- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $22.39 / $26.30
| Facility | 26 | $7.08 | $22.39 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $19.95 / $40.74
| Professional | | $12.88 | $19.95 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $2.00 / $3.98 / $9.77
| Professional | 26 | $2.00 | $3.98 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $10.96 / $15.85 / $30.90
| Professional | TC | $10.96 | $15.85 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $30.90 / $51.29
| Professional | | $16.98 | $30.90 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $3.02 / $6.31 / $10.00
| Professional | 26 | $3.02 | $6.31 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $13.18 / $23.44 / $36.31
| Professional | TC | $13.18 | $23.44 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $29.51 / $53.70
| Professional | | $19.05 | $29.51 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $3.55 / $7.24 / $10.72
| Professional | 26 | $3.55 | $7.24 | $10.72 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.14 / $23.44 / $43.65
| Professional | TC | $15.14 | $23.44 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $28.18 / $36.31
| Professional | | $20.89 | $28.18 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $3.39 / $4.57 / $7.76
| Professional | 26 | $3.39 | $4.57 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.38 / $23.44 / $28.84
| Professional | TC | $17.38 | $23.44 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $26.30 / $53.70
| Professional | | $18.62 | $26.30 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $3.55 / $5.37 / $11.22
| Professional | 26 | $3.55 | $5.37 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.14 / $21.88 / $44.67
| Professional | TC | $15.14 | $21.88 | $44.67 |