- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $97.72 / $363.08
| Facility | | $34.67 | $97.72 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- CO
- Typical Low / Median / Typical High
- $97.72 / $263.03 / $436.52
| Facility | CO | $97.72 | $263.03 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $81.28 / $128.82 / $302.00
| Facility | CQ | $81.28 | $128.82 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $36.31 / $114.82
| Professional | | $21.88 | $36.31 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- CO
- Typical Low / Median / Typical High
- $20.42 / $54.95 / $125.89
| Professional | CO | $20.42 | $54.95 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $30.90 / $60.26 / $158.49
| Professional | CQ | $30.90 | $60.26 | $158.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $83.18 / $275.42
| Facility | | $45.71 | $83.18 | $275.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $35.48 / $37.15
| Professional | | $31.62 | $35.48 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $64.57 / $107.15
| Facility | | $44.67 | $64.57 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $39.81 / $66.07
| Professional | | $23.99 | $39.81 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $48.98 / $83.18
| Professional | | $33.11 | $48.98 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $43.65 / $45.71
| Professional | | $42.66 | $43.65 | $45.71 |
- 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
- $34.67 / $38.90 / $51.29
| Facility | | $34.67 | $38.90 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $36.31 / $67.61
| Professional | | $28.18 | $36.31 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $39.81 / $39.81 / $39.81
| Professional | CQ | $39.81 | $39.81 | $39.81 |