- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $3.02 / $4.37 / $8.91
| Facility | 26 | $3.02 | $4.37 | $8.91 |
- 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 / $8.91
| Professional | 26 | $2.00 | $3.98 | $8.91 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $10.96 / $15.14 / $29.51
| Professional | TC | $10.96 | $15.14 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $13.18 / $14.79
| Professional | | $11.75 | $13.18 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $2.63 / $2.63 / $2.63
| Professional | 26 | $2.63 | $2.63 | $2.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $12.88 / $26.30
| Professional | | $3.24 | $12.88 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $25.70 / $45.71
| Professional | | $16.22 | $25.70 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $3.02 / $5.37 / $10.00
| Professional | 26 | $3.02 | $5.37 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $12.88 / $19.95 / $36.31
| Professional | TC | $12.88 | $19.95 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $26.92 / $60.26
| Professional | | $14.79 | $26.92 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $2.82 / $5.89 / $17.78
| Professional | 26 | $2.82 | $5.89 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $11.75 / $19.05 / $43.65
| Professional | TC | $11.75 | $19.05 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $100.00
| Facility | 26 | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $17.78 / $19.95
| Professional | | $17.78 | $17.78 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $3.02 / $3.47 / $3.80
| Professional | 26 | $3.02 | $3.47 | $3.80 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $14.45 / $14.79 / $16.22
| Professional | TC | $14.45 | $14.79 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $32.36 / $33.11
| Professional | | $12.59 | $32.36 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $26.92 / $42.66
| Professional | | $19.05 | $26.92 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $3.89 / $6.03 / $9.33
| Professional | 26 | $3.89 | $6.03 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.14 / $20.89 / $33.11
| Professional | TC | $15.14 | $20.89 | $33.11 |