- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.03 / $6.03 / $14.13
| Facility | 26 | $6.03 | $6.03 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $45.71 / $154.88
| Professional | | $23.99 | $45.71 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.31 / $11.48 / $34.67
| Professional | 26 | $6.31 | $11.48 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.85 / $22.39 / $58.88
| Professional | TC | $15.85 | $22.39 | $58.88 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $16.60 / $21.88 / $104.71
| Facility | 26 | $16.60 | $21.88 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $56.23 / $645.65
| Professional | | $25.12 | $56.23 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.92 / $11.22 / $229.09
| Professional | 26 | $6.92 | $11.22 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.05 / $42.66 / $537.03
| Professional | TC | $19.05 | $42.66 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $51.29 / $77.62
| Professional | | $33.88 | $51.29 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.94 / $11.75 / $17.38
| Professional | 26 | $7.94 | $11.75 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.12 / $9.12 / $9.12
| Facility | 26 | $9.12 | $9.12 | $9.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $48.98 / $89.13
| Professional | | $27.54 | $48.98 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.41 / $11.48 / $20.89
| Professional | 26 | $7.41 | $11.48 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.42 / $36.31 / $67.61
| Professional | TC | $20.42 | $36.31 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $15.85 / $38.90
| Professional | | $5.01 | $15.85 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $42.66 / $67.61
| Professional | | $26.30 | $42.66 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.59 / $11.48 / $19.50
| Professional | 26 | $7.59 | $11.48 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $18.62 / $32.36 / $50.12
| Professional | TC | $18.62 | $32.36 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $15.14 / $17.78
| Professional | | $12.30 | $15.14 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $16.60 / $21.88 / $104.71
| Facility | 26 | $16.60 | $21.88 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $56.23 / $645.65
| Professional | | $25.12 | $56.23 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.92 / $11.22 / $229.09
| Professional | 26 | $6.92 | $11.22 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.05 / $42.66 / $537.03
| Professional | TC | $19.05 | $42.66 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $52.48 / $79.43
| Professional | | $26.92 | $52.48 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.59 / $11.48 / $22.91
| Professional | 26 | $7.59 | $11.48 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.50 / $37.15 / $60.26
| Professional | TC | $19.50 | $37.15 | $60.26 |