- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $93.33 / $120.23
| Facility | | $23.99 | $93.33 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $12.88 / $18.20
| Professional | | $8.91 | $12.88 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $13.80 / $22.39 / $25.70
| Professional | CQ | $13.80 | $22.39 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $17.38 / $19.05
| Facility | | $12.88 | $17.38 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $16.98 / $20.89
| Professional | | $12.88 | $16.98 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $15.14 / $15.49
| Professional | | $12.02 | $15.14 | $15.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $17.38 / $35.48
| Facility | | $10.00 | $17.38 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $15.49 / $48.98
| Professional | | $13.80 | $15.49 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $18.20 / $25.12
| Professional | | $17.38 | $18.20 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $17.38 / $36.31
| Professional | | $17.38 | $17.38 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $22.39 / $28.18
| Professional | | $16.60 | $22.39 | $28.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $16.22 / $16.22
| Facility | | $16.22 | $16.22 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $14.79 / $33.88
| Professional | | $12.59 | $14.79 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $19.95 / $23.44
| Professional | | $18.20 | $19.95 | $23.44 |