- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $501.19 / $891.25
| Facility | | $70.79 | $501.19 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $38.90 / $45.71 / $57.54
| Facility | 26 | $38.90 | $45.71 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $64.57 / $181.97
| Professional | | $42.66 | $64.57 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $23.99 / $32.36 / $173.78
| Professional | 26 | $23.99 | $32.36 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.95 / $30.20 / $131.83
| Professional | TC | $19.95 | $30.20 | $131.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56,234.13 / $69,183.10 / $81,283.05
| Facility | | $56,234.13 | $69,183.10 | $81,283.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $40.74 / $74.13
| Professional | | $21.38 | $40.74 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $190.55 / $323.59
| Professional | | $50.12 | $190.55 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $26.30 / $41.69 / $56.23
| Professional | 26 | $26.30 | $41.69 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.91 / $154.88 / $263.03
| Professional | TC | $22.91 | $154.88 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $67.61
| Professional | | $32.36 | $33.11 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $91.20 / $245.47
| Facility | | $56.23 | $91.20 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $151.36 / $323.59
| Professional | | $50.12 | $151.36 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $26.92 / $43.65 / $56.23
| Professional | 26 | $26.92 | $43.65 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.91 / $177.83 / $269.15
| Professional | TC | $22.91 | $177.83 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $117.49 / $173.78
| Facility | | $41.69 | $117.49 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $151.36 / $269.15
| Professional | | $58.88 | $151.36 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $32.36 / $35.48 / $79.43
| Professional | 26 | $32.36 | $35.48 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $25.70 / $79.43 / $208.93
| Professional | TC | $25.70 | $79.43 | $208.93 |