- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $691.83 / $954.99 / $1,096.48
| Facility | 26 | $691.83 | $954.99 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,862.09 / $2,511.89 / $10,232.93
| Professional | | $1,862.09 | $2,511.89 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $380.19 / $691.83 / $1,819.70
| Professional | 26 | $380.19 | $691.83 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $1,445.44 / $1,949.84 / $4,265.80
| Professional | TC | $1,445.44 | $1,949.84 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,691.53 / $3,715.35 / $5,495.41
| Professional | | $2,691.53 | $3,715.35 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $524.81 / $794.33 / $1,148.15
| Professional | 26 | $524.81 | $794.33 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $2,089.30 / $2,951.21 / $4,365.16
| Professional | TC | $2,089.30 | $2,951.21 | $4,365.16 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,981.07 / $4,677.35 / $5,128.61
| Professional | | $3,981.07 | $4,677.35 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $812.83 / $977.24 / $1,122.02
| Professional | 26 | $812.83 | $977.24 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $3,019.95 / $3,630.78 / $3,981.07
| Professional | TC | $3,019.95 | $3,630.78 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $537.03 / $954.99 / $1,096.48
| Facility | 26 | $537.03 | $954.99 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $3,715.35 / $6,025.60
| Professional | | $2,137.96 | $3,715.35 | $6,025.60 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $436.52 / $870.96 / $1,380.38
| Professional | 26 | $436.52 | $870.96 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $1,737.80 / $3,090.30 / $4,570.88
| Professional | TC | $1,737.80 | $3,090.30 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $1,047.13 / $3,388.44
| Professional | | $630.96 | $1,047.13 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $4,073.80 / $5,370.32
| Professional | | $2,951.21 | $4,073.80 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $588.84 / $812.83 / $1,174.90
| Professional | 26 | $588.84 | $812.83 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $2,238.72 / $3,235.94 / $4,265.80
| Professional | TC | $2,238.72 | $3,235.94 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $3,981.07 / $3,981.07 / $3,981.07
| Facility | 26 | $3,981.07 | $3,981.07 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,388.44 / $4,265.80 / $5,128.61
| Professional | | $3,388.44 | $4,265.80 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $741.31 / $933.25 / $1,174.90
| Professional | 26 | $741.31 | $933.25 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $2,630.27 / $3,311.31 / $4,073.80
| Professional | TC | $2,630.27 | $3,311.31 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $2,454.71 / $5,128.61
| Professional | | $2,344.23 | $2,454.71 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $281.84 / $537.03 / $1,122.02
| Professional | 26 | $281.84 | $537.03 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $1,698.24 / $1,949.84 / $4,265.80
| Professional | TC | $1,698.24 | $1,949.84 | $4,265.80 |