- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $7.41 / $14.13
| Facility | 26 | $7.08 | $7.41 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $30.20 / $72.44
| Professional | | $18.62 | $30.20 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $8.91 / $28.84
| Professional | 26 | $7.08 | $8.91 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $128.82 / $128.82 / $128.82
| Professional | 50 | $128.82 | $128.82 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $12.02 / $19.05 / $38.90
| Professional | TC | $12.02 | $19.05 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $16.22 / $19.05
| Professional | | $16.22 | $16.22 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.92 / $6.92 / $8.13
| Professional | 26 | $6.92 | $6.92 | $8.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $34.67 / $58.88
| Professional | | $24.55 | $34.67 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.12 / $14.13 / $24.55
| Professional | 26 | $9.12 | $14.13 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $14.79 / $16.98 / $38.90
| Professional | TC | $14.79 | $16.98 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $35.48 / $58.88
| Professional | | $25.70 | $35.48 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.71 / $11.75 / $18.62
| Professional | 26 | $8.71 | $11.75 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $16.98 / $22.91 / $38.02
| Professional | TC | $16.98 | $22.91 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $60.26 / $60.26
| Professional | | $60.26 | $60.26 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $18.20 / $18.20 / $18.20
| Professional | 26 | $18.20 | $18.20 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $32.36 / $53.70
| Professional | | $23.99 | $32.36 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.94 / $10.23 / $18.62
| Professional | 26 | $7.94 | $10.23 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $16.22 / $21.38 / $35.48
| Professional | TC | $16.22 | $21.38 | $35.48 |