- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.96 / $13.18 / $16.60
| Facility | 26 | $10.96 | $13.18 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $34.67 / $58.88
| Professional | | $25.12 | $34.67 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.03 / $7.94 / $19.95
| Professional | 26 | $6.03 | $7.94 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.05 / $25.70 / $43.65
| Professional | TC | $19.05 | $25.70 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $26.92 / $46.77
| Professional | | $7.24 | $26.92 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $44.67 / $66.07
| Professional | | $29.51 | $44.67 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.24 / $11.75 / $16.60
| Professional | 26 | $7.24 | $11.75 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.39 / $32.36 / $50.12
| Professional | TC | $22.39 | $32.36 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $33.11 / $43.65
| Professional | | $15.49 | $33.11 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $53.70 / $85.11
| Professional | | $32.36 | $53.70 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.41 / $11.75 / $16.60
| Professional | 26 | $7.41 | $11.75 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $25.12 / $32.36 / $46.77
| Professional | TC | $25.12 | $32.36 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $37.15 / $83.18
| Professional | | $30.20 | $37.15 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.71 / $9.33 / $20.42
| Professional | 26 | $8.71 | $9.33 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.89 / $27.54 / $53.70
| Professional | TC | $20.89 | $27.54 | $53.70 |