- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $97.72 / $120.23 / $123.03
| Facility | 26 | $97.72 | $120.23 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $309.03 / $512.86
| Professional | | $251.19 | $309.03 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $147.91 / $251.19 / $389.05
| Professional | | $147.91 | $251.19 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $28.84 / $134.90 / $194.98
| Facility | 26 | $28.84 | $134.90 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $512.86 / $1,047.13
| Professional | | $295.12 | $512.86 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $741.31 / $741.31 / $741.31
| Facility | 26 | $741.31 | $741.31 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $2,511.89 / $2,511.89
| Professional | | $2,238.72 | $2,511.89 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $107.15 / $123.03 / $158.49
| Facility | 26 | $107.15 | $123.03 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $346.74 / $812.83
| Professional | | $251.19 | $346.74 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $380.19
| Professional | | $32.36 | $33.11 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $1,230.27 / $1,412.54
| Professional | | $812.83 | $1,230.27 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $29.51 / $138.04 / $194.98
| Facility | 26 | $29.51 | $138.04 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $501.19 / $1,122.02
| Professional | | $288.40 | $501.19 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $549.54 / $954.99
| Professional | | $407.38 | $549.54 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $295.12 / $354.81
| Professional | | $281.84 | $295.12 | $354.81 |