- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.02 / $19.05 / $21.88
| Facility | 26 | $12.02 | $19.05 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $40.74 / $138.04
| Professional | | $25.12 | $40.74 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $16.60 / $37.15
| Professional | 26 | $7.08 | $16.60 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.38 / $26.30 / $64.57
| Professional | TC | $17.38 | $26.30 | $64.57 |
- 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
- $29.51 / $57.54 / $87.10
| Professional | | $29.51 | $57.54 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.91 / $15.85 / $23.99
| Professional | 26 | $8.91 | $15.85 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.89 / $41.69 / $64.57
| Professional | TC | $20.89 | $41.69 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $69.18 / $85.11
| Professional | | $61.66 | $69.18 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $16.60 / $19.05 / $22.39
| Professional | 26 | $16.60 | $19.05 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $44.67 / $50.12 / $63.10
| Professional | TC | $44.67 | $50.12 | $63.10 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.02 / $17.78 / $21.88
| Facility | 26 | $12.02 | $17.78 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $60.26 / $93.33
| Professional | | $34.67 | $60.26 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.33 / $17.78 / $27.54
| Professional | 26 | $9.33 | $17.78 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.39 / $45.71 / $64.57
| Professional | TC | $22.39 | $45.71 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $19.95 / $44.67
| Professional | | $11.22 | $19.95 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $61.66 / $89.13
| Professional | | $47.86 | $61.66 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $11.48 / $16.98 / $24.55
| Professional | 26 | $11.48 | $16.98 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $26.92 / $42.66 / $64.57
| Professional | TC | $26.92 | $42.66 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $208.93 / $208.93 / $208.93
| Facility | 26 | $208.93 | $208.93 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $66.07 / $89.13
| Professional | | $51.29 | $66.07 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $14.79 / $18.62 / $25.12
| Professional | 26 | $14.79 | $18.62 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $37.15 / $47.86 / $64.57
| Professional | TC | $37.15 | $47.86 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $35.48 / $85.11
| Professional | | $26.92 | $35.48 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.32 / $10.96 / $24.55
| Professional | 26 | $8.32 | $10.96 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $18.20 / $25.12 / $60.26
| Professional | TC | $18.20 | $25.12 | $60.26 |