- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $181.97 / $630.96
| Facility | | $47.86 | $181.97 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.24 / $12.30 / $38.02
| Facility | 26 | $7.24 | $12.30 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $23.99 / $102.33 / $501.19
| Facility | TC | $23.99 | $102.33 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $38.90 / $120.23
| Professional | | $9.12 | $38.90 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.59 / $14.13 / $42.66
| Professional | 26 | $7.59 | $14.13 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $37.15 / $125.89 / $288.40
| Professional | 50 | $37.15 | $125.89 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $30.90 / $30.90 / $30.90
| Professional | 52 | $30.90 | $30.90 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $21.88 / $39.81 / $79.43
| Professional | TC | $21.88 | $39.81 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $37.15 / $64.57
| Professional | | $25.70 | $37.15 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.92 / $10.72 / $15.49
| Professional | 26 | $6.92 | $10.72 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $45.71 / $66.07 / $107.15
| Professional | 50 | $45.71 | $66.07 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.91 / $35.48 / $56.23
| Professional | TC | $22.91 | $35.48 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $53.70 / $97.72
| Facility | | $31.62 | $53.70 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $39.81 / $70.79
| Professional | | $29.51 | $39.81 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.32 / $11.48 / $19.05
| Professional | 26 | $8.32 | $11.48 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $44.67 / $60.26 / $107.15
| Professional | 50 | $44.67 | $60.26 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.89 / $28.84 / $51.29
| Professional | TC | $20.89 | $28.84 | $51.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $36.31 / $53.70
| Facility | | $11.48 | $36.31 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $29.51 / $44.67
| Professional | | $8.51 | $29.51 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $61.66 / $158.49
| Facility | | $42.66 | $61.66 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $45.71 / $85.11
| Professional | | $28.84 | $45.71 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.41 / $12.02 / $21.88
| Professional | 26 | $7.41 | $12.02 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.89 / $33.88 / $66.07
| Professional | TC | $20.89 | $33.88 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $48.98 / $114.82
| Professional | | $38.02 | $48.98 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.51 / $11.48 / $30.20
| Professional | 26 | $8.51 | $11.48 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $45.71
| Professional | 52 | $32.36 | $32.36 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $29.51 / $38.02 / $81.28
| Professional | TC | $29.51 | $38.02 | $81.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $1,737.80 / $11,481.54
| Facility | | $1,737.80 | $1,737.80 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $35.48 / $63.10
| Professional | | $8.91 | $35.48 | $63.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $186.21 / $218.78
| Facility | | $23.44 | $186.21 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $38.90 / $74.13
| Professional | | $29.51 | $38.90 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.94 / $10.23 / $19.95
| Professional | 26 | $7.94 | $10.23 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.89 / $28.18 / $56.23
| Professional | TC | $20.89 | $28.18 | $56.23 |