- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $10.96 / $23.44
| Professional | | $8.91 | $10.96 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.22 / $41.69 / $91,201.08
| Facility | | $16.22 | $41.69 | $91,201.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.22 / $16.22 / $16.22
| Professional | | $16.22 | $16.22 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.38 / $20.42 / $67.61
| Facility | | $17.38 | $20.42 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.13 / $13.49 / $17.38
| Professional | | $8.13 | $13.49 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.02 / $16.98 / $37.15
| Facility | | $12.02 | $16.98 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.02 / $16.98 / $37.15
| Professional | | $12.02 | $16.98 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.38 / $20.42 / $67.61
| Facility | | $17.38 | $20.42 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.72 / $10.72 / $17.38
| Professional | | $10.72 | $10.72 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.01 / $5.13 / $16.60
| Professional | | $5.01 | $5.13 | $16.60 |