- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $125.89 / $398.11
| Facility | | $63.10 | $125.89 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $38.90 / $83.18
| Professional | | $20.89 | $38.90 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- CO
- Typical Low / Median / Typical High
- $47.86 / $51.29 / $51.29
| Professional | CO | $47.86 | $51.29 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $25.12 / $47.86 / $70.79
| Professional | CQ | $25.12 | $47.86 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $39.81 / $43.65
| Facility | | $29.51 | $39.81 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $41.69 / $46.77
| Professional | | $29.51 | $41.69 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $34.67 / $35.48
| Professional | | $28.18 | $34.67 | $35.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $41.69 / $114.82
| Facility | | $23.99 | $41.69 | $114.82 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $63.10 / $63.10 / $128.82
| Facility | CQ | $63.10 | $63.10 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $41.69 / $85.11
| Professional | | $28.84 | $41.69 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $40.74 / $58.88
| Professional | | $39.81 | $40.74 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $39.81 / $75.86
| Professional | | $36.31 | $39.81 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $48.98 / $64.57
| Professional | | $36.31 | $48.98 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $37.15 / $37.15
| Facility | | $37.15 | $37.15 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $33.88 / $77.62
| Professional | | $28.84 | $33.88 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $44.67 / $52.48
| Professional | | $40.74 | $44.67 | $52.48 |