- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.47 / $14.79 / $31.62
| Facility | 26 | $10.47 | $14.79 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $51.29 / $114.82
| Professional | | $38.90 | $51.29 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.47 / $14.79 / $33.88
| Professional | 26 | $10.47 | $14.79 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $26.92 / $33.11 / $74.13
| Professional | TC | $26.92 | $33.11 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $47.86 / $85.11
| Professional | | $38.02 | $47.86 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.23 / $10.72 / $22.39
| Professional | 26 | $10.23 | $10.72 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $44.67 / $79.43
| Professional | | $38.02 | $44.67 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.55 / $11.48 / $20.89
| Professional | 26 | $9.55 | $11.48 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $28.18 / $33.11 / $57.54
| Professional | TC | $28.18 | $33.11 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $44.67 / $61.66
| Professional | | $17.38 | $44.67 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $2.88 / $13.49 / $19.05
| Facility | 26 | $2.88 | $13.49 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $63.10 / $144.54
| Professional | | $45.71 | $63.10 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.02 / $17.38 / $38.02
| Professional | 26 | $12.02 | $17.38 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $33.11 / $45.71 / $109.65
| Professional | TC | $33.11 | $45.71 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $57.54 / $75.86 / $107.15
| Professional | | $57.54 | $75.86 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $13.18 / $17.78 / $25.70
| Professional | 26 | $13.18 | $17.78 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $43.65 / $58.88 / $87.10
| Professional | TC | $43.65 | $58.88 | $87.10 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $11.22 / $11.22 / $11.22
| Facility | 26 | $11.22 | $11.22 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $54.95 / $93.33
| Professional | | $30.90 | $54.95 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.91 / $14.79 / $25.12
| Professional | 26 | $8.91 | $14.79 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.39 / $39.81 / $69.18
| Professional | TC | $22.39 | $39.81 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.12 / $9.12 / $9.12
| Professional | 26 | $9.12 | $9.12 | $9.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $53.70 / $104.71
| Professional | | $43.65 | $53.70 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $13.18 / $15.14 / $16.98
| Professional | 26 | $13.18 | $15.14 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $60.26 / $117.49
| Professional | | $50.12 | $60.26 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $13.80 / $16.98 / $31.62
| Professional | 26 | $13.80 | $16.98 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $36.31 / $42.66 / $85.11
| Professional | TC | $36.31 | $42.66 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $72.44 / $288.40
| Professional | | $44.67 | $72.44 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $11.48 / $18.20 / $81.28
| Professional | 26 | $11.48 | $18.20 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $33.88 / $54.95 / $208.93
| Professional | TC | $33.88 | $54.95 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.71 / $14.79 / $23.99
| Facility | 26 | $8.71 | $14.79 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $54.95 / $97.72
| Professional | | $34.67 | $54.95 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.12 / $14.79 / $28.84
| Professional | 26 | $9.12 | $14.79 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $25.12 / $39.81 / $69.18
| Professional | TC | $25.12 | $39.81 | $69.18 |