- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $20.89 / $20.89 / $25.70
| Facility | 26 | $20.89 | $20.89 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $50.12 / $70.79
| Professional | | $33.11 | $50.12 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $16.98 / $21.88 / $34.67
| Professional | 26 | $16.98 | $21.88 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $53.70 / $91.20
| Professional | | $33.88 | $53.70 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $18.62 / $23.99 / $37.15
| Professional | 26 | $18.62 | $23.99 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $50.12 / $97.72
| Professional | | $31.62 | $50.12 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $18.62 / $25.12 / $39.81
| Professional | 26 | $18.62 | $25.12 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.30 / $29.51 / $81.28
| Professional | | $0.30 | $29.51 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $0.20 / $18.62 / $33.11
| Professional | 26 | $0.20 | $18.62 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.30 / $0.30 / $77.62
| Professional | | $0.30 | $0.30 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $0.20 / $0.20 / $30.20
| Professional | 26 | $0.20 | $0.20 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $51.29 / $69.18
| Professional | | $47.86 | $51.29 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $19.50 / $20.42 / $28.84
| Professional | 26 | $19.50 | $20.42 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $48.98 / $83.18
| Professional | | $31.62 | $48.98 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $19.50 / $27.54 / $41.69
| Professional | 26 | $19.50 | $27.54 | $41.69 |