- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $117.49 / $154.88 / $346.74
| Facility | 26 | $117.49 | $154.88 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $588.84 / $2,754.23
| Professional | | $354.81 | $588.84 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $97.72 / $165.96 / $588.84
| Professional | 26 | $97.72 | $165.96 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $245.47 / $363.08 / $1,230.27
| Professional | TC | $245.47 | $363.08 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $724.44 / $1,023.29
| Professional | | $645.65 | $724.44 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $77.62 / $177.83 / $199.53
| Professional | 26 | $77.62 | $177.83 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $537.03 / $537.03 / $537.03
| Professional | TC | $537.03 | $537.03 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $707.95 / $707.95 / $707.95
| Facility | 26 | $707.95 | $707.95 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $758.58 / $1,071.52
| Professional | | $489.78 | $758.58 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $144.54 / $218.78 / $309.03
| Professional | 26 | $144.54 | $218.78 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $346.74 / $537.03 / $776.25
| Professional | TC | $346.74 | $537.03 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $776.25 / $1,445.44
| Professional | | $346.74 | $776.25 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $89.13 / $165.96 / $309.03
| Professional | 26 | $89.13 | $165.96 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $245.47 / $630.96 / $1,174.90
| Professional | TC | $245.47 | $630.96 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $123.03 / $204.17 / $1,000.00
| Facility | 26 | $123.03 | $204.17 | $1,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $831.76 / $1,202.26
| Professional | | $512.86 | $831.76 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $102.33 / $190.55 / $263.03
| Professional | 26 | $102.33 | $190.55 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $380.19 / $630.96 / $977.24
| Professional | TC | $380.19 | $630.96 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $151.36
| Professional | | $32.36 | $33.11 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $288.40 / $660.69
| Professional | | $162.18 | $288.40 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $141.25 / $141.25 / $141.25
| Facility | 26 | $141.25 | $141.25 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $741.31 / $1,023.29
| Professional | | $478.63 | $741.31 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $141.25 / $213.80 / $302.00
| Professional | 26 | $141.25 | $213.80 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $331.13 / $537.03 / $724.44
| Professional | TC | $331.13 | $537.03 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $707.95 / $707.95 / $707.95
| Facility | 26 | $707.95 | $707.95 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $758.58 / $1,023.29
| Professional | | $489.78 | $758.58 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $144.54 / $218.78 / $295.12
| Professional | 26 | $144.54 | $218.78 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $346.74 / $537.03 / $758.58
| Professional | TC | $346.74 | $537.03 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $630.96 / $1,258.93
| Professional | | $338.84 | $630.96 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $91.20 / $123.03 / $295.12
| Professional | 26 | $91.20 | $123.03 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $239.88 / $478.63 / $954.99
| Professional | TC | $239.88 | $478.63 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $398.11 / $758.58
| Professional | | $398.11 | $398.11 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $109.65 / $117.49 / $208.93
| Professional | 26 | $109.65 | $117.49 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $281.84 / $288.40 / $537.03
| Professional | TC | $281.84 | $288.40 | $537.03 |