- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $15.49 / $22.91
| Facility | 26 | $7.08 | $15.49 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $46.77 / $190.55
| Professional | | $23.99 | $46.77 | $190.55 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.61 / $12.02 / $81.28
| Professional | 26 | $6.61 | $12.02 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.85 / $23.99 / $44.67
| Professional | TC | $15.85 | $23.99 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $39.81 / $120.23
| Professional | | $25.70 | $39.81 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.24 / $11.22 / $32.36
| Professional | 26 | $7.24 | $11.22 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $18.62 / $28.84 / $87.10
| Professional | TC | $18.62 | $28.84 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $20.89 / $35.48
| Professional | | $8.91 | $20.89 | $35.48 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $18.20 / $20.89 / $33.88
| Facility | 26 | $18.20 | $20.89 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $74.13 / $85.11
| Professional | | $33.11 | $74.13 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.12 / $20.42 / $23.44
| Professional | 26 | $9.12 | $20.42 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $23.44 / $52.48 / $63.10
| Professional | TC | $23.44 | $52.48 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $51.29 / $74.13
| Professional | | $45.71 | $51.29 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.59 / $14.45 / $20.89
| Professional | 26 | $12.59 | $14.45 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $32.36 / $37.15 / $53.70
| Professional | TC | $32.36 | $37.15 | $53.70 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $104.71 / $104.71 / $104.71
| Facility | 26 | $104.71 | $104.71 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $54.95 / $645.65
| Professional | | $26.92 | $54.95 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.59 / $13.80 / $229.09
| Professional | 26 | $7.59 | $13.80 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.50 / $40.74 / $537.03
| Professional | TC | $19.50 | $40.74 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $33.11 / $70.79
| Professional | | $25.70 | $33.11 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $38.90 / $79.43
| Professional | | $22.91 | $38.90 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.46 / $12.02 / $22.39
| Professional | 26 | $6.46 | $12.02 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $16.60 / $30.20 / $57.54
| Professional | TC | $16.60 | $30.20 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $61.66 / $125.89
| Professional | | $33.11 | $61.66 | $125.89 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $100.00 / $104.71 / $104.71
| Facility | 26 | $100.00 | $104.71 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $169.82 / $645.65
| Professional | | $37.15 | $169.82 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.00 / $36.31 / $229.09
| Professional | 26 | $10.00 | $36.31 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $26.30 / $141.25 / $537.03
| Professional | TC | $26.30 | $141.25 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $85.11 / $85.11
| Professional | | $85.11 | $85.11 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $23.44 / $23.44 / $23.44
| Professional | 26 | $23.44 | $23.44 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $61.66 / $61.66 / $61.66
| Professional | TC | $61.66 | $61.66 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $109.65 / $158.49 / $186.21
| Professional | | $109.65 | $158.49 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $29.51 / $36.31 / $39.81
| Professional | 26 | $29.51 | $36.31 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $72.44 / $87.10 / $117.49
| Professional | TC | $72.44 | $87.10 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $45.71 / $104.71
| Professional | | $26.92 | $45.71 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.59 / $11.22 / $30.20
| Professional | 26 | $7.59 | $11.22 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.50 / $32.36 / $75.86
| Professional | TC | $19.50 | $32.36 | $75.86 |