- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $18.20 / $213.80
| Facility | | $8.51 | $18.20 | $213.80 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $14.13 / $18.20 / $18.20
| Facility | CQ | $14.13 | $18.20 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $9.55 / $24.55
| Professional | | $7.08 | $9.55 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $7.59 / $27.54 / $31.62
| Professional | CQ | $7.59 | $27.54 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $15.49 / $25.12
| Professional | | $11.22 | $15.49 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $15.85 / $19.50
| Facility | | $10.96 | $15.85 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $12.88 / $26.30
| Professional | | $11.48 | $12.88 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $70.79 / $79.43
| Facility | | $26.30 | $70.79 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $15.85 / $27.54
| Professional | | $7.41 | $15.85 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $14.79 / $34.67
| Professional | | $10.23 | $14.79 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $15.49 / $16.60
| Professional | | $14.45 | $15.49 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $12.02 / $17.38
| Facility | | $12.02 | $12.02 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $12.59 / $21.38
| Professional | | $10.23 | $12.59 | $21.38 |