- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $354.81 / $436.52
| Facility | | $50.12 | $354.81 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- QZ
- Typical Low / Median / Typical High
- $812.83 / $812.83 / $812.83
| Facility | QZ | $812.83 | $812.83 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $489.78 / $831.76 / $1,122.02
| Professional | AA | $489.78 | $831.76 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $251.19 / $371.54 / $645.65
| Professional | QK | $251.19 | $371.54 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $263.03 / $398.11 / $676.08
| Professional | QX | $263.03 | $398.11 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- QY
- Typical Low / Median / Typical High
- $251.19 / $331.13 / $660.69
| Professional | QY | $251.19 | $331.13 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $549.54 / $691.83 / $1,096.48
| Professional | QZ | $549.54 | $691.83 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $169.82 / $302.00 / $549.54
| Professional | AA | $169.82 | $302.00 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $89.13 / $95.50 / $100.00
| Professional | QK | $89.13 | $95.50 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $89.13 / $95.50 / $100.00
| Professional | QX | $89.13 | $95.50 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $102.33 / $169.82 / $501.19
| Professional | QZ | $102.33 | $169.82 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $151.36 / $251.19 / $407.38
| Facility | | $151.36 | $251.19 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $257.04 / $363.08
| Facility | | $234.42 | $257.04 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $79.43 / $85.11 / $630.96
| Professional | AA | $79.43 | $85.11 | $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 / $79.43 / $446.68
| Professional | QZ | $54.95 | $79.43 | $446.68 |