- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $32.36 / $74.13 / $107.15
| Facility | 26 | $32.36 | $74.13 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $87.10 / $154.88
| Professional | | $70.79 | $87.10 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $46.77 / $61.66 / $100.00
| Professional | TC | $46.77 | $61.66 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $89.13 / $165.96
| Professional | | $85.11 | $89.13 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $57.54 / $60.26 / $109.65
| Professional | TC | $57.54 | $60.26 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $114.82 / $194.98
| Professional | | $70.79 | $114.82 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $51.29 / $81.28 / $147.91
| Professional | TC | $51.29 | $81.28 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $89.13 / $120.23 / $144.54
| Professional | | $89.13 | $120.23 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $61.66 / $81.28 / $102.33
| Professional | TC | $61.66 | $81.28 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $102.33 / $177.83
| Professional | | $60.26 | $102.33 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $36.31 / $69.18 / $120.23
| Professional | TC | $36.31 | $69.18 | $120.23 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $26.92 / $60.26 / $104.71
| Facility | 26 | $26.92 | $60.26 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $85.11 / $141.25
| Professional | | $70.79 | $85.11 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $46.77 / $61.66 / $95.50
| Professional | TC | $46.77 | $61.66 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $102.33 / $208.93
| Professional | | $50.12 | $102.33 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $27.54 / $27.54 / $31.62
| Facility | 26 | $27.54 | $27.54 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $70.79 / $93.33
| Professional | | $38.90 | $70.79 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $47.86 / $58.88 / $64.57
| Professional | TC | $47.86 | $58.88 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $72.44 / $104.71 / $186.21
| Professional | | $72.44 | $104.71 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $50.12 / $74.13 / $131.83
| Professional | TC | $50.12 | $74.13 | $131.83 |