Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PR ARTHRT PST CAPSUL RLS ANKLE W/WO ACHLL TDN LNGTH

Professional

Both

$2,126.00

Service Code	HCPCS 27612
Min. Negotiated Rate	$369.98
Max. Negotiated Rate	$2,976.66
Rate for Payer: Aetna Commercial	$742.06
Rate for Payer: BCBS Complete	$388.48
Rate for Payer: BCBS Trust/PPO	$2,976.66
Rate for Payer: Cash Price	$1,700.80
Rate for Payer: Cash Price	$1,700.80
Rate for Payer: Mclaren Medicaid	$369.98
Rate for Payer: Meridian Medicaid	$388.48
Rate for Payer: Priority Health Choice Medicaid	$369.98
Rate for Payer: Priority Health Cigna Priority Health	$1,488.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$868.61
Rate for Payer: Priority Health Narrow Network	$868.61
Rate for Payer: Priority Health SBD	$868.61

PR ARTHRT RDCRPL/MIDCARPL JT W/EXPL DRG/RMVL FB

Professional

Both

$1,851.00

Service Code	HCPCS 25040
Min. Negotiated Rate	$363.38
Max. Negotiated Rate	$1,295.70
Rate for Payer: Aetna Commercial	$746.44
Rate for Payer: BCBS Complete	$381.55
Rate for Payer: BCBS Trust/PPO	$1,197.13
Rate for Payer: Cash Price	$1,480.80
Rate for Payer: Cash Price	$1,480.80
Rate for Payer: Mclaren Medicaid	$363.38
Rate for Payer: Meridian Medicaid	$381.55
Rate for Payer: Priority Health Choice Medicaid	$363.38
Rate for Payer: Priority Health Cigna Priority Health	$1,295.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$863.51
Rate for Payer: Priority Health Narrow Network	$863.51
Rate for Payer: Priority Health SBD	$863.51

PR ARTHRT W/EXC SEMILUNAR CRTLG KNEE MEDIAL/LAT

Professional

Both

$2,342.00

Service Code	HCPCS 27332
Min. Negotiated Rate	$419.82
Max. Negotiated Rate	$1,639.40
Rate for Payer: Aetna Commercial	$860.52
Rate for Payer: BCBS Complete	$440.81
Rate for Payer: BCBS Trust/PPO	$1,236.22
Rate for Payer: Cash Price	$1,873.60
Rate for Payer: Cash Price	$1,873.60
Rate for Payer: Mclaren Medicaid	$419.82
Rate for Payer: Meridian Medicaid	$440.81
Rate for Payer: Priority Health Choice Medicaid	$419.82
Rate for Payer: Priority Health Cigna Priority Health	$1,639.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$996.28
Rate for Payer: Priority Health Narrow Network	$996.28
Rate for Payer: Priority Health SBD	$996.28

PR ARTHRT W/EXPL DRG/RMVL LOOSE/FB IPHAL JT

Professional

Both

$719.00

Service Code	HCPCS 28024
Min. Negotiated Rate	$199.16
Max. Negotiated Rate	$678.87
Rate for Payer: Aetna Commercial	$400.11
Rate for Payer: BCBS Complete	$209.12
Rate for Payer: BCBS Trust/PPO	$678.87
Rate for Payer: Cash Price	$575.20
Rate for Payer: Cash Price	$575.20
Rate for Payer: Mclaren Medicaid	$199.16
Rate for Payer: Meridian Medicaid	$209.12
Rate for Payer: Priority Health Choice Medicaid	$199.16
Rate for Payer: Priority Health Cigna Priority Health	$503.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$466.74
Rate for Payer: Priority Health Narrow Network	$466.74
Rate for Payer: Priority Health SBD	$466.74

PR ARTHRT W/EXPL DRG/RMVL LOOSE/FB MTTARPHLNGL JT

Professional

Both

$820.00

Service Code	HCPCS 28022
Min. Negotiated Rate	$211.51
Max. Negotiated Rate	$574.00
Rate for Payer: Aetna Commercial	$430.37
Rate for Payer: BCBS Complete	$222.09
Rate for Payer: BCBS Trust/PPO	$383.55
Rate for Payer: Cash Price	$656.00
Rate for Payer: Cash Price	$656.00
Rate for Payer: Mclaren Medicaid	$211.51
Rate for Payer: Meridian Medicaid	$222.09
Rate for Payer: Priority Health Choice Medicaid	$211.51
Rate for Payer: Priority Health Cigna Priority Health	$574.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$498.40
Rate for Payer: Priority Health Narrow Network	$498.40
Rate for Payer: Priority Health SBD	$498.40

PR ARTHRT W/EXPL DRG/RMVL LOOSE/FB NTRTRSL/TARS JT

Professional

Both

$901.00

Service Code	HCPCS 28020
Min. Negotiated Rate	$236.00
Max. Negotiated Rate	$1,710.64
Rate for Payer: Aetna Commercial	$485.15
Rate for Payer: BCBS Complete	$247.80
Rate for Payer: BCBS Trust/PPO	$1,710.64
Rate for Payer: Cash Price	$720.80
Rate for Payer: Cash Price	$720.80
Rate for Payer: Mclaren Medicaid	$236.00
Rate for Payer: Meridian Medicaid	$247.80
Rate for Payer: Priority Health Choice Medicaid	$236.00
Rate for Payer: Priority Health Cigna Priority Health	$630.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$563.75
Rate for Payer: Priority Health Narrow Network	$563.75
Rate for Payer: Priority Health SBD	$563.75

PR ARTHRT WRST W/JT EXPL W/WO BX W/WO RMVL LOOSE/FB

Professional

Both

$1,350.00

Service Code	HCPCS 25101
Min. Negotiated Rate	$107.77
Max. Negotiated Rate	$945.00
Rate for Payer: Aetna Commercial	$537.23
Rate for Payer: BCBS Complete	$279.56
Rate for Payer: BCBS Trust/PPO	$107.77
Rate for Payer: Cash Price	$1,080.00
Rate for Payer: Cash Price	$1,080.00
Rate for Payer: Mclaren Medicaid	$266.25
Rate for Payer: Meridian Medicaid	$279.56
Rate for Payer: Priority Health Choice Medicaid	$266.25
Rate for Payer: Priority Health Cigna Priority Health	$945.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$628.10
Rate for Payer: Priority Health Narrow Network	$628.10
Rate for Payer: Priority Health SBD	$628.10

PR ARTHRT W/SYNVCT KNE ANT&POST W/POP AREA

Professional

Both

$2,726.00

Service Code	HCPCS 27335
Hospital Charge Code	27335
Min. Negotiated Rate	$496.29
Max. Negotiated Rate	$1,908.20
Rate for Payer: Aetna Commercial	$1,022.94
Rate for Payer: BCBS Complete	$521.10
Rate for Payer: BCBS Trust/PPO	$901.28
Rate for Payer: Cash Price	$2,180.80
Rate for Payer: Cash Price	$2,180.80
Rate for Payer: Mclaren Medicaid	$496.29
Rate for Payer: Meridian Medicaid	$521.10
Rate for Payer: Priority Health Choice Medicaid	$496.29
Rate for Payer: Priority Health Cigna Priority Health	$1,908.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,178.07
Rate for Payer: Priority Health Narrow Network	$1,178.07
Rate for Payer: Priority Health SBD	$1,178.07

PR ARTHRT W/SYNVCT KNE ANT&POST W/POP AREA

Professional

Both

$2,726.00

Service Code	HCPCS 27335
Min. Negotiated Rate	$496.29
Max. Negotiated Rate	$1,908.20
Rate for Payer: Aetna Commercial	$1,022.94
Rate for Payer: BCBS Complete	$521.10
Rate for Payer: BCBS Trust/PPO	$901.28
Rate for Payer: Cash Price	$2,180.80
Rate for Payer: Cash Price	$2,180.80
Rate for Payer: Mclaren Medicaid	$496.29
Rate for Payer: Meridian Medicaid	$521.10
Rate for Payer: Priority Health Choice Medicaid	$496.29
Rate for Payer: Priority Health Cigna Priority Health	$1,908.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,178.07
Rate for Payer: Priority Health Narrow Network	$1,178.07
Rate for Payer: Priority Health SBD	$1,178.07

PR ARTHRT W/SYNVCT KNE ANT&POST W/POP AREA

Facility

$2,726.00

Service Code	CPT 27335
Hospital Charge Code	27335
Min. Negotiated Rate	$1,717.38
Max. Negotiated Rate	$2,453.40
Rate for Payer: Aetna Commercial	$2,317.10
Rate for Payer: Aetna New Business (MI Preferred)	$1,771.90
Rate for Payer: Cash Price	$2,180.80
Rate for Payer: Cofinity Commercial	$2,344.36
Rate for Payer: Cofinity Commercial	$1,908.20
Rate for Payer: Healthscope Commercial	$2,453.40
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,317.10
Rate for Payer: PHP Commercial	$2,317.10
Rate for Payer: Priority Health Cigna Priority Health	$1,908.20
Rate for Payer: Priority Health SBD	$1,717.38

PR ARTHRT W/SYNVCT KNE ANT&POST W/POP AREA

Facility

$2,726.00

Service Code	CPT 27335
Hospital Charge Code	27335
Min. Negotiated Rate	$762.94
Max. Negotiated Rate	$19,502.65
Rate for Payer: Aetna Commercial	$2,317.10
Rate for Payer: Aetna Medicare	$6,620.26
Rate for Payer: Aetna New Business (MI Preferred)	$1,771.90
Rate for Payer: Allen County Amish Medical Aid Commercial	$7,957.04
Rate for Payer: Amish Plain Church Group Commercial	$7,957.04
Rate for Payer: BCBS Complete	$3,656.42
Rate for Payer: BCBS MAPPO	$6,365.63
Rate for Payer: BCBS Trust/PPO	$2,299.99
Rate for Payer: BCN Medicare Advantage	$6,365.63
Rate for Payer: Cash Price	$2,180.80
Rate for Payer: Cash Price	$2,180.80
Rate for Payer: Cofinity Commercial	$1,908.20
Rate for Payer: Cofinity Commercial	$2,344.36
Rate for Payer: Health Alliance Plan Medicare Advantage	$6,365.63
Rate for Payer: Healthscope Commercial	$2,453.40
Rate for Payer: Mclaren Medicaid	$3,482.00
Rate for Payer: Mclaren Medicare	$6,365.63
Rate for Payer: Meridian Medicaid	$3,656.42
Rate for Payer: Meridian Wellcare - Medicare Advantage	$6,683.91
Rate for Payer: MI Amish Medical Board Commercial	$7,320.47
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,317.10
Rate for Payer: PACE Medicare	$6,047.35
Rate for Payer: PACE SWMI	$6,365.63
Rate for Payer: PHP Commercial	$2,317.10
Rate for Payer: PHP Medicare Advantage	$6,365.63
Rate for Payer: Priority Health Choice Medicaid	$3,482.00
Rate for Payer: Priority Health Cigna Priority Health	$1,908.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$19,502.65
Rate for Payer: Priority Health Medicare	$6,365.63
Rate for Payer: Priority Health Narrow Network	$15,602.12
Rate for Payer: Priority Health SBD	$1,717.38
Rate for Payer: Railroad Medicare Medicare	$6,365.63
Rate for Payer: UHC All Payor (Choice/PPO)	$839.23
Rate for Payer: UHC Dual Complete DSNP	$6,365.63
Rate for Payer: UHC Exchange	$762.94
Rate for Payer: UHC Medicare Advantage	$6,556.60
Rate for Payer: VA VA	$6,365.63

PR ARTIFICIAL INSEMINATION INTRA-CERVICAL

Professional

Both

$131.00

Service Code	HCPCS 58321
Min. Negotiated Rate	$52.40
Max. Negotiated Rate	$91.70
Rate for Payer: Aetna Commercial	$58.02
Rate for Payer: BCBS Complete	$52.40
Rate for Payer: BCBS Trust/PPO	$80.30
Rate for Payer: Cash Price	$104.80
Rate for Payer: Cash Price	$104.80
Rate for Payer: Priority Health Cigna Priority Health	$91.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$68.65
Rate for Payer: Priority Health Narrow Network	$68.65
Rate for Payer: Priority Health SBD	$68.65

PR ARTIFICIAL INSEMINATION INTRA-UTERINE

Professional

Both

$240.00

Service Code	HCPCS 58322
Min. Negotiated Rate	$69.05
Max. Negotiated Rate	$307.47
Rate for Payer: Aetna Commercial	$69.05
Rate for Payer: BCBS Complete	$96.00
Rate for Payer: BCBS Trust/PPO	$307.47
Rate for Payer: Cash Price	$192.00
Rate for Payer: Cash Price	$192.00
Rate for Payer: Priority Health Cigna Priority Health	$168.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$81.43
Rate for Payer: Priority Health Narrow Network	$81.43
Rate for Payer: Priority Health SBD	$81.43

PR ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX CUTDOWN

Professional

Both

$314.00

Service Code	HCPCS 36625
Min. Negotiated Rate	$66.03
Max. Negotiated Rate	$664.07
Rate for Payer: Aetna Commercial	$142.11
Rate for Payer: BCBS Complete	$69.33
Rate for Payer: BCBS Trust/PPO	$664.07
Rate for Payer: Cash Price	$251.20
Rate for Payer: Cash Price	$251.20
Rate for Payer: Mclaren Medicaid	$66.03
Rate for Payer: Meridian Medicaid	$69.33
Rate for Payer: Priority Health Choice Medicaid	$66.03
Rate for Payer: Priority Health Cigna Priority Health	$219.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$165.44
Rate for Payer: Priority Health Narrow Network	$165.44
Rate for Payer: Priority Health SBD	$165.44

PR ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX PRQ

Professional

Both

$310.00

Service Code	HCPCS 36620
Min. Negotiated Rate	$27.69
Max. Negotiated Rate	$962.03
Rate for Payer: Aetna Commercial	$59.84
Rate for Payer: BCBS Complete	$29.07
Rate for Payer: BCBS Trust/PPO	$962.03
Rate for Payer: Cash Price	$248.00
Rate for Payer: Cash Price	$248.00
Rate for Payer: Mclaren Medicaid	$27.69
Rate for Payer: Meridian Medicaid	$29.07
Rate for Payer: Priority Health Choice Medicaid	$27.69
Rate for Payer: Priority Health Cigna Priority Health	$217.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$69.68
Rate for Payer: Priority Health Narrow Network	$69.68
Rate for Payer: Priority Health SBD	$69.68

PR ARTL CATHJ PROLNG NFS THER CHEMOTX CUTDOWN

Professional

Both

$547.00

Service Code	HCPCS 36640
Min. Negotiated Rate	$74.55
Max. Negotiated Rate	$802.49
Rate for Payer: Aetna Commercial	$154.82
Rate for Payer: BCBS Complete	$78.28
Rate for Payer: BCBS Trust/PPO	$802.49
Rate for Payer: Cash Price	$437.60
Rate for Payer: Cash Price	$437.60
Rate for Payer: Mclaren Medicaid	$74.55
Rate for Payer: Meridian Medicaid	$78.28
Rate for Payer: Priority Health Choice Medicaid	$74.55
Rate for Payer: Priority Health Cigna Priority Health	$382.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$182.99
Rate for Payer: Priority Health Narrow Network	$182.99
Rate for Payer: Priority Health SBD	$182.99

PR ARVEN ANAST OPN F/ARM VEIN TRPOS

Professional

Both

$1,494.00

Service Code	HCPCS 36820
Min. Negotiated Rate	$454.54
Max. Negotiated Rate	$1,126.68
Rate for Payer: Aetna Commercial	$967.99
Rate for Payer: BCBS Complete	$477.27
Rate for Payer: BCBS Trust/PPO	$769.73
Rate for Payer: Cash Price	$1,195.20
Rate for Payer: Cash Price	$1,195.20
Rate for Payer: Mclaren Medicaid	$454.54
Rate for Payer: Meridian Medicaid	$477.27
Rate for Payer: Priority Health Choice Medicaid	$454.54
Rate for Payer: Priority Health Cigna Priority Health	$1,045.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,126.68
Rate for Payer: Priority Health Narrow Network	$1,126.68
Rate for Payer: Priority Health SBD	$1,126.68

PR ARVEN ANAST OPN UPR ARM BASILIC VEIN TRPOS

Professional

Both

$2,387.00

Service Code	HCPCS 36819
Min. Negotiated Rate	$156.91
Max. Negotiated Rate	$1,670.90
Rate for Payer: Aetna Commercial	$981.67
Rate for Payer: BCBS Complete	$479.73
Rate for Payer: BCBS Trust/PPO	$156.91
Rate for Payer: Cash Price	$1,909.60
Rate for Payer: Cash Price	$1,909.60
Rate for Payer: Mclaren Medicaid	$456.89
Rate for Payer: Meridian Medicaid	$479.73
Rate for Payer: Priority Health Choice Medicaid	$456.89
Rate for Payer: Priority Health Cigna Priority Health	$1,670.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,136.79
Rate for Payer: Priority Health Narrow Network	$1,136.79
Rate for Payer: Priority Health SBD	$1,136.79

PR ARVEN ANAST OPN UPR ARM CEPHALIC VEIN TRPOS

Professional

Both

$1,970.00

Service Code	HCPCS 36818
Min. Negotiated Rate	$431.54
Max. Negotiated Rate	$1,379.00
Rate for Payer: Aetna Commercial	$926.10
Rate for Payer: BCBS Complete	$453.12
Rate for Payer: BCBS Trust/PPO	$1,179.17
Rate for Payer: Cash Price	$1,576.00
Rate for Payer: Cash Price	$1,576.00
Rate for Payer: Mclaren Medicaid	$431.54
Rate for Payer: Meridian Medicaid	$453.12
Rate for Payer: Priority Health Choice Medicaid	$431.54
Rate for Payer: Priority Health Cigna Priority Health	$1,379.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,074.02
Rate for Payer: Priority Health Narrow Network	$1,074.02
Rate for Payer: Priority Health SBD	$1,074.02

PR ARYSM VASC MALFRMJ/CRTD-OCCLUSION CRTD ART

Professional

Both

$8,262.00

Service Code	HCPCS 61705
Min. Negotiated Rate	$404.15
Max. Negotiated Rate	$5,783.40
Rate for Payer: Aetna Commercial	$3,364.49
Rate for Payer: BCBS Complete	$1,767.73
Rate for Payer: BCBS Trust/PPO	$404.15
Rate for Payer: Cash Price	$6,609.60
Rate for Payer: Cash Price	$6,609.60
Rate for Payer: Mclaren Medicaid	$1,683.55
Rate for Payer: Meridian Medicaid	$1,767.73
Rate for Payer: Priority Health Choice Medicaid	$1,683.55
Rate for Payer: Priority Health Cigna Priority Health	$5,783.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$4,440.32
Rate for Payer: Priority Health Narrow Network	$4,440.32
Rate for Payer: Priority Health SBD	$4,440.32

PR ARYTENOIDECTOMY/ARYTENOIDOPEXY XTRNL APPROACH

Professional

Both

$2,046.00

Service Code	HCPCS 31400
Min. Negotiated Rate	$649.44
Max. Negotiated Rate	$1,845.88
Rate for Payer: Aetna Commercial	$1,275.34
Rate for Payer: BCBS Complete	$681.91
Rate for Payer: BCBS Trust/PPO	$1,845.88
Rate for Payer: Cash Price	$1,636.80
Rate for Payer: Cash Price	$1,636.80
Rate for Payer: Mclaren Medicaid	$649.44
Rate for Payer: Meridian Medicaid	$681.91
Rate for Payer: Priority Health Choice Medicaid	$649.44
Rate for Payer: Priority Health Cigna Priority Health	$1,432.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,413.68
Rate for Payer: Priority Health Narrow Network	$1,413.68
Rate for Payer: Priority Health SBD	$1,413.68

PR AS-AORT GRF W/CARD BYP & AORTIC ROOT RPLCMT

Professional

Both

$6,492.28

Service Code	HCPCS 33863
Min. Negotiated Rate	$745.43
Max. Negotiated Rate	$4,892.42
Rate for Payer: Aetna Commercial	$4,233.55
Rate for Payer: BCBS Complete	$2,061.60
Rate for Payer: BCBS Trust/PPO	$745.43
Rate for Payer: Cash Price	$5,193.82
Rate for Payer: Cash Price	$5,193.82
Rate for Payer: Mclaren Medicaid	$1,963.43
Rate for Payer: Meridian Medicaid	$2,061.60
Rate for Payer: Priority Health Choice Medicaid	$1,963.43
Rate for Payer: Priority Health Cigna Priority Health	$4,544.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$4,892.42
Rate for Payer: Priority Health Narrow Network	$4,892.42
Rate for Payer: Priority Health SBD	$4,892.42

PR AS-AORT GRF W/CARD BYP F/AORTIC DISSECTION

Professional

Both

$6,985.00

Service Code	HCPCS 33858
Min. Negotiated Rate	$313.81
Max. Negotiated Rate	$5,281.27
Rate for Payer: Aetna Commercial	$4,563.31
Rate for Payer: BCBS Complete	$2,224.20
Rate for Payer: BCBS Trust/PPO	$313.81
Rate for Payer: Cash Price	$5,588.00
Rate for Payer: Cash Price	$5,588.00
Rate for Payer: Mclaren Medicaid	$2,118.29
Rate for Payer: Meridian Medicaid	$2,224.20
Rate for Payer: Priority Health Choice Medicaid	$2,118.29
Rate for Payer: Priority Health Cigna Priority Health	$4,889.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$5,281.27
Rate for Payer: Priority Health Narrow Network	$5,281.27
Rate for Payer: Priority Health SBD	$5,281.27

PR AS-AORT GRF W/CARD BYP F/AORTIC DS OTH/THN DSJ

Professional

Both

$5,011.00

Service Code	HCPCS 33859
Min. Negotiated Rate	$1,128.45
Max. Negotiated Rate	$3,793.40
Rate for Payer: Aetna Commercial	$3,277.53
Rate for Payer: BCBS Complete	$1,598.88
Rate for Payer: BCBS Trust/PPO	$1,128.45
Rate for Payer: Cash Price	$4,008.80
Rate for Payer: Cash Price	$4,008.80
Rate for Payer: Mclaren Medicaid	$1,522.74
Rate for Payer: Meridian Medicaid	$1,598.88
Rate for Payer: Priority Health Choice Medicaid	$1,522.74
Rate for Payer: Priority Health Cigna Priority Health	$3,507.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$3,793.40
Rate for Payer: Priority Health Narrow Network	$3,793.40
Rate for Payer: Priority Health SBD	$3,793.40

PR ASCEND AORTA GRAFT INCL VAVLE SUSPENSION

Professional

Both

$9,858.00

Service Code	HCPCS 33860
Min. Negotiated Rate	$3,943.20
Max. Negotiated Rate	$6,900.60
Rate for Payer: BCBS Complete	$3,943.20
Rate for Payer: Cash Price	$7,886.40
Rate for Payer: Priority Health Cigna Priority Health	$6,900.60

Know your out-of-pocket cost for care.

All Charges