- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $16.22 / $245.47
| Facility | | $5.13 | $16.22 | $245.47 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.03 / $9.33 / $57.54
| Facility | 26 | $6.03 | $9.33 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $10.96 / $21.38
| Professional | | $7.94 | $10.96 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.03 / $7.08 / $16.22
| Professional | 26 | $6.03 | $7.08 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $2.00 / $3.02 / $5.89
| Professional | TC | $2.00 | $3.02 | $5.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $8.71 / $8.71
| Professional | | $8.71 | $8.71 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $19.50 / $27.54
| Facility | | $14.13 | $19.50 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $10.96 / $14.79
| Professional | | $7.76 | $10.96 | $14.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $15.14 / $31.62
| Facility | | $13.80 | $15.14 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.13 / $8.13 / $13.80
| Facility | 26 | $8.13 | $8.13 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $12.30 / $19.05
| Professional | | $10.00 | $12.30 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.76 / $8.71 / $13.80
| Professional | 26 | $6.76 | $8.71 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $2.75 / $3.47 / $6.46
| Professional | TC | $2.75 | $3.47 | $6.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $15.14 / $109.65
| Facility | | $9.33 | $15.14 | $109.65 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $17.78 / $100.00 / $100.00
| Facility | 26 | $17.78 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $13.80 / $1,412.54
| Professional | | $10.72 | $13.80 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $9.55 / $1,288.25
| Professional | 26 | $7.08 | $9.55 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $3.39 / $4.17 / $977.24
| Professional | TC | $3.39 | $4.17 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $43.65 / $69.18
| Facility | | $12.59 | $43.65 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $12.88 / $17.78
| Professional | | $10.23 | $12.88 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.92 / $8.71 / $12.30
| Professional | 26 | $6.92 | $8.71 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $3.16 / $3.98 / $5.37
| Professional | TC | $3.16 | $3.98 | $5.37 |