- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $27.54 / $37.15 / $37.15
| Facility | 26 | $27.54 | $37.15 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $28.18 / $85.11
| Professional | | $15.14 | $28.18 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.03 / $10.23 / $28.84
| Professional | 26 | $6.03 | $10.23 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $10.00 / $18.20 / $42.66
| Professional | TC | $10.00 | $18.20 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $44.67 / $87.10
| Professional | | $31.62 | $44.67 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.55 / $14.45 / $30.20
| Professional | 26 | $9.55 | $14.45 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $21.38 / $23.44 / $56.23
| Professional | TC | $21.38 | $23.44 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $27.54 / $27.54 / $37.15
| Facility | 26 | $27.54 | $27.54 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $64.57 / $104.71
| Professional | | $28.18 | $64.57 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.00 / $26.30 / $53.70
| Professional | 26 | $10.00 | $26.30 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.50 / $40.74 / $67.61
| Professional | TC | $19.50 | $40.74 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $97.72 / $112.20 / $173.78
| Professional | | $97.72 | $112.20 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $32.36 / $35.48 / $58.88
| Professional | 26 | $32.36 | $35.48 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $61.66 / $75.86 / $120.23
| Professional | TC | $61.66 | $75.86 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $60.26 / $74.13
| Professional | | $33.11 | $60.26 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.41 / $12.30 / $31.62
| Professional | 26 | $7.41 | $12.30 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $14.13 / $30.20 / $58.88
| Professional | TC | $14.13 | $30.20 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $67.61 / $204.17
| Professional | | $31.62 | $67.61 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.47 / $25.12 / $54.95
| Professional | 26 | $10.47 | $25.12 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $18.20 / $41.69 / $89.13
| Professional | TC | $18.20 | $41.69 | $89.13 |