- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $275.42 / $446.68
| Facility | | $29.51 | $275.42 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- QZ
- Typical Low / Median / Typical High
- $1,258.93 / $1,258.93 / $1,479.11
| Facility | QZ | $1,258.93 | $1,258.93 | $1,479.11 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $426.58 / $741.31 / $1,047.13
| Professional | AA | $426.58 | $741.31 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $218.78 / $331.13 / $616.60
| Professional | QK | $218.78 | $331.13 | $616.60 |
- 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 / $338.84 / $616.60
| Professional | QY | $223.87 | $338.84 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $354.81 / $549.54 / $794.33
| Professional | QZ | $354.81 | $549.54 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $107.15 / $151.36 / $223.87
| Professional | AA | $107.15 | $151.36 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $64.57 / $81.28 / $112.20
| Professional | QK | $64.57 | $81.28 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $66.07 / $102.33 / $112.20
| Professional | QX | $66.07 | $102.33 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- QY
- Typical Low / Median / Typical High
- $102.33 / $102.33 / $109.65
| Professional | QY | $102.33 | $102.33 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $97.72 / $147.91 / $218.78
| Professional | QZ | $97.72 | $147.91 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $120.23 / $218.78 / $338.84
| Professional | | $120.23 | $218.78 | $338.84 |
- 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
- $81.28 / $81.28 / $81.28
| Professional | AA | $81.28 | $81.28 | $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
- $54.95 / $87.10 / $89.13
| Professional | QZ | $54.95 | $87.10 | $89.13 |