- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $21.88 / $50.12
| Facility | | $12.02 | $21.88 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $12.88 / $19.95
| Professional | | $10.00 | $12.88 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $11.48 / $12.02 / $12.59
| Professional | CQ | $11.48 | $12.02 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $79.43 / $234.42
| Facility | | $15.14 | $79.43 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $18.62 / $22.39
| Professional | | $17.38 | $18.62 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $39.81 / $120.23
| Facility | | $16.98 | $39.81 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $14.79 / $20.42
| Professional | | $12.59 | $14.79 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $16.98 / $32.36
| Facility | | $11.48 | $16.98 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $18.20 / $18.20
| Professional | | $18.20 | $18.20 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $18.20 / $19.95
| Facility | | $18.20 | $18.20 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $16.60 / $20.89
| Professional | | $14.79 | $16.60 | $20.89 |