- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.94 / $8.91 / $18.20
| Facility | 26 | $7.94 | $8.91 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $44.67 / $97.72
| Professional | | $32.36 | $44.67 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.91 / $12.02 / $30.20
| Professional | 26 | $8.91 | $12.02 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.91 / $30.90 / $58.88
| Professional | TC | $22.91 | $30.90 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $38.90 / $63.10
| Professional | | $30.20 | $38.90 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.33 / $11.75 / $23.44
| Professional | 26 | $9.33 | $11.75 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $21.88 / $21.88 / $27.54
| Professional | TC | $21.88 | $21.88 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $33.88 / $50.12
| Professional | | $10.23 | $33.88 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $47.86 / $72.44
| Professional | | $40.74 | $47.86 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $11.75 / $28.18 / $28.18
| Professional | 26 | $11.75 | $28.18 | $28.18 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $3.02 / $14.13 / $20.42
| Facility | 26 | $3.02 | $14.13 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $48.98 / $89.13
| Professional | | $34.67 | $48.98 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.47 / $14.45 / $27.54
| Professional | 26 | $10.47 | $14.45 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $23.99 / $34.67 / $66.07
| Professional | TC | $23.99 | $34.67 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $100.00
| Facility | 26 | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $389.05 / $389.05
| Professional | | $309.03 | $389.05 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $100.00
| Professional | 26 | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $251.19 / $295.12 / $295.12
| Professional | TC | $251.19 | $295.12 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.94 / $10.47 / $16.60
| Facility | 26 | $7.94 | $10.47 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $52.48 / $107.15
| Professional | | $33.11 | $52.48 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.91 / $14.45 / $29.51
| Professional | 26 | $8.91 | $14.45 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $23.99 / $37.15 / $74.13
| Professional | TC | $23.99 | $37.15 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $32.36 / $38.02
| Professional | | $10.47 | $32.36 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $89.13 / $128.82
| Professional | | $70.79 | $89.13 | $128.82 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $3.16 / $14.45 / $20.89
| Facility | 26 | $3.16 | $14.45 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $47.86 / $102.33
| Professional | | $34.67 | $47.86 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.47 / $13.49 / $23.99
| Professional | 26 | $10.47 | $13.49 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $23.99 / $33.11 / $60.26
| Professional | TC | $23.99 | $33.11 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $44.67 / $93.33
| Professional | | $37.15 | $44.67 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.96 / $12.88 / $33.11
| Professional | 26 | $10.96 | $12.88 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $26.30 / $30.90 / $66.07
| Professional | TC | $26.30 | $30.90 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $46.77 / $56.23
| Professional | | $44.67 | $46.77 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.02 / $12.59 / $15.14
| Professional | 26 | $12.02 | $12.59 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $32.36 / $34.67 / $40.74
| Professional | TC | $32.36 | $34.67 | $40.74 |