- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $660.69 / $758.58 / $758.58
| Facility | 26 | $660.69 | $758.58 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $1,584.89 / $3,019.95
| Professional | | $1,230.27 | $1,584.89 | $3,019.95 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $346.74 / $660.69 / $2,089.30
| Professional | 26 | $346.74 | $660.69 | $2,089.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,995.26 / $6,760.83
| Professional | | $1,202.26 | $1,995.26 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $354.81 / $562.34 / $1,949.84
| Professional | 26 | $354.81 | $562.34 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $891.25 / $1,047.13 / $1,698.24
| Facility | 26 | $891.25 | $1,047.13 | $1,698.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $3,548.13 / $4,365.16
| Professional | | $1,995.26 | $3,548.13 | $4,365.16 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $562.34 / $1,023.29 / $1,230.27
| Professional | 26 | $562.34 | $1,023.29 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $2,951.21 / $3,467.37
| Professional | | $2,187.76 | $2,951.21 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $645.65 / $870.96 / $1,023.29
| Professional | 26 | $645.65 | $870.96 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $2,398.83 / $6,760.83
| Professional | | $1,513.56 | $2,398.83 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $426.58 / $724.44 / $1,995.26
| Professional | 26 | $426.58 | $724.44 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $58.88 / $2,630.27
| Professional | | $32.36 | $58.88 | $2,630.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $3,090.30 / $5,370.32
| Professional | | $1,737.80 | $3,090.30 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $512.86 / $954.99 / $1,548.82
| Professional | 26 | $512.86 | $954.99 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $2,884.03 / $4,466.84
| Professional | | $2,344.23 | $2,884.03 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $794.33 / $794.33 / $3,311.31
| Facility | 26 | $794.33 | $794.33 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $6,165.95 / $8,317.64
| Professional | | $1,737.80 | $6,165.95 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $524.81 / $1,778.28 / $2,290.87
| Professional | 26 | $524.81 | $1,778.28 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6,760.83 / $6,760.83 / $6,760.83
| Professional | | $6,760.83 | $6,760.83 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $1,862.09 / $1,862.09 / $1,862.09
| Professional | 26 | $1,862.09 | $1,862.09 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,754.40 / $8,511.38 / $9,120.11
| Professional | | $5,754.40 | $8,511.38 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $1,584.89 / $1,862.09 / $2,041.74
| Professional | 26 | $1,584.89 | $1,862.09 | $2,041.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $2,454.71 / $5,495.41
| Professional | | $1,445.44 | $2,454.71 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $426.58 / $724.44 / $1,584.89
| Professional | 26 | $426.58 | $724.44 | $1,584.89 |