- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $251.19 / $562.34
| Facility | | $48.98 | $251.19 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.32 / $10.47 / $13.80
| Facility | 26 | $8.32 | $10.47 | $13.80 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $28.84 / $239.88 / $575.44
| Facility | TC | $28.84 | $239.88 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $33.88 / $107.15
| Professional | | $7.94 | $33.88 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.41 / $14.45 / $47.86
| Professional | 26 | $7.41 | $14.45 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $46.77 / $112.20 / $295.12
| Professional | 50 | $46.77 | $112.20 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $28.18 / $46.77 / $61.66
| Professional | 52 | $28.18 | $46.77 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.95 / $31.62 / $70.79
| Professional | TC | $19.95 | $31.62 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $112.20 / $177.83
| Facility | | $81.28 | $112.20 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $45.71 / $69.18
| Professional | | $31.62 | $45.71 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.76 / $10.47 / $15.85
| Professional | 26 | $7.76 | $10.47 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $36.31 / $47.86 / $63.10
| Professional | 50 | $36.31 | $47.86 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.91 / $35.48 / $53.70
| Professional | TC | $22.91 | $35.48 | $53.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $125.89 / $354.81
| Facility | | $63.10 | $125.89 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $16.22 / $16.22 / $16.22
| Facility | 26 | $16.22 | $16.22 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $48.98 / $48.98 / $48.98
| Facility | TC | $48.98 | $48.98 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $39.81 / $70.79
| Professional | | $26.30 | $39.81 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.24 / $10.96 / $19.05
| Professional | 26 | $7.24 | $10.96 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $18.20 / $28.18 / $52.48
| Professional | TC | $18.20 | $28.18 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $56.23 / $141.25
| Professional | | $44.67 | $56.23 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $11.48 / $12.59 / $43.65
| Professional | 26 | $11.48 | $12.59 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $39.81 / $43.65 / $97.72
| Professional | TC | $39.81 | $43.65 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $36.31 / $52.48
| Professional | | $32.36 | $36.31 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.94 / $8.13 / $12.59
| Professional | 26 | $7.94 | $8.13 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $24.55 / $28.18 / $39.81
| Professional | TC | $24.55 | $28.18 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $181.97 / $181.97
| Facility | | $46.77 | $181.97 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $46.77 / $77.62
| Professional | | $28.84 | $46.77 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.32 / $13.80 / $27.54
| Professional | 26 | $8.32 | $13.80 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.42 / $33.88 / $60.26
| Professional | TC | $20.42 | $33.88 | $60.26 |