- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.31 / $9.33 / $16.60
| Facility | 26 | $6.31 | $9.33 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $44.67 / $141.25
| Professional | | $25.12 | $44.67 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.61 / $11.48 / $34.67
| Professional | 26 | $6.61 | $11.48 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $16.98 / $22.39 / $54.95
| Professional | TC | $16.98 | $22.39 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $19.50 / $19.50
| Professional | | $19.50 | $19.50 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.75 / $5.75 / $45.71
| Professional | 26 | $5.75 | $5.75 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $30.20 / $64.57
| Professional | | $24.55 | $30.20 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.46 / $7.94 / $15.85
| Professional | 26 | $6.46 | $7.94 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.78 / $21.38 / $46.77
| Professional | TC | $17.78 | $21.38 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $26.92 / $37.15
| Professional | | $10.23 | $26.92 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $1.74 / $8.13 / $11.48
| Facility | 26 | $1.74 | $8.13 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $44.67 / $100.00
| Professional | | $26.92 | $44.67 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.24 / $11.22 / $26.30
| Professional | 26 | $7.24 | $11.22 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.95 / $33.88 / $79.43
| Professional | TC | $19.95 | $33.88 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $36.31 / $52.48
| Professional | | $28.84 | $36.31 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.76 / $10.96 / $26.92
| Professional | 26 | $7.76 | $10.96 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.89 / $26.30 / $37.15
| Professional | TC | $20.89 | $26.30 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $37.15 / $60.26
| Professional | | $22.91 | $37.15 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.31 / $10.00 / $15.14
| Professional | 26 | $6.31 | $10.00 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $16.22 / $27.54 / $38.02
| Professional | TC | $16.22 | $27.54 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.41 / $7.41 / $10.72
| Professional | 26 | $7.41 | $7.41 | $10.72 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.55 / $9.55 / $15.14
| Professional | 26 | $9.55 | $9.55 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $36.31 / $58.88
| Professional | | $30.90 | $36.31 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.51 / $10.23 / $15.85
| Professional | 26 | $8.51 | $10.23 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.39 / $26.30 / $43.65
| Professional | TC | $22.39 | $26.30 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $38.90 / $97.72
| Professional | | $25.70 | $38.90 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $10.23 / $26.30
| Professional | 26 | $7.08 | $10.23 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $18.62 / $26.92 / $70.79
| Professional | TC | $18.62 | $26.92 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.75 / $9.77 / $30.20
| Facility | 26 | $5.75 | $9.77 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $34.67 / $79.43
| Professional | | $20.42 | $34.67 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.89 / $9.77 / $22.39
| Professional | 26 | $5.89 | $9.77 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $14.45 / $25.12 / $56.23
| Professional | TC | $14.45 | $25.12 | $56.23 |