- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.94 / $16.22 / $44.67
| Facility | 26 | $7.94 | $16.22 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $51.29 / $269.15 / $912.01
| Facility | TC | $51.29 | $269.15 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $53.70 / $169.82
| Professional | | $20.42 | $53.70 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.00 / $22.91 / $53.70
| Professional | 26 | $10.00 | $22.91 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $46.77 / $123.03 / $257.04
| Professional | 50 | $46.77 | $123.03 | $257.04 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $43.65 / $43.65 / $43.65
| Professional | 52 | $43.65 | $43.65 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $28.18 / $46.77 / $104.71
| Professional | TC | $28.18 | $46.77 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $26.30 / $100.00 / $100.00
| Facility | 26 | $26.30 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $91.20 / $229.09 / $229.09
| Facility | TC | $91.20 | $229.09 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $57.54 / $295.12
| Professional | | $37.15 | $57.54 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.55 / $15.14 / $91.20
| Professional | 26 | $9.55 | $15.14 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $28.84 / $46.77 / $229.09
| Professional | TC | $28.84 | $46.77 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.59 / $21.88 / $28.84
| Professional | 26 | $12.59 | $21.88 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $45.71 / $45.71 / $67.61
| Professional | TC | $45.71 | $45.71 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $28.18 / $28.18 / $28.18
| Facility | TC | $28.18 | $28.18 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $67.61 / $128.82
| Professional | | $37.15 | $67.61 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.33 / $16.60 / $30.90
| Professional | 26 | $9.33 | $16.60 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $28.18 / $53.70 / $97.72
| Professional | TC | $28.18 | $53.70 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $54.95 / $93.33
| Professional | | $14.13 | $54.95 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $77.62 / $154.88
| Professional | | $51.29 | $77.62 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $11.22 / $16.98 / $30.20
| Professional | 26 | $11.22 | $16.98 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $39.81 / $56.23 / $107.15
| Professional | TC | $39.81 | $56.23 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $23.44 / $74.13
| Professional | | $16.22 | $23.44 | $74.13 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $26.30 / $100.00 / $100.00
| Facility | 26 | $26.30 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $91.20 / $229.09 / $229.09
| Facility | TC | $91.20 | $229.09 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $57.54 / $295.12
| Professional | | $37.15 | $57.54 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.55 / $15.14 / $91.20
| Professional | 26 | $9.55 | $15.14 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $28.84 / $46.77 / $229.09
| Professional | TC | $28.84 | $46.77 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $47.86 / $83.18
| Professional | | $37.15 | $47.86 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $63.10 / $154.88
| Professional | | $41.69 | $63.10 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.72 / $15.49 / $38.02
| Professional | 26 | $10.72 | $15.49 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $30.90 / $46.77 / $107.15
| Professional | TC | $30.90 | $46.77 | $107.15 |