- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $52.48 / $66.07 / $107.15
| Facility | 26 | $52.48 | $66.07 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $436.52 / $630.96
| Professional | | $354.81 | $436.52 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $51.29 / $64.57 / $123.03
| Professional | 26 | $51.29 | $64.57 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $302.00 / $380.19 / $537.03
| Professional | TC | $302.00 | $380.19 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $446.68 / $575.44
| Professional | | $446.68 | $446.68 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $67.61 / $67.61 / $79.43
| Professional | 26 | $67.61 | $67.61 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $229.09 / $229.09 / $229.09
| Professional | TC | $229.09 | $229.09 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $323.59 / $602.56
| Professional | | $50.12 | $323.59 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $512.86 / $758.58
| Professional | | $446.68 | $512.86 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $57.54 / $79.43 / $79.43
| Professional | 26 | $57.54 | $79.43 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $562.34 / $891.25
| Professional | | $416.87 | $562.34 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $58.88 / $81.28 / $144.54
| Professional | 26 | $58.88 | $81.28 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $354.81 / $478.63 / $776.25
| Professional | TC | $354.81 | $478.63 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $416.87 / $416.87 / $416.87
| Facility | 26 | $416.87 | $416.87 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,715.35 / $3,715.35 / $4,168.69
| Professional | | $3,715.35 | $3,715.35 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $645.65 / $645.65 / $645.65
| Professional | 26 | $645.65 | $645.65 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $3,715.35 / $3,715.35 / $3,715.35
| Professional | TC | $3,715.35 | $3,715.35 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $43.65 / $58.88 / $107.15
| Facility | 26 | $43.65 | $58.88 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $457.09 / $870.96
| Professional | | $346.74 | $457.09 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $51.29 / $64.57 / $117.49
| Professional | 26 | $51.29 | $64.57 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $295.12 / $380.19 / $758.58
| Professional | TC | $295.12 | $380.19 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $371.54
| Professional | | $32.36 | $33.11 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $851.14 / $1,023.29
| Professional | | $660.69 | $851.14 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $562.34 / $1,000.00
| Professional | | $398.11 | $562.34 | $1,000.00 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $56.23 / $79.43 / $141.25
| Professional | 26 | $56.23 | $79.43 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $331.13 / $467.74 / $776.25
| Professional | TC | $331.13 | $467.74 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $467.74 / $776.25
| Professional | | $346.74 | $467.74 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $48.98 / $67.61 / $123.03
| Professional | 26 | $48.98 | $67.61 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $295.12 / $398.11 / $660.69
| Professional | TC | $295.12 | $398.11 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $478.63 / $575.44
| Professional | | $338.84 | $478.63 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $42.66 / $58.88 / $70.79
| Professional | 26 | $42.66 | $58.88 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $295.12 / $416.87 / $501.19
| Professional | TC | $295.12 | $416.87 | $501.19 |