- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $213.80 / $239.88 / $275.42
| Facility | 26 | $213.80 | $239.88 | $275.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $501.19 / $1,202.26
| Professional | | $223.87 | $501.19 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $102.33 / $194.98 / $588.84
| Professional | 26 | $102.33 | $194.98 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $316.23 / $436.52 / $794.33
| Professional | TC | $316.23 | $436.52 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $660.69 / $2,398.83
| Professional | | $416.87 | $660.69 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $100.00 / $158.49 / $575.44
| Professional | 26 | $100.00 | $158.49 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $316.23 / $549.54 / $1,862.09
| Professional | TC | $316.23 | $549.54 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $269.15 / $309.03 / $501.19
| Facility | 26 | $269.15 | $309.03 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $1,148.15 / $1,737.80
| Professional | | $467.74 | $1,148.15 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $109.65 / $239.88 / $416.87
| Professional | 26 | $109.65 | $239.88 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $389.05 / $954.99 / $1,318.26
| Professional | TC | $389.05 | $954.99 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $912.01 / $1,258.93
| Professional | | $758.58 | $912.01 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $186.21 / $223.87 / $302.00
| Professional | 26 | $186.21 | $223.87 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $575.44 / $691.83 / $1,000.00
| Professional | TC | $575.44 | $691.83 | $1,000.00 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $954.99 / $954.99 / $954.99
| Facility | 26 | $954.99 | $954.99 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $1,174.90 / $6,025.60
| Professional | | $549.54 | $1,174.90 | $6,025.60 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $114.82 / $234.42 / $676.08
| Professional | 26 | $114.82 | $234.42 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $426.58 / $933.25 / $5,495.41
| Professional | TC | $426.58 | $933.25 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $758.58
| Professional | | $32.36 | $33.11 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $1,096.48 / $1,584.89
| Professional | | $524.81 | $1,096.48 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $141.25 / $239.88 / $407.38
| Professional | 26 | $141.25 | $239.88 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $478.63 / $812.83 / $1,348.96
| Professional | TC | $478.63 | $812.83 | $1,348.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $1,023.29 / $2,041.74
| Professional | | $537.03 | $1,023.29 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $239.88 / $933.25 / $933.25
| Facility | 26 | $239.88 | $933.25 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $3,388.44 / $6,165.95
| Professional | | $602.56 | $3,388.44 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $147.91 / $524.81 / $676.08
| Professional | 26 | $147.91 | $524.81 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $446.68 / $3,090.30 / $5,623.41
| Professional | TC | $446.68 | $3,090.30 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $1,122.02 / $1,122.02
| Professional | | $1,122.02 | $1,122.02 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $269.15 / $269.15 / $269.15
| Professional | 26 | $269.15 | $269.15 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $870.96 / $870.96 / $870.96
| Professional | TC | $870.96 | $870.96 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $2,630.27 / $3,630.78
| Professional | | $2,137.96 | $2,630.27 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $457.09 / $588.84 / $724.44
| Professional | 26 | $457.09 | $588.84 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $1,659.59 / $2,290.87 / $2,691.53
| Professional | TC | $1,659.59 | $2,290.87 | $2,691.53 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $1,548.82 / $3,311.31
| Professional | | $85.11 | $1,548.82 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $87.10 / $363.08 / $776.25
| Professional | 26 | $87.10 | $363.08 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $380.19 / $724.44 / $1,737.80
| Professional | TC | $380.19 | $724.44 | $1,737.80 |