Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

DIVALPROEX 250 MG TABLET,DELAYED RELEASE

Facility

$3.81

Service Code	NDC 0832-7123-89
Hospital Charge Code	2552
Hospital Revenue Code	637
Min. Negotiated Rate	$2.40
Max. Negotiated Rate	$3.43
Rate for Payer: Aetna Commercial	$3.24
Rate for Payer: Aetna New Business (MI Preferred)	$2.48
Rate for Payer: Cash Price	$3.05
Rate for Payer: Cofinity Commercial	$2.67
Rate for Payer: Cofinity Commercial	$3.28
Rate for Payer: Healthscope Commercial	$3.43
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3.24
Rate for Payer: PHP Commercial	$3.24
Rate for Payer: Priority Health Cigna Priority Health	$2.67
Rate for Payer: Priority Health SBD	$2.40

DIVALPROEX 250 MG TABLET,DELAYED RELEASE

Facility

$380.70

Service Code	NDC 0832-7123-01
Hospital Charge Code	2552
Hospital Revenue Code	637
Min. Negotiated Rate	$239.84
Max. Negotiated Rate	$342.63
Rate for Payer: Aetna Commercial	$323.60
Rate for Payer: Aetna New Business (MI Preferred)	$247.46
Rate for Payer: Cash Price	$304.56
Rate for Payer: Cofinity Commercial	$266.49
Rate for Payer: Cofinity Commercial	$327.40
Rate for Payer: Healthscope Commercial	$342.63
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$323.60
Rate for Payer: PHP Commercial	$323.60
Rate for Payer: Priority Health Cigna Priority Health	$266.49
Rate for Payer: Priority Health SBD	$239.84

DIVALPROEX 250 MG TABLET,DELAYED RELEASE

Facility

$1,316.00

Service Code	NDC 62756-797-13
Hospital Charge Code	2552
Hospital Revenue Code	637
Min. Negotiated Rate	$829.08
Max. Negotiated Rate	$1,184.40
Rate for Payer: Aetna Commercial	$1,118.60
Rate for Payer: Aetna New Business (MI Preferred)	$855.40
Rate for Payer: Cash Price	$1,052.80
Rate for Payer: Cofinity Commercial	$1,131.76
Rate for Payer: Cofinity Commercial	$921.20
Rate for Payer: Healthscope Commercial	$1,184.40
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,118.60
Rate for Payer: PHP Commercial	$1,118.60
Rate for Payer: Priority Health Cigna Priority Health	$921.20
Rate for Payer: Priority Health SBD	$829.08

DIVALPROEX 250 MG TABLET,DELAYED RELEASE

Facility

$333.70

Service Code	NDC 68084-776-01
Hospital Charge Code	2552
Hospital Revenue Code	637
Min. Negotiated Rate	$210.23
Max. Negotiated Rate	$300.33
Rate for Payer: Aetna Commercial	$283.64
Rate for Payer: Aetna New Business (MI Preferred)	$216.90
Rate for Payer: Cash Price	$266.96
Rate for Payer: Cofinity Commercial	$233.59
Rate for Payer: Cofinity Commercial	$286.98
Rate for Payer: Healthscope Commercial	$300.33
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$283.64
Rate for Payer: PHP Commercial	$283.64
Rate for Payer: Priority Health Cigna Priority Health	$233.59
Rate for Payer: Priority Health SBD	$210.23

DIVALPROEX 500 MG TABLET,DELAYED RELEASE

Facility

$221.35

Service Code	NDC 62756-798-88
Hospital Charge Code	2553
Hospital Revenue Code	637
Min. Negotiated Rate	$139.45
Max. Negotiated Rate	$199.22
Rate for Payer: Aetna Commercial	$188.15
Rate for Payer: Aetna New Business (MI Preferred)	$143.88
Rate for Payer: Cash Price	$177.08
Rate for Payer: Cofinity Commercial	$154.94
Rate for Payer: Cofinity Commercial	$190.36
Rate for Payer: Healthscope Commercial	$199.22
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$188.15
Rate for Payer: PHP Commercial	$188.15
Rate for Payer: Priority Health Cigna Priority Health	$154.94
Rate for Payer: Priority Health SBD	$139.45

DIVALPROEX 500 MG TABLET,DELAYED RELEASE

Facility

$293.75

Service Code	NDC 57237-048-01
Hospital Charge Code	2553
Hospital Revenue Code	637
Min. Negotiated Rate	$185.06
Max. Negotiated Rate	$264.38
Rate for Payer: Aetna Commercial	$249.69
Rate for Payer: Aetna New Business (MI Preferred)	$190.94
Rate for Payer: Cash Price	$235.00
Rate for Payer: Cofinity Commercial	$205.62
Rate for Payer: Cofinity Commercial	$252.62
Rate for Payer: Healthscope Commercial	$264.38
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$249.69
Rate for Payer: PHP Commercial	$249.69
Rate for Payer: Priority Health Cigna Priority Health	$205.62
Rate for Payer: Priority Health SBD	$185.06

DIVALPROEX 500 MG TABLET,DELAYED RELEASE

Facility

$218.88

Service Code	NDC 68084-782-61
Hospital Charge Code	2553
Hospital Revenue Code	637
Min. Negotiated Rate	$137.89
Max. Negotiated Rate	$196.99
Rate for Payer: Aetna Commercial	$186.05
Rate for Payer: Aetna New Business (MI Preferred)	$142.27
Rate for Payer: Cash Price	$175.10
Rate for Payer: Cofinity Commercial	$153.22
Rate for Payer: Cofinity Commercial	$188.24
Rate for Payer: Healthscope Commercial	$196.99
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$186.05
Rate for Payer: PHP Commercial	$186.05
Rate for Payer: Priority Health Cigna Priority Health	$153.22
Rate for Payer: Priority Health SBD	$137.89

DIVALPROEX ER 250 MG TABLET,EXTENDED RELEASE 24 HR

Facility

$404.16

Service Code	NDC 68084-310-01
Hospital Charge Code	34418
Hospital Revenue Code	637
Min. Negotiated Rate	$254.62
Max. Negotiated Rate	$363.74
Rate for Payer: Aetna Commercial	$343.54
Rate for Payer: Aetna New Business (MI Preferred)	$262.70
Rate for Payer: Cash Price	$323.33
Rate for Payer: Cofinity Commercial	$282.91
Rate for Payer: Cofinity Commercial	$347.58
Rate for Payer: Healthscope Commercial	$363.74
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$343.54
Rate for Payer: PHP Commercial	$343.54
Rate for Payer: Priority Health Cigna Priority Health	$282.91
Rate for Payer: Priority Health SBD	$254.62

DIVALPROEX ER 250 MG TABLET,EXTENDED RELEASE 24 HR

Facility

$4.05

Service Code	NDC 68084-310-11
Hospital Charge Code	34418
Hospital Revenue Code	637
Min. Negotiated Rate	$2.55
Max. Negotiated Rate	$3.64
Rate for Payer: Aetna Commercial	$3.44
Rate for Payer: Aetna New Business (MI Preferred)	$2.63
Rate for Payer: Cash Price	$3.24
Rate for Payer: Cofinity Commercial	$2.84
Rate for Payer: Cofinity Commercial	$3.48
Rate for Payer: Healthscope Commercial	$3.64
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3.44
Rate for Payer: PHP Commercial	$3.44
Rate for Payer: Priority Health Cigna Priority Health	$2.84
Rate for Payer: Priority Health SBD	$2.55

DIVALPROEX ER 250 MG TABLET,EXTENDED RELEASE 24 HR

Facility

$385.44

Service Code	NDC 0904-6363-61
Hospital Charge Code	34418
Hospital Revenue Code	637
Min. Negotiated Rate	$242.83
Max. Negotiated Rate	$346.90
Rate for Payer: Aetna Commercial	$327.62
Rate for Payer: Aetna New Business (MI Preferred)	$250.54
Rate for Payer: Cash Price	$308.35
Rate for Payer: Cofinity Commercial	$269.81
Rate for Payer: Cofinity Commercial	$331.48
Rate for Payer: Healthscope Commercial	$346.90
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$327.62
Rate for Payer: PHP Commercial	$327.62
Rate for Payer: Priority Health Cigna Priority Health	$269.81
Rate for Payer: Priority Health SBD	$242.83

DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR

Facility

$797.28

Service Code	NDC 68084-415-01
Hospital Charge Code	81426
Hospital Revenue Code	637
Min. Negotiated Rate	$502.29
Max. Negotiated Rate	$717.55
Rate for Payer: Aetna Commercial	$677.69
Rate for Payer: Aetna New Business (MI Preferred)	$518.23
Rate for Payer: Cash Price	$637.82
Rate for Payer: Cofinity Commercial	$685.66
Rate for Payer: Cofinity Commercial	$558.10
Rate for Payer: Healthscope Commercial	$717.55
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$677.69
Rate for Payer: PHP Commercial	$677.69
Rate for Payer: Priority Health Cigna Priority Health	$558.10
Rate for Payer: Priority Health SBD	$502.29

DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR

Facility

$604.80

Service Code	NDC 0904-6364-61
Hospital Charge Code	81426
Hospital Revenue Code	637
Min. Negotiated Rate	$381.02
Max. Negotiated Rate	$544.32
Rate for Payer: Aetna Commercial	$514.08
Rate for Payer: Aetna New Business (MI Preferred)	$393.12
Rate for Payer: Cash Price	$483.84
Rate for Payer: Cofinity Commercial	$423.36
Rate for Payer: Cofinity Commercial	$520.13
Rate for Payer: Healthscope Commercial	$544.32
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$514.08
Rate for Payer: PHP Commercial	$514.08
Rate for Payer: Priority Health Cigna Priority Health	$423.36
Rate for Payer: Priority Health SBD	$381.02

DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR

Facility

$258.40

Service Code	NDC 65162-757-10
Hospital Charge Code	81426
Hospital Revenue Code	637
Min. Negotiated Rate	$162.79
Max. Negotiated Rate	$232.56
Rate for Payer: Aetna Commercial	$219.64
Rate for Payer: Aetna New Business (MI Preferred)	$167.96
Rate for Payer: Cash Price	$206.72
Rate for Payer: Cofinity Commercial	$222.22
Rate for Payer: Cofinity Commercial	$180.88
Rate for Payer: Healthscope Commercial	$232.56
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$219.64
Rate for Payer: PHP Commercial	$219.64
Rate for Payer: Priority Health Cigna Priority Health	$180.88
Rate for Payer: Priority Health SBD	$162.79

DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR

Facility

$2,007.25

Service Code	NDC 0074-7126-11
Hospital Charge Code	81426
Hospital Revenue Code	637
Min. Negotiated Rate	$1,264.57
Max. Negotiated Rate	$1,806.52
Rate for Payer: Aetna Commercial	$1,706.16
Rate for Payer: Aetna New Business (MI Preferred)	$1,304.71
Rate for Payer: Cash Price	$1,605.80
Rate for Payer: Cofinity Commercial	$1,405.08
Rate for Payer: Cofinity Commercial	$1,726.24
Rate for Payer: Healthscope Commercial	$1,806.52
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,706.16
Rate for Payer: PHP Commercial	$1,706.16
Rate for Payer: Priority Health Cigna Priority Health	$1,405.08
Rate for Payer: Priority Health SBD	$1,264.57

DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR

Facility

$7.98

Service Code	NDC 68084-415-11
Hospital Charge Code	81426
Hospital Revenue Code	637
Min. Negotiated Rate	$5.03
Max. Negotiated Rate	$7.18
Rate for Payer: Aetna Commercial	$6.78
Rate for Payer: Aetna New Business (MI Preferred)	$5.19
Rate for Payer: Cash Price	$6.38
Rate for Payer: Cofinity Commercial	$5.59
Rate for Payer: Cofinity Commercial	$6.86
Rate for Payer: Healthscope Commercial	$7.18
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$6.78
Rate for Payer: PHP Commercial	$6.78
Rate for Payer: Priority Health Cigna Priority Health	$5.59
Rate for Payer: Priority Health SBD	$5.03

DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) INTRAVENOUS SOLUTION

Facility

$20.03

Service Code	HCPCS J1250
Hospital Charge Code	9892
Hospital Revenue Code	636
Min. Negotiated Rate	$12.62
Max. Negotiated Rate	$18.03
Rate for Payer: Aetna Commercial	$17.03
Rate for Payer: Aetna New Business (MI Preferred)	$13.02
Rate for Payer: Cash Price	$16.02
Rate for Payer: Cofinity Commercial	$14.02
Rate for Payer: Cofinity Commercial	$17.23
Rate for Payer: Healthscope Commercial	$18.03
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$17.03
Rate for Payer: PHP Commercial	$17.03
Rate for Payer: Priority Health Cigna Priority Health	$14.02
Rate for Payer: Priority Health SBD	$12.62

DOBUTAMINE 500 MG/250 ML (2,000 MCG/ML) IN 5 % DEXTROSE IV

Facility

$89.51

Service Code	HCPCS J1250
Hospital Charge Code	18315
Hospital Revenue Code	636
Min. Negotiated Rate	$56.39
Max. Negotiated Rate	$80.56
Rate for Payer: Aetna Commercial	$76.08
Rate for Payer: Aetna New Business (MI Preferred)	$58.18
Rate for Payer: Cash Price	$71.61
Rate for Payer: Cofinity Commercial	$62.66
Rate for Payer: Cofinity Commercial	$76.98
Rate for Payer: Healthscope Commercial	$80.56
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$76.08
Rate for Payer: PHP Commercial	$76.08
Rate for Payer: Priority Health Cigna Priority Health	$62.66
Rate for Payer: Priority Health SBD	$56.39

DOCETAXEL 160 MG/8 ML (20 MG/ML) INTRAVENOUS SOLUTION

Facility

$346.45

Service Code	HCPCS J9171
Hospital Charge Code	161671
Hospital Revenue Code	636
Min. Negotiated Rate	$2.93
Max. Negotiated Rate	$311.80
Rate for Payer: Aetna Commercial	$294.48
Rate for Payer: Aetna Commercial	$943.50
Rate for Payer: Aetna Commercial	$927.78
Rate for Payer: Aetna New Business (MI Preferred)	$721.50
Rate for Payer: Aetna New Business (MI Preferred)	$709.48
Rate for Payer: Aetna New Business (MI Preferred)	$225.19
Rate for Payer: BCBS Complete	$138.58
Rate for Payer: BCBS Complete	$444.00
Rate for Payer: BCBS Complete	$436.60
Rate for Payer: BCBS Trust/PPO	$2.93
Rate for Payer: BCBS Trust/PPO	$2.93
Rate for Payer: BCBS Trust/PPO	$2.93
Rate for Payer: Cash Price	$888.00
Rate for Payer: Cash Price	$873.20
Rate for Payer: Cash Price	$873.20
Rate for Payer: Cash Price	$888.00
Rate for Payer: Cash Price	$277.16
Rate for Payer: Cash Price	$277.16
Rate for Payer: Cofinity Commercial	$938.69
Rate for Payer: Cofinity Commercial	$764.05
Rate for Payer: Cofinity Commercial	$954.60
Rate for Payer: Cofinity Commercial	$777.00
Rate for Payer: Cofinity Commercial	$297.95
Rate for Payer: Cofinity Commercial	$242.52
Rate for Payer: Healthscope Commercial	$982.35
Rate for Payer: Healthscope Commercial	$999.00
Rate for Payer: Healthscope Commercial	$311.80
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$943.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$294.48
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$927.78
Rate for Payer: PHP Commercial	$927.78
Rate for Payer: PHP Commercial	$294.48
Rate for Payer: PHP Commercial	$943.50
Rate for Payer: Priority Health Cigna Priority Health	$764.05
Rate for Payer: Priority Health Cigna Priority Health	$777.00
Rate for Payer: Priority Health Cigna Priority Health	$242.52
Rate for Payer: Priority Health SBD	$687.64
Rate for Payer: Priority Health SBD	$699.30
Rate for Payer: Priority Health SBD	$218.26

DOCETAXEL 160 MG/8 ML (20 MG/ML) INTRAVENOUS SOLUTION

Facility

$1,091.50

Service Code	HCPCS J9171
Hospital Charge Code	161671
Hospital Revenue Code	636
Min. Negotiated Rate	$687.64
Max. Negotiated Rate	$982.35
Rate for Payer: Aetna Commercial	$927.78
Rate for Payer: Aetna New Business (MI Preferred)	$709.48
Rate for Payer: Cash Price	$873.20
Rate for Payer: Cofinity Commercial	$764.05
Rate for Payer: Cofinity Commercial	$938.69
Rate for Payer: Healthscope Commercial	$982.35
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$927.78
Rate for Payer: PHP Commercial	$927.78
Rate for Payer: Priority Health Cigna Priority Health	$764.05
Rate for Payer: Priority Health SBD	$687.64

DOCETAXEL 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION

Facility

$717.88

Service Code	HCPCS J9171
Hospital Charge Code	120029
Hospital Revenue Code	636
Min. Negotiated Rate	$452.26
Max. Negotiated Rate	$646.09
Rate for Payer: Aetna Commercial	$610.20
Rate for Payer: Aetna New Business (MI Preferred)	$466.62
Rate for Payer: Cash Price	$574.30
Rate for Payer: Cofinity Commercial	$502.52
Rate for Payer: Cofinity Commercial	$617.38
Rate for Payer: Healthscope Commercial	$646.09
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$610.20
Rate for Payer: PHP Commercial	$610.20
Rate for Payer: Priority Health Cigna Priority Health	$502.52
Rate for Payer: Priority Health SBD	$452.26

DOCETAXEL 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION

Facility

$499.25

Service Code	HCPCS J9171
Hospital Charge Code	120029
Hospital Revenue Code	636
Min. Negotiated Rate	$2.93
Max. Negotiated Rate	$449.32
Rate for Payer: Aetna Commercial	$424.36
Rate for Payer: Aetna Commercial	$610.20
Rate for Payer: Aetna New Business (MI Preferred)	$324.51
Rate for Payer: Aetna New Business (MI Preferred)	$466.62
Rate for Payer: BCBS Complete	$199.70
Rate for Payer: BCBS Complete	$287.15
Rate for Payer: BCBS Trust/PPO	$2.93
Rate for Payer: BCBS Trust/PPO	$2.93
Rate for Payer: Cash Price	$399.40
Rate for Payer: Cash Price	$399.40
Rate for Payer: Cash Price	$574.30
Rate for Payer: Cash Price	$574.30
Rate for Payer: Cofinity Commercial	$429.36
Rate for Payer: Cofinity Commercial	$617.38
Rate for Payer: Cofinity Commercial	$502.52
Rate for Payer: Cofinity Commercial	$349.48
Rate for Payer: Healthscope Commercial	$646.09
Rate for Payer: Healthscope Commercial	$449.32
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$610.20
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$424.36
Rate for Payer: PHP Commercial	$424.36
Rate for Payer: PHP Commercial	$610.20
Rate for Payer: Priority Health Cigna Priority Health	$349.48
Rate for Payer: Priority Health Cigna Priority Health	$502.52
Rate for Payer: Priority Health SBD	$452.26
Rate for Payer: Priority Health SBD	$314.53

DOCUSATE SODIUM 100 MG CAPSULE

Facility

$14.00

Service Code	NDC 63739-478-02
Hospital Charge Code	2566
Hospital Revenue Code	637
Min. Negotiated Rate	$8.82
Max. Negotiated Rate	$12.60
Rate for Payer: Aetna Commercial	$11.90
Rate for Payer: Aetna New Business (MI Preferred)	$9.10
Rate for Payer: Cash Price	$11.20
Rate for Payer: Cofinity Commercial	$12.04
Rate for Payer: Cofinity Commercial	$9.80
Rate for Payer: Healthscope Commercial	$12.60
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$11.90
Rate for Payer: PHP Commercial	$11.90
Rate for Payer: Priority Health Cigna Priority Health	$9.80
Rate for Payer: Priority Health SBD	$8.82

DOCUSATE SODIUM 100 MG CAPSULE

Facility

$176.00

Service Code	NDC 0904-7183-61
Hospital Charge Code	2566
Hospital Revenue Code	637
Min. Negotiated Rate	$110.88
Max. Negotiated Rate	$158.40
Rate for Payer: Aetna Commercial	$149.60
Rate for Payer: Aetna New Business (MI Preferred)	$114.40
Rate for Payer: Cash Price	$140.80
Rate for Payer: Cofinity Commercial	$123.20
Rate for Payer: Cofinity Commercial	$151.36
Rate for Payer: Healthscope Commercial	$158.40
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$149.60
Rate for Payer: PHP Commercial	$149.60
Rate for Payer: Priority Health Cigna Priority Health	$123.20
Rate for Payer: Priority Health SBD	$110.88

DOCUSATE SODIUM 100 MG CAPSULE

Facility

$189.00

Service Code	NDC 63739-478-10
Hospital Charge Code	2566
Hospital Revenue Code	637
Min. Negotiated Rate	$119.07
Max. Negotiated Rate	$170.10
Rate for Payer: Aetna Commercial	$160.65
Rate for Payer: Aetna New Business (MI Preferred)	$122.85
Rate for Payer: Cash Price	$151.20
Rate for Payer: Cofinity Commercial	$132.30
Rate for Payer: Cofinity Commercial	$162.54
Rate for Payer: Healthscope Commercial	$170.10
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$160.65
Rate for Payer: PHP Commercial	$160.65
Rate for Payer: Priority Health Cigna Priority Health	$132.30
Rate for Payer: Priority Health SBD	$119.07

DOCUSATE SODIUM 100 MG CAPSULE

Facility

$1,228.50

Service Code	NDC 63739-478-01
Hospital Charge Code	2566
Hospital Revenue Code	637
Min. Negotiated Rate	$773.96
Max. Negotiated Rate	$1,105.65
Rate for Payer: Aetna Commercial	$1,044.22
Rate for Payer: Aetna New Business (MI Preferred)	$798.52
Rate for Payer: Cash Price	$982.80
Rate for Payer: Cofinity Commercial	$1,056.51
Rate for Payer: Cofinity Commercial	$859.95
Rate for Payer: Healthscope Commercial	$1,105.65
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,044.22
Rate for Payer: PHP Commercial	$1,044.22
Rate for Payer: Priority Health Cigna Priority Health	$859.95
Rate for Payer: Priority Health SBD	$773.96

Know your out-of-pocket cost for care.

All Charges