- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $234.42 / $363.08
| Facility | | $48.98 | $234.42 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.72 / $16.60 / $21.38
| Facility | 26 | $10.72 | $16.60 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $33.11 / $66.07 / $323.59
| Facility | TC | $33.11 | $66.07 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $38.90 / $112.20
| Professional | | $10.96 | $38.90 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.41 / $14.79 / $37.15
| Professional | 26 | $7.41 | $14.79 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $21.88 / $77.62 / $257.04
| Professional | 50 | $21.88 | $77.62 | $257.04 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.05 / $35.48 / $66.07
| Professional | TC | $19.05 | $35.48 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $239.88 / $302.00
| Facility | | $26.30 | $239.88 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $1.86 / $8.71 / $12.59
| Facility | 26 | $1.86 | $8.71 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $5.62 / $26.30 / $37.15
| Facility | TC | $5.62 | $26.30 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $57.54 / $89.13
| Professional | | $29.51 | $57.54 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.12 / $14.79 / $22.39
| Professional | 26 | $9.12 | $14.79 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.89 / $43.65 / $67.61
| Professional | TC | $20.89 | $43.65 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $69.18 / $85.11
| Professional | | $63.10 | $69.18 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $14.79 / $16.98 / $19.95
| Professional | 26 | $14.79 | $16.98 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $46.77 / $53.70 / $66.07
| Professional | TC | $46.77 | $53.70 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $56.23 / $316.23
| Facility | | $30.90 | $56.23 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.72 / $15.49 / $21.38
| Facility | 26 | $10.72 | $15.49 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $33.11 / $60.26 / $323.59
| Facility | TC | $33.11 | $60.26 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $51.29 / $95.50
| Professional | | $16.60 | $51.29 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.71 / $15.49 / $24.55
| Professional | 26 | $8.71 | $15.49 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $21.88 / $36.31 / $229.09
| Professional | 50 | $21.88 | $36.31 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $24.55 / $46.77 / $69.18
| Professional | TC | $24.55 | $46.77 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $39.81 / $63.10
| Facility | | $15.14 | $39.81 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $21.88 / $42.66
| Professional | | $11.22 | $21.88 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $45.71 / $79.43
| Facility | | $29.51 | $45.71 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $63.10 / $89.13
| Professional | | $46.77 | $63.10 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.72 / $16.98 / $22.39
| Professional | 26 | $10.72 | $16.98 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $26.92 / $43.65 / $67.61
| Professional | TC | $26.92 | $43.65 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $281.84 / $363.08
| Facility | | $204.17 | $281.84 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $208.93 / $208.93 / $208.93
| Facility | 26 | $208.93 | $208.93 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $208.93 / $208.93 / $208.93
| Facility | TC | $208.93 | $208.93 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $67.61 / $91.20
| Professional | | $51.29 | $67.61 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $14.13 / $16.98 / $21.88
| Professional | 26 | $14.13 | $16.98 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $35.48 / $50.12 / $69.18
| Professional | TC | $35.48 | $50.12 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $323.59 / $426.58
| Facility | | $263.03 | $323.59 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $38.02 / $87.10
| Professional | | $26.92 | $38.02 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.32 / $10.72 / $23.44
| Professional | 26 | $8.32 | $10.72 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $18.20 / $28.84 / $64.57
| Professional | TC | $18.20 | $28.84 | $64.57 |