- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $14.45 / $66.07
| Facility | | $12.02 | $14.45 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $13.80 / $13.80 / $66.07
| Facility | CQ | $13.80 | $13.80 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $10.96 / $23.44
| Professional | | $7.94 | $10.96 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $7.94 / $9.12 / $9.12
| Professional | CQ | $7.94 | $9.12 | $9.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $22.91 / $36.31
| Facility | | $15.49 | $22.91 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $23.44 / $25.12
| Professional | | $17.38 | $23.44 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $11.75 / $11.75
| Professional | | $11.75 | $11.75 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $13.18 / $16.98
| Facility | | $8.32 | $13.18 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- CQ
- Typical Low / Median / Typical High
- $13.80 / $13.80 / $66.07
| Facility | CQ | $13.80 | $13.80 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $22.39 / $25.12
| Professional | | $11.75 | $22.39 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Typical Low / Median / Typical High
- $9.12 / $9.12 / $9.12
| Professional | CQ | $9.12 | $9.12 | $9.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $32.36 / $33.11
| Professional | | $30.20 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $17.38 / $26.92
| Facility | | $17.38 | $17.38 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $17.38 / $23.99
| Professional | | $14.79 | $17.38 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $12.02 / $30.90
| Professional | | $11.48 | $12.02 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $17.38 / $22.91
| Professional | | $12.88 | $17.38 | $22.91 |