- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $467.74 / $794.33 / $891.25
| Facility | 26 | $467.74 | $794.33 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,548.82 / $2,754.23
| Professional | | $1,202.26 | $1,548.82 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $354.81 / $512.86 / $1,621.81
| Professional | 26 | $354.81 | $512.86 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $2,754.23 / $3,630.78
| Professional | | $1,621.81 | $2,754.23 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $512.86 / $758.58 / $1,023.29
| Professional | 26 | $512.86 | $758.58 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $2,818.38 / $3,235.94
| Professional | | $1,949.84 | $2,818.38 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $575.44 / $812.83 / $912.01
| Professional | 26 | $575.44 | $812.83 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $467.74 / $707.95 / $891.25
| Facility | 26 | $467.74 | $707.95 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $2,511.89 / $3,801.89
| Professional | | $1,698.24 | $2,511.89 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $398.11 / $794.33 / $1,202.26
| Professional | 26 | $398.11 | $794.33 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $776.25 / $1,621.81
| Professional | | $524.81 | $776.25 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $2,691.53 / $3,630.78
| Professional | | $1,819.70 | $2,691.53 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $512.86 / $758.58 / $1,047.13
| Professional | 26 | $512.86 | $758.58 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $9,549.93 / $9,549.93 / $9,549.93
| Facility | 26 | $9,549.93 | $9,549.93 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $2,951.21 / $3,890.45
| Professional | | $2,454.71 | $2,951.21 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $724.44 / $891.25 / $1,148.15
| Professional | 26 | $724.44 | $891.25 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $2,511.89 / $3,548.13
| Professional | | $1,819.70 | $2,511.89 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $562.34 / $776.25 / $1,047.13
| Professional | 26 | $562.34 | $776.25 | $1,047.13 |