- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $436.52 / $1,122.02
| Facility | | $43.65 | $436.52 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.51 / $9.33 / $19.50
| Facility | 26 | $8.51 | $9.33 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $35.48 / $74.13
| Professional | | $25.70 | $35.48 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.00 / $15.85 / $58.88
| Professional | 26 | $10.00 | $15.85 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.85 / $21.88 / $43.65
| Professional | TC | $15.85 | $21.88 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $30.90 / $40.74
| Professional | | $26.92 | $30.90 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.55 / $14.13 / $26.30
| Professional | 26 | $9.55 | $14.13 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $36.31 / $81.28
| Facility | | $14.79 | $36.31 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $28.84 / $38.02
| Professional | | $10.96 | $28.84 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $44.67 / $489.78
| Facility | | $42.66 | $44.67 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $48.98 / $67.61
| Professional | | $35.48 | $48.98 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $13.49 / $38.90
| Facility | | $13.49 | $13.49 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.59 / $14.45 / $14.45
| Professional | 26 | $12.59 | $14.45 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $97.72 / $109.65
| Facility | | $40.74 | $97.72 | $109.65 |
- 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
- $28.18 / $38.90 / $72.44
| Professional | | $28.18 | $38.90 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $11.22 / $15.49 / $28.84
| Professional | 26 | $11.22 | $15.49 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.85 / $22.39 / $45.71
| Professional | TC | $15.85 | $22.39 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $537.03 / $537.03
| Facility | | $251.19 | $537.03 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $100.00
| Facility | 26 | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $288.40 / $323.59
| Professional | | $44.67 | $288.40 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $107.15 / $107.15 / $204.17
| Professional | 26 | $107.15 | $107.15 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $229.09 / $229.09 / $229.09
| Professional | TC | $229.09 | $229.09 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $47.86 / $144.54
| Facility | | $30.90 | $47.86 | $144.54 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.51 / $10.96 / $17.78
| Facility | 26 | $8.51 | $10.96 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $44.67 / $81.28
| Professional | | $26.92 | $44.67 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.00 / $17.38 / $38.90
| Professional | 26 | $10.00 | $17.38 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $16.98 / $28.84 / $51.29
| Professional | TC | $16.98 | $28.84 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $32.36 / $33.11
| Professional | | $11.48 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,943.28 / $11,220.18 / $12,882.50
| Facility | | $7,943.28 | $11,220.18 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $38.90 / $83.18
| Professional | | $14.45 | $38.90 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $46.77 / $79.43
| Facility | | $32.36 | $46.77 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $3.47 / $16.22 / $23.44
| Facility | 26 | $3.47 | $16.22 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $38.90 / $75.86
| Professional | | $28.18 | $38.90 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $11.22 / $14.79 / $27.54
| Professional | 26 | $11.22 | $14.79 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.85 / $21.88 / $41.69
| Professional | TC | $15.85 | $21.88 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $22.39 / $66.07
| Facility | | $14.13 | $22.39 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $38.02 / $58.88
| Professional | | $29.51 | $38.02 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.30 / $15.85 / $30.90
| Professional | 26 | $12.30 | $15.85 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $16.60 / $22.39 / $35.48
| Professional | TC | $16.60 | $22.39 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $40.74 / $47.86
| Professional | | $38.90 | $40.74 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $13.49 / $14.13 / $16.60
| Professional | 26 | $13.49 | $14.13 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $25.12 / $26.92 / $31.62
| Professional | TC | $25.12 | $26.92 | $31.62 |