- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $239.88 / $398.11
| Facility | | $44.67 | $239.88 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $346.74 / $478.63 / $1,071.52
| Professional | AA | $346.74 | $478.63 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $162.18 / $302.00 / $467.74
| Professional | QK | $162.18 | $302.00 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $114.82 / $316.23 / $489.78
| Professional | QX | $114.82 | $316.23 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- QY
- Typical Low / Median / Typical High
- $173.78 / $316.23 / $407.38
| Professional | QY | $173.78 | $316.23 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $302.00 / $363.08 / $457.09
| Professional | QZ | $302.00 | $363.08 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $100.00
| Professional | AA | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $70.79 / $79.43 / $123.03
| Professional | QK | $70.79 | $79.43 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $70.79 / $79.43 / $91.20
| Professional | QX | $70.79 | $79.43 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- QY
- Typical Low / Median / Typical High
- $46.77 / $46.77 / $46.77
| Professional | QY | $46.77 | $46.77 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $97.72 / $141.25 / $275.42
| Professional | QZ | $97.72 | $141.25 | $275.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.02 / $0.02 / $0.03
| Facility | | $0.02 | $0.02 | $0.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $72.44 / $72.44 / $72.44
| Facility | | $72.44 | $72.44 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $79.43 / $79.43 / $630.96
| Professional | AA | $79.43 | $79.43 | $630.96 |
- 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 / $89.13 / $446.68
| Professional | QZ | $54.95 | $89.13 | $446.68 |