- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $48.98 / $128.82 / $218.78
| Facility | 26 | $48.98 | $128.82 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $107.15 / $416.87
| Professional | | $79.43 | $107.15 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $42.66 / $57.54 / $144.54
| Professional | 26 | $42.66 | $57.54 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $34.67 / $54.95 / $123.03
| Professional | TC | $34.67 | $54.95 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $51.29 / $53.70 / $89.13
| Professional | 26 | $51.29 | $53.70 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $93.33 / $114.82 / $234.42
| Professional | | $93.33 | $114.82 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $50.12 / $63.10 / $109.65
| Professional | 26 | $50.12 | $63.10 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $42.66 / $54.95 / $177.83
| Professional | TC | $42.66 | $54.95 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $141.25 / $245.47
| Professional | | $85.11 | $141.25 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $41.69 / $58.88 / $95.50
| Professional | 26 | $41.69 | $58.88 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $40.74 / $72.44 / $173.78
| Professional | TC | $40.74 | $72.44 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $123.03 / $123.03 / $158.49
| Professional | | $123.03 | $123.03 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $66.07 / $66.07 / $81.28
| Professional | 26 | $66.07 | $66.07 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $57.54 / $57.54 / $77.62
| Professional | TC | $57.54 | $57.54 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $107.15 / $151.36 / $263.03
| Professional | | $107.15 | $151.36 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $38.02 / $60.26 / $97.72
| Professional | 26 | $38.02 | $60.26 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $52.48 / $91.20 / $162.18
| Professional | TC | $52.48 | $91.20 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $53.70 / $120.23 / $245.47
| Professional | | $53.70 | $120.23 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $54.95 / $58.88 / $85.11
| Professional | 26 | $54.95 | $58.88 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $51.29 / $53.70 / $67.61
| Professional | 26 | $51.29 | $53.70 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $47.86 / $74.13 / $158.49
| Facility | 26 | $47.86 | $74.13 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $114.82 / $223.87
| Professional | | $79.43 | $114.82 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $41.69 / $57.54 / $109.65
| Professional | 26 | $41.69 | $57.54 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $37.15 / $61.66 / $107.15
| Professional | TC | $37.15 | $61.66 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $169.82 / $269.15
| Professional | | $141.25 | $169.82 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $48.98 / $48.98 / $51.29
| Facility | 26 | $48.98 | $48.98 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $89.13 / $194.98
| Professional | | $11.75 | $89.13 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $47.86 / $48.98 / $51.29
| Professional | 26 | $47.86 | $48.98 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $40.74 / $41.69 / $169.82
| Professional | TC | $40.74 | $41.69 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $120.23 / $199.53
| Professional | | $83.18 | $120.23 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $43.65 / $57.54 / $95.50
| Professional | 26 | $43.65 | $57.54 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $37.15 / $56.23 / $134.90
| Professional | TC | $37.15 | $56.23 | $134.90 |