- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $707.95 / $3,090.30
| Facility | | $44.67 | $707.95 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- AA
- Typical Low / Median / Typical High
- $1,862.09 / $1,862.09 / $2,454.71
| Facility | AA | $1,862.09 | $1,862.09 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- QK
- Typical Low / Median / Typical High
- $446.68 / $724.44 / $977.24
| Facility | QK | $446.68 | $724.44 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- QX
- Typical Low / Median / Typical High
- $549.54 / $933.25 / $2,951.21
| Facility | QX | $549.54 | $933.25 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- QY
- Typical Low / Median / Typical High
- $501.19 / $501.19 / $741.31
| Facility | QY | $501.19 | $501.19 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- QZ
- Typical Low / Median / Typical High
- $707.95 / $1,698.24 / $3,162.28
| Facility | QZ | $707.95 | $1,698.24 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,162.28 / $3,388.44 / $4,168.69
| Facility | | $3,162.28 | $3,388.44 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $61.66 / $50,118.72
| Facility | | $61.66 | $61.66 | $50,118.72 |
- 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
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $54.95 / $54.95
| Facility | | $54.95 | $54.95 | $54.95 |