- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.41 / $10.72 / $20.89
| Facility | 26 | $7.41 | $10.72 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $26.92 / $60.26
| Professional | | $19.95 | $26.92 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.03 / $11.22 / $24.55
| Professional | 26 | $6.03 | $11.22 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $12.88 / $16.98 / $41.69
| Professional | TC | $12.88 | $16.98 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $18.20 / $19.05
| Professional | | $15.85 | $18.20 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.75 / $6.92 / $10.47
| Professional | 26 | $5.75 | $6.92 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $26.92 / $43.65
| Professional | | $21.38 | $26.92 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.76 / $10.23 / $16.60
| Professional | 26 | $7.76 | $10.23 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $12.88 / $16.98 / $27.54
| Professional | TC | $12.88 | $16.98 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $27.54 / $28.84
| Professional | | $26.30 | $27.54 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.51 / $9.33 / $9.77
| Professional | 26 | $8.51 | $9.33 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.38 / $18.20 / $19.05
| Professional | TC | $17.38 | $18.20 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $18.62 / $35.48
| Professional | | $7.94 | $18.62 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $29.51 / $52.48
| Professional | | $19.50 | $29.51 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.61 / $10.23 / $17.38
| Professional | 26 | $6.61 | $10.23 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $13.18 / $20.42 / $36.31
| Professional | TC | $13.18 | $20.42 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $1.86 / $8.71 / $12.59
| Facility | 26 | $1.86 | $8.71 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $28.84 / $48.98
| Professional | | $19.50 | $28.84 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.92 / $10.00 / $17.78
| Professional | 26 | $6.92 | $10.00 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $13.18 / $19.95 / $33.11
| Professional | TC | $13.18 | $19.95 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $32.36 / $33.11
| Professional | | $11.75 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $107.15 / $107.15 / $107.15
| Facility | 26 | $107.15 | $107.15 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $28.84 / $51.29
| Professional | | $23.44 | $28.84 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.94 / $9.77 / $17.38
| Professional | 26 | $7.94 | $9.77 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.49 / $19.05 / $33.88
| Professional | TC | $15.49 | $19.05 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $24.55 / $41.69
| Professional | | $18.20 | $24.55 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.31 / $8.71 / $20.42
| Professional | 26 | $6.31 | $8.71 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $11.75 / $16.60 / $27.54
| Professional | TC | $11.75 | $16.60 | $27.54 |