- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $60.26 / $66.07 / $75.86
| Facility | 26 | $60.26 | $66.07 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $131.83 / $223.87 / $851.14
| Professional | | $131.83 | $223.87 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $66.07 / $102.33 / $269.15
| Professional | 26 | $66.07 | $102.33 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $173.78 / $245.47
| Professional | | $141.25 | $173.78 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $85.11 / $89.13 / $123.03
| Professional | 26 | $85.11 | $89.13 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $69.18 / $138.04 / $190.55
| Professional | | $69.18 | $138.04 | $190.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $158.49 / $234.42 / $389.05
| Professional | | $158.49 | $234.42 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $83.18 / $138.04 / $138.04
| Professional | 26 | $83.18 | $138.04 | $138.04 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $21.88 / $102.33 / $144.54
| Facility | 26 | $21.88 | $102.33 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $144.54 / $199.53 / $380.19
| Professional | | $144.54 | $199.53 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $74.13 / $100.00 / $194.98
| Professional | 26 | $74.13 | $100.00 | $194.98 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $575.44 / $575.44 / $575.44
| Facility | 26 | $575.44 | $575.44 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $1,479.11 / $1,513.56
| Professional | | $1,479.11 | $1,479.11 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $630.96 / $707.95 / $707.95
| Professional | 26 | $630.96 | $707.95 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $60.26 / $75.86 / $120.23
| Facility | 26 | $60.26 | $75.86 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $131.83 / $229.09 / $467.74
| Professional | | $131.83 | $229.09 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $67.61 / $114.82 / $223.87
| Professional | 26 | $67.61 | $114.82 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $75.86 / $154.88
| Professional | | $32.36 | $75.86 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $89.13 / $177.83 / $398.11
| Professional | | $89.13 | $177.83 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $22.91 / $107.15 / $151.36
| Facility | 26 | $22.91 | $107.15 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $144.54 / $190.55 / $389.05
| Professional | | $144.54 | $190.55 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $74.13 / $93.33 / $173.78
| Professional | 26 | $74.13 | $93.33 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $194.98 / $346.74
| Professional | | $141.25 | $194.98 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $77.62 / $100.00 / $190.55
| Professional | 26 | $77.62 | $100.00 | $190.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $173.78 / $181.97 / $218.78
| Professional | | $173.78 | $181.97 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $91.20 / $91.20 / $109.65
| Professional | 26 | $91.20 | $91.20 | $109.65 |