- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.86 / $6.44 / $9.05
| Professional | | $4.86 | $6.44 | $9.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.67 / $13.67 / $13.67
| Facility | | $13.67 | $13.67 | $13.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.67 / $21.36 / $21.36
| Professional | | $13.67 | $21.36 | $21.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.41 / $11.52 / $16.45
| Facility | | $5.41 | $11.52 | $16.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.92 / $21.36 / $2,400,000.00
| Professional | | $11.92 | $21.36 | $2,400,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.30 / $5.63 / $5.63
| Professional | | $5.30 | $5.63 | $5.63 |