- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $25.70 / $27.54 / $33.88
| Facility | 26 | $25.70 | $27.54 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $72.44 / $134.90
| Professional | | $41.69 | $72.44 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $25.12 / $47.86 / $100.00
| Professional | 26 | $25.12 | $47.86 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $51.29 / $67.61
| Professional | | $37.15 | $51.29 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $25.12 / $33.11 / $45.71
| Professional | 26 | $25.12 | $33.11 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $18.20 / $22.39
| Professional | | $16.22 | $18.20 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.41 / $34.67 / $50.12
| Facility | 26 | $7.41 | $34.67 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $61.66 / $95.50
| Professional | | $42.66 | $61.66 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $27.54 / $38.90 / $61.66
| Professional | 26 | $27.54 | $38.90 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $38.90 / $48.98
| Professional | | $36.31 | $38.90 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $21.88 / $23.44 / $35.48
| Professional | 26 | $21.88 | $23.44 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $33.11 / $60.26
| Professional | | $18.20 | $33.11 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $57.54 / $102.33
| Professional | | $39.81 | $57.54 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $25.70 / $38.02 / $66.07
| Professional | 26 | $25.70 | $38.02 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $38.02 / $54.95
| Professional | | $38.02 | $38.02 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $22.39 / $22.39 / $33.11
| Professional | 26 | $22.39 | $22.39 | $33.11 |