- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $18.20 / $23.99 / $32.36
| Facility | 26 | $18.20 | $23.99 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $85.11 / $181.97
| Professional | | $61.66 | $85.11 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $17.78 / $21.88 / $47.86
| Professional | 26 | $17.78 | $21.88 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $69.18 / $109.65 / $154.88
| Professional | | $69.18 | $109.65 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $24.55 / $33.88 / $36.31
| Professional | 26 | $24.55 | $33.88 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $77.62 / $154.88
| Professional | | $34.67 | $77.62 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $19.95 / $28.84 / $39.81
| Professional | 26 | $19.95 | $28.84 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $60.26 / $89.13
| Professional | | $19.50 | $60.26 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $93.33 / $169.82
| Professional | | $50.12 | $93.33 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $20.42 / $26.30 / $43.65
| Professional | 26 | $20.42 | $26.30 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $107.15 / $144.54
| Professional | | $85.11 | $107.15 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $20.89 / $28.18 / $60.26
| Professional | 26 | $20.89 | $28.18 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $85.11 / $114.82
| Professional | | $30.20 | $85.11 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $79.43 / $154.88
| Professional | | $43.65 | $79.43 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $16.98 / $24.55 / $43.65
| Professional | 26 | $16.98 | $24.55 | $43.65 |