- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $398.11 / $870.96 / $1,230.27
| Facility | 26 | $398.11 | $870.96 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $2,511.89 / $10,715.19
| Professional | | $1,548.82 | $2,511.89 | $10,715.19 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $389.05 / $630.96 / $1,949.84
| Professional | 26 | $389.05 | $630.96 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $1,202.26 / $2,041.74 / $8,317.64
| Professional | TC | $1,202.26 | $2,041.74 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $1,318.26 / $1,318.26 / $1,318.26
| Facility | 26 | $1,318.26 | $1,318.26 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $4,466.84 / $5,623.41
| Professional | | $3,801.89 | $4,466.84 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $912.01 / $1,000.00 / $1,258.93
| Professional | 26 | $912.01 | $1,000.00 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $2,951.21 / $3,467.37 / $4,365.16
| Professional | TC | $2,951.21 | $3,467.37 | $4,365.16 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $2,511.89 / $6,606.93
| Professional | | $1,621.81 | $2,511.89 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $436.52 / $676.08 / $1,584.89
| Professional | 26 | $436.52 | $676.08 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $1,380.38 / $2,137.96 / $5,623.41
| Professional | TC | $1,380.38 | $2,137.96 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $1,288.25 / $1,905.46 / $1,905.46
| Facility | 26 | $1,288.25 | $1,905.46 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,905.46 / $3,235.94 / $11,748.98
| Professional | | $1,905.46 | $3,235.94 | $11,748.98 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $446.68 / $549.54 / $2,818.38
| Professional | 26 | $446.68 | $549.54 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $1,288.25 / $1,905.46 / $8,912.51
| Professional | TC | $1,288.25 | $1,905.46 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,630.78 / $4,168.69 / $5,370.32
| Professional | | $3,630.78 | $4,168.69 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $851.14 / $977.24 / $1,445.44
| Professional | 26 | $851.14 | $977.24 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $2,754.23 / $3,235.94 / $3,890.45
| Professional | TC | $2,754.23 | $3,235.94 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $1,318.26 / $1,318.26 / $1,318.26
| Facility | 26 | $1,318.26 | $1,318.26 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,365.16 / $4,365.16 / $4,897.79
| Professional | | $4,365.16 | $4,365.16 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $1,000.00 / $1,000.00 / $1,122.02
| Professional | 26 | $1,000.00 | $1,000.00 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $3,388.44 / $3,388.44 / $3,801.89
| Professional | TC | $3,388.44 | $3,388.44 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $1,584.89 / $3,388.44
| Professional | | $436.52 | $1,584.89 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,778.28 / $2,398.83 / $4,073.80
| Professional | | $1,778.28 | $2,398.83 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $416.87 / $537.03 / $954.99
| Professional | 26 | $416.87 | $537.03 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $1,380.38 / $1,819.70 / $3,235.94
| Professional | TC | $1,380.38 | $1,819.70 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,691.53 / $3,388.44 / $4,073.80
| Professional | | $2,691.53 | $3,388.44 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $616.60 / $776.25 / $912.01
| Professional | 26 | $616.60 | $776.25 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $2,089.30 / $2,630.27 / $3,090.30
| Professional | TC | $2,089.30 | $2,630.27 | $3,090.30 |