- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $288.40 / $446.68
| Facility | | $181.97 | $288.40 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- QZ
- Typical Low / Median / Typical High
- $758.58 / $758.58 / $758.58
| Facility | QZ | $758.58 | $758.58 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $380.19 / $575.44 / $977.24
| Professional | AA | $380.19 | $575.44 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $234.42 / $338.84 / $660.69
| Professional | QK | $234.42 | $338.84 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $181.97 / $316.23 / $630.96
| Professional | QX | $181.97 | $316.23 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- QY
- Typical Low / Median / Typical High
- $251.19 / $338.84 / $691.83
| Professional | QY | $251.19 | $338.84 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $331.13 / $524.81 / $794.33
| Professional | QZ | $331.13 | $524.81 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $281.84 / $281.84 / $354.81
| Professional | AA | $281.84 | $281.84 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $223.87 / $323.59
| Professional | | $169.82 | $223.87 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $64.57 / $2,570.40
| Facility | | $23.44 | $64.57 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $1,548.82 / $4,365.16
| Facility | | $870.96 | $1,548.82 | $4,365.16 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $79.43 / $79.43 / $81.28
| Professional | AA | $79.43 | $79.43 | $81.28 |
- 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
- $89.13 / $89.13 / $89.13
| Professional | QZ | $89.13 | $89.13 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $199.53 / $245.47 / $245.47
| Professional | QX | $199.53 | $245.47 | $245.47 |