- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.76 / $10.47 / $15.14
| Facility | 26 | $7.76 | $10.47 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $40.74 / $120.23
| Professional | | $28.18 | $40.74 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $10.96 / $28.18
| Professional | 26 | $7.08 | $10.96 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.89 / $30.20 / $58.88
| Professional | TC | $20.89 | $30.20 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $30.90 / $42.66
| Professional | | $26.92 | $30.90 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.94 / $7.94 / $15.14
| Professional | 26 | $7.94 | $7.94 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $23.44 / $23.44 / $30.90
| Professional | TC | $23.44 | $23.44 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $29.51 / $52.48
| Professional | | $27.54 | $29.51 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.91 / $9.33 / $16.60
| Professional | 26 | $8.91 | $9.33 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $18.62 / $19.95 / $36.31
| Professional | TC | $18.62 | $19.95 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $10.96 / $12.88
| Professional | | $8.51 | $10.96 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $2.04 / $9.55 / $13.49
| Facility | 26 | $2.04 | $9.55 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $50.12 / $177.83
| Professional | | $28.84 | $50.12 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.76 / $13.18 / $41.69
| Professional | 26 | $7.76 | $13.18 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $21.38 / $37.15 / $138.04
| Professional | TC | $21.38 | $37.15 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $32.36 / $33.11
| Professional | | $14.13 | $32.36 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $33.11 / $58.88
| Professional | | $26.30 | $33.11 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.59 / $9.12 / $16.22
| Professional | 26 | $7.59 | $9.12 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $18.62 / $23.99 / $44.67
| Professional | TC | $18.62 | $23.99 | $44.67 |