- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.32 / $8.91 / $14.79
| Facility | 26 | $8.32 | $8.91 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $37.15 / $134.90
| Professional | | $25.12 | $37.15 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $13.49 / $40.74
| Professional | 26 | $7.08 | $13.49 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.49 / $21.88 / $52.48
| Professional | TC | $15.49 | $21.88 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $20.42 / $35.48
| Professional | | $20.42 | $20.42 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.61 / $8.91 / $10.47
| Professional | 26 | $6.61 | $8.91 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.50 / $19.50 / $21.88
| Professional | TC | $19.50 | $19.50 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $26.92 / $45.71
| Professional | | $23.99 | $26.92 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.91 / $9.33 / $15.85
| Professional | 26 | $8.91 | $9.33 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $14.79 / $15.49 / $28.84
| Professional | TC | $14.79 | $15.49 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $21.88 / $36.31
| Professional | | $8.91 | $21.88 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $2.14 / $10.00 / $14.13
| Facility | 26 | $2.14 | $10.00 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $42.66 / $147.91
| Professional | | $24.55 | $42.66 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.76 / $13.18 / $41.69
| Professional | 26 | $7.76 | $13.18 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $16.60 / $29.51 / $107.15
| Professional | TC | $16.60 | $29.51 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $32.36 / $33.11
| Professional | | $11.48 | $32.36 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $28.18 / $51.29
| Professional | | $23.44 | $28.18 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.76 / $9.33 / $15.85
| Professional | 26 | $7.76 | $9.33 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $14.79 / $19.05 / $33.88
| Professional | TC | $14.79 | $19.05 | $33.88 |