- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $11.48 / $37.15 / $46.77
| Facility | 26 | $11.48 | $37.15 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $20.89 / $77.62
| Professional | | $14.13 | $20.89 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.94 / $11.22 / $37.15
| Professional | 26 | $7.94 | $11.22 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $6.03 / $8.91 / $20.89
| Professional | TC | $6.03 | $8.91 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $15.49 / $15.49
| Professional | | $15.49 | $15.49 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $19.05 / $77.62
| Professional | | $15.85 | $19.05 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.94 / $9.55 / $38.90
| Professional | 26 | $7.94 | $9.55 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $8.13 / $9.55 / $38.90
| Professional | TC | $8.13 | $9.55 | $38.90 |
- 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
- $15.85 / $25.70 / $42.66
| Professional | | $15.85 | $25.70 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.32 / $11.75 / $22.39
| Professional | 26 | $8.32 | $11.75 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $6.92 / $12.30 / $24.55
| Professional | TC | $6.92 | $12.30 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $23.44 / $100.00 / $100.00
| Facility | 26 | $23.44 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $25.12 / $208.93
| Professional | | $19.50 | $25.12 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.77 / $11.48 / $104.71
| Professional | 26 | $9.77 | $11.48 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $8.71 / $12.59 / $128.82
| Professional | TC | $8.71 | $12.59 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $22.39 / $35.48
| Professional | | $18.62 | $22.39 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.33 / $11.22 / $35.48
| Professional | 26 | $9.33 | $11.22 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $8.51 / $10.96 / $18.62
| Professional | TC | $8.51 | $10.96 | $18.62 |