- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $208.93 / $363.08
| Facility | | $50.12 | $208.93 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.55 / $10.00 / $10.47
| Facility | 26 | $9.55 | $10.00 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $28.84 / $95.50 / $302.00
| Facility | TC | $28.84 | $95.50 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $35.48 / $79.43
| Professional | | $15.49 | $35.48 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.03 / $12.30 / $30.20
| Professional | 26 | $6.03 | $12.30 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $35.48 / $48.98 / $125.89
| Professional | 50 | $35.48 | $48.98 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $24.55 / $31.62 / $47.86
| Professional | 52 | $24.55 | $31.62 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.85 / $25.70 / $53.70
| Professional | TC | $15.85 | $25.70 | $53.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $100.00 / $112.20
| Facility | | $81.28 | $100.00 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $45.71 / $61.66
| Professional | | $28.84 | $45.71 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.76 / $10.72 / $15.14
| Professional | 26 | $6.76 | $10.72 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $43.65 / $67.61 / $93.33
| Professional | 50 | $43.65 | $67.61 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.39 / $33.88 / $46.77
| Professional | TC | $22.39 | $33.88 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $41.69 / $81.28
| Professional | | $29.51 | $41.69 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.59 / $11.22 / $21.88
| Professional | 26 | $7.59 | $11.22 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.42 / $30.90 / $61.66
| Professional | TC | $20.42 | $30.90 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $51.29 / $93.33
| Professional | | $38.90 | $51.29 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.77 / $12.30 / $22.91
| Professional | 26 | $9.77 | $12.30 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $29.51 / $37.15 / $69.18
| Professional | TC | $29.51 | $37.15 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $38.90 / $4,570.88
| Facility | | $35.48 | $38.90 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.55 / $10.00 / $1,148.15
| Facility | 26 | $9.55 | $10.00 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $26.30 / $28.84 / $3,467.37
| Facility | TC | $26.30 | $28.84 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $38.90 / $72.44
| Professional | | $27.54 | $38.90 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $10.00 / $19.05
| Professional | 26 | $7.08 | $10.00 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.95 / $28.84 / $53.70
| Professional | TC | $19.95 | $28.84 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $47.86 / $95.50
| Professional | | $32.36 | $47.86 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.91 / $13.18 / $50.12
| Professional | 26 | $8.91 | $13.18 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $23.44 / $34.67 / $95.50
| Professional | TC | $23.44 | $34.67 | $95.50 |