- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $63.10 / $234.42
| Facility | | $26.92 | $63.10 | $234.42 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $70.79 / $112.20 / $114.82
| Facility | CQ | $70.79 | $112.20 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $23.99 / $114.82
| Professional | | $14.45 | $23.99 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $17.38 / $21.88 / $56.23
| Professional | CQ | $17.38 | $21.88 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $104.71 / $120.23
| Facility | | $75.86 | $104.71 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $32.36 / $77.62
| Professional | | $25.70 | $32.36 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $61.66 / $74.13
| Professional | | $47.86 | $61.66 | $74.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $31.62 / $69.18
| Facility | | $23.99 | $31.62 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $70.79 / $112.20 / $114.82
| Facility | CQ | $70.79 | $112.20 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $48.98 / $72.44
| Professional | | $29.51 | $48.98 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $17.38 / $21.88 / $56.23
| Professional | CQ | $17.38 | $21.88 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $57.54 / $58.88
| Facility | | $36.31 | $57.54 | $58.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $33.11 / $74.13
| Facility | | $22.91 | $33.11 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $58.88 / $79.43
| Professional | | $30.20 | $58.88 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $79.43 / $123.03
| Facility | | $43.65 | $79.43 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $46.77 / $85.11
| Professional | | $33.11 | $46.77 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $31.62 / $46.77
| Facility | | $31.62 | $31.62 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $30.90 / $79.43
| Professional | | $26.30 | $30.90 | $79.43 |