- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $87.10 / $1,778.28
| Facility | | $37.15 | $87.10 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $13.49 / $20.42 / $30.90
| Facility | 26 | $13.49 | $20.42 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $38.90 / $85.11
| Professional | | $28.84 | $38.90 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $11.48 / $19.95 / $66.07
| Professional | 26 | $11.48 | $19.95 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $16.98 / $23.44 / $48.98
| Professional | TC | $16.98 | $23.44 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $29.51 / $64.57
| Professional | | $28.84 | $29.51 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.71 / $10.47 / $22.91
| Professional | 26 | $8.71 | $10.47 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $38.02 / $67.61
| Professional | | $31.62 | $38.02 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $14.45 / $17.38 / $27.54
| Professional | 26 | $14.45 | $17.38 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $16.98 / $19.95 / $40.74
| Professional | TC | $16.98 | $19.95 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $25.70 / $45.71
| Facility | | $19.50 | $25.70 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $44.67 / $57.54
| Professional | | $41.69 | $44.67 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $14.79 / $16.22 / $22.91
| Professional | 26 | $14.79 | $16.22 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $26.30 / $28.84 / $35.48
| Professional | TC | $26.30 | $28.84 | $35.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $58.88 / $58.88
| Facility | | $58.88 | $58.88 | $58.88 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $3.31 / $15.49 / $21.88
| Facility | 26 | $3.31 | $15.49 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $42.66 / $85.11
| Professional | | $30.20 | $42.66 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.30 / $18.20 / $36.31
| Professional | 26 | $12.30 | $18.20 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.38 / $25.12 / $54.95
| Professional | TC | $17.38 | $25.12 | $54.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $50.12 / $91.20
| Facility | | $35.48 | $50.12 | $91.20 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $31.62 / $100.00 / $100.00
| Facility | 26 | $31.62 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $44.67 / $288.40
| Professional | | $31.62 | $44.67 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $13.18 / $18.62 / $204.17
| Professional | 26 | $13.18 | $18.62 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.78 / $26.30 / $229.09
| Professional | TC | $17.78 | $26.30 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $24.55 / $66.07
| Facility | | $15.14 | $24.55 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $38.90 / $63.10
| Professional | | $32.36 | $38.90 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $13.18 / $16.60 / $38.90
| Professional | 26 | $13.18 | $16.60 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.78 / $22.91 / $38.02
| Professional | TC | $17.78 | $22.91 | $38.02 |