- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $93.33 / $436.52
| Facility | | $23.44 | $93.33 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $52.48 / $109.65 / $309.03
| Facility | CQ | $52.48 | $109.65 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $30.90 / $95.50
| Professional | | $16.98 | $30.90 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- CO
- Typical Low / Median / Typical High
- $35.48 / $123.03 / $154.88
| Professional | CO | $35.48 | $123.03 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $17.78 / $40.74 / $117.49
| Professional | CQ | $17.78 | $40.74 | $117.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $72.44 / $186.21
| Facility | | $38.02 | $72.44 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $19.05 / $25.12
| Professional | | $17.78 | $19.05 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $64.57 / $107.15
| Facility | | $44.67 | $64.57 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $33.88 / $52.48
| Professional | | $18.20 | $33.88 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $38.90 / $77.62
| Professional | | $26.30 | $38.90 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $34.67 / $36.31
| Professional | | $33.88 | $34.67 | $36.31 |
- 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
- $26.92 / $30.20 / $40.74
| Facility | | $26.92 | $30.20 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $27.54 / $53.70
| Professional | | $23.44 | $27.54 | $53.70 |