- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $97.72 / $446.68
| Facility | | $28.18 | $97.72 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.51 / $25.70 / $35.48
| Facility | 26 | $8.51 | $25.70 | $35.48 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $29.51 / $52.48 / $138.04
| Facility | TC | $29.51 | $52.48 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $36.31 / $112.20
| Professional | | $17.38 | $36.31 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.03 / $14.45 / $43.65
| Professional | 26 | $6.03 | $14.45 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $18.62 / $85.11 / $257.04
| Professional | 50 | $18.62 | $85.11 | $257.04 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $18.62 / $33.11 / $204.17
| Professional | 52 | $18.62 | $33.11 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.85 / $24.55 / $75.86
| Professional | TC | $15.85 | $24.55 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $21.88 / $28.18
| Professional | | $18.20 | $21.88 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $3.80 / $6.03 / $7.41
| Professional | 26 | $3.80 | $6.03 | $7.41 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $34.67 / $34.67 / $39.81
| Professional | 50 | $34.67 | $34.67 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $13.18 / $14.45 / $19.95
| Professional | TC | $13.18 | $14.45 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $64.57 / $123.03
| Facility | | $15.85 | $64.57 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $29.51 / $120.23
| Professional | | $24.55 | $29.51 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.89 / $7.24 / $28.18
| Professional | 26 | $5.89 | $7.24 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.05 / $22.39 / $91.20
| Professional | TC | $19.05 | $22.39 | $91.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $93.33 / $269.15
| Facility | | $56.23 | $93.33 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $1.82 / $8.51 / $12.02
| Facility | 26 | $1.82 | $8.51 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $4.90 / $22.91 / $32.36
| Facility | TC | $4.90 | $22.91 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $30.90 / $60.26
| Professional | | $22.91 | $30.90 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.17 / $8.71 / $16.22
| Professional | 26 | $6.17 | $8.71 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $16.60 / $21.88 / $42.66
| Professional | TC | $16.60 | $21.88 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $32.36 / $60.26
| Facility | | $24.55 | $32.36 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $17.38 / $100.00 / $100.00
| Facility | 26 | $17.38 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $44.67 / $100.00 / $100.00
| Facility | TC | $44.67 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $28.84 / $181.97
| Professional | | $25.70 | $28.84 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.24 / $8.32 / $67.61
| Professional | 26 | $7.24 | $8.32 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $53.70 / $53.70 / $53.70
| Professional | 52 | $53.70 | $53.70 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.78 / $21.38 / $154.88
| Professional | TC | $17.78 | $21.38 | $154.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $74.13 / $95.50
| Facility | | $13.18 | $74.13 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $28.18 / $74.13
| Professional | | $25.12 | $28.18 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.24 / $8.13 / $45.71
| Professional | 26 | $7.24 | $8.13 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.78 / $20.42 / $61.66
| Professional | TC | $17.78 | $20.42 | $61.66 |