- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $46.77 / $54.95
| Facility | | $41.69 | $46.77 | $54.95 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $13.18 / $14.79 / $17.78
| Facility | 26 | $13.18 | $14.79 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $38.90 / $75.86
| Professional | | $29.51 | $38.90 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.02 / $16.98 / $56.23
| Professional | 26 | $12.02 | $16.98 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.38 / $25.12 / $45.71
| Professional | TC | $17.38 | $25.12 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $46.77 / $83.18
| Professional | | $28.84 | $46.77 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.96 / $18.20 / $30.20
| Professional | 26 | $10.96 | $18.20 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $16.22 / $30.20 / $54.95
| Professional | TC | $16.22 | $30.20 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $51.29 / $61.66
| Professional | | $25.12 | $51.29 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $20.42 / $20.89 / $21.88
| Professional | 26 | $20.42 | $20.89 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $37.15 / $38.90 / $40.74
| Professional | TC | $37.15 | $38.90 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $52.48 / $61.66
| Professional | | $47.86 | $52.48 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $15.14 / $16.60 / $19.05
| Professional | 26 | $15.14 | $16.60 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $33.11 / $36.31 / $42.66
| Professional | TC | $33.11 | $36.31 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $46.77 / $74.13
| Professional | | $37.15 | $46.77 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $13.18 / $19.05 / $112.20
| Professional | 26 | $13.18 | $19.05 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.39 / $26.92 / $41.69
| Professional | TC | $22.39 | $26.92 | $41.69 |
University Health Alliance - Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $60.26 / $72.44
| Professional | | $37.15 | $60.26 | $72.44 |
University Health Alliance - Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $16.22 / $20.89 / $31.62
| Professional | 26 | $16.22 | $20.89 | $31.62 |
University Health Alliance - Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $25.12 / $38.90 / $45.71
| Professional | TC | $25.12 | $38.90 | $45.71 |