- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $123.03 / $223.87
| Facility | | $43.65 | $123.03 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- CO
- Typical Low / Median / Typical High
- $44.67 / $44.67 / $44.67
| Facility | CO | $44.67 | $44.67 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $54.95 / $69.18 / $162.18
| Facility | CQ | $54.95 | $69.18 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $40.74 / $89.13
| Professional | | $21.88 | $40.74 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- CO
- Typical Low / Median / Typical High
- $5.75 / $30.20 / $87.10
| Professional | CO | $5.75 | $30.20 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $30.90 / $57.54 / $173.78
| Professional | CQ | $30.90 | $57.54 | $173.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $56.23 / $83.18
| Facility | | $47.86 | $56.23 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $66.07 / $72.44
| Professional | | $39.81 | $66.07 | $72.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $75.86 / $100.00
| Facility | | $70.79 | $75.86 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $36.31 / $57.54
| Professional | | $26.92 | $36.31 | $57.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $41.69 / $173.78
| Facility | | $29.51 | $41.69 | $173.78 |
- Facility/Professional
- Facility
- Modifier
- CO
- Typical Low / Median / Typical High
- $44.67 / $44.67 / $44.67
| Facility | CO | $44.67 | $44.67 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $54.95 / $69.18 / $162.18
| Facility | CQ | $54.95 | $69.18 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $53.70 / $77.62
| Professional | | $25.70 | $53.70 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- CO
- Typical Low / Median / Typical High
- $87.10 / $87.10 / $87.10
| Professional | CO | $87.10 | $87.10 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $32.36 / $57.54 / $165.96
| Professional | CQ | $32.36 | $57.54 | $165.96 |
- 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
- $54.95 / $54.95 / $83.18
| Facility | | $54.95 | $54.95 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $39.81 / $44.67
| Professional | | $33.11 | $39.81 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $33.88 / $72.44
| Professional | | $33.11 | $33.88 | $72.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $39.81 / $39.81
| Facility | | $39.81 | $39.81 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $36.31 / $40.74
| Professional | | $33.11 | $36.31 | $40.74 |