- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $18.20 / $25.12
| Professional | | $13.80 | $18.20 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.91 / $12.02 / $33.88
| Professional | 26 | $8.91 | $12.02 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $5.25 / $6.92 / $12.59
| Professional | TC | $5.25 | $6.92 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.62 / $5.62 / $36.31
| Professional | 26 | $5.62 | $5.62 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $10.23 / $20.89
| Professional | | $9.12 | $10.23 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.37 / $5.89 / $15.85
| Professional | 26 | $5.37 | $5.89 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $3.72 / $4.37 / $5.13
| Professional | TC | $3.72 | $4.37 | $5.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $14.79 / $27.54
| Facility | | $14.13 | $14.79 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.32 / $8.71 / $16.22
| Facility | 26 | $8.32 | $8.71 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $5.75 / $6.17 / $11.22
| Facility | TC | $5.75 | $6.17 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $10.72 / $33.11
| Professional | | $9.77 | $10.72 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.75 / $6.31 / $19.50
| Professional | 26 | $5.75 | $6.31 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $3.16 / $4.37 / $13.80
| Professional | TC | $3.16 | $4.37 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $25.70 / $31.62
| Professional | | $4.79 | $25.70 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $2.82 / $14.79 / $18.62
| Professional | 26 | $2.82 | $14.79 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $1.95 / $10.72 / $13.49
| Professional | TC | $1.95 | $10.72 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $19.50 / $33.88
| Professional | | $18.62 | $19.50 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.96 / $11.22 / $20.89
| Professional | 26 | $10.96 | $11.22 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $7.59 / $8.32 / $13.18
| Professional | TC | $7.59 | $8.32 | $13.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $8.32 / $14.13
| Facility | | $4.68 | $8.32 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $13.18 / $54.95
| Professional | | $10.47 | $13.18 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.92 / $7.76 / $35.48
| Professional | 26 | $6.92 | $7.76 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $4.27 / $5.37 / $19.95
| Professional | TC | $4.27 | $5.37 | $19.95 |