- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.88 / $20.89 / $38.02
| Facility | 26 | $12.88 | $20.89 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $47.86 / $131.83
| Professional | | $36.31 | $47.86 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.00 / $14.45 / $45.71
| Professional | 26 | $10.00 | $14.45 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $23.99 / $33.11 / $75.86
| Professional | TC | $23.99 | $33.11 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.00 / $10.00 / $10.47
| Professional | 26 | $10.00 | $10.00 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $48.98 / $85.11
| Professional | | $39.81 | $48.98 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $13.80 / $17.38 / $27.54
| Professional | 26 | $13.80 | $17.38 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $26.30 / $33.11 / $58.88
| Professional | TC | $26.30 | $33.11 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $51.29 / $64.57
| Professional | | $47.86 | $51.29 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $14.13 / $14.45 / $19.95
| Professional | 26 | $14.13 | $14.45 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $33.11 / $36.31 / $45.71
| Professional | TC | $33.11 | $36.31 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $3.24 / $15.14 / $21.88
| Facility | 26 | $3.24 | $15.14 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $57.54 / $93.33
| Professional | | $37.15 | $57.54 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $11.75 / $18.20 / $33.11
| Professional | 26 | $11.75 | $18.20 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $25.70 / $39.81 / $75.86
| Professional | TC | $25.70 | $39.81 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $31.62 / $100.00 / $100.00
| Facility | 26 | $31.62 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $61.66 / $436.52
| Professional | | $42.66 | $61.66 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $13.49 / $19.50 / $97.72
| Professional | 26 | $13.49 | $19.50 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $28.18 / $42.66 / $426.58
| Professional | TC | $28.18 | $42.66 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $51.29 / $91.20
| Professional | | $41.69 | $51.29 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.88 / $16.60 / $37.15
| Professional | 26 | $12.88 | $16.60 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $27.54 / $33.88 / $60.26
| Professional | TC | $27.54 | $33.88 | $60.26 |