- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $22.39 / $48.98 / $70.79
| Facility | 26 | $22.39 | $48.98 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $64.57 / $245.47
| Professional | | $31.62 | $64.57 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $21.88 / $34.67 / $79.43
| Professional | 26 | $21.88 | $34.67 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $12.88 / $32.36 / $120.23
| Professional | TC | $12.88 | $32.36 | $120.23 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $89.13 / $89.13 / $89.13
| Facility | 26 | $89.13 | $89.13 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $87.10 / $97.72 / $123.03
| Professional | | $87.10 | $97.72 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $51.29 / $57.54 / $70.79
| Professional | 26 | $51.29 | $57.54 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $33.88 / $40.74 / $50.12
| Professional | TC | $33.88 | $40.74 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $72.44 / $229.09
| Professional | | $40.74 | $72.44 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $24.55 / $39.81 / $125.89
| Professional | 26 | $24.55 | $39.81 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $16.22 / $28.84 / $134.90
| Professional | TC | $16.22 | $28.84 | $134.90 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $87.10 / $120.23 / $120.23
| Facility | 26 | $87.10 | $120.23 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $95.50 / $389.05
| Professional | | $51.29 | $95.50 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $25.70 / $34.67 / $338.84
| Professional | 26 | $25.70 | $34.67 | $338.84 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.39 / $48.98 / $338.84
| Professional | TC | $22.39 | $48.98 | $338.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $102.33 / $281.84
| Professional | | $77.62 | $102.33 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $47.86 / $56.23 / $97.72
| Professional | 26 | $47.86 | $56.23 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $30.20 / $38.02 / $186.21
| Professional | TC | $30.20 | $38.02 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $89.13 / $89.13 / $89.13
| Facility | 26 | $89.13 | $89.13 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $95.50 / $95.50 / $102.33
| Professional | | $95.50 | $95.50 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $56.23 / $56.23 / $63.10
| Professional | 26 | $56.23 | $56.23 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $38.02 / $39.81 / $39.81
| Professional | TC | $38.02 | $39.81 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $33.88 / $70.79
| Professional | | $16.98 | $33.88 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $83.18 / $107.15
| Professional | | $48.98 | $83.18 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $25.70 / $33.11 / $53.70
| Professional | 26 | $25.70 | $33.11 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.39 / $35.48 / $63.10
| Professional | TC | $22.39 | $35.48 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $75.86 / $89.13
| Professional | | $60.26 | $75.86 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $35.48 / $44.67 / $52.48
| Professional | 26 | $35.48 | $44.67 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $24.55 / $31.62 / $37.15
| Professional | TC | $24.55 | $31.62 | $37.15 |