- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $52.48 / $66.07 / $89.13
| Facility | 26 | $52.48 | $66.07 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $354.81 / $758.58
| Professional | | $281.84 | $354.81 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $51.29 / $63.10 / $158.49
| Professional | 26 | $51.29 | $63.10 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $489.78 / $691.83
| Professional | | $32.36 | $489.78 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $57.54 / $100.00 / $112.20
| Professional | 26 | $57.54 | $100.00 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $354.81 / $575.44
| Professional | | $208.93 | $354.81 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $50.12 / $72.44 / $104.71
| Professional | 26 | $50.12 | $72.44 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $436.52 / $794.33
| Professional | | $245.47 | $436.52 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $57.54 / $79.43 / $138.04
| Professional | 26 | $57.54 | $79.43 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $467.74 / $1,148.15
| Professional | | $288.40 | $467.74 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $58.88 / $77.62 / $181.97
| Professional | 26 | $58.88 | $77.62 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $66.07 / $380.19 / $758.58
| Professional | | $66.07 | $380.19 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $380.19 / $794.33
| Professional | | $251.19 | $380.19 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $53.70 / $75.86 / $131.83
| Professional | 26 | $53.70 | $75.86 | $131.83 |