- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.91 / $19.05 / $31.62
| Facility | 26 | $8.91 | $19.05 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $42.66 / $104.71
| Professional | | $33.11 | $42.66 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.94 / $12.02 / $26.30
| Professional | 26 | $7.94 | $12.02 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $23.99 / $30.20 / $60.26
| Professional | TC | $23.99 | $30.20 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.71 / $8.71 / $8.71
| Professional | 26 | $8.71 | $8.71 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $40.74 / $91.20
| Professional | | $13.18 | $40.74 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $51.29 / $75.86
| Professional | | $32.36 | $51.29 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.91 / $14.79 / $21.38
| Professional | 26 | $8.91 | $14.79 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $23.99 / $38.02 / $57.54
| Professional | TC | $23.99 | $38.02 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $95.50 / $204.17
| Professional | | $46.77 | $95.50 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.30 / $21.88 / $70.79
| Professional | 26 | $12.30 | $21.88 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $33.88 / $54.95 / $144.54
| Professional | TC | $33.88 | $54.95 | $144.54 |
- 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
- $47.86 / $48.98 / $53.70
| Professional | | $47.86 | $48.98 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.59 / $12.88 / $13.49
| Professional | 26 | $12.59 | $12.88 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $35.48 / $37.15 / $39.81
| Professional | TC | $35.48 | $37.15 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $33.11
| Professional | | $32.36 | $33.11 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $61.66 / $107.15
| Professional | | $38.02 | $61.66 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.96 / $16.98 / $67.61
| Professional | 26 | $10.96 | $16.98 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $25.12 / $33.88 / $51.29
| Professional | TC | $25.12 | $33.88 | $51.29 |