- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $51.29 / $75.86
| Professional | | $39.81 | $51.29 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $8.32 / $16.60
| Professional | 26 | $7.08 | $8.32 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $33.11 / $41.69 / $60.26
| Professional | TC | $33.11 | $41.69 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $57.54 / $57.54 / $60.26
| Professional | | $57.54 | $57.54 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $53.70 / $89.13
| Professional | | $52.48 | $53.70 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.71 / $9.12 / $15.49
| Professional | 26 | $8.71 | $9.12 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $43.65 / $45.71 / $74.13
| Professional | TC | $43.65 | $45.71 | $74.13 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $2.14 / $9.77 / $14.13
| Facility | 26 | $2.14 | $9.77 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $53.70 / $95.50
| Professional | | $38.90 | $53.70 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.92 / $9.77 / $16.60
| Professional | 26 | $6.92 | $9.77 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $32.36 / $44.67 / $79.43
| Professional | TC | $32.36 | $44.67 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $69.18 / $69.18 / $95.50
| Professional | | $69.18 | $69.18 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.23 / $10.23 / $14.13
| Professional | 26 | $10.23 | $10.23 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $57.54 / $57.54 / $79.43
| Professional | TC | $57.54 | $57.54 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $53.70 / $89.13
| Professional | | $39.81 | $53.70 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.51 / $9.55 / $14.79
| Professional | 26 | $8.51 | $9.55 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $29.51 / $44.67 / $74.13
| Professional | TC | $29.51 | $44.67 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $66.07 / $67.61 / $67.61
| Professional | | $66.07 | $67.61 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $57.54 / $57.54 / $57.54
| Professional | | $57.54 | $57.54 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $50.12 / $75.86
| Professional | | $39.81 | $50.12 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.03 / $8.32 / $12.02
| Professional | 26 | $6.03 | $8.32 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $33.11 / $41.69 / $63.10
| Professional | TC | $33.11 | $41.69 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $37.15 / $117.49
| Professional | | $37.15 | $37.15 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $22.91 / $70.79
| Professional | | $6.92 | $22.91 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.32 / $8.51 / $8.91
| Professional | 26 | $8.32 | $8.51 | $8.91 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $23.44 / $42.66 / $46.77
| Professional | TC | $23.44 | $42.66 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $47.86 / $79.43
| Professional | | $33.88 | $47.86 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.89 / $8.71 / $14.13
| Professional | 26 | $5.89 | $8.71 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $27.54 / $40.74 / $64.57
| Professional | TC | $27.54 | $40.74 | $64.57 |