- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $177.83 / $354.81
| Facility | | $32.36 | $177.83 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- CO
- Typical Low / Median / Typical High
- $281.84 / $281.84 / $281.84
| Facility | CO | $281.84 | $281.84 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $23.44 / $69.18 / $177.83
| Facility | CQ | $23.44 | $69.18 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $33.88 / $158.49
| Professional | | $16.98 | $33.88 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- CO
- Typical Low / Median / Typical High
- $5.75 / $30.20 / $54.95
| Professional | CO | $5.75 | $30.20 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $29.51 / $39.81 / $75.86
| Professional | CQ | $29.51 | $39.81 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $56.23 / $75.86
| Professional | | $19.95 | $56.23 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $60.26 / $70.79
| Facility | | $54.95 | $60.26 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $29.51 / $38.90
| Professional | | $19.05 | $29.51 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.25 / $32.36 / $56.23
| Professional | | $0.25 | $32.36 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.25 / $0.25 / $52.48
| Professional | | $0.25 | $0.25 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $34.67 / $38.02
| Professional | | $32.36 | $34.67 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $38.02 / $38.02
| Facility | | $38.02 | $38.02 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $35.48 / $60.26
| Professional | | $26.92 | $35.48 | $60.26 |