- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $39.81 / $52.48
| Facility | | $30.20 | $39.81 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $18.20 / $45.71
| Professional | | $10.96 | $18.20 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $3.02 / $5.37 / $15.14
| Professional | 26 | $3.02 | $5.37 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $7.08 / $12.02 / $25.70
| Professional | TC | $7.08 | $12.02 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $2.04 / $4.17 / $6.17
| Professional | 26 | $2.04 | $4.17 | $6.17 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $6.61 / $6.61 / $6.61
| Professional | TC | $6.61 | $6.61 | $6.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $25.12 / $26.92
| Professional | | $18.62 | $25.12 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.92 / $6.92 / $9.33
| Professional | 26 | $6.92 | $6.92 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $14.79 / $14.79 / $14.79
| Professional | TC | $14.79 | $14.79 | $14.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $15.14 / $39.81
| Facility | | $4.07 | $15.14 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $14.79 / $28.84
| Professional | | $4.90 | $14.79 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $9.55 / $36.31
| Professional | | $7.08 | $9.55 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $2.00 / $2.63 / $12.88
| Professional | 26 | $2.00 | $2.63 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $4.68 / $6.03 / $21.38
| Professional | TC | $4.68 | $6.03 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $39.81 / $52.48
| Facility | | $30.20 | $39.81 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $23.44 / $40.74
| Professional | | $12.88 | $23.44 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $3.55 / $5.62 / $12.59
| Professional | 26 | $3.55 | $5.62 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $8.91 / $15.85 / $30.90
| Professional | TC | $8.91 | $15.85 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $8.71 / $26.30
| Professional | | $7.08 | $8.71 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $2.00 / $2.29 / $10.96
| Professional | 26 | $2.00 | $2.29 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $4.68 / $6.03 / $20.42
| Professional | TC | $4.68 | $6.03 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $16.60 / $46.77
| Professional | | $9.77 | $16.60 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $2.82 / $4.68 / $18.62
| Professional | 26 | $2.82 | $4.68 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $7.08 / $12.02 / $20.89
| Professional | TC | $7.08 | $12.02 | $20.89 |