- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.92 / $7.08 / $19.95
| Facility | 26 | $6.92 | $7.08 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $31.62 / $64.57
| Professional | | $16.98 | $31.62 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $11.48 / $23.99
| Professional | 26 | $7.08 | $11.48 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $18.20 / $25.12 / $47.86
| Professional | TC | $18.20 | $25.12 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $30.90 / $40.74
| Professional | | $25.12 | $30.90 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.41 / $9.33 / $19.05
| Professional | 26 | $7.41 | $9.33 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $16.22 / $20.89 / $33.88
| Professional | TC | $16.22 | $20.89 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $41.69 / $41.69
| Professional | | $41.69 | $41.69 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $36.31 / $51.29
| Professional | | $22.91 | $36.31 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.92 / $11.48 / $16.22
| Professional | 26 | $6.92 | $11.48 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.85 / $26.30 / $35.48
| Professional | TC | $15.85 | $26.30 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $32.36 / $33.11
| Professional | | $18.20 | $32.36 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $31.62 / $53.70
| Professional | | $21.38 | $31.62 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.76 / $8.71 / $16.60
| Professional | 26 | $6.76 | $8.71 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $14.45 / $22.39 / $38.02
| Professional | TC | $14.45 | $22.39 | $38.02 |