- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.71 / $22.39 / $46.77
| Facility | 26 | $8.71 | $22.39 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $19.95 / $48.98
| Professional | | $14.13 | $19.95 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.94 / $10.96 / $33.11
| Professional | 26 | $7.94 | $10.96 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $6.03 / $8.71 / $20.89
| Professional | TC | $6.03 | $8.71 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $30.20 / $30.90
| Professional | | $30.20 | $30.20 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.23 / $16.98 / $47.86
| Professional | 26 | $10.23 | $16.98 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $30.90 / $53.70
| Professional | | $20.42 | $30.90 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.00 / $13.80 / $22.91
| Professional | 26 | $10.00 | $13.80 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $9.33 / $15.14 / $32.36
| Professional | TC | $9.33 | $15.14 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $12.02 / $23.44
| Professional | | $8.71 | $12.02 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $30.90 / $57.54
| Professional | | $16.60 | $30.90 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.12 / $14.45 / $25.70
| Professional | 26 | $9.12 | $14.45 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $7.59 / $15.14 / $27.54
| Professional | TC | $7.59 | $15.14 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $25.70 / $89.13
| Professional | | $19.50 | $25.70 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.23 / $13.80 / $35.48
| Professional | 26 | $10.23 | $13.80 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $9.55 / $12.30 / $69.18
| Professional | TC | $9.55 | $12.30 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $17.78 / $39.81
| Professional | | $9.55 | $17.78 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $27.54 / $46.77
| Professional | | $17.78 | $27.54 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.33 / $12.02 / $22.39
| Professional | 26 | $9.33 | $12.02 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $8.13 / $12.59 / $23.99
| Professional | TC | $8.13 | $12.59 | $23.99 |