- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $93.33 / $562.34 / $691.83
| Facility | | $93.33 | $562.34 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $870.96 / $1,479.11 / $2,290.87
| Professional | AA | $870.96 | $1,479.11 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $436.52 / $575.44 / $776.25
| Professional | QK | $436.52 | $575.44 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $416.87 / $562.34 / $812.83
| Professional | QX | $416.87 | $562.34 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $1,412.54 / $1,412.54 / $1,412.54
| Professional | QZ | $1,412.54 | $1,412.54 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $234.42 / $794.33 / $1,047.13
| Professional | AA | $234.42 | $794.33 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $208.93 / $208.93 / $208.93
| Professional | QK | $208.93 | $208.93 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $190.55 / $190.55 / $208.93
| Professional | QX | $190.55 | $190.55 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $234.42 / $245.47 / $331.13
| Professional | QZ | $234.42 | $245.47 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $213.80 / $251.19 / $331.13
| Professional | QK | $213.80 | $251.19 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $213.80 / $251.19 / $331.13
| Professional | QX | $213.80 | $251.19 | $331.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $416.87 / $575.44
| Facility | | $380.19 | $416.87 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $213.80 / $257.04 / $323.59
| Professional | QK | $213.80 | $257.04 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- QX
- Typical Low / Median / Typical High
- $213.80 / $257.04 / $323.59
| Professional | QX | $213.80 | $257.04 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- AA
- Typical Low / Median / Typical High
- $81.28 / $512.86 / $1,348.96
| Professional | AA | $81.28 | $512.86 | $1,348.96 |
- Facility/Professional
- Professional
- Modifier
- QK
- Typical Low / Median / Typical High
- $89.13 / $89.13 / $436.52
| Professional | QK | $89.13 | $89.13 | $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 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Typical Low / Median / Typical High
- $75.86 / $75.86 / $75.86
| Professional | QZ | $75.86 | $75.86 | $75.86 |