- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,200.00 / $5,521.00 / $8,380.00
| Facility | | $1,200.00 | $5,521.00 | $8,380.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,650.00 / $5,058.00 / $5,521.00
| Facility | | $1,650.00 | $5,058.00 | $5,521.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $374.31 / $861.00 / $900.00
| Facility | | $374.31 | $861.00 | $900.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $110.00 / $275.00 / $25,886.78
| Facility | | $110.00 | $275.00 | $25,886.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,200.00 / $1,602.00 / $5,309.00
| Facility | | $1,200.00 | $1,602.00 | $5,309.00 |
University Health Alliance - Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,280.00 / $3,772.00 / $14,755.00
| Facility | | $1,280.00 | $3,772.00 | $14,755.00 |