- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.77 / $10.96 / $19.95
| Facility | 26 | $9.77 | $10.96 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $52.48 / $117.49
| Professional | | $37.15 | $52.48 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.96 / $15.85 / $38.02
| Professional | 26 | $10.96 | $15.85 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $25.70 / $36.31 / $69.18
| Professional | TC | $25.70 | $36.31 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $39.81 / $57.54
| Professional | | $24.55 | $39.81 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $11.75 / $14.79 / $28.84
| Professional | 26 | $11.75 | $14.79 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $38.02 / $56.23
| Professional | | $12.88 | $38.02 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $57.54 / $70.79
| Professional | | $43.65 | $57.54 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $14.45 / $31.62 / $31.62
| Professional | 26 | $14.45 | $31.62 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $3.80 / $17.38 / $25.12
| Facility | 26 | $3.80 | $17.38 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $56.23 / $102.33
| Professional | | $40.74 | $56.23 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.88 / $17.78 / $33.88
| Professional | 26 | $12.88 | $17.78 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $28.18 / $39.81 / $72.44
| Professional | TC | $28.18 | $39.81 | $72.44 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $100.00
| Facility | 26 | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $436.52 / $436.52
| Professional | | $338.84 | $436.52 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $123.03 / $125.89 / $125.89
| Professional | 26 | $123.03 | $125.89 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $288.40 / $316.23 / $316.23
| Professional | TC | $288.40 | $316.23 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.77 / $12.88 / $20.42
| Facility | 26 | $9.77 | $12.88 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $58.88 / $120.23
| Professional | | $38.02 | $58.88 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.96 / $18.20 / $36.31
| Professional | 26 | $10.96 | $18.20 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $26.92 / $42.66 / $85.11
| Professional | TC | $26.92 | $42.66 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $32.36 / $42.66
| Professional | | $12.88 | $32.36 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $53.70 / $117.49
| Professional | | $15.85 | $53.70 | $117.49 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $3.80 / $17.78 / $25.70
| Facility | 26 | $3.80 | $17.78 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $56.23 / $114.82
| Professional | | $40.74 | $56.23 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.88 / $16.60 / $29.51
| Professional | 26 | $12.88 | $16.60 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $26.92 / $37.15 / $69.18
| Professional | TC | $26.92 | $37.15 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $52.48 / $95.50
| Professional | | $43.65 | $52.48 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $13.18 / $15.85 / $37.15
| Professional | 26 | $13.18 | $15.85 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $28.84 / $36.31 / $60.26
| Professional | TC | $28.84 | $36.31 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $51.29 / $61.66
| Professional | | $48.98 | $51.29 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $14.79 / $15.49 / $18.20
| Professional | 26 | $14.79 | $15.49 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $34.67 / $36.31 / $43.65
| Professional | TC | $34.67 | $36.31 | $43.65 |