- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.63 / $31.21 / $35.84
| Professional | | $24.63 | $31.21 | $35.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.13 / $30.25 / $43.90
| Professional | | $23.13 | $30.25 | $43.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.14 / $38.96 / $45.83
| Professional | | $37.14 | $38.96 | $45.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.63 / $38.63 / $49.17
| Professional | | $38.63 | $38.63 | $49.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.48 / $37.93 / $46.80
| Professional | | $18.48 | $37.93 | $46.80 |
University Health Alliance - Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.69 / $28.10 / $44.85
| Professional | | $17.69 | $28.10 | $44.85 |