- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $12.02 / $13.18
| Facility | | $9.77 | $12.02 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $20.42 / $53.70
| Professional | | $12.88 | $20.42 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.91 / $25.12 / $63.10
| Professional | 26 | $8.91 | $25.12 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $5.01 / $7.08 / $18.20
| Professional | TC | $5.01 | $7.08 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $18.20 / $22.39
| Professional | | $7.76 | $18.20 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.77 / $11.48 / $13.49
| Professional | 26 | $9.77 | $11.48 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $7.41 / $8.71 / $9.77
| Professional | TC | $7.41 | $8.71 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $12.02 / $38.02
| Professional | | $8.51 | $12.02 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $0.14 / $7.08 / $20.89
| Professional | 26 | $0.14 | $7.08 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $0.10 / $5.01 / $16.22
| Professional | TC | $0.10 | $5.01 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $25.12 / $33.11
| Professional | | $20.89 | $25.12 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $11.75 / $14.79 / $23.99
| Professional | 26 | $11.75 | $14.79 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $8.91 / $10.72 / $16.22
| Professional | TC | $8.91 | $10.72 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $17.38 / $38.02
| Professional | | $12.30 | $17.38 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.76 / $10.47 / $24.55
| Professional | 26 | $7.76 | $10.47 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $4.57 / $7.24 / $13.49
| Professional | TC | $4.57 | $7.24 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $28.84 / $32.36
| Professional | | $18.62 | $28.84 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.96 / $16.22 / $18.20
| Professional | 26 | $10.96 | $16.22 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $7.94 / $12.59 / $14.13
| Professional | TC | $7.94 | $12.59 | $14.13 |