- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.88 / $15.14 / $16.60
| Facility | 26 | $12.88 | $15.14 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $19.05 / $52.48
| Professional | | $12.88 | $19.05 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $10.00 / $23.99
| Professional | 26 | $7.08 | $10.00 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $5.13 / $7.94 / $12.88
| Professional | TC | $5.13 | $7.94 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $23.44 / $30.20
| Professional | | $20.42 | $23.44 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $11.75 / $13.49 / $17.38
| Professional | 26 | $11.75 | $13.49 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $8.71 / $10.00 / $12.88
| Professional | TC | $8.71 | $10.00 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $13.80 / $28.18
| Professional | | $9.12 | $13.80 | $28.18 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $2.45 / $11.48 / $16.22
| Facility | 26 | $2.45 | $11.48 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $28.84 / $48.98
| Professional | | $16.98 | $28.84 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.12 / $13.80 / $19.95
| Professional | 26 | $9.12 | $13.80 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $7.59 / $12.59 / $26.92
| Professional | TC | $7.59 | $12.59 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $25.12 / $44.67
| Professional | | $17.38 | $25.12 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.77 / $12.02 / $21.88
| Professional | 26 | $9.77 | $12.02 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $7.76 / $11.22 / $24.55
| Professional | TC | $7.76 | $11.22 | $24.55 |