- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $575.44 / $977.24
| Facility | | $323.59 | $575.44 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- QK
- Typical Low / Median / Typical High
- $141.25 / $141.25 / $141.25
| Facility | QK | $141.25 | $141.25 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $776.25 / $1,202.26 / $2,089.30
| Professional | AA | $776.25 | $1,202.26 | $2,089.30 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $169.82 / $489.78 / $707.95
| Professional | QK | $169.82 | $489.78 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $204.17 / $501.19 / $724.44
| Professional | QX | $204.17 | $501.19 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $512.86 / $812.83 / $2,238.72
| Professional | QZ | $512.86 | $812.83 | $2,238.72 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $229.09 / $323.59 / $467.74
| Professional | AA | $229.09 | $323.59 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $162.18 / $162.18 / $173.78
| Professional | QK | $162.18 | $162.18 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $10.00 / $131.83 / $199.53
| Professional | QX | $10.00 | $131.83 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $346.74 / $346.74 / $346.74
| Professional | QZ | $346.74 | $346.74 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $602.56 / $602.56
| Facility | | $602.56 | $602.56 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $186.21 / $426.58 / $630.96
| Professional | AA | $186.21 | $426.58 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $186.21 / $426.58 / $630.96
| Professional | QK | $186.21 | $426.58 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $186.21 / $426.58 / $630.96
| Professional | QX | $186.21 | $426.58 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $186.21 / $426.58 / $630.96
| Professional | QZ | $186.21 | $426.58 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $630.96 / $891.25 / $1,584.89
| Professional | AA | $630.96 | $891.25 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $575.44 / $776.25 / $1,380.38
| Professional | QK | $575.44 | $776.25 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $602.56 / $794.33 / $1,445.44
| Professional | QX | $602.56 | $794.33 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $446.68 / $602.56 / $758.58
| Professional | QZ | $446.68 | $602.56 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $524.81 / $676.08
| Facility | | $47.86 | $524.81 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $81.28 / $85.11 / $851.14
| Professional | AA | $81.28 | $85.11 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $245.47 / $245.47 / $245.47
| Professional | QK | $245.47 | $245.47 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $79.43 / $79.43 / $79.43
| Professional | QX | $79.43 | $79.43 | $79.43 |