Modern makers of contemporary native american flutes commonly tuned to one of twelve keys. A flute is typically described by the pitch that the flute plays when all holes are covered. The table above describes the pitches and approximate pitches that are possible for each key of flute and its most common fingering. The first column of the table is the key of the flute, i.e., all holes closed. The remaining columns along that row give the other pitches that are possible, based upon the fingering that is depicted above it.
In theory, flutes that are described as concert tuned are better tuned and support more notes from the extended scale. But some makers do not optimize their tuning to support all of the extended scale. Basically they tune the flute for the basic scale as best they can, and ignore the extra notes in the extended scale. For this reason some of the pitches are annotated with a ± mark. Very few makers support half-holing or quarter-holing, so those notes are annotated with a ? mark.
Consult the Extended Scale for potential alternate fingers, that may be closer to the given pitch.