- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $104.71 / $851.14
| Facility | | $43.65 | $104.71 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $13.49 / $18.20 / $63.10
| Facility | 26 | $13.49 | $18.20 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $39.81 / $97.72
| Professional | | $28.84 | $39.81 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.02 / $21.38 / $56.23
| Professional | 26 | $12.02 | $21.38 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.38 / $25.70 / $50.12
| Professional | TC | $17.38 | $25.70 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $30.20 / $36.31
| Professional | | $28.84 | $30.20 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.23 / $13.18 / $20.89
| Professional | 26 | $10.23 | $13.18 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $85.11 / $89.13
| Facility | | $75.86 | $85.11 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $40.74 / $63.10
| Professional | | $30.90 | $40.74 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $14.13 / $19.05 / $29.51
| Professional | 26 | $14.13 | $19.05 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $16.22 / $21.38 / $35.48
| Professional | TC | $16.22 | $21.38 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $48.98 / $75.86
| Professional | | $40.74 | $48.98 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $15.14 / $17.38 / $26.92
| Professional | 26 | $15.14 | $17.38 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $26.30 / $31.62 / $48.98
| Professional | TC | $26.30 | $31.62 | $48.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $28.84 / $57.54
| Facility | | $14.45 | $28.84 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $27.54 / $52.48
| Professional | | $13.80 | $27.54 | $52.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $60.26 / $60.26
| Facility | | $56.23 | $60.26 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $43.65 / $74.13
| Professional | | $30.20 | $43.65 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.30 / $18.20 / $30.90
| Professional | 26 | $12.30 | $18.20 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.38 / $26.30 / $47.86
| Professional | TC | $17.38 | $26.30 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $281.84 / $691.83
| Facility | | $77.62 | $281.84 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $43.65 / $74.13
| Professional | | $28.84 | $43.65 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.30 / $19.95 / $32.36
| Professional | 26 | $12.30 | $19.95 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.38 / $26.92 / $45.71
| Professional | TC | $17.38 | $26.92 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $32.36 / $33.11
| Professional | | $13.80 | $32.36 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $48.98 / $89.13
| Professional | | $39.81 | $48.98 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $14.13 / $18.62 / $31.62
| Professional | 26 | $14.13 | $18.62 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $25.70 / $31.62 / $57.54
| Professional | TC | $25.70 | $31.62 | $57.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $18.62 / $34.67
| Facility | | $14.79 | $18.62 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $38.02 / $61.66
| Professional | | $28.18 | $38.02 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $11.75 / $16.22 / $30.90
| Professional | 26 | $11.75 | $16.22 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.85 / $22.39 / $36.31
| Professional | TC | $15.85 | $22.39 | $36.31 |