- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $91.20 / $380.19
| Facility | | $20.42 | $91.20 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- CO
- Typical Low / Median / Typical High
- $75.86 / $190.55 / $562.34
| Facility | CO | $75.86 | $190.55 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $44.67 / $72.44 / $338.84
| Facility | CQ | $44.67 | $72.44 | $338.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $23.99 / $54.95
| Professional | | $14.13 | $23.99 | $54.95 |
- 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
- $20.89 / $60.26 / $87.10
| Professional | CQ | $20.89 | $60.26 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $19.95 / $19.95 / $26.30
| Professional | CQ | $19.95 | $19.95 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $79.43 / $128.82
| Facility | | $45.71 | $79.43 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $29.51 / $39.81
| Professional | | $22.39 | $29.51 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $64.57 / $89.13
| Facility | | $60.26 | $64.57 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $28.84 / $43.65
| Professional | | $17.78 | $28.84 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $33.88 / $104.71
| Facility | | $19.50 | $33.88 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- CO
- Typical Low / Median / Typical High
- $56.23 / $114.82 / $114.82
| Facility | CO | $56.23 | $114.82 | $114.82 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $56.23 / $114.82 / $114.82
| Facility | CQ | $56.23 | $114.82 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $28.18 / $186.21
| Professional | | $23.44 | $28.18 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $23.99 / $42.66
| Facility | | $23.44 | $23.99 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $26.92 / $34.67
| Professional | | $23.44 | $26.92 | $34.67 |