- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $138.04 / $549.54
| Facility | | $41.69 | $138.04 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.55 / $29.51 / $83.18
| Facility | 26 | $9.55 | $29.51 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $36.31 / $63.10 / $281.84
| Facility | TC | $36.31 | $63.10 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $40.74 / $120.23
| Professional | | $9.77 | $40.74 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.76 / $14.79 / $48.98
| Professional | 26 | $7.76 | $14.79 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $26.30 / $89.13 / $199.53
| Professional | 50 | $26.30 | $89.13 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $29.51 / $29.51 / $125.89
| Professional | 52 | $29.51 | $29.51 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $21.88 / $39.81 / $85.11
| Professional | TC | $21.88 | $39.81 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $26.92 / $40.74
| Professional | | $22.91 | $26.92 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.62 / $6.76 / $12.02
| Professional | 26 | $5.62 | $6.76 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $32.36 / $42.66 / $47.86
| Professional | 50 | $32.36 | $42.66 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $18.62 / $22.91 / $31.62
| Professional | TC | $18.62 | $22.91 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $79.43 / $141.25
| Facility | | $21.38 | $79.43 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $38.02 / $154.88
| Professional | | $31.62 | $38.02 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.61 / $8.32 / $32.36
| Professional | 26 | $6.61 | $8.32 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $25.12 / $30.20 / $123.03
| Professional | TC | $25.12 | $30.20 | $123.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $123.03 / $269.15
| Facility | | $67.61 | $123.03 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $2.04 / $9.55 / $13.49
| Facility | 26 | $2.04 | $9.55 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $6.46 / $30.20 / $43.65
| Facility | TC | $6.46 | $30.20 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $38.02 / $74.13
| Professional | | $28.18 | $38.02 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.92 / $9.55 / $18.20
| Professional | 26 | $6.92 | $9.55 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.42 / $27.54 / $54.95
| Professional | TC | $20.42 | $27.54 | $54.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $41.69 / $109.65
| Facility | | $30.90 | $41.69 | $109.65 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $19.50 / $100.00 / $100.00
| Facility | 26 | $19.50 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $58.88 / $125.89 / $125.89
| Facility | TC | $58.88 | $125.89 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $37.15 / $234.42
| Professional | | $30.20 | $37.15 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.13 / $10.00 / $70.79
| Professional | 26 | $8.13 | $10.00 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $21.88 / $26.92 / $181.97
| Professional | TC | $21.88 | $26.92 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $74.13 / $95.50
| Facility | | $14.45 | $74.13 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $35.48 / $102.33
| Professional | | $29.51 | $35.48 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.13 / $9.33 / $52.48
| Professional | 26 | $8.13 | $9.33 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $21.88 / $26.30 / $85.11
| Professional | TC | $21.88 | $26.30 | $85.11 |