Plasmon resonances play a pivotal role in enhancing light-matter interactions in nanophotonics, but their low-quality factors have hindered applications demanding high spectral selectivity. Here, we demonstrate the design and 3D laser nanoprinting of plasmonic nanofin metasurfaces, which support symmetry-protected bound states in the continuum up to the fourth order. By breaking the nanofins' out-of-plane symmetry in parameter space, we achieve high-quality factor (up to 180) modes under normal incidence. The out-of-plane symmetry breaking can be fine-tuned by the nanofins' triangle angle, opening a pathway to precisely control the ratio of radiative to intrinsic losses. This enables access to the under-, critical, and over-coupled regimes, which we exploit for pixelated molecular sensing. We observe a strong dependence of the sensing performance on the coupling regime, demonstrating the importance of judicious tailoring of light-matter interactions. Our demonstration provides a metasurface platform for enhanced light-matter interaction with a wide range of applications.