- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $199.53 / $467.74
| Facility | | $44.67 | $199.53 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.51 / $10.72 / $16.22
| Facility | 26 | $8.51 | $10.72 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $26.92 / $74.13 / $676.08
| Facility | TC | $26.92 | $74.13 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $29.51 / $72.44
| Professional | | $8.51 | $29.51 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.94 / $12.59 / $36.31
| Professional | 26 | $7.94 | $12.59 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $18.62 / $141.25 / $269.15
| Professional | 50 | $18.62 | $141.25 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.89 / $30.90 / $64.57
| Professional | TC | $20.89 | $30.90 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $27.54 / $36.31
| Professional | | $22.39 | $27.54 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.61 / $10.72 / $14.13
| Professional | 26 | $6.61 | $10.72 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $21.88 / $24.55 / $38.02
| Professional | TC | $21.88 | $24.55 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $213.80 / $223.87
| Facility | | $190.55 | $213.80 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $39.81 / $64.57
| Professional | | $30.20 | $39.81 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.33 / $11.75 / $19.50
| Professional | 26 | $9.33 | $11.75 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $45.71 / $58.88 / $95.50
| Professional | 50 | $45.71 | $58.88 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.89 / $27.54 / $44.67
| Professional | TC | $20.89 | $27.54 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $43.65 / $67.61
| Professional | | $38.02 | $43.65 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.77 / $10.96 / $16.98
| Professional | 26 | $9.77 | $10.96 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $28.18 / $32.36 / $50.12
| Professional | TC | $28.18 | $32.36 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $32.36 / $52.48
| Facility | | $9.77 | $32.36 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $30.20 / $51.29
| Professional | | $9.12 | $30.20 | $51.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $117.49 / $269.15
| Facility | | $75.86 | $117.49 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $42.66 / $74.13
| Professional | | $28.18 | $42.66 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.76 / $11.75 / $20.42
| Professional | 26 | $7.76 | $11.75 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $43.65 / $43.65 / $43.65
| Professional | 50 | $43.65 | $43.65 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $21.38 / $30.90 / $57.54
| Professional | TC | $21.38 | $30.90 | $57.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $218.78 / $346.74
| Facility | | $81.28 | $218.78 | $346.74 |
- 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 / $38.02 / $257.04
| Facility | TC | $6.31 | $38.02 | $257.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $39.81 / $67.61
| Professional | | $26.92 | $39.81 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.76 / $12.02 / $24.55
| Professional | 26 | $7.76 | $12.02 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.42 / $29.51 / $48.98
| Professional | TC | $20.42 | $29.51 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $32.36 / $33.11
| Professional | | $16.98 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $107.15 / $107.15 / $107.15
| Facility | | $107.15 | $107.15 | $107.15 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $107.15 / $107.15 / $107.15
| Facility | 26 | $107.15 | $107.15 | $107.15 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $107.15 / $107.15 / $107.15
| Facility | TC | $107.15 | $107.15 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $43.65 / $77.62
| Professional | | $34.67 | $43.65 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.91 / $11.75 / $19.95
| Professional | 26 | $8.91 | $11.75 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $25.70 / $32.36 / $57.54
| Professional | TC | $25.70 | $32.36 | $57.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $66.07 / $199.53
| Facility | | $10.96 | $66.07 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $36.31 / $70.79
| Professional | | $26.92 | $36.31 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.41 / $10.47 / $23.99
| Professional | 26 | $7.41 | $10.47 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $18.62 / $25.70 / $43.65
| Professional | TC | $18.62 | $25.70 | $43.65 |