- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $13.49 / $32.36
| Facility | 26 | $7.08 | $13.49 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $32.36 / $64.57
| Professional | | $22.91 | $32.36 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $12.02 / $51.29
| Professional | 26 | $7.08 | $12.02 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $36.31 / $37.15 / $169.82
| Professional | 50 | $36.31 | $37.15 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.85 / $22.91 / $38.02
| Professional | TC | $15.85 | $22.91 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $40.74 / $64.57
| Professional | | $28.84 | $40.74 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.76 / $10.72 / $16.60
| Professional | 26 | $7.76 | $10.72 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $43.65 / $63.10 / $95.50
| Professional | 50 | $43.65 | $63.10 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.42 / $30.90 / $47.86
| Professional | TC | $20.42 | $30.90 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $37.15 / $77.62
| Professional | | $14.13 | $37.15 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.32 / $9.33 / $11.75
| Professional | 26 | $8.32 | $9.33 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $23.99 / $28.18 / $42.66
| Professional | TC | $23.99 | $28.18 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $14.13 / $14.13 / $14.13
| Facility | 26 | $14.13 | $14.13 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $33.88 / $64.57
| Professional | | $24.55 | $33.88 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.76 / $10.23 / $17.78
| Professional | 26 | $6.76 | $10.23 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.38 / $23.99 / $48.98
| Professional | TC | $17.38 | $23.99 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $38.90 / $48.98
| Professional | | $32.36 | $38.90 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.94 / $10.00 / $12.59
| Professional | 26 | $7.94 | $10.00 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $23.44 / $28.84 / $37.15
| Professional | TC | $23.44 | $28.84 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $39.81 / $69.18
| Professional | | $32.36 | $39.81 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.30 / $15.49 / $18.20
| Professional | 26 | $12.30 | $15.49 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $44.67 / $52.48
| Professional | | $44.67 | $44.67 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $31.62 / $87.10
| Professional | | $10.23 | $31.62 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.71 / $11.22 / $19.50
| Professional | 26 | $8.71 | $11.22 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.50 / $28.84 / $51.29
| Professional | TC | $19.50 | $28.84 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $34.67 / $63.10
| Professional | | $21.38 | $34.67 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.46 / $10.00 / $17.78
| Professional | 26 | $6.46 | $10.00 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.49 / $24.55 / $50.12
| Professional | TC | $15.49 | $24.55 | $50.12 |