- Facility/Professional
- Professional
- Modifier
- AA
- Low / Median / High Price
- $794.33 / $1,318.26 / $1,949.84
| Professional | AA | $794.33 | $1,318.26 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- QK
- Low / Median / High Price
- $120.23 / $676.08 / $954.99
| Professional | QK | $120.23 | $676.08 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- QX
- Low / Median / High Price
- $602.56 / $831.76 / $933.25
| Professional | QX | $602.56 | $831.76 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Low / Median / High Price
- $173.78 / $194.98 / $194.98
| Professional | QZ | $173.78 | $194.98 | $194.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.67 / $50.12 / $3,311.31
| Facility | | $44.67 | $50.12 | $3,311.31 |