- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $43.65 / $851.14
| Facility | | $39.81 | $43.65 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $426.58 / $691.83 / $1,122.02
| Professional | AA | $426.58 | $691.83 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $169.82 / $323.59 / $812.83
| Professional | QK | $169.82 | $323.59 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $151.36 / $208.93 / $977.24
| Professional | QX | $151.36 | $208.93 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- QY
- Typical Low / Median / Typical High
- $154.88 / $575.44 / $1,230.27
| Professional | QY | $154.88 | $575.44 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $245.47 / $436.52 / $758.58
| Professional | QZ | $245.47 | $436.52 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $102.33 / $102.33 / $102.33
| Professional | AA | $102.33 | $102.33 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $48.98 / $48.98 / $56.23
| Professional | QK | $48.98 | $48.98 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $48.98 / $56.23 / $72.44
| Professional | QX | $48.98 | $56.23 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- QY
- Typical Low / Median / Typical High
- $58.88 / $58.88 / $67.61
| Professional | QY | $58.88 | $58.88 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $97.72 / $117.49 / $194.98
| Professional | QZ | $97.72 | $117.49 | $194.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $50.12 / $3,090.30
| Facility | | $42.66 | $50.12 | $3,090.30 |
- 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
- QZ
- Typical Low / Median / Typical High
- $234.42 / $234.42 / $275.42
| Professional | QZ | $234.42 | $234.42 | $275.42 |