- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $302.00 / $537.03
| Facility | | $44.67 | $302.00 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- QX
- Typical Low / Median / Typical High
- $87.10 / $100.00 / $223.87
| Facility | QX | $87.10 | $100.00 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- QZ
- Typical Low / Median / Typical High
- $1,230.27 / $1,230.27 / $1,659.59
| Facility | QZ | $1,230.27 | $1,230.27 | $1,659.59 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $446.68 / $794.33 / $1,348.96
| Professional | AA | $446.68 | $794.33 | $1,348.96 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $173.78 / $363.08 / $691.83
| Professional | QK | $173.78 | $363.08 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $186.21 / $346.74 / $660.69
| Professional | QX | $186.21 | $346.74 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- QY
- Typical Low / Median / Typical High
- $208.93 / $338.84 / $660.69
| Professional | QY | $208.93 | $338.84 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $354.81 / $562.34 / $831.76
| Professional | QZ | $354.81 | $562.34 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $134.90 / $194.98 / $309.03
| Professional | AA | $134.90 | $194.98 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $77.62 / $104.71 / $194.98
| Professional | QK | $77.62 | $104.71 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $91.20 / $177.83 / $194.98
| Professional | QX | $91.20 | $177.83 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- QY
- Typical Low / Median / Typical High
- $120.23 / $131.83 / $151.36
| Professional | QY | $120.23 | $131.83 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $123.03 / $162.18 / $218.78
| Professional | QZ | $123.03 | $162.18 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $323.59 / $501.19
| Professional | | $169.82 | $323.59 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $75.86 / $79.43 / $89.13
| Professional | AA | $75.86 | $79.43 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $79.43 / $79.43 / $79.43
| Professional | QK | $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 / $81.28 / $89.13
| Professional | QZ | $79.43 | $81.28 | $89.13 |