- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $125.89 / $323.59
| Facility | | $27.54 | $125.89 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- CO
- Typical Low / Median / Typical High
- $45.71 / $69.18 / $2,041.74
| Facility | CO | $45.71 | $69.18 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $64.57 / $107.15 / $467.74
| Facility | CQ | $64.57 | $107.15 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $30.20 / $100.00
| Professional | | $19.95 | $30.20 | $100.00 |
- 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 / $46.77 / $151.36
| Professional | CQ | $30.90 | $46.77 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- CO
- Typical Low / Median / Typical High
- $26.92 / $26.92 / $27.54
| Professional | CO | $26.92 | $26.92 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $26.30 / $26.30 / $26.30
| Professional | CQ | $26.30 | $26.30 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $54.95 / $70.79
| Facility | | $38.02 | $54.95 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $36.31 / $36.31
| Professional | | $34.67 | $36.31 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $19.95 / $39.81
| Facility | | $15.14 | $19.95 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $33.88 / $38.90
| Professional | | $33.88 | $33.88 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $53.70 / $53.70 / $64.57
| Facility | | $53.70 | $53.70 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $41.69 / $75.86
| Professional | | $25.70 | $41.69 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $120.23 / $281.84
| Facility | | $27.54 | $120.23 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- CO
- Typical Low / Median / Typical High
- $45.71 / $67.61 / $2,041.74
| Facility | CO | $45.71 | $67.61 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $64.57 / $107.15 / $467.74
| Facility | CQ | $64.57 | $107.15 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $32.36 / $72.44
| Professional | | $21.88 | $32.36 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- CO
- Typical Low / Median / Typical High
- $31.62 / $31.62 / $54.95
| Professional | CO | $31.62 | $31.62 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $30.90 / $46.77 / $151.36
| Professional | CQ | $30.90 | $46.77 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $75.86 / $75.86
| Professional | | $30.90 | $75.86 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $34.67 / $34.67
| Facility | | $28.18 | $34.67 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $33.88 / $70.79
| Professional | | $28.18 | $33.88 | $70.79 |