- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $16.22 / $21.88 / $35.48
| Facility | 26 | $16.22 | $21.88 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $123.03 / $478.63
| Professional | | $85.11 | $123.03 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $20.89 / $32.36 / $109.65
| Professional | 26 | $20.89 | $32.36 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $58.88 / $83.18 / $141.25
| Professional | TC | $58.88 | $83.18 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $109.65 / $131.83
| Professional | | $77.62 | $109.65 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $17.38 / $26.92 / $46.77
| Professional | 26 | $17.38 | $26.92 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $70.79 / $134.90
| Professional | | $20.89 | $70.79 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $97.72 / $123.03 / $177.83
| Professional | | $97.72 | $123.03 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $24.55 / $34.67 / $34.67
| Professional | 26 | $24.55 | $34.67 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.03 / $28.18 / $39.81
| Facility | 26 | $6.03 | $28.18 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $134.90 / $229.09
| Professional | | $100.00 | $134.90 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $25.12 / $34.67 / $58.88
| Professional | 26 | $25.12 | $34.67 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $75.86 / $102.33 / $177.83
| Professional | TC | $75.86 | $102.33 | $177.83 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $154.88 / $154.88 / $154.88
| Facility | 26 | $154.88 | $154.88 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $114.82 / $691.83 / $812.83
| Professional | | $114.82 | $691.83 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $234.42 / $234.42 / $281.84
| Professional | 26 | $234.42 | $234.42 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $478.63 / $616.60 / $616.60
| Professional | TC | $478.63 | $616.60 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $16.22 / $22.39 / $38.90
| Facility | 26 | $16.22 | $22.39 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $128.82 / $302.00
| Professional | | $81.28 | $128.82 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $20.89 / $33.11 / $77.62
| Professional | 26 | $20.89 | $33.11 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $60.26 / $93.33 / $169.82
| Professional | TC | $60.26 | $93.33 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $33.11 / $77.62
| Professional | | $19.50 | $33.11 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $123.03 / $269.15
| Professional | | $27.54 | $123.03 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.31 / $29.51 / $41.69
| Facility | 26 | $6.31 | $29.51 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $97.72 / $138.04 / $223.87
| Professional | | $97.72 | $138.04 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $25.12 / $34.67 / $53.70
| Professional | 26 | $25.12 | $34.67 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $75.86 / $100.00 / $158.49
| Professional | TC | $75.86 | $100.00 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $114.82 / $194.98
| Professional | | $85.11 | $114.82 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $21.38 / $28.84 / $47.86
| Professional | 26 | $21.38 | $28.84 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $63.10 / $87.10 / $144.54
| Professional | TC | $63.10 | $87.10 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $97.72 / $102.33 / $120.23
| Professional | | $97.72 | $102.33 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $23.99 / $25.12 / $30.20
| Professional | 26 | $23.99 | $25.12 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $72.44 / $75.86 / $91.20
| Professional | TC | $72.44 | $75.86 | $91.20 |