- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $158.49 / $446.68
| Facility | | $38.02 | $158.49 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- CO
- Typical Low / Median / Typical High
- $141.25 / $354.81 / $588.84
| Facility | CO | $141.25 | $354.81 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $66.07 / $190.55 / $316.23
| Facility | CQ | $66.07 | $190.55 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $41.69 / $338.84
| Professional | | $22.91 | $41.69 | $338.84 |
- Facility/Professional
- Professional
- Modifier
- CO
- Typical Low / Median / Typical High
- $104.71 / $151.36 / $158.49
| Professional | CO | $104.71 | $151.36 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $34.67 / $61.66 / $165.96
| Professional | CQ | $34.67 | $61.66 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $26.30 / $26.30 / $50.12
| Professional | CQ | $26.30 | $26.30 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $54.95 / $109.65
| Facility | | $45.71 | $54.95 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $38.02 / $75.86
| Professional | | $35.48 | $38.02 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $104.71 / $107.15 / $151.36
| Facility | | $104.71 | $107.15 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $38.02 / $93.33
| Professional | | $27.54 | $38.02 | $93.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $46.77 / $102.33
| Facility | | $32.36 | $46.77 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $46.77 / $89.13
| Professional | | $32.36 | $46.77 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $32.36 / $33.11
| Professional | | $23.44 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $67.61 / $75.86
| Facility | | $45.71 | $67.61 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $67.61 / $120.23
| Facility | | $44.67 | $67.61 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $61.66 / $93.33
| Professional | | $37.15 | $61.66 | $93.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $54.95 / $109.65
| Facility | | $45.71 | $54.95 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $38.90 / $72.44
| Professional | | $36.31 | $38.90 | $72.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $38.90 / $38.90
| Facility | | $34.67 | $38.90 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $40.74 / $91.20
| Professional | | $32.36 | $40.74 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $40.74 / $75.86
| Professional | | $36.31 | $40.74 | $75.86 |