- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.94 / $8.71 / $18.62
| Facility | 26 | $7.94 | $8.71 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $67.61 / $208.93
| Professional | | $51.29 | $67.61 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.94 / $10.47 / $35.48
| Professional | 26 | $7.94 | $10.47 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $8.13 / $8.32 / $39.81
| Professional | 52 | $8.13 | $8.32 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $42.66 / $52.48 / $104.71
| Professional | TC | $42.66 | $52.48 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $60.26 / $72.44
| Professional | | $50.12 | $60.26 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.59 / $10.00 / $12.88
| Professional | 26 | $7.59 | $10.00 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $114.82 / $114.82 / $114.82
| Professional | TC | $114.82 | $114.82 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $53.70 / $83.18
| Professional | | $38.02 | $53.70 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.89 / $8.13 / $12.88
| Professional | 26 | $5.89 | $8.13 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $32.36 / $42.66 / $70.79
| Professional | TC | $32.36 | $42.66 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $67.61 / $120.23
| Professional | | $52.48 | $67.61 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.51 / $10.47 / $19.05
| Professional | 26 | $8.51 | $10.47 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $43.65 / $56.23 / $100.00
| Professional | TC | $43.65 | $56.23 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $20.42 / $79.43 / $79.43
| Facility | 26 | $20.42 | $79.43 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $66.07 / $371.54
| Professional | | $48.98 | $66.07 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.94 / $10.72 / $54.95
| Professional | 26 | $7.94 | $10.72 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $41.69 / $57.54 / $316.23
| Professional | TC | $41.69 | $57.54 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $60.26 / $107.15
| Professional | | $47.86 | $60.26 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.76 / $9.77 / $19.05
| Professional | 26 | $7.76 | $9.77 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $40.74 / $50.12 / $91.20
| Professional | TC | $40.74 | $50.12 | $91.20 |