- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $389.05 / $977.24
| Facility | | $44.67 | $389.05 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- AA
- Typical Low / Median / Typical High
- $9.77 / $446.68 / $812.83
| Facility | AA | $9.77 | $446.68 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- QK
- Typical Low / Median / Typical High
- $154.88 / $218.78 / $524.81
| Facility | QK | $154.88 | $218.78 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- QX
- Typical Low / Median / Typical High
- $177.83 / $380.19 / $676.08
| Facility | QX | $177.83 | $380.19 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- QY
- Typical Low / Median / Typical High
- $81.28 / $186.21 / $186.21
| Facility | QY | $81.28 | $186.21 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- QZ
- Typical Low / Median / Typical High
- $162.18 / $831.76 / $1,288.25
| Facility | QZ | $162.18 | $831.76 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $380.19 / $691.83 / $1,096.48
| Professional | AA | $380.19 | $691.83 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $218.78 / $323.59 / $588.84
| Professional | QK | $218.78 | $323.59 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $213.80 / $316.23 / $602.56
| Professional | QX | $213.80 | $316.23 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- QY
- Typical Low / Median / Typical High
- $223.87 / $331.13 / $588.84
| Professional | QY | $223.87 | $331.13 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $331.13 / $524.81 / $831.76
| Professional | QZ | $331.13 | $524.81 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $199.53 / $199.53 / $389.05
| Facility | | $199.53 | $199.53 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $309.03 / $446.68 / $467.74
| Professional | AA | $309.03 | $446.68 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $446.68 / $467.74 / $467.74
| Professional | QZ | $446.68 | $467.74 | $467.74 |
- 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
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $281.84 / $354.81 / $467.74
| Professional | AA | $281.84 | $354.81 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- QY
- Typical Low / Median / Typical High
- $302.00 / $302.00 / $302.00
| Professional | QY | $302.00 | $302.00 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $54.95 / $54.95
| Facility | | $54.95 | $54.95 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $79.43 / $85.11 / $630.96
| Professional | AA | $79.43 | $85.11 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $112.20 / $162.18 / $162.18
| Professional | QK | $112.20 | $162.18 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $85.11 / $85.11 / $128.82
| Professional | QX | $85.11 | $85.11 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- QY
- Typical Low / Median / Typical High
- $134.90 / $134.90 / $281.84
| Professional | QY | $134.90 | $134.90 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $70.79 / $125.89 / $446.68
| Professional | QZ | $70.79 | $125.89 | $446.68 |