- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $89.13 / $239.88
| Facility | | $26.92 | $89.13 | $239.88 |
- Facility/Professional
- Facility
- Modifier
- CO
- Typical Low / Median / Typical High
- $54.95 / $223.87 / $363.08
| Facility | CO | $54.95 | $223.87 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $70.79 / $100.00 / $398.11
| Facility | CQ | $70.79 | $100.00 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $25.70 / $79.43
| Professional | | $19.05 | $25.70 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- CO
- Typical Low / Median / Typical High
- $20.89 / $66.07 / $70.79
| Professional | CO | $20.89 | $66.07 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $35.48 / $69.18 / $81.28
| Professional | CQ | $35.48 | $69.18 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $22.39 / $22.39
| Professional | | $22.39 | $22.39 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $83.18 / $295.12
| Facility | | $44.67 | $83.18 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $33.88 / $34.67
| Professional | | $33.88 | $33.88 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $70.79 / $107.15
| Facility | | $44.67 | $70.79 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $39.81 / $61.66
| Professional | | $21.88 | $39.81 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $44.67 / $63.10
| Professional | | $30.90 | $44.67 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $40.74 / $42.66
| Professional | | $39.81 | $40.74 | $42.66 |
- 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
- $32.36 / $35.48 / $46.77
| Facility | | $32.36 | $35.48 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $32.36 / $57.54
| Professional | | $26.92 | $32.36 | $57.54 |