- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $14.13 / $104.71
| Facility | | $8.32 | $14.13 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $19.95 / $72.44 / $346.74
| Facility | CQ | $19.95 | $72.44 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $10.00 / $26.30
| Professional | | $7.94 | $10.00 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- CO
- Typical Low / Median / Typical High
- $10.47 / $10.47 / $10.47
| Professional | CO | $10.47 | $10.47 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $7.59 / $8.71 / $23.99
| Professional | CQ | $7.59 | $8.71 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $18.62 / $46.77
| Facility | | $13.49 | $18.62 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $16.98 / $75.86
| Professional | | $10.23 | $16.98 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $39.81 / $102.33
| Facility | | $19.50 | $39.81 | $102.33 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $16.60 / $16.60 / $16.60
| Facility | CQ | $16.60 | $16.60 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $11.75 / $17.78
| Professional | | $11.75 | $11.75 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $12.59 / $13.80
| Facility | | $10.23 | $12.59 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $15.14 / $34.67
| Professional | | $10.72 | $15.14 | $34.67 |