- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.59 / $8.13 / $11.48
| Facility | 26 | $7.59 | $8.13 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $41.69 / $81.28
| Professional | | $30.20 | $41.69 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.94 / $10.96 / $24.55
| Professional | 26 | $7.94 | $10.96 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $21.88 / $30.20 / $53.70
| Professional | TC | $21.88 | $30.20 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $35.48 / $60.26
| Professional | | $29.51 | $35.48 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.55 / $12.30 / $24.55
| Professional | 26 | $9.55 | $12.30 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $31.62 / $47.86
| Professional | | $9.77 | $31.62 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $48.98 / $97.72
| Professional | | $38.90 | $48.98 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.96 / $26.30 / $26.30
| Professional | 26 | $10.96 | $26.30 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $2.88 / $13.49 / $19.05
| Facility | 26 | $2.88 | $13.49 | $19.05 |
- 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
- $8.91 / $12.59 / $23.44
| Professional | 26 | $8.91 | $12.59 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $25.12 / $35.48 / $66.07
| Professional | TC | $25.12 | $35.48 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $102.33 / $102.33 / $102.33
| Facility | 26 | $102.33 | $102.33 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $371.54 / $371.54
| Professional | | $288.40 | $371.54 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $112.20 / $112.20 / $112.20
| Professional | 26 | $112.20 | $112.20 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $269.15 / $281.84 / $281.84
| Professional | TC | $269.15 | $281.84 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.59 / $10.72 / $15.49
| Facility | 26 | $7.59 | $10.72 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $50.12 / $102.33
| Professional | | $30.20 | $50.12 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.94 / $12.88 / $26.92
| Professional | 26 | $7.94 | $12.88 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.39 / $36.31 / $70.79
| Professional | TC | $22.39 | $36.31 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $32.36 / $35.48
| Professional | | $9.77 | $32.36 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $41.69 / $93.33
| Professional | | $11.75 | $41.69 | $93.33 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $2.88 / $13.49 / $19.05
| Facility | 26 | $2.88 | $13.49 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $47.86 / $97.72
| Professional | | $33.88 | $47.86 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.71 / $12.02 / $21.88
| Professional | 26 | $8.71 | $12.02 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $24.55 / $33.88 / $63.10
| Professional | TC | $24.55 | $33.88 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $43.65 / $87.10
| Professional | | $36.31 | $43.65 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.55 / $12.02 / $24.55
| Professional | 26 | $9.55 | $12.02 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $26.30 / $33.11 / $53.70
| Professional | TC | $26.30 | $33.11 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $44.67 / $52.48
| Professional | | $41.69 | $44.67 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $11.22 / $11.48 / $13.80
| Professional | 26 | $11.22 | $11.48 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $30.90 / $32.36 / $38.90
| Professional | TC | $30.90 | $32.36 | $38.90 |