- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $97.72 / $407.38
| Facility | | $27.54 | $97.72 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- CO
- Typical Low / Median / Typical High
- $54.95 / $549.54 / $549.54
| Facility | CO | $54.95 | $549.54 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $56.23 / $144.54 / $758.58
| Facility | CQ | $56.23 | $144.54 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $54.95 / $245.47
| Professional | | $19.05 | $54.95 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- CO
- Typical Low / Median / Typical High
- $18.62 / $43.65 / $138.04
| Professional | CO | $18.62 | $43.65 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $21.88 / $56.23 / $147.91
| Professional | CQ | $21.88 | $56.23 | $147.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $50.12 / $64.57
| Facility | | $33.88 | $50.12 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $31.62 / $48.98
| Professional | | $25.12 | $31.62 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $39.81 / $74.13
| Professional | | $26.30 | $39.81 | $74.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $50.12 / $134.90
| Facility | | $24.55 | $50.12 | $134.90 |
- Facility/Professional
- Facility
- Modifier
- CO
- Typical Low / Median / Typical High
- $114.82 / $114.82 / $114.82
| Facility | CO | $114.82 | $114.82 | $114.82 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $114.82 / $114.82 / $114.82
| Facility | CQ | $114.82 | $114.82 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $37.15 / $83.18
| Professional | | $24.55 | $37.15 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $44.67 / $97.72
| Professional | | $37.15 | $44.67 | $97.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $33.88 / $33.88
| Facility | | $33.88 | $33.88 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $35.48 / $50.12
| Professional | | $35.48 | $35.48 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $38.02 / $60.26
| Professional | | $28.18 | $38.02 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $31.62 / $45.71
| Facility | | $31.62 | $31.62 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $29.51 / $79.43
| Professional | | $23.44 | $29.51 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $37.15 / $43.65
| Professional | | $37.15 | $37.15 | $43.65 |