- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.33 / $17.78 / $60.26
| Facility | 26 | $9.33 | $17.78 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $38.90 / $79.43
| Professional | | $28.84 | $38.90 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.91 / $13.80 / $33.88
| Professional | 26 | $8.91 | $13.80 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.89 / $28.18 / $54.95
| Professional | TC | $20.89 | $28.18 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $47.86 / $74.13
| Professional | | $35.48 | $47.86 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.55 / $13.49 / $20.42
| Professional | 26 | $9.55 | $13.49 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $25.12 / $34.67 / $53.70
| Professional | TC | $25.12 | $34.67 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $42.66 / $131.83
| Professional | | $10.96 | $42.66 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.77 / $12.30 / $16.98
| Professional | 26 | $9.77 | $12.30 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $28.18 / $31.62 / $39.81
| Professional | TC | $28.18 | $31.62 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $16.98 / $16.98 / $16.98
| Facility | 26 | $16.98 | $16.98 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $47.86 / $81.28
| Professional | | $30.20 | $47.86 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.32 / $13.80 / $23.99
| Professional | 26 | $8.32 | $13.80 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $21.38 / $33.88 / $57.54
| Professional | TC | $21.38 | $33.88 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $44.67 / $56.23
| Professional | | $37.15 | $44.67 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.55 / $11.75 / $15.14
| Professional | 26 | $9.55 | $11.75 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $26.92 / $33.11 / $41.69
| Professional | TC | $26.92 | $33.11 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $69.18 / $83.18
| Professional | | $54.95 | $69.18 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $17.38 / $21.88 / $22.39
| Professional | 26 | $17.38 | $21.88 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $39.81 / $61.66
| Professional | | $39.81 | $39.81 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $43.65 / $173.78
| Professional | | $14.79 | $43.65 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.72 / $14.79 / $24.55
| Professional | 26 | $10.72 | $14.79 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $26.30 / $36.31 / $58.88
| Professional | TC | $26.30 | $36.31 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $44.67 / $77.62
| Professional | | $28.84 | $44.67 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.71 / $13.18 / $23.99
| Professional | 26 | $8.71 | $13.18 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.95 / $30.90 / $57.54
| Professional | TC | $19.95 | $30.90 | $57.54 |