- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $16.60 / $37.15
| Facility | 26 | $7.08 | $16.60 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $46.77 / $338.84
| Professional | | $20.89 | $46.77 | $338.84 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.91 / $10.47 / $51.29
| Professional | 26 | $8.91 | $10.47 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $12.02 / $23.44 / $120.23
| Professional | TC | $12.02 | $23.44 | $120.23 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $21.88 / $38.90 / $131.83
| Facility | 26 | $21.88 | $38.90 | $131.83 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $67.61 / $67.61 / $67.61
| Facility | 53 | $67.61 | $67.61 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $46.77 / $812.83
| Professional | | $22.39 | $46.77 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.51 / $12.88 / $131.83
| Professional | 26 | $8.51 | $12.88 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $13.49 / $26.30 / $741.31
| Professional | TC | $13.49 | $26.30 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $67.61 / $177.83
| Professional | | $38.02 | $67.61 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.72 / $18.20 / $24.55
| Professional | 26 | $10.72 | $18.20 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $46.77 / $158.49
| Professional | | $20.89 | $46.77 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.59 / $14.13 / $27.54
| Professional | 26 | $7.59 | $14.13 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $13.18 / $31.62 / $144.54
| Professional | TC | $13.18 | $31.62 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $24.55 / $48.98
| Professional | | $12.02 | $24.55 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $35.48 / $72.44
| Professional | | $24.55 | $35.48 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.55 / $12.88 / $25.12
| Professional | 26 | $9.55 | $12.88 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $16.60 / $23.44 / $50.12
| Professional | TC | $16.60 | $23.44 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $15.85 / $77.62
| Professional | | $13.18 | $15.85 | $77.62 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $21.88 / $38.90 / $131.83
| Facility | 26 | $21.88 | $38.90 | $131.83 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $67.61 / $67.61 / $67.61
| Facility | 53 | $67.61 | $67.61 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $46.77 / $812.83
| Professional | | $22.39 | $46.77 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.51 / $12.88 / $131.83
| Professional | 26 | $8.51 | $12.88 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $13.49 / $26.30 / $741.31
| Professional | TC | $13.49 | $26.30 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $47.86 / $70.79
| Professional | | $29.51 | $47.86 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $47.86 / $147.91
| Professional | | $25.12 | $47.86 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.55 / $13.49 / $34.67
| Professional | 26 | $9.55 | $13.49 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $14.13 / $26.92 / $125.89
| Professional | TC | $14.13 | $26.92 | $125.89 |