- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.14 / $22.08 / $10,918.18
| Facility | | $12.14 | $22.08 | $10,918.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.03 / $12.14 / $3,788.79
| Professional | | $11.03 | $12.14 | $3,788.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.04 / $17.05 / $34.54
| Facility | | $11.04 | $17.05 | $34.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.04 / $11.43 / $47.98
| Professional | | $11.04 | $11.43 | $47.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.41 / $10.41 / $25.56
| Facility | | $10.41 | $10.41 | $25.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.04 / $11.04 / $13.54
| Professional | | $11.04 | $11.04 | $13.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.02 / $13.79 / $23.56
| Facility | | $11.02 | $13.79 | $23.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.11 / $21.60 / $39.82
| Facility | | $11.11 | $21.60 | $39.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.34 / $12.13 / $47.98
| Professional | | $10.34 | $12.13 | $47.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.04 / $13.25 / $26.82
| Facility | | $11.04 | $13.25 | $26.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.04 / $11.04 / $11.04
| Professional | | $11.04 | $11.04 | $11.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.04 / $11.04 / $11.04
| Professional | | $11.04 | $11.04 | $11.04 |