- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $123.03 / $363.08
| Facility | | $26.30 | $123.03 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $61.66 / $93.33 / $302.00
| Facility | CQ | $61.66 | $93.33 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $30.90 / $87.10
| Professional | | $19.95 | $30.90 | $87.10 |
- 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
- $21.88 / $38.02 / $97.72
| Professional | CQ | $21.88 | $38.02 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $22.39 / $32.36
| Professional | | $16.98 | $22.39 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $29.51 / $75.86
| Professional | | $24.55 | $29.51 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $72.44 / $204.17
| Facility | | $52.48 | $72.44 | $204.17 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $44.67 / $44.67 / $44.67
| Facility | CQ | $44.67 | $44.67 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $30.20 / $60.26
| Professional | | $23.44 | $30.20 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $35.48 / $42.66
| Professional | | $28.84 | $35.48 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $39.81 / $40.74
| Professional | | $33.11 | $39.81 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $30.90 / $53.70
| Facility | | $21.38 | $30.90 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $36.31 / $36.31
| Professional | | $36.31 | $36.31 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $38.90 / $144.54
| Facility | | $22.39 | $38.90 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $38.90 / $144.54
| Professional | | $22.39 | $38.90 | $144.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $36.31 / $37.15
| Facility | | $32.36 | $36.31 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $33.88 / $43.65
| Professional | | $23.99 | $33.88 | $43.65 |