- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $128.82 / $398.11
| Facility | | $30.20 | $128.82 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.94 / $9.12 / $12.59
| Facility | 26 | $7.94 | $9.12 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.89 / $31.62 / $501.19
| Facility | TC | $20.89 | $31.62 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $33.88 / $79.43
| Professional | | $15.14 | $33.88 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.03 / $10.96 / $34.67
| Professional | 26 | $6.03 | $10.96 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $16.98 / $81.28 / $257.04
| Professional | 50 | $16.98 | $81.28 | $257.04 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $15.14 / $24.55 / $50.12
| Professional | 52 | $15.14 | $24.55 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.14 / $21.88 / $42.66
| Professional | TC | $15.14 | $21.88 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $20.42 / $25.12
| Professional | | $16.22 | $20.42 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.25 / $7.24 / $13.18
| Professional | 26 | $5.25 | $7.24 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $28.84 / $33.11 / $36.31
| Professional | 50 | $28.84 | $33.11 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $13.49 / $13.49 / $13.49
| Professional | TC | $13.49 | $13.49 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $95.50 / $181.97
| Facility | | $42.66 | $95.50 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $34.67 / $41.69
| Professional | | $29.51 | $34.67 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.13 / $10.00 / $13.18
| Professional | 26 | $8.13 | $10.00 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $21.38 / $25.12 / $30.20
| Professional | TC | $21.38 | $25.12 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $39.81 / $74.13
| Facility | | $26.30 | $39.81 | $74.13 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.05 / $19.95 / $39.81
| Facility | TC | $19.05 | $19.95 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.92 / $16.98 / $16.98
| Professional | 26 | $6.92 | $16.98 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $56.23 / $83.18
| Facility | | $37.15 | $56.23 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $26.92 / $54.95
| Professional | | $17.78 | $26.92 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.01 / $8.13 / $15.14
| Professional | 26 | $5.01 | $8.13 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $12.59 / $19.50 / $38.90
| Professional | TC | $12.59 | $19.50 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $131.83 / $218.78
| Facility | | $44.67 | $131.83 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $28.18 / $42.66
| Professional | | $20.42 | $28.18 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.17 / $7.94 / $12.02
| Professional | 26 | $6.17 | $7.94 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $14.13 / $19.50 / $29.51
| Professional | TC | $14.13 | $19.50 | $29.51 |