- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $48.98 / $114.82
| Professional | | $37.15 | $48.98 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $23.99 / $39.81 / $100.00
| Professional | 26 | $23.99 | $39.81 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $12.02 / $16.98 / $38.02
| Professional | TC | $12.02 | $16.98 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $38.90 / $158.49
| Professional | | $23.99 | $38.90 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $16.22 / $16.22 / $97.72
| Professional | 26 | $16.22 | $16.22 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $9.33 / $9.33 / $53.70
| Professional | TC | $9.33 | $9.33 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $40.74 / $79.43
| Professional | | $26.30 | $40.74 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.91 / $41.69 / $58.88
| Facility | 26 | $8.91 | $41.69 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $66.07 / $204.17
| Professional | | $32.36 | $66.07 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $19.95 / $43.65 / $123.03
| Professional | 26 | $19.95 | $43.65 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $11.22 / $22.91 / $81.28
| Professional | TC | $11.22 | $22.91 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $51.29 / $81.28
| Professional | | $40.74 | $51.29 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $26.30 / $37.15 / $52.48
| Professional | 26 | $26.30 | $37.15 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $12.30 / $18.62 / $29.51
| Professional | TC | $12.30 | $18.62 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $67.61 / $109.65
| Professional | | $52.48 | $67.61 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $31.62 / $44.67 / $72.44
| Professional | 26 | $31.62 | $44.67 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.78 / $23.99 / $37.15
| Professional | TC | $17.78 | $23.99 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $34.67 / $74.13 / $77.62
| Professional | 26 | $34.67 | $74.13 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $54.95 / $66.07
| Professional | | $54.95 | $54.95 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $36.31 / $36.31 / $42.66
| Professional | 26 | $36.31 | $36.31 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.50 / $19.50 / $21.38
| Professional | TC | $19.50 | $19.50 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $54.95 / $109.65
| Professional | | $28.84 | $54.95 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $19.05 / $37.15 / $81.28
| Professional | 26 | $19.05 | $37.15 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $9.77 / $19.50 / $39.81
| Professional | TC | $9.77 | $19.50 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $67.61 / $128.82
| Professional | | $45.71 | $67.61 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $30.20 / $44.67 / $85.11
| Professional | 26 | $30.20 | $44.67 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.49 / $22.91 / $43.65
| Professional | TC | $15.49 | $22.91 | $43.65 |