- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $128.82 / $380.19
| Facility | | $35.48 | $128.82 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- CO
- Typical Low / Median / Typical High
- $69.18 / $97.72 / $257.04
| Facility | CO | $69.18 | $97.72 | $257.04 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $56.23 / $95.50 / $371.54
| Facility | CQ | $56.23 | $95.50 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $47.86 / $128.82
| Professional | | $19.05 | $47.86 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- CO
- Typical Low / Median / Typical High
- $51.29 / $64.57 / $104.71
| Professional | CO | $51.29 | $64.57 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $36.31 / $63.10 / $204.17
| Professional | CQ | $36.31 | $63.10 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $23.44 / $26.92
| Professional | | $19.95 | $23.44 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- CO
- Typical Low / Median / Typical High
- $43.65 / $43.65 / $43.65
| Professional | CO | $43.65 | $43.65 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $29.51 / $43.65
| Facility | | $23.44 | $29.51 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $23.99 / $40.74
| Professional | | $19.05 | $23.99 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $33.88 / $39.81
| Facility | | $27.54 | $33.88 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $32.36 / $38.02
| Professional | | $28.18 | $32.36 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $72.44 / $89.13
| Facility | | $29.51 | $72.44 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $28.84 / $50.12
| Professional | | $20.89 | $28.84 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $34.67 / $42.66
| Facility | | $23.44 | $34.67 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $28.18 / $54.95
| Professional | | $24.55 | $28.18 | $54.95 |