- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $23.99 / $36.31 / $38.02
| Facility | 26 | $23.99 | $36.31 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $56.23 / $102.33
| Professional | | $37.15 | $56.23 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $19.95 / $25.70 / $75.86
| Professional | 26 | $19.95 | $25.70 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $51.29 / $104.71
| Professional | | $23.44 | $51.29 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $64.57 / $102.33
| Professional | | $42.66 | $64.57 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $21.88 / $30.20 / $48.98
| Professional | 26 | $21.88 | $30.20 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $81.28 / $158.49
| Professional | | $48.98 | $81.28 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $21.38 / $33.88 / $114.82
| Professional | 26 | $21.38 | $33.88 | $114.82 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $100.00
| Facility | 26 | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $61.66 / $66.07
| Professional | | $61.66 | $61.66 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $26.30 / $26.30 / $27.54
| Professional | 26 | $26.30 | $26.30 | $27.54 |
- 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
- $37.15 / $53.70 / $87.10
| Professional | | $37.15 | $53.70 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $20.89 / $27.54 / $43.65
| Professional | 26 | $20.89 | $27.54 | $43.65 |