- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $407.38 / $794.33 / $1,412.54
| Facility | 26 | $407.38 | $794.33 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $2,511.89 / $9,772.37
| Professional | | $1,737.80 | $2,511.89 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $371.54 / $776.25 / $2,041.74
| Professional | 26 | $371.54 | $776.25 | $2,041.74 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $1,230.27 / $1,905.46 / $5,248.07
| Professional | TC | $1,230.27 | $1,905.46 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $1,621.81 / $3,090.30
| Professional | | $1,548.82 | $1,621.81 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $363.08 / $588.84 / $851.14
| Professional | 26 | $363.08 | $588.84 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $2,454.71 / $2,454.71 / $2,454.71
| Facility | 26 | $2,454.71 | $2,454.71 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,511.89 / $3,890.45 / $5,754.40
| Professional | | $2,511.89 | $3,890.45 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $562.34 / $870.96 / $1,318.26
| Professional | 26 | $562.34 | $870.96 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $1,905.46 / $3,019.95 / $4,570.88
| Professional | TC | $1,905.46 | $3,019.95 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $3,630.78 / $6,025.60
| Professional | | $2,344.23 | $3,630.78 | $6,025.60 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $489.78 / $794.33 / $1,258.93
| Professional | 26 | $489.78 | $794.33 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $1,905.46 / $2,818.38 / $4,677.35
| Professional | TC | $1,905.46 | $2,818.38 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $537.03 / $954.99 / $6,025.60
| Facility | 26 | $537.03 | $954.99 | $6,025.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $4,168.69 / $5,495.41
| Professional | | $2,398.83 | $4,168.69 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $537.03 / $891.25 / $1,148.15
| Professional | 26 | $537.03 | $891.25 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $1,905.46 / $3,235.94 / $4,365.16
| Professional | TC | $1,905.46 | $3,235.94 | $4,365.16 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $954.99 / $3,090.30
| Professional | | $537.03 | $954.99 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $549.54 / $549.54 / $575.44
| Facility | 26 | $549.54 | $549.54 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,511.89 / $3,890.45 / $5,248.07
| Professional | | $2,511.89 | $3,890.45 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $575.44 / $891.25 / $1,202.26
| Professional | 26 | $575.44 | $891.25 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $1,949.84 / $3,019.95 / $4,073.80
| Professional | TC | $1,949.84 | $3,019.95 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $2,454.71 / $2,454.71 / $2,454.71
| Facility | 26 | $2,454.71 | $2,454.71 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,511.89 / $3,890.45 / $5,754.40
| Professional | | $2,511.89 | $3,890.45 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $588.84 / $870.96 / $1,318.26
| Professional | 26 | $588.84 | $870.96 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $2,041.74 / $2,951.21 / $4,466.84
| Professional | TC | $2,041.74 | $2,951.21 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $2,454.71 / $4,786.30
| Professional | | $1,819.70 | $2,454.71 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $323.59 / $524.81 / $1,071.52
| Professional | 26 | $323.59 | $524.81 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $1,380.38 / $1,949.84 / $3,630.78
| Professional | TC | $1,380.38 | $1,949.84 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $2,754.23 / $4,466.84
| Professional | | $2,344.23 | $2,754.23 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $467.74 / $575.44 / $870.96
| Professional | 26 | $467.74 | $575.44 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $1,862.09 / $2,187.76 / $3,548.13
| Professional | TC | $1,862.09 | $2,187.76 | $3,548.13 |