Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC OT Z STOCKINGS NON CUSTOM $325

Facility

$325.00

Service Code	HCPCS A6549
Hospital Charge Code	98300124
Hospital Revenue Code	270
Min. Negotiated Rate	$130.00
Max. Negotiated Rate	$381.58
Rate for Payer: Aetna Commercial	$276.25
Rate for Payer: Aetna New Business (MI Preferred)	$211.25
Rate for Payer: BCBS Complete	$130.00
Rate for Payer: BCBS Trust/PPO	$381.58
Rate for Payer: Cash Price	$260.00
Rate for Payer: Cash Price	$260.00
Rate for Payer: Cofinity Commercial	$227.50
Rate for Payer: Cofinity Commercial	$279.50
Rate for Payer: Healthscope Commercial	$292.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$276.25
Rate for Payer: PHP Commercial	$276.25
Rate for Payer: Priority Health Cigna Priority Health	$227.50
Rate for Payer: Priority Health SBD	$204.75

HC OT Z STOCKINGS NON CUSTOM $325

Facility

$325.00

Service Code	HCPCS A6549
Hospital Charge Code	98300124
Hospital Revenue Code	270
Min. Negotiated Rate	$204.75
Max. Negotiated Rate	$292.50
Rate for Payer: Aetna Commercial	$276.25
Rate for Payer: Aetna New Business (MI Preferred)	$211.25
Rate for Payer: Cash Price	$260.00
Rate for Payer: Cofinity Commercial	$227.50
Rate for Payer: Cofinity Commercial	$279.50
Rate for Payer: Healthscope Commercial	$292.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$276.25
Rate for Payer: PHP Commercial	$276.25
Rate for Payer: Priority Health Cigna Priority Health	$227.50
Rate for Payer: Priority Health SBD	$204.75

HC OT Z STOCKINGS NON CUSTOM $350

Facility

$350.00

Service Code	HCPCS A6549
Hospital Charge Code	98300125
Hospital Revenue Code	270
Min. Negotiated Rate	$140.00
Max. Negotiated Rate	$381.58
Rate for Payer: Aetna Commercial	$297.50
Rate for Payer: Aetna New Business (MI Preferred)	$227.50
Rate for Payer: BCBS Complete	$140.00
Rate for Payer: BCBS Trust/PPO	$381.58
Rate for Payer: Cash Price	$280.00
Rate for Payer: Cash Price	$280.00
Rate for Payer: Cofinity Commercial	$245.00
Rate for Payer: Cofinity Commercial	$301.00
Rate for Payer: Healthscope Commercial	$315.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$297.50
Rate for Payer: PHP Commercial	$297.50
Rate for Payer: Priority Health Cigna Priority Health	$245.00
Rate for Payer: Priority Health SBD	$220.50

HC OT Z STOCKINGS NON CUSTOM $350

Facility

$350.00

Service Code	HCPCS A6549
Hospital Charge Code	98300125
Hospital Revenue Code	270
Min. Negotiated Rate	$220.50
Max. Negotiated Rate	$315.00
Rate for Payer: Aetna Commercial	$297.50
Rate for Payer: Aetna New Business (MI Preferred)	$227.50
Rate for Payer: Cash Price	$280.00
Rate for Payer: Cofinity Commercial	$245.00
Rate for Payer: Cofinity Commercial	$301.00
Rate for Payer: Healthscope Commercial	$315.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$297.50
Rate for Payer: PHP Commercial	$297.50
Rate for Payer: Priority Health Cigna Priority Health	$245.00
Rate for Payer: Priority Health SBD	$220.50

HC OT Z STOCKINGS NON CUSTOM $375

Facility

$375.00

Service Code	HCPCS A6549
Hospital Charge Code	98300126
Hospital Revenue Code	270
Min. Negotiated Rate	$236.25
Max. Negotiated Rate	$337.50
Rate for Payer: Aetna Commercial	$318.75
Rate for Payer: Aetna New Business (MI Preferred)	$243.75
Rate for Payer: Cash Price	$300.00
Rate for Payer: Cofinity Commercial	$262.50
Rate for Payer: Cofinity Commercial	$322.50
Rate for Payer: Healthscope Commercial	$337.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$318.75
Rate for Payer: PHP Commercial	$318.75
Rate for Payer: Priority Health Cigna Priority Health	$262.50
Rate for Payer: Priority Health SBD	$236.25

HC OT Z STOCKINGS NON CUSTOM $375

Facility

$375.00

Service Code	HCPCS A6549
Hospital Charge Code	98300126
Hospital Revenue Code	270
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$381.58
Rate for Payer: Aetna Commercial	$318.75
Rate for Payer: Aetna New Business (MI Preferred)	$243.75
Rate for Payer: BCBS Complete	$150.00
Rate for Payer: BCBS Trust/PPO	$381.58
Rate for Payer: Cash Price	$300.00
Rate for Payer: Cash Price	$300.00
Rate for Payer: Cofinity Commercial	$262.50
Rate for Payer: Cofinity Commercial	$322.50
Rate for Payer: Healthscope Commercial	$337.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$318.75
Rate for Payer: PHP Commercial	$318.75
Rate for Payer: Priority Health Cigna Priority Health	$262.50
Rate for Payer: Priority Health SBD	$236.25

HC OT Z STOCKINGS NON CUSTOM $40

Facility

$40.00

Service Code	HCPCS A6549
Hospital Charge Code	98300127
Hospital Revenue Code	270
Min. Negotiated Rate	$16.00
Max. Negotiated Rate	$381.58
Rate for Payer: Aetna Commercial	$34.00
Rate for Payer: Aetna New Business (MI Preferred)	$26.00
Rate for Payer: BCBS Complete	$16.00
Rate for Payer: BCBS Trust/PPO	$381.58
Rate for Payer: Cash Price	$32.00
Rate for Payer: Cash Price	$32.00
Rate for Payer: Cofinity Commercial	$28.00
Rate for Payer: Cofinity Commercial	$34.40
Rate for Payer: Healthscope Commercial	$36.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$34.00
Rate for Payer: PHP Commercial	$34.00
Rate for Payer: Priority Health Cigna Priority Health	$28.00
Rate for Payer: Priority Health SBD	$25.20

HC OT Z STOCKINGS NON CUSTOM $40

Facility

$40.00

Service Code	HCPCS A6549
Hospital Charge Code	98300127
Hospital Revenue Code	270
Min. Negotiated Rate	$25.20
Max. Negotiated Rate	$36.00
Rate for Payer: Aetna Commercial	$34.00
Rate for Payer: Aetna New Business (MI Preferred)	$26.00
Rate for Payer: Cash Price	$32.00
Rate for Payer: Cofinity Commercial	$28.00
Rate for Payer: Cofinity Commercial	$34.40
Rate for Payer: Healthscope Commercial	$36.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$34.00
Rate for Payer: PHP Commercial	$34.00
Rate for Payer: Priority Health Cigna Priority Health	$28.00
Rate for Payer: Priority Health SBD	$25.20

HC OT Z STOCKINGS NON CUSTOM $400

Facility

$400.00

Service Code	HCPCS A6549
Hospital Charge Code	98300128
Hospital Revenue Code	270
Min. Negotiated Rate	$160.00
Max. Negotiated Rate	$381.58
Rate for Payer: Aetna Commercial	$340.00
Rate for Payer: Aetna New Business (MI Preferred)	$260.00
Rate for Payer: BCBS Complete	$160.00
Rate for Payer: BCBS Trust/PPO	$381.58
Rate for Payer: Cash Price	$320.00
Rate for Payer: Cash Price	$320.00
Rate for Payer: Cofinity Commercial	$280.00
Rate for Payer: Cofinity Commercial	$344.00
Rate for Payer: Healthscope Commercial	$360.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$340.00
Rate for Payer: PHP Commercial	$340.00
Rate for Payer: Priority Health Cigna Priority Health	$280.00
Rate for Payer: Priority Health SBD	$252.00

HC OT Z STOCKINGS NON CUSTOM $400

Facility

$400.00

Service Code	HCPCS A6549
Hospital Charge Code	98300128
Hospital Revenue Code	270
Min. Negotiated Rate	$252.00
Max. Negotiated Rate	$360.00
Rate for Payer: Aetna Commercial	$340.00
Rate for Payer: Aetna New Business (MI Preferred)	$260.00
Rate for Payer: Cash Price	$320.00
Rate for Payer: Cofinity Commercial	$280.00
Rate for Payer: Cofinity Commercial	$344.00
Rate for Payer: Healthscope Commercial	$360.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$340.00
Rate for Payer: PHP Commercial	$340.00
Rate for Payer: Priority Health Cigna Priority Health	$280.00
Rate for Payer: Priority Health SBD	$252.00

HC OT Z STOCKINGS NON CUSTOM $425

Facility

$425.00

Service Code	HCPCS A6549
Hospital Charge Code	98300129
Hospital Revenue Code	270
Min. Negotiated Rate	$170.00
Max. Negotiated Rate	$382.50
Rate for Payer: Aetna Commercial	$361.25
Rate for Payer: Aetna New Business (MI Preferred)	$276.25
Rate for Payer: BCBS Complete	$170.00
Rate for Payer: BCBS Trust/PPO	$381.58
Rate for Payer: Cash Price	$340.00
Rate for Payer: Cash Price	$340.00
Rate for Payer: Cofinity Commercial	$297.50
Rate for Payer: Cofinity Commercial	$365.50
Rate for Payer: Healthscope Commercial	$382.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$361.25
Rate for Payer: PHP Commercial	$361.25
Rate for Payer: Priority Health Cigna Priority Health	$297.50
Rate for Payer: Priority Health SBD	$267.75

HC OT Z STOCKINGS NON CUSTOM $425

Facility

$425.00

Service Code	HCPCS A6549
Hospital Charge Code	98300129
Hospital Revenue Code	270
Min. Negotiated Rate	$267.75
Max. Negotiated Rate	$382.50
Rate for Payer: Aetna Commercial	$361.25
Rate for Payer: Aetna New Business (MI Preferred)	$276.25
Rate for Payer: Cash Price	$340.00
Rate for Payer: Cofinity Commercial	$297.50
Rate for Payer: Cofinity Commercial	$365.50
Rate for Payer: Healthscope Commercial	$382.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$361.25
Rate for Payer: PHP Commercial	$361.25
Rate for Payer: Priority Health Cigna Priority Health	$297.50
Rate for Payer: Priority Health SBD	$267.75

HC OT Z STOCKINGS NON CUSTOM $450

Facility

$450.00

Service Code	HCPCS A6549
Hospital Charge Code	98300130
Hospital Revenue Code	270
Min. Negotiated Rate	$283.50
Max. Negotiated Rate	$405.00
Rate for Payer: Aetna Commercial	$382.50
Rate for Payer: Aetna New Business (MI Preferred)	$292.50
Rate for Payer: Cash Price	$360.00
Rate for Payer: Cofinity Commercial	$315.00
Rate for Payer: Cofinity Commercial	$387.00
Rate for Payer: Healthscope Commercial	$405.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$382.50
Rate for Payer: PHP Commercial	$382.50
Rate for Payer: Priority Health Cigna Priority Health	$315.00
Rate for Payer: Priority Health SBD	$283.50

HC OT Z STOCKINGS NON CUSTOM $450

Facility

$450.00

Service Code	HCPCS A6549
Hospital Charge Code	98300130
Hospital Revenue Code	270
Min. Negotiated Rate	$180.00
Max. Negotiated Rate	$405.00
Rate for Payer: Aetna Commercial	$382.50
Rate for Payer: Aetna New Business (MI Preferred)	$292.50
Rate for Payer: BCBS Complete	$180.00
Rate for Payer: BCBS Trust/PPO	$381.58
Rate for Payer: Cash Price	$360.00
Rate for Payer: Cash Price	$360.00
Rate for Payer: Cofinity Commercial	$315.00
Rate for Payer: Cofinity Commercial	$387.00
Rate for Payer: Healthscope Commercial	$405.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$382.50
Rate for Payer: PHP Commercial	$382.50
Rate for Payer: Priority Health Cigna Priority Health	$315.00
Rate for Payer: Priority Health SBD	$283.50

HC OT Z STOCKINGS NON CUSTOM $50

Facility

$50.00

Service Code	HCPCS A6549
Hospital Charge Code	98300131
Hospital Revenue Code	270
Min. Negotiated Rate	$20.00
Max. Negotiated Rate	$381.58
Rate for Payer: Aetna Commercial	$42.50
Rate for Payer: Aetna New Business (MI Preferred)	$32.50
Rate for Payer: BCBS Complete	$20.00
Rate for Payer: BCBS Trust/PPO	$381.58
Rate for Payer: Cash Price	$40.00
Rate for Payer: Cash Price	$40.00
Rate for Payer: Cofinity Commercial	$43.00
Rate for Payer: Cofinity Commercial	$35.00
Rate for Payer: Healthscope Commercial	$45.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$42.50
Rate for Payer: PHP Commercial	$42.50
Rate for Payer: Priority Health Cigna Priority Health	$35.00
Rate for Payer: Priority Health SBD	$31.50

HC OT Z STOCKINGS NON CUSTOM $50

Facility

$50.00

Service Code	HCPCS A6549
Hospital Charge Code	98300131
Hospital Revenue Code	270
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$45.00
Rate for Payer: Aetna Commercial	$42.50
Rate for Payer: Aetna New Business (MI Preferred)	$32.50
Rate for Payer: Cash Price	$40.00
Rate for Payer: Cofinity Commercial	$35.00
Rate for Payer: Cofinity Commercial	$43.00
Rate for Payer: Healthscope Commercial	$45.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$42.50
Rate for Payer: PHP Commercial	$42.50
Rate for Payer: Priority Health Cigna Priority Health	$35.00
Rate for Payer: Priority Health SBD	$31.50

HC OT Z STOCKINGS NON CUSTOM $60

Facility

$60.00

Service Code	HCPCS A6549
Hospital Charge Code	98300132
Hospital Revenue Code	270
Min. Negotiated Rate	$24.00
Max. Negotiated Rate	$381.58
Rate for Payer: Aetna Commercial	$51.00
Rate for Payer: Aetna New Business (MI Preferred)	$39.00
Rate for Payer: BCBS Complete	$24.00
Rate for Payer: BCBS Trust/PPO	$381.58
Rate for Payer: Cash Price	$48.00
Rate for Payer: Cash Price	$48.00
Rate for Payer: Cofinity Commercial	$51.60
Rate for Payer: Cofinity Commercial	$42.00
Rate for Payer: Healthscope Commercial	$54.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$51.00
Rate for Payer: PHP Commercial	$51.00
Rate for Payer: Priority Health Cigna Priority Health	$42.00
Rate for Payer: Priority Health SBD	$37.80

HC OT Z STOCKINGS NON CUSTOM $60

Facility

$60.00

Service Code	HCPCS A6549
Hospital Charge Code	98300132
Hospital Revenue Code	270
Min. Negotiated Rate	$37.80
Max. Negotiated Rate	$54.00
Rate for Payer: Aetna Commercial	$51.00
Rate for Payer: Aetna New Business (MI Preferred)	$39.00
Rate for Payer: Cash Price	$48.00
Rate for Payer: Cofinity Commercial	$42.00
Rate for Payer: Cofinity Commercial	$51.60
Rate for Payer: Healthscope Commercial	$54.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$51.00
Rate for Payer: PHP Commercial	$51.00
Rate for Payer: Priority Health Cigna Priority Health	$42.00
Rate for Payer: Priority Health SBD	$37.80

HC OT Z STOCKINGS NON CUSTOM $70

Facility

$70.00

Service Code	HCPCS A6549
Hospital Charge Code	98300133
Hospital Revenue Code	270
Min. Negotiated Rate	$44.10
Max. Negotiated Rate	$63.00
Rate for Payer: Aetna Commercial	$59.50
Rate for Payer: Aetna New Business (MI Preferred)	$45.50
Rate for Payer: Cash Price	$56.00
Rate for Payer: Cofinity Commercial	$49.00
Rate for Payer: Cofinity Commercial	$60.20
Rate for Payer: Healthscope Commercial	$63.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$59.50
Rate for Payer: PHP Commercial	$59.50
Rate for Payer: Priority Health Cigna Priority Health	$49.00
Rate for Payer: Priority Health SBD	$44.10

HC OT Z STOCKINGS NON CUSTOM $70

Facility

$70.00

Service Code	HCPCS A6549
Hospital Charge Code	98300133
Hospital Revenue Code	270
Min. Negotiated Rate	$28.00
Max. Negotiated Rate	$381.58
Rate for Payer: Aetna Commercial	$59.50
Rate for Payer: Aetna New Business (MI Preferred)	$45.50
Rate for Payer: BCBS Complete	$28.00
Rate for Payer: BCBS Trust/PPO	$381.58
Rate for Payer: Cash Price	$56.00
Rate for Payer: Cash Price	$56.00
Rate for Payer: Cofinity Commercial	$60.20
Rate for Payer: Cofinity Commercial	$49.00
Rate for Payer: Healthscope Commercial	$63.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$59.50
Rate for Payer: PHP Commercial	$59.50
Rate for Payer: Priority Health Cigna Priority Health	$49.00
Rate for Payer: Priority Health SBD	$44.10

HC OT Z STOCKINGS NON CUSTOM $80

Facility

$80.00

Service Code	HCPCS A6549
Hospital Charge Code	98300134
Hospital Revenue Code	270
Min. Negotiated Rate	$32.00
Max. Negotiated Rate	$381.58
Rate for Payer: Aetna Commercial	$68.00
Rate for Payer: Aetna New Business (MI Preferred)	$52.00
Rate for Payer: BCBS Complete	$32.00
Rate for Payer: BCBS Trust/PPO	$381.58
Rate for Payer: Cash Price	$64.00
Rate for Payer: Cash Price	$64.00
Rate for Payer: Cofinity Commercial	$68.80
Rate for Payer: Cofinity Commercial	$56.00
Rate for Payer: Healthscope Commercial	$72.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$68.00
Rate for Payer: PHP Commercial	$68.00
Rate for Payer: Priority Health Cigna Priority Health	$56.00
Rate for Payer: Priority Health SBD	$50.40

HC OT Z STOCKINGS NON CUSTOM $80

Facility

$80.00

Service Code	HCPCS A6549
Hospital Charge Code	98300134
Hospital Revenue Code	270
Min. Negotiated Rate	$50.40
Max. Negotiated Rate	$72.00
Rate for Payer: Aetna Commercial	$68.00
Rate for Payer: Aetna New Business (MI Preferred)	$52.00
Rate for Payer: Cash Price	$64.00
Rate for Payer: Cofinity Commercial	$56.00
Rate for Payer: Cofinity Commercial	$68.80
Rate for Payer: Healthscope Commercial	$72.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$68.00
Rate for Payer: PHP Commercial	$68.00
Rate for Payer: Priority Health Cigna Priority Health	$56.00
Rate for Payer: Priority Health SBD	$50.40

HC OT Z STOCKINGS NON CUSTOM $90

Facility

$90.00

Service Code	HCPCS A6549
Hospital Charge Code	98300135
Hospital Revenue Code	270
Min. Negotiated Rate	$56.70
Max. Negotiated Rate	$81.00
Rate for Payer: Aetna Commercial	$76.50
Rate for Payer: Aetna New Business (MI Preferred)	$58.50
Rate for Payer: Cash Price	$72.00
Rate for Payer: Cofinity Commercial	$63.00
Rate for Payer: Cofinity Commercial	$77.40
Rate for Payer: Healthscope Commercial	$81.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$76.50
Rate for Payer: PHP Commercial	$76.50
Rate for Payer: Priority Health Cigna Priority Health	$63.00
Rate for Payer: Priority Health SBD	$56.70

HC OT Z STOCKINGS NON CUSTOM $90

Facility

$90.00

Service Code	HCPCS A6549
Hospital Charge Code	98300135
Hospital Revenue Code	270
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$381.58
Rate for Payer: Aetna Commercial	$76.50
Rate for Payer: Aetna New Business (MI Preferred)	$58.50
Rate for Payer: BCBS Complete	$36.00
Rate for Payer: BCBS Trust/PPO	$381.58
Rate for Payer: Cash Price	$72.00
Rate for Payer: Cash Price	$72.00
Rate for Payer: Cofinity Commercial	$63.00
Rate for Payer: Cofinity Commercial	$77.40
Rate for Payer: Healthscope Commercial	$81.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$76.50
Rate for Payer: PHP Commercial	$76.50
Rate for Payer: Priority Health Cigna Priority Health	$63.00
Rate for Payer: Priority Health SBD	$56.70

HC OVA & PARASITES

Facility

$86.10

Service Code	CPT 87177
Hospital Charge Code	30600096
Hospital Revenue Code	306
Min. Negotiated Rate	$4.87
Max. Negotiated Rate	$77.49
Rate for Payer: Aetna Commercial	$73.18
Rate for Payer: Aetna Medicare	$9.26
Rate for Payer: Aetna New Business (MI Preferred)	$55.96
Rate for Payer: Allen County Amish Medical Aid Commercial	$11.12
Rate for Payer: Amish Plain Church Group Commercial	$11.12
Rate for Payer: BCBS Complete	$5.11
Rate for Payer: BCBS MAPPO	$8.90
Rate for Payer: BCBS Trust/PPO	$6.97
Rate for Payer: BCN Medicare Advantage	$8.90
Rate for Payer: Cash Price	$68.88
Rate for Payer: Cash Price	$68.88
Rate for Payer: Cofinity Commercial	$60.27
Rate for Payer: Cofinity Commercial	$74.05
Rate for Payer: Health Alliance Plan Medicare Advantage	$8.90
Rate for Payer: Healthscope Commercial	$77.49
Rate for Payer: Mclaren Medicaid	$4.87
Rate for Payer: Mclaren Medicare	$8.90
Rate for Payer: Meridian Medicaid	$5.11
Rate for Payer: Meridian Wellcare - Medicare Advantage	$9.34
Rate for Payer: MI Amish Medical Board Commercial	$10.24
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$73.18
Rate for Payer: PACE Medicare	$8.46
Rate for Payer: PACE SWMI	$8.90
Rate for Payer: PHP Commercial	$73.18
Rate for Payer: PHP Medicare Advantage	$8.90
Rate for Payer: Priority Health Choice Medicaid	$4.87
Rate for Payer: Priority Health Cigna Priority Health	$60.27
Rate for Payer: Priority Health Medicare	$8.90
Rate for Payer: Priority Health SBD	$54.24
Rate for Payer: Railroad Medicare Medicare	$8.90
Rate for Payer: UHC All Payor (Choice/PPO)	$10.68
Rate for Payer: UHC Core	$15.12
Rate for Payer: UHC Dual Complete DSNP	$8.90
Rate for Payer: UHC Exchange	$8.90
Rate for Payer: UHC Medicare Advantage	$9.17
Rate for Payer: VA VA	$8.90

Know your out-of-pocket cost for care.

All Charges