- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $97.72 / $616.60 / $794.33
| Facility | | $97.72 | $616.60 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.94 / $8.51 / $81.28
| Facility | 26 | $7.94 | $8.51 | $81.28 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $34.67 / $223.87 / $398.11
| Facility | TC | $34.67 | $223.87 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $43.65 / $144.54
| Professional | | $12.02 | $43.65 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.41 / $13.49 / $48.98
| Professional | 26 | $7.41 | $13.49 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $85.11 / $112.20 / $169.82
| Professional | 50 | $85.11 | $112.20 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.91 / $39.81 / $117.49
| Professional | TC | $22.91 | $39.81 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $28.18 / $41.69
| Professional | | $24.55 | $28.18 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.46 / $6.76 / $12.88
| Professional | 26 | $6.46 | $6.76 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.38 / $36.31 / $89.13
| Professional | TC | $17.38 | $36.31 | $89.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $48.98 / $48.98
| Facility | | $30.90 | $48.98 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $34.67 / $57.54
| Professional | | $33.11 | $34.67 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.76 / $7.94 / $13.49
| Professional | 26 | $7.76 | $7.94 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $41.69 / $48.98 / $63.10
| Professional | 50 | $41.69 | $48.98 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $23.99 / $26.92 / $43.65
| Professional | TC | $23.99 | $26.92 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $169.82 / $501.19
| Facility | | $63.10 | $169.82 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $39.81 / $64.57
| Professional | | $28.84 | $39.81 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.92 / $10.47 / $15.85
| Professional | 26 | $6.92 | $10.47 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.95 / $29.51 / $52.48
| Professional | TC | $19.95 | $29.51 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.25 / $44.67 / $58.88
| Professional | | $0.25 | $44.67 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $0.09 / $10.00 / $13.18
| Professional | 26 | $0.09 | $10.00 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $0.16 / $34.67 / $45.71
| Professional | TC | $0.16 | $34.67 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.25 / $0.25 / $54.95
| Professional | | $0.25 | $0.25 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $0.09 / $0.09 / $12.59
| Professional | 26 | $0.09 | $0.09 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $0.16 / $0.16 / $42.66
| Professional | TC | $0.16 | $0.16 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $37.15 / $38.02
| Professional | | $35.48 | $37.15 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.94 / $8.32 / $8.51
| Professional | 26 | $7.94 | $8.32 | $8.51 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $26.92 / $28.84 / $29.51
| Professional | TC | $26.92 | $28.84 | $29.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $38.02 / $181.97
| Facility | | $38.02 | $38.02 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $36.31 / $61.66
| Professional | | $24.55 | $36.31 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.31 / $9.12 / $16.60
| Professional | 26 | $6.31 | $9.12 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $16.60 / $26.30 / $47.86
| Professional | TC | $16.60 | $26.30 | $47.86 |