- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.23 / $11.22 / $14.79
| Facility | 26 | $10.23 | $11.22 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $33.11 / $109.65
| Professional | | $14.79 | $33.11 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.03 / $8.91 / $39.81
| Professional | 26 | $6.03 | $8.91 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $398.11 / $398.11 / $398.11
| Professional | 50 | $398.11 | $398.11 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.85 / $23.44 / $61.66
| Professional | TC | $15.85 | $23.44 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $21.38 / $33.11
| Professional | | $19.05 | $21.38 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $22.39 / $38.02
| Professional | | $5.75 | $22.39 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $38.90 / $54.95
| Professional | | $25.12 | $38.90 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.76 / $10.47 / $15.14
| Professional | 26 | $6.76 | $10.47 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $18.20 / $27.54 / $40.74
| Professional | TC | $18.20 | $27.54 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $32.36 / $36.31
| Professional | | $14.45 | $32.36 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $45.71 / $72.44
| Professional | | $27.54 | $45.71 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.92 / $10.47 / $15.14
| Professional | 26 | $6.92 | $10.47 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.42 / $27.54 / $38.02
| Professional | TC | $20.42 | $27.54 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $31.62 / $69.18
| Professional | | $26.92 | $31.62 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.59 / $8.71 / $21.38
| Professional | 26 | $7.59 | $8.71 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $18.62 / $22.91 / $47.86
| Professional | TC | $18.62 | $22.91 | $47.86 |