- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $95.50 / $245.47
| Facility | | $32.36 | $95.50 | $245.47 |
- Facility/Professional
- Facility
- Modifier
- CO
- Typical Low / Median / Typical High
- $57.54 / $58.88 / $181.97
| Facility | CO | $57.54 | $58.88 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $44.67 / $89.13 / $269.15
| Facility | CQ | $44.67 | $89.13 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $43.65 / $144.54
| Professional | | $19.05 | $43.65 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- CO
- Typical Low / Median / Typical High
- $47.86 / $48.98 / $95.50
| Professional | CO | $47.86 | $48.98 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $36.31 / $63.10 / $281.84
| Professional | CQ | $36.31 | $63.10 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $52.48 / $79.43
| Facility | | $43.65 | $52.48 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $51.29 / $60.26
| Professional | | $31.62 | $51.29 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $75.86 / $100.00
| Facility | | $70.79 | $75.86 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $28.18 / $44.67
| Professional | | $21.88 | $28.18 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $36.31 / $169.82
| Facility | | $24.55 | $36.31 | $169.82 |
- Facility/Professional
- Facility
- Modifier
- CO
- Typical Low / Median / Typical High
- $58.88 / $58.88 / $181.97
| Facility | CO | $58.88 | $58.88 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $44.67 / $138.04 / $269.15
| Facility | CQ | $44.67 | $138.04 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $45.71 / $72.44
| Professional | | $21.88 | $45.71 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $31.62 / $54.95 / $257.04
| Professional | CQ | $31.62 | $54.95 | $257.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $43.65 / $67.61
| Facility | | $43.65 | $43.65 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $31.62 / $35.48
| Professional | | $26.92 | $31.62 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $28.18 / $69.18
| Professional | | $27.54 | $28.18 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $33.11 / $33.11
| Facility | | $33.11 | $33.11 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $31.62 / $34.67
| Professional | | $26.92 | $31.62 | $34.67 |