- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $398.11 / $436.52
| Facility | | $50.12 | $398.11 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $446.68 / $549.54 / $891.25
| Professional | AA | $446.68 | $549.54 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $234.42 / $295.12 / $389.05
| Professional | QK | $234.42 | $295.12 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $223.87 / $263.03 / $389.05
| Professional | QX | $223.87 | $263.03 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- QY
- Typical Low / Median / Typical High
- $190.55 / $371.54 / $616.60
| Professional | QY | $190.55 | $371.54 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $436.52 / $537.03 / $645.65
| Professional | QZ | $436.52 | $537.03 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $407.38 / $524.81 / $630.96
| Professional | AA | $407.38 | $524.81 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $295.12 / $371.54 / $501.19
| Professional | QK | $295.12 | $371.54 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $281.84 / $380.19 / $575.44
| Professional | QX | $281.84 | $380.19 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- QY
- Typical Low / Median / Typical High
- $323.59 / $398.11 / $537.03
| Professional | QY | $323.59 | $398.11 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $263.03 / $354.81 / $489.78
| Professional | QZ | $263.03 | $354.81 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $354.81 / $354.81 / $354.81
| Professional | AA | $354.81 | $354.81 | $354.81 |
- 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
- $75.86 / $89.13 / $281.84
| Professional | QZ | $75.86 | $89.13 | $281.84 |