- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $28.18 / $39.81 / $43.65
| Facility | 26 | $28.18 | $39.81 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $38.02 / $104.71
| Professional | | $22.91 | $38.02 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $10.96 / $31.62
| Professional | 26 | $7.08 | $10.96 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $30.20 / $33.88 / $54.95
| Professional | 52 | $30.20 | $33.88 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.14 / $23.99 / $64.57
| Professional | TC | $15.14 | $23.99 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.24 / $7.24 / $7.24
| Professional | 26 | $7.24 | $7.24 | $7.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $29.51 / $123.03
| Professional | | $25.12 | $29.51 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.24 / $8.51 / $34.67
| Professional | 26 | $7.24 | $8.51 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.78 / $21.38 / $87.10
| Professional | TC | $17.78 | $21.38 | $87.10 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $2.19 / $10.23 / $14.79
| Facility | 26 | $2.19 | $10.23 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $39.81 / $69.18
| Professional | | $24.55 | $39.81 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.59 / $11.75 / $20.89
| Professional | 26 | $7.59 | $11.75 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $16.22 / $27.54 / $51.29
| Professional | TC | $16.22 | $27.54 | $51.29 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $20.89 / $100.00 / $100.00
| Facility | 26 | $20.89 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $38.90 / $213.80
| Professional | | $30.90 | $38.90 | $213.80 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.12 / $11.22 / $79.43
| Professional | 26 | $9.12 | $11.22 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $21.88 / $26.92 / $204.17
| Professional | TC | $21.88 | $26.92 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $36.31 / $85.11
| Professional | | $30.20 | $36.31 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.12 / $11.22 / $66.07
| Professional | 26 | $9.12 | $11.22 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.42 / $25.12 / $39.81
| Professional | TC | $20.42 | $25.12 | $39.81 |