- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $588.84 / $588.84 / $1,148.15
| Facility | 26 | $588.84 | $588.84 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $1,479.11 / $2,691.53
| Professional | | $1,122.02 | $1,479.11 | $2,691.53 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $316.23 / $512.86 / $1,819.70
| Professional | 26 | $316.23 | $512.86 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,819.70 / $6,165.95
| Professional | | $1,096.48 | $1,819.70 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $316.23 / $501.19 / $1,737.80
| Professional | 26 | $316.23 | $501.19 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $812.83 / $933.25 / $1,513.56
| Facility | 26 | $812.83 | $933.25 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,778.28 / $3,162.28 / $3,890.45
| Professional | | $1,778.28 | $3,162.28 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $501.19 / $912.01 / $1,096.48
| Professional | 26 | $501.19 | $912.01 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $2,630.27 / $3,162.28
| Professional | | $1,949.84 | $2,630.27 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $575.44 / $776.25 / $912.01
| Professional | 26 | $575.44 | $776.25 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $2,238.72 / $6,309.57
| Professional | | $1,348.96 | $2,238.72 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $380.19 / $645.65 / $1,778.28
| Professional | 26 | $380.19 | $645.65 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $58.88 / $2,511.89
| Professional | | $32.36 | $58.88 | $2,511.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $2,818.38 / $4,897.79
| Professional | | $1,548.82 | $2,818.38 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $457.09 / $851.14 / $1,380.38
| Professional | 26 | $457.09 | $851.14 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,089.30 / $2,630.27 / $4,073.80
| Professional | | $2,089.30 | $2,630.27 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $707.95 / $707.95 / $2,951.21
| Facility | 26 | $707.95 | $707.95 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $5,623.41 / $7,413.10
| Professional | | $1,584.89 | $5,623.41 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $467.74 / $1,584.89 / $2,041.74
| Professional | 26 | $467.74 | $1,584.89 | $2,041.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6,025.60 / $6,025.60 / $6,025.60
| Professional | | $6,025.60 | $6,025.60 | $6,025.60 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $1,659.59 / $1,659.59 / $1,659.59
| Professional | 26 | $1,659.59 | $1,659.59 | $1,659.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,248.07 / $7,762.47 / $8,317.64
| Professional | | $5,248.07 | $7,762.47 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $1,412.54 / $1,659.59 / $1,819.70
| Professional | 26 | $1,412.54 | $1,659.59 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $2,238.72 / $4,897.79
| Professional | | $1,288.25 | $2,238.72 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $380.19 / $645.65 / $1,412.54
| Professional | 26 | $380.19 | $645.65 | $1,412.54 |