- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $234.42 / $363.08
| Facility | | $75.86 | $234.42 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $22.91 / $37.15 / $37.15
| Facility | 26 | $22.91 | $37.15 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $34.67 / $51.29 / $331.13
| Facility | TC | $34.67 | $51.29 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $56.23 / $138.04
| Professional | | $30.90 | $56.23 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $18.20 / $23.99 / $58.88
| Professional | 26 | $18.20 | $23.99 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $77.62 / $81.28 / $89.13
| Professional | 50 | $77.62 | $81.28 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $16.60 / $151.36 / $158.49
| Professional | 52 | $16.60 | $151.36 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $12.88 / $26.30 / $95.50
| Professional | TC | $12.88 | $26.30 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $37.15 / $46.77
| Professional | | $33.11 | $37.15 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $8.32 / $10.23 / $10.47
| Professional | 52 | $8.32 | $10.23 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $109.65 / $3,630.78
| Facility | | $58.88 | $109.65 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $53.70 / $102.33
| Professional | | $35.48 | $53.70 | $102.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $75.86 / $77.62
| Facility | | $75.86 | $75.86 | $77.62 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $23.99 / $23.99 / $23.99
| Facility | 26 | $23.99 | $23.99 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $52.48 / $52.48 / $52.48
| Facility | TC | $52.48 | $52.48 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $77.62 / $134.90
| Professional | | $32.36 | $77.62 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $16.60 / $27.54 / $46.77
| Professional | 26 | $16.60 | $27.54 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $14.13 / $48.98 / $93.33
| Professional | TC | $14.13 | $48.98 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $57.54 / $74.13
| Professional | | $37.15 | $57.54 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $19.95 / $30.90 / $39.81
| Professional | 26 | $19.95 | $30.90 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.38 / $26.30 / $33.88
| Professional | TC | $17.38 | $26.30 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $436.52 / $660.69
| Facility | | $269.15 | $436.52 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $44.67 / $128.82
| Professional | | $20.42 | $44.67 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $17.38 / $28.84 / $57.54
| Professional | 26 | $17.38 | $28.84 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.39 / $43.65 / $112.20
| Professional | TC | $22.39 | $43.65 | $112.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $74.13 / $562.34
| Facility | | $24.55 | $74.13 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $46.77 / $100.00
| Professional | | $27.54 | $46.77 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.30 / $22.91 / $39.81
| Professional | 26 | $12.30 | $22.91 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $12.30 / $26.30 / $66.07
| Professional | TC | $12.30 | $26.30 | $66.07 |