- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.91 / $16.22 / $46.77
| Facility | 26 | $8.91 | $16.22 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $44.67 / $154.88
| Professional | | $28.84 | $44.67 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.91 / $16.22 / $38.02
| Professional | 26 | $8.91 | $16.22 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.89 / $32.36 / $85.11
| Professional | TC | $20.89 | $32.36 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $27.54 / $100.00 / $100.00
| Facility | 26 | $27.54 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $56.23 / $281.84
| Professional | | $33.88 | $56.23 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.72 / $16.98 / $95.50
| Professional | 26 | $10.72 | $16.98 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $25.70 / $42.66 / $208.93
| Professional | TC | $25.70 | $42.66 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $13.80 / $23.44 / $31.62
| Professional | 26 | $13.80 | $23.44 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $63.10 / $114.82
| Professional | | $34.67 | $63.10 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.00 / $17.78 / $34.67
| Professional | 26 | $10.00 | $17.78 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $25.70 / $46.77 / $87.10
| Professional | TC | $25.70 | $46.77 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $44.67 / $81.28
| Professional | | $15.14 | $44.67 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $67.61 / $134.90
| Professional | | $44.67 | $67.61 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.02 / $17.78 / $30.90
| Professional | 26 | $12.02 | $17.78 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $32.36 / $47.86 / $83.18
| Professional | TC | $32.36 | $47.86 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $19.50 / $70.79
| Professional | | $16.60 | $19.50 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $27.54 / $100.00 / $100.00
| Facility | 26 | $27.54 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $56.23 / $281.84
| Professional | | $33.88 | $56.23 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.72 / $16.98 / $95.50
| Professional | 26 | $10.72 | $16.98 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $25.70 / $42.66 / $208.93
| Professional | TC | $25.70 | $42.66 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $58.88 / $134.90
| Professional | | $40.74 | $58.88 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.02 / $17.38 / $38.90
| Professional | 26 | $12.02 | $17.38 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $28.84 / $41.69 / $91.20
| Professional | TC | $28.84 | $41.69 | $91.20 |