- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $14.13 / $14.79 / $17.78
| Facility | 26 | $14.13 | $14.79 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $32.36 / $38.90 / $380.19
| Facility | TC | $32.36 | $38.90 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $51.29 / $181.97
| Professional | | $19.95 | $51.29 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.91 / $19.50 / $51.29
| Professional | 26 | $8.91 | $19.50 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $33.11 / $87.10 / $239.88
| Professional | 50 | $33.11 | $87.10 | $239.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $25.70 / $40.74 / $83.18
| Professional | TC | $25.70 | $40.74 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $39.81 / $77.62
| Professional | | $33.11 | $39.81 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.91 / $9.12 / $17.38
| Professional | 26 | $8.91 | $9.12 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $53.70 / $53.70 / $53.70
| Professional | 50 | $53.70 | $53.70 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $35.48 / $35.48 / $35.48
| Professional | TC | $35.48 | $35.48 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $50.12 / $64.57
| Professional | | $43.65 | $50.12 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.59 / $14.45 / $18.62
| Professional | 26 | $12.59 | $14.45 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $30.90 / $35.48 / $45.71
| Professional | TC | $30.90 | $35.48 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $40.74 / $72.44
| Professional | | $12.30 | $40.74 | $72.44 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $2.69 / $12.59 / $17.78
| Facility | 26 | $2.69 | $12.59 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $8.51 / $39.81 / $56.23
| Facility | TC | $8.51 | $39.81 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $51.29 / $83.18
| Professional | | $35.48 | $51.29 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.77 / $14.13 / $22.39
| Professional | 26 | $9.77 | $14.13 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $24.55 / $35.48 / $58.88
| Professional | TC | $24.55 | $35.48 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $70.79 / $91.20
| Professional | | $46.77 | $70.79 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $17.38 / $21.38 / $30.90
| Professional | 26 | $17.38 | $21.38 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $48.98 / $109.65 / $138.04
| Professional | 50 | $48.98 | $109.65 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $28.18 / $41.69 / $70.79
| Professional | TC | $28.18 | $41.69 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $45.71 / $87.10
| Professional | | $36.31 | $45.71 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.23 / $12.59 / $22.91
| Professional | 26 | $10.23 | $12.59 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $25.12 / $33.11 / $63.10
| Professional | TC | $25.12 | $33.11 | $63.10 |