- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $60.26 / $389.05
| Facility | | $29.51 | $60.26 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.01 / $11.48 / $29.51
| Facility | 26 | $5.01 | $11.48 | $29.51 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $14.45 / $54.95 / $269.15
| Facility | TC | $14.45 | $54.95 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $38.02 / $112.20
| Professional | | $16.22 | $38.02 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.46 / $15.85 / $37.15
| Professional | 26 | $6.46 | $15.85 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $24.55 / $109.65 / $190.55
| Professional | 50 | $24.55 | $109.65 | $190.55 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $15.14 / $26.30 / $158.49
| Professional | 52 | $15.14 | $26.30 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.14 / $25.12 / $60.26
| Professional | TC | $15.14 | $25.12 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $87.10 / $363.08
| Facility | | $26.92 | $87.10 | $363.08 |
- 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
- $52.48 / $134.90 / $134.90
| Facility | TC | $52.48 | $134.90 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $38.02 / $181.97
| Professional | | $23.44 | $38.02 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.76 / $10.23 / $70.79
| Professional | 26 | $6.76 | $10.23 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $18.62 / $28.84 / $154.88
| Professional | TC | $18.62 | $28.84 | $154.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $109.65 / $141.25
| Facility | | $70.79 | $109.65 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.32 / $14.13 / $19.05
| Professional | 26 | $8.32 | $14.13 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $4.17 / $9.55 / $32.36
| Professional | 52 | $4.17 | $9.55 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $169.82 / $275.42
| Facility | | $63.10 | $169.82 | $275.42 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $21.88 / $21.88 / $21.88
| Facility | TC | $21.88 | $21.88 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $42.66 / $77.62
| Professional | | $22.91 | $42.66 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.17 / $11.22 / $20.89
| Professional | 26 | $6.17 | $11.22 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $16.98 / $32.36 / $57.54
| Professional | TC | $16.98 | $32.36 | $57.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $30.20 / $66.07
| Facility | | $9.77 | $30.20 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $29.51 / $53.70
| Professional | | $9.55 | $29.51 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $46.77 / $89.13
| Professional | | $30.90 | $46.77 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.94 / $11.22 / $20.42
| Professional | 26 | $7.94 | $11.22 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.91 / $32.36 / $58.88
| Professional | TC | $22.91 | $32.36 | $58.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $52.48 / $288.40
| Facility | | $21.38 | $52.48 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $14.79 / $60.26
| Professional | | $10.72 | $14.79 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $87.10 / $363.08
| Facility | | $26.92 | $87.10 | $363.08 |
- 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
- $52.48 / $134.90 / $134.90
| Facility | TC | $52.48 | $134.90 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $38.02 / $181.97
| Professional | | $23.44 | $38.02 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.76 / $10.23 / $70.79
| Professional | 26 | $6.76 | $10.23 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $18.62 / $28.84 / $154.88
| Professional | TC | $18.62 | $28.84 | $154.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $97.72 / $177.83
| Facility | | $22.39 | $97.72 | $177.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $79.43 / $288.40
| Facility | | $12.30 | $79.43 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $39.81 / $95.50
| Professional | | $27.54 | $39.81 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.41 / $10.72 / $25.70
| Professional | 26 | $7.41 | $10.72 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.95 / $28.84 / $67.61
| Professional | TC | $19.95 | $28.84 | $67.61 |