- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.30 / $15.49 / $16.98
| Facility | 26 | $12.30 | $15.49 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $30.90 / $75.86
| Professional | | $20.89 | $30.90 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $8.91 / $19.95
| Professional | 26 | $7.08 | $8.91 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $13.80 / $19.95 / $30.20
| Professional | TC | $13.80 | $19.95 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $36.31 / $46.77
| Professional | | $31.62 | $36.31 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.47 / $12.02 / $15.49
| Professional | 26 | $10.47 | $12.02 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $21.38 / $24.55 / $31.62
| Professional | TC | $21.38 | $24.55 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $26.92 / $46.77
| Professional | | $10.23 | $26.92 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $2.29 / $10.72 / $15.14
| Facility | 26 | $2.29 | $10.72 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $38.90 / $58.88
| Professional | | $25.70 | $38.90 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.91 / $12.88 / $19.50
| Professional | 26 | $8.91 | $12.88 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.85 / $25.70 / $40.74
| Professional | TC | $15.85 | $25.70 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $36.31 / $64.57
| Professional | | $24.55 | $36.31 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.32 / $11.48 / $20.89
| Professional | 26 | $8.32 | $11.48 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $16.22 / $22.91 / $43.65
| Professional | TC | $16.22 | $22.91 | $43.65 |