- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $31.62 / $60.26
| Facility | | $24.55 | $31.62 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $15.14 / $15.14 / $20.42
| Facility | 26 | $15.14 | $15.14 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $9.55 / $9.55 / $11.22
| Facility | TC | $9.55 | $9.55 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $20.89 / $54.95
| Professional | | $14.13 | $20.89 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.91 / $21.38 / $64.57
| Professional | 26 | $8.91 | $21.38 | $64.57 |
- 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
- $18.62 / $18.62 / $19.05
| Professional | | $18.62 | $18.62 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.50 / $13.80 / $15.49
| Professional | 26 | $5.50 | $13.80 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $8.13 / $24.55
| Professional | | $8.13 | $8.13 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.37 / $5.37 / $19.05
| Professional | 26 | $5.37 | $5.37 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $2.82 / $3.16 / $5.25
| Professional | TC | $2.82 | $3.16 | $5.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $15.49 / $26.30
| Facility | | $9.55 | $15.49 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $14.13 / $25.12
| Professional | | $8.13 | $14.13 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $34.67 / $34.67
| Facility | | $22.39 | $34.67 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $3.16 / $14.79 / $21.38
| Facility | 26 | $3.16 | $14.79 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $2.00 / $9.33 / $13.18
| Facility | TC | $2.00 | $9.33 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $20.89 / $95.50
| Professional | | $9.55 | $20.89 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.62 / $14.45 / $60.26
| Professional | 26 | $5.62 | $14.45 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $3.72 / $6.17 / $38.90
| Professional | TC | $3.72 | $6.17 | $38.90 |
- 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
- $7.24 / $10.96 / $18.20
| Facility | | $7.24 | $10.96 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $20.42 / $43.65
| Professional | | $13.18 | $20.42 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.12 / $12.59 / $29.51
| Professional | 26 | $9.12 | $12.59 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $4.57 / $7.94 / $13.80
| Professional | TC | $4.57 | $7.94 | $13.80 |