- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $338.84 / $512.86
| Facility | | $83.18 | $338.84 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $38.02 / $43.65 / $354.81
| Facility | CQ | $38.02 | $43.65 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $32.36 / $91.20
| Professional | | $19.95 | $32.36 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $7.08 / $40.74 / $74.13
| Professional | CQ | $7.08 | $40.74 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $36.31 / $112.20
| Professional | | $23.99 | $36.31 | $112.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $46.77 / $416.87
| Facility | | $27.54 | $46.77 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $38.02 / $74.13 / $457.09
| Facility | CQ | $38.02 | $74.13 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $83.18 / $144.54
| Professional | | $36.31 | $83.18 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $44.67 / $44.67 / $44.67
| Professional | CQ | $44.67 | $44.67 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $54.95 / $3,467.37
| Facility | | $41.69 | $54.95 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $66.07 / $125.89
| Professional | | $51.29 | $66.07 | $125.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $35.48 / $75.86
| Facility | | $26.30 | $35.48 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $46.77 / $83.18
| Professional | | $34.67 | $46.77 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $36.31 / $93.33
| Professional | | $27.54 | $36.31 | $93.33 |