- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $208.93 / $616.60
| Facility | | $46.77 | $208.93 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.61 / $11.22 / $29.51
| Facility | 26 | $6.61 | $11.22 | $29.51 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.95 / $64.57 / $812.83
| Facility | TC | $19.95 | $64.57 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $27.54 / $67.61
| Professional | | $15.49 | $27.54 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.03 / $13.49 / $43.65
| Professional | 26 | $6.03 | $13.49 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $22.39 / $54.95 / $186.21
| Professional | 50 | $22.39 | $54.95 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $16.22 / $23.44 / $50.12
| Professional | 52 | $16.22 | $23.44 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.85 / $22.91 / $45.71
| Professional | TC | $15.85 | $22.91 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $120.23 / $151.36
| Facility | | $100.00 | $120.23 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $36.31 / $56.23
| Professional | | $26.30 | $36.31 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.76 / $9.33 / $14.45
| Professional | 26 | $6.76 | $9.33 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $39.81 / $54.95 / $85.11
| Professional | 50 | $39.81 | $54.95 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.50 / $26.92 / $41.69
| Professional | TC | $19.50 | $26.92 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $32.36 / $83.18
| Professional | | $19.95 | $32.36 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $7.76 / $10.96
| Professional | 26 | $7.08 | $7.76 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.42 / $24.55 / $30.90
| Professional | TC | $20.42 | $24.55 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $85.11 / $524.81
| Facility | | $50.12 | $85.11 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.02 / $12.02 / $12.02
| Facility | 26 | $12.02 | $12.02 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $32.36
| Facility | TC | $32.36 | $32.36 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $33.11 / $57.54
| Professional | | $21.88 | $33.11 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.75 / $9.12 / $16.22
| Professional | 26 | $5.75 | $9.12 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.85 / $22.91 / $43.65
| Professional | TC | $15.85 | $22.91 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $33.88 / $42.66
| Professional | | $28.18 | $33.88 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $8.71 / $11.22
| Professional | 26 | $7.08 | $8.71 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.42 / $25.12 / $32.36
| Professional | TC | $20.42 | $25.12 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $42.66 / $61.66
| Professional | | $33.88 | $42.66 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $11.48 / $14.13 / $16.22
| Professional | 26 | $11.48 | $14.13 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $36.31 / $57.54
| Facility | | $23.99 | $36.31 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $30.20 / $45.71
| Professional | | $30.20 | $30.20 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $25.70 / $67.61
| Facility | | $8.71 | $25.70 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $30.90 / $117.49
| Professional | | $9.55 | $30.90 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.59 / $9.77 / $16.60
| Professional | 26 | $7.59 | $9.77 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.95 / $26.30 / $45.71
| Professional | TC | $19.95 | $26.30 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $35.48 / $186.21
| Facility | | $9.33 | $35.48 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $32.36 / $57.54
| Professional | | $20.89 | $32.36 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.89 / $9.12 / $16.60
| Professional | 26 | $5.89 | $9.12 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $14.79 / $23.44 / $41.69
| Professional | TC | $14.79 | $23.44 | $41.69 |