Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC BRACE SOFT HELMET

Facility

$309.47

Service Code	HCPCS A8000
Hospital Charge Code	27000006
Hospital Revenue Code	274
Min. Negotiated Rate	$123.79
Max. Negotiated Rate	$278.52
Rate for Payer: Aetna Commercial	$263.05
Rate for Payer: Aetna New Business (MI Preferred)	$201.16
Rate for Payer: BCBS Complete	$123.79
Rate for Payer: Cash Price	$247.58
Rate for Payer: Cofinity Commercial	$216.63
Rate for Payer: Cofinity Commercial	$266.14
Rate for Payer: Healthscope Commercial	$278.52
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$263.05
Rate for Payer: PHP Commercial	$263.05
Rate for Payer: Priority Health Cigna Priority Health	$216.63
Rate for Payer: Priority Health SBD	$194.97

HC BRACE SOFT HELMET

Facility

$309.47

Service Code	HCPCS A8000
Hospital Charge Code	27000006
Hospital Revenue Code	274
Min. Negotiated Rate	$194.97
Max. Negotiated Rate	$278.52
Rate for Payer: Aetna Commercial	$263.05
Rate for Payer: Aetna New Business (MI Preferred)	$201.16
Rate for Payer: Cash Price	$247.58
Rate for Payer: Cofinity Commercial	$216.63
Rate for Payer: Cofinity Commercial	$266.14
Rate for Payer: Healthscope Commercial	$278.52
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$263.05
Rate for Payer: PHP Commercial	$263.05
Rate for Payer: Priority Health Cigna Priority Health	$216.63
Rate for Payer: Priority Health SBD	$194.97

HC BRACE STUMP SHRINKER AK

Facility

$154.02

Service Code	HCPCS L8460
Hospital Charge Code	27000015
Hospital Revenue Code	274
Min. Negotiated Rate	$97.03
Max. Negotiated Rate	$138.62
Rate for Payer: Aetna Commercial	$130.92
Rate for Payer: Aetna New Business (MI Preferred)	$100.11
Rate for Payer: Cash Price	$123.22
Rate for Payer: Cofinity Commercial	$107.81
Rate for Payer: Cofinity Commercial	$132.46
Rate for Payer: Healthscope Commercial	$138.62
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$130.92
Rate for Payer: PHP Commercial	$130.92
Rate for Payer: Priority Health Cigna Priority Health	$107.81
Rate for Payer: Priority Health SBD	$97.03

HC BRACE STUMP SHRINKER AK

Facility

$154.02

Service Code	HCPCS L8460
Hospital Charge Code	27000015
Hospital Revenue Code	274
Min. Negotiated Rate	$61.61
Max. Negotiated Rate	$221.24
Rate for Payer: Aetna Commercial	$130.92
Rate for Payer: Aetna New Business (MI Preferred)	$100.11
Rate for Payer: BCBS Complete	$61.61
Rate for Payer: BCBS Trust/PPO	$221.24
Rate for Payer: Cash Price	$123.22
Rate for Payer: Cash Price	$123.22
Rate for Payer: Cofinity Commercial	$107.81
Rate for Payer: Cofinity Commercial	$132.46
Rate for Payer: Healthscope Commercial	$138.62
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$130.92
Rate for Payer: PHP Commercial	$130.92
Rate for Payer: Priority Health Cigna Priority Health	$107.81
Rate for Payer: Priority Health SBD	$97.03
Rate for Payer: UHC All Payor (Choice/PPO)	$124.99
Rate for Payer: UHC Exchange	$104.16

HC BRACE STUMP SHRINKER BK

Facility

$108.36

Service Code	HCPCS L8440
Hospital Charge Code	27000016
Hospital Revenue Code	274
Min. Negotiated Rate	$43.34
Max. Negotiated Rate	$155.63
Rate for Payer: Aetna Commercial	$92.11
Rate for Payer: Aetna New Business (MI Preferred)	$70.43
Rate for Payer: BCBS Complete	$43.34
Rate for Payer: BCBS Trust/PPO	$155.63
Rate for Payer: Cash Price	$86.69
Rate for Payer: Cash Price	$86.69
Rate for Payer: Cofinity Commercial	$75.85
Rate for Payer: Cofinity Commercial	$93.19
Rate for Payer: Healthscope Commercial	$97.52
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$92.11
Rate for Payer: PHP Commercial	$92.11
Rate for Payer: Priority Health Cigna Priority Health	$75.85
Rate for Payer: Priority Health SBD	$68.27
Rate for Payer: UHC All Payor (Choice/PPO)	$78.42
Rate for Payer: UHC Exchange	$65.35

HC BRACE STUMP SHRINKER BK

Facility

$108.36

Service Code	HCPCS L8440
Hospital Charge Code	27000016
Hospital Revenue Code	274
Min. Negotiated Rate	$68.27
Max. Negotiated Rate	$97.52
Rate for Payer: Aetna Commercial	$92.11
Rate for Payer: Aetna New Business (MI Preferred)	$70.43
Rate for Payer: Cash Price	$86.69
Rate for Payer: Cofinity Commercial	$75.85
Rate for Payer: Cofinity Commercial	$93.19
Rate for Payer: Healthscope Commercial	$97.52
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$92.11
Rate for Payer: PHP Commercial	$92.11
Rate for Payer: Priority Health Cigna Priority Health	$75.85
Rate for Payer: Priority Health SBD	$68.27

HC BRACE THUMB SPICA SPLINT

Facility

$96.49

Service Code	HCPCS L3908
Hospital Charge Code	27400017
Hospital Revenue Code	274
Min. Negotiated Rate	$60.79
Max. Negotiated Rate	$86.84
Rate for Payer: Aetna Commercial	$82.02
Rate for Payer: Aetna New Business (MI Preferred)	$62.72
Rate for Payer: Cash Price	$77.19
Rate for Payer: Cofinity Commercial	$67.54
Rate for Payer: Cofinity Commercial	$82.98
Rate for Payer: Healthscope Commercial	$86.84
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$82.02
Rate for Payer: PHP Commercial	$82.02
Rate for Payer: Priority Health Cigna Priority Health	$67.54
Rate for Payer: Priority Health SBD	$60.79

HC BRACE THUMB SPICA SPLINT

Facility

$96.49

Service Code	HCPCS L3908
Hospital Charge Code	27400017
Hospital Revenue Code	274
Min. Negotiated Rate	$38.60
Max. Negotiated Rate	$222.34
Rate for Payer: Aetna Commercial	$82.02
Rate for Payer: Aetna New Business (MI Preferred)	$62.72
Rate for Payer: BCBS Complete	$38.60
Rate for Payer: BCBS Trust/PPO	$222.34
Rate for Payer: Cash Price	$77.19
Rate for Payer: Cash Price	$77.19
Rate for Payer: Cofinity Commercial	$67.54
Rate for Payer: Cofinity Commercial	$82.98
Rate for Payer: Healthscope Commercial	$86.84
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$82.02
Rate for Payer: PHP Commercial	$82.02
Rate for Payer: Priority Health Cigna Priority Health	$67.54
Rate for Payer: Priority Health SBD	$60.79
Rate for Payer: UHC All Payor (Choice/PPO)	$103.20
Rate for Payer: UHC Exchange	$86.00

HC BRACE TLSO

Facility

$3,200.00

Service Code	HCPCS L0486
Hospital Charge Code	27400007
Hospital Revenue Code	274
Min. Negotiated Rate	$2,016.00
Max. Negotiated Rate	$2,880.00
Rate for Payer: Aetna Commercial	$2,720.00
Rate for Payer: Aetna New Business (MI Preferred)	$2,080.00
Rate for Payer: Cash Price	$2,560.00
Rate for Payer: Cofinity Commercial	$2,240.00
Rate for Payer: Cofinity Commercial	$2,752.00
Rate for Payer: Healthscope Commercial	$2,880.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,720.00
Rate for Payer: PHP Commercial	$2,720.00
Rate for Payer: Priority Health Cigna Priority Health	$2,240.00
Rate for Payer: Priority Health SBD	$2,016.00

HC BRACE TLSO

Facility

$3,200.00

Service Code	HCPCS L0486
Hospital Charge Code	27400007
Hospital Revenue Code	274
Min. Negotiated Rate	$1,280.00
Max. Negotiated Rate	$6,818.78
Rate for Payer: Aetna Commercial	$2,720.00
Rate for Payer: Aetna New Business (MI Preferred)	$2,080.00
Rate for Payer: BCBS Complete	$1,280.00
Rate for Payer: BCBS Trust/PPO	$6,818.78
Rate for Payer: Cash Price	$2,560.00
Rate for Payer: Cash Price	$2,560.00
Rate for Payer: Cofinity Commercial	$2,752.00
Rate for Payer: Cofinity Commercial	$2,240.00
Rate for Payer: Healthscope Commercial	$2,880.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,720.00
Rate for Payer: PHP Commercial	$2,720.00
Rate for Payer: Priority Health Cigna Priority Health	$2,240.00
Rate for Payer: Priority Health SBD	$2,016.00
Rate for Payer: UHC All Payor (Choice/PPO)	$3,318.94
Rate for Payer: UHC Exchange	$2,765.78

HC BRACE TLSO PREFAB

Facility

$2,957.53

Service Code	HCPCS L0464
Hospital Charge Code	27400037
Hospital Revenue Code	274
Min. Negotiated Rate	$1,863.24
Max. Negotiated Rate	$2,661.78
Rate for Payer: Aetna Commercial	$2,513.90
Rate for Payer: Aetna New Business (MI Preferred)	$1,922.39
Rate for Payer: Cash Price	$2,366.02
Rate for Payer: Cofinity Commercial	$2,070.27
Rate for Payer: Cofinity Commercial	$2,543.48
Rate for Payer: Healthscope Commercial	$2,661.78
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,513.90
Rate for Payer: PHP Commercial	$2,513.90
Rate for Payer: Priority Health Cigna Priority Health	$2,070.27
Rate for Payer: Priority Health SBD	$1,863.24

HC BRACE TLSO PREFAB

Facility

$2,957.53

Service Code	HCPCS L0464
Hospital Charge Code	27400037
Hospital Revenue Code	274
Min. Negotiated Rate	$1,183.01
Max. Negotiated Rate	$4,953.26
Rate for Payer: Aetna Commercial	$2,513.90
Rate for Payer: Aetna New Business (MI Preferred)	$1,922.39
Rate for Payer: BCBS Complete	$1,183.01
Rate for Payer: BCBS Trust/PPO	$4,953.26
Rate for Payer: Cash Price	$2,366.02
Rate for Payer: Cash Price	$2,366.02
Rate for Payer: Cofinity Commercial	$2,070.27
Rate for Payer: Cofinity Commercial	$2,543.48
Rate for Payer: Healthscope Commercial	$2,661.78
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,513.90
Rate for Payer: PHP Commercial	$2,513.90
Rate for Payer: Priority Health Cigna Priority Health	$2,070.27
Rate for Payer: Priority Health SBD	$1,863.24
Rate for Payer: UHC All Payor (Choice/PPO)	$2,499.83
Rate for Payer: UHC Exchange	$2,083.19

HC BRACE TLSO PREFAB CUSTOM FIT

Facility

$1,964.25

Service Code	HCPCS L0460
Hospital Charge Code	27400023
Hospital Revenue Code	274
Min. Negotiated Rate	$1,237.48
Max. Negotiated Rate	$1,767.82
Rate for Payer: Aetna Commercial	$1,669.61
Rate for Payer: Aetna New Business (MI Preferred)	$1,276.76
Rate for Payer: Cash Price	$1,571.40
Rate for Payer: Cofinity Commercial	$1,374.98
Rate for Payer: Cofinity Commercial	$1,689.26
Rate for Payer: Healthscope Commercial	$1,767.82
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,669.61
Rate for Payer: PHP Commercial	$1,669.61
Rate for Payer: Priority Health Cigna Priority Health	$1,374.98
Rate for Payer: Priority Health SBD	$1,237.48

HC BRACE TLSO PREFAB CUSTOM FIT

Facility

$1,964.25

Service Code	HCPCS L0460
Hospital Charge Code	27400023
Hospital Revenue Code	274
Min. Negotiated Rate	$785.70
Max. Negotiated Rate	$3,345.07
Rate for Payer: Aetna Commercial	$1,669.61
Rate for Payer: Aetna New Business (MI Preferred)	$1,276.76
Rate for Payer: BCBS Complete	$785.70
Rate for Payer: BCBS Trust/PPO	$3,345.07
Rate for Payer: Cash Price	$1,571.40
Rate for Payer: Cash Price	$1,571.40
Rate for Payer: Cofinity Commercial	$1,689.26
Rate for Payer: Cofinity Commercial	$1,374.98
Rate for Payer: Healthscope Commercial	$1,767.82
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,669.61
Rate for Payer: PHP Commercial	$1,669.61
Rate for Payer: Priority Health Cigna Priority Health	$1,374.98
Rate for Payer: Priority Health SBD	$1,237.48
Rate for Payer: UHC All Payor (Choice/PPO)	$1,688.22
Rate for Payer: UHC Exchange	$1,406.85

HC BRACE UE FX RAD/ULNAR ORTHOSIS

Facility

$47.00

Service Code	HCPCS L3982
Hospital Charge Code	27400026
Hospital Revenue Code	274
Min. Negotiated Rate	$18.80
Max. Negotiated Rate	$1,191.28
Rate for Payer: Aetna Commercial	$39.95
Rate for Payer: Aetna New Business (MI Preferred)	$30.55
Rate for Payer: BCBS Complete	$18.80
Rate for Payer: BCBS Trust/PPO	$1,191.28
Rate for Payer: Cash Price	$37.60
Rate for Payer: Cash Price	$37.60
Rate for Payer: Cofinity Commercial	$40.42
Rate for Payer: Cofinity Commercial	$32.90
Rate for Payer: Healthscope Commercial	$42.30
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$39.95
Rate for Payer: PHP Commercial	$39.95
Rate for Payer: Priority Health Cigna Priority Health	$32.90
Rate for Payer: Priority Health SBD	$29.61
Rate for Payer: UHC All Payor (Choice/PPO)	$643.04
Rate for Payer: UHC Exchange	$535.87

HC BRACE UE FX RAD/ULNAR ORTHOSIS

Facility

$47.00

Service Code	HCPCS L3982
Hospital Charge Code	27400026
Hospital Revenue Code	274
Min. Negotiated Rate	$29.61
Max. Negotiated Rate	$42.30
Rate for Payer: Aetna Commercial	$39.95
Rate for Payer: Aetna New Business (MI Preferred)	$30.55
Rate for Payer: Cash Price	$37.60
Rate for Payer: Cofinity Commercial	$32.90
Rate for Payer: Cofinity Commercial	$40.42
Rate for Payer: Healthscope Commercial	$42.30
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$39.95
Rate for Payer: PHP Commercial	$39.95
Rate for Payer: Priority Health Cigna Priority Health	$32.90
Rate for Payer: Priority Health SBD	$29.61

HC BRACE UNIVERSAL COCKUP SPLINT

Facility

$35.44

Service Code	HCPCS L3908
Hospital Charge Code	27400012
Hospital Revenue Code	274
Min. Negotiated Rate	$14.18
Max. Negotiated Rate	$222.34
Rate for Payer: Aetna Commercial	$30.12
Rate for Payer: Aetna New Business (MI Preferred)	$23.04
Rate for Payer: BCBS Complete	$14.18
Rate for Payer: BCBS Trust/PPO	$222.34
Rate for Payer: Cash Price	$28.35
Rate for Payer: Cash Price	$28.35
Rate for Payer: Cofinity Commercial	$30.48
Rate for Payer: Cofinity Commercial	$24.81
Rate for Payer: Healthscope Commercial	$31.90
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$30.12
Rate for Payer: PHP Commercial	$30.12
Rate for Payer: Priority Health Cigna Priority Health	$24.81
Rate for Payer: Priority Health SBD	$22.33
Rate for Payer: UHC All Payor (Choice/PPO)	$103.20
Rate for Payer: UHC Exchange	$86.00

HC BRACE UNIVERSAL COCKUP SPLINT

Facility

$35.44

Service Code	HCPCS L3908
Hospital Charge Code	27400012
Hospital Revenue Code	274
Min. Negotiated Rate	$22.33
Max. Negotiated Rate	$31.90
Rate for Payer: Aetna Commercial	$30.12
Rate for Payer: Aetna New Business (MI Preferred)	$23.04
Rate for Payer: Cash Price	$28.35
Rate for Payer: Cofinity Commercial	$24.81
Rate for Payer: Cofinity Commercial	$30.48
Rate for Payer: Healthscope Commercial	$31.90
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$30.12
Rate for Payer: PHP Commercial	$30.12
Rate for Payer: Priority Health Cigna Priority Health	$24.81
Rate for Payer: Priority Health SBD	$22.33

HC BRACE WAIST BELT

Facility

$144.63

Service Code	HCPCS L5688
Hospital Charge Code	27400031
Hospital Revenue Code	274
Min. Negotiated Rate	$91.12
Max. Negotiated Rate	$130.17
Rate for Payer: Aetna Commercial	$122.94
Rate for Payer: Aetna New Business (MI Preferred)	$94.01
Rate for Payer: Cash Price	$115.70
Rate for Payer: Cofinity Commercial	$101.24
Rate for Payer: Cofinity Commercial	$124.38
Rate for Payer: Healthscope Commercial	$130.17
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$122.94
Rate for Payer: PHP Commercial	$122.94
Rate for Payer: Priority Health Cigna Priority Health	$101.24
Rate for Payer: Priority Health SBD	$91.12

HC BRACE WAIST BELT

Facility

$144.63

Service Code	HCPCS L5688
Hospital Charge Code	27400031
Hospital Revenue Code	274
Min. Negotiated Rate	$57.85
Max. Negotiated Rate	$204.10
Rate for Payer: Aetna Commercial	$122.94
Rate for Payer: Aetna New Business (MI Preferred)	$94.01
Rate for Payer: BCBS Complete	$57.85
Rate for Payer: BCBS Trust/PPO	$204.10
Rate for Payer: Cash Price	$115.70
Rate for Payer: Cash Price	$115.70
Rate for Payer: Cofinity Commercial	$101.24
Rate for Payer: Cofinity Commercial	$124.38
Rate for Payer: Healthscope Commercial	$130.17
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$122.94
Rate for Payer: PHP Commercial	$122.94
Rate for Payer: Priority Health Cigna Priority Health	$101.24
Rate for Payer: Priority Health SBD	$91.12
Rate for Payer: UHC All Payor (Choice/PPO)	$114.56
Rate for Payer: UHC Exchange	$95.47

HC BRACE WHFO RIGID W/O JOINTS

Facility

$332.52

Service Code	HCPCS L3808
Hospital Charge Code	27400040
Hospital Revenue Code	274
Min. Negotiated Rate	$133.01
Max. Negotiated Rate	$1,080.31
Rate for Payer: Aetna Commercial	$282.64
Rate for Payer: Aetna New Business (MI Preferred)	$216.14
Rate for Payer: BCBS Complete	$133.01
Rate for Payer: BCBS Trust/PPO	$1,080.31
Rate for Payer: Cash Price	$266.02
Rate for Payer: Cash Price	$266.02
Rate for Payer: Cofinity Commercial	$232.76
Rate for Payer: Cofinity Commercial	$285.97
Rate for Payer: Healthscope Commercial	$299.27
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$282.64
Rate for Payer: PHP Commercial	$282.64
Rate for Payer: Priority Health Cigna Priority Health	$232.76
Rate for Payer: Priority Health SBD	$209.49
Rate for Payer: UHC All Payor (Choice/PPO)	$570.41
Rate for Payer: UHC Exchange	$475.34

HC BRACE WHFO RIGID W/O JOINTS

Facility

$332.52

Service Code	HCPCS L3808
Hospital Charge Code	27400040
Hospital Revenue Code	274
Min. Negotiated Rate	$209.49
Max. Negotiated Rate	$299.27
Rate for Payer: Aetna Commercial	$282.64
Rate for Payer: Aetna New Business (MI Preferred)	$216.14
Rate for Payer: Cash Price	$266.02
Rate for Payer: Cofinity Commercial	$232.76
Rate for Payer: Cofinity Commercial	$285.97
Rate for Payer: Healthscope Commercial	$299.27
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$282.64
Rate for Payer: PHP Commercial	$282.64
Rate for Payer: Priority Health Cigna Priority Health	$232.76
Rate for Payer: Priority Health SBD	$209.49

HC BRACE WHO W/O JOINTS CF

Facility

$473.28

Service Code	HCPCS L3906
Hospital Charge Code	27400041
Hospital Revenue Code	274
Min. Negotiated Rate	$189.31
Max. Negotiated Rate	$1,536.85
Rate for Payer: Aetna Commercial	$402.29
Rate for Payer: Aetna New Business (MI Preferred)	$307.63
Rate for Payer: BCBS Complete	$189.31
Rate for Payer: BCBS Trust/PPO	$1,536.85
Rate for Payer: Cash Price	$378.62
Rate for Payer: Cash Price	$378.62
Rate for Payer: Cofinity Commercial	$331.30
Rate for Payer: Cofinity Commercial	$407.02
Rate for Payer: Healthscope Commercial	$425.95
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$402.29
Rate for Payer: PHP Commercial	$402.29
Rate for Payer: Priority Health Cigna Priority Health	$331.30
Rate for Payer: Priority Health SBD	$298.17
Rate for Payer: UHC All Payor (Choice/PPO)	$680.64
Rate for Payer: UHC Exchange	$567.20

HC BRACE WHO W/O JOINTS CF

Facility

$473.28

Service Code	HCPCS L3906
Hospital Charge Code	27400041
Hospital Revenue Code	274
Min. Negotiated Rate	$298.17
Max. Negotiated Rate	$425.95
Rate for Payer: Aetna Commercial	$402.29
Rate for Payer: Aetna New Business (MI Preferred)	$307.63
Rate for Payer: Cash Price	$378.62
Rate for Payer: Cofinity Commercial	$331.30
Rate for Payer: Cofinity Commercial	$407.02
Rate for Payer: Healthscope Commercial	$425.95
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$402.29
Rate for Payer: PHP Commercial	$402.29
Rate for Payer: Priority Health Cigna Priority Health	$331.30
Rate for Payer: Priority Health SBD	$298.17

HC BRACE WRIST/THUMB SPLINT

Facility

$132.19

Service Code	HCPCS L3908
Hospital Charge Code	27400014
Hospital Revenue Code	274
Min. Negotiated Rate	$52.88
Max. Negotiated Rate	$222.34
Rate for Payer: Aetna Commercial	$112.36
Rate for Payer: Aetna New Business (MI Preferred)	$85.92
Rate for Payer: BCBS Complete	$52.88
Rate for Payer: BCBS Trust/PPO	$222.34
Rate for Payer: Cash Price	$105.75
Rate for Payer: Cash Price	$105.75
Rate for Payer: Cofinity Commercial	$113.68
Rate for Payer: Cofinity Commercial	$92.53
Rate for Payer: Healthscope Commercial	$118.97
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$112.36
Rate for Payer: PHP Commercial	$112.36
Rate for Payer: Priority Health Cigna Priority Health	$92.53
Rate for Payer: Priority Health SBD	$83.28
Rate for Payer: UHC All Payor (Choice/PPO)	$103.20
Rate for Payer: UHC Exchange	$86.00

Know your out-of-pocket cost for care.

All Charges