- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.01 / $8.71 / $26.30
| Facility | 26 | $5.01 | $8.71 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $32.36 / $95.50
| Professional | | $17.78 | $32.36 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.03 / $10.72 / $31.62
| Professional | 26 | $6.03 | $10.72 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $50.12 / $109.65 / $190.55
| Professional | 50 | $50.12 | $109.65 | $190.55 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $21.88 / $30.20 / $107.15
| Professional | 52 | $21.88 | $30.20 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $14.13 / $21.38 / $47.86
| Professional | TC | $14.13 | $21.38 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $23.44 / $50.12
| Professional | | $19.05 | $23.44 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $4.47 / $7.08 / $13.49
| Professional | 26 | $4.47 | $7.08 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $27.54 / $31.62 / $33.11
| Professional | 50 | $27.54 | $31.62 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.14 / $24.55 / $40.74
| Professional | TC | $15.14 | $24.55 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $20.42 / $22.39
| Professional | | $16.98 | $20.42 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $1.86 / $8.71 / $15.14
| Facility | 26 | $1.86 | $8.71 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $28.18 / $58.88
| Professional | | $19.50 | $28.18 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.50 / $8.91 / $17.78
| Professional | 26 | $5.50 | $8.91 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $13.80 / $20.89 / $45.71
| Professional | TC | $13.80 | $20.89 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.51 / $8.51 / $8.51
| Facility | 26 | $8.51 | $8.51 | $8.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $25.12 / $38.02
| Professional | | $19.50 | $25.12 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.37 / $7.59 / $11.22
| Professional | 26 | $5.37 | $7.59 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $14.13 / $17.38 / $27.54
| Professional | TC | $14.13 | $17.38 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $19.95 / $33.11
| Professional | | $5.50 | $19.95 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $26.92 / $58.88
| Professional | | $20.89 | $26.92 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.17 / $7.94 / $17.38
| Professional | 26 | $6.17 | $7.94 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $14.45 / $18.62 / $39.81
| Professional | TC | $14.45 | $18.62 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $17.78 / $29.51
| Professional | | $17.78 | $17.78 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $4.79 / $4.79 / $7.94
| Professional | 26 | $4.79 | $4.79 | $7.94 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $12.88 / $12.88 / $21.38
| Professional | TC | $12.88 | $12.88 | $21.38 |