- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $81.28 / $295.12
| Facility | | $17.78 | $81.28 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $64.57 / $91.20 / $269.15
| Facility | CQ | $64.57 | $91.20 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $36.31 / $123.03
| Professional | | $15.85 | $36.31 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- CO
- Typical Low / Median / Typical High
- $17.78 / $123.03 / $154.88
| Professional | CO | $17.78 | $123.03 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $17.78 / $38.02 / $97.72
| Professional | CQ | $17.78 | $38.02 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $26.30 / $26.30 / $26.30
| Professional | CQ | $26.30 | $26.30 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $63.10 / $134.90
| Facility | | $18.62 | $63.10 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $28.84 / $67.61
| Professional | | $18.20 | $28.84 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $57.54 / $64.57
| Facility | | $54.95 | $57.54 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $28.18 / $47.86
| Professional | | $18.62 | $28.18 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $26.30 / $87.10
| Facility | | $14.45 | $26.30 | $87.10 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $53.70 / $107.15 / $107.15
| Facility | CQ | $53.70 | $107.15 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $27.54 / $79.43
| Professional | | $19.05 | $27.54 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $27.54 / $40.74
| Facility | | $22.91 | $27.54 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $27.54 / $43.65
| Professional | | $23.44 | $27.54 | $43.65 |