Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION

Facility

$63.07

Service Code	NDC 55150-209-02
Hospital Charge Code	27103
Hospital Revenue Code	250
Min. Negotiated Rate	$39.73
Max. Negotiated Rate	$56.76
Rate for Payer: Aetna Commercial	$53.61
Rate for Payer: Aetna New Business (MI Preferred)	$41.00
Rate for Payer: Cash Price	$50.46
Rate for Payer: Cofinity Commercial	$44.15
Rate for Payer: Cofinity Commercial	$54.24
Rate for Payer: Healthscope Commercial	$56.76
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$53.61
Rate for Payer: PHP Commercial	$53.61
Rate for Payer: Priority Health Cigna Priority Health	$44.15
Rate for Payer: Priority Health SBD	$39.73

DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION

Facility

$84.57

Service Code	NDC 0409-1638-02
Hospital Charge Code	27103
Hospital Revenue Code	250
Min. Negotiated Rate	$53.28
Max. Negotiated Rate	$76.11
Rate for Payer: Aetna Commercial	$71.88
Rate for Payer: Aetna New Business (MI Preferred)	$54.97
Rate for Payer: Cash Price	$67.66
Rate for Payer: Cofinity Commercial	$59.20
Rate for Payer: Cofinity Commercial	$72.73
Rate for Payer: Healthscope Commercial	$76.11
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$71.88
Rate for Payer: PHP Commercial	$71.88
Rate for Payer: Priority Health Cigna Priority Health	$59.20
Rate for Payer: Priority Health SBD	$53.28

DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION

Facility

$63.07

Service Code	NDC 16729-239-30
Hospital Charge Code	27103
Hospital Revenue Code	250
Min. Negotiated Rate	$39.73
Max. Negotiated Rate	$56.76
Rate for Payer: Aetna Commercial	$53.61
Rate for Payer: Aetna New Business (MI Preferred)	$41.00
Rate for Payer: Cash Price	$50.46
Rate for Payer: Cofinity Commercial	$44.15
Rate for Payer: Cofinity Commercial	$54.24
Rate for Payer: Healthscope Commercial	$56.76
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$53.61
Rate for Payer: PHP Commercial	$53.61
Rate for Payer: Priority Health Cigna Priority Health	$44.15
Rate for Payer: Priority Health SBD	$39.73

DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV

Facility

$103.74

Service Code	NDC 55150-297-10
Hospital Charge Code	166083
Hospital Revenue Code	250
Min. Negotiated Rate	$65.36
Max. Negotiated Rate	$93.37
Rate for Payer: Aetna Commercial	$88.18
Rate for Payer: Aetna New Business (MI Preferred)	$67.43
Rate for Payer: Cash Price	$82.99
Rate for Payer: Cofinity Commercial	$72.62
Rate for Payer: Cofinity Commercial	$89.22
Rate for Payer: Healthscope Commercial	$93.37
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$88.18
Rate for Payer: PHP Commercial	$88.18
Rate for Payer: Priority Health Cigna Priority Health	$72.62
Rate for Payer: Priority Health SBD	$65.36

DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV

Facility

$103.74

Service Code	NDC 55150-297-01
Hospital Charge Code	166083
Hospital Revenue Code	250
Min. Negotiated Rate	$65.36
Max. Negotiated Rate	$93.37
Rate for Payer: Aetna Commercial	$88.18
Rate for Payer: Aetna New Business (MI Preferred)	$67.43
Rate for Payer: Cash Price	$82.99
Rate for Payer: Cofinity Commercial	$72.62
Rate for Payer: Cofinity Commercial	$89.22
Rate for Payer: Healthscope Commercial	$93.37
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$88.18
Rate for Payer: PHP Commercial	$88.18
Rate for Payer: Priority Health Cigna Priority Health	$72.62
Rate for Payer: Priority Health SBD	$65.36

DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV

Facility

$141.71

Service Code	NDC 70121-1389-1
Hospital Charge Code	166083
Hospital Revenue Code	250
Min. Negotiated Rate	$89.28
Max. Negotiated Rate	$127.54
Rate for Payer: Aetna Commercial	$120.45
Rate for Payer: Aetna New Business (MI Preferred)	$92.11
Rate for Payer: Cash Price	$113.37
Rate for Payer: Cofinity Commercial	$121.87
Rate for Payer: Cofinity Commercial	$99.20
Rate for Payer: Healthscope Commercial	$127.54
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$120.45
Rate for Payer: PHP Commercial	$120.45
Rate for Payer: Priority Health Cigna Priority Health	$99.20
Rate for Payer: Priority Health SBD	$89.28

DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV

Facility

$89.32

Service Code	NDC 9900-0011-36
Hospital Charge Code	166083
Hospital Revenue Code	250
Min. Negotiated Rate	$56.27
Max. Negotiated Rate	$80.39
Rate for Payer: Aetna Commercial	$75.92
Rate for Payer: Aetna New Business (MI Preferred)	$58.06
Rate for Payer: Cash Price	$71.46
Rate for Payer: Cofinity Commercial	$62.52
Rate for Payer: Cofinity Commercial	$76.82
Rate for Payer: Healthscope Commercial	$80.39
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$75.92
Rate for Payer: PHP Commercial	$75.92
Rate for Payer: Priority Health Cigna Priority Health	$62.52
Rate for Payer: Priority Health SBD	$56.27

DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV

Facility

$113.23

Service Code	NDC 0409-1660-10
Hospital Charge Code	166083
Hospital Revenue Code	250
Min. Negotiated Rate	$71.33
Max. Negotiated Rate	$101.91
Rate for Payer: Aetna Commercial	$96.25
Rate for Payer: Aetna New Business (MI Preferred)	$73.60
Rate for Payer: Cash Price	$90.58
Rate for Payer: Cofinity Commercial	$79.26
Rate for Payer: Cofinity Commercial	$97.38
Rate for Payer: Healthscope Commercial	$101.91
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$96.25
Rate for Payer: PHP Commercial	$96.25
Rate for Payer: Priority Health Cigna Priority Health	$79.26
Rate for Payer: Priority Health SBD	$71.33

DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV

Facility

$141.71

Service Code	NDC 70121-1389-7
Hospital Charge Code	166083
Hospital Revenue Code	250
Min. Negotiated Rate	$89.28
Max. Negotiated Rate	$127.54
Rate for Payer: Aetna Commercial	$120.45
Rate for Payer: Aetna New Business (MI Preferred)	$92.11
Rate for Payer: Cash Price	$113.37
Rate for Payer: Cofinity Commercial	$121.87
Rate for Payer: Cofinity Commercial	$99.20
Rate for Payer: Healthscope Commercial	$127.54
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$120.45
Rate for Payer: PHP Commercial	$120.45
Rate for Payer: Priority Health Cigna Priority Health	$99.20
Rate for Payer: Priority Health SBD	$89.28

DEXMEDETOMIDINE 4 MCG/ML IV PUSH SOLUTION

Facility

$191.17

Service Code	NDC 9900-0011-20
Hospital Charge Code	300091
Hospital Revenue Code	250
Min. Negotiated Rate	$120.44
Max. Negotiated Rate	$172.05
Rate for Payer: Aetna Commercial	$162.49
Rate for Payer: Aetna New Business (MI Preferred)	$124.26
Rate for Payer: Cash Price	$152.94
Rate for Payer: Cofinity Commercial	$133.82
Rate for Payer: Cofinity Commercial	$164.41
Rate for Payer: Healthscope Commercial	$172.05
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$162.49
Rate for Payer: PHP Commercial	$162.49
Rate for Payer: Priority Health Cigna Priority Health	$133.82
Rate for Payer: Priority Health SBD	$120.44

DEXMEDETOMIDINE 80 MCG/20 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV

Facility

$91.39

Service Code	NDC 0409-1660-22
Hospital Charge Code	173991
Hospital Revenue Code	250
Min. Negotiated Rate	$57.58
Max. Negotiated Rate	$82.25
Rate for Payer: Aetna Commercial	$77.68
Rate for Payer: Aetna New Business (MI Preferred)	$59.40
Rate for Payer: Cash Price	$73.11
Rate for Payer: Cofinity Commercial	$63.97
Rate for Payer: Cofinity Commercial	$78.60
Rate for Payer: Healthscope Commercial	$82.25
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$77.68
Rate for Payer: PHP Commercial	$77.68
Rate for Payer: Priority Health Cigna Priority Health	$63.97
Rate for Payer: Priority Health SBD	$57.58

DEXMEDETOMIDINE 80 MCG/20 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV

Facility

$58.14

Service Code	NDC 0781-3493-80
Hospital Charge Code	173991
Hospital Revenue Code	250
Min. Negotiated Rate	$36.63
Max. Negotiated Rate	$52.33
Rate for Payer: Aetna Commercial	$49.42
Rate for Payer: Aetna New Business (MI Preferred)	$37.79
Rate for Payer: Cash Price	$46.51
Rate for Payer: Cofinity Commercial	$40.70
Rate for Payer: Cofinity Commercial	$50.00
Rate for Payer: Healthscope Commercial	$52.33
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$49.42
Rate for Payer: PHP Commercial	$49.42
Rate for Payer: Priority Health Cigna Priority Health	$40.70
Rate for Payer: Priority Health SBD	$36.63

DEXMEDETOMIDINE 80 MCG/20 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV

Facility

$91.39

Service Code	NDC 0409-1660-20
Hospital Charge Code	173991
Hospital Revenue Code	250
Min. Negotiated Rate	$57.58
Max. Negotiated Rate	$82.25
Rate for Payer: Aetna Commercial	$77.68
Rate for Payer: Aetna New Business (MI Preferred)	$59.40
Rate for Payer: Cash Price	$73.11
Rate for Payer: Cofinity Commercial	$63.97
Rate for Payer: Cofinity Commercial	$78.60
Rate for Payer: Healthscope Commercial	$82.25
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$77.68
Rate for Payer: PHP Commercial	$77.68
Rate for Payer: Priority Health Cigna Priority Health	$63.97
Rate for Payer: Priority Health SBD	$57.58

DEXMEDETOMIDINE 80 MCG/20 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV

Facility

$58.14

Service Code	NDC 0781-3493-95
Hospital Charge Code	173991
Hospital Revenue Code	250
Min. Negotiated Rate	$36.63
Max. Negotiated Rate	$52.33
Rate for Payer: Aetna Commercial	$49.42
Rate for Payer: Aetna New Business (MI Preferred)	$37.79
Rate for Payer: Cash Price	$46.51
Rate for Payer: Cofinity Commercial	$40.70
Rate for Payer: Cofinity Commercial	$50.00
Rate for Payer: Healthscope Commercial	$52.33
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$49.42
Rate for Payer: PHP Commercial	$49.42
Rate for Payer: Priority Health Cigna Priority Health	$40.70
Rate for Payer: Priority Health SBD	$36.63

DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION

Facility

$896.42

Service Code	HCPCS J1190
Hospital Charge Code	15156
Hospital Revenue Code	636
Min. Negotiated Rate	$564.74
Max. Negotiated Rate	$806.78
Rate for Payer: Aetna Commercial	$761.96
Rate for Payer: Aetna New Business (MI Preferred)	$582.67
Rate for Payer: Cash Price	$717.14
Rate for Payer: Cofinity Commercial	$627.49
Rate for Payer: Cofinity Commercial	$770.92
Rate for Payer: Healthscope Commercial	$806.78
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$761.96
Rate for Payer: PHP Commercial	$761.96
Rate for Payer: Priority Health Cigna Priority Health	$627.49
Rate for Payer: Priority Health SBD	$564.74

DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION

Facility

$983.57

Service Code	HCPCS J1190
Hospital Charge Code	15157
Hospital Revenue Code	636
Min. Negotiated Rate	$59.08
Max. Negotiated Rate	$885.21
Rate for Payer: Aetna Commercial	$836.03
Rate for Payer: Aetna Medicare	$112.33
Rate for Payer: Aetna New Business (MI Preferred)	$639.32
Rate for Payer: Allen County Amish Medical Aid Commercial	$135.01
Rate for Payer: Amish Plain Church Group Commercial	$135.01
Rate for Payer: BCBS Complete	$62.04
Rate for Payer: BCBS MAPPO	$108.01
Rate for Payer: BCBS Trust/PPO	$319.74
Rate for Payer: BCN Medicare Advantage	$108.01
Rate for Payer: Cash Price	$786.86
Rate for Payer: Cash Price	$786.86
Rate for Payer: Cofinity Commercial	$845.87
Rate for Payer: Cofinity Commercial	$688.50
Rate for Payer: Health Alliance Plan Medicare Advantage	$108.01
Rate for Payer: Healthscope Commercial	$885.21
Rate for Payer: Mclaren Medicaid	$59.08
Rate for Payer: Mclaren Medicare	$108.01
Rate for Payer: Meridian Medicaid	$62.04
Rate for Payer: Meridian Wellcare - Medicare Advantage	$113.41
Rate for Payer: MI Amish Medical Board Commercial	$124.21
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$836.03
Rate for Payer: PACE Medicare	$102.61
Rate for Payer: PACE SWMI	$108.01
Rate for Payer: PHP Commercial	$836.03
Rate for Payer: PHP Medicare Advantage	$108.01
Rate for Payer: Priority Health Choice Medicaid	$59.08
Rate for Payer: Priority Health Cigna Priority Health	$688.50
Rate for Payer: Priority Health Medicare	$108.01
Rate for Payer: Priority Health SBD	$619.65
Rate for Payer: Railroad Medicare Medicare	$108.01
Rate for Payer: UHC Dual Complete DSNP	$108.01
Rate for Payer: UHC Medicare Advantage	$111.25
Rate for Payer: VA VA	$108.01

DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION

Facility

$983.57

Service Code	HCPCS J1190
Hospital Charge Code	15157
Hospital Revenue Code	636
Min. Negotiated Rate	$619.65
Max. Negotiated Rate	$885.21
Rate for Payer: Aetna Commercial	$836.03
Rate for Payer: Aetna New Business (MI Preferred)	$639.32
Rate for Payer: Cash Price	$786.86
Rate for Payer: Cofinity Commercial	$688.50
Rate for Payer: Cofinity Commercial	$845.87
Rate for Payer: Healthscope Commercial	$885.21
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$836.03
Rate for Payer: PHP Commercial	$836.03
Rate for Payer: Priority Health Cigna Priority Health	$688.50
Rate for Payer: Priority Health SBD	$619.65

DEXTRAN 40 10 % IN 5 % DEXTROSE INTRAVENOUS

Facility

$134.56

Service Code	HCPCS J7100
Hospital Charge Code	9759
Hospital Revenue Code	250
Min. Negotiated Rate	$84.77
Max. Negotiated Rate	$121.10
Rate for Payer: Aetna Commercial	$114.38
Rate for Payer: Aetna New Business (MI Preferred)	$87.46
Rate for Payer: Cash Price	$107.65
Rate for Payer: Cofinity Commercial	$115.72
Rate for Payer: Cofinity Commercial	$94.19
Rate for Payer: Healthscope Commercial	$121.10
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$114.38
Rate for Payer: PHP Commercial	$114.38
Rate for Payer: Priority Health Cigna Priority Health	$94.19
Rate for Payer: Priority Health SBD	$84.77

DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET

Facility

$610.75

Service Code	NDC 13107-070-01
Hospital Charge Code	108419
Hospital Revenue Code	637
Min. Negotiated Rate	$384.77
Max. Negotiated Rate	$549.68
Rate for Payer: Aetna Commercial	$519.14
Rate for Payer: Aetna New Business (MI Preferred)	$396.99
Rate for Payer: Cash Price	$488.60
Rate for Payer: Cofinity Commercial	$427.52
Rate for Payer: Cofinity Commercial	$525.24
Rate for Payer: Healthscope Commercial	$549.68
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$519.14
Rate for Payer: PHP Commercial	$519.14
Rate for Payer: Priority Health Cigna Priority Health	$427.52
Rate for Payer: Priority Health SBD	$384.77

DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET

Facility

$822.50

Service Code	NDC 0527-1502-37
Hospital Charge Code	108419
Hospital Revenue Code	637
Min. Negotiated Rate	$518.18
Max. Negotiated Rate	$740.25
Rate for Payer: Aetna Commercial	$699.12
Rate for Payer: Aetna New Business (MI Preferred)	$534.62
Rate for Payer: Cash Price	$658.00
Rate for Payer: Cofinity Commercial	$575.75
Rate for Payer: Cofinity Commercial	$707.35
Rate for Payer: Healthscope Commercial	$740.25
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$699.12
Rate for Payer: PHP Commercial	$699.12
Rate for Payer: Priority Health Cigna Priority Health	$575.75
Rate for Payer: Priority Health SBD	$518.18

DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET

Facility

$3,290.76

Service Code	NDC 57844-110-01
Hospital Charge Code	108419
Hospital Revenue Code	637
Min. Negotiated Rate	$2,073.18
Max. Negotiated Rate	$2,961.68
Rate for Payer: Aetna Commercial	$2,797.15
Rate for Payer: Aetna New Business (MI Preferred)	$2,138.99
Rate for Payer: Cash Price	$2,632.61
Rate for Payer: Cofinity Commercial	$2,303.53
Rate for Payer: Cofinity Commercial	$2,830.05
Rate for Payer: Healthscope Commercial	$2,961.68
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,797.15
Rate for Payer: PHP Commercial	$2,797.15
Rate for Payer: Priority Health Cigna Priority Health	$2,303.53
Rate for Payer: Priority Health SBD	$2,073.18

DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET

Facility

$563.50

Service Code	NDC 0555-0972-02
Hospital Charge Code	108419
Hospital Revenue Code	637
Min. Negotiated Rate	$355.00
Max. Negotiated Rate	$507.15
Rate for Payer: Aetna Commercial	$478.98
Rate for Payer: Aetna New Business (MI Preferred)	$366.28
Rate for Payer: Cash Price	$450.80
Rate for Payer: Cofinity Commercial	$394.45
Rate for Payer: Cofinity Commercial	$484.61
Rate for Payer: Healthscope Commercial	$507.15
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$478.98
Rate for Payer: PHP Commercial	$478.98
Rate for Payer: Priority Health Cigna Priority Health	$394.45
Rate for Payer: Priority Health SBD	$355.00

DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE

Facility

$976.50

Service Code	NDC 70010-030-01
Hospital Charge Code	31587
Hospital Revenue Code	637
Min. Negotiated Rate	$615.20
Max. Negotiated Rate	$878.85
Rate for Payer: Aetna Commercial	$830.02
Rate for Payer: Aetna New Business (MI Preferred)	$634.72
Rate for Payer: Cash Price	$781.20
Rate for Payer: Cofinity Commercial	$683.55
Rate for Payer: Cofinity Commercial	$839.79
Rate for Payer: Healthscope Commercial	$878.85
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$830.02
Rate for Payer: PHP Commercial	$830.02
Rate for Payer: Priority Health Cigna Priority Health	$683.55
Rate for Payer: Priority Health SBD	$615.20

DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE

Facility

$716.10

Service Code	NDC 66993-595-02
Hospital Charge Code	31587
Hospital Revenue Code	637
Min. Negotiated Rate	$451.14
Max. Negotiated Rate	$644.49
Rate for Payer: Aetna Commercial	$608.68
Rate for Payer: Aetna New Business (MI Preferred)	$465.46
Rate for Payer: Cash Price	$572.88
Rate for Payer: Cofinity Commercial	$501.27
Rate for Payer: Cofinity Commercial	$615.85
Rate for Payer: Healthscope Commercial	$644.49
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$608.68
Rate for Payer: PHP Commercial	$608.68
Rate for Payer: Priority Health Cigna Priority Health	$501.27
Rate for Payer: Priority Health SBD	$451.14

DEXTROAMPHETAMINE-AMPHETAMINE ER 5 MG 24HR CAPSULE,EXTEND RELEASE

Facility

$491.04

Service Code	NDC 66993-594-02
Hospital Charge Code	33005
Hospital Revenue Code	637
Min. Negotiated Rate	$309.36
Max. Negotiated Rate	$441.94
Rate for Payer: Aetna Commercial	$417.38
Rate for Payer: Aetna New Business (MI Preferred)	$319.18
Rate for Payer: Cash Price	$392.83
Rate for Payer: Cofinity Commercial	$343.73
Rate for Payer: Cofinity Commercial	$422.29
Rate for Payer: Healthscope Commercial	$441.94
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$417.38
Rate for Payer: PHP Commercial	$417.38
Rate for Payer: Priority Health Cigna Priority Health	$343.73
Rate for Payer: Priority Health SBD	$309.36

Know your out-of-pocket cost for care.

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