- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $14.13 / $117.49
| Facility | | $13.49 | $14.13 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $12.88 / $23.44
| Professional | | $10.00 | $12.88 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $12.59 / $12.59 / $12.59
| Professional | CQ | $12.59 | $12.59 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $27.54 / $35.48
| Facility | | $19.50 | $27.54 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $17.78 / $19.05
| Professional | | $16.98 | $17.78 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $16.98 / $31.62
| Facility | | $15.14 | $16.98 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $17.38 / $19.95
| Professional | | $17.38 | $17.38 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $53.70 / $53.70 / $64.57
| Facility | | $53.70 | $53.70 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $25.70 / $75.86
| Professional | | $12.88 | $25.70 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $16.98 / $56.23
| Facility | | $13.49 | $16.98 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $17.78 / $30.90
| Professional | | $12.02 | $17.78 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $12.59 / $12.59 / $12.59
| Professional | CQ | $12.59 | $12.59 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $75.86 / $75.86
| Professional | | $15.49 | $75.86 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $18.20 / $18.62
| Facility | | $14.45 | $18.20 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $16.98 / $26.92
| Professional | | $15.14 | $16.98 | $26.92 |