- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $38.02 / $173.78
| Professional | | $27.54 | $38.02 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.94 / $20.42 / $70.79
| Professional | 26 | $7.94 | $20.42 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $18.20 / $28.84 / $52.48
| Professional | TC | $18.20 | $28.84 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $26.30 / $42.66
| Professional | | $21.38 | $26.30 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.25 / $10.72 / $20.89
| Professional | 26 | $5.25 | $10.72 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $37.15 / $37.15 / $64.57
| Professional | TC | $37.15 | $37.15 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $79.43 / $114.82
| Professional | | $56.23 | $79.43 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $15.14 / $20.42 / $31.62
| Professional | 26 | $15.14 | $20.42 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $40.74 / $58.88 / $87.10
| Professional | TC | $40.74 | $58.88 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $44.67 / $64.57
| Professional | | $20.89 | $44.67 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.89 / $11.22 / $16.60
| Professional | 26 | $5.89 | $11.22 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $14.79 / $33.11 / $48.98
| Professional | TC | $14.79 | $33.11 | $48.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $102.33 / $223.87
| Facility | | $50.12 | $102.33 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $14.45 / $26.30 / $223.87
| Facility | 26 | $14.45 | $26.30 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $35.48 / $72.44 / $223.87
| Facility | TC | $35.48 | $72.44 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $97.72 / $125.89
| Professional | | $50.12 | $97.72 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $14.45 / $22.39 / $30.90
| Professional | 26 | $14.45 | $22.39 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $35.48 / $72.44 / $95.50
| Professional | TC | $35.48 | $72.44 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $32.36 / $33.11
| Professional | | $21.38 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $63.10 / $91.20
| Facility | | $21.38 | $63.10 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $35.48 / $95.50
| Professional | | $14.79 | $35.48 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $95.50 / $117.49
| Professional | | $58.88 | $95.50 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $14.79 / $24.55 / $30.20
| Professional | 26 | $14.79 | $24.55 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $43.65 / $69.18 / $87.10
| Professional | TC | $43.65 | $69.18 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $83.18 / $112.20
| Professional | | $56.23 | $83.18 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $15.14 / $20.89 / $31.62
| Professional | 26 | $15.14 | $20.89 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $40.74 / $60.26 / $85.11
| Professional | TC | $40.74 | $60.26 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $19.95 / $41.69
| Facility | | $10.72 | $19.95 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $41.69 / $95.50
| Professional | | $25.12 | $41.69 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.76 / $11.22 / $27.54
| Professional | 26 | $6.76 | $11.22 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.78 / $30.20 / $69.18
| Professional | TC | $17.78 | $30.20 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $48.98 / $48.98
| Professional | | $48.98 | $48.98 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $11.22 / $11.22 / $11.22
| Professional | 26 | $11.22 | $11.22 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $37.15 / $37.15 / $37.15
| Professional | TC | $37.15 | $37.15 | $37.15 |