- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $309.03 / $891.25
| Facility | | $257.04 | $309.03 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- QZ
- Typical Low / Median / Typical High
- $501.19 / $501.19 / $501.19
| Facility | QZ | $501.19 | $501.19 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $457.09 / $776.25 / $1,047.13
| Professional | AA | $457.09 | $776.25 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $218.78 / $354.81 / $588.84
| Professional | QK | $218.78 | $354.81 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $173.78 / $331.13 / $562.34
| Professional | QX | $173.78 | $331.13 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- QY
- Typical Low / Median / Typical High
- $239.88 / $338.84 / $537.03
| Professional | QY | $239.88 | $338.84 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $331.13 / $537.03 / $933.25
| Professional | QZ | $331.13 | $537.03 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $107.15 / $123.03 / $181.97
| Professional | AA | $107.15 | $123.03 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $51.29 / $63.10 / $100.00
| Professional | QK | $51.29 | $63.10 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $51.29 / $72.44 / $100.00
| Professional | QX | $51.29 | $72.44 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $85.11 / $102.33 / $245.47
| Professional | QZ | $85.11 | $102.33 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $114.82 / $144.54 / $144.54
| Professional | QX | $114.82 | $144.54 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- QY
- Typical Low / Median / Typical High
- $234.42 / $234.42 / $234.42
| Professional | QY | $234.42 | $234.42 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $218.78 / $269.15 / $269.15
| Professional | QZ | $218.78 | $269.15 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $239.88 / $398.11
| Facility | | $239.88 | $239.88 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- QY
- Typical Low / Median / Typical High
- $302.00 / $302.00 / $302.00
| Professional | QY | $302.00 | $302.00 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $257.04 / $724.44
| Facility | | $257.04 | $257.04 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- QZ
- Typical Low / Median / Typical High
- $501.19 / $501.19 / $501.19
| Facility | QZ | $501.19 | $501.19 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $407.38 / $758.58 / $1,023.29
| Professional | AA | $407.38 | $758.58 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $208.93 / $331.13 / $562.34
| Professional | QK | $208.93 | $331.13 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $169.82 / $295.12 / $537.03
| Professional | QX | $169.82 | $295.12 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- QY
- Typical Low / Median / Typical High
- $181.97 / $338.84 / $616.60
| Professional | QY | $181.97 | $338.84 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $338.84 / $501.19 / $776.25
| Professional | QZ | $338.84 | $501.19 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- QY
- Typical Low / Median / Typical High
- $302.00 / $302.00 / $302.00
| Professional | QY | $302.00 | $302.00 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $89.13 / $354.81 / $630.96
| Professional | AA | $89.13 | $354.81 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $162.18 / $162.18 / $162.18
| Professional | QK | $162.18 | $162.18 | $162.18 |
- 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
- QY
- Typical Low / Median / Typical High
- $134.90 / $134.90 / $134.90
| Professional | QY | $134.90 | $134.90 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $75.86 / $275.42 / $446.68
| Professional | QZ | $75.86 | $275.42 | $446.68 |