- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $44.67 / $50.12 / $67.61
| Facility | 26 | $44.67 | $50.12 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $363.08 / $794.33
| Professional | | $269.15 | $363.08 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $50.12 / $67.61 / $158.49
| Professional | 26 | $50.12 | $67.61 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $354.81 / $645.65
| Professional | | $281.84 | $354.81 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $52.48 / $61.66 / $104.71
| Professional | 26 | $52.48 | $61.66 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $281.84 / $338.84
| Professional | | $190.55 | $281.84 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $13.49 / $63.10 / $89.13
| Facility | 26 | $13.49 | $63.10 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $416.87 / $831.76
| Professional | | $251.19 | $416.87 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $50.12 / $74.13 / $141.25
| Professional | 26 | $50.12 | $74.13 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $144.54 / $275.42 / $407.38
| Professional | | $144.54 | $275.42 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $30.20 / $43.65 / $67.61
| Professional | 26 | $30.20 | $43.65 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $229.09 / $562.34
| Professional | | $32.36 | $229.09 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $338.84 / $676.08
| Professional | | $223.87 | $338.84 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $44.67 / $61.66 / $120.23
| Professional | 26 | $44.67 | $61.66 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $263.03 / $389.05
| Professional | | $263.03 | $263.03 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $42.66 / $42.66 / $60.26
| Professional | 26 | $42.66 | $42.66 | $60.26 |