- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $363.08 / $630.96
| Facility | | $75.86 | $363.08 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- QZ
- Typical Low / Median / Typical High
- $537.03 / $616.60 / $1,380.38
| Facility | QZ | $537.03 | $616.60 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $380.19 / $537.03 / $831.76
| Professional | AA | $380.19 | $537.03 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $218.78 / $288.40 / $363.08
| Professional | QK | $218.78 | $288.40 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $151.36 / $204.17 / $323.59
| Professional | QX | $151.36 | $204.17 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- QY
- Typical Low / Median / Typical High
- $199.53 / $251.19 / $263.03
| Professional | QY | $199.53 | $251.19 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $380.19 / $512.86 / $616.60
| Professional | QZ | $380.19 | $512.86 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $114.82 / $199.53 / $575.44
| Professional | AA | $114.82 | $199.53 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $537.03 / $537.03 / $537.03
| Professional | QK | $537.03 | $537.03 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $537.03 / $537.03 / $537.03
| Professional | QX | $537.03 | $537.03 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $97.72 / $194.98 / $562.34
| Professional | QZ | $97.72 | $194.98 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $57.54 / $112.20
| Facility | | $44.67 | $57.54 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $281.84 / $281.84 / $354.81
| Professional | AA | $281.84 | $281.84 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $83.18 / $891.25
| Facility | | $21.88 | $83.18 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $1,737.80 / $1,737.80
| Facility | | $1,479.11 | $1,737.80 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $81.28 / $81.28 / $81.28
| Professional | AA | $81.28 | $81.28 | $81.28 |