- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $147.91 / $398.11
| Facility | | $36.31 | $147.91 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.46 / $14.13 / $33.88
| Facility | 26 | $6.46 | $14.13 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.78 / $46.77 / $407.38
| Facility | TC | $17.78 | $46.77 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $38.90 / $109.65
| Professional | | $16.98 | $38.90 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.03 / $14.45 / $38.02
| Professional | 26 | $6.03 | $14.45 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $46.77 / $109.65 / $275.42
| Professional | 50 | $46.77 | $109.65 | $275.42 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $12.88 / $26.92 / $125.89
| Professional | 52 | $12.88 | $26.92 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.85 / $22.91 / $47.86
| Professional | TC | $15.85 | $22.91 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $27.54 / $51.29
| Professional | | $19.95 | $27.54 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.17 / $9.77 / $14.45
| Professional | 26 | $6.17 | $9.77 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $34.67 / $57.54 / $162.18
| Professional | 50 | $34.67 | $57.54 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $14.45 / $28.18 / $36.31
| Professional | TC | $14.45 | $28.18 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $43.65 / $72.44
| Facility | | $25.12 | $43.65 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $33.11 / $58.88
| Professional | | $25.12 | $33.11 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.59 / $10.23 / $17.38
| Professional | 26 | $7.59 | $10.23 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $37.15 / $50.12 / $87.10
| Professional | 50 | $37.15 | $50.12 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.38 / $23.44 / $42.66
| Professional | TC | $17.38 | $23.44 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $26.92 / $41.69
| Facility | | $10.00 | $26.92 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $22.39 / $34.67
| Professional | | $7.59 | $22.39 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $46.77 / $158.49
| Facility | | $33.11 | $46.77 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $37.15 / $67.61
| Professional | | $22.91 | $37.15 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.61 / $10.96 / $19.05
| Professional | 26 | $6.61 | $10.96 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $16.98 / $26.30 / $50.12
| Professional | TC | $16.98 | $26.30 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $38.02 / $93.33
| Professional | | $29.51 | $38.02 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.76 / $10.47 / $26.30
| Professional | 26 | $7.76 | $10.47 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $25.12 / $25.12 / $35.48
| Professional | 52 | $25.12 | $25.12 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $21.38 / $28.18 / $72.44
| Professional | TC | $21.38 | $28.18 | $72.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $151.36 / $194.98 / $1,659.59
| Facility | | $151.36 | $194.98 | $1,659.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $27.54 / $48.98
| Professional | | $8.13 | $27.54 | $48.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $186.21 / $218.78
| Facility | | $21.88 | $186.21 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $31.62 / $60.26
| Professional | | $25.12 | $31.62 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $8.91 / $16.98
| Professional | 26 | $7.08 | $8.91 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.78 / $22.39 / $42.66
| Professional | TC | $17.78 | $22.39 | $42.66 |