- 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
- $313.30 / $525.00 / $900.00
| Facility | | $313.30 | $525.00 | $900.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $225.00 / $831.00 / $24,382.00
| Facility | | $225.00 | $831.00 | $24,382.00 |
- 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 |