- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.46 / $8.32 / $20.89
| Facility | 26 | $6.46 | $8.32 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $29.51 / $67.61 / $489.78
| Facility | TC | $29.51 | $67.61 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $39.81 / $109.65
| Professional | | $11.22 | $39.81 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.89 / $10.72 / $28.84
| Professional | 26 | $5.89 | $10.72 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $20.42 / $117.49 / $181.97
| Professional | 50 | $20.42 | $117.49 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $10.47 / $26.92 / $158.49
| Professional | 52 | $10.47 | $26.92 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.91 / $38.02 / $70.79
| Professional | TC | $22.91 | $38.02 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $31.62 / $63.10
| Professional | | $25.70 | $31.62 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $4.90 / $5.25 / $10.96
| Professional | 26 | $4.90 | $5.25 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $95.50 / $95.50 / $95.50
| Professional | 50 | $95.50 | $95.50 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.95 / $20.89 / $53.70
| Professional | TC | $19.95 | $20.89 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $36.31 / $60.26
| Professional | | $30.20 | $36.31 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.92 / $8.51 / $13.80
| Professional | 26 | $6.92 | $8.51 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $45.71 / $53.70 / $91.20
| Professional | 50 | $45.71 | $53.70 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $23.44 / $27.54 / $46.77
| Professional | TC | $23.44 | $27.54 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $42.66 / $50.12
| Professional | | $39.81 | $42.66 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.24 / $7.41 / $10.00
| Professional | 26 | $7.24 | $7.41 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $32.36 / $35.48 / $41.69
| Professional | TC | $32.36 | $35.48 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $1.62 / $7.59 / $10.96
| Facility | 26 | $1.62 | $7.59 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $7.41 / $34.67 / $48.98
| Facility | TC | $7.41 | $34.67 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $40.74 / $74.13
| Professional | | $25.70 | $40.74 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.75 / $8.91 / $16.22
| Professional | 26 | $5.75 | $8.91 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.95 / $31.62 / $61.66
| Professional | TC | $19.95 | $31.62 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $15.49 / $100.00 / $100.00
| Facility | 26 | $15.49 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $67.61 / $144.54 / $144.54
| Facility | TC | $67.61 | $144.54 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $43.65 / $239.88
| Professional | | $28.18 | $43.65 | $239.88 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.61 / $9.77 / $51.29
| Professional | 26 | $6.61 | $9.77 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $21.88 / $35.48 / $199.53
| Professional | TC | $21.88 | $35.48 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $38.90 / $79.43
| Professional | | $27.54 | $38.90 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.46 / $8.13 / $23.44
| Professional | 26 | $6.46 | $8.13 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $21.88 / $30.20 / $64.57
| Professional | TC | $21.88 | $30.20 | $64.57 |