- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $83.18 / $407.38
| Facility | | $18.62 | $83.18 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $25.12 / $97.72 / $446.68
| Facility | CQ | $25.12 | $97.72 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $31.62 / $87.10
| Professional | | $16.98 | $31.62 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- CO
- Typical Low / Median / Typical High
- $17.78 / $85.11 / $154.88
| Professional | CO | $17.78 | $85.11 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $17.78 / $38.90 / $85.11
| Professional | CQ | $17.78 | $38.90 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- CO
- Typical Low / Median / Typical High
- $25.12 / $25.12 / $25.12
| Professional | CO | $25.12 | $25.12 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $30.20 / $30.20 / $30.20
| Professional | CQ | $30.20 | $30.20 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $26.92 / $48.98
| Professional | | $21.88 | $26.92 | $48.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $37.15 / $44.67
| Facility | | $25.70 | $37.15 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $30.20 / $61.66
| Professional | | $26.30 | $30.20 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $70.79 / $79.43
| Facility | | $54.95 | $70.79 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $28.84 / $46.77
| Professional | | $14.79 | $28.84 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $30.90 / $48.98
| Professional | | $23.44 | $30.90 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $19.05 / $19.05 / $19.05
| Professional | 52 | $19.05 | $19.05 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $36.31 / $38.90
| Professional | | $33.88 | $36.31 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $27.54 / $40.74
| Facility | | $27.54 | $27.54 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $28.84 / $41.69
| Professional | | $20.89 | $28.84 | $41.69 |