- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $61.66 / $74.13
| Facility | | $20.89 | $61.66 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $26.92 / $123.03
| Professional | | $19.05 | $26.92 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $295.12 / $295.12 / $295.12
| Professional | CQ | $295.12 | $295.12 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $50.12 / $64.57
| Facility | | $50.12 | $50.12 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $36.31 / $51.29
| Professional | | $27.54 | $36.31 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $43.65 / $83.18
| Professional | | $30.90 | $43.65 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $41.69 / $154.88
| Facility | | $23.99 | $41.69 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $38.90 / $213.80
| Professional | | $25.70 | $38.90 | $213.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $51.29 / $104.71
| Professional | | $41.69 | $51.29 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $37.15 / $58.88
| Professional | | $37.15 | $37.15 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $43.65 / $69.18
| Professional | | $32.36 | $43.65 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $37.15 / $52.48
| Facility | | $37.15 | $37.15 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $33.88 / $81.28
| Professional | | $24.55 | $33.88 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $42.66 / $50.12
| Professional | | $42.66 | $42.66 | $50.12 |