- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $38.02 / $58.88 / $75.86
| Facility | 26 | $38.02 | $58.88 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $57.54 / $79.43 / $288.40
| Professional | | $57.54 | $79.43 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $25.70 / $44.67 / $104.71
| Professional | 26 | $25.70 | $44.67 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $30.20 / $37.15 / $85.11
| Professional | TC | $30.20 | $37.15 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $138.04 / $169.82
| Professional | | $64.57 | $138.04 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $29.51 / $57.54 / $72.44
| Professional | 26 | $29.51 | $57.54 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $33.88 / $79.43 / $97.72
| Professional | TC | $33.88 | $79.43 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $104.71 / $346.74
| Professional | | $60.26 | $104.71 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $26.30 / $46.77 / $131.83
| Professional | 26 | $26.30 | $46.77 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $31.62 / $48.98 / $263.03
| Professional | TC | $31.62 | $48.98 | $263.03 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $64.57 / $123.03 / $123.03
| Facility | 26 | $64.57 | $123.03 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $117.49 / $724.44
| Professional | | $61.66 | $117.49 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $29.51 / $52.48 / $331.13
| Professional | 26 | $29.51 | $52.48 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $30.90 / $52.48 / $562.34
| Professional | TC | $30.90 | $52.48 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $72.44 / $138.04 / $162.18
| Professional | | $72.44 | $138.04 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $50.12 / $67.61 / $107.15
| Professional | 26 | $50.12 | $67.61 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $53.70 / $72.44 / $89.13
| Professional | TC | $53.70 | $72.44 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $112.20 / $117.49 / $229.09
| Professional | | $112.20 | $117.49 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $46.77 / $52.48 / $67.61
| Professional | 26 | $46.77 | $52.48 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $58.88 / $58.88 / $181.97
| Professional | TC | $58.88 | $58.88 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $67.61 / $141.25
| Professional | | $30.20 | $67.61 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $89.13 / $158.49
| Professional | | $60.26 | $89.13 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $28.18 / $45.71 / $81.28
| Professional | 26 | $28.18 | $45.71 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $30.20 / $44.67 / $75.86
| Professional | TC | $30.20 | $44.67 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $95.50 / $120.23 / $141.25
| Professional | | $95.50 | $120.23 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $40.74 / $51.29 / $60.26
| Professional | 26 | $40.74 | $51.29 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $53.70 / $69.18 / $81.28
| Professional | TC | $53.70 | $69.18 | $81.28 |