- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $16.98 / $19.50 / $19.50
| Facility | 26 | $16.98 | $19.50 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $64.57 / $234.42
| Professional | | $51.29 | $64.57 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $15.85 / $29.51 / $75.86
| Professional | 26 | $15.85 | $29.51 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $28.84 / $28.84 / $177.83
| Professional | 50 | $28.84 | $28.84 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $37.15 / $43.65 / $67.61
| Professional | TC | $37.15 | $43.65 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $41.69 / $109.65
| Professional | | $17.78 | $41.69 | $109.65 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $4.37 / $20.42 / $29.51
| Facility | 26 | $4.37 | $20.42 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $81.28 / $281.84
| Professional | | $56.23 | $81.28 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $17.38 / $26.30 / $85.11
| Professional | 26 | $17.38 | $26.30 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $38.02 / $52.48 / $194.98
| Professional | TC | $38.02 | $52.48 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $74.13 / $74.13 / $123.03
| Professional | | $74.13 | $74.13 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $24.55 / $38.02 / $38.02
| Professional | 26 | $24.55 | $38.02 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $67.61 / $95.50
| Professional | | $47.86 | $67.61 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $14.79 / $21.38 / $30.20
| Professional | 26 | $14.79 | $21.38 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $32.36 / $47.86 / $64.57
| Professional | TC | $32.36 | $47.86 | $64.57 |