- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $575.44 / $851.14
| Professional | | $407.38 | $575.44 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $45.71 / $57.54 / $89.13
| Professional | 26 | $45.71 | $57.54 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $363.08 / $524.81 / $758.58
| Professional | TC | $363.08 | $524.81 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $1,348.96 / $3,715.35
| Professional | | $257.04 | $1,348.96 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $24.55 / $154.88 / $354.81
| Professional | 26 | $24.55 | $154.88 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $234.42 / $1,479.11 / $3,311.31
| Professional | TC | $234.42 | $1,479.11 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $177.83 / $199.53 / $295.12
| Facility | 26 | $177.83 | $199.53 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $691.83 / $1,659.59
| Professional | | $331.13 | $691.83 | $1,659.59 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $33.11 / $69.18 / $169.82
| Professional | 26 | $33.11 | $69.18 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $302.00 / $630.96 / $1,548.82
| Professional | TC | $302.00 | $630.96 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $1,513.56 / $1,698.24
| Professional | | $1,513.56 | $1,513.56 | $1,698.24 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $154.88 / $154.88 / $173.78
| Professional | 26 | $154.88 | $154.88 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $1,348.96 / $1,348.96 / $1,513.56
| Professional | TC | $1,348.96 | $1,348.96 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $257.04 / $257.04 / $257.04
| Facility | 26 | $257.04 | $257.04 | $257.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $562.34 / $3,981.07
| Professional | | $426.58 | $562.34 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $40.74 / $58.88 / $363.08
| Professional | 26 | $40.74 | $58.88 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $371.54 / $501.19 / $3,548.13
| Professional | TC | $371.54 | $501.19 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $64.57 / $102.33
| Professional | | $32.36 | $64.57 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $831.76 / $1,819.70
| Professional | | $524.81 | $831.76 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $53.70 / $83.18 / $177.83
| Professional | 26 | $53.70 | $83.18 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $467.74 / $741.31 / $1,659.59
| Professional | TC | $467.74 | $741.31 | $1,659.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $1,288.25 / $1,862.09
| Professional | | $912.01 | $1,288.25 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $107.15 / $107.15 / $363.08
| Facility | 26 | $107.15 | $107.15 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $2,818.38 / $3,981.07
| Professional | | $380.19 | $2,818.38 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $42.66 / $295.12 / $363.08
| Professional | 26 | $42.66 | $295.12 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $331.13 / $2,511.89 / $3,548.13
| Professional | TC | $331.13 | $2,511.89 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $457.09 / $1,258.93
| Professional | | $457.09 | $457.09 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $44.67 / $44.67 / $120.23
| Professional | 26 | $44.67 | $44.67 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $416.87 / $416.87 / $1,148.15
| Professional | TC | $416.87 | $416.87 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $1,513.56 / $2,951.21
| Professional | | $457.09 | $1,513.56 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $44.67 / $44.67 / $213.80
| Professional | 26 | $44.67 | $44.67 | $213.80 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $416.87 / $416.87 / $1,995.26
| Professional | TC | $416.87 | $416.87 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $562.34 / $1,380.38
| Professional | | $354.81 | $562.34 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $36.31 / $58.88 / $154.88
| Professional | 26 | $36.31 | $58.88 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $316.23 / $501.19 / $1,202.26
| Professional | TC | $316.23 | $501.19 | $1,202.26 |