- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $275.42 / $1,071.52
| Facility | | $34.67 | $275.42 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- QZ
- Typical Low / Median / Typical High
- $1,348.96 / $1,348.96 / $1,348.96
| Facility | QZ | $1,348.96 | $1,348.96 | $1,348.96 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $478.63 / $891.25 / $1,445.44
| Professional | AA | $478.63 | $891.25 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $234.42 / $398.11 / $724.44
| Professional | QK | $234.42 | $398.11 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $181.97 / $346.74 / $724.44
| Professional | QX | $181.97 | $346.74 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- QY
- Typical Low / Median / Typical High
- $251.19 / $524.81 / $933.25
| Professional | QY | $251.19 | $524.81 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $446.68 / $707.95 / $1,258.93
| Professional | QZ | $446.68 | $707.95 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $54.95 / $67.61 / $67.61
| Professional | QX | $54.95 | $67.61 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $281.84 / $346.74 / $524.81
| Professional | AA | $281.84 | $346.74 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $269.15 / $323.59 / $851.14
| Professional | AA | $269.15 | $323.59 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $33.11 / $245.47
| Facility | | $17.38 | $33.11 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $81.28 / $89.13 / $630.96
| Professional | AA | $81.28 | $89.13 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $89.13 / $89.13 / $446.68
| Professional | QZ | $89.13 | $89.13 | $446.68 |