- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $316.23 / $489.78
| Facility | | $33.88 | $316.23 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.32 / $8.91 / $13.49
| Facility | 26 | $8.32 | $8.91 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.91 / $33.11 / $263.03
| Facility | TC | $22.91 | $33.11 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $34.67 / $107.15
| Professional | | $8.71 | $34.67 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $12.02 / $39.81
| Professional | 26 | $7.08 | $12.02 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $169.82 / $177.83 / $177.83
| Professional | 50 | $169.82 | $177.83 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.50 / $26.92 / $56.23
| Professional | TC | $19.50 | $26.92 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $33.11 / $36.31
| Professional | | $26.30 | $33.11 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.61 / $8.91 / $11.48
| Professional | 26 | $6.61 | $8.91 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $21.88 / $23.99 / $31.62
| Professional | TC | $21.88 | $23.99 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $28.18 / $41.69
| Professional | | $27.54 | $28.18 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.71 / $9.12 / $12.30
| Professional | 26 | $8.71 | $9.12 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $41.69 / $42.66 / $63.10
| Professional | 50 | $41.69 | $42.66 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.05 / $19.50 / $28.84
| Professional | TC | $19.05 | $19.50 | $28.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $30.90 / $44.67
| Facility | | $8.91 | $30.90 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $26.30 / $41.69
| Professional | | $8.91 | $26.30 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $54.95 / $95.50
| Facility | | $37.15 | $54.95 | $95.50 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $2.14 / $10.00 / $14.13
| Facility | 26 | $2.14 | $10.00 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $6.31 / $29.51 / $41.69
| Facility | TC | $6.31 | $29.51 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $45.71 / $165.96
| Professional | | $28.84 | $45.71 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.76 / $13.49 / $40.74
| Professional | 26 | $7.76 | $13.49 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $21.88 / $34.67 / $125.89
| Professional | TC | $21.88 | $34.67 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $32.36 / $33.11
| Professional | | $7.94 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $28.84 / $66.07
| Facility | | $8.51 | $28.84 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $33.88 / $57.54
| Professional | | $28.84 | $33.88 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.13 / $10.23 / $17.78
| Professional | 26 | $8.13 | $10.23 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.95 / $23.99 / $38.90
| Professional | TC | $19.95 | $23.99 | $38.90 |