- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.96 / $12.02 / $12.88
| Facility | 26 | $10.96 | $12.02 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $44.67 / $75.86
| Professional | | $25.12 | $44.67 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.02 / $15.49 / $34.67
| Professional | 26 | $12.02 | $15.49 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $12.02 / $28.84 / $44.67
| Professional | TC | $12.02 | $28.84 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $13.49 / $13.49 / $13.49
| Professional | 26 | $13.49 | $13.49 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $25.70 / $33.88
| Professional | | $12.59 | $25.70 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $3.55 / $16.60 / $23.44
| Facility | 26 | $3.55 | $16.60 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $50.12 / $100.00
| Professional | | $31.62 | $50.12 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.88 / $19.95 / $40.74
| Professional | 26 | $12.88 | $19.95 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.14 / $30.20 / $61.66
| Professional | TC | $15.14 | $30.20 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $30.20 / $46.77
| Professional | | $11.48 | $30.20 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.31 / $10.72 / $16.22
| Professional | 26 | $6.31 | $10.72 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $5.13 / $20.42 / $27.54
| Professional | TC | $5.13 | $20.42 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $32.36 / $60.26
| Professional | | $14.13 | $32.36 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $33.88 / $67.61
| Professional | | $21.88 | $33.88 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $11.22 / $15.49 / $28.84
| Professional | 26 | $11.22 | $15.49 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $9.55 / $18.20 / $39.81
| Professional | TC | $9.55 | $18.20 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $28.84 / $46.77
| Professional | | $28.84 | $28.84 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.33 / $9.33 / $15.14
| Professional | 26 | $9.33 | $9.33 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.50 / $19.50 / $32.36
| Professional | TC | $19.50 | $19.50 | $32.36 |