- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $91.20 / $131.83
| Facility | | $12.88 | $91.20 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $12.88 / $35.48
| Professional | | $8.91 | $12.88 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $11.48 / $14.45 / $29.51
| Professional | CQ | $11.48 | $14.45 | $29.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $28.18 / $56.23
| Facility | | $13.18 | $28.18 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $33.11 / $41.69
| Professional | | $17.38 | $33.11 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $26.92 / $26.92 / $26.92
| Professional | CQ | $26.92 | $26.92 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $61.66 / $81.28
| Facility | | $36.31 | $61.66 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $15.49 / $24.55
| Professional | | $12.30 | $15.49 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $60.26 / $64.57
| Facility | | $30.90 | $60.26 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $12.02 / $19.50
| Professional | | $12.02 | $12.02 | $19.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $33.11 / $181.97
| Facility | | $15.49 | $33.11 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $16.60 / $43.65
| Professional | | $13.49 | $16.60 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $16.22 / $16.60
| Facility | | $14.79 | $16.22 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $17.78 / $48.98
| Professional | | $12.88 | $17.78 | $48.98 |