | $30.20 | $53.70 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $33.88 / $75.86
| Professional | | $8.71 | $33.88 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $10.00 / $23.99
| Professional | 26 | $7.08 | $10.00 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $28.18 / $28.18 / $28.18
| Professional | 50 | $28.18 | $28.18 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.89 / $28.84 / $51.29
| Professional | TC | $20.89 | $28.84 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $26.30 / $37.15
| Professional | | $21.38 | $26.30 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.46 / $6.61 / $10.47
| Professional | 26 | $6.46 | $6.61 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $38.90 / $38.90 / $38.90
| Professional | 50 | $38.90 | $38.90 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.50 / $29.51 / $31.62
| Professional | TC | $19.50 | $29.51 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $104.71 / $109.65 / $109.65
| Facility | | $104.71 | $109.65 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $45.71 / $45.71
| Professional | | $45.71 | $45.71 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $107.15 / $194.98
| Facility | | $48.98 | $107.15 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $38.90 / $66.07
| Professional | | $26.30 | $38.90 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.41 / $11.48 / $17.38
| Professional | 26 | $7.41 | $11.48 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.50 / $30.20 / $52.48
| Professional | TC | $19.50 | $30.20 | $52.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $44.67 / $89.13
| Facility | | $33.88 | $44.67 | $89.13 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $20.42 / $20.42 / $70.79
| Facility | 26 | $20.42 | $20.42 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $57.54 / $57.54 / $123.03
| Facility | TC | $57.54 | $57.54 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $40.74 / $223.87
| Professional | | $32.36 | $40.74 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.12 / $11.22 / $54.95
| Professional | 26 | $9.12 | $11.22 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.91 / $28.18 / $169.82
| Professional | TC | $22.91 | $28.18 | $169.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $66.07 / $173.78
| Facility | | $28.84 | $66.07 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $34.67 / $61.66
| Professional | | $32.36 | $34.67 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.91 / $10.23 / $16.98
| Professional | 26 | $8.91 | $10.23 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $21.88 / $25.70 / $43.65
| Professional | TC | $21.88 | $25.70 | $43.65 |