- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $18.62 / $36.31
| Professional | | $12.88 | $18.62 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $2.00 / $3.98 / $10.00
| Professional | 26 | $2.00 | $3.98 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $10.96 / $12.88 / $23.99
| Professional | TC | $10.96 | $12.88 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $15.49 / $21.38
| Professional | | $2.57 | $15.49 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $2.57 / $2.88 / $5.37
| Professional | 26 | $2.57 | $2.88 | $5.37 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $14.13 / $14.13 / $25.70
| Professional | TC | $14.13 | $14.13 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $25.12 / $39.81
| Professional | | $15.14 | $25.12 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $2.57 / $5.37 / $8.32
| Professional | 26 | $2.57 | $5.37 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $12.02 / $19.95 / $33.11
| Professional | TC | $12.02 | $19.95 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $19.05 / $28.18
| Professional | | $14.79 | $19.05 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $2.34 / $2.95 / $4.68
| Professional | 26 | $2.34 | $2.95 | $4.68 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $12.59 / $16.22 / $21.88
| Professional | TC | $12.59 | $16.22 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $25.70 / $41.69
| Professional | | $18.20 | $25.70 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $3.72 / $5.50 / $8.71
| Professional | 26 | $3.72 | $5.50 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $14.45 / $20.89 / $33.88
| Professional | TC | $14.45 | $20.89 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $19.05 / $24.55
| Professional | | $16.60 | $19.05 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $2.95 / $2.95 / $3.98
| Professional | 26 | $2.95 | $2.95 | $3.98 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $13.80 / $16.22 / $20.89
| Professional | TC | $13.80 | $16.22 | $20.89 |