- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.96 / $17.78 / $27.54
| Facility | 26 | $10.96 | $17.78 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $53.70 / $223.87
| Professional | | $34.67 | $53.70 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.96 / $17.38 / $58.88
| Professional | 26 | $10.96 | $17.38 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $144.54 / $144.54 / $144.54
| Professional | 52 | $144.54 | $144.54 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.39 / $30.20 / $89.13
| Professional | TC | $22.39 | $30.20 | $89.13 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $47.86 / $47.86 / $47.86
| Facility | 26 | $47.86 | $47.86 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $107.15 / $134.90
| Professional | | $43.65 | $107.15 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $13.18 / $30.20 / $38.02
| Professional | 26 | $13.18 | $30.20 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $26.92 / $77.62 / $97.72
| Professional | TC | $26.92 | $77.62 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $72.44 / $165.96
| Professional | | $40.74 | $72.44 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.02 / $17.38 / $43.65
| Professional | 26 | $12.02 | $17.38 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $28.18 / $41.69 / $87.10
| Professional | TC | $28.18 | $41.69 | $87.10 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $46.77 / $79.43 / $79.43
| Facility | 26 | $46.77 | $79.43 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $69.18 / $288.40
| Professional | | $38.90 | $69.18 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $13.49 / $18.20 / $83.18
| Professional | 26 | $13.49 | $18.20 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $23.44 / $36.31 / $208.93
| Professional | TC | $23.44 | $36.31 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $97.72 / $114.82
| Professional | | $83.18 | $97.72 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $26.30 / $31.62 / $33.11
| Professional | 26 | $26.30 | $31.62 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $50.12 / $69.18 / $81.28
| Professional | TC | $50.12 | $69.18 | $81.28 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $47.86 / $47.86 / $47.86
| Facility | 26 | $47.86 | $47.86 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $107.15 / $112.20
| Professional | | $77.62 | $107.15 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $28.84 / $30.20 / $32.36
| Professional | 26 | $28.84 | $30.20 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $48.98 / $75.86 / $81.28
| Professional | TC | $48.98 | $75.86 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $34.67 / $79.43
| Professional | | $13.80 | $34.67 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $61.66 / $120.23
| Professional | | $38.90 | $61.66 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $13.49 / $22.39 / $85.11
| Professional | 26 | $13.49 | $22.39 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $26.30 / $39.81 / $95.50
| Professional | TC | $26.30 | $39.81 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $83.18 / $97.72
| Professional | | $83.18 | $83.18 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $23.99 / $23.99 / $28.18
| Professional | 26 | $23.99 | $23.99 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $60.26 / $60.26 / $70.79
| Professional | TC | $60.26 | $60.26 | $70.79 |