- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $43.65 / $60.26
| Facility | | $16.60 | $43.65 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $12.88 / $37.15
| Professional | | $8.91 | $12.88 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- CO
- Typical Low / Median / Typical High
- $19.05 / $19.05 / $19.05
| Professional | CO | $19.05 | $19.05 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $10.47 / $14.45 / $60.26
| Professional | CQ | $10.47 | $14.45 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $50.12 / $100.00
| Facility | | $13.80 | $50.12 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $10.72 / $23.44
| Professional | | $7.24 | $10.72 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $57.54 / $64.57
| Facility | | $54.95 | $57.54 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $15.49 / $29.51
| Professional | | $12.02 | $15.49 | $29.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $14.13 / $79.43
| Facility | | $10.47 | $14.13 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $16.22 / $91.20
| Professional | | $12.88 | $16.22 | $91.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $16.60 / $21.88
| Facility | | $12.02 | $16.60 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $15.14 / $22.91
| Professional | | $12.88 | $15.14 | $22.91 |