- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.76 / $12.88 / $35.48
| Facility | 26 | $7.76 | $12.88 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $26.92 / $56.23
| Professional | | $18.20 | $26.92 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $12.59 / $28.84
| Professional | 26 | $7.08 | $12.59 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $58.88 / $58.88 / $128.82
| Professional | 50 | $58.88 | $58.88 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $10.96 / $18.62 / $33.11
| Professional | TC | $10.96 | $18.62 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $30.90 / $47.86
| Professional | | $22.39 | $30.90 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.13 / $11.22 / $16.98
| Professional | 26 | $8.13 | $11.22 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $33.88 / $46.77 / $70.79
| Professional | 50 | $33.88 | $46.77 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $14.45 / $20.42 / $30.90
| Professional | TC | $14.45 | $20.42 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $26.92 / $89.13
| Professional | | $9.33 | $26.92 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.32 / $8.32 / $14.13
| Professional | 26 | $8.32 | $8.32 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.85 / $18.62 / $24.55
| Professional | TC | $15.85 | $18.62 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $14.13 / $14.13 / $14.13
| Facility | 26 | $14.13 | $14.13 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $33.88 / $54.95
| Professional | | $20.42 | $33.88 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.92 / $10.47 / $18.62
| Professional | 26 | $6.92 | $10.47 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $12.59 / $22.91 / $38.02
| Professional | TC | $12.59 | $22.91 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $29.51 / $36.31
| Professional | | $24.55 | $29.51 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.51 / $10.47 / $13.18
| Professional | 26 | $8.51 | $10.47 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.85 / $19.05 / $23.44
| Professional | TC | $15.85 | $19.05 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $45.71 / $51.29
| Professional | | $36.31 | $45.71 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.30 / $15.49 / $19.05
| Professional | 26 | $12.30 | $15.49 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $30.20 / $38.90
| Professional | | $30.20 | $30.20 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $30.90 / $77.62
| Professional | | $11.22 | $30.90 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.71 / $11.75 / $19.95
| Professional | 26 | $8.71 | $11.75 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.85 / $25.70 / $42.66
| Professional | TC | $15.85 | $25.70 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $33.11 / $60.26
| Professional | | $21.38 | $33.11 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.61 / $10.47 / $19.05
| Professional | 26 | $6.61 | $10.47 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $14.45 / $22.39 / $38.90
| Professional | TC | $14.45 | $22.39 | $38.90 |