- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.01 / $7.08 / $12.88
| Facility | | $5.01 | $7.08 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.98 / $6.03 / $14.13
| Professional | | $3.98 | $6.03 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.63 / $3.16 / $10.00
| Professional | | $2.63 | $3.16 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.31 / $6.76 / $6.76
| Facility | | $6.31 | $6.76 | $6.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.76 / $6.76 / $6.76
| Professional | | $6.76 | $6.76 | $6.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.88 / $12.88 / $50,118.72
| Facility | | $12.88 | $12.88 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.31 / $3.31 / $8.13
| Professional | | $3.31 | $3.31 | $8.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.32 / $13.49 / $31.62
| Facility | | $8.32 | $13.49 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.32 / $12.02 / $16.22
| Professional | | $8.32 | $12.02 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.47 / $10.47 / $10.47
| Facility | | $10.47 | $10.47 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.47 / $11.22 / $11.22
| Professional | | $10.47 | $11.22 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50,118.72 / $53,703.18 / $75,857.76
| Facility | | $50,118.72 | $53,703.18 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.37 / $7.94 / $7.94
| Professional | | $5.37 | $7.94 | $7.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.69 / $4.07 / $7.41
| Professional | | $2.69 | $4.07 | $7.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.47 / $10.47 / $10.47
| Facility | | $10.47 | $10.47 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.47 / $10.47 / $11.22
| Professional | | $10.47 | $10.47 | $11.22 |