- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $50.12 / $302.00
| Facility | | $41.69 | $50.12 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $363.08 / $676.08 / $1,096.48
| Professional | AA | $363.08 | $676.08 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $194.98 / $302.00 / $537.03
| Professional | QK | $194.98 | $302.00 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $204.17 / $295.12 / $575.44
| Professional | QX | $204.17 | $295.12 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- QY
- Typical Low / Median / Typical High
- $199.53 / $316.23 / $575.44
| Professional | QY | $199.53 | $316.23 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $331.13 / $478.63 / $691.83
| Professional | QZ | $331.13 | $478.63 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $104.71 / $389.05 / $588.84
| Professional | AA | $104.71 | $389.05 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $58.88 / $229.09 / $316.23
| Professional | QK | $58.88 | $229.09 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $52.48 / $229.09 / $316.23
| Professional | QX | $52.48 | $229.09 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- QY
- Typical Low / Median / Typical High
- $186.21 / $194.98 / $354.81
| Professional | QY | $186.21 | $194.98 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $100.00 / $323.59 / $467.74
| Professional | QZ | $100.00 | $323.59 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,162.28 / $3,388.44 / $4,168.69
| Facility | | $3,162.28 | $3,388.44 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $72.44 / $72.44
| Facility | | $39.81 | $72.44 | $72.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $61.66 / $61.66
| Facility | | $61.66 | $61.66 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- QK
- Typical Low / Median / Typical High
- $30.90 / $30.90 / $30.90
| Facility | QK | $30.90 | $30.90 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- QX
- Typical Low / Median / Typical High
- $30.90 / $30.90 / $30.90
| Facility | QX | $30.90 | $30.90 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- QY
- Typical Low / Median / Typical High
- $30.90 / $30.90 / $30.90
| Facility | QY | $30.90 | $30.90 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $104.71 / $104.71 / $104.71
| Facility | | $104.71 | $104.71 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- QK
- Typical Low / Median / Typical High
- $52.48 / $52.48 / $52.48
| Facility | QK | $52.48 | $52.48 | $52.48 |
- Facility/Professional
- Facility
- Modifier
- QX
- Typical Low / Median / Typical High
- $52.48 / $52.48 / $52.48
| Facility | QX | $52.48 | $52.48 | $52.48 |
- Facility/Professional
- Facility
- Modifier
- QY
- Typical Low / Median / Typical High
- $52.48 / $52.48 / $52.48
| Facility | QY | $52.48 | $52.48 | $52.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $263.03 / $4,677.35
| Facility | | $42.66 | $263.03 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $363.08 / $660.69 / $1,096.48
| Professional | AA | $363.08 | $660.69 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $181.97 / $281.84 / $602.56
| Professional | QK | $181.97 | $281.84 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $181.97 / $281.84 / $602.56
| Professional | QX | $181.97 | $281.84 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- QY
- Typical Low / Median / Typical High
- $162.18 / $346.74 / $977.24
| Professional | QY | $162.18 | $346.74 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $309.03 / $446.68 / $707.95
| Professional | QZ | $309.03 | $446.68 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $2,137.96 / $3,311.31
| Facility | | $1,445.44 | $2,137.96 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $2,511.89 / $4,677.35
| Facility | | $45.71 | $2,511.89 | $4,677.35 |
- 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
- AA
- Typical Low / Median / Typical High
- $79.43 / $81.28 / $316.23
| Professional | AA | $79.43 | $81.28 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $44.67 / $85.11 / $85.11
| Professional | QX | $44.67 | $85.11 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $54.95 / $234.42 / $338.84
| Professional | QZ | $54.95 | $234.42 | $338.84 |