- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $229.09 / $489.78
| Facility | | $43.65 | $229.09 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.13 / $10.23 / $19.50
| Facility | 26 | $8.13 | $10.23 | $19.50 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $26.92 / $63.10 / $436.52
| Facility | TC | $26.92 | $63.10 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $35.48 / $107.15
| Professional | | $8.51 | $35.48 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.76 / $13.49 / $38.90
| Professional | 26 | $7.76 | $13.49 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $19.50 / $83.18 / $165.96
| Professional | 50 | $19.50 | $83.18 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $60.26 / $81.28 / $125.89
| Professional | 52 | $60.26 | $81.28 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.91 / $38.90 / $83.18
| Professional | TC | $22.91 | $38.90 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $26.92 / $57.54
| Professional | | $22.91 | $26.92 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.31 / $8.32 / $13.80
| Professional | 26 | $6.31 | $8.32 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $51.29 / $72.44 / $91.20
| Professional | 50 | $51.29 | $72.44 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $16.98 / $23.99 / $46.77
| Professional | TC | $16.98 | $23.99 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $38.02 / $61.66
| Professional | | $30.20 | $38.02 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.71 / $10.72 / $17.38
| Professional | 26 | $8.71 | $10.72 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $45.71 / $56.23 / $93.33
| Professional | 50 | $45.71 | $56.23 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $21.38 / $26.92 / $45.71
| Professional | TC | $21.38 | $26.92 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $30.20 / $52.48
| Facility | | $22.39 | $30.20 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $40.74 / $50.12
| Professional | | $37.15 | $40.74 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.12 / $9.33 / $12.30
| Professional | 26 | $9.12 | $9.33 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $28.84 / $30.90 / $38.02
| Professional | TC | $28.84 | $30.90 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $95.50 / $245.47
| Facility | | $60.26 | $95.50 | $245.47 |
- 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 / $41.69 / $70.79
| Professional | | $28.18 | $41.69 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.24 / $11.48 / $20.42
| Professional | 26 | $7.24 | $11.48 | $20.42 |
- 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
- Facility
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $52.48 / $346.74
| Facility | | $32.36 | $52.48 | $346.74 |
- 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 / $45.71 / $234.42
| Professional | | $30.20 | $45.71 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.51 / $12.02 / $70.79
| Professional | 26 | $8.51 | $12.02 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.39 / $33.88 / $181.97
| Professional | TC | $22.39 | $33.88 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $74.13 / $177.83
| Facility | | $31.62 | $74.13 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $38.90 / $85.11
| Professional | | $30.20 | $38.90 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.13 / $10.47 / $39.81
| Professional | 26 | $8.13 | $10.47 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $21.88 / $28.18 / $60.26
| Professional | TC | $21.88 | $28.18 | $60.26 |