- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.71 / $10.47 / $13.49
| Facility | 26 | $8.71 | $10.47 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $44.67 / $114.82
| Professional | | $25.70 | $44.67 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- 25
- Typical Low / Median / Typical High
- $10.96 / $10.96 / $10.96
| Professional | 25 | $10.96 | $10.96 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.41 / $10.96 / $27.54
| Professional | 26 | $7.41 | $10.96 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $16.98 / $26.92 / $44.67
| Professional | TC | $16.98 | $26.92 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $37.15 / $56.23
| Professional | | $28.18 | $37.15 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.13 / $10.72 / $16.22
| Professional | 26 | $8.13 | $10.72 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.42 / $26.30 / $39.81
| Professional | TC | $20.42 | $26.30 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $42.66 / $64.57
| Professional | | $32.36 | $42.66 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.51 / $10.96 / $16.98
| Professional | 26 | $8.51 | $10.96 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.39 / $31.62 / $47.86
| Professional | TC | $22.39 | $31.62 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $44.67 / $64.57
| Professional | | $28.84 | $44.67 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.76 / $12.02 / $16.98
| Professional | 26 | $7.76 | $12.02 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.89 / $32.36 / $47.86
| Professional | TC | $20.89 | $32.36 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $30.90 / $48.98
| Professional | | $27.54 | $30.90 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.76 / $8.51 / $14.79
| Professional | 26 | $7.76 | $8.51 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.50 / $22.91 / $33.88
| Professional | TC | $19.50 | $22.91 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $45.71 / $67.61
| Professional | | $33.11 | $45.71 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.71 / $12.88 / $20.42
| Professional | 26 | $8.71 | $12.88 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $21.88 / $33.11 / $50.12
| Professional | TC | $21.88 | $33.11 | $50.12 |