- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $12.30 / $32.36
| Facility | 26 | $7.08 | $12.30 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $28.84 / $67.61
| Professional | | $11.22 | $28.84 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $13.49 / $28.18
| Professional | 26 | $7.08 | $13.49 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $61.66 / $125.89 / $162.18
| Professional | 50 | $61.66 | $125.89 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $18.20 / $25.70 / $48.98
| Professional | TC | $18.20 | $25.70 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $41.69 / $64.57
| Professional | | $29.51 | $41.69 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.41 / $10.23 / $15.85
| Professional | 26 | $7.41 | $10.23 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $44.67 / $63.10 / $95.50
| Professional | 50 | $44.67 | $63.10 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.89 / $30.90 / $48.98
| Professional | TC | $20.89 | $30.90 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $37.15 / $87.10
| Professional | | $25.70 | $37.15 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.76 / $8.51 / $10.72
| Professional | 26 | $7.76 | $8.51 | $10.72 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $23.99 / $28.84 / $43.65
| Professional | TC | $23.99 | $28.84 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $13.18 / $13.18 / $13.18
| Facility | 26 | $13.18 | $13.18 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $34.67 / $63.10
| Professional | | $24.55 | $34.67 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.31 / $9.55 / $17.38
| Professional | 26 | $6.31 | $9.55 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $18.20 / $24.55 / $48.98
| Professional | TC | $18.20 | $24.55 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $39.81 / $48.98
| Professional | | $33.11 | $39.81 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.41 / $9.12 / $11.75
| Professional | 26 | $7.41 | $9.12 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $25.12 / $30.20 / $37.15
| Professional | TC | $25.12 | $30.20 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $44.67 / $69.18
| Professional | | $35.48 | $44.67 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $11.48 / $14.13 / $17.38
| Professional | 26 | $11.48 | $14.13 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $30.20 / $52.48
| Professional | | $30.20 | $30.20 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $33.11 / $134.90
| Professional | | $10.23 | $33.11 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.13 / $10.72 / $18.20
| Professional | 26 | $8.13 | $10.72 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.05 / $28.84 / $48.98
| Professional | TC | $19.05 | $28.84 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $36.31 / $64.57
| Professional | | $22.39 | $36.31 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.31 / $9.77 / $18.20
| Professional | 26 | $6.31 | $9.77 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.85 / $25.70 / $46.77
| Professional | TC | $15.85 | $25.70 | $46.77 |