- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $16.98 / $45.71
| Professional | | $14.13 | $16.98 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.91 / $33.88 / $95.50
| Professional | 26 | $8.91 | $33.88 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $5.01 / $7.08 / $52.48
| Professional | TC | $5.01 | $7.08 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $18.20 / $20.42
| Professional | | $7.76 | $18.20 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.23 / $11.48 / $13.80
| Professional | 26 | $10.23 | $11.48 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $7.76 / $8.71 / $8.71
| Professional | TC | $7.76 | $8.71 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $11.75 / $83.18
| Professional | | $9.12 | $11.75 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.50 / $7.24 / $46.77
| Professional | 26 | $5.50 | $7.24 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $3.24 / $5.13 / $35.48
| Professional | TC | $3.24 | $5.13 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $46.77 / $46.77
| Professional | | $25.70 | $46.77 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $14.13 / $26.30 / $26.30
| Professional | 26 | $14.13 | $26.30 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $11.22 / $20.89 / $20.89
| Professional | TC | $11.22 | $20.89 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $36.31 / $95.50
| Professional | | $14.13 | $36.31 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.32 / $20.89 / $47.86
| Professional | 26 | $8.32 | $20.89 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $5.37 / $7.24 / $17.78
| Professional | TC | $5.37 | $7.24 | $17.78 |