- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $346.74 / $524.81 / $707.95
| Facility | 26 | $346.74 | $524.81 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $1,380.38 / $2,691.53
| Professional | | $1,230.27 | $1,380.38 | $2,691.53 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $346.74 / $426.58 / $794.33
| Professional | 26 | $346.74 | $426.58 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,548.82 / $2,187.76
| Professional | | $1,174.90 | $1,548.82 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $346.74 / $457.09 / $645.65
| Professional | 26 | $346.74 | $457.09 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $2,187.76 / $11,481.54
| Professional | | $446.68 | $2,187.76 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $398.11 / $398.11 / $616.60
| Professional | 26 | $398.11 | $398.11 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $1,698.24 / $3,162.28
| Professional | | $1,348.96 | $1,698.24 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $389.05 / $512.86 / $933.25
| Professional | 26 | $389.05 | $512.86 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,412.54 / $1,737.80
| Professional | | $1,174.90 | $1,412.54 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $346.74 / $416.87 / $512.86
| Professional | 26 | $346.74 | $416.87 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $1,995.26 / $2,570.40
| Professional | | $1,584.89 | $1,995.26 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $549.54 / $691.83 / $691.83
| Professional | 26 | $549.54 | $691.83 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $1,380.38 / $11,748.98
| Professional | | $457.09 | $1,380.38 | $11,748.98 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $380.19 / $489.78 / $851.14
| Professional | 26 | $380.19 | $489.78 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,819.70 / $2,818.38
| Professional | | $1,174.90 | $1,819.70 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $331.13 / $537.03 / $794.33
| Professional | 26 | $331.13 | $537.03 | $794.33 |