- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $107.15 / $446.68
| Facility | | $60.26 | $107.15 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.23 / $30.90 / $36.31
| Facility | 26 | $10.23 | $30.90 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $48.98 / $77.62 / $245.47
| Facility | TC | $48.98 | $77.62 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $33.88 / $120.23
| Professional | | $8.51 | $33.88 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $15.49 / $44.67
| Professional | 26 | $7.08 | $15.49 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $17.78 / $64.57 / $257.04
| Professional | 50 | $17.78 | $64.57 | $257.04 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $16.98 / $28.84 / $72.44
| Professional | TC | $16.98 | $28.84 | $72.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $58.88 / $89.13
| Facility | | $36.31 | $58.88 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $39.81 / $70.79
| Professional | | $26.92 | $39.81 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.46 / $10.47 / $18.62
| Professional | 26 | $6.46 | $10.47 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $38.90 / $57.54 / $89.13
| Professional | 50 | $38.90 | $57.54 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.95 / $28.84 / $51.29
| Professional | TC | $19.95 | $28.84 | $51.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $85.11 / $199.53
| Facility | | $44.67 | $85.11 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $44.67 / $77.62
| Professional | | $30.90 | $44.67 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.91 / $11.48 / $18.20
| Professional | 26 | $8.91 | $11.48 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.39 / $33.88 / $70.79
| Professional | TC | $22.39 | $33.88 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $35.48 / $48.98
| Professional | | $27.54 | $35.48 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.91 / $10.47 / $12.59
| Professional | 26 | $8.91 | $10.47 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.91 / $32.36 / $40.74
| Professional | TC | $22.91 | $32.36 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $208.93 / $239.88
| Facility | | $83.18 | $208.93 | $239.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $15.49 / $60.26
| Professional | | $11.22 | $15.49 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $40.74 / $87.10
| Professional | | $26.30 | $40.74 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.76 / $10.00 / $26.30
| Professional | 26 | $6.76 | $10.00 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $18.62 / $31.62 / $72.44
| Professional | TC | $18.62 | $31.62 | $72.44 |