- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $331.13 / $537.03
| Facility | | $213.80 | $331.13 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- QZ
- Typical Low / Median / Typical High
- $2,290.87 / $2,290.87 / $2,290.87
| Facility | QZ | $2,290.87 | $2,290.87 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $398.11 / $588.84 / $1,071.52
| Professional | AA | $398.11 | $588.84 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $83.18 / $354.81 / $630.96
| Professional | QK | $83.18 | $354.81 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $147.91 / $331.13 / $645.65
| Professional | QX | $147.91 | $331.13 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- QY
- Typical Low / Median / Typical High
- $239.88 / $338.84 / $660.69
| Professional | QY | $239.88 | $338.84 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $363.08 / $602.56 / $933.25
| Professional | QZ | $363.08 | $602.56 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $416.87 / $416.87 / $524.81
| Professional | AA | $416.87 | $416.87 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $331.13 / $489.78
| Professional | | $257.04 | $331.13 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $57.54 / $89.13 / $2,570.40
| Facility | | $57.54 | $89.13 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $2,238.72 / $6,025.60
| Facility | | $851.14 | $2,238.72 | $6,025.60 |
- 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
- $79.43 / $79.43 / $81.28
| Professional | QZ | $79.43 | $79.43 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $199.53 / $245.47 / $245.47
| Professional | QX | $199.53 | $245.47 | $245.47 |