- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.57 / $56.64 / $114.10
| Professional | | $29.57 | $56.64 | $114.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.65 / $87.56 / $105.08
| Professional | | $63.65 | $87.56 | $105.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.20 / $60.54 / $98.57
| Professional | | $51.20 | $60.54 | $98.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.77 / $74.25 / $87.56
| Professional | | $35.77 | $74.25 | $87.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,078.00 / $1,078.00 / $1,078.00
| Facility | | $1,078.00 | $1,078.00 | $1,078.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.22 / $85.03 / $103.55
| Professional | | $63.22 | $85.03 | $103.55 |
University Health Alliance - Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.01 / $43.67 / $86.21
| Professional | | $29.01 | $43.67 | $86.21 |