- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $27.54 / $43.65 / $63.10
| Facility | 26 | $27.54 | $43.65 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $60.26 / $275.42
| Professional | | $30.90 | $60.26 | $275.42 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $19.05 / $23.99 / $43.65
| Professional | 26 | $19.05 | $23.99 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $74.13 / $104.71
| Professional | | $44.67 | $74.13 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $19.05 / $30.90 / $42.66
| Professional | 26 | $19.05 | $30.90 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $97.72 / $120.23
| Professional | | $47.86 | $97.72 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $25.12 / $42.66 / $53.70
| Professional | 26 | $25.12 | $42.66 | $53.70 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $47.86 / $97.72 / $97.72
| Facility | 26 | $47.86 | $97.72 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $53.70 / $75.86 / $331.13
| Professional | | $53.70 | $75.86 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $32.36 / $41.69 / $128.82
| Professional | 26 | $32.36 | $41.69 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $74.13 / $77.62 / $123.03
| Professional | | $74.13 | $77.62 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $38.02 / $42.66 / $56.23
| Professional | 26 | $38.02 | $42.66 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $112.20 / $123.03
| Professional | | $44.67 | $112.20 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $26.92 / $45.71 / $51.29
| Professional | 26 | $26.92 | $45.71 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $57.54 / $83.18 / $120.23
| Professional | | $57.54 | $83.18 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $33.11 / $41.69 / $54.95
| Professional | 26 | $33.11 | $41.69 | $54.95 |