- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.21 / $12.28 / $16.16
| Professional | | $6.21 | $12.28 | $16.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $100.00 / $10,000.00
| Facility | | $80.00 | $100.00 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.16 / $102.65 / $110.18
| Professional | | $16.16 | $102.65 | $110.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.22 / $7.22 / $7.22
| Professional | | $7.22 | $7.22 | $7.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.54 / $17.20 / $41.21
| Facility | | $10.54 | $17.20 | $41.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.63 / $17.27 / $33.44
| Professional | | $10.63 | $17.27 | $33.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.00 / $70.00 / $70.00
| Professional | | $70.00 | $70.00 | $70.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.69 / $14.69 / $15.04
| Facility | | $14.69 | $14.69 | $15.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $10,000.00 / $10,000.00
| Facility | | $10,000.00 | $10,000.00 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10,000.00 / $10,000.00 / $10,000.00
| Professional | | $10,000.00 | $10,000.00 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.04 / $15.04 / $15.04
| Facility | | $15.04 | $15.04 | $15.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.94 / $7.51 / $14.31
| Professional | | $6.94 | $7.51 | $14.31 |