Price Transparency

Know your out-of-pocket cost for care.

search
Charge Type Setting Price  
Service Code HCPCS J3480
Hospital Charge Code 11076
Hospital Revenue Code 636
Min. Negotiated Rate $0.35
Max. Negotiated Rate $72.37
Rate for Payer: Aetna Commercial $68.35
Rate for Payer: Aetna New Business (MI Preferred) $52.27
Rate for Payer: BCBS Complete $32.16
Rate for Payer: BCBS Trust/PPO $0.35
Rate for Payer: Cash Price $64.33
Rate for Payer: Cash Price $64.33
Rate for Payer: Cofinity Commercial $56.29
Rate for Payer: Cofinity Commercial $69.15
Rate for Payer: Healthscope Commercial $72.37
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $68.35
Rate for Payer: PHP Commercial $68.35
Rate for Payer: Priority Health Cigna Priority Health $56.29
Rate for Payer: Priority Health SBD $50.66
Service Code HCPCS J3480
Hospital Charge Code 11076
Hospital Revenue Code 636
Min. Negotiated Rate $95.30
Max. Negotiated Rate $136.14
Rate for Payer: Aetna Commercial $128.58
Rate for Payer: Aetna Commercial $68.35
Rate for Payer: Aetna Commercial $47.46
Rate for Payer: Aetna Commercial $66.44
Rate for Payer: Aetna New Business (MI Preferred) $50.80
Rate for Payer: Aetna New Business (MI Preferred) $52.27
Rate for Payer: Aetna New Business (MI Preferred) $98.33
Rate for Payer: Aetna New Business (MI Preferred) $36.29
Rate for Payer: Cash Price $44.66
Rate for Payer: Cash Price $62.53
Rate for Payer: Cash Price $64.33
Rate for Payer: Cash Price $121.02
Rate for Payer: Cofinity Commercial $67.22
Rate for Payer: Cofinity Commercial $39.08
Rate for Payer: Cofinity Commercial $48.01
Rate for Payer: Cofinity Commercial $69.15
Rate for Payer: Cofinity Commercial $56.29
Rate for Payer: Cofinity Commercial $105.89
Rate for Payer: Cofinity Commercial $54.71
Rate for Payer: Cofinity Commercial $130.09
Rate for Payer: Healthscope Commercial $50.25
Rate for Payer: Healthscope Commercial $72.37
Rate for Payer: Healthscope Commercial $136.14
Rate for Payer: Healthscope Commercial $70.34
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $128.58
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $47.46
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $66.44
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $68.35
Rate for Payer: PHP Commercial $66.44
Rate for Payer: PHP Commercial $128.58
Rate for Payer: PHP Commercial $47.46
Rate for Payer: PHP Commercial $68.35
Rate for Payer: Priority Health Cigna Priority Health $54.71
Rate for Payer: Priority Health Cigna Priority Health $39.08
Rate for Payer: Priority Health Cigna Priority Health $105.89
Rate for Payer: Priority Health Cigna Priority Health $56.29
Rate for Payer: Priority Health SBD $50.66
Rate for Payer: Priority Health SBD $49.24
Rate for Payer: Priority Health SBD $35.17
Rate for Payer: Priority Health SBD $95.30
Service Code NDC 0904-7062-62
Hospital Charge Code 6432
Hospital Revenue Code 637
Min. Negotiated Rate $28.60
Max. Negotiated Rate $40.86
Rate for Payer: Aetna Commercial $38.59
Rate for Payer: Aetna New Business (MI Preferred) $29.51
Rate for Payer: Cash Price $36.32
Rate for Payer: Cofinity Commercial $31.78
Rate for Payer: Cofinity Commercial $39.04
Rate for Payer: Healthscope Commercial $40.86
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $38.59
Rate for Payer: PHP Commercial $38.59
Rate for Payer: Priority Health Cigna Priority Health $31.78
Rate for Payer: Priority Health SBD $28.60
Service Code NDC 66689-048-50
Hospital Charge Code 6432
Hospital Revenue Code 637
Min. Negotiated Rate $45.95
Max. Negotiated Rate $65.64
Rate for Payer: Aetna Commercial $61.99
Rate for Payer: Aetna New Business (MI Preferred) $47.40
Rate for Payer: Cash Price $58.34
Rate for Payer: Cofinity Commercial $51.05
Rate for Payer: Cofinity Commercial $62.72
Rate for Payer: Healthscope Commercial $65.64
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $61.99
Rate for Payer: PHP Commercial $61.99
Rate for Payer: Priority Health Cigna Priority Health $51.05
Rate for Payer: Priority Health SBD $45.95
Service Code NDC 0904-7062-73
Hospital Charge Code 6432
Hospital Revenue Code 637
Min. Negotiated Rate $19.51
Max. Negotiated Rate $27.87
Rate for Payer: Aetna Commercial $26.32
Rate for Payer: Aetna New Business (MI Preferred) $20.13
Rate for Payer: Cash Price $24.78
Rate for Payer: Cofinity Commercial $21.68
Rate for Payer: Cofinity Commercial $26.63
Rate for Payer: Healthscope Commercial $27.87
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $26.32
Rate for Payer: PHP Commercial $26.32
Rate for Payer: Priority Health Cigna Priority Health $21.68
Rate for Payer: Priority Health SBD $19.51
Service Code NDC 0121-1896-00
Hospital Charge Code 6432
Hospital Revenue Code 637
Min. Negotiated Rate $23.08
Max. Negotiated Rate $32.97
Rate for Payer: Aetna Commercial $31.14
Rate for Payer: Aetna New Business (MI Preferred) $23.81
Rate for Payer: Cash Price $29.30
Rate for Payer: Cofinity Commercial $25.64
Rate for Payer: Cofinity Commercial $31.50
Rate for Payer: Healthscope Commercial $32.97
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $31.14
Rate for Payer: PHP Commercial $31.14
Rate for Payer: Priority Health Cigna Priority Health $25.64
Rate for Payer: Priority Health SBD $23.08
Service Code NDC 0121-1896-30
Hospital Charge Code 6432
Hospital Revenue Code 637
Min. Negotiated Rate $23.08
Max. Negotiated Rate $32.97
Rate for Payer: Aetna Commercial $31.14
Rate for Payer: Aetna New Business (MI Preferred) $23.81
Rate for Payer: Cash Price $29.30
Rate for Payer: Cofinity Commercial $31.50
Rate for Payer: Cofinity Commercial $25.64
Rate for Payer: Healthscope Commercial $32.97
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $31.14
Rate for Payer: PHP Commercial $31.14
Rate for Payer: Priority Health Cigna Priority Health $25.64
Rate for Payer: Priority Health SBD $23.08
Service Code NDC 66689-048-01
Hospital Charge Code 6432
Hospital Revenue Code 637
Min. Negotiated Rate $45.25
Max. Negotiated Rate $64.64
Rate for Payer: Aetna Commercial $61.05
Rate for Payer: Aetna New Business (MI Preferred) $46.68
Rate for Payer: Cash Price $57.46
Rate for Payer: Cofinity Commercial $50.27
Rate for Payer: Cofinity Commercial $61.77
Rate for Payer: Healthscope Commercial $64.64
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $61.05
Rate for Payer: PHP Commercial $61.05
Rate for Payer: Priority Health Cigna Priority Health $50.27
Rate for Payer: Priority Health SBD $45.25
Service Code HCPCS J3480
Hospital Charge Code 11081
Hospital Revenue Code 250
Min. Negotiated Rate $44.05
Max. Negotiated Rate $62.93
Rate for Payer: Aetna Commercial $59.43
Rate for Payer: Aetna Commercial $62.42
Rate for Payer: Aetna New Business (MI Preferred) $45.45
Rate for Payer: Aetna New Business (MI Preferred) $47.74
Rate for Payer: Cash Price $55.94
Rate for Payer: Cash Price $58.75
Rate for Payer: Cofinity Commercial $48.94
Rate for Payer: Cofinity Commercial $51.41
Rate for Payer: Cofinity Commercial $63.16
Rate for Payer: Cofinity Commercial $60.13
Rate for Payer: Healthscope Commercial $66.10
Rate for Payer: Healthscope Commercial $62.93
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $59.43
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $62.42
Rate for Payer: PHP Commercial $62.42
Rate for Payer: PHP Commercial $59.43
Rate for Payer: Priority Health Cigna Priority Health $48.94
Rate for Payer: Priority Health Cigna Priority Health $51.41
Rate for Payer: Priority Health SBD $44.05
Rate for Payer: Priority Health SBD $46.27
Service Code HCPCS J3480
Hospital Charge Code 11081
Hospital Revenue Code 250
Min. Negotiated Rate $0.35
Max. Negotiated Rate $66.10
Rate for Payer: Aetna Commercial $62.42
Rate for Payer: Aetna Commercial $59.43
Rate for Payer: Aetna New Business (MI Preferred) $45.45
Rate for Payer: Aetna New Business (MI Preferred) $47.74
Rate for Payer: BCBS Complete $27.97
Rate for Payer: BCBS Complete $29.38
Rate for Payer: BCBS Trust/PPO $0.35
Rate for Payer: BCBS Trust/PPO $0.35
Rate for Payer: Cash Price $58.75
Rate for Payer: Cash Price $58.75
Rate for Payer: Cash Price $55.94
Rate for Payer: Cash Price $55.94
Rate for Payer: Cofinity Commercial $51.41
Rate for Payer: Cofinity Commercial $48.94
Rate for Payer: Cofinity Commercial $63.16
Rate for Payer: Cofinity Commercial $60.13
Rate for Payer: Healthscope Commercial $66.10
Rate for Payer: Healthscope Commercial $62.93
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $59.43
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $62.42
Rate for Payer: PHP Commercial $59.43
Rate for Payer: PHP Commercial $62.42
Rate for Payer: Priority Health Cigna Priority Health $48.94
Rate for Payer: Priority Health Cigna Priority Health $51.41
Rate for Payer: Priority Health SBD $46.27
Rate for Payer: Priority Health SBD $44.05
Service Code NDC 0338-0671-04
Hospital Charge Code 300206
Hospital Revenue Code 250
Min. Negotiated Rate $44.05
Max. Negotiated Rate $62.93
Rate for Payer: Aetna Commercial $59.43
Rate for Payer: Aetna New Business (MI Preferred) $45.45
Rate for Payer: Cash Price $55.94
Rate for Payer: Cofinity Commercial $48.94
Rate for Payer: Cofinity Commercial $60.13
Rate for Payer: Healthscope Commercial $62.93
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $59.43
Rate for Payer: PHP Commercial $59.43
Rate for Payer: Priority Health Cigna Priority Health $48.94
Rate for Payer: Priority Health SBD $44.05
Service Code NDC 0338-0671-04
Hospital Charge Code 9801
Hospital Revenue Code 250
Min. Negotiated Rate $27.97
Max. Negotiated Rate $62.93
Rate for Payer: Aetna Commercial $59.43
Rate for Payer: Aetna New Business (MI Preferred) $45.45
Rate for Payer: BCBS Complete $27.97
Rate for Payer: Cash Price $55.94
Rate for Payer: Cofinity Commercial $48.94
Rate for Payer: Cofinity Commercial $60.13
Rate for Payer: Healthscope Commercial $62.93
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $59.43
Rate for Payer: PHP Commercial $59.43
Rate for Payer: Priority Health Cigna Priority Health $48.94
Rate for Payer: Priority Health SBD $44.05
Service Code NDC 0338-0671-04
Hospital Charge Code 9801
Hospital Revenue Code 250
Min. Negotiated Rate $44.05
Max. Negotiated Rate $62.93
Rate for Payer: Aetna Commercial $59.43
Rate for Payer: Aetna New Business (MI Preferred) $45.45
Rate for Payer: Cash Price $55.94
Rate for Payer: Cofinity Commercial $48.94
Rate for Payer: Cofinity Commercial $60.13
Rate for Payer: Healthscope Commercial $62.93
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $59.43
Rate for Payer: PHP Commercial $59.43
Rate for Payer: Priority Health Cigna Priority Health $48.94
Rate for Payer: Priority Health SBD $44.05
Service Code HCPCS J3480
Hospital Charge Code 6429
Hospital Revenue Code 636
Min. Negotiated Rate $0.35
Max. Negotiated Rate $24.27
Rate for Payer: Aetna Commercial $22.92
Rate for Payer: Aetna Commercial $17.93
Rate for Payer: Aetna New Business (MI Preferred) $17.53
Rate for Payer: Aetna New Business (MI Preferred) $13.71
Rate for Payer: BCBS Complete $8.44
Rate for Payer: BCBS Complete $10.79
Rate for Payer: BCBS Trust/PPO $0.35
Rate for Payer: BCBS Trust/PPO $0.35
Rate for Payer: Cash Price $21.58
Rate for Payer: Cash Price $16.87
Rate for Payer: Cash Price $16.87
Rate for Payer: Cash Price $21.58
Rate for Payer: Cofinity Commercial $23.19
Rate for Payer: Cofinity Commercial $18.14
Rate for Payer: Cofinity Commercial $14.76
Rate for Payer: Cofinity Commercial $18.88
Rate for Payer: Healthscope Commercial $18.98
Rate for Payer: Healthscope Commercial $24.27
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $22.92
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $17.93
Rate for Payer: PHP Commercial $22.92
Rate for Payer: PHP Commercial $17.93
Rate for Payer: Priority Health Cigna Priority Health $14.76
Rate for Payer: Priority Health Cigna Priority Health $18.88
Rate for Payer: Priority Health SBD $13.29
Rate for Payer: Priority Health SBD $16.99
Service Code HCPCS J3480
Hospital Charge Code 6429
Hospital Revenue Code 636
Min. Negotiated Rate $11.51
Max. Negotiated Rate $16.44
Rate for Payer: Aetna Commercial $15.53
Rate for Payer: Aetna Commercial $17.78
Rate for Payer: Aetna Commercial $68.21
Rate for Payer: Aetna Commercial $22.92
Rate for Payer: Aetna Commercial $16.80
Rate for Payer: Aetna Commercial $17.93
Rate for Payer: Aetna New Business (MI Preferred) $13.71
Rate for Payer: Aetna New Business (MI Preferred) $11.88
Rate for Payer: Aetna New Business (MI Preferred) $12.84
Rate for Payer: Aetna New Business (MI Preferred) $13.60
Rate for Payer: Aetna New Business (MI Preferred) $17.53
Rate for Payer: Aetna New Business (MI Preferred) $52.16
Rate for Payer: Cash Price $16.87
Rate for Payer: Cash Price $16.74
Rate for Payer: Cash Price $21.58
Rate for Payer: Cash Price $15.81
Rate for Payer: Cash Price $14.62
Rate for Payer: Cash Price $64.20
Rate for Payer: Cofinity Commercial $56.18
Rate for Payer: Cofinity Commercial $14.64
Rate for Payer: Cofinity Commercial $17.99
Rate for Payer: Cofinity Commercial $13.83
Rate for Payer: Cofinity Commercial $23.19
Rate for Payer: Cofinity Commercial $18.88
Rate for Payer: Cofinity Commercial $12.79
Rate for Payer: Cofinity Commercial $69.02
Rate for Payer: Cofinity Commercial $16.99
Rate for Payer: Cofinity Commercial $15.71
Rate for Payer: Cofinity Commercial $14.76
Rate for Payer: Cofinity Commercial $18.14
Rate for Payer: Healthscope Commercial $16.44
Rate for Payer: Healthscope Commercial $18.98
Rate for Payer: Healthscope Commercial $72.22
Rate for Payer: Healthscope Commercial $17.78
Rate for Payer: Healthscope Commercial $18.83
Rate for Payer: Healthscope Commercial $24.27
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $68.21
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $16.80
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $15.53
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $17.78
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $17.93
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $22.92
Rate for Payer: PHP Commercial $17.93
Rate for Payer: PHP Commercial $17.78
Rate for Payer: PHP Commercial $68.21
Rate for Payer: PHP Commercial $16.80
Rate for Payer: PHP Commercial $15.53
Rate for Payer: PHP Commercial $22.92
Rate for Payer: Priority Health Cigna Priority Health $14.76
Rate for Payer: Priority Health Cigna Priority Health $18.88
Rate for Payer: Priority Health Cigna Priority Health $14.64
Rate for Payer: Priority Health Cigna Priority Health $12.79
Rate for Payer: Priority Health Cigna Priority Health $13.83
Rate for Payer: Priority Health Cigna Priority Health $56.18
Rate for Payer: Priority Health SBD $12.45
Rate for Payer: Priority Health SBD $16.99
Rate for Payer: Priority Health SBD $50.56
Rate for Payer: Priority Health SBD $13.18
Rate for Payer: Priority Health SBD $13.29
Rate for Payer: Priority Health SBD $11.51
Service Code HCPCS J3480
Hospital Charge Code 300444
Hospital Revenue Code 636
Min. Negotiated Rate $421.31
Max. Negotiated Rate $601.88
Rate for Payer: Aetna Commercial $568.44
Rate for Payer: Aetna New Business (MI Preferred) $434.69
Rate for Payer: Cash Price $535.00
Rate for Payer: Cofinity Commercial $468.12
Rate for Payer: Cofinity Commercial $575.12
Rate for Payer: Healthscope Commercial $601.88
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $568.44
Rate for Payer: PHP Commercial $568.44
Rate for Payer: Priority Health Cigna Priority Health $468.12
Rate for Payer: Priority Health SBD $421.31
Service Code NDC 0904-6930-61
Hospital Charge Code 13644
Hospital Revenue Code 637
Min. Negotiated Rate $114.82
Max. Negotiated Rate $258.34
Rate for Payer: Aetna Commercial $243.98
Rate for Payer: Aetna New Business (MI Preferred) $186.58
Rate for Payer: BCBS Complete $114.82
Rate for Payer: Cash Price $229.63
Rate for Payer: Cofinity Commercial $200.93
Rate for Payer: Cofinity Commercial $246.85
Rate for Payer: Healthscope Commercial $258.34
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $243.98
Rate for Payer: PHP Commercial $243.98
Rate for Payer: Priority Health Cigna Priority Health $200.93
Rate for Payer: Priority Health SBD $180.84
Service Code NDC 0904-6930-61
Hospital Charge Code 13644
Hospital Revenue Code 637
Min. Negotiated Rate $180.84
Max. Negotiated Rate $258.34
Rate for Payer: Aetna Commercial $243.98
Rate for Payer: Aetna New Business (MI Preferred) $186.58
Rate for Payer: Cash Price $229.63
Rate for Payer: Cofinity Commercial $200.93
Rate for Payer: Cofinity Commercial $246.85
Rate for Payer: Healthscope Commercial $258.34
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $243.98
Rate for Payer: PHP Commercial $243.98
Rate for Payer: Priority Health Cigna Priority Health $200.93
Rate for Payer: Priority Health SBD $180.84
Service Code NDC 0832-5323-11
Hospital Charge Code 6436
Hospital Revenue Code 637
Min. Negotiated Rate $164.34
Max. Negotiated Rate $234.76
Rate for Payer: Aetna Commercial $221.72
Rate for Payer: Aetna New Business (MI Preferred) $169.55
Rate for Payer: Cash Price $208.68
Rate for Payer: Cofinity Commercial $182.60
Rate for Payer: Cofinity Commercial $224.33
Rate for Payer: Healthscope Commercial $234.76
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $221.72
Rate for Payer: PHP Commercial $221.72
Rate for Payer: Priority Health Cigna Priority Health $182.60
Rate for Payer: Priority Health SBD $164.34
Service Code NDC 60687-466-11
Hospital Charge Code 6436
Hospital Revenue Code 637
Min. Negotiated Rate $1.53
Max. Negotiated Rate $2.19
Rate for Payer: Aetna Commercial $2.07
Rate for Payer: Aetna New Business (MI Preferred) $1.58
Rate for Payer: Cash Price $1.94
Rate for Payer: Cofinity Commercial $2.09
Rate for Payer: Cofinity Commercial $1.70
Rate for Payer: Healthscope Commercial $2.19
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $2.07
Rate for Payer: PHP Commercial $2.07
Rate for Payer: Priority Health Cigna Priority Health $1.70
Rate for Payer: Priority Health SBD $1.53
Service Code NDC 66758-160-01
Hospital Charge Code 6436
Hospital Revenue Code 637
Min. Negotiated Rate $189.72
Max. Negotiated Rate $271.04
Rate for Payer: Aetna Commercial $255.98
Rate for Payer: Aetna New Business (MI Preferred) $195.75
Rate for Payer: Cash Price $240.92
Rate for Payer: Cofinity Commercial $210.80
Rate for Payer: Cofinity Commercial $258.99
Rate for Payer: Healthscope Commercial $271.04
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $255.98
Rate for Payer: PHP Commercial $255.98
Rate for Payer: Priority Health Cigna Priority Health $210.80
Rate for Payer: Priority Health SBD $189.72
Service Code NDC 60687-466-01
Hospital Charge Code 6436
Hospital Revenue Code 637
Min. Negotiated Rate $152.62
Max. Negotiated Rate $218.02
Rate for Payer: Aetna Commercial $205.91
Rate for Payer: Aetna New Business (MI Preferred) $157.46
Rate for Payer: Cash Price $193.80
Rate for Payer: Cofinity Commercial $169.58
Rate for Payer: Cofinity Commercial $208.34
Rate for Payer: Healthscope Commercial $218.02
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $205.91
Rate for Payer: PHP Commercial $205.91
Rate for Payer: Priority Health Cigna Priority Health $169.58
Rate for Payer: Priority Health SBD $152.62
Service Code NDC 0574-0275-11
Hospital Charge Code 6436
Hospital Revenue Code 637
Min. Negotiated Rate $169.38
Max. Negotiated Rate $241.96
Rate for Payer: Aetna Commercial $228.52
Rate for Payer: Aetna New Business (MI Preferred) $174.75
Rate for Payer: Cash Price $215.08
Rate for Payer: Cofinity Commercial $188.20
Rate for Payer: Cofinity Commercial $231.21
Rate for Payer: Healthscope Commercial $241.96
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $228.52
Rate for Payer: PHP Commercial $228.52
Rate for Payer: Priority Health Cigna Priority Health $188.20
Rate for Payer: Priority Health SBD $169.38
Service Code NDC 66758-160-13
Hospital Charge Code 6436
Hospital Revenue Code 637
Min. Negotiated Rate $134.52
Max. Negotiated Rate $302.67
Rate for Payer: Aetna Commercial $285.86
Rate for Payer: Aetna New Business (MI Preferred) $218.60
Rate for Payer: BCBS Complete $134.52
Rate for Payer: Cash Price $269.04
Rate for Payer: Cofinity Commercial $235.41
Rate for Payer: Cofinity Commercial $289.22
Rate for Payer: Healthscope Commercial $302.67
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $285.86
Rate for Payer: PHP Commercial $285.86
Rate for Payer: Priority Health Cigna Priority Health $235.41
Rate for Payer: Priority Health SBD $211.87
Service Code NDC 66758-160-13
Hospital Charge Code 6436
Hospital Revenue Code 637
Min. Negotiated Rate $211.87
Max. Negotiated Rate $302.67
Rate for Payer: Aetna Commercial $285.86
Rate for Payer: Aetna New Business (MI Preferred) $218.60
Rate for Payer: Cash Price $269.04
Rate for Payer: Cofinity Commercial $289.22
Rate for Payer: Cofinity Commercial $235.41
Rate for Payer: Healthscope Commercial $302.67
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $285.86
Rate for Payer: PHP Commercial $285.86
Rate for Payer: Priority Health Cigna Priority Health $235.41
Rate for Payer: Priority Health SBD $211.87