- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $22.91 / $32.36 / $61.66
| Facility | 26 | $22.91 | $32.36 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $28.84 / $51.29
| Professional | | $23.99 | $28.84 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $16.98 / $23.99 / $32.36
| Professional | 26 | $16.98 | $23.99 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $26.30 / $41.69 / $47.86
| Professional | 52 | $26.30 | $41.69 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $3.02 / $3.98 / $28.84
| Professional | TC | $3.02 | $3.98 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $42.66 / $93.33
| Professional | | $25.12 | $42.66 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $17.78 / $25.70 / $51.29
| Professional | 26 | $17.78 | $25.70 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $3.16 / $9.12 / $46.77
| Professional | TC | $3.16 | $9.12 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.03 / $32.36 / $66.07
| Facility | 26 | $6.03 | $32.36 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $42.66 / $85.11
| Professional | | $24.55 | $42.66 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $18.20 / $28.18 / $64.57
| Professional | 26 | $18.20 | $28.18 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $3.02 / $6.17 / $45.71
| Professional | TC | $3.02 | $6.17 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $33.88 / $69.18
| Professional | | $22.91 | $33.88 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $15.85 / $23.44 / $44.67
| Professional | 26 | $15.85 | $23.44 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $3.02 / $5.01 / $38.90
| Professional | TC | $3.02 | $5.01 | $38.90 |