Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

DILTIAZEM CD 180 MG CAPSULE,EXTENDED RELEASE 24 HR

Facility

$172.71

Service Code	NDC 50742-249-90
Hospital Charge Code	29272
Hospital Revenue Code	637
Min. Negotiated Rate	$108.81
Max. Negotiated Rate	$155.44
Rate for Payer: Aetna Commercial	$146.80
Rate for Payer: Aetna New Business (MI Preferred)	$112.26
Rate for Payer: Cash Price	$138.17
Rate for Payer: Cofinity Commercial	$120.90
Rate for Payer: Cofinity Commercial	$148.53
Rate for Payer: Healthscope Commercial	$155.44
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$146.80
Rate for Payer: PHP Commercial	$146.80
Rate for Payer: Priority Health Cigna Priority Health	$120.90
Rate for Payer: Priority Health SBD	$108.81

DILTIAZEM CD 180 MG CAPSULE,EXTENDED RELEASE 24 HR

Facility

$3.06

Service Code	NDC 60687-206-11
Hospital Charge Code	29272
Hospital Revenue Code	637
Min. Negotiated Rate	$1.93
Max. Negotiated Rate	$2.75
Rate for Payer: Aetna Commercial	$2.60
Rate for Payer: Aetna New Business (MI Preferred)	$1.99
Rate for Payer: Cash Price	$2.45
Rate for Payer: Cofinity Commercial	$2.14
Rate for Payer: Cofinity Commercial	$2.63
Rate for Payer: Healthscope Commercial	$2.75
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2.60
Rate for Payer: PHP Commercial	$2.60
Rate for Payer: Priority Health Cigna Priority Health	$2.14
Rate for Payer: Priority Health SBD	$1.93

DILTIAZEM CD 240 MG CAPSULE,EXTENDED RELEASE 24 HR

Facility

$254.88

Service Code	NDC 60687-217-01
Hospital Charge Code	29274
Hospital Revenue Code	637
Min. Negotiated Rate	$160.57
Max. Negotiated Rate	$229.39
Rate for Payer: Aetna Commercial	$216.65
Rate for Payer: Aetna New Business (MI Preferred)	$165.67
Rate for Payer: Cash Price	$203.90
Rate for Payer: Cofinity Commercial	$178.42
Rate for Payer: Cofinity Commercial	$219.20
Rate for Payer: Healthscope Commercial	$229.39
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$216.65
Rate for Payer: PHP Commercial	$216.65
Rate for Payer: Priority Health Cigna Priority Health	$178.42
Rate for Payer: Priority Health SBD	$160.57

DILTIAZEM CD 240 MG CAPSULE,EXTENDED RELEASE 24 HR

Facility

$333.45

Service Code	NDC 0904-7219-61
Hospital Charge Code	29274
Hospital Revenue Code	637
Min. Negotiated Rate	$210.07
Max. Negotiated Rate	$300.10
Rate for Payer: Aetna Commercial	$283.43
Rate for Payer: Aetna New Business (MI Preferred)	$216.74
Rate for Payer: Cash Price	$266.76
Rate for Payer: Cofinity Commercial	$286.77
Rate for Payer: Cofinity Commercial	$233.42
Rate for Payer: Healthscope Commercial	$300.10
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$283.43
Rate for Payer: PHP Commercial	$283.43
Rate for Payer: Priority Health Cigna Priority Health	$233.42
Rate for Payer: Priority Health SBD	$210.07

DILTIAZEM CD 240 MG CAPSULE,EXTENDED RELEASE 24 HR

Facility

$2.55

Service Code	NDC 60687-217-11
Hospital Charge Code	29274
Hospital Revenue Code	637
Min. Negotiated Rate	$1.61
Max. Negotiated Rate	$2.30
Rate for Payer: Aetna Commercial	$2.17
Rate for Payer: Aetna New Business (MI Preferred)	$1.66
Rate for Payer: Cash Price	$2.04
Rate for Payer: Cofinity Commercial	$1.78
Rate for Payer: Cofinity Commercial	$2.19
Rate for Payer: Healthscope Commercial	$2.30
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2.17
Rate for Payer: PHP Commercial	$2.17
Rate for Payer: Priority Health Cigna Priority Health	$1.78
Rate for Payer: Priority Health SBD	$1.61

DIMENHYDRINATE 50 MG/ML INJECTION SOLUTION

Facility

$24.01

Service Code	HCPCS J1240
Hospital Charge Code	2483
Hospital Revenue Code	636
Min. Negotiated Rate	$15.13
Max. Negotiated Rate	$21.61
Rate for Payer: Aetna Commercial	$20.41
Rate for Payer: Aetna New Business (MI Preferred)	$15.61
Rate for Payer: Cash Price	$19.21
Rate for Payer: Cofinity Commercial	$16.81
Rate for Payer: Cofinity Commercial	$20.65
Rate for Payer: Healthscope Commercial	$21.61
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$20.41
Rate for Payer: PHP Commercial	$20.41
Rate for Payer: Priority Health Cigna Priority Health	$16.81
Rate for Payer: Priority Health SBD	$15.13

DIMENHYDRINATE 50 MG TABLET

Facility

$88.20

Service Code	NDC 0904-2051-59
Hospital Charge Code	2485
Hospital Revenue Code	637
Min. Negotiated Rate	$55.57
Max. Negotiated Rate	$79.38
Rate for Payer: Aetna Commercial	$74.97
Rate for Payer: Aetna New Business (MI Preferred)	$57.33
Rate for Payer: Cash Price	$70.56
Rate for Payer: Cofinity Commercial	$61.74
Rate for Payer: Cofinity Commercial	$75.85
Rate for Payer: Healthscope Commercial	$79.38
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$74.97
Rate for Payer: PHP Commercial	$74.97
Rate for Payer: Priority Health Cigna Priority Health	$61.74
Rate for Payer: Priority Health SBD	$55.57

DINOPROSTONE ER 10 MG VAGINAL INSERT,CONTROLLED RELEASE

Facility

$1,733.68

Service Code	NDC 55566-2800-0
Hospital Charge Code	27467
Hospital Revenue Code	637
Min. Negotiated Rate	$1,092.22
Max. Negotiated Rate	$1,560.31
Rate for Payer: Aetna Commercial	$1,473.63
Rate for Payer: Aetna New Business (MI Preferred)	$1,126.89
Rate for Payer: Cash Price	$1,386.94
Rate for Payer: Cofinity Commercial	$1,213.58
Rate for Payer: Cofinity Commercial	$1,490.96
Rate for Payer: Healthscope Commercial	$1,560.31
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,473.63
Rate for Payer: PHP Commercial	$1,473.63
Rate for Payer: Priority Health Cigna Priority Health	$1,213.58
Rate for Payer: Priority Health SBD	$1,092.22

DINOPROSTONE ER 10 MG VAGINAL INSERT,CONTROLLED RELEASE

Facility

$1,733.68

Service Code	NDC 55566-2800-1
Hospital Charge Code	27467
Hospital Revenue Code	637
Min. Negotiated Rate	$1,092.22
Max. Negotiated Rate	$1,560.31
Rate for Payer: Aetna Commercial	$1,473.63
Rate for Payer: Aetna New Business (MI Preferred)	$1,126.89
Rate for Payer: Cash Price	$1,386.94
Rate for Payer: Cofinity Commercial	$1,213.58
Rate for Payer: Cofinity Commercial	$1,490.96
Rate for Payer: Healthscope Commercial	$1,560.31
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,473.63
Rate for Payer: PHP Commercial	$1,473.63
Rate for Payer: Priority Health Cigna Priority Health	$1,213.58
Rate for Payer: Priority Health SBD	$1,092.22

DIPHENHYD 25 MG-LIDO 200 MG-MAG,AL 400 MG-SIMETH 40 MG/30 ML MOUTHWASH

Facility

$292.80

Service Code	NDC 65628-050-04
Hospital Charge Code	39984
Hospital Revenue Code	637
Min. Negotiated Rate	$184.46
Max. Negotiated Rate	$263.52
Rate for Payer: Aetna Commercial	$248.88
Rate for Payer: Aetna New Business (MI Preferred)	$190.32
Rate for Payer: Cash Price	$234.24
Rate for Payer: Cofinity Commercial	$204.96
Rate for Payer: Cofinity Commercial	$251.81
Rate for Payer: Healthscope Commercial	$263.52
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$248.88
Rate for Payer: PHP Commercial	$248.88
Rate for Payer: Priority Health Cigna Priority Health	$204.96
Rate for Payer: Priority Health SBD	$184.46

DIPHENHYDRAMINE 12.5 MG/5 ML ORAL ELIXIR

Facility

$12.95

Service Code	HCPCS Q0163
Hospital Charge Code	2511
Hospital Revenue Code	636
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$11.66
Rate for Payer: Aetna Commercial	$11.01
Rate for Payer: Aetna New Business (MI Preferred)	$8.42
Rate for Payer: BCBS Complete	$5.18
Rate for Payer: BCBS Trust/PPO	$0.29
Rate for Payer: Cash Price	$10.36
Rate for Payer: Cash Price	$10.36
Rate for Payer: Cofinity Commercial	$11.14
Rate for Payer: Cofinity Commercial	$9.06
Rate for Payer: Healthscope Commercial	$11.66
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$11.01
Rate for Payer: PHP Commercial	$11.01
Rate for Payer: Priority Health Cigna Priority Health	$9.06
Rate for Payer: Priority Health SBD	$8.16

DIPHENHYDRAMINE 12.5 MG/5 ML ORAL ELIXIR

Facility

$12.95

Service Code	HCPCS Q0163
Hospital Charge Code	2511
Hospital Revenue Code	636
Min. Negotiated Rate	$8.16
Max. Negotiated Rate	$11.66
Rate for Payer: Aetna Commercial	$11.01
Rate for Payer: Aetna New Business (MI Preferred)	$8.42
Rate for Payer: Cash Price	$10.36
Rate for Payer: Cofinity Commercial	$11.14
Rate for Payer: Cofinity Commercial	$9.06
Rate for Payer: Healthscope Commercial	$11.66
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$11.01
Rate for Payer: PHP Commercial	$11.01
Rate for Payer: Priority Health Cigna Priority Health	$9.06
Rate for Payer: Priority Health SBD	$8.16

DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID

Facility

$19.86

Service Code	NDC 69339-152-17
Hospital Charge Code	12556
Hospital Revenue Code	637
Min. Negotiated Rate	$12.51
Max. Negotiated Rate	$17.87
Rate for Payer: Aetna Commercial	$16.88
Rate for Payer: Aetna New Business (MI Preferred)	$12.91
Rate for Payer: Cash Price	$15.89
Rate for Payer: Cofinity Commercial	$17.08
Rate for Payer: Cofinity Commercial	$13.90
Rate for Payer: Healthscope Commercial	$17.87
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$16.88
Rate for Payer: PHP Commercial	$16.88
Rate for Payer: Priority Health Cigna Priority Health	$13.90
Rate for Payer: Priority Health SBD	$12.51

DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID

Facility

$41.83

Service Code	NDC 68094-024-62
Hospital Charge Code	12556
Hospital Revenue Code	637
Min. Negotiated Rate	$26.35
Max. Negotiated Rate	$37.65
Rate for Payer: Aetna Commercial	$35.56
Rate for Payer: Aetna New Business (MI Preferred)	$27.19
Rate for Payer: Cash Price	$33.46
Rate for Payer: Cofinity Commercial	$29.28
Rate for Payer: Cofinity Commercial	$35.97
Rate for Payer: Healthscope Commercial	$37.65
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$35.56
Rate for Payer: PHP Commercial	$35.56
Rate for Payer: Priority Health Cigna Priority Health	$29.28
Rate for Payer: Priority Health SBD	$26.35

DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID

Facility

$41.83

Service Code	NDC 68094-024-59
Hospital Charge Code	12556
Hospital Revenue Code	637
Min. Negotiated Rate	$26.35
Max. Negotiated Rate	$37.65
Rate for Payer: Aetna Commercial	$35.56
Rate for Payer: Aetna New Business (MI Preferred)	$27.19
Rate for Payer: Cash Price	$33.46
Rate for Payer: Cofinity Commercial	$29.28
Rate for Payer: Cofinity Commercial	$35.97
Rate for Payer: Healthscope Commercial	$37.65
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$35.56
Rate for Payer: PHP Commercial	$35.56
Rate for Payer: Priority Health Cigna Priority Health	$29.28
Rate for Payer: Priority Health SBD	$26.35

DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID

Facility

$19.86

Service Code	NDC 69339-152-01
Hospital Charge Code	12556
Hospital Revenue Code	637
Min. Negotiated Rate	$12.51
Max. Negotiated Rate	$17.87
Rate for Payer: Aetna Commercial	$16.88
Rate for Payer: Aetna New Business (MI Preferred)	$12.91
Rate for Payer: Cash Price	$15.89
Rate for Payer: Cofinity Commercial	$17.08
Rate for Payer: Cofinity Commercial	$13.90
Rate for Payer: Healthscope Commercial	$17.87
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$16.88
Rate for Payer: PHP Commercial	$16.88
Rate for Payer: Priority Health Cigna Priority Health	$13.90
Rate for Payer: Priority Health SBD	$12.51

DIPHENHYDRAMINE 25 MG TABLET

Facility

$162.80

Service Code	NDC 50580-226-50
Hospital Charge Code	2505
Hospital Revenue Code	637
Min. Negotiated Rate	$102.56
Max. Negotiated Rate	$146.52
Rate for Payer: Aetna Commercial	$138.38
Rate for Payer: Aetna New Business (MI Preferred)	$105.82
Rate for Payer: Cash Price	$130.24
Rate for Payer: Cofinity Commercial	$113.96
Rate for Payer: Cofinity Commercial	$140.01
Rate for Payer: Healthscope Commercial	$146.52
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$138.38
Rate for Payer: PHP Commercial	$138.38
Rate for Payer: Priority Health Cigna Priority Health	$113.96
Rate for Payer: Priority Health SBD	$102.56

DIPHENHYDRAMINE 25 MG TABLET

Facility

$142.80

Service Code	NDC 68094-018-61
Hospital Charge Code	2505
Hospital Revenue Code	637
Min. Negotiated Rate	$89.96
Max. Negotiated Rate	$128.52
Rate for Payer: Aetna Commercial	$121.38
Rate for Payer: Aetna New Business (MI Preferred)	$92.82
Rate for Payer: Cash Price	$114.24
Rate for Payer: Cofinity Commercial	$122.81
Rate for Payer: Cofinity Commercial	$99.96
Rate for Payer: Healthscope Commercial	$128.52
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$121.38
Rate for Payer: PHP Commercial	$121.38
Rate for Payer: Priority Health Cigna Priority Health	$99.96
Rate for Payer: Priority Health SBD	$89.96

DIPHENHYDRAMINE 25 MG TABLET

Facility

$100.80

Service Code	NDC 0904-5551-59
Hospital Charge Code	2505
Hospital Revenue Code	637
Min. Negotiated Rate	$63.50
Max. Negotiated Rate	$90.72
Rate for Payer: Aetna Commercial	$85.68
Rate for Payer: Aetna New Business (MI Preferred)	$65.52
Rate for Payer: Cash Price	$80.64
Rate for Payer: Cofinity Commercial	$70.56
Rate for Payer: Cofinity Commercial	$86.69
Rate for Payer: Healthscope Commercial	$90.72
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$85.68
Rate for Payer: PHP Commercial	$85.68
Rate for Payer: Priority Health Cigna Priority Health	$70.56
Rate for Payer: Priority Health SBD	$63.50

DIPHENHYDRAMINE 25 MG TABLET

Facility

$100.80

Service Code	NDC 0904-5551-59
Hospital Charge Code	2505
Hospital Revenue Code	637
Min. Negotiated Rate	$40.32
Max. Negotiated Rate	$90.72
Rate for Payer: Aetna Commercial	$85.68
Rate for Payer: Aetna New Business (MI Preferred)	$65.52
Rate for Payer: BCBS Complete	$40.32
Rate for Payer: Cash Price	$80.64
Rate for Payer: Cofinity Commercial	$86.69
Rate for Payer: Cofinity Commercial	$70.56
Rate for Payer: Healthscope Commercial	$90.72
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$85.68
Rate for Payer: PHP Commercial	$85.68
Rate for Payer: Priority Health Cigna Priority Health	$70.56
Rate for Payer: Priority Health SBD	$63.50

DIPHENHYDRAMINE 25 MG TABLET

Facility

$134.20

Service Code	NDC 45017014
Hospital Charge Code	2505
Hospital Revenue Code	637
Min. Negotiated Rate	$84.55
Max. Negotiated Rate	$120.78
Rate for Payer: Aetna Commercial	$114.07
Rate for Payer: Aetna New Business (MI Preferred)	$87.23
Rate for Payer: Cash Price	$107.36
Rate for Payer: Cofinity Commercial	$115.41
Rate for Payer: Cofinity Commercial	$93.94
Rate for Payer: Healthscope Commercial	$120.78
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$114.07
Rate for Payer: PHP Commercial	$114.07
Rate for Payer: Priority Health Cigna Priority Health	$93.94
Rate for Payer: Priority Health SBD	$84.55

DIPHENHYDRAMINE 25 MG TABLET

Facility

$1.43

Service Code	NDC 68094-018-59
Hospital Charge Code	2505
Hospital Revenue Code	637
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$1.29
Rate for Payer: Aetna Commercial	$1.22
Rate for Payer: Aetna New Business (MI Preferred)	$0.93
Rate for Payer: Cash Price	$1.14
Rate for Payer: Cofinity Commercial	$1.00
Rate for Payer: Cofinity Commercial	$1.23
Rate for Payer: Healthscope Commercial	$1.29
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1.22
Rate for Payer: PHP Commercial	$1.22
Rate for Payer: Priority Health Cigna Priority Health	$1.00
Rate for Payer: Priority Health SBD	$0.90

DIPHENHYDRAMINE 50 MG/ML INJECTION (CODE)

Facility

$20.65

Service Code	HCPCS J1200
Hospital Charge Code	163710
Hospital Revenue Code	636
Min. Negotiated Rate	$13.01
Max. Negotiated Rate	$18.58
Rate for Payer: Aetna Commercial	$17.55
Rate for Payer: Aetna Commercial	$10.31
Rate for Payer: Aetna New Business (MI Preferred)	$7.88
Rate for Payer: Aetna New Business (MI Preferred)	$13.42
Rate for Payer: Cash Price	$9.70
Rate for Payer: Cash Price	$16.52
Rate for Payer: Cofinity Commercial	$14.46
Rate for Payer: Cofinity Commercial	$10.43
Rate for Payer: Cofinity Commercial	$8.49
Rate for Payer: Cofinity Commercial	$17.76
Rate for Payer: Healthscope Commercial	$18.58
Rate for Payer: Healthscope Commercial	$10.92
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$10.31
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$17.55
Rate for Payer: PHP Commercial	$10.31
Rate for Payer: PHP Commercial	$17.55
Rate for Payer: Priority Health Cigna Priority Health	$14.46
Rate for Payer: Priority Health Cigna Priority Health	$8.49
Rate for Payer: Priority Health SBD	$7.64
Rate for Payer: Priority Health SBD	$13.01

DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION

Facility

$20.65

Service Code	HCPCS J1200
Hospital Charge Code	2508
Hospital Revenue Code	636
Min. Negotiated Rate	$13.01
Max. Negotiated Rate	$18.58
Rate for Payer: Aetna Commercial	$17.55
Rate for Payer: Aetna Commercial	$91.94
Rate for Payer: Aetna Commercial	$10.31
Rate for Payer: Aetna Commercial	$11.47
Rate for Payer: Aetna New Business (MI Preferred)	$7.88
Rate for Payer: Aetna New Business (MI Preferred)	$8.77
Rate for Payer: Aetna New Business (MI Preferred)	$13.42
Rate for Payer: Aetna New Business (MI Preferred)	$70.31
Rate for Payer: Cash Price	$10.79
Rate for Payer: Cash Price	$16.52
Rate for Payer: Cash Price	$86.54
Rate for Payer: Cash Price	$9.70
Rate for Payer: Cofinity Commercial	$11.60
Rate for Payer: Cofinity Commercial	$75.72
Rate for Payer: Cofinity Commercial	$93.03
Rate for Payer: Cofinity Commercial	$17.76
Rate for Payer: Cofinity Commercial	$14.46
Rate for Payer: Cofinity Commercial	$10.43
Rate for Payer: Cofinity Commercial	$8.49
Rate for Payer: Cofinity Commercial	$9.44
Rate for Payer: Healthscope Commercial	$18.58
Rate for Payer: Healthscope Commercial	$97.35
Rate for Payer: Healthscope Commercial	$10.92
Rate for Payer: Healthscope Commercial	$12.14
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$17.55
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$11.47
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$10.31
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$91.94
Rate for Payer: PHP Commercial	$11.47
Rate for Payer: PHP Commercial	$17.55
Rate for Payer: PHP Commercial	$10.31
Rate for Payer: PHP Commercial	$91.94
Rate for Payer: Priority Health Cigna Priority Health	$8.49
Rate for Payer: Priority Health Cigna Priority Health	$75.72
Rate for Payer: Priority Health Cigna Priority Health	$14.46
Rate for Payer: Priority Health Cigna Priority Health	$9.44
Rate for Payer: Priority Health SBD	$13.01
Rate for Payer: Priority Health SBD	$7.64
Rate for Payer: Priority Health SBD	$8.50
Rate for Payer: Priority Health SBD	$68.15

DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION

Facility

$12.13

Service Code	HCPCS J1200
Hospital Charge Code	2508
Hospital Revenue Code	636
Min. Negotiated Rate	$2.35
Max. Negotiated Rate	$10.92
Rate for Payer: Aetna Commercial	$10.31
Rate for Payer: Aetna Commercial	$91.94
Rate for Payer: Aetna New Business (MI Preferred)	$70.31
Rate for Payer: Aetna New Business (MI Preferred)	$7.88
Rate for Payer: BCBS Complete	$4.85
Rate for Payer: BCBS Complete	$43.27
Rate for Payer: BCBS Trust/PPO	$2.35
Rate for Payer: BCBS Trust/PPO	$2.35
Rate for Payer: Cash Price	$86.54
Rate for Payer: Cash Price	$86.54
Rate for Payer: Cash Price	$9.70
Rate for Payer: Cash Price	$9.70
Rate for Payer: Cofinity Commercial	$10.43
Rate for Payer: Cofinity Commercial	$75.72
Rate for Payer: Cofinity Commercial	$93.03
Rate for Payer: Cofinity Commercial	$8.49
Rate for Payer: Healthscope Commercial	$97.35
Rate for Payer: Healthscope Commercial	$10.92
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$10.31
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$91.94
Rate for Payer: PHP Commercial	$91.94
Rate for Payer: PHP Commercial	$10.31
Rate for Payer: Priority Health Cigna Priority Health	$75.72
Rate for Payer: Priority Health Cigna Priority Health	$8.49
Rate for Payer: Priority Health SBD	$68.15
Rate for Payer: Priority Health SBD	$7.64

Know your out-of-pocket cost for care.

All Charges