- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.13 / $9.12 / $10.72
| Facility | 26 | $8.13 | $9.12 | $10.72 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $24.55 / $28.84 / $32.36
| Facility | TC | $24.55 | $28.84 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $30.20 / $89.13
| Professional | | $20.89 | $30.20 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.03 / $8.13 / $22.39
| Professional | 26 | $6.03 | $8.13 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.14 / $20.89 / $51.29
| Professional | TC | $15.14 | $20.89 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $34.67 / $47.86
| Professional | | $22.39 | $34.67 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.76 / $10.23 / $15.14
| Professional | 26 | $6.76 | $10.23 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.49 / $24.55 / $36.31
| Professional | TC | $15.49 | $24.55 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $41.69 / $42.66
| Professional | | $13.18 | $41.69 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.47 / $10.96 / $11.48
| Professional | 26 | $10.47 | $10.96 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $30.20 / $31.62 / $33.11
| Professional | TC | $30.20 | $31.62 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $38.90 / $45.71
| Professional | | $35.48 | $38.90 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.12 / $9.77 / $11.48
| Professional | 26 | $9.12 | $9.77 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $26.30 / $28.84 / $33.88
| Professional | TC | $26.30 | $28.84 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $40.74 / $64.57
| Professional | | $28.18 | $40.74 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.33 / $13.49 / $87.10
| Professional | 26 | $9.33 | $13.49 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.89 / $28.18 / $44.67
| Professional | TC | $20.89 | $28.18 | $44.67 |
University Health Alliance - Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $47.86 / $72.44
| Professional | | $39.81 | $47.86 | $72.44 |
University Health Alliance - Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.00 / $12.59 / $20.42
| Professional | 26 | $10.00 | $12.59 | $20.42 |
University Health Alliance - Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $29.51 / $36.31 / $51.29
| Professional | TC | $29.51 | $36.31 | $51.29 |