- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.77 / $10.72 / $14.45
| Facility | 26 | $9.77 | $10.72 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $28.84 / $72.44
| Professional | | $19.05 | $28.84 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $10.96 / $26.92
| Professional | 26 | $7.08 | $10.96 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $54.95 / $61.66 / $117.49
| Professional | 50 | $54.95 | $61.66 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $10.96 / $18.20 / $38.90
| Professional | TC | $10.96 | $18.20 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $38.02 / $38.02
| Professional | | $38.02 | $38.02 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.17 / $7.94 / $10.23
| Professional | 26 | $6.17 | $7.94 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $13.18 / $13.18 / $13.18
| Professional | TC | $13.18 | $13.18 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $31.62 / $43.65
| Professional | | $25.12 | $31.62 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.55 / $11.75 / $15.49
| Professional | 26 | $9.55 | $11.75 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.49 / $18.20 / $29.51
| Professional | TC | $15.49 | $18.20 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.13 / $13.18 / $13.18
| Professional | 26 | $8.13 | $13.18 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $27.54 / $54.95
| Professional | | $16.22 | $27.54 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.75 / $10.00 / $17.78
| Professional | 26 | $5.75 | $10.00 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $10.23 / $17.78 / $37.15
| Professional | TC | $10.23 | $17.78 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $28.18 / $44.67
| Professional | | $21.88 | $28.18 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.24 / $9.33 / $14.13
| Professional | 26 | $7.24 | $9.33 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $14.13 / $18.62 / $28.18
| Professional | TC | $14.13 | $18.62 | $28.18 |