- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $257.04 / $512.86
| Facility | | $26.92 | $257.04 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $134.90 / $147.91 / $288.40
| Facility | CQ | $134.90 | $147.91 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $43.65 / $144.54
| Professional | | $16.98 | $43.65 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- CO
- Typical Low / Median / Typical High
- $125.89 / $407.38 / $446.68
| Professional | CO | $125.89 | $407.38 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $17.78 / $61.66 / $281.84
| Professional | CQ | $17.78 | $61.66 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $23.99 / $77.62
| Professional | | $18.62 | $23.99 | $77.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $26.30 / $35.48
| Facility | | $26.30 | $26.30 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $26.30 / $26.92
| Professional | | $26.30 | $26.30 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $81.28 / $97.72
| Facility | | $64.57 | $81.28 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $40.74 / $81.28
| Professional | | $23.44 | $40.74 | $81.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $26.30 / $56.23
| Facility | | $18.20 | $26.30 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $54.95 / $79.43
| Professional | | $50.12 | $54.95 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $102.33 / $158.49
| Facility | | $25.70 | $102.33 | $158.49 |
- 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
- $25.12 / $32.36 / $134.90
| Professional | | $25.12 | $32.36 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $70.79
| Professional | | $32.36 | $33.11 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $40.74 / $60.26
| Facility | | $40.74 | $40.74 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $38.90 / $69.18
| Professional | | $25.12 | $38.90 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $64.57 / $91.20
| Professional | | $30.90 | $64.57 | $91.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $79.43 / $169.82
| Facility | | $64.57 | $79.43 | $169.82 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $56.23 / $144.54 / $144.54
| Facility | CQ | $56.23 | $144.54 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $138.04 / $169.82
| Professional | | $26.92 | $138.04 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $33.88 / $33.88
| Professional | | $33.88 | $33.88 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $58.88 / $58.88
| Facility | | $58.88 | $58.88 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $63.10 / $75.86
| Professional | | $33.88 | $63.10 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $30.20 / $30.20
| Facility | | $30.20 | $30.20 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $54.95 / $100.00
| Professional | | $27.54 | $54.95 | $100.00 |