- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $162.18 / $371.54
| Facility | | $34.67 | $162.18 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.32 / $10.96 / $19.95
| Facility | 26 | $8.32 | $10.96 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.95 / $33.88 / $302.00
| Facility | TC | $19.95 | $33.88 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $38.90 / $107.15
| Professional | | $23.99 | $38.90 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.76 / $10.00 / $30.90
| Professional | 26 | $7.76 | $10.00 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $16.98 / $26.92 / $54.95
| Professional | TC | $16.98 | $26.92 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $22.39 / $45.71
| Professional | | $18.62 | $22.39 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.61 / $8.32 / $14.45
| Professional | 26 | $6.61 | $8.32 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.14 / $15.14 / $36.31
| Professional | TC | $15.14 | $15.14 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $31.62 / $52.48
| Professional | | $25.70 | $31.62 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.12 / $10.96 / $17.78
| Professional | 26 | $9.12 | $10.96 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $16.22 / $19.50 / $35.48
| Professional | TC | $16.22 | $19.50 | $35.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $26.30 / $45.71
| Facility | | $24.55 | $26.30 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $32.36 / $40.74
| Professional | | $30.20 | $32.36 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.33 / $9.77 / $12.88
| Professional | 26 | $9.33 | $9.77 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.89 / $22.91 / $28.18
| Professional | TC | $20.89 | $22.91 | $28.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $72.44 / $199.53
| Facility | | $37.15 | $72.44 | $199.53 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $2.14 / $10.00 / $14.13
| Facility | 26 | $2.14 | $10.00 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $5.01 / $23.44 / $33.11
| Facility | TC | $5.01 | $23.44 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $34.67 / $66.07
| Professional | | $22.91 | $34.67 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.59 / $12.02 / $21.88
| Professional | 26 | $7.59 | $12.02 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.85 / $23.99 / $46.77
| Professional | TC | $15.85 | $23.99 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $42.66 / $263.03
| Facility | | $26.30 | $42.66 | $263.03 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $20.42 / $70.79 / $70.79
| Facility | 26 | $20.42 | $70.79 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $44.67 / $97.72 / $97.72
| Facility | TC | $44.67 | $97.72 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $35.48 / $194.98
| Professional | | $25.12 | $35.48 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.91 / $12.30 / $54.95
| Professional | 26 | $8.91 | $12.30 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.38 / $23.99 / $138.04
| Professional | TC | $17.38 | $23.99 | $138.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $74.13 / $177.83
| Facility | | $27.54 | $74.13 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $32.36 / $77.62
| Professional | | $26.30 | $32.36 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.71 / $10.96 / $41.69
| Professional | 26 | $8.71 | $10.96 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.38 / $21.88 / $44.67
| Professional | TC | $17.38 | $21.88 | $44.67 |