- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.24 / $7.94 / $35.48
| Facility | 26 | $7.24 | $7.94 | $35.48 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $26.30 / $87.10 / $302.00
| Facility | TC | $26.30 | $87.10 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $33.11 / $69.18
| Professional | | $12.88 | $33.11 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.01 / $8.91 / $19.95
| Professional | 26 | $5.01 | $8.91 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $16.98 / $25.70 / $54.95
| Professional | TC | $16.98 | $25.70 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $41.69 / $56.23
| Professional | | $26.30 | $41.69 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.62 / $8.91 / $12.02
| Professional | 26 | $5.62 | $8.91 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.89 / $32.36 / $43.65
| Professional | TC | $20.89 | $32.36 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $39.81 / $72.44
| Professional | | $25.12 | $39.81 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.03 / $9.12 / $17.78
| Professional | 26 | $6.03 | $9.12 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.05 / $30.90 / $57.54
| Professional | TC | $19.05 | $30.90 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $43.65 / $81.28
| Professional | | $33.88 | $43.65 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.59 / $9.55 / $17.78
| Professional | 26 | $7.59 | $9.55 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $26.92 / $33.88 / $64.57
| Professional | TC | $26.92 | $33.88 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.41 / $7.59 / $891.25
| Facility | 26 | $7.41 | $7.59 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $23.99 / $26.30 / $3,162.28
| Facility | TC | $23.99 | $26.30 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $36.31 / $64.57
| Professional | | $26.30 | $36.31 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.50 / $8.32 / $15.14
| Professional | 26 | $5.50 | $8.32 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.95 / $27.54 / $51.29
| Professional | TC | $19.95 | $27.54 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $41.69 / $95.50
| Professional | | $28.18 | $41.69 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.61 / $9.55 / $39.81
| Professional | 26 | $6.61 | $9.55 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $21.88 / $31.62 / $89.13
| Professional | TC | $21.88 | $31.62 | $89.13 |