- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $58.88 / $416.87
| Facility | | $26.30 | $58.88 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- CO
- Typical Low / Median / Typical High
- $74.13 / $309.03 / $316.23
| Facility | CO | $74.13 | $309.03 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $52.48 / $144.54 / $363.08
| Facility | CQ | $52.48 | $144.54 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $40.74 / $288.40
| Professional | | $21.88 | $40.74 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- CO
- Typical Low / Median / Typical High
- $151.36 / $151.36 / $158.49
| Professional | CO | $151.36 | $151.36 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $30.90 / $70.79 / $204.17
| Professional | CQ | $30.90 | $70.79 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $19.50 / $56.23
| Professional | | $14.13 | $19.50 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $38.02 / $57.54
| Professional | | $33.11 | $38.02 | $57.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $67.61 / $89.13
| Facility | | $50.12 | $67.61 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $33.11 / $69.18
| Professional | | $20.42 | $33.11 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $38.02 / $104.71
| Facility | | $23.99 | $38.02 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- CO
- Typical Low / Median / Typical High
- $66.07 / $138.04 / $138.04
| Facility | CO | $66.07 | $138.04 | $138.04 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $66.07 / $138.04 / $138.04
| Facility | CQ | $66.07 | $138.04 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $35.48 / $288.40
| Professional | | $26.30 | $35.48 | $288.40 |
- 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
- $26.30 / $34.67 / $58.88
| Professional | | $26.30 | $34.67 | $58.88 |