- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.01 / $5.62 / $7.59
| Facility | 26 | $5.01 | $5.62 | $7.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $30.90 / $52.48
| Professional | | $23.99 | $30.90 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $23.99 / $36.31
| Professional | | $7.08 | $23.99 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $1.95 / $9.12 / $13.18
| Facility | 26 | $1.95 | $9.12 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $38.02 / $70.79
| Professional | | $26.92 | $38.02 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $70.79 / $70.79 / $85.11
| Facility | 26 | $70.79 | $70.79 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $288.40 / $288.40
| Professional | | $208.93 | $288.40 | $288.40 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.01 / $7.24 / $10.72
| Facility | 26 | $5.01 | $7.24 | $10.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $38.02 / $70.79
| Professional | | $23.99 | $38.02 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $32.36 / $33.11
| Professional | | $6.76 | $32.36 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $31.62 / $64.57
| Professional | | $8.32 | $31.62 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $2.04 / $9.55 / $13.49
| Facility | 26 | $2.04 | $9.55 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $36.31 / $75.86
| Professional | | $26.92 | $36.31 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $34.67 / $61.66
| Professional | | $27.54 | $34.67 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $34.67 / $41.69
| Professional | | $33.11 | $34.67 | $41.69 |