- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $17.78 / $371.54
| Facility | | $9.55 | $17.78 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $42.66 / $70.79 / $660.69
| Facility | CQ | $42.66 | $70.79 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $12.02 / $23.99
| Professional | | $7.94 | $12.02 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- CO
- Typical Low / Median / Typical High
- $41.69 / $41.69 / $41.69
| Professional | CO | $41.69 | $41.69 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $9.77 / $14.13 / $39.81
| Professional | CQ | $9.77 | $14.13 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $15.49 / $15.85
| Professional | | $15.49 | $15.49 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $12.30 / $24.55
| Professional | | $10.23 | $12.30 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $19.05 / $22.91
| Facility | | $13.18 | $19.05 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $15.49 / $31.62
| Professional | | $13.49 | $15.49 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $70.79 / $79.43
| Facility | | $31.62 | $70.79 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $14.13 / $23.44
| Professional | | $7.94 | $14.13 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $16.60 / $28.18
| Professional | | $12.02 | $16.60 | $28.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $123.03 / $251.19 / $323.59
| Facility | | $123.03 | $251.19 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $18.62 / $19.95
| Professional | | $17.38 | $18.62 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $14.45 / $20.89
| Facility | | $14.45 | $14.45 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $12.88 / $20.89
| Professional | | $9.33 | $12.88 | $20.89 |