- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $53.70 / $60.26
| Professional | | $25.12 | $53.70 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.01 / $6.76 / $31.62
| Professional | 26 | $5.01 | $6.76 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $18.20 / $48.98 / $63.10
| Professional | TC | $18.20 | $48.98 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $20.42 / $97.72
| Professional | | $16.22 | $20.42 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $3.31 / $3.31 / $20.42
| Professional | 26 | $3.31 | $3.31 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $22.39 / $31.62
| Professional | | $16.98 | $22.39 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $3.02 / $3.39 / $18.20
| Professional | 26 | $3.02 | $3.39 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $13.49 / $19.95 / $19.95
| Professional | TC | $13.49 | $19.95 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $22.39 / $41.69
| Facility | | $20.89 | $22.39 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $4.57 / $4.90 / $9.12
| Facility | 26 | $4.57 | $4.90 | $9.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $29.51 / $54.95
| Professional | | $16.22 | $29.51 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $3.24 / $3.55 / $10.47
| Professional | 26 | $3.24 | $3.55 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $12.59 / $26.30 / $44.67
| Professional | TC | $12.59 | $26.30 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $41.69 / $52.48
| Professional | | $7.41 | $41.69 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $1.58 / $8.71 / $10.72
| Professional | 26 | $1.58 | $8.71 | $10.72 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $5.75 / $33.11 / $41.69
| Professional | TC | $5.75 | $33.11 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $32.36 / $53.70
| Professional | | $30.20 | $32.36 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.31 / $6.61 / $11.48
| Professional | 26 | $6.31 | $6.61 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $23.44 / $25.70 / $42.66
| Professional | TC | $23.44 | $25.70 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $15.49 / $60.26
| Facility | | $3.80 | $15.49 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $29.51 / $72.44
| Professional | | $19.05 | $29.51 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $3.89 / $4.37 / $19.50
| Professional | 26 | $3.89 | $4.37 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $14.45 / $23.99 / $53.70
| Professional | TC | $14.45 | $23.99 | $53.70 |