- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $17.38 / $32.36 / $87.10
| Facility | 26 | $17.38 | $32.36 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $25.70 / $64.57
| Professional | | $18.20 | $25.70 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $15.49 / $37.15 / $134.90
| Professional | 26 | $15.49 | $37.15 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $3.98 / $6.03 / $14.79
| Professional | TC | $3.98 | $6.03 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $26.30 / $66.07
| Professional | | $12.59 | $26.30 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.33 / $19.05 / $48.98
| Professional | 26 | $9.33 | $19.05 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $3.16 / $6.31 / $17.38
| Professional | TC | $3.16 | $6.31 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.75 / $30.90 / $75.86
| Facility | 26 | $5.75 | $30.90 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $27.54 / $56.23
| Professional | | $14.13 | $27.54 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.47 / $20.42 / $43.65
| Professional | 26 | $10.47 | $20.42 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $3.39 / $6.92 / $15.14
| Professional | TC | $3.39 | $6.92 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $30.20 / $74.13
| Professional | | $16.98 | $30.20 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.59 / $22.91 / $67.61
| Professional | 26 | $12.59 | $22.91 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $4.07 / $7.08 / $15.85
| Professional | TC | $4.07 | $7.08 | $15.85 |