Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

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

$148.05

Service Code	NDC 51079007320
Hospital Charge Code	3295
Hospital Revenue Code	637
Min. Negotiated Rate	$93.27
Max. Negotiated Rate	$133.24
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	$133.24
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

$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

$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	$51.00
Rate for Payer: Cofinity Commercial	$62.65
Rate for Payer: Cofinity Medicare Advantage	$51.00
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	$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

$148.05

Service Code	NDC 51079007320
Hospital Charge Code	3295
Hospital Revenue Code	637
Min. Negotiated Rate	$59.22
Max. Negotiated Rate	$133.24
Rate for Payer: Aetna Commercial	$125.84
Rate for Payer: Aetna Medicare	$74.02
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	$133.24
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

$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

$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

$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	$45.82
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

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	$51.00
Rate for Payer: Cofinity Commercial	$62.65
Rate for Payer: Cofinity Medicare Advantage	$51.00
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

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

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

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
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

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

G1004 CDSM - NATIONAL DECISION SUPPORT COMPANY

Facility

$0.01

Service Code	CPT G1004
Hospital Charge Code	99000396
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

G1004 CDSM - NATIONAL DECISION SUPPORT COMPANY

Facility

$0.01

Service Code	CPT G1004
Hospital Charge Code	99000396
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

G1007 CDSM - AIM SPECIALITY HEALTH

Facility

$0.01

Service Code	CPT G1007
Hospital Charge Code	99000399
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

G1007 CDSM - AIM SPECIALITY HEALTH

Facility

$0.01

Service Code	CPT G1007
Hospital Charge Code	99000399
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

G1008 CDSM - CRANBERRY PEAK

Facility

$0.01

Service Code	CPT G1008
Hospital Charge Code	99000400
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

G1008 CDSM - CRANBERRY PEAK

Facility

$0.01

Service Code	CPT G1008
Hospital Charge Code	99000400
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

G1010 CDSM - STANSON

Facility

$0.01

Service Code	CPT G1010
Hospital Charge Code	99000402
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

G1010 CDSM - STANSON

Facility

$0.01

Service Code	CPT G1010
Hospital Charge Code	99000402
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

G1011 CDSM - QUALIFIED TOOL NOT OTHERWISE SPECIFIED

Facility

$0.01

Service Code	CPT G1011
Hospital Charge Code	99000403
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

Know your out-of-pocket cost for care.

All Charges