- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.88 / $15.85 / $17.78
| Facility | 26 | $12.88 | $15.85 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $39.81 / $112.20
| Professional | | $17.38 | $39.81 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.02 / $19.95 / $46.77
| Professional | 26 | $12.02 | $19.95 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $10.00 / $25.12 / $56.23
| Professional | TC | $10.00 | $25.12 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $42.66 / $47.86
| Professional | | $11.22 | $42.66 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $13.49 / $14.45 / $16.22
| Professional | 26 | $13.49 | $14.45 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $27.54 / $29.51 / $33.88
| Professional | TC | $27.54 | $29.51 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $24.55 / $24.55 / $24.55
| Facility | 26 | $24.55 | $24.55 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $33.11 / $77.62
| Professional | | $15.85 | $33.11 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.76 / $12.02 / $28.18
| Professional | 26 | $6.76 | $12.02 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $9.55 / $22.39 / $54.95
| Professional | TC | $9.55 | $22.39 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $50.12 / $67.61
| Professional | | $38.90 | $50.12 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $13.49 / $16.22 / $22.91
| Professional | 26 | $13.49 | $16.22 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $25.70 / $33.88 / $45.71
| Professional | TC | $25.70 | $33.88 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $38.90 / $81.28
| Professional | | $18.20 | $38.90 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.61 / $14.45 / $32.36
| Professional | 26 | $6.61 | $14.45 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $10.96 / $23.99 / $50.12
| Professional | TC | $10.96 | $23.99 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $48.98 / $67.61
| Professional | | $16.22 | $48.98 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.62 / $15.85 / $22.91
| Professional | 26 | $5.62 | $15.85 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $10.72 / $33.11 / $45.71
| Professional | TC | $10.72 | $33.11 | $45.71 |