- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $63.10 / $93.33
| Facility | | $32.36 | $63.10 | $93.33 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $20.89 / $40.74 / $72.44
| Facility | 26 | $20.89 | $40.74 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $13.18 / $27.54
| Professional | | $9.33 | $13.18 | $27.54 |
- 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
- $12.30 / $12.30 / $12.30
| Professional | 50 | $12.30 | $12.30 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $2.00 / $3.98 / $7.76
| Professional | TC | $2.00 | $3.98 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $10.23 / $12.88
| Professional | | $8.71 | $10.23 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $17.38 / $38.02
| Professional | | $10.47 | $17.38 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $10.23 / $17.78
| Facility | | $8.91 | $10.23 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $16.98 / $29.51
| Professional | | $10.00 | $16.98 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.46 / $11.22 / $18.20
| Professional | 26 | $6.46 | $11.22 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $2.82 / $5.01 / $9.77
| Professional | TC | $2.82 | $5.01 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $14.45 / $22.91
| Professional | | $12.02 | $14.45 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.76 / $9.12 / $14.45
| Professional | 26 | $7.76 | $9.12 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $4.27 / $5.25 / $8.13
| Professional | TC | $4.27 | $5.25 | $8.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $81.28 / $128.82
| Facility | | $56.23 | $81.28 | $128.82 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $47.86 / $47.86 / $47.86
| Facility | 26 | $47.86 | $47.86 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $13.80 / $28.84
| Professional | | $9.33 | $13.80 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.76 / $9.33 / $18.62
| Professional | 26 | $6.76 | $9.33 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $3.47 / $4.47 / $10.47
| Professional | TC | $3.47 | $4.47 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $40.74 / $61.66
| Facility | | $24.55 | $40.74 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $13.49 / $23.44
| Professional | | $8.91 | $13.49 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.75 / $9.12 / $16.22
| Professional | 26 | $5.75 | $9.12 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $2.88 / $4.37 / $7.94
| Professional | TC | $2.88 | $4.37 | $7.94 |