- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $114.82 / $389.05
| Facility | | $21.38 | $114.82 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $56.23 / $61.66 / $112.20
| Facility | CQ | $56.23 | $61.66 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $51.29 / $309.03
| Professional | | $20.89 | $51.29 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- CO
- Typical Low / Median / Typical High
- $20.89 / $26.92 / $26.92
| Professional | CO | $20.89 | $26.92 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $21.38 / $40.74 / $83.18
| Professional | CQ | $21.38 | $40.74 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $50.12 / $64.57
| Facility | | $38.90 | $50.12 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $34.67 / $52.48
| Professional | | $27.54 | $34.67 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $43.65 / $81.28
| Professional | | $28.84 | $43.65 | $81.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $47.86 / $151.36
| Facility | | $25.70 | $47.86 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $128.82 / $128.82 / $128.82
| Facility | CQ | $128.82 | $128.82 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $40.74 / $95.50
| Professional | | $25.70 | $40.74 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $51.29 / $102.33
| Professional | | $40.74 | $51.29 | $102.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $38.90 / $38.90
| Facility | | $38.90 | $38.90 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $37.15 / $58.88
| Professional | | $37.15 | $37.15 | $58.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $75.86 / $630.96
| Facility | | $75.86 | $75.86 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $42.66 / $67.61
| Professional | | $31.62 | $42.66 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $36.31 / $51.29
| Facility | | $36.31 | $36.31 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $33.88 / $83.18
| Professional | | $25.12 | $33.88 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $40.74 / $48.98
| Professional | | $40.74 | $40.74 | $48.98 |