- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $151.36 / $524.81
| Facility | | $47.86 | $151.36 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- CO
- Typical Low / Median / Typical High
- $77.62 / $100.00 / $154.88
| Facility | CO | $77.62 | $100.00 | $154.88 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $87.10 / $144.54 / $213.80
| Facility | CQ | $87.10 | $144.54 | $213.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $41.69 / $151.36
| Professional | | $20.42 | $41.69 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- CO
- Typical Low / Median / Typical High
- $54.95 / $54.95 / $104.71
| Professional | CO | $54.95 | $54.95 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $30.90 / $53.70 / $114.82
| Professional | CQ | $30.90 | $53.70 | $114.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $91.20 / $234.42
| Facility | | $41.69 | $91.20 | $234.42 |
- Facility/Professional
- Facility
- Modifier
- CO
- Typical Low / Median / Typical High
- $199.53 / $199.53 / $199.53
| Facility | CO | $199.53 | $199.53 | $199.53 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $199.53 / $199.53 / $199.53
| Facility | CQ | $199.53 | $199.53 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $44.67 / $117.49
| Professional | | $31.62 | $44.67 | $117.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $190.55 / $251.19
| Facility | | $165.96 | $190.55 | $251.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $64.57 / $89.13
| Professional | | $38.90 | $64.57 | $89.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $89.13 / $120.23
| Facility | | $26.30 | $89.13 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $41.69 / $107.15
| Professional | | $24.55 | $41.69 | $107.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $39.81 / $89.13
| Facility | | $18.62 | $39.81 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $33.11 / $57.54
| Professional | | $18.62 | $33.11 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $42.66 / $93.33
| Professional | | $36.31 | $42.66 | $93.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $81.28 / $229.09
| Facility | | $54.95 | $81.28 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $75.86 / $131.83
| Professional | | $50.12 | $75.86 | $131.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $91.20 / $234.42
| Facility | | $41.69 | $91.20 | $234.42 |
- Facility/Professional
- Facility
- Modifier
- CO
- Typical Low / Median / Typical High
- $199.53 / $199.53 / $199.53
| Facility | CO | $199.53 | $199.53 | $199.53 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $199.53 / $199.53 / $199.53
| Facility | CQ | $199.53 | $199.53 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $44.67 / $117.49
| Professional | | $31.62 | $44.67 | $117.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $28.84 / $436.52
| Facility | | $24.55 | $28.84 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $28.84 / $58.88
| Professional | | $15.14 | $28.84 | $58.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $34.67 / $34.67
| Facility | | $23.44 | $34.67 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $42.66 / $97.72
| Professional | | $32.36 | $42.66 | $97.72 |