- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $58.88 / $89.13
| Professional | | $30.90 | $58.88 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $19.50 / $25.70 / $54.95
| Professional | 26 | $19.50 | $25.70 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $97.72 / $102.33
| Professional | | $79.43 | $97.72 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $33.88 / $42.66 / $44.67
| Professional | 26 | $33.88 | $42.66 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $72.44 / $100.00
| Professional | | $44.67 | $72.44 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $22.39 / $34.67 / $46.77
| Professional | 26 | $22.39 | $34.67 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $57.54 / $85.11 / $104.71
| Professional | | $57.54 | $85.11 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $24.55 / $35.48 / $43.65
| Professional | 26 | $24.55 | $35.48 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $33.11
| Professional | | $32.36 | $33.11 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $66.07 / $77.62 / $107.15
| Professional | | $66.07 | $77.62 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $26.92 / $31.62 / $50.12
| Professional | 26 | $26.92 | $31.62 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $50.12 / $91.20
| Professional | | $47.86 | $50.12 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $20.89 / $20.89 / $38.90
| Professional | 26 | $20.89 | $20.89 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $52.48 / $79.43
| Professional | | $38.02 | $52.48 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $22.91 / $30.20 / $38.90
| Professional | 26 | $22.91 | $30.20 | $38.90 |