- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $309.03 / $724.44
| Facility | | $51.29 | $309.03 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.51 / $10.96 / $16.98
| Facility | 26 | $8.51 | $10.96 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $32.36 / $251.19 / $549.54
| Facility | TC | $32.36 | $251.19 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $38.90 / $109.65
| Professional | | $8.91 | $38.90 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.76 / $15.85 / $52.48
| Professional | 26 | $7.76 | $15.85 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $40.74 / $109.65 / $316.23
| Professional | 50 | $40.74 | $109.65 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $21.88 / $21.88 / $21.88
| Professional | 52 | $21.88 | $21.88 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $21.88 / $38.90 / $75.86
| Professional | TC | $21.88 | $38.90 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $87.10 / $120.23 / $194.98
| Facility | | $87.10 | $120.23 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $48.98 / $74.13
| Professional | | $32.36 | $48.98 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.94 / $10.96 / $16.22
| Professional | 26 | $7.94 | $10.96 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $40.74 / $48.98 / $64.57
| Professional | 50 | $40.74 | $48.98 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.91 / $38.02 / $58.88
| Professional | TC | $22.91 | $38.02 | $58.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $125.89 / $354.81
| Facility | | $67.61 | $125.89 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $16.98 / $16.98 / $16.98
| Facility | 26 | $16.98 | $16.98 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $51.29 / $51.29 / $51.29
| Facility | TC | $51.29 | $51.29 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $41.69 / $75.86
| Professional | | $26.92 | $41.69 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.59 / $11.22 / $19.05
| Professional | 26 | $7.59 | $11.22 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.95 / $30.20 / $56.23
| Professional | TC | $19.95 | $30.20 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $60.26 / $147.91
| Professional | | $47.86 | $60.26 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.02 / $13.18 / $44.67
| Professional | 26 | $12.02 | $13.18 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $43.65 / $47.86 / $104.71
| Professional | TC | $43.65 | $47.86 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $38.90 / $56.23
| Professional | | $35.48 | $38.90 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.13 / $8.51 / $13.18
| Professional | 26 | $8.13 | $8.51 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $154.88 / $154.88 / $154.88
| Professional | 50 | $154.88 | $154.88 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $26.92 / $30.20 / $42.66
| Professional | TC | $26.92 | $30.20 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $181.97 / $181.97
| Facility | | $50.12 | $181.97 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $51.29 / $89.13
| Professional | | $30.90 | $51.29 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.51 / $14.45 / $28.84
| Professional | 26 | $8.51 | $14.45 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.39 / $36.31 / $63.10
| Professional | TC | $22.39 | $36.31 | $63.10 |