- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $165.96 / $436.52
| Facility | | $27.54 | $165.96 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- CO
- Typical Low / Median / Typical High
- $70.79 / $120.23 / $257.04
| Facility | CO | $70.79 | $120.23 | $257.04 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $42.66 / $109.65 / $309.03
| Facility | CQ | $42.66 | $109.65 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $37.15 / $114.82
| Professional | | $21.88 | $37.15 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- CO
- Typical Low / Median / Typical High
- $26.92 / $104.71 / $104.71
| Professional | CO | $26.92 | $104.71 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $30.90 / $52.48 / $112.20
| Professional | CQ | $30.90 | $52.48 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- CO
- Typical Low / Median / Typical High
- $20.89 / $20.89 / $20.89
| Professional | CO | $20.89 | $20.89 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $20.89 / $34.67 / $41.69
| Professional | CQ | $20.89 | $34.67 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $31.62 / $60.26
| Professional | | $24.55 | $31.62 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $46.77 / $57.54
| Facility | | $32.36 | $46.77 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $38.02 / $75.86
| Professional | | $33.11 | $38.02 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $70.79 / $79.43
| Facility | | $54.95 | $70.79 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $37.15 / $61.66
| Professional | | $19.50 | $37.15 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $40.74 / $54.95
| Professional | | $29.51 | $40.74 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $46.77 / $48.98
| Professional | | $42.66 | $46.77 | $48.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $34.67 / $51.29
| Facility | | $34.67 | $34.67 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $35.48 / $53.70
| Professional | | $23.99 | $35.48 | $53.70 |