- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.02 / $15.49 / $35.48
| Facility | 26 | $12.02 | $15.49 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $75.86 / $204.17
| Professional | | $45.71 | $75.86 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.02 / $20.89 / $46.77
| Professional | 26 | $12.02 | $20.89 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $30.90 / $50.12 / $89.13
| Professional | TC | $30.90 | $50.12 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $43.65 / $83.18
| Professional | | $36.31 | $43.65 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.24 / $7.59 / $19.50
| Professional | 26 | $7.24 | $7.59 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $31.62 / $46.77 / $72.44
| Professional | TC | $31.62 | $46.77 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $50.12 / $114.82
| Professional | | $39.81 | $50.12 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.33 / $11.75 / $30.20
| Professional | 26 | $9.33 | $11.75 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $30.20 / $38.02 / $79.43
| Professional | TC | $30.20 | $38.02 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $54.95 / $74.13
| Professional | | $19.05 | $54.95 | $74.13 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $3.16 / $14.79 / $21.38
| Facility | 26 | $3.16 | $14.79 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $70.79 / $199.53
| Professional | | $42.66 | $70.79 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.96 / $20.42 / $51.29
| Professional | 26 | $10.96 | $20.42 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $30.90 / $52.48 / $190.55
| Professional | TC | $30.90 | $52.48 | $190.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $57.54 / $75.86 / $114.82
| Professional | | $57.54 | $75.86 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $13.18 / $19.50 / $42.66
| Professional | 26 | $13.18 | $19.50 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $45.71 / $60.26 / $87.10
| Professional | TC | $45.71 | $60.26 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $70.79 / $125.89
| Professional | | $36.31 | $70.79 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.47 / $17.38 / $30.20
| Professional | 26 | $10.47 | $17.38 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $27.54 / $52.48 / $95.50
| Professional | TC | $27.54 | $52.48 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $53.70 / $54.95 / $74.13
| Professional | | $53.70 | $54.95 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $13.80 / $17.78 / $23.99
| Professional | 26 | $13.80 | $17.78 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $57.54 / $69.18 / $141.25
| Professional | | $57.54 | $69.18 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $15.49 / $18.62 / $33.88
| Professional | 26 | $15.49 | $18.62 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $41.69 / $50.12 / $107.15
| Professional | TC | $41.69 | $50.12 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $72.44 / $204.17
| Professional | | $45.71 | $72.44 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $11.75 / $16.98 / $66.07
| Professional | 26 | $11.75 | $16.98 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $33.88 / $54.95 / $162.18
| Professional | TC | $33.88 | $54.95 | $162.18 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.47 / $15.14 / $48.98
| Facility | 26 | $10.47 | $15.14 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $70.79 / $131.83
| Professional | | $36.31 | $70.79 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.47 / $17.38 / $37.15
| Professional | 26 | $10.47 | $17.38 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $27.54 / $52.48 / $102.33
| Professional | TC | $27.54 | $52.48 | $102.33 |