- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.13 / $21.88 / $39.81
| Facility | 26 | $5.13 | $21.88 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $30.20 / $61.66 / $151.36
| Facility | TC | $30.20 | $61.66 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $33.11 / $89.13
| Professional | | $11.48 | $33.11 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.01 / $8.71 / $21.88
| Professional | 26 | $5.01 | $8.71 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $16.98 / $25.12 / $56.23
| Professional | TC | $16.98 | $25.12 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $18.62 / $35.48
| Professional | | $18.62 | $18.62 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $4.90 / $5.37 / $9.77
| Professional | 26 | $4.90 | $5.37 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.42 / $20.89 / $24.55
| Professional | TC | $20.42 | $20.89 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $1,000.00 / $1,000.00 / $1,000.00
| Facility | TC | $1,000.00 | $1,000.00 | $1,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $45.71 / $93.33
| Professional | | $36.31 | $45.71 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.59 / $7.59 / $14.13
| Professional | 26 | $7.59 | $7.59 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $4.37 / $4.37 / $4.37
| Facility | 26 | $4.37 | $4.37 | $4.37 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $11.22 / $11.22 / $11.22
| Facility | TC | $11.22 | $11.22 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $36.31 / $63.10
| Professional | | $22.91 | $36.31 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $4.90 / $7.94 / $13.49
| Professional | 26 | $4.90 | $7.94 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $16.60 / $25.70 / $46.77
| Professional | TC | $16.60 | $25.70 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $40.74 / $48.98
| Professional | | $29.51 | $40.74 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.31 / $8.71 / $10.47
| Professional | 26 | $6.31 | $8.71 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $23.44 / $32.36 / $38.90
| Professional | TC | $23.44 | $32.36 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $25.12 / $9,120.11 / $25,118.86
| Facility | TC | $25.12 | $9,120.11 | $25,118.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $30.20 / $69.18
| Professional | | $27.54 | $30.20 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.50 / $6.46 / $12.02
| Professional | 26 | $5.50 | $6.46 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.05 / $23.44 / $46.77
| Professional | TC | $19.05 | $23.44 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $31.62 / $54.95
| Professional | | $19.95 | $31.62 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $4.79 / $7.41 / $12.88
| Professional | 26 | $4.79 | $7.41 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.49 / $24.55 / $44.67
| Professional | TC | $15.49 | $24.55 | $44.67 |