- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $346.74 / $524.81
| Facility | | $47.86 | $346.74 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- QX
- Typical Low / Median / Typical High
- $66.07 / $208.93 / $288.40
| Facility | QX | $66.07 | $208.93 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $537.03 / $724.44 / $1,096.48
| Professional | AA | $537.03 | $724.44 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $181.97 / $316.23 / $562.34
| Professional | QX | $181.97 | $316.23 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- QY
- Typical Low / Median / Typical High
- $234.42 / $309.03 / $758.58
| Professional | QY | $234.42 | $309.03 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $354.81 / $691.83 / $1,380.38
| Professional | QZ | $354.81 | $691.83 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $61.66 / $61.66
| Facility | | $61.66 | $61.66 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- QK
- Typical Low / Median / Typical High
- $30.90 / $30.90 / $30.90
| Facility | QK | $30.90 | $30.90 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- QX
- Typical Low / Median / Typical High
- $30.90 / $30.90 / $30.90
| Facility | QX | $30.90 | $30.90 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- QY
- Typical Low / Median / Typical High
- $30.90 / $30.90 / $30.90
| Facility | QY | $30.90 | $30.90 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $575.44 / $575.44 / $660.69
| Professional | AA | $575.44 | $575.44 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $57.54 / $69.18 / $107.15
| Facility | | $57.54 | $69.18 | $107.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $138.04 / $239.88
| Facility | | $33.11 | $138.04 | $239.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $323.59 / $512.86
| Professional | | $309.03 | $323.59 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $407.38 / $407.38
| Professional | | $407.38 | $407.38 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- AD
- Typical Low / Median / Typical High
- $245.47 / $245.47 / $245.47
| Professional | AD | $245.47 | $245.47 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $79.43 / $79.43 / $79.43
| Professional | AA | $79.43 | $79.43 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $85.11 / $85.11 / $85.11
| Professional | QX | $85.11 | $85.11 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $67.61 / $79.43 / $89.13
| Professional | QZ | $67.61 | $79.43 | $89.13 |