- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $104.71 / $234.42
| Facility | | $20.89 | $104.71 | $234.42 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $2.00 / $3.39 / $9.33
| Facility | 26 | $2.00 | $3.39 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $29.51 / $70.79
| Professional | | $18.20 | $29.51 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $2.00 / $3.02 / $16.60
| Professional | 26 | $2.00 | $3.02 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.14 / $20.89 / $39.81
| Professional | TC | $15.14 | $20.89 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $21.88 / $28.84
| Professional | | $20.42 | $21.88 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $3.16 / $3.16 / $3.16
| Professional | 26 | $3.16 | $3.16 | $3.16 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $51.29 / $89.13
| Professional | | $28.18 | $51.29 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $3.80 / $12.30 / $20.42
| Professional | 26 | $3.80 | $12.30 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $41.69 / $77.62 / $134.90
| Professional | 50 | $41.69 | $77.62 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $23.44 / $39.81 / $70.79
| Professional | TC | $23.44 | $39.81 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $21.38 / $33.88
| Facility | | $3.31 | $21.38 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $20.42 / $32.36
| Professional | | $3.09 | $20.42 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $35.48 / $45.71
| Facility | | $18.62 | $35.48 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $33.11 / $64.57
| Professional | | $19.05 | $33.11 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $2.75 / $4.79 / $13.80
| Professional | 26 | $2.75 | $4.79 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $16.60 / $26.30 / $50.12
| Professional | TC | $16.60 | $26.30 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $77.62 / $77.62
| Facility | | $35.48 | $77.62 | $77.62 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $0.72 / $3.39 / $4.79
| Facility | 26 | $0.72 | $3.39 | $4.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $31.62 / $63.10
| Professional | | $17.78 | $31.62 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $2.69 / $4.37 / $14.45
| Professional | 26 | $2.69 | $4.37 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.49 / $25.70 / $47.86
| Professional | TC | $15.49 | $25.70 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $32.36 / $33.11
| Professional | | $4.07 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $45.71 / $45.71
| Facility | | $45.71 | $45.71 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $45.71 / $45.71 / $45.71
| Facility | 26 | $45.71 | $45.71 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $28.18 / $51.29
| Professional | | $22.91 | $28.18 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $3.09 / $3.80 / $6.76
| Professional | 26 | $3.09 | $3.80 | $6.76 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.95 / $24.55 / $43.65
| Professional | TC | $19.95 | $24.55 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $43.65 / $114.82
| Facility | | $10.72 | $43.65 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $26.30 / $53.70
| Professional | | $17.38 | $26.30 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $2.57 / $3.80 / $12.30
| Professional | 26 | $2.57 | $3.80 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $14.79 / $21.88 / $41.69
| Professional | TC | $14.79 | $21.88 | $41.69 |