- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $123.03 / $234.42
| Facility | | $63.10 | $123.03 | $234.42 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $89.13 / $97.72 / $371.54
| Facility | CQ | $89.13 | $97.72 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $30.90 / $131.83
| Professional | | $16.98 | $30.90 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- CO
- Typical Low / Median / Typical High
- $134.90 / $407.38 / $446.68
| Professional | CO | $134.90 | $407.38 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $17.78 / $42.66 / $147.91
| Professional | CQ | $17.78 | $42.66 | $147.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $141.25 / $141.25
| Facility | | $38.90 | $141.25 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $63.10 / $79.43
| Professional | | $33.11 | $63.10 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- CO
- Typical Low / Median / Typical High
- $48.98 / $51.29 / $61.66
| Professional | CO | $48.98 | $51.29 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $120.23 / $154.88
| Facility | | $70.79 | $120.23 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $30.20 / $47.86
| Professional | | $23.99 | $30.20 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $117.49 / $125.89
| Facility | | $60.26 | $117.49 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $23.44 / $38.02
| Professional | | $23.44 | $23.44 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $89.13 / $141.25
| Facility | | $37.15 | $89.13 | $141.25 |
- 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
- $26.92 / $54.95 / $77.62
| Professional | | $26.92 | $54.95 | $77.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $30.20 / $31.62
| Facility | | $27.54 | $30.20 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $30.20 / $87.10
| Professional | | $24.55 | $30.20 | $87.10 |