- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $16.60 / $85.11
| Facility | | $9.77 | $16.60 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.91 / $9.12 / $11.48
| Facility | 26 | $8.91 | $9.12 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $14.45 / $38.90
| Professional | | $9.77 | $14.45 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.03 / $8.91 / $33.11
| Professional | 26 | $6.03 | $8.91 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $11.48 / $11.48 / $11.48
| Professional | 50 | $11.48 | $11.48 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $3.02 / $3.98 / $8.32
| Professional | TC | $3.02 | $3.98 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $9.77 / $11.48
| Professional | | $9.55 | $9.77 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.23 / $10.23 / $10.23
| Professional | 26 | $10.23 | $10.23 | $10.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $9.12 / $15.49
| Facility | | $6.17 | $9.12 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $16.98 / $16.98
| Professional | | $12.02 | $16.98 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.30 / $12.30 / $12.30
| Professional | 26 | $12.30 | $12.30 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $10.00 / $16.98
| Facility | | $4.17 | $10.00 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $9.12 / $16.22
| Professional | | $3.47 | $9.12 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $22.39 / $22.39
| Facility | | $22.39 | $22.39 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $15.14 / $30.90
| Professional | | $9.77 | $15.14 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.31 / $10.23 / $20.42
| Professional | 26 | $6.31 | $10.23 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $3.02 / $4.90 / $11.22
| Professional | TC | $3.02 | $4.90 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $18.62 / $85.11
| Facility | | $9.77 | $18.62 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.91 / $12.59 / $22.39
| Facility | 26 | $8.91 | $12.59 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $14.45 / $33.88
| Professional | | $10.00 | $14.45 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $9.12 / $19.50
| Professional | 26 | $7.08 | $9.12 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $11.48 / $11.48 / $11.48
| Professional | 50 | $11.48 | $11.48 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $3.02 / $4.57 / $9.12
| Professional | TC | $3.02 | $4.57 | $9.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $22.39 / $22.39
| Facility | | $22.39 | $22.39 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $14.79 / $22.91
| Professional | | $9.77 | $14.79 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.31 / $10.00 / $16.98
| Professional | 26 | $6.31 | $10.00 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $2.88 / $4.90 / $9.12
| Professional | TC | $2.88 | $4.90 | $9.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $22.91 / $75.86
| Facility | | $8.32 | $22.91 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $14.13 / $21.38
| Professional | | $10.96 | $14.13 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.76 / $9.77 / $14.45
| Professional | 26 | $7.76 | $9.77 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $3.31 / $4.37 / $6.92
| Professional | TC | $3.31 | $4.37 | $6.92 |