- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $41.69 / $218.78
| Facility | | $18.62 | $41.69 | $218.78 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $18.20 / $38.02 / $95.50
| Facility | CQ | $18.20 | $38.02 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $21.38 / $42.66
| Professional | | $12.88 | $21.38 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- CO
- Typical Low / Median / Typical High
- $21.38 / $66.07 / $309.03
| Professional | CO | $21.38 | $66.07 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $16.98 / $30.20 / $56.23
| Professional | CQ | $16.98 | $30.20 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $24.55 / $24.55 / $24.55
| Professional | CQ | $24.55 | $24.55 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $77.62 / $128.82
| Facility | | $31.62 | $77.62 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $26.92 / $36.31
| Professional | | $20.42 | $26.92 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $64.57 / $89.13
| Facility | | $60.26 | $64.57 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $26.92 / $40.74
| Professional | | $17.78 | $26.92 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $29.51 / $89.13
| Facility | | $17.38 | $29.51 | $89.13 |
- 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
- $21.88 / $25.70 / $169.82
| Professional | | $21.88 | $25.70 | $169.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $22.39 / $40.74
| Facility | | $22.39 | $22.39 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $24.55 / $33.11
| Professional | | $21.88 | $24.55 | $33.11 |