- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $229.09 / $467.74
| Facility | | $60.26 | $229.09 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $11.48 / $16.98
| Facility | 26 | $7.08 | $11.48 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $26.30 / $162.18 / $549.54
| Facility | TC | $26.30 | $162.18 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $41.69 / $154.88
| Professional | | $9.12 | $41.69 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.59 / $15.14 / $52.48
| Professional | 26 | $7.59 | $15.14 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $34.67 / $95.50 / $213.80
| Professional | 50 | $34.67 | $95.50 | $213.80 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $60.26 / $125.89 / $125.89
| Professional | 52 | $60.26 | $125.89 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.91 / $39.81 / $151.36
| Professional | TC | $22.91 | $39.81 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $109.65 / $109.65 / $109.65
| Facility | | $109.65 | $109.65 | $109.65 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $27.54 / $27.54 / $27.54
| Facility | 26 | $27.54 | $27.54 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $81.28 / $81.28 / $81.28
| Facility | TC | $81.28 | $81.28 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $87.10 / $107.15
| Professional | | $32.36 | $87.10 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.32 / $19.05 / $23.99
| Professional | 26 | $8.32 | $19.05 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.91 / $67.61 / $85.11
| Professional | TC | $22.91 | $67.61 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $54.95 / $120.23
| Professional | | $32.36 | $54.95 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.76 / $13.80 / $54.95
| Professional | 26 | $7.76 | $13.80 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $23.99 / $38.90 / $66.07
| Professional | TC | $23.99 | $38.90 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $107.15 / $346.74
| Facility | | $43.65 | $107.15 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $26.92 / $100.00 / $100.00
| Facility | 26 | $26.92 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $112.20 / $125.89 / $151.36
| Facility | TC | $112.20 | $125.89 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $57.54 / $234.42
| Professional | | $30.90 | $57.54 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.71 / $14.13 / $70.79
| Professional | 26 | $8.71 | $14.13 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $21.88 / $33.11 / $181.97
| Professional | TC | $21.88 | $33.11 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $77.62 / $95.50
| Professional | | $61.66 | $77.62 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $16.98 / $20.42 / $28.18
| Professional | 26 | $16.98 | $20.42 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $43.65 / $60.26 / $72.44
| Professional | TC | $43.65 | $60.26 | $72.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $109.65 / $109.65 / $109.65
| Facility | | $109.65 | $109.65 | $109.65 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $27.54 / $27.54 / $27.54
| Facility | 26 | $27.54 | $27.54 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $81.28 / $81.28 / $81.28
| Facility | TC | $81.28 | $81.28 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $85.11 / $93.33
| Professional | | $67.61 | $85.11 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $16.60 / $20.42 / $25.12
| Professional | 26 | $16.60 | $20.42 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $51.29 / $66.07 / $72.44
| Professional | TC | $51.29 | $66.07 | $72.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $7,079.46 / $19,498.45
| Facility | | $1,380.38 | $7,079.46 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $29.51 / $63.10
| Professional | | $8.71 | $29.51 | $63.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $109.65 / $190.55 / $245.47
| Facility | | $109.65 | $190.55 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $57.54 / $109.65
| Professional | | $32.36 | $57.54 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.71 / $14.79 / $85.11
| Professional | 26 | $8.71 | $14.79 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $23.44 / $37.15 / $95.50
| Professional | TC | $23.44 | $37.15 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $61.66 / $72.44
| Professional | | $61.66 | $61.66 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $14.45 / $14.45 / $16.98
| Professional | 26 | $14.45 | $14.45 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $47.86 / $47.86 / $56.23
| Professional | TC | $47.86 | $47.86 | $56.23 |