- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $257.04 / $346.74
| Facility | | $251.19 | $257.04 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- QZ
- Typical Low / Median / Typical High
- $257.04 / $257.04 / $257.04
| Facility | QZ | $257.04 | $257.04 | $257.04 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $134.90 / $707.95 / $1,096.48
| Professional | AA | $134.90 | $707.95 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $85.11 / $323.59 / $562.34
| Professional | QX | $85.11 | $323.59 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- QY
- Typical Low / Median / Typical High
- $239.88 / $302.00 / $512.86
| Professional | QY | $239.88 | $302.00 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $123.03 / $575.44 / $977.24
| Professional | QZ | $123.03 | $575.44 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $29.51 / $29.51 / $107.15
| Professional | AA | $29.51 | $29.51 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $83.18 / $114.82 / $128.82
| Professional | QX | $83.18 | $114.82 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- QY
- Typical Low / Median / Typical High
- $85.11 / $85.11 / $85.11
| Professional | QY | $85.11 | $85.11 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $107.15 / $128.82 / $186.21
| Professional | QZ | $107.15 | $128.82 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $151.36 / $177.83 / $177.83
| Professional | QX | $151.36 | $177.83 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $288.40 / $338.84 / $338.84
| Professional | QZ | $288.40 | $338.84 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $302.00 / $489.78
| Facility | | $302.00 | $302.00 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- QY
- Typical Low / Median / Typical High
- $302.00 / $302.00 / $302.00
| Professional | QY | $302.00 | $302.00 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $257.04 / $338.84
| Facility | | $257.04 | $257.04 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- QZ
- Typical Low / Median / Typical High
- $257.04 / $257.04 / $257.04
| Facility | QZ | $257.04 | $257.04 | $257.04 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $120.23 / $691.83 / $1,096.48
| Professional | AA | $120.23 | $691.83 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $64.57 / $316.23 / $575.44
| Professional | QX | $64.57 | $316.23 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- QY
- Typical Low / Median / Typical High
- $154.88 / $316.23 / $616.60
| Professional | QY | $154.88 | $316.23 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $120.23 / $562.34 / $933.25
| Professional | QZ | $120.23 | $562.34 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- QY
- Typical Low / Median / Typical High
- $302.00 / $302.00 / $302.00
| Professional | QY | $302.00 | $302.00 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $79.43 / $79.43 / $537.03
| Professional | AA | $79.43 | $79.43 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $85.11 / $85.11 / $162.18
| Professional | QX | $85.11 | $85.11 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- QY
- Typical Low / Median / Typical High
- $134.90 / $134.90 / $134.90
| Professional | QY | $134.90 | $134.90 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $79.43 / $79.43 / $85.11
| Professional | QZ | $79.43 | $79.43 | $85.11 |