- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $12.02 / $229.09
| Facility | | $7.24 | $12.02 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.94 / $12.30 / $16.98
| Facility | 26 | $7.94 | $12.30 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $12.88 / $31.62
| Professional | | $9.33 | $12.88 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.03 / $7.08 / $12.59
| Professional | 26 | $6.03 | $7.08 | $12.59 |
- 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 / $5.62
| Professional | TC | $2.00 | $3.02 | $5.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $30.90 / $46.77
| Facility | | $20.89 | $30.90 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $21.88 / $21.88
| Professional | | $21.88 | $21.88 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $32.36 / $64.57
| Facility | | $11.22 | $32.36 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $14.79 / $24.55
| Professional | | $9.33 | $14.79 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.46 / $10.00 / $16.98
| Professional | 26 | $6.46 | $10.00 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $3.02 / $4.90 / $9.12
| Professional | TC | $3.02 | $4.90 | $9.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $14.45 / $28.84
| Facility | | $11.22 | $14.45 | $28.84 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $17.78 / $17.78 / $100.00
| Facility | 26 | $17.78 | $17.78 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $15.85 / $1,412.54
| Professional | | $12.02 | $15.85 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.13 / $11.22 / $1,288.25
| Professional | 26 | $8.13 | $11.22 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $3.31 / $5.13 / $977.24
| Professional | TC | $3.31 | $5.13 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $21.88 / $56.23
| Facility | | $10.47 | $21.88 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $13.49 / $21.38
| Professional | | $12.02 | $13.49 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.13 / $9.77 / $15.14
| Professional | 26 | $8.13 | $9.77 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $3.31 / $4.27 / $6.76
| Professional | TC | $3.31 | $4.27 | $6.76 |