- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $489.78 / $645.65 / $1,000.00
| Facility | 26 | $489.78 | $645.65 | $1,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,584.89 / $2,884.03
| Professional | | $1,202.26 | $1,584.89 | $2,884.03 |
- 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
- 26
- Typical Low / Median / Typical High
- $588.84 / $660.69 / $741.31
| Professional | 26 | $588.84 | $660.69 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $5,623.41 / $5,623.41 / $5,623.41
| Facility | 26 | $5,623.41 | $5,623.41 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,778.28 / $2,344.23 / $3,162.28
| Professional | | $1,778.28 | $2,344.23 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $501.19 / $691.83 / $933.25
| Professional | 26 | $501.19 | $691.83 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $2,511.89 / $3,801.89
| Professional | | $1,548.82 | $2,511.89 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $478.63 / $724.44 / $1,071.52
| Professional | 26 | $478.63 | $724.44 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $575.44 / $831.76 / $13,803.84
| Facility | 26 | $575.44 | $831.76 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $2,754.23 / $3,630.78
| Professional | | $1,819.70 | $2,754.23 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $457.09 / $776.25 / $1,023.29
| Professional | 26 | $457.09 | $776.25 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $75.86
| Professional | | $32.36 | $33.11 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $436.52 / $933.25
| Professional | | $436.52 | $436.52 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $501.19 / $501.19 / $501.19
| Facility | 26 | $501.19 | $501.19 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $2,398.83 / $3,467.37
| Professional | | $1,659.59 | $2,398.83 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $501.19 / $741.31 / $1,047.13
| Professional | 26 | $501.19 | $741.31 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $5,623.41 / $5,623.41 / $5,623.41
| Facility | 26 | $5,623.41 | $5,623.41 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,778.28 / $2,238.72 / $3,162.28
| Professional | | $1,778.28 | $2,238.72 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $501.19 / $676.08 / $933.25
| Professional | 26 | $501.19 | $676.08 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $1,949.84 / $3,235.94
| Professional | | $1,318.26 | $1,949.84 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $363.08 / $588.84 / $954.99
| Professional | 26 | $363.08 | $588.84 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $1,698.24 / $2,691.53
| Professional | | $1,445.44 | $1,698.24 | $2,691.53 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $416.87 / $489.78 / $741.31
| Professional | 26 | $416.87 | $489.78 | $741.31 |