- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.91 / $10.00 / $13.49
| Facility | 26 | $8.91 | $10.00 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $21.88 / $31.62 / $97.72
| Facility | TC | $21.88 | $31.62 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $28.84 / $75.86
| Professional | | $18.20 | $28.84 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.03 / $10.00 / $24.55
| Professional | 26 | $6.03 | $10.00 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.14 / $20.89 / $33.11
| Professional | TC | $15.14 | $20.89 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $19.50 / $27.54
| Professional | | $19.05 | $19.50 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.46 / $6.46 / $7.59
| Professional | 26 | $6.46 | $6.46 | $7.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $35.48 / $42.66
| Professional | | $30.20 | $35.48 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.91 / $10.47 / $13.49
| Professional | 26 | $8.91 | $10.47 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $21.38 / $25.12 / $29.51
| Professional | TC | $21.38 | $25.12 | $29.51 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.95 / $20.42 / $39.81
| Facility | TC | $19.95 | $20.42 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.59 / $7.94 / $39.81
| Professional | 26 | $7.59 | $7.94 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $27.54 / $52.48
| Professional | | $18.62 | $27.54 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.50 / $8.71 / $16.22
| Professional | 26 | $5.50 | $8.71 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $12.88 / $19.95 / $38.90
| Professional | TC | $12.88 | $19.95 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $28.84 / $44.67
| Professional | | $20.89 | $28.84 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.76 / $8.71 / $13.18
| Professional | 26 | $6.76 | $8.71 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $14.13 / $19.95 / $30.20
| Professional | TC | $14.13 | $19.95 | $30.20 |