- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.88 / $13.18 / $14.79
| Facility | 26 | $12.88 | $13.18 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $45.71 / $87.10
| Professional | | $32.36 | $45.71 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.91 / $14.13 / $28.84
| Professional | 26 | $8.91 | $14.13 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $21.38 / $30.90 / $66.07
| Professional | TC | $21.38 | $30.90 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $54.95 / $75.86
| Professional | | $34.67 | $54.95 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.33 / $15.14 / $20.42
| Professional | 26 | $9.33 | $15.14 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $25.70 / $38.02 / $54.95
| Professional | TC | $25.70 | $38.02 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $52.48 / $97.72
| Professional | | $37.15 | $52.48 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.23 / $15.49 / $30.20
| Professional | 26 | $10.23 | $15.49 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $26.30 / $38.02 / $70.79
| Professional | TC | $26.30 | $38.02 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $60.26 / $109.65
| Professional | | $45.71 | $60.26 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.59 / $15.85 / $29.51
| Professional | 26 | $12.59 | $15.85 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $34.67 / $42.66 / $81.28
| Professional | TC | $34.67 | $42.66 | $81.28 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.88 / $13.18 / $1,479.11
| Facility | 26 | $12.88 | $13.18 | $1,479.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $48.98 / $87.10
| Professional | | $33.88 | $48.98 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.33 / $14.13 / $25.12
| Professional | 26 | $9.33 | $14.13 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $24.55 / $35.48 / $63.10
| Professional | TC | $24.55 | $35.48 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $54.95 / $109.65
| Professional | | $40.74 | $54.95 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $11.48 / $16.22 / $64.57
| Professional | 26 | $11.48 | $16.22 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $26.92 / $38.02 / $95.50
| Professional | TC | $26.92 | $38.02 | $95.50 |