- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $15.14 / $17.38 / $22.39
| Facility | 26 | $15.14 | $17.38 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $48.98 / $72.44
| Professional | | $32.36 | $48.98 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.00 / $15.14 / $47.86
| Professional | 26 | $10.00 | $15.14 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.91 / $33.88 / $52.48
| Professional | TC | $22.91 | $33.88 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $34.67 / $63.10
| Professional | | $34.67 | $34.67 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.30 / $12.30 / $19.05
| Professional | 26 | $12.30 | $12.30 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $58.88 / $69.18
| Professional | | $50.12 | $58.88 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $14.79 / $18.20 / $23.44
| Professional | 26 | $14.79 | $18.20 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $34.67 / $41.69 / $46.77
| Professional | TC | $34.67 | $41.69 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.59 / $12.88 / $39.81
| Professional | 26 | $12.59 | $12.88 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $44.67 / $87.10
| Professional | | $29.51 | $44.67 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.91 / $15.14 / $27.54
| Professional | 26 | $8.91 | $15.14 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.95 / $30.90 / $58.88
| Professional | TC | $19.95 | $30.90 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $46.77 / $70.79
| Professional | | $33.11 | $46.77 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $11.22 / $14.45 / $21.88
| Professional | 26 | $11.22 | $14.45 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $21.88 / $30.90 / $46.77
| Professional | TC | $21.88 | $30.90 | $46.77 |