- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.71 / $11.48 / $15.85
| Facility | 26 | $8.71 | $11.48 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $67.61 / $162.18
| Professional | | $51.29 | $67.61 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.94 / $10.47 / $23.99
| Professional | 26 | $7.94 | $10.47 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $42.66 / $50.12 / $89.13
| Professional | TC | $42.66 | $50.12 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $54.95 / $77.62
| Professional | | $41.69 | $54.95 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.13 / $11.22 / $12.59
| Professional | 26 | $8.13 | $11.22 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $13.80 / $13.80 / $13.80
| Professional | 52 | $13.80 | $13.80 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $46.77 / $64.57
| Professional | | $39.81 | $46.77 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.61 / $7.76 / $10.47
| Professional | 26 | $6.61 | $7.76 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $33.11 / $39.81 / $53.70
| Professional | TC | $33.11 | $39.81 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $46.77 / $67.61
| Professional | | $8.91 | $46.77 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $2.14 / $10.00 / $14.13
| Facility | 26 | $2.14 | $10.00 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $74.13 / $263.03
| Professional | | $50.12 | $74.13 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.32 / $12.02 / $40.74
| Professional | 26 | $8.32 | $12.02 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $41.69 / $61.66 / $223.87
| Professional | TC | $41.69 | $61.66 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $32.36 / $42.66
| Professional | | $7.08 | $32.36 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $57.54 / $100.00
| Professional | | $46.77 | $57.54 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.76 / $9.77 / $17.78
| Professional | 26 | $7.76 | $9.77 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $38.90 / $47.86 / $81.28
| Professional | TC | $38.90 | $47.86 | $81.28 |