- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $95.50 / $407.38
| Facility | | $44.67 | $95.50 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $37.15 / $63.10 / $891.25
| Facility | CQ | $37.15 | $63.10 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $51.29 / $131.83
| Professional | | $19.95 | $51.29 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- CO
- Typical Low / Median / Typical High
- $47.86 / $47.86 / $47.86
| Professional | CO | $47.86 | $47.86 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $26.92 / $58.88 / $138.04
| Professional | CQ | $26.92 | $58.88 | $138.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $64,565.42 / $77,624.71 / $95,499.26
| Facility | | $64,565.42 | $77,624.71 | $95,499.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $46.77 / $46.77
| Professional | | $43.65 | $46.77 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $51.29 / $54.95
| Facility | | $38.90 | $51.29 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $38.90 / $51.29
| Professional | | $21.38 | $38.90 | $51.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $51.29 / $53.70
| Facility | | $42.66 | $51.29 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $51.29 / $53.70
| Professional | | $42.66 | $51.29 | $53.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $30.20 / $54.95
| Facility | | $18.20 | $30.20 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $46.77 / $79.43
| Professional | | $28.84 | $46.77 | $79.43 |
- 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
- $28.18 / $31.62 / $58.88
| Professional | | $28.18 | $31.62 | $58.88 |