- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $95.50 / $457.09
| Facility | | $23.44 | $95.50 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- CO
- Typical Low / Median / Typical High
- $77.62 / $398.11 / $398.11
| Facility | CO | $77.62 | $398.11 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $40.74 / $40.74 / $100.00
| Facility | CQ | $40.74 | $40.74 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $25.70 / $60.26
| Professional | | $19.05 | $25.70 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- CO
- Typical Low / Median / Typical High
- $27.54 / $27.54 / $27.54
| Professional | CO | $27.54 | $27.54 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $20.42 / $26.92 / $81.28
| Professional | CQ | $20.42 | $26.92 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $30.90 / $56.23
| Professional | | $23.44 | $30.90 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $43.65 / $52.48
| Facility | | $30.20 | $43.65 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $35.48 / $70.79
| Professional | | $30.90 | $35.48 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $57.54 / $70.79 / $79.43
| Facility | | $57.54 | $70.79 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $34.67 / $56.23
| Professional | | $17.38 | $34.67 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $38.02 / $54.95
| Professional | | $26.92 | $38.02 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $42.66 / $42.66
| Professional | | $42.66 | $42.66 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $46.77
| Facility | | $32.36 | $32.36 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $33.88 / $50.12
| Professional | | $23.99 | $33.88 | $50.12 |