- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $74.13 / $177.83
| Facility | | $30.20 | $74.13 | $177.83 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $38.02 / $41.69 / $69.18
| Facility | CQ | $38.02 | $41.69 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $30.90 / $107.15
| Professional | | $18.20 | $30.90 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- CO
- Typical Low / Median / Typical High
- $39.81 / $134.90 / $134.90
| Professional | CO | $39.81 | $134.90 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $17.38 / $45.71 / $223.87
| Professional | CQ | $17.38 | $45.71 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $50.12 / $66.07
| Facility | | $39.81 | $50.12 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $48.98 / $57.54
| Professional | | $28.84 | $48.98 | $57.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $75.86 / $100.00
| Facility | | $70.79 | $75.86 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $25.70 / $40.74
| Professional | | $20.42 | $25.70 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $30.90 / $74.13
| Facility | | $22.91 | $30.90 | $74.13 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $38.02 / $41.69 / $69.18
| Facility | CQ | $38.02 | $41.69 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $41.69 / $56.23
| Professional | | $20.89 | $41.69 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- CO
- Typical Low / Median / Typical High
- $134.90 / $134.90 / $134.90
| Professional | CO | $134.90 | $134.90 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $15.49 / $44.67 / $173.78
| Professional | CQ | $15.49 | $44.67 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $40.74 / $60.26
| Facility | | $40.74 | $40.74 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $28.84 / $33.11
| Professional | | $24.55 | $28.84 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $26.92 / $64.57
| Professional | | $25.70 | $26.92 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $31.62 / $31.62
| Facility | | $31.62 | $31.62 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $28.84 / $34.67
| Professional | | $25.12 | $28.84 | $34.67 |