- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $47.86 / $104.71
| Facility | | $37.15 | $47.86 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $30.20 / $177.83
| Professional | | $19.05 | $30.20 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- CO
- Typical Low / Median / Typical High
- $70.79 / $70.79 / $70.79
| Professional | CO | $70.79 | $70.79 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $35.48 / $35.48 / $35.48
| Professional | CQ | $35.48 | $35.48 | $35.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $69.18 / $245.47 / $398.11
| Facility | | $69.18 | $245.47 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $28.84 / $38.02
| Professional | | $22.91 | $28.84 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $75.86 / $89.13
| Facility | | $64.57 | $75.86 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $36.31 / $53.70
| Professional | | $20.42 | $36.31 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $46.77
| Professional | | $32.36 | $33.11 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $32.36 / $70.79
| Facility | | $23.44 | $32.36 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $36.31 / $53.70
| Professional | | $20.42 | $36.31 | $53.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $38.90
| Facility | | $32.36 | $32.36 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $34.67 / $40.74
| Professional | | $29.51 | $34.67 | $40.74 |