- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $97.72 / $331.13
| Facility | | $39.81 | $97.72 | $331.13 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $44.67 / $100.00 / $302.00
| Facility | CQ | $44.67 | $100.00 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $53.70 / $128.82
| Professional | | $18.20 | $53.70 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- CO
- Typical Low / Median / Typical High
- $42.66 / $42.66 / $43.65
| Professional | CO | $42.66 | $42.66 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $22.39 / $61.66 / $125.89
| Professional | CQ | $22.39 | $61.66 | $125.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $74.13 / $186.21
| Facility | | $32.36 | $74.13 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- CO
- Typical Low / Median / Typical High
- $158.49 / $158.49 / $158.49
| Facility | CO | $158.49 | $158.49 | $158.49 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $158.49 / $158.49 / $158.49
| Facility | CQ | $158.49 | $158.49 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $34.67 / $93.33
| Professional | | $26.92 | $34.67 | $93.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $190.55 / $251.19
| Facility | | $165.96 | $190.55 | $251.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $47.86 / $61.66
| Professional | | $28.18 | $47.86 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $83.18 / $93.33
| Facility | | $20.42 | $83.18 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $33.88 / $83.18
| Professional | | $20.42 | $33.88 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $29.51 / $77.62
| Facility | | $11.22 | $29.51 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $23.99 / $47.86
| Professional | | $11.22 | $23.99 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $35.48 / $75.86
| Professional | | $29.51 | $35.48 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $77.62 / $239.88
| Facility | | $54.95 | $77.62 | $239.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $54.95 / $75.86
| Professional | | $39.81 | $54.95 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $74.13 / $186.21
| Facility | | $32.36 | $74.13 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- CO
- Typical Low / Median / Typical High
- $158.49 / $158.49 / $158.49
| Facility | CO | $158.49 | $158.49 | $158.49 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $158.49 / $158.49 / $158.49
| Facility | CQ | $158.49 | $158.49 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $34.67 / $93.33
| Professional | | $26.92 | $34.67 | $93.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $22.39 / $478.63
| Facility | | $22.39 | $22.39 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $22.91 / $50.12
| Professional | | $15.14 | $22.91 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $28.84 / $28.84
| Facility | | $22.39 | $28.84 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $34.67 / $81.28
| Professional | | $26.92 | $34.67 | $81.28 |