- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,200.00 / $4,078.00 / $8,380.00
| Facility | | $1,200.00 | $4,078.00 | $8,380.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,650.00 / $4,078.00 / $7,445.00
| Facility | | $1,650.00 | $4,078.00 | $7,445.00 |
- 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
- $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 / $3,921.00 / $5,697.00
| Facility | | $1,200.00 | $3,921.00 | $5,697.00 |
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 |