- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $117.49 / $323.59
| Facility | | $39.81 | $117.49 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $25.12 / $45.71 / $47.86
| Facility | 26 | $25.12 | $45.71 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $77.62 / $194.98
| Professional | | $39.81 | $77.62 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $26.92 / $38.02 / $89.13
| Professional | 26 | $26.92 | $38.02 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $42.66 / $120.23 / $281.84
| Professional | 50 | $42.66 | $120.23 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $15.85 / $22.39 / $43.65
| Professional | 52 | $15.85 | $22.39 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.14 / $32.36 / $97.72
| Professional | TC | $15.14 | $32.36 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $44.67 / $67.61
| Professional | | $42.66 | $44.67 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $26.92 / $28.84 / $54.95
| Professional | 26 | $26.92 | $28.84 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $14.79 / $16.60 / $54.95
| Professional | TC | $14.79 | $16.60 | $54.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $208.93 / $501.19
| Facility | | $162.18 | $208.93 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $52.48 / $112.20
| Professional | | $32.36 | $52.48 | $112.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $125.89 / $125.89 / $125.89
| Facility | | $125.89 | $125.89 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $81.28 / $147.91
| Professional | | $45.71 | $81.28 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $26.92 / $39.81 / $61.66
| Professional | 26 | $26.92 | $39.81 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $16.60 / $38.02 / $91.20
| Professional | TC | $16.60 | $38.02 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $102.33 / $263.03
| Professional | | $52.48 | $102.33 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $32.36 / $51.29 / $165.96
| Professional | 26 | $32.36 | $51.29 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.78 / $26.30 / $181.97
| Professional | TC | $17.78 | $26.30 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $100.00
| Facility | 26 | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $57.54 / $61.66
| Professional | | $56.23 | $57.54 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $36.31 / $36.31 / $38.02
| Professional | 26 | $36.31 | $36.31 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.95 / $20.89 / $22.91
| Professional | TC | $19.95 | $20.89 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $33.11
| Professional | | $32.36 | $33.11 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $97.72 / $354.81
| Facility | | $30.20 | $97.72 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $53.70 / $83.18 / $131.83
| Professional | | $53.70 | $83.18 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $26.92 / $34.67 / $56.23
| Professional | 26 | $26.92 | $34.67 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $21.88 / $46.77 / $79.43
| Professional | TC | $21.88 | $46.77 | $79.43 |