- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $512.86 / $602.56
| Facility | | $30.20 | $512.86 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $407.38 / $1,023.29 / $2,884.03
| Professional | AA | $407.38 | $1,023.29 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $346.74 / $537.03 / $776.25
| Professional | QK | $346.74 | $537.03 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $363.08 / $537.03 / $776.25
| Professional | QX | $363.08 | $537.03 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $165.96 / $794.33 / $1,174.90
| Professional | QZ | $165.96 | $794.33 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $851.14 / $1,258.93 / $1,819.70
| Professional | AA | $851.14 | $1,258.93 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $134.90 / $478.63 / $776.25
| Professional | QK | $134.90 | $478.63 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $114.82 / $426.58 / $724.44
| Professional | QX | $114.82 | $426.58 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $162.18 / $162.18 / $1,318.26
| Professional | QZ | $162.18 | $162.18 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $309.03 / $309.03
| Facility | | $309.03 | $309.03 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $645.65 / $1,047.13
| Professional | | $302.00 | $645.65 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $194.98 / $194.98 / $263.03
| Professional | QK | $194.98 | $194.98 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $194.98 / $194.98 / $263.03
| Professional | QX | $194.98 | $194.98 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- QY
- Typical Low / Median / Typical High
- $194.98 / $194.98 / $263.03
| Professional | QY | $194.98 | $194.98 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $81.28 / $512.86 / $851.14
| Professional | AA | $81.28 | $512.86 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $89.13 / $89.13 / $89.13
| Professional | QK | $89.13 | $89.13 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $79.43 / $79.43 / $85.11
| Professional | QX | $79.43 | $79.43 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $446.68 / $446.68 / $446.68
| Professional | QZ | $446.68 | $446.68 | $446.68 |