- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $16.98 / $19.05 / $25.12
| Facility | 26 | $16.98 | $19.05 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $40.74 / $79.43
| Professional | | $19.05 | $40.74 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.91 / $16.98 / $38.02
| Professional | 26 | $8.91 | $16.98 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $10.00 / $25.12 / $36.31
| Professional | TC | $10.00 | $25.12 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $13.80 / $15.49 / $20.89
| Professional | 26 | $13.80 | $15.49 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $52.48 / $60.26
| Professional | | $28.18 | $52.48 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $13.49 / $19.50 / $24.55
| Professional | 26 | $13.49 | $19.50 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $13.80 / $33.11 / $35.48
| Professional | TC | $13.80 | $33.11 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $14.13 / $15.85 / $15.85
| Professional | 26 | $14.13 | $15.85 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $33.11 / $70.79
| Professional | | $14.13 | $33.11 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.76 / $14.13 / $27.54
| Professional | 26 | $7.76 | $14.13 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $9.33 / $21.88 / $42.66
| Professional | TC | $9.33 | $21.88 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $38.02 / $56.23
| Professional | | $16.22 | $38.02 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.76 / $14.45 / $21.38
| Professional | 26 | $6.76 | $14.45 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $9.33 / $23.99 / $35.48
| Professional | TC | $9.33 | $23.99 | $35.48 |