- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $34.67 / $38.02 / $48.98
| Facility | 26 | $34.67 | $38.02 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $66.07 / $93.33 / $302.00
| Professional | | $66.07 | $93.33 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $32.36 / $43.65 / $97.72
| Professional | 26 | $32.36 | $43.65 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $30.90 / $44.67 / $190.55
| Professional | TC | $30.90 | $44.67 | $190.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $77.62 / $131.83
| Professional | | $52.48 | $77.62 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $28.18 / $38.02 / $69.18
| Professional | 26 | $28.18 | $38.02 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $61.66 / $87.10
| Professional | | $28.84 | $61.66 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $69.18 / $100.00 / $144.54
| Professional | | $69.18 | $100.00 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $35.48 / $39.81 / $39.81
| Professional | 26 | $35.48 | $39.81 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.12 / $42.66 / $61.66
| Facility | 26 | $9.12 | $42.66 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $91.20 / $213.80
| Professional | | $60.26 | $91.20 | $213.80 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $31.62 / $43.65 / $81.28
| Professional | 26 | $31.62 | $43.65 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $27.54 / $47.86 / $144.54
| Professional | TC | $27.54 | $47.86 | $144.54 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $239.88 / $239.88 / $239.88
| Facility | 26 | $239.88 | $239.88 | $239.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $707.95 / $1,071.52
| Professional | | $707.95 | $707.95 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $239.88 / $302.00 / $302.00
| Professional | 26 | $239.88 | $302.00 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $549.54 / $549.54 / $831.76
| Professional | TC | $549.54 | $549.54 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $34.67 / $38.02 / $50.12
| Facility | 26 | $34.67 | $38.02 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $66.07 / $104.71 / $316.23
| Professional | | $66.07 | $104.71 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $33.11 / $48.98 / $97.72
| Professional | 26 | $33.11 | $48.98 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $30.90 / $53.70 / $158.49
| Professional | TC | $30.90 | $53.70 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $33.11 / $63.10
| Professional | | $31.62 | $33.11 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $91.20 / $229.09
| Professional | | $38.90 | $91.20 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.33 / $43.65 / $63.10
| Facility | 26 | $9.33 | $43.65 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $91.20 / $208.93
| Professional | | $60.26 | $91.20 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $31.62 / $40.74 / $72.44
| Professional | 26 | $31.62 | $40.74 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $27.54 / $44.67 / $138.04
| Professional | TC | $27.54 | $44.67 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $87.10 / $177.83
| Professional | | $61.66 | $87.10 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $33.88 / $40.74 / $95.50
| Professional | 26 | $33.88 | $40.74 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $27.54 / $41.69 / $91.20
| Professional | TC | $27.54 | $41.69 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $79.43 / $95.50
| Professional | | $79.43 | $79.43 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $36.31 / $38.02 / $45.71
| Professional | 26 | $36.31 | $38.02 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $39.81 / $41.69 / $48.98
| Professional | TC | $39.81 | $41.69 | $48.98 |