- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $61.66 / $218.78
| Facility | | $37.15 | $61.66 | $218.78 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $63.10 / $63.10 / $158.49
| Facility | CQ | $63.10 | $63.10 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $30.90 / $97.72
| Professional | | $19.05 | $30.90 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $28.18 / $28.18 / $83.18
| Professional | CQ | $28.18 | $28.18 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $54.95 / $87.10
| Facility | | $38.90 | $54.95 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $61.66 / $67.61
| Professional | | $35.48 | $61.66 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $70.79 / $75.86
| Facility | | $70.79 | $70.79 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $31.62 / $50.12
| Professional | | $23.99 | $31.62 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $35.48 / $69.18
| Facility | | $25.70 | $35.48 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $63.10 / $63.10 / $158.49
| Facility | CQ | $63.10 | $63.10 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $44.67 / $66.07
| Professional | | $23.44 | $44.67 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $28.18 / $28.18 / $83.18
| Professional | CQ | $28.18 | $28.18 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $48.98 / $72.44
| Facility | | $48.98 | $48.98 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $35.48 / $39.81
| Professional | | $29.51 | $35.48 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $31.62 / $74.13
| Professional | | $30.90 | $31.62 | $74.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $36.31 / $36.31
| Facility | | $36.31 | $36.31 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $34.67 / $35.48
| Professional | | $29.51 | $34.67 | $35.48 |