- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $37.15 / $46.77 / $89.13
| Facility | 26 | $37.15 | $46.77 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $125.89 / $436.52
| Professional | | $52.48 | $125.89 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $33.11 / $57.54 / $104.71
| Professional | 26 | $33.11 | $57.54 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $95.50 / $158.49 / $158.49
| Professional | 52 | $95.50 | $158.49 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $70.79 / $93.33 / $223.87
| Professional | TC | $70.79 | $93.33 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $91.20 / $97.72 / $208.93
| Professional | | $91.20 | $97.72 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $28.18 / $38.02 / $64.57
| Professional | 26 | $28.18 | $38.02 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $112.20 / $131.83 / $229.09
| Professional | | $112.20 | $131.83 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $38.90 / $46.77 / $72.44
| Professional | 26 | $38.90 | $46.77 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $67.61 / $91.20 / $154.88
| Professional | TC | $67.61 | $91.20 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $125.89 / $134.90 / $186.21
| Professional | | $125.89 | $134.90 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $40.74 / $42.66 / $54.95
| Professional | 26 | $40.74 | $42.66 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $85.11 / $93.33 / $128.82
| Professional | TC | $85.11 | $93.33 | $128.82 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.33 / $43.65 / $61.66
| Facility | 26 | $9.33 | $43.65 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $104.71 / $162.18 / $275.42
| Professional | | $104.71 | $162.18 | $275.42 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $32.36 / $51.29 / $95.50
| Professional | 26 | $32.36 | $51.29 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $74.13 / $114.82 / $190.55
| Professional | TC | $74.13 | $114.82 | $190.55 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $91.20 / $173.78 / $173.78
| Facility | 26 | $91.20 | $173.78 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $123.03 / $165.96 / $812.83
| Professional | | $123.03 | $165.96 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $39.81 / $51.29 / $239.88
| Professional | 26 | $39.81 | $51.29 | $239.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $81.28 / $117.49 / $562.34
| Professional | TC | $81.28 | $117.49 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $112.20 / $151.36 / $251.19
| Professional | | $112.20 | $151.36 | $251.19 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $38.02 / $50.12 / $91.20
| Professional | 26 | $38.02 | $50.12 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $85.11 / $107.15 / $177.83
| Professional | TC | $85.11 | $107.15 | $177.83 |