- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $147.91 / $446.68
| Facility | | $25.12 | $147.91 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- CO
- Typical Low / Median / Typical High
- $363.08 / $363.08 / $363.08
| Facility | CO | $363.08 | $363.08 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $69.18 / $89.13 / $416.87
| Facility | CQ | $69.18 | $89.13 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $32.36 / $117.49
| Professional | | $16.98 | $32.36 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- CO
- Typical Low / Median / Typical High
- $47.86 / $47.86 / $85.11
| Professional | CO | $47.86 | $47.86 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $21.38 / $47.86 / $97.72
| Professional | CQ | $21.38 | $47.86 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $43.65 / $75.86
| Professional | | $19.95 | $43.65 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $60.26 / $70.79
| Facility | | $54.95 | $60.26 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $25.12 / $37.15
| Professional | | $18.62 | $25.12 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.25 / $28.84 / $46.77
| Professional | | $0.25 | $28.84 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.25 / $0.25 / $43.65
| Professional | | $0.25 | $0.25 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $28.84 / $31.62
| Professional | | $27.54 | $28.84 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $30.20 / $30.20
| Facility | | $30.20 | $30.20 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $31.62 / $54.95
| Professional | | $22.91 | $31.62 | $54.95 |