- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $128.82 / $234.42
| Facility | | $63.10 | $128.82 | $234.42 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $69.18 / $117.49 / $371.54
| Facility | CQ | $69.18 | $117.49 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $25.70 / $79.43
| Professional | | $16.98 | $25.70 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- CO
- Typical Low / Median / Typical High
- $21.38 / $93.33 / $309.03
| Professional | CO | $21.38 | $93.33 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $17.78 / $36.31 / $58.88
| Professional | CQ | $17.78 | $36.31 | $58.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $33.88 / $36.31
| Facility | | $24.55 | $33.88 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $33.88 / $39.81
| Professional | | $24.55 | $33.88 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $29.51 / $30.20
| Professional | | $23.44 | $29.51 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $43.65 / $123.03
| Facility | | $21.38 | $43.65 | $123.03 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $53.70 / $53.70 / $107.15
| Facility | CQ | $53.70 | $53.70 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $33.88 / $63.10
| Professional | | $25.70 | $33.88 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $34.67 / $46.77
| Professional | | $32.36 | $34.67 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $67.61
| Professional | | $32.36 | $32.36 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $41.69 / $54.95
| Professional | | $30.20 | $41.69 | $54.95 |
- 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
- $23.99 / $30.20 / $63.10
| Professional | | $23.99 | $30.20 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $38.02 / $44.67
| Professional | | $34.67 | $38.02 | $44.67 |