Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

TIZANIDINE 2 MG TABLET

Facility

$2.89

Service Code	NDC 50268-759-11
Hospital Charge Code	14792
Hospital Revenue Code	637
Min. Negotiated Rate	$1.82
Max. Negotiated Rate	$2.60
Rate for Payer: Aetna Commercial	$2.46
Rate for Payer: Aetna New Business (MI Preferred)	$1.88
Rate for Payer: Cash Price	$2.31
Rate for Payer: Cofinity Commercial	$2.02
Rate for Payer: Cofinity Commercial	$2.49
Rate for Payer: Healthscope Commercial	$2.60
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2.46
Rate for Payer: PHP Commercial	$2.46
Rate for Payer: Priority Health Cigna Priority Health	$2.02
Rate for Payer: Priority Health SBD	$1.82

TIZANIDINE 2 MG TABLET

Facility

$144.24

Service Code	NDC 50268-759-15
Hospital Charge Code	14792
Hospital Revenue Code	637
Min. Negotiated Rate	$90.87
Max. Negotiated Rate	$129.82
Rate for Payer: Aetna Commercial	$122.60
Rate for Payer: Aetna New Business (MI Preferred)	$93.76
Rate for Payer: Cash Price	$115.39
Rate for Payer: Cofinity Commercial	$100.97
Rate for Payer: Cofinity Commercial	$124.05
Rate for Payer: Healthscope Commercial	$129.82
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$122.60
Rate for Payer: PHP Commercial	$122.60
Rate for Payer: Priority Health Cigna Priority Health	$100.97
Rate for Payer: Priority Health SBD	$90.87

TIZANIDINE 2 MG TABLET

Facility

$3.00

Service Code	NDC 68084-775-95
Hospital Charge Code	14792
Hospital Revenue Code	637
Min. Negotiated Rate	$1.89
Max. Negotiated Rate	$2.70
Rate for Payer: Aetna Commercial	$2.55
Rate for Payer: Aetna New Business (MI Preferred)	$1.95
Rate for Payer: Cash Price	$2.40
Rate for Payer: Cofinity Commercial	$2.10
Rate for Payer: Cofinity Commercial	$2.58
Rate for Payer: Healthscope Commercial	$2.70
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2.55
Rate for Payer: PHP Commercial	$2.55
Rate for Payer: Priority Health Cigna Priority Health	$2.10
Rate for Payer: Priority Health SBD	$1.89

TIZANIDINE 2 MG TABLET

Facility

$89.86

Service Code	NDC 68084-775-25
Hospital Charge Code	14792
Hospital Revenue Code	637
Min. Negotiated Rate	$56.61
Max. Negotiated Rate	$80.87
Rate for Payer: Aetna Commercial	$76.38
Rate for Payer: Aetna New Business (MI Preferred)	$58.41
Rate for Payer: Cash Price	$71.89
Rate for Payer: Cofinity Commercial	$62.90
Rate for Payer: Cofinity Commercial	$77.28
Rate for Payer: Healthscope Commercial	$80.87
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$76.38
Rate for Payer: PHP Commercial	$76.38
Rate for Payer: Priority Health Cigna Priority Health	$62.90
Rate for Payer: Priority Health SBD	$56.61

TIZANIDINE 2 MG TABLET

Facility

$137.48

Service Code	NDC 57664-502-89
Hospital Charge Code	14792
Hospital Revenue Code	637
Min. Negotiated Rate	$86.61
Max. Negotiated Rate	$123.73
Rate for Payer: Aetna Commercial	$116.86
Rate for Payer: Aetna New Business (MI Preferred)	$89.36
Rate for Payer: Cash Price	$109.98
Rate for Payer: Cofinity Commercial	$118.23
Rate for Payer: Cofinity Commercial	$96.24
Rate for Payer: Healthscope Commercial	$123.73
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$116.86
Rate for Payer: PHP Commercial	$116.86
Rate for Payer: Priority Health Cigna Priority Health	$96.24
Rate for Payer: Priority Health SBD	$86.61

TIZANIDINE 4 MG TABLET

Facility

$389.50

Service Code	NDC 0904-6418-61
Hospital Charge Code	14793
Hospital Revenue Code	637
Min. Negotiated Rate	$245.38
Max. Negotiated Rate	$350.55
Rate for Payer: Aetna Commercial	$331.08
Rate for Payer: Aetna New Business (MI Preferred)	$253.18
Rate for Payer: Cash Price	$311.60
Rate for Payer: Cofinity Commercial	$272.65
Rate for Payer: Cofinity Commercial	$334.97
Rate for Payer: Healthscope Commercial	$350.55
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$331.08
Rate for Payer: PHP Commercial	$331.08
Rate for Payer: Priority Health Cigna Priority Health	$272.65
Rate for Payer: Priority Health SBD	$245.38

TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION

Facility

$297.40

Service Code	NDC 0078-0953-40
Hospital Charge Code	11567
Hospital Revenue Code	637
Min. Negotiated Rate	$187.36
Max. Negotiated Rate	$267.66
Rate for Payer: Aetna Commercial	$252.79
Rate for Payer: Aetna New Business (MI Preferred)	$193.31
Rate for Payer: Cash Price	$237.92
Rate for Payer: Cofinity Commercial	$208.18
Rate for Payer: Cofinity Commercial	$255.76
Rate for Payer: Healthscope Commercial	$267.66
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$252.79
Rate for Payer: PHP Commercial	$252.79
Rate for Payer: Priority Health Cigna Priority Health	$208.18
Rate for Payer: Priority Health SBD	$187.36

TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION

Facility

$164.61

Service Code	NDC 24208-295-25
Hospital Charge Code	11567
Hospital Revenue Code	637
Min. Negotiated Rate	$103.70
Max. Negotiated Rate	$148.15
Rate for Payer: Aetna Commercial	$139.92
Rate for Payer: Aetna New Business (MI Preferred)	$107.00
Rate for Payer: Cash Price	$131.69
Rate for Payer: Cofinity Commercial	$141.56
Rate for Payer: Cofinity Commercial	$115.23
Rate for Payer: Healthscope Commercial	$148.15
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$139.92
Rate for Payer: PHP Commercial	$139.92
Rate for Payer: Priority Health Cigna Priority Health	$115.23
Rate for Payer: Priority Health SBD	$103.70

TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION

Facility

$270.80

Service Code	NDC 0065-0647-25
Hospital Charge Code	11567
Hospital Revenue Code	637
Min. Negotiated Rate	$170.60
Max. Negotiated Rate	$243.72
Rate for Payer: Aetna Commercial	$230.18
Rate for Payer: Aetna New Business (MI Preferred)	$176.02
Rate for Payer: Cash Price	$216.64
Rate for Payer: Cofinity Commercial	$189.56
Rate for Payer: Cofinity Commercial	$232.89
Rate for Payer: Healthscope Commercial	$243.72
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$230.18
Rate for Payer: PHP Commercial	$230.18
Rate for Payer: Priority Health Cigna Priority Health	$189.56
Rate for Payer: Priority Health SBD	$170.60

TOBRAMYCIN 0.3 % EYE DROPS

Facility

$37.84

Service Code	NDC 17478-290-10
Hospital Charge Code	7995
Hospital Revenue Code	637
Min. Negotiated Rate	$23.84
Max. Negotiated Rate	$34.06
Rate for Payer: Aetna Commercial	$32.16
Rate for Payer: Aetna New Business (MI Preferred)	$24.60
Rate for Payer: Cash Price	$30.27
Rate for Payer: Cofinity Commercial	$26.49
Rate for Payer: Cofinity Commercial	$32.54
Rate for Payer: Healthscope Commercial	$34.06
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$32.16
Rate for Payer: PHP Commercial	$32.16
Rate for Payer: Priority Health Cigna Priority Health	$26.49
Rate for Payer: Priority Health SBD	$23.84

TOBRAMYCIN 0.3 % EYE DROPS

Facility

$24.19

Service Code	NDC 62332-518-05
Hospital Charge Code	7995
Hospital Revenue Code	637
Min. Negotiated Rate	$15.24
Max. Negotiated Rate	$21.77
Rate for Payer: Aetna Commercial	$20.56
Rate for Payer: Aetna New Business (MI Preferred)	$15.72
Rate for Payer: Cash Price	$19.35
Rate for Payer: Cofinity Commercial	$16.93
Rate for Payer: Cofinity Commercial	$20.80
Rate for Payer: Healthscope Commercial	$21.77
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$20.56
Rate for Payer: PHP Commercial	$20.56
Rate for Payer: Priority Health Cigna Priority Health	$16.93
Rate for Payer: Priority Health SBD	$15.24

TOBRAMYCIN 0.3 % EYE DROPS

Facility

$20.07

Service Code	NDC 70069-131-01
Hospital Charge Code	7995
Hospital Revenue Code	637
Min. Negotiated Rate	$12.64
Max. Negotiated Rate	$18.06
Rate for Payer: Aetna Commercial	$17.06
Rate for Payer: Aetna New Business (MI Preferred)	$13.05
Rate for Payer: Cash Price	$16.06
Rate for Payer: Cofinity Commercial	$14.05
Rate for Payer: Cofinity Commercial	$17.26
Rate for Payer: Healthscope Commercial	$18.06
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$17.06
Rate for Payer: PHP Commercial	$17.06
Rate for Payer: Priority Health Cigna Priority Health	$14.05
Rate for Payer: Priority Health SBD	$12.64

TOBRAMYCIN 0.3 % EYE DROPS

Facility

$51.56

Service Code	NDC 61314-643-05
Hospital Charge Code	7995
Hospital Revenue Code	637
Min. Negotiated Rate	$32.48
Max. Negotiated Rate	$46.40
Rate for Payer: Aetna Commercial	$43.83
Rate for Payer: Aetna New Business (MI Preferred)	$33.51
Rate for Payer: Cash Price	$41.25
Rate for Payer: Cofinity Commercial	$36.09
Rate for Payer: Cofinity Commercial	$44.34
Rate for Payer: Healthscope Commercial	$46.40
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$43.83
Rate for Payer: PHP Commercial	$43.83
Rate for Payer: Priority Health Cigna Priority Health	$36.09
Rate for Payer: Priority Health SBD	$32.48

TOBRAMYCIN 0.3 % EYE DROPS

Facility

$331.63

Service Code	NDC 0065-0643-05
Hospital Charge Code	7995
Hospital Revenue Code	637
Min. Negotiated Rate	$208.93
Max. Negotiated Rate	$298.47
Rate for Payer: Aetna Commercial	$281.89
Rate for Payer: Aetna New Business (MI Preferred)	$215.56
Rate for Payer: Cash Price	$265.30
Rate for Payer: Cofinity Commercial	$232.14
Rate for Payer: Cofinity Commercial	$285.20
Rate for Payer: Healthscope Commercial	$298.47
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$281.89
Rate for Payer: PHP Commercial	$281.89
Rate for Payer: Priority Health Cigna Priority Health	$232.14
Rate for Payer: Priority Health SBD	$208.93

TOBRAMYCIN 0.3 % EYE OINTMENT

Facility

$696.47

Service Code	NDC 0065-0644-35
Hospital Charge Code	19769
Hospital Revenue Code	637
Min. Negotiated Rate	$438.78
Max. Negotiated Rate	$626.82
Rate for Payer: Aetna Commercial	$592.00
Rate for Payer: Aetna New Business (MI Preferred)	$452.71
Rate for Payer: Cash Price	$557.18
Rate for Payer: Cofinity Commercial	$487.53
Rate for Payer: Cofinity Commercial	$598.96
Rate for Payer: Healthscope Commercial	$626.82
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$592.00
Rate for Payer: PHP Commercial	$592.00
Rate for Payer: Priority Health Cigna Priority Health	$487.53
Rate for Payer: Priority Health SBD	$438.78

TOBRAMYCIN 0.3 % EYE OINTMENT

Facility

$805.15

Service Code	NDC 0078-0813-01
Hospital Charge Code	19769
Hospital Revenue Code	637
Min. Negotiated Rate	$507.24
Max. Negotiated Rate	$724.64
Rate for Payer: Aetna Commercial	$684.38
Rate for Payer: Aetna New Business (MI Preferred)	$523.35
Rate for Payer: Cash Price	$644.12
Rate for Payer: Cofinity Commercial	$563.60
Rate for Payer: Cofinity Commercial	$692.43
Rate for Payer: Healthscope Commercial	$724.64
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$684.38
Rate for Payer: PHP Commercial	$684.38
Rate for Payer: Priority Health Cigna Priority Health	$563.60
Rate for Payer: Priority Health SBD	$507.24

TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION

Facility

$185.39

Service Code	HCPCS J3260
Hospital Charge Code	11565
Hospital Revenue Code	636
Min. Negotiated Rate	$116.80
Max. Negotiated Rate	$166.85
Rate for Payer: Aetna Commercial	$157.58
Rate for Payer: Aetna Commercial	$157.16
Rate for Payer: Aetna New Business (MI Preferred)	$120.18
Rate for Payer: Aetna New Business (MI Preferred)	$120.50
Rate for Payer: Cash Price	$147.91
Rate for Payer: Cash Price	$148.31
Rate for Payer: Cofinity Commercial	$129.77
Rate for Payer: Cofinity Commercial	$129.42
Rate for Payer: Cofinity Commercial	$159.01
Rate for Payer: Cofinity Commercial	$159.44
Rate for Payer: Healthscope Commercial	$166.40
Rate for Payer: Healthscope Commercial	$166.85
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$157.16
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$157.58
Rate for Payer: PHP Commercial	$157.58
Rate for Payer: PHP Commercial	$157.16
Rate for Payer: Priority Health Cigna Priority Health	$129.42
Rate for Payer: Priority Health Cigna Priority Health	$129.77
Rate for Payer: Priority Health SBD	$116.48
Rate for Payer: Priority Health SBD	$116.80

TOBRAMYCIN 300 MG/5 ML NEBULIZATION CUSTOM

Facility

$50.66

Service Code	HCPCS J7682
Hospital Charge Code	168920
Hospital Revenue Code	250
Min. Negotiated Rate	$31.92
Max. Negotiated Rate	$45.59
Rate for Payer: Aetna Commercial	$43.06
Rate for Payer: Aetna New Business (MI Preferred)	$32.93
Rate for Payer: Cash Price	$40.53
Rate for Payer: Cofinity Commercial	$35.46
Rate for Payer: Cofinity Commercial	$43.57
Rate for Payer: Healthscope Commercial	$45.59
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$43.06
Rate for Payer: PHP Commercial	$43.06
Rate for Payer: Priority Health Cigna Priority Health	$35.46
Rate for Payer: Priority Health SBD	$31.92

TOBRAMYCIN 40 MG/ML INJECTION SOLUTION

Facility

$18.74

Service Code	HCPCS J3260
Hospital Charge Code	7994
Hospital Revenue Code	636
Min. Negotiated Rate	$11.81
Max. Negotiated Rate	$16.87
Rate for Payer: Aetna Commercial	$15.93
Rate for Payer: Aetna Commercial	$9.52
Rate for Payer: Aetna Commercial	$43.35
Rate for Payer: Aetna Commercial	$76.48
Rate for Payer: Aetna New Business (MI Preferred)	$7.28
Rate for Payer: Aetna New Business (MI Preferred)	$33.15
Rate for Payer: Aetna New Business (MI Preferred)	$58.49
Rate for Payer: Aetna New Business (MI Preferred)	$12.18
Rate for Payer: Cash Price	$71.98
Rate for Payer: Cash Price	$40.80
Rate for Payer: Cash Price	$8.96
Rate for Payer: Cash Price	$14.99
Rate for Payer: Cofinity Commercial	$35.70
Rate for Payer: Cofinity Commercial	$13.12
Rate for Payer: Cofinity Commercial	$16.12
Rate for Payer: Cofinity Commercial	$77.38
Rate for Payer: Cofinity Commercial	$9.63
Rate for Payer: Cofinity Commercial	$7.84
Rate for Payer: Cofinity Commercial	$43.86
Rate for Payer: Cofinity Commercial	$62.99
Rate for Payer: Healthscope Commercial	$80.98
Rate for Payer: Healthscope Commercial	$10.08
Rate for Payer: Healthscope Commercial	$16.87
Rate for Payer: Healthscope Commercial	$45.90
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$76.48
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$15.93
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$43.35
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$9.52
Rate for Payer: PHP Commercial	$43.35
Rate for Payer: PHP Commercial	$15.93
Rate for Payer: PHP Commercial	$9.52
Rate for Payer: PHP Commercial	$76.48
Rate for Payer: Priority Health Cigna Priority Health	$62.99
Rate for Payer: Priority Health Cigna Priority Health	$13.12
Rate for Payer: Priority Health Cigna Priority Health	$35.70
Rate for Payer: Priority Health Cigna Priority Health	$7.84
Rate for Payer: Priority Health SBD	$11.81
Rate for Payer: Priority Health SBD	$32.13
Rate for Payer: Priority Health SBD	$7.06
Rate for Payer: Priority Health SBD	$56.69

TOBRAMYCIN-DEXAMETHASONE 0.3 %-0.1 % EYE OINTMENT

Facility

$857.19

Service Code	NDC 0078-0876-01
Hospital Charge Code	11566
Hospital Revenue Code	637
Min. Negotiated Rate	$540.03
Max. Negotiated Rate	$771.47
Rate for Payer: Aetna Commercial	$728.61
Rate for Payer: Aetna New Business (MI Preferred)	$557.17
Rate for Payer: Cash Price	$685.75
Rate for Payer: Cofinity Commercial	$600.03
Rate for Payer: Cofinity Commercial	$737.18
Rate for Payer: Healthscope Commercial	$771.47
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$728.61
Rate for Payer: PHP Commercial	$728.61
Rate for Payer: Priority Health Cigna Priority Health	$600.03
Rate for Payer: Priority Health SBD	$540.03

TOBRAMYCIN-DEXAMETHASONE 0.3 %-0.1 % EYE OINTMENT

Facility

$736.40

Service Code	NDC 0065-0648-35
Hospital Charge Code	11566
Hospital Revenue Code	637
Min. Negotiated Rate	$463.93
Max. Negotiated Rate	$662.76
Rate for Payer: Aetna Commercial	$625.94
Rate for Payer: Aetna New Business (MI Preferred)	$478.66
Rate for Payer: Cash Price	$589.12
Rate for Payer: Cofinity Commercial	$515.48
Rate for Payer: Cofinity Commercial	$633.30
Rate for Payer: Healthscope Commercial	$662.76
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$625.94
Rate for Payer: PHP Commercial	$625.94
Rate for Payer: Priority Health Cigna Priority Health	$515.48
Rate for Payer: Priority Health SBD	$463.93

TOCILIZUMAB 200 MG/10 ML (20 MG/ML) INTRAVENOUS SOLUTION

Facility

$3,597.06

Service Code	HCPCS J3262
Hospital Charge Code	119445
Hospital Revenue Code	636
Min. Negotiated Rate	$2,266.15
Max. Negotiated Rate	$3,237.35
Rate for Payer: Aetna Commercial	$3,057.50
Rate for Payer: Aetna New Business (MI Preferred)	$2,338.09
Rate for Payer: Cash Price	$2,877.65
Rate for Payer: Cofinity Commercial	$2,517.94
Rate for Payer: Cofinity Commercial	$3,093.47
Rate for Payer: Healthscope Commercial	$3,237.35
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3,057.50
Rate for Payer: PHP Commercial	$3,057.50
Rate for Payer: Priority Health Cigna Priority Health	$2,517.94
Rate for Payer: Priority Health SBD	$2,266.15

TOCILIZUMAB 400 MG/20 ML (20 MG/ML) INTRAVENOUS SOLUTION

Facility

$5,845.22

Service Code	HCPCS J3262
Hospital Charge Code	119446
Hospital Revenue Code	636
Min. Negotiated Rate	$3,682.49
Max. Negotiated Rate	$5,260.70
Rate for Payer: Cash Price	$4,676.18
Rate for Payer: Cofinity Commercial	$4,091.65
Rate for Payer: Cofinity Commercial	$5,026.89
Rate for Payer: Healthscope Commercial	$5,260.70
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$4,968.44
Rate for Payer: PHP Commercial	$4,968.44
Rate for Payer: Priority Health Cigna Priority Health	$4,091.65
Rate for Payer: Priority Health SBD	$3,682.49
Rate for Payer: Aetna Commercial	$4,968.44
Rate for Payer: Aetna New Business (MI Preferred)	$3,799.39

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

Facility

$1,532.36

Service Code	HCPCS J3262
Hospital Charge Code	99452
Hospital Revenue Code	636
Min. Negotiated Rate	$965.39
Max. Negotiated Rate	$1,379.12
Rate for Payer: Aetna Commercial	$1,302.51
Rate for Payer: Aetna New Business (MI Preferred)	$996.03
Rate for Payer: Cash Price	$1,225.89
Rate for Payer: Cofinity Commercial	$1,072.65
Rate for Payer: Cofinity Commercial	$1,317.83
Rate for Payer: Healthscope Commercial	$1,379.12
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,302.51
Rate for Payer: PHP Commercial	$1,302.51
Rate for Payer: Priority Health Cigna Priority Health	$1,072.65
Rate for Payer: Priority Health SBD	$965.39

TOLVAPTAN 15 MG TABLET

Facility

$19,151.06

Service Code	NDC 59148-020-50
Hospital Charge Code	97893
Hospital Revenue Code	637
Min. Negotiated Rate	$12,065.17
Max. Negotiated Rate	$17,235.95
Rate for Payer: Aetna Commercial	$16,278.40
Rate for Payer: Aetna New Business (MI Preferred)	$12,448.19
Rate for Payer: Cash Price	$15,320.85
Rate for Payer: Cofinity Commercial	$13,405.74
Rate for Payer: Cofinity Commercial	$16,469.91
Rate for Payer: Healthscope Commercial	$17,235.95
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$16,278.40
Rate for Payer: PHP Commercial	$16,278.40
Rate for Payer: Priority Health Cigna Priority Health	$13,405.74
Rate for Payer: Priority Health SBD	$12,065.17

Know your out-of-pocket cost for care.

All Charges