- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $12.02 / $85.11
| Professional | | $8.91 | $12.02 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.38 / $44.67 / $87,096.36
| Facility | | $17.38 | $44.67 | $87,096.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.38 / $17.38 / $17.38
| Professional | | $17.38 | $17.38 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.62 / $21.88 / $74.13
| Facility | | $18.62 | $21.88 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $14.79 / $18.62
| Professional | | $8.91 | $14.79 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.88 / $18.20 / $39.81
| Facility | | $12.88 | $18.20 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.88 / $18.20 / $39.81
| Professional | | $12.88 | $18.20 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.62 / $21.88 / $74.13
| Facility | | $18.62 | $21.88 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.48 / $11.48 / $18.62
| Professional | | $11.48 | $11.48 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.37 / $5.62 / $17.78
| Professional | | $5.37 | $5.62 | $17.78 |