- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $30.90 / $177.83
| Facility | | $24.55 | $30.90 | $177.83 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $47.86 / $74.13 / $1,071.52
| Facility | CQ | $47.86 | $74.13 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $13.18 / $57.54
| Professional | | $8.91 | $13.18 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- CO
- Typical Low / Median / Typical High
- $12.88 / $12.88 / $12.88
| Professional | CO | $12.88 | $12.88 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $5.75 / $11.48 / $19.05
| Professional | CQ | $5.75 | $11.48 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $125.89 / $288.40
| Facility | | $54.95 | $125.89 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $20.89 / $28.18
| Professional | | $12.30 | $20.89 | $28.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $16.22 / $58.88
| Facility | | $15.85 | $16.22 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $17.78 / $30.20
| Professional | | $12.02 | $17.78 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $63.10 / $120.23
| Facility | | $13.18 | $63.10 | $120.23 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $26.92 / $54.95 / $54.95
| Facility | CQ | $26.92 | $54.95 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $18.20 / $35.48
| Professional | | $10.00 | $18.20 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $21.38 / $30.20
| Professional | | $17.78 | $21.38 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $16.22 / $16.22
| Facility | | $16.22 | $16.22 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $17.78 / $32.36
| Professional | | $16.60 | $17.78 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $194.98 / $194.98
| Facility | | $165.96 | $194.98 | $194.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $12.88 / $16.22
| Facility | | $11.48 | $12.88 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $13.18 / $34.67
| Professional | | $10.96 | $13.18 | $34.67 |