- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $23.44 / $239.88
| Facility | | $5.37 | $23.44 | $239.88 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $15.14 / $31.62
| Facility | 26 | $7.08 | $15.14 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $16.98 / $38.02
| Professional | | $9.77 | $16.98 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.03 / $10.00 / $27.54
| Professional | 26 | $6.03 | $10.00 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $11.48 / $29.51 / $29.51
| Professional | 50 | $11.48 | $29.51 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $2.29 / $3.98 / $10.23
| Professional | TC | $2.29 | $3.98 | $10.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $43.65 / $79.43
| Facility | | $4.47 | $43.65 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.71 / $19.05 / $100.00
| Facility | 26 | $8.71 | $19.05 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $15.49 / $1,412.54
| Professional | | $10.23 | $15.49 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $10.96 / $1,288.25
| Professional | 26 | $7.08 | $10.96 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $2.88 / $5.13 / $977.24
| Professional | TC | $2.88 | $5.13 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $24.55 / $35.48
| Facility | | $19.50 | $24.55 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $25.70 / $25.70
| Professional | | $22.91 | $25.70 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $57.54 / $141.25
| Facility | | $15.85 | $57.54 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $18.20 / $33.88
| Professional | | $10.23 | $18.20 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.61 / $12.02 / $22.39
| Professional | 26 | $6.61 | $12.02 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $2.88 / $5.89 / $11.75
| Professional | TC | $2.88 | $5.89 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $10.47 / $28.18
| Facility | | $5.01 | $10.47 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $10.23 / $19.95
| Professional | | $5.01 | $10.23 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $14.13 / $30.90
| Professional | | $8.32 | $14.13 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.51 / $13.80 / $20.89
| Professional | 26 | $8.51 | $13.80 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $4.07 / $5.01 / $9.55
| Professional | TC | $4.07 | $5.01 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $47.86 / $48.98
| Facility | | $47.86 | $47.86 | $48.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $43.65 / $79.43
| Facility | | $4.47 | $43.65 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.71 / $19.05 / $100.00
| Facility | 26 | $8.71 | $19.05 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $15.49 / $1,412.54
| Professional | | $10.23 | $15.49 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $10.96 / $1,288.25
| Professional | 26 | $7.08 | $10.96 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $2.88 / $5.13 / $977.24
| Professional | TC | $2.88 | $5.13 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $22.91 / $95.50
| Facility | | $3.89 | $22.91 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $16.60 / $35.48
| Professional | | $10.96 | $16.60 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.76 / $11.22 / $21.88
| Professional | 26 | $7.76 | $11.22 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $3.16 / $5.62 / $11.48
| Professional | TC | $3.16 | $5.62 | $11.48 |