- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $109.65 / $251.19
| Facility | | $7.08 | $109.65 | $251.19 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.01 / $10.00 / $91.20
| Facility | 26 | $5.01 | $10.00 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $14.13 / $35.48
| Professional | | $8.71 | $14.13 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.25 / $7.94 / $24.55
| Professional | 26 | $5.25 | $7.94 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $29.51 / $29.51 / $29.51
| Professional | 50 | $29.51 | $29.51 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $2.00 / $3.02 / $7.24
| Professional | TC | $2.00 | $3.02 | $7.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $11.22 / $20.42
| Professional | | $8.71 | $11.22 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.33 / $10.23 / $13.80
| Professional | 26 | $9.33 | $10.23 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $3.02 / $3.02 / $3.02
| Professional | TC | $3.02 | $3.02 | $3.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $5.89 / $30.20
| Facility | | $3.02 | $5.89 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $4.37 / $5.62
| Professional | | $3.47 | $4.37 | $5.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $56.23 / $81.28
| Facility | | $39.81 | $56.23 | $81.28 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $1.86 / $10.00 / $29.51
| Facility | 26 | $1.86 | $10.00 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $13.49 / $26.30
| Professional | | $8.51 | $13.49 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.50 / $9.77 / $19.05
| Professional | 26 | $5.50 | $9.77 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $2.57 / $4.27 / $9.33
| Professional | TC | $2.57 | $4.27 | $9.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $2.51 / $16.22
| Facility | | $2.40 | $2.51 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.47 / $10.47 / $10.47
| Facility | 26 | $10.47 | $10.47 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $12.30 / $20.42
| Professional | | $8.13 | $12.30 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $4.07 / $8.71 / $13.18
| Professional | 26 | $4.07 | $8.71 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $2.24 / $3.63 / $7.24
| Professional | TC | $2.24 | $3.63 | $7.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $9.12 / $33.11
| Professional | | $3.24 | $9.12 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $22.39 / $44.67
| Facility | | $5.89 | $22.39 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $12.30 / $22.39
| Professional | | $9.55 | $12.30 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.46 / $7.94 / $15.14
| Professional | 26 | $6.46 | $7.94 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $2.88 / $3.98 / $7.41
| Professional | TC | $2.88 | $3.98 | $7.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $8.71 / $12.30
| Professional | | $8.71 | $8.71 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.89 / $5.89 / $7.94
| Professional | 26 | $5.89 | $5.89 | $7.94 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $2.82 / $2.82 / $4.37
| Professional | TC | $2.82 | $2.82 | $4.37 |