- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $61.66 / $223.87
| Facility | | $25.12 | $61.66 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $32.36 / $117.49 / $323.59
| Facility | CQ | $32.36 | $117.49 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $39.81 / $123.03
| Professional | | $16.98 | $39.81 | $123.03 |
- 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
- $16.22 / $39.81 / $107.15
| Professional | CQ | $16.22 | $39.81 | $107.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $104.71 / $120.23
| Facility | | $75.86 | $104.71 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $30.90 / $74.13
| Professional | | $25.70 | $30.90 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $57.54 / $70.79
| Professional | | $42.66 | $57.54 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $30.20 / $67.61
| Facility | | $22.39 | $30.20 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $30.90 / $123.03 / $323.59
| Facility | CQ | $30.90 | $123.03 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $48.98 / $70.79
| Professional | | $25.70 | $48.98 | $70.79 |
- 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
- $16.22 / $44.67 / $117.49
| Professional | CQ | $16.22 | $44.67 | $117.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $53.70 / $57.54
| Facility | | $33.88 | $53.70 | $57.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $32.36 / $72.44
| Facility | | $21.38 | $32.36 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $56.23 / $79.43
| Professional | | $28.84 | $56.23 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $72.44 / $114.82
| Facility | | $40.74 | $72.44 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $43.65 / $79.43
| Professional | | $27.54 | $43.65 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $30.20 / $44.67
| Facility | | $30.20 | $30.20 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $28.84 / $74.13
| Professional | | $23.99 | $28.84 | $74.13 |