Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

FUROSEMIDE 20 MG TABLET

Facility

$368.95

Service Code	NDC 00054829725
Hospital Charge Code	3294
Hospital Revenue Code	637
Min. Negotiated Rate	$232.44
Max. Negotiated Rate	$332.06
Rate for Payer: Aetna Commercial	$313.61
Rate for Payer: Aetna New Business (MI Preferred)	$239.82
Rate for Payer: Cash Price	$295.16
Rate for Payer: Cofinity Commercial	$258.26
Rate for Payer: Cofinity Commercial	$317.30
Rate for Payer: Cofinity Medicare Advantage	$258.26
Rate for Payer: Encore Health Key Benefits Commercial	$295.16
Rate for Payer: Healthscope Commercial	$332.06
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$313.61
Rate for Payer: PHP Commercial	$313.61
Rate for Payer: Priority Health Cigna Priority Health	$239.82
Rate for Payer: Priority Health SBD	$232.44

FUROSEMIDE 20 MG TABLET

Facility

$119.85

Service Code	NDC 00054429725
Hospital Charge Code	3294
Hospital Revenue Code	637
Min. Negotiated Rate	$75.51
Max. Negotiated Rate	$107.86
Rate for Payer: Aetna Commercial	$101.87
Rate for Payer: Aetna New Business (MI Preferred)	$77.90
Rate for Payer: Cash Price	$95.88
Rate for Payer: Cofinity Commercial	$103.07
Rate for Payer: Cofinity Commercial	$83.89
Rate for Payer: Cofinity Medicare Advantage	$83.89
Rate for Payer: Encore Health Key Benefits Commercial	$95.88
Rate for Payer: Healthscope Commercial	$107.86
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$101.87
Rate for Payer: PHP Commercial	$101.87
Rate for Payer: Priority Health Cigna Priority Health	$77.90
Rate for Payer: Priority Health SBD	$75.51

FUROSEMIDE 20 MG TABLET

Facility

$1.37

Service Code	NDC 51079007201
Hospital Charge Code	3294
Hospital Revenue Code	637
Min. Negotiated Rate	$0.55
Max. Negotiated Rate	$1.23
Rate for Payer: Aetna Commercial	$1.16
Rate for Payer: Aetna Medicare	$0.69
Rate for Payer: Aetna New Business (MI Preferred)	$0.89
Rate for Payer: BCBS Complete	$0.55
Rate for Payer: Cash Price	$1.10
Rate for Payer: Cofinity Commercial	$0.96
Rate for Payer: Cofinity Commercial	$1.18
Rate for Payer: Cofinity Medicare Advantage	$0.96
Rate for Payer: Encore Health Key Benefits Commercial	$1.10
Rate for Payer: Healthscope Commercial	$1.23
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1.16
Rate for Payer: PHP Commercial	$1.16
Rate for Payer: Priority Health Cigna Priority Health	$0.89
Rate for Payer: Priority Health SBD	$0.86

FUROSEMIDE 20 MG TABLET

Facility

$136.30

Service Code	NDC 51079007220
Hospital Charge Code	3294
Hospital Revenue Code	637
Min. Negotiated Rate	$54.52
Max. Negotiated Rate	$122.67
Rate for Payer: Aetna Commercial	$115.86
Rate for Payer: Aetna Medicare	$68.15
Rate for Payer: Aetna New Business (MI Preferred)	$88.59
Rate for Payer: BCBS Complete	$54.52
Rate for Payer: Cash Price	$109.04
Rate for Payer: Cofinity Commercial	$117.22
Rate for Payer: Cofinity Commercial	$95.41
Rate for Payer: Cofinity Medicare Advantage	$95.41
Rate for Payer: Encore Health Key Benefits Commercial	$109.04
Rate for Payer: Healthscope Commercial	$122.67
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$115.86
Rate for Payer: PHP Commercial	$115.86
Rate for Payer: Priority Health Cigna Priority Health	$88.59
Rate for Payer: Priority Health SBD	$85.87

FUROSEMIDE 20 MG TABLET

Facility

$82.25

Service Code	NDC 69315011601
Hospital Charge Code	3294
Hospital Revenue Code	637
Min. Negotiated Rate	$51.82
Max. Negotiated Rate	$74.03
Rate for Payer: Aetna Commercial	$69.91
Rate for Payer: Aetna New Business (MI Preferred)	$53.46
Rate for Payer: Cash Price	$65.80
Rate for Payer: Cofinity Commercial	$57.58
Rate for Payer: Cofinity Commercial	$70.73
Rate for Payer: Cofinity Medicare Advantage	$57.58
Rate for Payer: Encore Health Key Benefits Commercial	$65.80
Rate for Payer: Healthscope Commercial	$74.03
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$69.91
Rate for Payer: PHP Commercial	$69.91
Rate for Payer: Priority Health Cigna Priority Health	$53.46
Rate for Payer: Priority Health SBD	$51.82

FUROSEMIDE 20 MG TABLET

Facility

$1.37

Service Code	NDC 51079007201
Hospital Charge Code	3294
Hospital Revenue Code	637
Min. Negotiated Rate	$0.86
Max. Negotiated Rate	$1.23
Rate for Payer: Aetna Commercial	$1.16
Rate for Payer: Aetna New Business (MI Preferred)	$0.89
Rate for Payer: Cash Price	$1.10
Rate for Payer: Cofinity Commercial	$0.96
Rate for Payer: Cofinity Commercial	$1.18
Rate for Payer: Cofinity Medicare Advantage	$0.96
Rate for Payer: Encore Health Key Benefits Commercial	$1.10
Rate for Payer: Healthscope Commercial	$1.23
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1.16
Rate for Payer: PHP Commercial	$1.16
Rate for Payer: Priority Health Cigna Priority Health	$0.89
Rate for Payer: Priority Health SBD	$0.86

FUROSEMIDE 20 MG TABLET

Facility

$368.95

Service Code	NDC 00054829725
Hospital Charge Code	3294
Hospital Revenue Code	637
Min. Negotiated Rate	$147.58
Max. Negotiated Rate	$332.06
Rate for Payer: Aetna Commercial	$313.61
Rate for Payer: Aetna Medicare	$184.47
Rate for Payer: Aetna New Business (MI Preferred)	$239.82
Rate for Payer: BCBS Complete	$147.58
Rate for Payer: Cash Price	$295.16
Rate for Payer: Cofinity Commercial	$258.26
Rate for Payer: Cofinity Commercial	$317.30
Rate for Payer: Cofinity Medicare Advantage	$258.26
Rate for Payer: Encore Health Key Benefits Commercial	$295.16
Rate for Payer: Healthscope Commercial	$332.06
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$313.61
Rate for Payer: PHP Commercial	$313.61
Rate for Payer: Priority Health Cigna Priority Health	$239.82
Rate for Payer: Priority Health SBD	$232.44

FUROSEMIDE 20 MG TABLET

Facility

$136.30

Service Code	NDC 51079007220
Hospital Charge Code	3294
Hospital Revenue Code	637
Min. Negotiated Rate	$85.87
Max. Negotiated Rate	$122.67
Rate for Payer: Aetna Commercial	$115.86
Rate for Payer: Aetna New Business (MI Preferred)	$88.59
Rate for Payer: Cash Price	$109.04
Rate for Payer: Cofinity Commercial	$117.22
Rate for Payer: Cofinity Commercial	$95.41
Rate for Payer: Cofinity Medicare Advantage	$95.41
Rate for Payer: Encore Health Key Benefits Commercial	$109.04
Rate for Payer: Healthscope Commercial	$122.67
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$115.86
Rate for Payer: PHP Commercial	$115.86
Rate for Payer: Priority Health Cigna Priority Health	$88.59
Rate for Payer: Priority Health SBD	$85.87

FUROSEMIDE 20 MG TABLET

Facility

$82.25

Service Code	NDC 69315011601
Hospital Charge Code	3294
Hospital Revenue Code	637
Min. Negotiated Rate	$32.90
Max. Negotiated Rate	$74.03
Rate for Payer: Aetna Commercial	$69.91
Rate for Payer: Aetna Medicare	$41.12
Rate for Payer: Aetna New Business (MI Preferred)	$53.46
Rate for Payer: BCBS Complete	$32.90
Rate for Payer: Cash Price	$65.80
Rate for Payer: Cofinity Commercial	$57.58
Rate for Payer: Cofinity Commercial	$70.73
Rate for Payer: Cofinity Medicare Advantage	$57.58
Rate for Payer: Encore Health Key Benefits Commercial	$65.80
Rate for Payer: Healthscope Commercial	$74.03
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$69.91
Rate for Payer: PHP Commercial	$69.91
Rate for Payer: Priority Health Cigna Priority Health	$53.46
Rate for Payer: Priority Health SBD	$51.82

FUROSEMIDE 20 MG TABLET

Facility

$119.85

Service Code	NDC 00054429725
Hospital Charge Code	3294
Hospital Revenue Code	637
Min. Negotiated Rate	$47.94
Max. Negotiated Rate	$107.86
Rate for Payer: Aetna Commercial	$101.87
Rate for Payer: Aetna Medicare	$59.92
Rate for Payer: Aetna New Business (MI Preferred)	$77.90
Rate for Payer: BCBS Complete	$47.94
Rate for Payer: Cash Price	$95.88
Rate for Payer: Cofinity Commercial	$103.07
Rate for Payer: Cofinity Commercial	$83.89
Rate for Payer: Cofinity Medicare Advantage	$83.89
Rate for Payer: Encore Health Key Benefits Commercial	$95.88
Rate for Payer: Healthscope Commercial	$107.86
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$101.87
Rate for Payer: PHP Commercial	$101.87
Rate for Payer: Priority Health Cigna Priority Health	$77.90
Rate for Payer: Priority Health SBD	$75.51

FUROSEMIDE 40 MG TABLET

Facility

$72.85

Service Code	NDC 43547040210
Hospital Charge Code	3295
Hospital Revenue Code	637
Min. Negotiated Rate	$29.14
Max. Negotiated Rate	$65.56
Rate for Payer: Aetna Commercial	$61.92
Rate for Payer: Aetna Medicare	$36.42
Rate for Payer: Aetna New Business (MI Preferred)	$47.35
Rate for Payer: BCBS Complete	$29.14
Rate for Payer: Cash Price	$58.28
Rate for Payer: Cofinity Commercial	$50.99
Rate for Payer: Cofinity Commercial	$62.65
Rate for Payer: Cofinity Medicare Advantage	$50.99
Rate for Payer: Encore Health Key Benefits Commercial	$58.28
Rate for Payer: Healthscope Commercial	$65.56
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$61.92
Rate for Payer: PHP Commercial	$61.92
Rate for Payer: Priority Health Cigna Priority Health	$47.35
Rate for Payer: Priority Health SBD	$45.90

FUROSEMIDE 40 MG TABLET

Facility

$148.05

Service Code	NDC 51079007320
Hospital Charge Code	3295
Hospital Revenue Code	637
Min. Negotiated Rate	$59.22
Max. Negotiated Rate	$133.25
Rate for Payer: Aetna Commercial	$125.84
Rate for Payer: Aetna Medicare	$74.03
Rate for Payer: Aetna New Business (MI Preferred)	$96.23
Rate for Payer: BCBS Complete	$59.22
Rate for Payer: Cash Price	$118.44
Rate for Payer: Cofinity Commercial	$103.64
Rate for Payer: Cofinity Commercial	$127.32
Rate for Payer: Cofinity Medicare Advantage	$103.64
Rate for Payer: Encore Health Key Benefits Commercial	$118.44
Rate for Payer: Healthscope Commercial	$133.25
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$125.84
Rate for Payer: PHP Commercial	$125.84
Rate for Payer: Priority Health Cigna Priority Health	$96.23
Rate for Payer: Priority Health SBD	$93.27

FUROSEMIDE 40 MG TABLET

Facility

$148.05

Service Code	NDC 51079007320
Hospital Charge Code	3295
Hospital Revenue Code	637
Min. Negotiated Rate	$93.27
Max. Negotiated Rate	$133.25
Rate for Payer: Aetna Commercial	$125.84
Rate for Payer: Aetna New Business (MI Preferred)	$96.23
Rate for Payer: Cash Price	$118.44
Rate for Payer: Cofinity Commercial	$103.64
Rate for Payer: Cofinity Commercial	$127.32
Rate for Payer: Cofinity Medicare Advantage	$103.64
Rate for Payer: Encore Health Key Benefits Commercial	$118.44
Rate for Payer: Healthscope Commercial	$133.25
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$125.84
Rate for Payer: PHP Commercial	$125.84
Rate for Payer: Priority Health Cigna Priority Health	$96.23
Rate for Payer: Priority Health SBD	$93.27

FUROSEMIDE 40 MG TABLET

Facility

$72.85

Service Code	NDC 43547040210
Hospital Charge Code	3295
Hospital Revenue Code	637
Min. Negotiated Rate	$45.90
Max. Negotiated Rate	$65.56
Rate for Payer: Aetna Commercial	$61.92
Rate for Payer: Aetna New Business (MI Preferred)	$47.35
Rate for Payer: Cash Price	$58.28
Rate for Payer: Cofinity Commercial	$50.99
Rate for Payer: Cofinity Commercial	$62.65
Rate for Payer: Cofinity Medicare Advantage	$50.99
Rate for Payer: Encore Health Key Benefits Commercial	$58.28
Rate for Payer: Healthscope Commercial	$65.56
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$61.92
Rate for Payer: PHP Commercial	$61.92
Rate for Payer: Priority Health Cigna Priority Health	$47.35
Rate for Payer: Priority Health SBD	$45.90

FUROSEMIDE 40 MG TABLET

Facility

$112.80

Service Code	NDC 00378021601
Hospital Charge Code	3295
Hospital Revenue Code	637
Min. Negotiated Rate	$45.12
Max. Negotiated Rate	$101.52
Rate for Payer: Aetna Commercial	$95.88
Rate for Payer: Aetna Medicare	$56.40
Rate for Payer: Aetna New Business (MI Preferred)	$73.32
Rate for Payer: BCBS Complete	$45.12
Rate for Payer: Cash Price	$90.24
Rate for Payer: Cofinity Commercial	$78.96
Rate for Payer: Cofinity Commercial	$97.01
Rate for Payer: Cofinity Medicare Advantage	$78.96
Rate for Payer: Encore Health Key Benefits Commercial	$90.24
Rate for Payer: Healthscope Commercial	$101.52
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$95.88
Rate for Payer: PHP Commercial	$95.88
Rate for Payer: Priority Health Cigna Priority Health	$73.32
Rate for Payer: Priority Health SBD	$71.06

FUROSEMIDE 40 MG TABLET

Facility

$112.80

Service Code	NDC 00378021601
Hospital Charge Code	3295
Hospital Revenue Code	637
Min. Negotiated Rate	$71.06
Max. Negotiated Rate	$101.52
Rate for Payer: Aetna Commercial	$95.88
Rate for Payer: Aetna New Business (MI Preferred)	$73.32
Rate for Payer: Cash Price	$90.24
Rate for Payer: Cofinity Commercial	$78.96
Rate for Payer: Cofinity Commercial	$97.01
Rate for Payer: Cofinity Medicare Advantage	$78.96
Rate for Payer: Encore Health Key Benefits Commercial	$90.24
Rate for Payer: Healthscope Commercial	$101.52
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$95.88
Rate for Payer: PHP Commercial	$95.88
Rate for Payer: Priority Health Cigna Priority Health	$73.32
Rate for Payer: Priority Health SBD	$71.06

FUROSEMIDE 40 MG TABLET

Facility

$1.49

Service Code	NDC 51079007301
Hospital Charge Code	3295
Hospital Revenue Code	637
Min. Negotiated Rate	$0.94
Max. Negotiated Rate	$1.34
Rate for Payer: Aetna Commercial	$1.27
Rate for Payer: Aetna New Business (MI Preferred)	$0.97
Rate for Payer: Cash Price	$1.19
Rate for Payer: Cofinity Commercial	$1.04
Rate for Payer: Cofinity Commercial	$1.28
Rate for Payer: Cofinity Medicare Advantage	$1.04
Rate for Payer: Encore Health Key Benefits Commercial	$1.19
Rate for Payer: Healthscope Commercial	$1.34
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1.27
Rate for Payer: PHP Commercial	$1.27
Rate for Payer: Priority Health Cigna Priority Health	$0.97
Rate for Payer: Priority Health SBD	$0.94

FUROSEMIDE 40 MG TABLET

Facility

$91.65

Service Code	NDC 69315011701
Hospital Charge Code	3295
Hospital Revenue Code	637
Min. Negotiated Rate	$57.74
Max. Negotiated Rate	$82.48
Rate for Payer: Aetna Commercial	$77.90
Rate for Payer: Aetna New Business (MI Preferred)	$59.57
Rate for Payer: Cash Price	$73.32
Rate for Payer: Cofinity Commercial	$64.16
Rate for Payer: Cofinity Commercial	$78.82
Rate for Payer: Cofinity Medicare Advantage	$64.16
Rate for Payer: Encore Health Key Benefits Commercial	$73.32
Rate for Payer: Healthscope Commercial	$82.48
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$77.90
Rate for Payer: PHP Commercial	$77.90
Rate for Payer: Priority Health Cigna Priority Health	$59.57
Rate for Payer: Priority Health SBD	$57.74

FUROSEMIDE 40 MG TABLET

Facility

$1.49

Service Code	NDC 51079007301
Hospital Charge Code	3295
Hospital Revenue Code	637
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$1.34
Rate for Payer: Aetna Commercial	$1.27
Rate for Payer: Aetna Medicare	$0.75
Rate for Payer: Aetna New Business (MI Preferred)	$0.97
Rate for Payer: BCBS Complete	$0.60
Rate for Payer: Cash Price	$1.19
Rate for Payer: Cofinity Commercial	$1.04
Rate for Payer: Cofinity Commercial	$1.28
Rate for Payer: Cofinity Medicare Advantage	$1.04
Rate for Payer: Encore Health Key Benefits Commercial	$1.19
Rate for Payer: Healthscope Commercial	$1.34
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1.27
Rate for Payer: PHP Commercial	$1.27
Rate for Payer: Priority Health Cigna Priority Health	$0.97
Rate for Payer: Priority Health SBD	$0.94

FUROSEMIDE 40 MG TABLET

Facility

$91.65

Service Code	NDC 69315011701
Hospital Charge Code	3295
Hospital Revenue Code	637
Min. Negotiated Rate	$36.66
Max. Negotiated Rate	$82.48
Rate for Payer: Aetna Commercial	$77.90
Rate for Payer: Aetna Medicare	$45.83
Rate for Payer: Aetna New Business (MI Preferred)	$59.57
Rate for Payer: BCBS Complete	$36.66
Rate for Payer: Cash Price	$73.32
Rate for Payer: Cofinity Commercial	$64.16
Rate for Payer: Cofinity Commercial	$78.82
Rate for Payer: Cofinity Medicare Advantage	$64.16
Rate for Payer: Encore Health Key Benefits Commercial	$73.32
Rate for Payer: Healthscope Commercial	$82.48
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$77.90
Rate for Payer: PHP Commercial	$77.90
Rate for Payer: Priority Health Cigna Priority Health	$59.57
Rate for Payer: Priority Health SBD	$57.74

G1001 CDSM - EVICORE

Facility

$0.01

Service Code	CPT G1001
Hospital Charge Code	99000393
Hospital Revenue Code	990
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna Commercial	$0.01
Rate for Payer: Aetna Medicare	$0.01
Rate for Payer: Aetna New Business (MI Preferred)	$0.01
Rate for Payer: BCBS Complete	$0.00
Rate for Payer: Cash Price	$0.01
Rate for Payer: Cofinity Commercial	$0.01
Rate for Payer: Cofinity Commercial	$0.01
Rate for Payer: Cofinity Medicare Advantage	$0.01
Rate for Payer: Encore Health Key Benefits Commercial	$0.01
Rate for Payer: Healthscope Commercial	$0.01
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$0.01
Rate for Payer: PHP Commercial	$0.01
Rate for Payer: Priority Health Cigna Priority Health	$0.01
Rate for Payer: Priority Health SBD	$0.01

G1001 CDSM - EVICORE

Facility

$0.01

Service Code	CPT G1001
Hospital Charge Code	99000393
Hospital Revenue Code	990
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna Commercial	$0.01
Rate for Payer: Aetna New Business (MI Preferred)	$0.01
Rate for Payer: Cash Price	$0.01
Rate for Payer: Cofinity Commercial	$0.01
Rate for Payer: Cofinity Commercial	$0.01
Rate for Payer: Cofinity Medicare Advantage	$0.01
Rate for Payer: Encore Health Key Benefits Commercial	$0.01
Rate for Payer: Healthscope Commercial	$0.01
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$0.01
Rate for Payer: PHP Commercial	$0.01
Rate for Payer: Priority Health Cigna Priority Health	$0.01
Rate for Payer: Priority Health SBD	$0.01

G1002 CDSM - MEDCURRENT

Facility

$0.01

Service Code	CPT G1002
Hospital Charge Code	99000394
Hospital Revenue Code	990
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna Commercial	$0.01
Rate for Payer: Aetna New Business (MI Preferred)	$0.01
Rate for Payer: Cash Price	$0.01
Rate for Payer: Cofinity Commercial	$0.01
Rate for Payer: Cofinity Commercial	$0.01
Rate for Payer: Cofinity Medicare Advantage	$0.01
Rate for Payer: Encore Health Key Benefits Commercial	$0.01
Rate for Payer: Healthscope Commercial	$0.01
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$0.01
Rate for Payer: PHP Commercial	$0.01
Rate for Payer: Priority Health Cigna Priority Health	$0.01
Rate for Payer: Priority Health SBD	$0.01

G1002 CDSM - MEDCURRENT

Facility

$0.01

Service Code	CPT G1002
Hospital Charge Code	99000394
Hospital Revenue Code	990
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna Commercial	$0.01
Rate for Payer: Aetna Medicare	$0.01
Rate for Payer: Aetna New Business (MI Preferred)	$0.01
Rate for Payer: BCBS Complete	$0.00
Rate for Payer: Cash Price	$0.01
Rate for Payer: Cofinity Commercial	$0.01
Rate for Payer: Cofinity Commercial	$0.01
Rate for Payer: Cofinity Medicare Advantage	$0.01
Rate for Payer: Encore Health Key Benefits Commercial	$0.01
Rate for Payer: Healthscope Commercial	$0.01
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$0.01
Rate for Payer: PHP Commercial	$0.01
Rate for Payer: Priority Health Cigna Priority Health	$0.01
Rate for Payer: Priority Health SBD	$0.01

G1003 CDSM - MEDICALIS

Facility

$0.01

Service Code	CPT G1003
Hospital Charge Code	99000395
Hospital Revenue Code	990
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna Commercial	$0.01
Rate for Payer: Aetna Medicare	$0.01
Rate for Payer: Aetna New Business (MI Preferred)	$0.01
Rate for Payer: BCBS Complete	$0.00
Rate for Payer: Cash Price	$0.01
Rate for Payer: Cofinity Commercial	$0.01
Rate for Payer: Cofinity Commercial	$0.01
Rate for Payer: Cofinity Medicare Advantage	$0.01
Rate for Payer: Encore Health Key Benefits Commercial	$0.01
Rate for Payer: Healthscope Commercial	$0.01
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$0.01
Rate for Payer: PHP Commercial	$0.01
Rate for Payer: Priority Health Cigna Priority Health	$0.01
Rate for Payer: Priority Health SBD	$0.01

Know your out-of-pocket cost for care.

All Charges