- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $52.48 / $83.18 / $177.83
| Facility | 26 | $52.48 | $83.18 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $147.91 / $338.84 / $977.24
| Professional | | $147.91 | $338.84 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $61.66 / $109.65 / $331.13
| Professional | 26 | $61.66 | $109.65 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $138.04 / $478.63 / $1,778.28
| Professional | 50 | $138.04 | $478.63 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $1,023.29
| Professional | 52 | $100.00 | $100.00 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $141.25 / $245.47 / $512.86
| Professional | TC | $141.25 | $245.47 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $151.36 / $190.55 / $398.11
| Professional | | $151.36 | $190.55 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $47.86 / $66.07 / $125.89
| Professional | 26 | $47.86 | $66.07 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $107.15 / $134.90 / $147.91
| Professional | TC | $107.15 | $134.90 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $162.18 / $218.78
| Professional | | $50.12 | $162.18 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $194.98 / $295.12 / $707.95
| Professional | | $194.98 | $295.12 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $60.26 / $114.82 / $114.82
| Professional | 26 | $60.26 | $114.82 | $114.82 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $15.49 / $72.44 / $104.71
| Facility | 26 | $15.49 | $72.44 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $371.54 / $741.31
| Professional | | $190.55 | $371.54 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $53.70 / $81.28 / $144.54
| Professional | 26 | $53.70 | $81.28 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $131.83 / $263.03 / $575.44
| Professional | TC | $131.83 | $263.03 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $407.38 / $407.38 / $407.38
| Facility | 26 | $407.38 | $407.38 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $2,884.03 / $2,884.03
| Professional | | $251.19 | $2,884.03 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $537.03 / $537.03 / $537.03
| Professional | 26 | $537.03 | $537.03 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $2,511.89 / $2,511.89 / $2,511.89
| Professional | TC | $2,511.89 | $2,511.89 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $54.95 / $69.18 / $120.23
| Facility | 26 | $54.95 | $69.18 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $338.84 / $870.96
| Professional | | $186.21 | $338.84 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $60.26 / $104.71 / $223.87
| Professional | 26 | $60.26 | $104.71 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $138.04 / $478.63 / $1,778.28
| Professional | 50 | $138.04 | $478.63 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $1,023.29
| Professional | 52 | $100.00 | $100.00 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $134.90 / $229.09 / $501.19
| Professional | TC | $134.90 | $229.09 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $165.96
| Professional | | $32.36 | $33.11 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $66.07 / $194.98 / $575.44
| Professional | | $66.07 | $194.98 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $15.85 / $74.13 / $107.15
| Facility | 26 | $15.85 | $74.13 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $371.54 / $707.95
| Professional | | $186.21 | $371.54 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $53.70 / $81.28 / $134.90
| Professional | 26 | $53.70 | $81.28 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $128.82 / $263.03 / $562.34
| Professional | TC | $128.82 | $263.03 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $309.03 / $676.08
| Professional | | $186.21 | $309.03 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $54.95 / $69.18 / $151.36
| Professional | 26 | $54.95 | $69.18 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $131.83 / $213.80 / $524.81
| Professional | TC | $131.83 | $213.80 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $194.98 / $204.17 / $245.47
| Professional | | $194.98 | $204.17 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $61.66 / $64.57 / $75.86
| Professional | 26 | $61.66 | $64.57 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $134.90 / $141.25 / $169.82
| Professional | TC | $134.90 | $141.25 | $169.82 |