- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.03 / $12.02 / $32.36
| Facility | 26 | $6.03 | $12.02 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $35.48 / $109.65
| Professional | | $14.79 | $35.48 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $16.60 / $38.02
| Professional | 26 | $7.08 | $16.60 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $32.36 / $87.10 / $162.18
| Professional | 50 | $32.36 | $87.10 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.85 / $28.84 / $70.79
| Professional | TC | $15.85 | $28.84 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $19.05 / $100.00 / $100.00
| Facility | 26 | $19.05 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $41.69 / $208.93
| Professional | | $25.70 | $41.69 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $11.22 / $83.18
| Professional | 26 | $7.08 | $11.22 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.95 / $33.11 / $162.18
| Professional | TC | $19.95 | $33.11 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.12 / $15.85 / $20.89
| Professional | 26 | $9.12 | $15.85 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $31.62 / $53.70 / $70.79
| Professional | TC | $31.62 | $53.70 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $46.77 / $89.13
| Professional | | $25.70 | $46.77 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.76 / $12.02 / $22.91
| Professional | 26 | $6.76 | $12.02 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.50 / $36.31 / $66.07
| Professional | TC | $19.50 | $36.31 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $36.31 / $61.66
| Professional | | $10.23 | $36.31 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $52.48 / $104.71
| Professional | | $34.67 | $52.48 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.32 / $11.75 / $21.38
| Professional | 26 | $8.32 | $11.75 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $26.30 / $39.81 / $70.79
| Professional | TC | $26.30 | $39.81 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $14.79 / $66.07
| Professional | | $11.75 | $14.79 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $19.05 / $100.00 / $100.00
| Facility | 26 | $19.05 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $41.69 / $208.93
| Professional | | $25.70 | $41.69 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $11.22 / $83.18
| Professional | 26 | $7.08 | $11.22 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.95 / $33.11 / $162.18
| Professional | TC | $19.95 | $33.11 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $29.51 / $38.90
| Professional | | $26.92 | $29.51 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $43.65 / $104.71
| Professional | | $30.20 | $43.65 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.94 / $11.22 / $26.30
| Professional | 26 | $7.94 | $11.22 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.39 / $33.11 / $79.43
| Professional | TC | $22.39 | $33.11 | $79.43 |