- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $28.18 / $33.88 / $50.12
| Facility | 26 | $28.18 | $33.88 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $69.18 / $204.17
| Professional | | $31.62 | $69.18 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $19.50 / $41.69 / $97.72
| Professional | 26 | $19.50 | $41.69 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $69.18 / $69.18 / $70.79
| Professional | 50 | $69.18 | $69.18 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $7.94 / $28.18 / $67.61
| Professional | TC | $7.94 | $28.18 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $51.29 / $87.10
| Professional | | $36.31 | $51.29 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $19.95 / $30.20 / $41.69
| Professional | 26 | $19.95 | $30.20 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $24.55 / $28.84 / $42.66
| Professional | TC | $24.55 | $28.84 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $33.88 / $52.48
| Professional | | $24.55 | $33.88 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $16.60 / $22.91 / $31.62
| Professional | 26 | $16.60 | $22.91 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $37.15 / $50.12 / $79.43
| Professional | 50 | $37.15 | $50.12 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $7.94 / $10.23 / $15.49
| Professional | TC | $7.94 | $10.23 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $38.02 / $74.13
| Professional | | $29.51 | $38.02 | $74.13 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.94 / $37.15 / $53.70
| Facility | 26 | $7.94 | $37.15 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $60.26 / $302.00
| Professional | | $33.11 | $60.26 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $22.39 / $38.90 / $151.36
| Professional | 26 | $22.39 | $38.90 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $10.72 / $28.18 / $147.91
| Professional | TC | $10.72 | $28.18 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $32.36 / $33.11
| Professional | | $17.38 | $32.36 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $46.77 / $93.33
| Professional | | $30.20 | $46.77 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $19.95 / $25.12 / $46.77
| Professional | 26 | $19.95 | $25.12 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $9.77 / $24.55 / $52.48
| Professional | TC | $9.77 | $24.55 | $52.48 |