- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $25.12 / $70.79
| Professional | | $18.20 | $25.12 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $14.13 / $24.55 / $91.20
| Professional | 26 | $14.13 | $24.55 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $3.98 / $6.61 / $18.62
| Professional | TC | $3.98 | $6.61 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $22.91 / $26.92
| Professional | | $7.94 | $22.91 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $15.14 / $17.78 / $20.42
| Professional | 26 | $15.14 | $17.78 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $6.76 / $7.24 / $8.91
| Professional | TC | $6.76 | $7.24 | $8.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $16.98 / $50.12
| Professional | | $12.88 | $16.98 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $0.24 / $12.59 / $36.31
| Professional | 26 | $0.24 | $12.59 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $0.10 / $4.47 / $13.49
| Professional | TC | $0.10 | $4.47 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $35.48 / $46.77
| Professional | | $30.20 | $35.48 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $21.38 / $25.12 / $33.11
| Professional | 26 | $21.38 | $25.12 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $9.33 / $11.22 / $14.79
| Professional | TC | $9.33 | $11.22 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $24.55 / $53.70
| Professional | | $19.05 | $24.55 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $14.45 / $18.62 / $41.69
| Professional | 26 | $14.45 | $18.62 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $4.57 / $6.03 / $12.88
| Professional | TC | $4.57 | $6.03 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $42.66 / $46.77
| Professional | | $25.70 | $42.66 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $19.05 / $28.84 / $32.36
| Professional | 26 | $19.05 | $28.84 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $6.31 / $13.18 / $14.79
| Professional | TC | $6.31 | $13.18 | $14.79 |