- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $52.48 / $81.28 / $109.65
| Facility | 26 | $52.48 | $81.28 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $371.54 / $676.08
| Professional | | $234.42 | $371.54 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $60.26 / $97.72 / $173.78
| Professional | 26 | $60.26 | $97.72 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $165.96 / $257.04 / $446.68
| Professional | TC | $165.96 | $257.04 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $151.36 / $169.82 / $281.84
| Professional | | $151.36 | $169.82 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $47.86 / $67.61 / $117.49
| Professional | 26 | $47.86 | $67.61 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $123.03 / $123.03 / $123.03
| Professional | TC | $123.03 | $123.03 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $177.83 / $239.88
| Professional | | $52.48 | $177.83 | $239.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $316.23 / $501.19
| Professional | | $213.80 | $316.23 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $58.88 / $58.88 / $64.57
| Professional | 26 | $58.88 | $58.88 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $15.49 / $72.44 / $102.33
| Facility | 26 | $15.49 | $72.44 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $389.05 / $776.25
| Professional | | $213.80 | $389.05 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $53.70 / $81.28 / $147.91
| Professional | 26 | $53.70 | $81.28 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $158.49 / $295.12 / $630.96
| Professional | TC | $158.49 | $295.12 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $407.38 / $407.38 / $407.38
| Facility | 26 | $407.38 | $407.38 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $2,884.03 / $2,951.21
| Professional | | $2,884.03 | $2,884.03 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $645.65 / $645.65 / $645.65
| Professional | 26 | $645.65 | $645.65 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $2,511.89 / $2,511.89 / $2,511.89
| Professional | TC | $2,511.89 | $2,511.89 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $52.48 / $69.18 / $91.20
| Facility | 26 | $52.48 | $69.18 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $380.19 / $794.33
| Professional | | $234.42 | $380.19 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $61.66 / $97.72 / $173.78
| Professional | 26 | $61.66 | $97.72 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $162.18 / $263.03 / $562.34
| Professional | TC | $162.18 | $263.03 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $186.21
| Professional | | $32.36 | $33.11 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $831.76 / $977.24
| Professional | | $436.52 | $831.76 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $15.85 / $74.13 / $104.71
| Facility | 26 | $15.85 | $74.13 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $398.11 / $741.31
| Professional | | $213.80 | $398.11 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $53.70 / $79.43 / $134.90
| Professional | 26 | $53.70 | $79.43 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $151.36 / $281.84 / $630.96
| Professional | TC | $151.36 | $281.84 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $363.08 / $724.44
| Professional | | $218.78 | $363.08 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $54.95 / $69.18 / $154.88
| Professional | 26 | $54.95 | $69.18 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $165.96 / $295.12 / $537.03
| Professional | TC | $165.96 | $295.12 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $223.87 / $269.15
| Professional | | $213.80 | $223.87 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $60.26 / $63.10 / $75.86
| Professional | 26 | $60.26 | $63.10 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $154.88 / $162.18 / $194.98
| Professional | TC | $154.88 | $162.18 | $194.98 |