- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $33.11 / $37.15 / $64.57
| Facility | 26 | $33.11 | $37.15 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $81.28 / $144.54
| Professional | | $61.66 | $81.28 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $33.88 / $44.67 / $87.10
| Professional | 26 | $33.88 | $44.67 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.39 / $36.31 / $56.23
| Professional | TC | $22.39 | $36.31 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $75.86 / $95.50
| Professional | | $70.79 | $75.86 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $39.81 / $48.98 / $64.57
| Professional | 26 | $39.81 | $48.98 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $67.61 / $109.65
| Professional | | $37.15 | $67.61 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $123.03 / $123.03
| Professional | | $85.11 | $123.03 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $39.81 / $57.54 / $57.54
| Professional | 26 | $39.81 | $57.54 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $69.18 / $95.50 / $162.18
| Professional | | $69.18 | $95.50 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $40.74 / $56.23 / $95.50
| Professional | 26 | $40.74 | $56.23 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $23.99 / $38.02 / $69.18
| Professional | TC | $23.99 | $38.02 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $263.03 / $263.03 / $263.03
| Facility | 26 | $263.03 | $263.03 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $645.65 / $645.65
| Professional | | $616.60 | $645.65 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $269.15 / $323.59 / $323.59
| Professional | 26 | $269.15 | $323.59 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $263.03 / $323.59 / $323.59
| Professional | TC | $263.03 | $323.59 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $33.11 / $40.74 / $64.57
| Facility | 26 | $33.11 | $40.74 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $85.11 / $147.91
| Professional | | $61.66 | $85.11 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $33.88 / $46.77 / $79.43
| Professional | 26 | $33.88 | $46.77 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $23.44 / $40.74 / $69.18
| Professional | TC | $23.44 | $40.74 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $66.07
| Professional | | $32.36 | $33.11 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $77.62 / $154.88
| Professional | | $38.90 | $77.62 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $69.18 / $95.50 / $162.18
| Professional | | $69.18 | $95.50 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $40.74 / $54.95 / $85.11
| Professional | 26 | $40.74 | $54.95 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $23.99 / $38.02 / $63.10
| Professional | TC | $23.99 | $38.02 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $75.86 / $125.89
| Professional | | $54.95 | $75.86 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $34.67 / $46.77 / $74.13
| Professional | 26 | $34.67 | $46.77 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $18.62 / $28.18 / $46.77
| Professional | TC | $18.62 | $28.18 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $79.43 / $95.50
| Professional | | $75.86 | $79.43 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $39.81 / $40.74 / $48.98
| Professional | 26 | $39.81 | $40.74 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $36.31 / $38.02 / $44.67
| Professional | TC | $36.31 | $38.02 | $44.67 |