- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $64.57 / $72.44 / $93.33
| Facility | 26 | $64.57 | $72.44 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $117.49 / $186.21 / $380.19
| Professional | | $117.49 | $186.21 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $42.66 / $61.66 / $138.04
| Professional | 26 | $42.66 | $61.66 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $79.43 / $125.89 / $158.49
| Professional | TC | $79.43 | $125.89 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $58.88 / $58.88 / $61.66
| Professional | 26 | $58.88 | $58.88 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $199.53 / $229.09 / $251.19
| Professional | | $199.53 | $229.09 | $251.19 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $64.57 / $83.18 / $93.33
| Professional | 26 | $64.57 | $83.18 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $131.83 / $141.25 / $158.49
| Professional | TC | $131.83 | $141.25 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $39.81 / $51.29 / $53.70
| Professional | 26 | $39.81 | $51.29 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $102.33 / $186.21 / $371.54
| Professional | | $102.33 | $186.21 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $34.67 / $63.10 / $120.23
| Professional | 26 | $34.67 | $63.10 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $69.18 / $123.03 / $251.19
| Professional | TC | $69.18 | $123.03 | $251.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $134.90 / $190.55 / $263.03
| Professional | | $134.90 | $190.55 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $46.77 / $58.88 / $89.13
| Professional | 26 | $46.77 | $58.88 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $87.10 / $123.03 / $181.97
| Professional | TC | $87.10 | $123.03 | $181.97 |