- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $128.82 / $281.84
| Facility | | $43.65 | $128.82 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.23 / $10.23 / $13.18
| Facility | 26 | $10.23 | $10.23 | $13.18 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $30.20 / $60.26 / $234.42
| Facility | TC | $30.20 | $60.26 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $36.31 / $107.15
| Professional | | $8.71 | $36.31 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.94 / $13.18 / $47.86
| Professional | 26 | $7.94 | $13.18 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $28.18 / $79.43 / $177.83
| Professional | 50 | $28.18 | $79.43 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.89 / $30.20 / $69.18
| Professional | TC | $20.89 | $30.20 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $27.54 / $66.07
| Professional | | $22.39 | $27.54 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $10.47 / $14.13
| Professional | 26 | $7.08 | $10.47 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.39 / $24.55 / $25.12
| Professional | TC | $22.39 | $24.55 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $67.61 / $114.82
| Facility | | $44.67 | $67.61 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $53.70 / $102.33 / $107.15
| Professional | | $53.70 | $102.33 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $13.80 / $13.80 / $13.80
| Professional | 26 | $13.80 | $13.80 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $114.82 / $114.82 / $114.82
| Professional | 50 | $114.82 | $114.82 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $42.66 / $42.66 / $42.66
| Professional | TC | $42.66 | $42.66 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $30.90 / $52.48
| Facility | | $10.23 | $30.90 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $30.90 / $50.12
| Professional | | $9.55 | $30.90 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $38.90 / $93.33
| Professional | | $26.92 | $38.90 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.24 / $11.48 / $22.39
| Professional | 26 | $7.24 | $11.48 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $33.88 / $48.98 / $53.70
| Professional | 50 | $33.88 | $48.98 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.42 / $30.20 / $70.79
| Professional | TC | $20.42 | $30.20 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $131.83 / $288.40
| Facility | | $41.69 | $131.83 | $288.40 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.23 / $10.23 / $19.05
| Facility | 26 | $10.23 | $10.23 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $30.20 / $56.23 / $234.42
| Facility | TC | $30.20 | $56.23 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $40.74 / $100.00
| Professional | | $13.80 | $40.74 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.76 / $11.48 / $36.31
| Professional | 26 | $7.76 | $11.48 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $18.62 / $77.62 / $194.98
| Professional | 50 | $18.62 | $77.62 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.50 / $30.20 / $60.26
| Professional | TC | $19.50 | $30.20 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $34.67 / $67.61
| Professional | | $26.30 | $34.67 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.41 / $10.72 / $18.62
| Professional | 26 | $7.41 | $10.72 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $33.88 / $48.98 / $53.70
| Professional | 50 | $33.88 | $48.98 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.50 / $25.70 / $47.86
| Professional | TC | $19.50 | $25.70 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $81.28 / $229.09
| Facility | | $26.30 | $81.28 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $37.15 / $112.20
| Professional | | $30.20 | $37.15 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.71 / $11.22 / $79.43
| Professional | 26 | $8.71 | $11.22 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.89 / $25.12 / $45.71
| Professional | TC | $20.89 | $25.12 | $45.71 |