- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $44.67 / $77.62
| Facility | | $18.62 | $44.67 | $77.62 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.37 / $5.37 / $7.59
| Facility | 26 | $5.37 | $5.37 | $7.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $15.14 / $44.67
| Professional | | $10.00 | $15.14 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $3.02 / $6.61 / $11.48
| Professional | 26 | $3.02 | $6.61 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $6.03 / $10.23 / $25.70
| Professional | TC | $6.03 | $10.23 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $10.00 / $15.14
| Professional | | $10.00 | $10.00 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $4.27 / $5.25 / $5.89
| Professional | 26 | $4.27 | $5.25 | $5.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $10.47 / $16.60
| Professional | | $9.77 | $10.47 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.50 / $6.76 / $7.76
| Professional | 26 | $5.50 | $6.76 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $2.88 / $3.24 / $12.30
| Professional | TC | $2.88 | $3.24 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $14.79 / $20.89
| Facility | | $5.62 | $14.79 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $11.48 / $20.42
| Professional | | $4.79 | $11.48 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $35.48 / $35.48
| Facility | | $27.54 | $35.48 | $35.48 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $1.05 / $4.90 / $6.92
| Facility | 26 | $1.05 | $4.90 | $6.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $18.62 / $77.62
| Professional | | $7.41 | $18.62 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $2.09 / $5.01 / $26.30
| Professional | 26 | $2.09 | $5.01 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $5.13 / $13.49 / $60.26
| Professional | TC | $5.13 | $13.49 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $7.94 / $13.18
| Facility | | $5.25 | $7.94 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $18.20 / $33.88
| Professional | | $13.80 | $18.20 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $3.24 / $4.57 / $12.02
| Professional | 26 | $3.24 | $4.57 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $9.77 / $13.80 / $22.91
| Professional | TC | $9.77 | $13.80 | $22.91 |