Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

FLUCONAZOLE 200 MG TABLET

Facility

$288.00

Service Code	NDC 50268-339-15
Hospital Charge Code	10045
Hospital Revenue Code	637
Min. Negotiated Rate	$181.44
Max. Negotiated Rate	$259.20
Rate for Payer: Aetna Commercial	$244.80
Rate for Payer: Aetna New Business (MI Preferred)	$187.20
Rate for Payer: Cash Price	$230.40
Rate for Payer: Cofinity Commercial	$247.68
Rate for Payer: Cofinity Commercial	$201.60
Rate for Payer: Healthscope Commercial	$259.20
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$244.80
Rate for Payer: PHP Commercial	$244.80
Rate for Payer: Priority Health Cigna Priority Health	$201.60
Rate for Payer: Priority Health SBD	$181.44

FLUCONAZOLE 200 MG TABLET

Facility

$275.28

Service Code	NDC 0904-6501-06
Hospital Charge Code	10045
Hospital Revenue Code	637
Min. Negotiated Rate	$173.43
Max. Negotiated Rate	$247.75
Rate for Payer: Aetna Commercial	$233.99
Rate for Payer: Aetna New Business (MI Preferred)	$178.93
Rate for Payer: Cash Price	$220.22
Rate for Payer: Cofinity Commercial	$192.70
Rate for Payer: Cofinity Commercial	$236.74
Rate for Payer: Healthscope Commercial	$247.75
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$233.99
Rate for Payer: PHP Commercial	$233.99
Rate for Payer: Priority Health Cigna Priority Health	$192.70
Rate for Payer: Priority Health SBD	$173.43

FLUCONAZOLE 200 MG TABLET

Facility

$612.48

Service Code	NDC 55111-146-01
Hospital Charge Code	10045
Hospital Revenue Code	637
Min. Negotiated Rate	$385.86
Max. Negotiated Rate	$551.23
Rate for Payer: Aetna Commercial	$520.61
Rate for Payer: Aetna New Business (MI Preferred)	$398.11
Rate for Payer: Cash Price	$489.98
Rate for Payer: Cofinity Commercial	$428.74
Rate for Payer: Cofinity Commercial	$526.73
Rate for Payer: Healthscope Commercial	$551.23
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$520.61
Rate for Payer: PHP Commercial	$520.61
Rate for Payer: Priority Health Cigna Priority Health	$428.74
Rate for Payer: Priority Health SBD	$385.86

FLUCONAZOLE 200 MG TABLET

Facility

$7.81

Service Code	NDC 68084-735-11
Hospital Charge Code	10045
Hospital Revenue Code	637
Min. Negotiated Rate	$4.92
Max. Negotiated Rate	$7.03
Rate for Payer: Aetna Commercial	$6.64
Rate for Payer: Aetna New Business (MI Preferred)	$5.08
Rate for Payer: Cash Price	$6.25
Rate for Payer: Cofinity Commercial	$5.47
Rate for Payer: Cofinity Commercial	$6.72
Rate for Payer: Healthscope Commercial	$7.03
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$6.64
Rate for Payer: PHP Commercial	$6.64
Rate for Payer: Priority Health Cigna Priority Health	$5.47
Rate for Payer: Priority Health SBD	$4.92

FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK

Facility

$63.80

Service Code	HCPCS J1450
Hospital Charge Code	10050
Hospital Revenue Code	636
Min. Negotiated Rate	$40.19
Max. Negotiated Rate	$57.42
Rate for Payer: Aetna Commercial	$54.23
Rate for Payer: Aetna Commercial	$81.34
Rate for Payer: Aetna New Business (MI Preferred)	$41.47
Rate for Payer: Aetna New Business (MI Preferred)	$62.20
Rate for Payer: Cash Price	$51.04
Rate for Payer: Cash Price	$76.56
Rate for Payer: Cofinity Commercial	$54.87
Rate for Payer: Cofinity Commercial	$44.66
Rate for Payer: Cofinity Commercial	$82.30
Rate for Payer: Cofinity Commercial	$66.99
Rate for Payer: Healthscope Commercial	$86.13
Rate for Payer: Healthscope Commercial	$57.42
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$81.34
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$54.23
Rate for Payer: PHP Commercial	$54.23
Rate for Payer: PHP Commercial	$81.34
Rate for Payer: Priority Health Cigna Priority Health	$44.66
Rate for Payer: Priority Health Cigna Priority Health	$66.99
Rate for Payer: Priority Health SBD	$60.29
Rate for Payer: Priority Health SBD	$40.19

FLUDARABINE 50 MG/2 ML INTRAVENOUS SOLUTION

Facility

$976.50

Service Code	HCPCS J9185
Hospital Charge Code	41294
Hospital Revenue Code	636
Min. Negotiated Rate	$95.16
Max. Negotiated Rate	$878.85
Rate for Payer: Aetna Commercial	$830.02
Rate for Payer: Aetna Medicare	$180.93
Rate for Payer: Aetna New Business (MI Preferred)	$634.72
Rate for Payer: Allen County Amish Medical Aid Commercial	$217.46
Rate for Payer: Amish Plain Church Group Commercial	$217.46
Rate for Payer: BCBS Complete	$99.93
Rate for Payer: BCBS MAPPO	$173.97
Rate for Payer: BCBS Trust/PPO	$515.04
Rate for Payer: BCN Medicare Advantage	$173.97
Rate for Payer: Cash Price	$781.20
Rate for Payer: Cash Price	$781.20
Rate for Payer: Cofinity Commercial	$839.79
Rate for Payer: Cofinity Commercial	$683.55
Rate for Payer: Health Alliance Plan Medicare Advantage	$173.97
Rate for Payer: Healthscope Commercial	$878.85
Rate for Payer: Mclaren Medicaid	$95.16
Rate for Payer: Mclaren Medicare	$173.97
Rate for Payer: Meridian Medicaid	$99.93
Rate for Payer: Meridian Wellcare - Medicare Advantage	$182.67
Rate for Payer: MI Amish Medical Board Commercial	$200.06
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$830.02
Rate for Payer: PACE Medicare	$165.27
Rate for Payer: PACE SWMI	$173.97
Rate for Payer: PHP Commercial	$830.02
Rate for Payer: PHP Medicare Advantage	$173.97
Rate for Payer: Priority Health Choice Medicaid	$95.16
Rate for Payer: Priority Health Cigna Priority Health	$683.55
Rate for Payer: Priority Health Medicare	$173.97
Rate for Payer: Priority Health SBD	$615.20
Rate for Payer: Railroad Medicare Medicare	$173.97
Rate for Payer: UHC Dual Complete DSNP	$173.97
Rate for Payer: UHC Medicare Advantage	$179.19
Rate for Payer: VA VA	$173.97

FLUDARABINE 50 MG/2 ML INTRAVENOUS SOLUTION

Facility

$394.01

Service Code	HCPCS J9185
Hospital Charge Code	41294
Hospital Revenue Code	636
Min. Negotiated Rate	$248.23
Max. Negotiated Rate	$354.61
Rate for Payer: Aetna Commercial	$334.91
Rate for Payer: Aetna Commercial	$830.02
Rate for Payer: Aetna New Business (MI Preferred)	$634.72
Rate for Payer: Aetna New Business (MI Preferred)	$256.11
Rate for Payer: Cash Price	$315.21
Rate for Payer: Cash Price	$781.20
Rate for Payer: Cofinity Commercial	$338.85
Rate for Payer: Cofinity Commercial	$275.81
Rate for Payer: Cofinity Commercial	$683.55
Rate for Payer: Cofinity Commercial	$839.79
Rate for Payer: Healthscope Commercial	$354.61
Rate for Payer: Healthscope Commercial	$878.85
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$830.02
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$334.91
Rate for Payer: PHP Commercial	$830.02
Rate for Payer: PHP Commercial	$334.91
Rate for Payer: Priority Health Cigna Priority Health	$275.81
Rate for Payer: Priority Health Cigna Priority Health	$683.55
Rate for Payer: Priority Health SBD	$248.23
Rate for Payer: Priority Health SBD	$615.20

FLUDROCORTISONE 0.1 MG TABLET

Facility

$3.62

Service Code	NDC 68084-288-11
Hospital Charge Code	10054
Hospital Revenue Code	637
Min. Negotiated Rate	$2.28
Max. Negotiated Rate	$3.26
Rate for Payer: Aetna Commercial	$3.08
Rate for Payer: Aetna New Business (MI Preferred)	$2.35
Rate for Payer: Cash Price	$2.90
Rate for Payer: Cofinity Commercial	$2.53
Rate for Payer: Cofinity Commercial	$3.11
Rate for Payer: Healthscope Commercial	$3.26
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3.08
Rate for Payer: PHP Commercial	$3.08
Rate for Payer: Priority Health Cigna Priority Health	$2.53
Rate for Payer: Priority Health SBD	$2.28

FLUDROCORTISONE 0.1 MG TABLET

Facility

$361.44

Service Code	NDC 68084-288-01
Hospital Charge Code	10054
Hospital Revenue Code	637
Min. Negotiated Rate	$227.71
Max. Negotiated Rate	$325.30
Rate for Payer: Aetna Commercial	$307.22
Rate for Payer: Aetna New Business (MI Preferred)	$234.94
Rate for Payer: Cash Price	$289.15
Rate for Payer: Cofinity Commercial	$253.01
Rate for Payer: Cofinity Commercial	$310.84
Rate for Payer: Healthscope Commercial	$325.30
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$307.22
Rate for Payer: PHP Commercial	$307.22
Rate for Payer: Priority Health Cigna Priority Health	$253.01
Rate for Payer: Priority Health SBD	$227.71

FLUDROCORTISONE 0.1 MG TABLET

Facility

$263.04

Service Code	NDC 0115-7033-01
Hospital Charge Code	10054
Hospital Revenue Code	637
Min. Negotiated Rate	$165.72
Max. Negotiated Rate	$236.74
Rate for Payer: Aetna Commercial	$223.58
Rate for Payer: Aetna New Business (MI Preferred)	$170.98
Rate for Payer: Cash Price	$210.43
Rate for Payer: Cofinity Commercial	$184.13
Rate for Payer: Cofinity Commercial	$226.21
Rate for Payer: Healthscope Commercial	$236.74
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$223.58
Rate for Payer: PHP Commercial	$223.58
Rate for Payer: Priority Health Cigna Priority Health	$184.13
Rate for Payer: Priority Health SBD	$165.72

FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION

Facility

$18.50

Service Code	NDC 0143-9684-01
Hospital Charge Code	10055
Hospital Revenue Code	250
Min. Negotiated Rate	$11.66
Max. Negotiated Rate	$16.65
Rate for Payer: Aetna Commercial	$15.72
Rate for Payer: Aetna New Business (MI Preferred)	$12.02
Rate for Payer: Cash Price	$14.80
Rate for Payer: Cofinity Commercial	$12.95
Rate for Payer: Cofinity Commercial	$15.91
Rate for Payer: Healthscope Commercial	$16.65
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$15.72
Rate for Payer: PHP Commercial	$15.72
Rate for Payer: Priority Health Cigna Priority Health	$12.95
Rate for Payer: Priority Health SBD	$11.66

FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION

Facility

$30.67

Service Code	NDC 63323-424-05
Hospital Charge Code	10055
Hospital Revenue Code	250
Min. Negotiated Rate	$19.32
Max. Negotiated Rate	$27.60
Rate for Payer: Aetna Commercial	$26.07
Rate for Payer: Aetna New Business (MI Preferred)	$19.94
Rate for Payer: Cash Price	$24.54
Rate for Payer: Cofinity Commercial	$21.47
Rate for Payer: Cofinity Commercial	$26.38
Rate for Payer: Healthscope Commercial	$27.60
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$26.07
Rate for Payer: PHP Commercial	$26.07
Rate for Payer: Priority Health Cigna Priority Health	$21.47
Rate for Payer: Priority Health SBD	$19.32

FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION

Facility

$18.50

Service Code	NDC 0143-9784-10
Hospital Charge Code	10055
Hospital Revenue Code	250
Min. Negotiated Rate	$11.66
Max. Negotiated Rate	$16.65
Rate for Payer: Aetna Commercial	$15.72
Rate for Payer: Aetna New Business (MI Preferred)	$12.02
Rate for Payer: Cash Price	$14.80
Rate for Payer: Cofinity Commercial	$12.95
Rate for Payer: Cofinity Commercial	$15.91
Rate for Payer: Healthscope Commercial	$16.65
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$15.72
Rate for Payer: PHP Commercial	$15.72
Rate for Payer: Priority Health Cigna Priority Health	$12.95
Rate for Payer: Priority Health SBD	$11.66

FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION

Facility

$18.50

Service Code	NDC 0143-9684-10
Hospital Charge Code	10055
Hospital Revenue Code	250
Min. Negotiated Rate	$11.66
Max. Negotiated Rate	$16.65
Rate for Payer: Aetna Commercial	$15.72
Rate for Payer: Aetna New Business (MI Preferred)	$12.02
Rate for Payer: Cash Price	$14.80
Rate for Payer: Cofinity Commercial	$12.95
Rate for Payer: Cofinity Commercial	$15.91
Rate for Payer: Healthscope Commercial	$16.65
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$15.72
Rate for Payer: PHP Commercial	$15.72
Rate for Payer: Priority Health Cigna Priority Health	$12.95
Rate for Payer: Priority Health SBD	$11.66

FLUMAZENIL 0.1 MG/ML IV (CODE)

Facility

$30.67

Service Code	NDC 63323-424-05
Hospital Charge Code	163712
Hospital Revenue Code	250
Min. Negotiated Rate	$19.32
Max. Negotiated Rate	$27.60
Rate for Payer: Aetna Commercial	$26.07
Rate for Payer: Aetna New Business (MI Preferred)	$19.94
Rate for Payer: Cash Price	$24.54
Rate for Payer: Cofinity Commercial	$21.47
Rate for Payer: Cofinity Commercial	$26.38
Rate for Payer: Healthscope Commercial	$27.60
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$26.07
Rate for Payer: PHP Commercial	$26.07
Rate for Payer: Priority Health Cigna Priority Health	$21.47
Rate for Payer: Priority Health SBD	$19.32

FLUOCINONIDE 0.05 % TOPICAL CREAM

Facility

$35.76

Service Code	NDC 51672-1386-1
Hospital Charge Code	3187
Hospital Revenue Code	637
Min. Negotiated Rate	$22.53
Max. Negotiated Rate	$32.18
Rate for Payer: Aetna Commercial	$30.40
Rate for Payer: Aetna New Business (MI Preferred)	$23.24
Rate for Payer: Cash Price	$28.61
Rate for Payer: Cofinity Commercial	$25.03
Rate for Payer: Cofinity Commercial	$30.75
Rate for Payer: Healthscope Commercial	$32.18
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$30.40
Rate for Payer: PHP Commercial	$30.40
Rate for Payer: Priority Health Cigna Priority Health	$25.03
Rate for Payer: Priority Health SBD	$22.53

FLUOCINONIDE 0.05 % TOPICAL CREAM

Facility

$117.34

Service Code	NDC 0093-0262-15
Hospital Charge Code	3187
Hospital Revenue Code	637
Min. Negotiated Rate	$73.92
Max. Negotiated Rate	$105.61
Rate for Payer: Aetna Commercial	$99.74
Rate for Payer: Aetna New Business (MI Preferred)	$76.27
Rate for Payer: Cash Price	$93.87
Rate for Payer: Cofinity Commercial	$100.91
Rate for Payer: Cofinity Commercial	$82.14
Rate for Payer: Healthscope Commercial	$105.61
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$99.74
Rate for Payer: PHP Commercial	$99.74
Rate for Payer: Priority Health Cigna Priority Health	$82.14
Rate for Payer: Priority Health SBD	$73.92

FLUORESCEIN 0.6 MG EYE STRIPS

Facility

$571.05

Service Code	NDC 17478-403-03
Hospital Charge Code	27662
Hospital Revenue Code	250
Min. Negotiated Rate	$359.76
Max. Negotiated Rate	$513.94
Rate for Payer: Aetna Commercial	$485.39
Rate for Payer: Aetna New Business (MI Preferred)	$371.18
Rate for Payer: Cash Price	$456.84
Rate for Payer: Cofinity Commercial	$399.74
Rate for Payer: Cofinity Commercial	$491.10
Rate for Payer: Healthscope Commercial	$513.94
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$485.39
Rate for Payer: PHP Commercial	$485.39
Rate for Payer: Priority Health Cigna Priority Health	$399.74
Rate for Payer: Priority Health SBD	$359.76

FLUORESCEIN 1 MG EYE STRIPS

Facility

$458.25

Service Code	NDC 17238-900-11
Hospital Charge Code	27663
Hospital Revenue Code	250
Min. Negotiated Rate	$288.70
Max. Negotiated Rate	$412.42
Rate for Payer: Aetna Commercial	$389.51
Rate for Payer: Aetna New Business (MI Preferred)	$297.86
Rate for Payer: Cash Price	$366.60
Rate for Payer: Cofinity Commercial	$320.78
Rate for Payer: Cofinity Commercial	$394.10
Rate for Payer: Healthscope Commercial	$412.42
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$389.51
Rate for Payer: PHP Commercial	$389.51
Rate for Payer: Priority Health Cigna Priority Health	$320.78
Rate for Payer: Priority Health SBD	$288.70

FLUORESCEIN 1 MG EYE STRIPS

Facility

$2.33

Service Code	NDC 17478-404-01
Hospital Charge Code	27663
Hospital Revenue Code	250
Min. Negotiated Rate	$1.47
Max. Negotiated Rate	$2.10
Rate for Payer: Aetna Commercial	$1.98
Rate for Payer: Aetna New Business (MI Preferred)	$1.51
Rate for Payer: Cash Price	$1.86
Rate for Payer: Cofinity Commercial	$1.63
Rate for Payer: Cofinity Commercial	$2.00
Rate for Payer: Healthscope Commercial	$2.10
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1.98
Rate for Payer: PHP Commercial	$1.98
Rate for Payer: Priority Health Cigna Priority Health	$1.63
Rate for Payer: Priority Health SBD	$1.47

FLUORESCEIN 500 MG/5 ML (10 %) INTRAVENOUS SOLUTION

Facility

$199.57

Service Code	NDC 0065-0092-65
Hospital Charge Code	10059
Hospital Revenue Code	250
Min. Negotiated Rate	$125.73
Max. Negotiated Rate	$179.61
Rate for Payer: Aetna Commercial	$169.63
Rate for Payer: Aetna New Business (MI Preferred)	$129.72
Rate for Payer: Cash Price	$159.66
Rate for Payer: Cofinity Commercial	$139.70
Rate for Payer: Cofinity Commercial	$171.63
Rate for Payer: Healthscope Commercial	$179.61
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$169.63
Rate for Payer: PHP Commercial	$169.63
Rate for Payer: Priority Health Cigna Priority Health	$139.70
Rate for Payer: Priority Health SBD	$125.73

FLUOROMETHOLONE 0.1 % EYE DROPS,SUSPENSION

Facility

$252.07

Service Code	NDC 60758-880-05
Hospital Charge Code	3208
Hospital Revenue Code	637
Min. Negotiated Rate	$158.80
Max. Negotiated Rate	$226.86
Rate for Payer: Aetna Commercial	$214.26
Rate for Payer: Aetna New Business (MI Preferred)	$163.85
Rate for Payer: Cash Price	$201.66
Rate for Payer: Cofinity Commercial	$176.45
Rate for Payer: Cofinity Commercial	$216.78
Rate for Payer: Healthscope Commercial	$226.86
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$214.26
Rate for Payer: PHP Commercial	$214.26
Rate for Payer: Priority Health Cigna Priority Health	$176.45
Rate for Payer: Priority Health SBD	$158.80

FLUOROMETHOLONE 0.1 % EYE DROPS,SUSPENSION

Facility

$548.21

Service Code	NDC 11980-211-05
Hospital Charge Code	3208
Hospital Revenue Code	637
Min. Negotiated Rate	$345.37
Max. Negotiated Rate	$493.39
Rate for Payer: Aetna Commercial	$465.98
Rate for Payer: Aetna New Business (MI Preferred)	$356.34
Rate for Payer: Cash Price	$438.57
Rate for Payer: Cofinity Commercial	$471.46
Rate for Payer: Cofinity Commercial	$383.75
Rate for Payer: Healthscope Commercial	$493.39
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$465.98
Rate for Payer: PHP Commercial	$465.98
Rate for Payer: Priority Health Cigna Priority Health	$383.75
Rate for Payer: Priority Health SBD	$345.37

FLUOROSCOPIC GUIDANCE FOR NEEDLE PLACEMENT (EG, BIOPSY, ASPIRATION, INJECTION, LOCALIZATION DEVICE) (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)

Facility

$148.93

Service Code	CPT 77002
Hospital Revenue Code	360
Min. Negotiated Rate	$113.95
Max. Negotiated Rate	$148.93
Rate for Payer: BCBS Trust/PPO	$148.93
Rate for Payer: UHC All Payor (Choice/PPO)	$125.34
Rate for Payer: UHC Exchange	$113.95

FLUOROURACIL 1 GRAM/20 ML INTRAVENOUS SOLUTION

Facility

$265.68

Service Code	HCPCS J9190
Hospital Charge Code	82204
Hospital Revenue Code	636
Min. Negotiated Rate	$167.38
Max. Negotiated Rate	$239.11
Rate for Payer: Aetna Commercial	$225.83
Rate for Payer: Aetna Commercial	$245.01
Rate for Payer: Aetna New Business (MI Preferred)	$187.36
Rate for Payer: Aetna New Business (MI Preferred)	$172.69
Rate for Payer: Cash Price	$212.54
Rate for Payer: Cash Price	$230.60
Rate for Payer: Cofinity Commercial	$185.98
Rate for Payer: Cofinity Commercial	$247.90
Rate for Payer: Cofinity Commercial	$201.78
Rate for Payer: Cofinity Commercial	$228.48
Rate for Payer: Healthscope Commercial	$239.11
Rate for Payer: Healthscope Commercial	$259.42
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$225.83
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$245.01
Rate for Payer: PHP Commercial	$225.83
Rate for Payer: PHP Commercial	$245.01
Rate for Payer: Priority Health Cigna Priority Health	$185.98
Rate for Payer: Priority Health Cigna Priority Health	$201.78
Rate for Payer: Priority Health SBD	$181.60
Rate for Payer: Priority Health SBD	$167.38

Know your out-of-pocket cost for care.

All Charges