- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $72.44 / $100.00
| Facility | | $23.44 | $72.44 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $69.18 / $83.18 / $125.89
| Facility | CQ | $69.18 | $83.18 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $21.88 / $45.71
| Professional | | $15.85 | $21.88 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $32.36 / $40.74 / $77.62
| Professional | CQ | $32.36 | $40.74 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $43.65 / $43.65 / $43.65
| Professional | CQ | $43.65 | $43.65 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $28.84 / $38.02
| Facility | | $20.89 | $28.84 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $22.91 / $35.48
| Professional | | $16.60 | $22.91 | $35.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $33.88 / $39.81
| Facility | | $27.54 | $33.88 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $32.36 / $38.02
| Professional | | $28.18 | $32.36 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $93.33 / $95.50
| Facility | | $64.57 | $93.33 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $28.18 / $50.12
| Professional | | $19.05 | $28.18 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $25.12 / $38.02
| Facility | | $21.38 | $25.12 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $26.92 / $45.71
| Professional | | $22.39 | $26.92 | $45.71 |