- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $891.25 / $3,090.30
| Facility | | $281.84 | $891.25 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $776.25 / $1,548.82 / $2,951.21
| Professional | AA | $776.25 | $1,548.82 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $346.74 / $512.86 / $741.31
| Professional | QK | $346.74 | $512.86 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $338.84 / $501.19 / $741.31
| Professional | QX | $338.84 | $501.19 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $660.69 / $933.25 / $1,318.26
| Professional | QZ | $660.69 | $933.25 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $251.19 / $323.59 / $851.14
| Professional | AA | $251.19 | $323.59 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $89.13 / $169.82 / $524.81
| Professional | QK | $89.13 | $169.82 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $89.13 / $131.83 / $457.09
| Professional | QX | $89.13 | $131.83 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $194.98 / $316.23 / $436.52
| Professional | QZ | $194.98 | $316.23 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $389.05 / $398.11 / $467.74
| Professional | AA | $389.05 | $398.11 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $309.03 / $309.03 / $309.03
| Professional | QX | $309.03 | $309.03 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $457.09 / $676.08 / $891.25
| Professional | QZ | $457.09 | $676.08 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $102.33 / $281.84
| Facility | | $63.10 | $102.33 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $331.13 / $977.24
| Facility | | $46.77 | $331.13 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $114.82 / $125.89 / $213.80
| Professional | QK | $114.82 | $125.89 | $213.80 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $117.49 / $117.49 / $117.49
| Professional | QX | $117.49 | $117.49 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $229.09 / $229.09 / $229.09
| Professional | QK | $229.09 | $229.09 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $229.09 / $229.09 / $257.04
| Professional | QX | $229.09 | $229.09 | $257.04 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $81.28 / $85.11 / $512.86
| Professional | AA | $81.28 | $85.11 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $89.13 / $245.47 / $436.52
| Professional | QK | $89.13 | $245.47 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $79.43 / $79.43 / $79.43
| Professional | QX | $79.43 | $79.43 | $79.43 |