- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $60.26 / $281.84
| Facility | | $33.88 | $60.26 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $87.10 / $173.78 / $190.55
| Facility | CQ | $87.10 | $173.78 | $190.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $40.74 / $354.81
| Professional | | $20.89 | $40.74 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- CO
- Typical Low / Median / Typical High
- $5.75 / $30.20 / $151.36
| Professional | CO | $5.75 | $30.20 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $29.51 / $36.31 / $87.10
| Professional | CQ | $29.51 | $36.31 | $87.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $72.44 / $72.44 / $75.86
| Facility | | $72.44 | $72.44 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $35.48 / $67.61
| Professional | | $20.42 | $35.48 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $41.69
| Professional | | $32.36 | $33.11 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $48.98 / $67.61
| Facility | | $45.71 | $48.98 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $42.66 / $51.29
| Professional | | $32.36 | $42.66 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $36.31 / $52.48
| Professional | | $32.36 | $36.31 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $47.86 / $69.18
| Professional | | $33.11 | $47.86 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $39.81 / $39.81
| Facility | | $39.81 | $39.81 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $35.48 / $47.86
| Professional | | $29.51 | $35.48 | $47.86 |