- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $51.29 / $269.15
| Facility | | $5.62 | $51.29 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $7.08 / $7.08
| Facility | 26 | $7.08 | $7.08 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $15.14 / $39.81
| Professional | | $10.00 | $15.14 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.03 / $8.32 / $25.12
| Professional | 26 | $6.03 | $8.32 | $25.12 |
- 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 / $7.41
| Professional | TC | $2.29 | $3.98 | $7.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $53.70 / $112.20
| Facility | | $32.36 | $53.70 | $112.20 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.37 / $6.46 / $6.46
| Facility | 26 | $5.37 | $6.46 | $6.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $28.18 / $40.74
| Professional | | $19.50 | $28.18 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $13.18 / $19.05 / $27.54
| Professional | 26 | $13.18 | $19.05 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $6.76 / $10.00 / $13.18
| Professional | TC | $6.76 | $10.00 | $13.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $40.74 / $95.50
| Facility | | $27.54 | $40.74 | $95.50 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.30 / $26.92 / $66.07
| Facility | 26 | $12.30 | $26.92 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $20.42 / $33.11
| Professional | | $14.13 | $20.42 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.00 / $14.13 / $22.39
| Professional | 26 | $10.00 | $14.13 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $4.37 / $6.46 / $10.47
| Professional | TC | $4.37 | $6.46 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $38.90 / $75.86
| Facility | | $30.90 | $38.90 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $21.38 / $26.30 / $52.48
| Facility | 26 | $21.38 | $26.30 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $16.22 / $29.51
| Professional | | $16.22 | $16.22 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $11.22 / $11.22 / $19.95
| Professional | 26 | $11.22 | $11.22 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $5.13 / $5.13 / $9.12
| Professional | TC | $5.13 | $5.13 | $9.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $19.05 / $33.88
| Facility | | $10.96 | $19.05 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $100.00
| Facility | 26 | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $22.91 / $1,412.54
| Professional | | $11.75 | $22.91 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.32 / $15.14 / $1,288.25
| Professional | 26 | $8.32 | $15.14 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $3.63 / $7.59 / $977.24
| Professional | TC | $3.63 | $7.59 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $72.44 / $102.33
| Facility | | $6.76 | $72.44 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $21.88 / $36.31
| Professional | | $11.75 | $21.88 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.32 / $14.79 / $24.55
| Professional | 26 | $8.32 | $14.79 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $3.80 / $7.24 / $11.75
| Professional | TC | $3.80 | $7.24 | $11.75 |