- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $27.54 / $114.82
| Facility | | $8.91 | $27.54 | $114.82 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.96 / $19.05 / $36.31
| Facility | 26 | $10.96 | $19.05 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $15.14 / $34.67
| Professional | | $9.33 | $15.14 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.03 / $8.91 / $25.70
| Professional | 26 | $6.03 | $8.91 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $11.48 / $11.48 / $29.51
| Professional | 50 | $11.48 | $11.48 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $2.00 / $3.89 / $9.12
| Professional | TC | $2.00 | $3.89 | $9.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $14.45 / $21.38
| Professional | | $9.55 | $14.45 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $14.13 / $14.13 / $14.13
| Professional | 26 | $14.13 | $14.13 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $5.62 / $5.62 / $5.62
| Professional | TC | $5.62 | $5.62 | $5.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $10.23 / $15.85
| Facility | | $5.37 | $10.23 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $17.38 / $25.12
| Professional | | $12.02 | $17.38 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.32 / $12.02 / $18.20
| Professional | 26 | $8.32 | $12.02 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $18.20 / $25.70 / $38.02
| Professional | 50 | $18.20 | $25.70 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $2.88 / $5.01 / $7.94
| Professional | TC | $2.88 | $5.01 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $10.72 / $16.60
| Facility | | $4.57 | $10.72 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $7.76 / $13.18
| Professional | | $3.39 | $7.76 | $13.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $8.51 / $64.57
| Facility | | $5.75 | $8.51 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $17.78 / $29.51
| Professional | | $11.22 | $17.78 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.41 / $12.02 / $20.89
| Professional | 26 | $7.41 | $12.02 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $3.02 / $5.50 / $9.77
| Professional | TC | $3.02 | $5.50 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $14.45 / $40.74
| Professional | | $12.02 | $14.45 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.76 / $9.33 / $27.54
| Professional | 26 | $7.76 | $9.33 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $4.17 / $4.79 / $29.51
| Professional | TC | $4.17 | $4.79 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $27.54 / $31.62
| Professional | | $20.89 | $27.54 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $60.26 / $70.79
| Facility | | $11.22 | $60.26 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $15.14 / $26.30
| Professional | | $10.96 | $15.14 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.59 / $10.72 / $17.78
| Professional | 26 | $7.59 | $10.72 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $3.24 / $4.47 / $8.51
| Professional | TC | $3.24 | $4.47 | $8.51 |