- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $123.03 / $223.87
| Facility | | $32.36 | $123.03 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $51.29 / $89.13 / $229.09
| Facility | CQ | $51.29 | $89.13 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $44.67 / $354.81
| Professional | | $19.95 | $44.67 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- CO
- Typical Low / Median / Typical High
- $26.92 / $26.92 / $26.92
| Professional | CO | $26.92 | $26.92 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $22.91 / $38.90 / $81.28
| Professional | CQ | $22.91 | $38.90 | $81.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $72.44 / $72.44 / $75.86
| Facility | | $72.44 | $72.44 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $32.36 / $63.10
| Professional | | $19.95 | $32.36 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $33.11
| Professional | | $32.36 | $33.11 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $45.71 / $61.66
| Facility | | $41.69 | $45.71 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $38.90 / $48.98
| Professional | | $30.20 | $38.90 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $33.88 / $46.77
| Professional | | $30.20 | $33.88 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $44.67 / $61.66
| Professional | | $32.36 | $44.67 | $61.66 |
- 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 / $44.67
| Professional | | $28.84 | $33.88 | $44.67 |