- Facility/Professional
- Facility
- Modifier
- AA
- Low / Median / High Price
- $5,161.20 / $5,161.20 / $5,161.20
| Facility | AA | $5,161.20 | $5,161.20 | $5,161.20 |
- Facility/Professional
- Facility
- Modifier
- QK
- Low / Median / High Price
- $410.85 / $598.03 / $598.03
| Facility | QK | $410.85 | $598.03 | $598.03 |
- Facility/Professional
- Facility
- Modifier
- QX
- Low / Median / High Price
- $434.12 / $873.24 / $888.72
| Facility | QX | $434.12 | $873.24 | $888.72 |
- Facility/Professional
- Facility
- Modifier
- QY
- Low / Median / High Price
- $373.50 / $373.50 / $373.50
| Facility | QY | $373.50 | $373.50 | $373.50 |
- Facility/Professional
- Facility
- Modifier
- QZ
- Low / Median / High Price
- $1,550.70 / $1,550.70 / $1,550.70
| Facility | QZ | $1,550.70 | $1,550.70 | $1,550.70 |