- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $11.22 / $19.50 / $47.86
| Facility | 26 | $11.22 | $19.50 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $74.13 / $173.78
| Professional | | $44.67 | $74.13 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.02 / $20.42 / $48.98
| Professional | 26 | $12.02 | $20.42 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $31.62 / $51.29 / $85.11
| Professional | TC | $31.62 | $51.29 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $46.77 / $81.28
| Professional | | $35.48 | $46.77 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.47 / $18.62 / $20.42
| Professional | 26 | $10.47 | $18.62 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $35.48 / $56.23 / $60.26
| Professional | TC | $35.48 | $56.23 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $53.70 / $63.10 / $81.28
| Professional | | $53.70 | $63.10 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $15.49 / $15.49 / $26.92
| Professional | 26 | $15.49 | $15.49 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $47.86 / $47.86 / $57.54
| Professional | TC | $47.86 | $47.86 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $61.66 / $112.20
| Professional | | $50.12 | $61.66 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.59 / $19.05 / $35.48
| Professional | 26 | $12.59 | $19.05 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $37.15 / $45.71 / $75.86
| Professional | TC | $37.15 | $45.71 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $61.66 / $100.00
| Professional | | $40.74 | $61.66 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.23 / $18.20 / $28.84
| Professional | 26 | $10.23 | $18.20 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $28.84 / $44.67 / $72.44
| Professional | TC | $28.84 | $44.67 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $74.13 / $91.20
| Professional | | $54.95 | $74.13 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.88 / $17.38 / $20.89
| Professional | 26 | $12.88 | $17.38 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $42.66 / $56.23 / $70.79
| Professional | TC | $42.66 | $56.23 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $60.26 / $107.15
| Professional | | $38.90 | $60.26 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.30 / $16.98 / $27.54
| Professional | 26 | $12.30 | $16.98 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $26.92 / $42.66 / $81.28
| Professional | TC | $26.92 | $42.66 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $57.54 / $77.62
| Professional | | $13.49 | $57.54 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $13.18 / $14.79 / $21.38
| Professional | 26 | $13.18 | $14.79 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $47.86 / $56.23 / $67.61
| Professional | TC | $47.86 | $56.23 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $63.10 / $81.28
| Professional | | $54.95 | $63.10 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $15.49 / $15.49 / $20.42
| Professional | 26 | $15.49 | $15.49 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $47.86 / $47.86 / $61.66
| Professional | TC | $47.86 | $47.86 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $11.22 / $16.22 / $36.31
| Facility | 26 | $11.22 | $16.22 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $60.26 / $112.20
| Professional | | $42.66 | $60.26 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.96 / $15.85 / $29.51
| Professional | 26 | $10.96 | $15.85 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $31.62 / $44.67 / $85.11
| Professional | TC | $31.62 | $44.67 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $67.61 / $102.33
| Professional | | $14.45 | $67.61 | $102.33 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.30 / $16.60 / $16.60
| Facility | 26 | $12.30 | $16.60 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $34.67 / $61.66
| Professional | | $10.47 | $34.67 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.02 / $12.59 / $16.60
| Professional | 26 | $12.02 | $12.59 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $36.31 / $37.15 / $40.74
| Professional | TC | $36.31 | $37.15 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $54.95 / $95.50
| Professional | | $41.69 | $54.95 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $11.22 / $15.49 / $33.11
| Professional | 26 | $11.22 | $15.49 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $30.20 / $39.81 / $79.43
| Professional | TC | $30.20 | $39.81 | $79.43 |