- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $446.68 / $1,122.02
| Facility | | $67.61 | $446.68 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- QZ
- Typical Low / Median / Typical High
- $831.76 / $851.14 / $933.25
| Facility | QZ | $831.76 | $851.14 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $446.68 / $645.65 / $812.83
| Professional | AA | $446.68 | $645.65 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $501.19 / $676.08 / $851.14
| Professional | QK | $501.19 | $676.08 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $549.54 / $660.69 / $891.25
| Professional | QX | $549.54 | $660.69 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- QY
- Typical Low / Median / Typical High
- $549.54 / $602.56 / $758.58
| Professional | QY | $549.54 | $602.56 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $302.00 / $588.84 / $1,348.96
| Professional | QZ | $302.00 | $588.84 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $457.09 / $4,677.35
| Facility | | $67.61 | $457.09 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- QZ
- Typical Low / Median / Typical High
- $831.76 / $851.14 / $933.25
| Facility | QZ | $831.76 | $851.14 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $446.68 / $602.56 / $776.25
| Professional | AA | $446.68 | $602.56 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $501.19 / $676.08 / $851.14
| Professional | QK | $501.19 | $676.08 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $549.54 / $660.69 / $891.25
| Professional | QX | $549.54 | $660.69 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- QY
- Typical Low / Median / Typical High
- $549.54 / $602.56 / $758.58
| Professional | QY | $549.54 | $602.56 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $338.84 / $588.84 / $1,288.25
| Professional | QZ | $338.84 | $588.84 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $3,311.31 / $5,128.61
| Facility | | $50.12 | $3,311.31 | $5,128.61 |
- 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 / $79.43
| Professional | QZ | $79.43 | $79.43 | $79.43 |