- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.12 / $10.00 / $11.75
| Facility | 26 | $9.12 | $10.00 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $66.07 / $144.54
| Professional | | $45.71 | $66.07 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.23 / $15.85 / $38.90
| Professional | 26 | $10.23 | $15.85 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $32.36 / $44.67 / $85.11
| Professional | TC | $32.36 | $44.67 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $50.12 / $77.62
| Professional | | $40.74 | $50.12 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $15.49 / $27.54
| Professional | 26 | $7.08 | $15.49 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $32.36 / $37.15 / $64.57
| Professional | TC | $32.36 | $37.15 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $47.86 / $61.66
| Professional | | $11.22 | $47.86 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $69.18 / $87.10
| Professional | | $51.29 | $69.18 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $13.49 / $37.15 / $37.15
| Professional | 26 | $13.49 | $37.15 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $3.55 / $16.60 / $23.44
| Facility | 26 | $3.55 | $16.60 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $69.18 / $128.82
| Professional | | $48.98 | $69.18 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.30 / $19.05 / $36.31
| Professional | 26 | $12.30 | $19.05 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $34.67 / $48.98 / $93.33
| Professional | TC | $34.67 | $48.98 | $93.33 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $125.89 / $125.89 / $125.89
| Facility | 26 | $125.89 | $125.89 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $524.81 / $524.81
| Professional | | $398.11 | $524.81 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $141.25 / $218.78 / $218.78
| Professional | 26 | $141.25 | $218.78 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $354.81 / $407.38 / $407.38
| Professional | TC | $354.81 | $407.38 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.12 / $11.48 / $19.05
| Facility | 26 | $9.12 | $11.48 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $72.44 / $141.25
| Professional | | $45.71 | $72.44 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.00 / $17.38 / $37.15
| Professional | 26 | $10.00 | $17.38 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $32.36 / $53.70 / $104.71
| Professional | TC | $32.36 | $53.70 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $33.11 / $50.12
| Professional | | $12.02 | $33.11 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $58.88 / $128.82
| Professional | | $15.14 | $58.88 | $128.82 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $3.63 / $16.98 / $23.99
| Facility | 26 | $3.63 | $16.98 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $66.07 / $131.83
| Professional | | $47.86 | $66.07 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.30 / $17.78 / $33.11
| Professional | 26 | $12.30 | $17.78 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $33.88 / $47.86 / $85.11
| Professional | TC | $33.88 | $47.86 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $64.57 / $114.82
| Professional | | $51.29 | $64.57 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $14.13 / $17.38 / $46.77
| Professional | 26 | $14.13 | $17.38 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $36.31 / $46.77 / $77.62
| Professional | TC | $36.31 | $46.77 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $63.10 / $74.13
| Professional | | $60.26 | $63.10 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $14.13 / $14.79 / $17.38
| Professional | 26 | $14.13 | $14.79 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $45.71 / $47.86 / $57.54
| Professional | TC | $45.71 | $47.86 | $57.54 |