Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC ACB ESTABLISHED PT LEVEL 4

Facility

$874.52

Service Code	CPT 99214
Hospital Charge Code	51000075
Hospital Revenue Code	510
Min. Negotiated Rate	$550.95
Max. Negotiated Rate	$787.07
Rate for Payer: Aetna Commercial	$743.34
Rate for Payer: Aetna New Business (MI Preferred)	$568.44
Rate for Payer: Cash Price	$699.62
Rate for Payer: Cofinity Commercial	$612.16
Rate for Payer: Cofinity Commercial	$752.09
Rate for Payer: Healthscope Commercial	$787.07
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$743.34
Rate for Payer: PHP Commercial	$743.34
Rate for Payer: Priority Health Cigna Priority Health	$612.16
Rate for Payer: Priority Health SBD	$550.95

HC ACB ESTABLISHED PT LEVEL 5

Facility

$1,042.88

Service Code	CPT 99215
Hospital Charge Code	51000076
Hospital Revenue Code	510
Min. Negotiated Rate	$657.01
Max. Negotiated Rate	$938.59
Rate for Payer: Aetna Commercial	$886.45
Rate for Payer: Aetna New Business (MI Preferred)	$677.87
Rate for Payer: Cash Price	$834.30
Rate for Payer: Cofinity Commercial	$730.02
Rate for Payer: Cofinity Commercial	$896.88
Rate for Payer: Healthscope Commercial	$938.59
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$886.45
Rate for Payer: PHP Commercial	$886.45
Rate for Payer: Priority Health Cigna Priority Health	$730.02
Rate for Payer: Priority Health SBD	$657.01

HC ACB ESTABLISHED PT LEVEL 5

Facility

$1,042.88

Service Code	CPT 99215
Hospital Charge Code	51000076
Hospital Revenue Code	510
Min. Negotiated Rate	$140.47
Max. Negotiated Rate	$938.59
Rate for Payer: Aetna Commercial	$886.45
Rate for Payer: Aetna New Business (MI Preferred)	$677.87
Rate for Payer: BCBS Complete	$417.15
Rate for Payer: BCBS Trust/PPO	$218.48
Rate for Payer: Cash Price	$834.30
Rate for Payer: Cash Price	$834.30
Rate for Payer: Cofinity Commercial	$730.02
Rate for Payer: Cofinity Commercial	$896.88
Rate for Payer: Healthscope Commercial	$938.59
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$886.45
Rate for Payer: PHP Commercial	$886.45
Rate for Payer: Priority Health Cigna Priority Health	$730.02
Rate for Payer: Priority Health SBD	$657.01
Rate for Payer: UHC All Payor (Choice/PPO)	$154.52
Rate for Payer: UHC Exchange	$140.47

HC ACB GARMENT MEASURE VISIT

Facility

$372.74

Service Code	CPT 99211
Hospital Charge Code	51000048
Hospital Revenue Code	761
Min. Negotiated Rate	$234.83
Max. Negotiated Rate	$335.47
Rate for Payer: Aetna Commercial	$316.83
Rate for Payer: Aetna New Business (MI Preferred)	$242.28
Rate for Payer: Cash Price	$298.19
Rate for Payer: Cofinity Commercial	$320.56
Rate for Payer: Cofinity Commercial	$260.92
Rate for Payer: Healthscope Commercial	$335.47
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$316.83
Rate for Payer: PHP Commercial	$316.83
Rate for Payer: Priority Health Cigna Priority Health	$260.92
Rate for Payer: Priority Health SBD	$234.83

HC ACB GARMENT MEASURE VISIT

Facility

$372.74

Service Code	CPT 99211
Hospital Charge Code	51000048
Hospital Revenue Code	761
Min. Negotiated Rate	$8.51
Max. Negotiated Rate	$335.47
Rate for Payer: Aetna Commercial	$316.83
Rate for Payer: Aetna New Business (MI Preferred)	$242.28
Rate for Payer: BCBS Complete	$149.10
Rate for Payer: BCBS Trust/PPO	$51.75
Rate for Payer: BCCCP Commercial	$22.00
Rate for Payer: Cash Price	$298.19
Rate for Payer: Cash Price	$298.19
Rate for Payer: Cofinity Commercial	$260.92
Rate for Payer: Cofinity Commercial	$320.56
Rate for Payer: Healthscope Commercial	$335.47
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$316.83
Rate for Payer: PHP Commercial	$316.83
Rate for Payer: Priority Health Cigna Priority Health	$260.92
Rate for Payer: Priority Health SBD	$234.83
Rate for Payer: UHC All Payor (Choice/PPO)	$9.36
Rate for Payer: UHC Exchange	$8.51

HC ACB NEW PATIENT VISIT

Facility

$165.16

Service Code	HCPCS 99211
Hospital Charge Code	51000100
Hospital Revenue Code	510
Min. Negotiated Rate	$104.05
Max. Negotiated Rate	$148.64
Rate for Payer: Aetna Commercial	$140.39
Rate for Payer: Aetna New Business (MI Preferred)	$107.35
Rate for Payer: Cash Price	$132.13
Rate for Payer: Cofinity Commercial	$115.61
Rate for Payer: Cofinity Commercial	$142.04
Rate for Payer: Healthscope Commercial	$148.64
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$140.39
Rate for Payer: PHP Commercial	$140.39
Rate for Payer: Priority Health Cigna Priority Health	$115.61
Rate for Payer: Priority Health SBD	$104.05

HC ACB NEW PATIENT VISIT

Facility

$165.16

Service Code	HCPCS 99211
Hospital Charge Code	51000100
Hospital Revenue Code	510
Min. Negotiated Rate	$8.51
Max. Negotiated Rate	$148.64
Rate for Payer: Aetna Commercial	$140.39
Rate for Payer: Aetna New Business (MI Preferred)	$107.35
Rate for Payer: BCBS Complete	$66.06
Rate for Payer: BCBS Trust/PPO	$51.75
Rate for Payer: BCCCP Commercial	$22.00
Rate for Payer: Cash Price	$132.13
Rate for Payer: Cash Price	$132.13
Rate for Payer: Cofinity Commercial	$115.61
Rate for Payer: Cofinity Commercial	$142.04
Rate for Payer: Healthscope Commercial	$148.64
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$140.39
Rate for Payer: PHP Commercial	$140.39
Rate for Payer: Priority Health Cigna Priority Health	$115.61
Rate for Payer: Priority Health SBD	$104.05
Rate for Payer: UHC All Payor (Choice/PPO)	$9.36
Rate for Payer: UHC Exchange	$8.51

HC ACB NEW PT LEVEL 2

Facility

$494.43

Service Code	CPT 99202
Hospital Charge Code	51000101
Hospital Revenue Code	510
Min. Negotiated Rate	$311.49
Max. Negotiated Rate	$444.99
Rate for Payer: Aetna Commercial	$420.27
Rate for Payer: Aetna New Business (MI Preferred)	$321.38
Rate for Payer: Cash Price	$395.54
Rate for Payer: Cofinity Commercial	$346.10
Rate for Payer: Cofinity Commercial	$425.21
Rate for Payer: Healthscope Commercial	$444.99
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$420.27
Rate for Payer: PHP Commercial	$420.27
Rate for Payer: Priority Health Cigna Priority Health	$346.10
Rate for Payer: Priority Health SBD	$311.49

HC ACB NEW PT LEVEL 2

Facility

$494.43

Service Code	CPT 99202
Hospital Charge Code	51000101
Hospital Revenue Code	510
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$444.99
Rate for Payer: Aetna Commercial	$420.27
Rate for Payer: Aetna New Business (MI Preferred)	$321.38
Rate for Payer: BCBS Complete	$197.77
Rate for Payer: BCBS Trust/PPO	$126.05
Rate for Payer: BCCCP Commercial	$45.00
Rate for Payer: Cash Price	$395.54
Rate for Payer: Cash Price	$395.54
Rate for Payer: Cofinity Commercial	$425.21
Rate for Payer: Cofinity Commercial	$346.10
Rate for Payer: Healthscope Commercial	$444.99
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$420.27
Rate for Payer: PHP Commercial	$420.27
Rate for Payer: Priority Health Cigna Priority Health	$346.10
Rate for Payer: Priority Health SBD	$311.49
Rate for Payer: UHC All Payor (Choice/PPO)	$50.79
Rate for Payer: UHC Exchange	$46.17

HC ACB NEW PT LEVEL 3

Facility

$688.85

Service Code	CPT 99203
Hospital Charge Code	51000102
Hospital Revenue Code	510
Min. Negotiated Rate	$79.90
Max. Negotiated Rate	$619.96
Rate for Payer: Aetna Commercial	$585.52
Rate for Payer: Aetna New Business (MI Preferred)	$447.75
Rate for Payer: BCBS Complete	$275.54
Rate for Payer: BCBS Trust/PPO	$166.58
Rate for Payer: BCCCP Commercial	$107.15
Rate for Payer: Cash Price	$551.08
Rate for Payer: Cash Price	$551.08
Rate for Payer: Cofinity Commercial	$592.41
Rate for Payer: Cofinity Commercial	$482.20
Rate for Payer: Healthscope Commercial	$619.96
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$585.52
Rate for Payer: PHP Commercial	$585.52
Rate for Payer: Priority Health Cigna Priority Health	$482.20
Rate for Payer: Priority Health SBD	$433.98
Rate for Payer: UHC All Payor (Choice/PPO)	$87.89
Rate for Payer: UHC Exchange	$79.90

HC ACB NEW PT LEVEL 3

Facility

$688.85

Service Code	CPT 99203
Hospital Charge Code	51000102
Hospital Revenue Code	510
Min. Negotiated Rate	$433.98
Max. Negotiated Rate	$619.96
Rate for Payer: Aetna Commercial	$585.52
Rate for Payer: Aetna New Business (MI Preferred)	$447.75
Rate for Payer: Cash Price	$551.08
Rate for Payer: Cofinity Commercial	$482.20
Rate for Payer: Cofinity Commercial	$592.41
Rate for Payer: Healthscope Commercial	$619.96
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$585.52
Rate for Payer: PHP Commercial	$585.52
Rate for Payer: Priority Health Cigna Priority Health	$482.20
Rate for Payer: Priority Health SBD	$433.98

HC ACB NEW PT LEVEL 4

Facility

$874.52

Service Code	CPT 99204
Hospital Charge Code	51000103
Hospital Revenue Code	510
Min. Negotiated Rate	$107.15
Max. Negotiated Rate	$787.07
Rate for Payer: Aetna Commercial	$743.34
Rate for Payer: Aetna New Business (MI Preferred)	$568.44
Rate for Payer: BCBS Complete	$349.81
Rate for Payer: BCBS Trust/PPO	$222.84
Rate for Payer: BCCCP Commercial	$107.15
Rate for Payer: Cash Price	$699.62
Rate for Payer: Cash Price	$699.62
Rate for Payer: Cofinity Commercial	$612.16
Rate for Payer: Cofinity Commercial	$752.09
Rate for Payer: Healthscope Commercial	$787.07
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$743.34
Rate for Payer: PHP Commercial	$743.34
Rate for Payer: Priority Health Cigna Priority Health	$612.16
Rate for Payer: Priority Health SBD	$550.95
Rate for Payer: UHC All Payor (Choice/PPO)	$142.99
Rate for Payer: UHC Exchange	$129.99

HC ACB NEW PT LEVEL 4

Facility

$874.52

Service Code	CPT 99204
Hospital Charge Code	51000103
Hospital Revenue Code	510
Min. Negotiated Rate	$550.95
Max. Negotiated Rate	$787.07
Rate for Payer: Aetna Commercial	$743.34
Rate for Payer: Aetna New Business (MI Preferred)	$568.44
Rate for Payer: Cash Price	$699.62
Rate for Payer: Cofinity Commercial	$612.16
Rate for Payer: Cofinity Commercial	$752.09
Rate for Payer: Healthscope Commercial	$787.07
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$743.34
Rate for Payer: PHP Commercial	$743.34
Rate for Payer: Priority Health Cigna Priority Health	$612.16
Rate for Payer: Priority Health SBD	$550.95

HC ACB NEW PT LEVEL 5

Facility

$1,042.88

Service Code	CPT 99205
Hospital Charge Code	51000104
Hospital Revenue Code	510
Min. Negotiated Rate	$657.01
Max. Negotiated Rate	$938.59
Rate for Payer: Aetna Commercial	$886.45
Rate for Payer: Aetna New Business (MI Preferred)	$677.87
Rate for Payer: Cash Price	$834.30
Rate for Payer: Cofinity Commercial	$896.88
Rate for Payer: Cofinity Commercial	$730.02
Rate for Payer: Healthscope Commercial	$938.59
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$886.45
Rate for Payer: PHP Commercial	$886.45
Rate for Payer: Priority Health Cigna Priority Health	$730.02
Rate for Payer: Priority Health SBD	$657.01

HC ACB NEW PT LEVEL 5

Facility

$1,042.88

Service Code	CPT 99205
Hospital Charge Code	51000104
Hospital Revenue Code	510
Min. Negotiated Rate	$107.15
Max. Negotiated Rate	$938.59
Rate for Payer: Aetna Commercial	$886.45
Rate for Payer: Aetna New Business (MI Preferred)	$677.87
Rate for Payer: BCBS Complete	$417.15
Rate for Payer: BCBS Trust/PPO	$270.08
Rate for Payer: BCCCP Commercial	$107.15
Rate for Payer: Cash Price	$834.30
Rate for Payer: Cash Price	$834.30
Rate for Payer: Cofinity Commercial	$896.88
Rate for Payer: Cofinity Commercial	$730.02
Rate for Payer: Healthscope Commercial	$938.59
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$886.45
Rate for Payer: PHP Commercial	$886.45
Rate for Payer: Priority Health Cigna Priority Health	$730.02
Rate for Payer: Priority Health SBD	$657.01
Rate for Payer: UHC All Payor (Choice/PPO)	$194.50
Rate for Payer: UHC Exchange	$176.82

HC ACCESS AORTA

Facility

$3,843.44

Service Code	CPT 36200
Hospital Charge Code	36100105
Hospital Revenue Code	361
Min. Negotiated Rate	$2,421.37
Max. Negotiated Rate	$3,459.10
Rate for Payer: Aetna Commercial	$3,266.92
Rate for Payer: Aetna New Business (MI Preferred)	$2,498.24
Rate for Payer: Cash Price	$3,074.75
Rate for Payer: Cofinity Commercial	$2,690.41
Rate for Payer: Cofinity Commercial	$3,305.36
Rate for Payer: Healthscope Commercial	$3,459.10
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3,266.92
Rate for Payer: PHP Commercial	$3,266.92
Rate for Payer: Priority Health Cigna Priority Health	$2,690.41
Rate for Payer: Priority Health SBD	$2,421.37

HC ACCESS AORTA

Facility

$3,843.44

Service Code	CPT 36200
Hospital Charge Code	36100105
Hospital Revenue Code	361
Min. Negotiated Rate	$133.27
Max. Negotiated Rate	$3,459.10
Rate for Payer: Aetna Commercial	$3,266.92
Rate for Payer: Aetna New Business (MI Preferred)	$2,498.24
Rate for Payer: BCBS Complete	$1,537.38
Rate for Payer: BCBS Trust/PPO	$1,071.75
Rate for Payer: Cash Price	$3,074.75
Rate for Payer: Cash Price	$3,074.75
Rate for Payer: Cofinity Commercial	$2,690.41
Rate for Payer: Cofinity Commercial	$3,305.36
Rate for Payer: Healthscope Commercial	$3,459.10
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3,266.92
Rate for Payer: PHP Commercial	$3,266.92
Rate for Payer: Priority Health Cigna Priority Health	$2,690.41
Rate for Payer: Priority Health SBD	$2,421.37
Rate for Payer: UHC All Payor (Choice/PPO)	$146.60
Rate for Payer: UHC Core	$878.00
Rate for Payer: UHC Exchange	$133.27

HC ACCESS EXTREMITY ARTERY

Facility

$491.10

Service Code	CPT 36140
Hospital Charge Code	36100102
Hospital Revenue Code	761
Min. Negotiated Rate	$85.13
Max. Negotiated Rate	$844.30
Rate for Payer: Aetna Commercial	$417.44
Rate for Payer: Aetna New Business (MI Preferred)	$319.22
Rate for Payer: BCBS Complete	$196.44
Rate for Payer: BCBS Trust/PPO	$844.30
Rate for Payer: Cash Price	$392.88
Rate for Payer: Cash Price	$392.88
Rate for Payer: Cofinity Commercial	$422.35
Rate for Payer: Cofinity Commercial	$343.77
Rate for Payer: Healthscope Commercial	$441.99
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$417.44
Rate for Payer: PHP Commercial	$417.44
Rate for Payer: Priority Health Cigna Priority Health	$343.77
Rate for Payer: Priority Health SBD	$309.39
Rate for Payer: UHC All Payor (Choice/PPO)	$93.64
Rate for Payer: UHC Exchange	$85.13

HC ACCESS EXTREMITY ARTERY

Facility

$491.10

Service Code	CPT 36140
Hospital Charge Code	36100102
Hospital Revenue Code	761
Min. Negotiated Rate	$309.39
Max. Negotiated Rate	$441.99
Rate for Payer: Aetna Commercial	$417.44
Rate for Payer: Aetna New Business (MI Preferred)	$319.22
Rate for Payer: Cash Price	$392.88
Rate for Payer: Cofinity Commercial	$343.77
Rate for Payer: Cofinity Commercial	$422.35
Rate for Payer: Healthscope Commercial	$441.99
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$417.44
Rate for Payer: PHP Commercial	$417.44
Rate for Payer: Priority Health Cigna Priority Health	$343.77
Rate for Payer: Priority Health SBD	$309.39

HC ACCESS MAIN PULMONARY

Facility

$419.20

Service Code	CPT 36013
Hospital Charge Code	36100099
Hospital Revenue Code	361
Min. Negotiated Rate	$120.17
Max. Negotiated Rate	$1,536.50
Rate for Payer: Aetna Commercial	$356.32
Rate for Payer: Aetna New Business (MI Preferred)	$272.48
Rate for Payer: BCBS Complete	$167.68
Rate for Payer: BCBS Trust/PPO	$1,536.50
Rate for Payer: Cash Price	$335.36
Rate for Payer: Cash Price	$335.36
Rate for Payer: Cofinity Commercial	$360.51
Rate for Payer: Cofinity Commercial	$293.44
Rate for Payer: Healthscope Commercial	$377.28
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$356.32
Rate for Payer: PHP Commercial	$356.32
Rate for Payer: Priority Health Cigna Priority Health	$293.44
Rate for Payer: Priority Health SBD	$264.10
Rate for Payer: UHC All Payor (Choice/PPO)	$132.19
Rate for Payer: UHC Core	$878.00
Rate for Payer: UHC Exchange	$120.17

HC ACCESS MAIN PULMONARY

Facility

$419.20

Service Code	CPT 36013
Hospital Charge Code	36100099
Hospital Revenue Code	361
Min. Negotiated Rate	$264.10
Max. Negotiated Rate	$377.28
Rate for Payer: Aetna Commercial	$356.32
Rate for Payer: Aetna New Business (MI Preferred)	$272.48
Rate for Payer: Cash Price	$335.36
Rate for Payer: Cofinity Commercial	$293.44
Rate for Payer: Cofinity Commercial	$360.51
Rate for Payer: Healthscope Commercial	$377.28
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$356.32
Rate for Payer: PHP Commercial	$356.32
Rate for Payer: Priority Health Cigna Priority Health	$293.44
Rate for Payer: Priority Health SBD	$264.10

HC ACCESS VEIN

Facility

$381.09

Service Code	CPT 36000
Hospital Charge Code	36100093
Hospital Revenue Code	361
Min. Negotiated Rate	$8.84
Max. Negotiated Rate	$878.00
Rate for Payer: Aetna Commercial	$323.93
Rate for Payer: Aetna New Business (MI Preferred)	$247.71
Rate for Payer: BCBS Complete	$152.44
Rate for Payer: BCBS Trust/PPO	$80.28
Rate for Payer: Cash Price	$304.87
Rate for Payer: Cash Price	$304.87
Rate for Payer: Cofinity Commercial	$266.76
Rate for Payer: Cofinity Commercial	$327.74
Rate for Payer: Healthscope Commercial	$342.98
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$323.93
Rate for Payer: PHP Commercial	$323.93
Rate for Payer: Priority Health Cigna Priority Health	$266.76
Rate for Payer: Priority Health SBD	$240.09
Rate for Payer: UHC All Payor (Choice/PPO)	$9.72
Rate for Payer: UHC Core	$878.00
Rate for Payer: UHC Exchange	$8.84

HC ACCESS VEIN

Facility

$381.09

Service Code	CPT 36000
Hospital Charge Code	36100093
Hospital Revenue Code	361
Min. Negotiated Rate	$240.09
Max. Negotiated Rate	$342.98
Rate for Payer: Aetna Commercial	$323.93
Rate for Payer: Aetna New Business (MI Preferred)	$247.71
Rate for Payer: Cash Price	$304.87
Rate for Payer: Cofinity Commercial	$266.76
Rate for Payer: Cofinity Commercial	$327.74
Rate for Payer: Healthscope Commercial	$342.98
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$323.93
Rate for Payer: PHP Commercial	$323.93
Rate for Payer: Priority Health Cigna Priority Health	$266.76
Rate for Payer: Priority Health SBD	$240.09

HC ACCESS VEIN ORGAN BLOOD SAMPLING

Facility

$1,048.38

Service Code	CPT 36500
Hospital Charge Code	36100118
Hospital Revenue Code	361
Min. Negotiated Rate	$660.48
Max. Negotiated Rate	$943.54
Rate for Payer: Aetna Commercial	$891.12
Rate for Payer: Aetna New Business (MI Preferred)	$681.45
Rate for Payer: Cash Price	$838.70
Rate for Payer: Cofinity Commercial	$733.87
Rate for Payer: Cofinity Commercial	$901.61
Rate for Payer: Healthscope Commercial	$943.54
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$891.12
Rate for Payer: PHP Commercial	$891.12
Rate for Payer: Priority Health Cigna Priority Health	$733.87
Rate for Payer: Priority Health SBD	$660.48

HC ACCESS VEIN ORGAN BLOOD SAMPLING

Facility

$1,048.38

Service Code	CPT 36500
Hospital Charge Code	36100118
Hospital Revenue Code	361
Min. Negotiated Rate	$174.53
Max. Negotiated Rate	$1,087.02
Rate for Payer: Aetna Commercial	$891.12
Rate for Payer: Aetna New Business (MI Preferred)	$681.45
Rate for Payer: BCBS Complete	$419.35
Rate for Payer: BCBS Trust/PPO	$1,087.02
Rate for Payer: Cash Price	$838.70
Rate for Payer: Cash Price	$838.70
Rate for Payer: Cofinity Commercial	$733.87
Rate for Payer: Cofinity Commercial	$901.61
Rate for Payer: Healthscope Commercial	$943.54
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$891.12
Rate for Payer: PHP Commercial	$891.12
Rate for Payer: Priority Health Cigna Priority Health	$733.87
Rate for Payer: Priority Health SBD	$660.48
Rate for Payer: UHC All Payor (Choice/PPO)	$191.98
Rate for Payer: UHC Core	$878.00
Rate for Payer: UHC Exchange	$174.53

Know your out-of-pocket cost for care.

All Charges