Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

METHADONE 5 MG TABLET

Facility

$4.41

Service Code	NDC 00406575523
Hospital Charge Code	4954
Hospital Revenue Code	637
Min. Negotiated Rate	$1.76
Max. Negotiated Rate	$3.97
Rate for Payer: Aetna Commercial	$3.75
Rate for Payer: Aetna Medicare	$2.21
Rate for Payer: Aetna New Business (MI Preferred)	$2.87
Rate for Payer: BCBS Complete	$1.76
Rate for Payer: Cash Price	$3.53
Rate for Payer: Cofinity Commercial	$3.09
Rate for Payer: Cofinity Commercial	$3.79
Rate for Payer: Cofinity Medicare Advantage	$3.09
Rate for Payer: Encore Health Key Benefits Commercial	$3.53
Rate for Payer: Healthscope Commercial	$3.97
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3.75
Rate for Payer: PHP Commercial	$3.75
Rate for Payer: Priority Health Cigna Priority Health	$2.87
Rate for Payer: Priority Health SBD	$2.78

METHADONE 5 MG TABLET

Facility

$441.00

Service Code	NDC 00406575562
Hospital Charge Code	4954
Hospital Revenue Code	637
Min. Negotiated Rate	$277.83
Max. Negotiated Rate	$396.90
Rate for Payer: Aetna Commercial	$374.85
Rate for Payer: Aetna New Business (MI Preferred)	$286.65
Rate for Payer: Cash Price	$352.80
Rate for Payer: Cofinity Commercial	$308.70
Rate for Payer: Cofinity Commercial	$379.26
Rate for Payer: Cofinity Medicare Advantage	$308.70
Rate for Payer: Encore Health Key Benefits Commercial	$352.80
Rate for Payer: Healthscope Commercial	$396.90
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$374.85
Rate for Payer: PHP Commercial	$374.85
Rate for Payer: Priority Health Cigna Priority Health	$286.65
Rate for Payer: Priority Health SBD	$277.83

METHADONE 5 MG TABLET

Facility

$4.41

Service Code	NDC 00406575523
Hospital Charge Code	4954
Hospital Revenue Code	637
Min. Negotiated Rate	$2.78
Max. Negotiated Rate	$3.97
Rate for Payer: Aetna Commercial	$3.75
Rate for Payer: Aetna New Business (MI Preferred)	$2.87
Rate for Payer: Cash Price	$3.53
Rate for Payer: Cofinity Commercial	$3.09
Rate for Payer: Cofinity Commercial	$3.79
Rate for Payer: Cofinity Medicare Advantage	$3.09
Rate for Payer: Encore Health Key Benefits Commercial	$3.53
Rate for Payer: Healthscope Commercial	$3.97
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3.75
Rate for Payer: PHP Commercial	$3.75
Rate for Payer: Priority Health Cigna Priority Health	$2.87
Rate for Payer: Priority Health SBD	$2.78

METHIMAZOLE 10 MG TABLET

Facility

$303.15

Service Code	NDC 23155007101
Hospital Charge Code	10552
Hospital Revenue Code	637
Min. Negotiated Rate	$121.26
Max. Negotiated Rate	$272.83
Rate for Payer: Aetna Commercial	$257.68
Rate for Payer: Aetna Medicare	$151.57
Rate for Payer: Aetna New Business (MI Preferred)	$197.05
Rate for Payer: BCBS Complete	$121.26
Rate for Payer: Cash Price	$242.52
Rate for Payer: Cofinity Commercial	$212.21
Rate for Payer: Cofinity Commercial	$260.71
Rate for Payer: Cofinity Medicare Advantage	$212.21
Rate for Payer: Encore Health Key Benefits Commercial	$242.52
Rate for Payer: Healthscope Commercial	$272.83
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$257.68
Rate for Payer: PHP Commercial	$257.68
Rate for Payer: Priority Health Cigna Priority Health	$197.05
Rate for Payer: Priority Health SBD	$190.98

METHIMAZOLE 10 MG TABLET

Facility

$2.52

Service Code	NDC 60687037011
Hospital Charge Code	10552
Hospital Revenue Code	637
Min. Negotiated Rate	$1.59
Max. Negotiated Rate	$2.27
Rate for Payer: Aetna Commercial	$2.14
Rate for Payer: Aetna New Business (MI Preferred)	$1.64
Rate for Payer: Cash Price	$2.02
Rate for Payer: Cofinity Commercial	$1.76
Rate for Payer: Cofinity Commercial	$2.17
Rate for Payer: Cofinity Medicare Advantage	$1.76
Rate for Payer: Encore Health Key Benefits Commercial	$2.02
Rate for Payer: Healthscope Commercial	$2.27
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2.14
Rate for Payer: PHP Commercial	$2.14
Rate for Payer: Priority Health Cigna Priority Health	$1.64
Rate for Payer: Priority Health SBD	$1.59

METHIMAZOLE 10 MG TABLET

Facility

$339.36

Service Code	NDC 60687068001
Hospital Charge Code	10552
Hospital Revenue Code	637
Min. Negotiated Rate	$213.80
Max. Negotiated Rate	$305.42
Rate for Payer: Aetna Commercial	$288.46
Rate for Payer: Aetna New Business (MI Preferred)	$220.58
Rate for Payer: Cash Price	$271.49
Rate for Payer: Cofinity Commercial	$237.55
Rate for Payer: Cofinity Commercial	$291.85
Rate for Payer: Cofinity Medicare Advantage	$237.55
Rate for Payer: Encore Health Key Benefits Commercial	$271.49
Rate for Payer: Healthscope Commercial	$305.42
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$288.46
Rate for Payer: PHP Commercial	$288.46
Rate for Payer: Priority Health Cigna Priority Health	$220.58
Rate for Payer: Priority Health SBD	$213.80

METHIMAZOLE 10 MG TABLET

Facility

$2.52

Service Code	NDC 60687037011
Hospital Charge Code	10552
Hospital Revenue Code	637
Min. Negotiated Rate	$1.01
Max. Negotiated Rate	$2.27
Rate for Payer: Aetna Commercial	$2.14
Rate for Payer: Aetna Medicare	$1.26
Rate for Payer: Aetna New Business (MI Preferred)	$1.64
Rate for Payer: BCBS Complete	$1.01
Rate for Payer: Cash Price	$2.02
Rate for Payer: Cofinity Commercial	$1.76
Rate for Payer: Cofinity Commercial	$2.17
Rate for Payer: Cofinity Medicare Advantage	$1.76
Rate for Payer: Encore Health Key Benefits Commercial	$2.02
Rate for Payer: Healthscope Commercial	$2.27
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2.14
Rate for Payer: PHP Commercial	$2.14
Rate for Payer: Priority Health Cigna Priority Health	$1.64
Rate for Payer: Priority Health SBD	$1.59

METHIMAZOLE 10 MG TABLET

Facility

$339.36

Service Code	NDC 60687068001
Hospital Charge Code	10552
Hospital Revenue Code	637
Min. Negotiated Rate	$135.74
Max. Negotiated Rate	$305.42
Rate for Payer: Aetna Commercial	$288.46
Rate for Payer: Aetna Medicare	$169.68
Rate for Payer: Aetna New Business (MI Preferred)	$220.58
Rate for Payer: BCBS Complete	$135.74
Rate for Payer: Cash Price	$271.49
Rate for Payer: Cofinity Commercial	$237.55
Rate for Payer: Cofinity Commercial	$291.85
Rate for Payer: Cofinity Medicare Advantage	$237.55
Rate for Payer: Encore Health Key Benefits Commercial	$271.49
Rate for Payer: Healthscope Commercial	$305.42
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$288.46
Rate for Payer: PHP Commercial	$288.46
Rate for Payer: Priority Health Cigna Priority Health	$220.58
Rate for Payer: Priority Health SBD	$213.80

METHIMAZOLE 10 MG TABLET

Facility

$3.40

Service Code	NDC 60687068011
Hospital Charge Code	10552
Hospital Revenue Code	637
Min. Negotiated Rate	$2.14
Max. Negotiated Rate	$3.06
Rate for Payer: Aetna Commercial	$2.89
Rate for Payer: Aetna New Business (MI Preferred)	$2.21
Rate for Payer: Cash Price	$2.72
Rate for Payer: Cofinity Commercial	$2.38
Rate for Payer: Cofinity Commercial	$2.92
Rate for Payer: Cofinity Medicare Advantage	$2.38
Rate for Payer: Encore Health Key Benefits Commercial	$2.72
Rate for Payer: Healthscope Commercial	$3.06
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2.89
Rate for Payer: PHP Commercial	$2.89
Rate for Payer: Priority Health Cigna Priority Health	$2.21
Rate for Payer: Priority Health SBD	$2.14

METHIMAZOLE 10 MG TABLET

Facility

$3.40

Service Code	NDC 60687068011
Hospital Charge Code	10552
Hospital Revenue Code	637
Min. Negotiated Rate	$1.36
Max. Negotiated Rate	$3.06
Rate for Payer: Aetna Commercial	$2.89
Rate for Payer: Aetna Medicare	$1.70
Rate for Payer: Aetna New Business (MI Preferred)	$2.21
Rate for Payer: BCBS Complete	$1.36
Rate for Payer: Cash Price	$2.72
Rate for Payer: Cofinity Commercial	$2.38
Rate for Payer: Cofinity Commercial	$2.92
Rate for Payer: Cofinity Medicare Advantage	$2.38
Rate for Payer: Encore Health Key Benefits Commercial	$2.72
Rate for Payer: Healthscope Commercial	$3.06
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2.89
Rate for Payer: PHP Commercial	$2.89
Rate for Payer: Priority Health Cigna Priority Health	$2.21
Rate for Payer: Priority Health SBD	$2.14

METHIMAZOLE 10 MG TABLET

Facility

$323.00

Service Code	NDC 68084027601
Hospital Charge Code	10552
Hospital Revenue Code	637
Min. Negotiated Rate	$203.49
Max. Negotiated Rate	$290.70
Rate for Payer: Aetna Commercial	$274.55
Rate for Payer: Aetna New Business (MI Preferred)	$209.95
Rate for Payer: Cash Price	$258.40
Rate for Payer: Cofinity Commercial	$226.10
Rate for Payer: Cofinity Commercial	$277.78
Rate for Payer: Cofinity Medicare Advantage	$226.10
Rate for Payer: Encore Health Key Benefits Commercial	$258.40
Rate for Payer: Healthscope Commercial	$290.70
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$274.55
Rate for Payer: PHP Commercial	$274.55
Rate for Payer: Priority Health Cigna Priority Health	$209.95
Rate for Payer: Priority Health SBD	$203.49

METHIMAZOLE 10 MG TABLET

Facility

$303.15

Service Code	NDC 23155007101
Hospital Charge Code	10552
Hospital Revenue Code	637
Min. Negotiated Rate	$190.98
Max. Negotiated Rate	$272.83
Rate for Payer: Aetna Commercial	$257.68
Rate for Payer: Aetna New Business (MI Preferred)	$197.05
Rate for Payer: Cash Price	$242.52
Rate for Payer: Cofinity Commercial	$212.21
Rate for Payer: Cofinity Commercial	$260.71
Rate for Payer: Cofinity Medicare Advantage	$212.21
Rate for Payer: Encore Health Key Benefits Commercial	$242.52
Rate for Payer: Healthscope Commercial	$272.83
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$257.68
Rate for Payer: PHP Commercial	$257.68
Rate for Payer: Priority Health Cigna Priority Health	$197.05
Rate for Payer: Priority Health SBD	$190.98

METHIMAZOLE 10 MG TABLET

Facility

$251.04

Service Code	NDC 60687037001
Hospital Charge Code	10552
Hospital Revenue Code	637
Min. Negotiated Rate	$158.16
Max. Negotiated Rate	$225.94
Rate for Payer: Aetna Commercial	$213.38
Rate for Payer: Aetna New Business (MI Preferred)	$163.18
Rate for Payer: Cash Price	$200.83
Rate for Payer: Cofinity Commercial	$175.73
Rate for Payer: Cofinity Commercial	$215.89
Rate for Payer: Cofinity Medicare Advantage	$175.73
Rate for Payer: Encore Health Key Benefits Commercial	$200.83
Rate for Payer: Healthscope Commercial	$225.94
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$213.38
Rate for Payer: PHP Commercial	$213.38
Rate for Payer: Priority Health Cigna Priority Health	$163.18
Rate for Payer: Priority Health SBD	$158.16

METHIMAZOLE 10 MG TABLET

Facility

$251.04

Service Code	NDC 60687037001
Hospital Charge Code	10552
Hospital Revenue Code	637
Min. Negotiated Rate	$100.42
Max. Negotiated Rate	$225.94
Rate for Payer: Aetna Commercial	$213.38
Rate for Payer: Aetna Medicare	$125.52
Rate for Payer: Aetna New Business (MI Preferred)	$163.18
Rate for Payer: BCBS Complete	$100.42
Rate for Payer: Cash Price	$200.83
Rate for Payer: Cofinity Commercial	$175.73
Rate for Payer: Cofinity Commercial	$215.89
Rate for Payer: Cofinity Medicare Advantage	$175.73
Rate for Payer: Encore Health Key Benefits Commercial	$200.83
Rate for Payer: Healthscope Commercial	$225.94
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$213.38
Rate for Payer: PHP Commercial	$213.38
Rate for Payer: Priority Health Cigna Priority Health	$163.18
Rate for Payer: Priority Health SBD	$158.16

METHIMAZOLE 10 MG TABLET

Facility

$323.00

Service Code	NDC 68084027601
Hospital Charge Code	10552
Hospital Revenue Code	637
Min. Negotiated Rate	$129.20
Max. Negotiated Rate	$290.70
Rate for Payer: Aetna Commercial	$274.55
Rate for Payer: Aetna Medicare	$161.50
Rate for Payer: Aetna New Business (MI Preferred)	$209.95
Rate for Payer: BCBS Complete	$129.20
Rate for Payer: Cash Price	$258.40
Rate for Payer: Cofinity Commercial	$226.10
Rate for Payer: Cofinity Commercial	$277.78
Rate for Payer: Cofinity Medicare Advantage	$226.10
Rate for Payer: Encore Health Key Benefits Commercial	$258.40
Rate for Payer: Healthscope Commercial	$290.70
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$274.55
Rate for Payer: PHP Commercial	$274.55
Rate for Payer: Priority Health Cigna Priority Health	$209.95
Rate for Payer: Priority Health SBD	$203.49

METHOCARBAMOL 500 MG TABLET

Facility

$2.16

Service Code	NDC 50268052011
Hospital Charge Code	4971
Hospital Revenue Code	637
Min. Negotiated Rate	$0.86
Max. Negotiated Rate	$1.94
Rate for Payer: Aetna Commercial	$1.84
Rate for Payer: Aetna Medicare	$1.08
Rate for Payer: Aetna New Business (MI Preferred)	$1.40
Rate for Payer: BCBS Complete	$0.86
Rate for Payer: Cash Price	$1.73
Rate for Payer: Cofinity Commercial	$1.51
Rate for Payer: Cofinity Commercial	$1.86
Rate for Payer: Cofinity Medicare Advantage	$1.51
Rate for Payer: Encore Health Key Benefits Commercial	$1.73
Rate for Payer: Healthscope Commercial	$1.94
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1.84
Rate for Payer: PHP Commercial	$1.84
Rate for Payer: Priority Health Cigna Priority Health	$1.40
Rate for Payer: Priority Health SBD	$1.36

METHOCARBAMOL 500 MG TABLET

Facility

$893.00

Service Code	NDC 69584061150
Hospital Charge Code	4971
Hospital Revenue Code	637
Min. Negotiated Rate	$562.59
Max. Negotiated Rate	$803.70
Rate for Payer: Aetna Commercial	$759.05
Rate for Payer: Aetna New Business (MI Preferred)	$580.45
Rate for Payer: Cash Price	$714.40
Rate for Payer: Cofinity Commercial	$625.10
Rate for Payer: Cofinity Commercial	$767.98
Rate for Payer: Cofinity Medicare Advantage	$625.10
Rate for Payer: Encore Health Key Benefits Commercial	$714.40
Rate for Payer: Healthscope Commercial	$803.70
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$759.05
Rate for Payer: PHP Commercial	$759.05
Rate for Payer: Priority Health Cigna Priority Health	$580.45
Rate for Payer: Priority Health SBD	$562.59

METHOCARBAMOL 500 MG TABLET

Facility

$107.83

Service Code	NDC 50268052015
Hospital Charge Code	4971
Hospital Revenue Code	637
Min. Negotiated Rate	$43.13
Max. Negotiated Rate	$97.05
Rate for Payer: Aetna Commercial	$91.66
Rate for Payer: Aetna Medicare	$53.91
Rate for Payer: Aetna New Business (MI Preferred)	$70.09
Rate for Payer: BCBS Complete	$43.13
Rate for Payer: Cash Price	$86.26
Rate for Payer: Cofinity Commercial	$75.48
Rate for Payer: Cofinity Commercial	$92.73
Rate for Payer: Cofinity Medicare Advantage	$75.48
Rate for Payer: Encore Health Key Benefits Commercial	$86.26
Rate for Payer: Healthscope Commercial	$97.05
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$91.66
Rate for Payer: PHP Commercial	$91.66
Rate for Payer: Priority Health Cigna Priority Health	$70.09
Rate for Payer: Priority Health SBD	$67.93

METHOCARBAMOL 500 MG TABLET

Facility

$107.83

Service Code	NDC 50268052015
Hospital Charge Code	4971
Hospital Revenue Code	637
Min. Negotiated Rate	$67.93
Max. Negotiated Rate	$97.05
Rate for Payer: Aetna Commercial	$91.66
Rate for Payer: Aetna New Business (MI Preferred)	$70.09
Rate for Payer: Cash Price	$86.26
Rate for Payer: Cofinity Commercial	$75.48
Rate for Payer: Cofinity Commercial	$92.73
Rate for Payer: Cofinity Medicare Advantage	$75.48
Rate for Payer: Encore Health Key Benefits Commercial	$86.26
Rate for Payer: Healthscope Commercial	$97.05
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$91.66
Rate for Payer: PHP Commercial	$91.66
Rate for Payer: Priority Health Cigna Priority Health	$70.09
Rate for Payer: Priority Health SBD	$67.93

METHOCARBAMOL 500 MG TABLET

Facility

$2.16

Service Code	NDC 50268052011
Hospital Charge Code	4971
Hospital Revenue Code	637
Min. Negotiated Rate	$1.36
Max. Negotiated Rate	$1.94
Rate for Payer: Aetna Commercial	$1.84
Rate for Payer: Aetna New Business (MI Preferred)	$1.40
Rate for Payer: Cash Price	$1.73
Rate for Payer: Cofinity Commercial	$1.51
Rate for Payer: Cofinity Commercial	$1.86
Rate for Payer: Cofinity Medicare Advantage	$1.51
Rate for Payer: Encore Health Key Benefits Commercial	$1.73
Rate for Payer: Healthscope Commercial	$1.94
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1.84
Rate for Payer: PHP Commercial	$1.84
Rate for Payer: Priority Health Cigna Priority Health	$1.40
Rate for Payer: Priority Health SBD	$1.36

METHOCARBAMOL 500 MG TABLET

Facility

$893.00

Service Code	NDC 69584061150
Hospital Charge Code	4971
Hospital Revenue Code	637
Min. Negotiated Rate	$357.20
Max. Negotiated Rate	$803.70
Rate for Payer: Aetna Commercial	$759.05
Rate for Payer: Aetna Medicare	$446.50
Rate for Payer: Aetna New Business (MI Preferred)	$580.45
Rate for Payer: BCBS Complete	$357.20
Rate for Payer: Cash Price	$714.40
Rate for Payer: Cofinity Commercial	$625.10
Rate for Payer: Cofinity Commercial	$767.98
Rate for Payer: Cofinity Medicare Advantage	$625.10
Rate for Payer: Encore Health Key Benefits Commercial	$714.40
Rate for Payer: Healthscope Commercial	$803.70
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$759.05
Rate for Payer: PHP Commercial	$759.05
Rate for Payer: Priority Health Cigna Priority Health	$580.45
Rate for Payer: Priority Health SBD	$562.59

METHOCARBAMOL 500 MG TABLET

Facility

$204.25

Service Code	NDC 63739099110
Hospital Charge Code	4971
Hospital Revenue Code	637
Min. Negotiated Rate	$128.68
Max. Negotiated Rate	$183.82
Rate for Payer: Aetna Commercial	$173.61
Rate for Payer: Aetna New Business (MI Preferred)	$132.76
Rate for Payer: Cash Price	$163.40
Rate for Payer: Cofinity Commercial	$142.97
Rate for Payer: Cofinity Commercial	$175.66
Rate for Payer: Cofinity Medicare Advantage	$142.97
Rate for Payer: Encore Health Key Benefits Commercial	$163.40
Rate for Payer: Healthscope Commercial	$183.82
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$173.61
Rate for Payer: PHP Commercial	$173.61
Rate for Payer: Priority Health Cigna Priority Health	$132.76
Rate for Payer: Priority Health SBD	$128.68

METHOCARBAMOL 500 MG TABLET

Facility

$204.25

Service Code	NDC 63739099110
Hospital Charge Code	4971
Hospital Revenue Code	637
Min. Negotiated Rate	$81.70
Max. Negotiated Rate	$183.82
Rate for Payer: Aetna Commercial	$173.61
Rate for Payer: Aetna Medicare	$102.12
Rate for Payer: Aetna New Business (MI Preferred)	$132.76
Rate for Payer: BCBS Complete	$81.70
Rate for Payer: Cash Price	$163.40
Rate for Payer: Cofinity Commercial	$142.97
Rate for Payer: Cofinity Commercial	$175.66
Rate for Payer: Cofinity Medicare Advantage	$142.97
Rate for Payer: Encore Health Key Benefits Commercial	$163.40
Rate for Payer: Healthscope Commercial	$183.82
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$173.61
Rate for Payer: PHP Commercial	$173.61
Rate for Payer: Priority Health Cigna Priority Health	$132.76
Rate for Payer: Priority Health SBD	$128.68

METHOCARBAMOL 750 MG TABLET

Facility

$230.85

Service Code	NDC 00904705861
Hospital Charge Code	4972
Hospital Revenue Code	637
Min. Negotiated Rate	$145.44
Max. Negotiated Rate	$207.76
Rate for Payer: Aetna Commercial	$196.22
Rate for Payer: Aetna New Business (MI Preferred)	$150.05
Rate for Payer: Cash Price	$184.68
Rate for Payer: Cofinity Commercial	$161.59
Rate for Payer: Cofinity Commercial	$198.53
Rate for Payer: Cofinity Medicare Advantage	$161.59
Rate for Payer: Encore Health Key Benefits Commercial	$184.68
Rate for Payer: Healthscope Commercial	$207.76
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$196.22
Rate for Payer: PHP Commercial	$196.22
Rate for Payer: Priority Health Cigna Priority Health	$150.05
Rate for Payer: Priority Health SBD	$145.44

METHOCARBAMOL 750 MG TABLET

Facility

$230.85

Service Code	NDC 00904705861
Hospital Charge Code	4972
Hospital Revenue Code	637
Min. Negotiated Rate	$92.34
Max. Negotiated Rate	$207.76
Rate for Payer: Aetna Commercial	$196.22
Rate for Payer: Aetna Medicare	$115.42
Rate for Payer: Aetna New Business (MI Preferred)	$150.05
Rate for Payer: BCBS Complete	$92.34
Rate for Payer: Cash Price	$184.68
Rate for Payer: Cofinity Commercial	$161.59
Rate for Payer: Cofinity Commercial	$198.53
Rate for Payer: Cofinity Medicare Advantage	$161.59
Rate for Payer: Encore Health Key Benefits Commercial	$184.68
Rate for Payer: Healthscope Commercial	$207.76
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$196.22
Rate for Payer: PHP Commercial	$196.22
Rate for Payer: Priority Health Cigna Priority Health	$150.05
Rate for Payer: Priority Health SBD	$145.44

Know your out-of-pocket cost for care.

All Charges