- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $15.14 / $123.03
| Facility | | $8.91 | $15.14 | $123.03 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $56.23 / $123.03 / $141.25
| Facility | CQ | $56.23 | $123.03 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $10.96 / $22.91
| Professional | | $7.94 | $10.96 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $11.48 / $30.20 / $44.67
| Professional | CQ | $11.48 | $30.20 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $10.47 / $13.18
| Professional | | $10.47 | $10.47 | $13.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $12.02 / $18.20
| Facility | | $12.02 | $12.02 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $8.91 / $17.78
| Professional | | $7.08 | $8.91 | $17.78 |
- 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
- $13.18 / $15.49 / $19.05
| Professional | | $13.18 | $15.49 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $22.91 / $75.86
| Facility | | $22.91 | $22.91 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $19.50 / $19.50 / $19.50
| Facility | CQ | $19.50 | $19.50 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $15.14 / $67.61
| Professional | | $7.76 | $15.14 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $32.36 / $33.11
| Professional | | $9.77 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $14.79 / $16.22
| Facility | | $14.79 | $14.79 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $12.30 / $16.60
| Professional | | $9.77 | $12.30 | $16.60 |