Copper Queen Community Hospital

All Charges

Charge

Type

Setting

Price

niCARdipine 20 mg/200 mL-NaCl Premix IV Sol[CQCH]

Facility

$0.43

Service Code	NDC 10122031310
Hospital Charge Code	124700531
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$0.39
Rate for Payer: Aetna of AZ Commercial	$0.39
Rate for Payer: Bisbee Police All Plans	$0.11
Rate for Payer: Cash Price	$0.35
Rate for Payer: Self Pay Self Pay	$0.34

niCARdipine 20 mg/200 mL-NaCl Premix IV Sol[CQCH]

Facility

$0.43

Service Code	NDC 10122031310
Hospital Charge Code	124700531
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$0.39
Rate for Payer: Aetna of AZ Commercial	$0.39
Rate for Payer: Aetna of AZ Medicare	$0.12
Rate for Payer: Allwell Medicare	$0.07
Rate for Payer: Amerigroup Medicare	$0.07
Rate for Payer: APIPA Medicare/Medicaid	$0.16
Rate for Payer: AZCH Complete Medicare	$0.07
Rate for Payer: Banner UC Health Medicare	$0.07
Rate for Payer: Bisbee Police All Plans	$0.11
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$0.29
Rate for Payer: Cash Price	$0.35
Rate for Payer: Cigna of AZ Commercial	$0.28
Rate for Payer: Copperpoint Commercial	$0.11
Rate for Payer: Health Net of AZ Commercial	$0.26
Rate for Payer: Health Net of AZ Medicare	$0.12
Rate for Payer: Humana of AZ Medicare	$0.07
Rate for Payer: Self Pay Self Pay	$0.34
Rate for Payer: TriWest Medicare	$0.07
Rate for Payer: UnitedHealth Group of AZ Commercial	$0.25
Rate for Payer: UnitedHealth Group of AZ Medicare	$0.08

nicotine 21 mg patch [CQCH]

Facility

$1.78

Service Code	NDC 67512614
Hospital Charge Code	105933829
Hospital Revenue Code	251
Min. Negotiated Rate	$0.28
Max. Negotiated Rate	$1.60
Rate for Payer: Aetna of AZ Commercial	$1.60
Rate for Payer: Aetna of AZ Medicare	$0.50
Rate for Payer: Allwell Medicare	$0.28
Rate for Payer: Amerigroup Medicare	$0.28
Rate for Payer: APIPA Medicare/Medicaid	$0.66
Rate for Payer: AZCH Complete Medicare	$0.28
Rate for Payer: Banner UC Health Medicare	$0.28
Rate for Payer: Bisbee Police All Plans	$0.46
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1.21
Rate for Payer: Cash Price	$1.42
Rate for Payer: Cigna of AZ Commercial	$1.16
Rate for Payer: Copperpoint Commercial	$0.44
Rate for Payer: Health Net of AZ Commercial	$1.07
Rate for Payer: Health Net of AZ Medicare	$0.50
Rate for Payer: Humana of AZ Medicare	$0.28
Rate for Payer: Self Pay Self Pay	$1.42
Rate for Payer: TriWest Medicare	$0.28
Rate for Payer: UnitedHealth Group of AZ Commercial	$1.04
Rate for Payer: UnitedHealth Group of AZ Medicare	$0.32

nicotine 21 mg patch [CQCH]

Facility

$1.78

Service Code	NDC 67512614
Hospital Charge Code	105933829
Hospital Revenue Code	251
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$1.60
Rate for Payer: Aetna of AZ Commercial	$1.60
Rate for Payer: Bisbee Police All Plans	$0.46
Rate for Payer: Cash Price	$1.42
Rate for Payer: Self Pay Self Pay	$1.42

nicotine 2mg Lozenge[CQCH]

Facility

$0.33

Service Code	NDC 135050802
Hospital Charge Code	122695398
Hospital Revenue Code	251
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$0.30
Rate for Payer: Aetna of AZ Commercial	$0.30
Rate for Payer: Aetna of AZ Medicare	$0.09
Rate for Payer: Allwell Medicare	$0.05
Rate for Payer: Amerigroup Medicare	$0.05
Rate for Payer: APIPA Medicare/Medicaid	$0.12
Rate for Payer: AZCH Complete Medicare	$0.05
Rate for Payer: Banner UC Health Medicare	$0.05
Rate for Payer: Bisbee Police All Plans	$0.09
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$0.22
Rate for Payer: Cash Price	$0.26
Rate for Payer: Cigna of AZ Commercial	$0.21
Rate for Payer: Copperpoint Commercial	$0.08
Rate for Payer: Health Net of AZ Commercial	$0.20
Rate for Payer: Health Net of AZ Medicare	$0.09
Rate for Payer: Humana of AZ Medicare	$0.05
Rate for Payer: Self Pay Self Pay	$0.26
Rate for Payer: TriWest Medicare	$0.05
Rate for Payer: UnitedHealth Group of AZ Commercial	$0.19
Rate for Payer: UnitedHealth Group of AZ Medicare	$0.06

nicotine 2mg Lozenge[CQCH]

Facility

$0.33

Service Code	NDC 135050802
Hospital Charge Code	122695398
Hospital Revenue Code	251
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$0.30
Rate for Payer: Aetna of AZ Commercial	$0.30
Rate for Payer: Bisbee Police All Plans	$0.09
Rate for Payer: Cash Price	$0.26
Rate for Payer: Self Pay Self Pay	$0.26

nicotine 7 mg patch [CQCH]

Facility

$1.76

Service Code	NDC 49348014646
Hospital Charge Code	108075360
Hospital Revenue Code	251
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$1.58
Rate for Payer: Aetna of AZ Commercial	$1.58
Rate for Payer: Bisbee Police All Plans	$0.46
Rate for Payer: Cash Price	$1.41
Rate for Payer: Self Pay Self Pay	$1.41

nicotine 7 mg patch [CQCH]

Facility

$1.76

Service Code	NDC 49348014646
Hospital Charge Code	108075360
Hospital Revenue Code	251
Min. Negotiated Rate	$0.28
Max. Negotiated Rate	$1.58
Rate for Payer: Aetna of AZ Commercial	$1.58
Rate for Payer: Aetna of AZ Medicare	$0.49
Rate for Payer: Allwell Medicare	$0.28
Rate for Payer: Amerigroup Medicare	$0.28
Rate for Payer: APIPA Medicare/Medicaid	$0.66
Rate for Payer: AZCH Complete Medicare	$0.28
Rate for Payer: Banner UC Health Medicare	$0.28
Rate for Payer: Bisbee Police All Plans	$0.46
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1.20
Rate for Payer: Cash Price	$1.41
Rate for Payer: Cigna of AZ Commercial	$1.14
Rate for Payer: Copperpoint Commercial	$0.44
Rate for Payer: Health Net of AZ Commercial	$1.06
Rate for Payer: Health Net of AZ Medicare	$0.49
Rate for Payer: Humana of AZ Medicare	$0.28
Rate for Payer: Self Pay Self Pay	$1.41
Rate for Payer: TriWest Medicare	$0.28
Rate for Payer: UnitedHealth Group of AZ Commercial	$1.03
Rate for Payer: UnitedHealth Group of AZ Medicare	$0.32

nitrofurantoin macrocrystals 100 mg Cap UD[CQCH]

Facility

$2.06

Service Code	NDC 60687048301
Hospital Charge Code	181685120
Hospital Revenue Code	251
Min. Negotiated Rate	$0.54
Max. Negotiated Rate	$1.85
Rate for Payer: Aetna of AZ Commercial	$1.85
Rate for Payer: Bisbee Police All Plans	$0.54
Rate for Payer: Cash Price	$1.65
Rate for Payer: Self Pay Self Pay	$1.65

nitrofurantoin macrocrystals 100 mg Cap UD[CQCH]

Facility

$2.06

Service Code	NDC 60687048301
Hospital Charge Code	181685120
Hospital Revenue Code	251
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$1.85
Rate for Payer: Aetna of AZ Commercial	$1.85
Rate for Payer: Aetna of AZ Medicare	$0.58
Rate for Payer: Allwell Medicare	$0.33
Rate for Payer: Amerigroup Medicare	$0.33
Rate for Payer: APIPA Medicare/Medicaid	$0.77
Rate for Payer: AZCH Complete Medicare	$0.33
Rate for Payer: Banner UC Health Medicare	$0.33
Rate for Payer: Bisbee Police All Plans	$0.54
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1.40
Rate for Payer: Cash Price	$1.65
Rate for Payer: Cigna of AZ Commercial	$1.34
Rate for Payer: Copperpoint Commercial	$0.51
Rate for Payer: Health Net of AZ Commercial	$1.24
Rate for Payer: Health Net of AZ Medicare	$0.58
Rate for Payer: Humana of AZ Medicare	$0.33
Rate for Payer: Self Pay Self Pay	$1.65
Rate for Payer: TriWest Medicare	$0.33
Rate for Payer: UnitedHealth Group of AZ Commercial	$1.20
Rate for Payer: UnitedHealth Group of AZ Medicare	$0.37

nitroglycerin 0.2 mg/hr patch [CQCH]

Facility

$0.46

Service Code	NDC 47781029703
Hospital Charge Code	105934020
Hospital Revenue Code	251
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$0.41
Rate for Payer: Aetna of AZ Commercial	$0.41
Rate for Payer: Aetna of AZ Medicare	$0.13
Rate for Payer: Allwell Medicare	$0.07
Rate for Payer: Amerigroup Medicare	$0.07
Rate for Payer: APIPA Medicare/Medicaid	$0.17
Rate for Payer: AZCH Complete Medicare	$0.07
Rate for Payer: Banner UC Health Medicare	$0.07
Rate for Payer: Bisbee Police All Plans	$0.12
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$0.31
Rate for Payer: Cash Price	$0.37
Rate for Payer: Cigna of AZ Commercial	$0.30
Rate for Payer: Copperpoint Commercial	$0.11
Rate for Payer: Health Net of AZ Commercial	$0.28
Rate for Payer: Health Net of AZ Medicare	$0.13
Rate for Payer: Humana of AZ Medicare	$0.07
Rate for Payer: Self Pay Self Pay	$0.37
Rate for Payer: TriWest Medicare	$0.07
Rate for Payer: UnitedHealth Group of AZ Commercial	$0.27
Rate for Payer: UnitedHealth Group of AZ Medicare	$0.08

nitroglycerin 0.2 mg/hr patch [CQCH]

Facility

$0.46

Service Code	NDC 47781029703
Hospital Charge Code	105934020
Hospital Revenue Code	251
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$0.41
Rate for Payer: Aetna of AZ Commercial	$0.41
Rate for Payer: Bisbee Police All Plans	$0.12
Rate for Payer: Cash Price	$0.37
Rate for Payer: Self Pay Self Pay	$0.37

nitroglycerin 0.4 mg/hr Patch [CQCH]

Facility

$0.49

Service Code	NDC 47781029803
Hospital Charge Code	105933959
Hospital Revenue Code	251
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$0.44
Rate for Payer: Aetna of AZ Commercial	$0.44
Rate for Payer: Bisbee Police All Plans	$0.13
Rate for Payer: Cash Price	$0.39
Rate for Payer: Self Pay Self Pay	$0.39

nitroglycerin 0.4 mg/hr Patch [CQCH]

Facility

$0.49

Service Code	NDC 47781029803
Hospital Charge Code	105933959
Hospital Revenue Code	251
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$0.44
Rate for Payer: Aetna of AZ Commercial	$0.44
Rate for Payer: Aetna of AZ Medicare	$0.14
Rate for Payer: Allwell Medicare	$0.08
Rate for Payer: Amerigroup Medicare	$0.08
Rate for Payer: APIPA Medicare/Medicaid	$0.18
Rate for Payer: AZCH Complete Medicare	$0.08
Rate for Payer: Banner UC Health Medicare	$0.08
Rate for Payer: Bisbee Police All Plans	$0.13
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$0.33
Rate for Payer: Cash Price	$0.39
Rate for Payer: Cigna of AZ Commercial	$0.32
Rate for Payer: Copperpoint Commercial	$0.12
Rate for Payer: Health Net of AZ Commercial	$0.29
Rate for Payer: Health Net of AZ Medicare	$0.14
Rate for Payer: Humana of AZ Medicare	$0.08
Rate for Payer: Self Pay Self Pay	$0.39
Rate for Payer: TriWest Medicare	$0.08
Rate for Payer: UnitedHealth Group of AZ Commercial	$0.29
Rate for Payer: UnitedHealth Group of AZ Medicare	$0.09

nitroglycerin 0.4 mg sublingual Tab [CQCH]

Facility

$0.57

Service Code	NDC 68462063945
Hospital Charge Code	105934081
Hospital Revenue Code	251
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.51
Rate for Payer: Aetna of AZ Commercial	$0.51
Rate for Payer: Bisbee Police All Plans	$0.15
Rate for Payer: Cash Price	$0.45
Rate for Payer: Self Pay Self Pay	$0.46

nitroglycerin 0.4 mg sublingual Tab [CQCH]

Facility

$0.57

Service Code	NDC 68462063945
Hospital Charge Code	105934081
Hospital Revenue Code	251
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$0.51
Rate for Payer: Aetna of AZ Commercial	$0.51
Rate for Payer: Aetna of AZ Medicare	$0.16
Rate for Payer: Allwell Medicare	$0.09
Rate for Payer: Amerigroup Medicare	$0.09
Rate for Payer: APIPA Medicare/Medicaid	$0.21
Rate for Payer: AZCH Complete Medicare	$0.09
Rate for Payer: Banner UC Health Medicare	$0.09
Rate for Payer: Bisbee Police All Plans	$0.15
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$0.39
Rate for Payer: Cash Price	$0.45
Rate for Payer: Cigna of AZ Commercial	$0.37
Rate for Payer: Copperpoint Commercial	$0.14
Rate for Payer: Health Net of AZ Commercial	$0.34
Rate for Payer: Health Net of AZ Medicare	$0.16
Rate for Payer: Humana of AZ Medicare	$0.09
Rate for Payer: Self Pay Self Pay	$0.46
Rate for Payer: TriWest Medicare	$0.09
Rate for Payer: UnitedHealth Group of AZ Commercial	$0.33
Rate for Payer: UnitedHealth Group of AZ Medicare	$0.10

nitroglycerin 200 mcg/ mL-250ml IV bottle [CQCH]

Facility

$0.08

Service Code	NDC 338104902
Hospital Charge Code	105934213
Hospital Revenue Code	251
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.07
Rate for Payer: Aetna of AZ Commercial	$0.07
Rate for Payer: Bisbee Police All Plans	$0.02
Rate for Payer: Cash Price	$0.07
Rate for Payer: Self Pay Self Pay	$0.06

nitroglycerin 200 mcg/ mL-250ml IV bottle [CQCH]

Facility

$0.08

Service Code	NDC 338104902
Hospital Charge Code	105934213
Hospital Revenue Code	251
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.07
Rate for Payer: Aetna of AZ Commercial	$0.07
Rate for Payer: Aetna of AZ Medicare	$0.02
Rate for Payer: Allwell Medicare	$0.01
Rate for Payer: Amerigroup Medicare	$0.01
Rate for Payer: APIPA Medicare/Medicaid	$0.03
Rate for Payer: AZCH Complete Medicare	$0.01
Rate for Payer: Banner UC Health Medicare	$0.01
Rate for Payer: Bisbee Police All Plans	$0.02
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$0.05
Rate for Payer: Cash Price	$0.07
Rate for Payer: Cigna of AZ Commercial	$0.05
Rate for Payer: Copperpoint Commercial	$0.02
Rate for Payer: Health Net of AZ Commercial	$0.05
Rate for Payer: Health Net of AZ Medicare	$0.02
Rate for Payer: Humana of AZ Medicare	$0.01
Rate for Payer: Self Pay Self Pay	$0.06
Rate for Payer: TriWest Medicare	$0.01
Rate for Payer: UnitedHealth Group of AZ Commercial	$0.05
Rate for Payer: UnitedHealth Group of AZ Medicare	$0.01

nitroglycerin 2% Top Oint [CQCH]

Facility

$1.98

Service Code	NDC 281032608
Hospital Charge Code	105934148
Hospital Revenue Code	251
Min. Negotiated Rate	$0.51
Max. Negotiated Rate	$1.78
Rate for Payer: Aetna of AZ Commercial	$1.78
Rate for Payer: Bisbee Police All Plans	$0.51
Rate for Payer: Cash Price	$1.58
Rate for Payer: Self Pay Self Pay	$1.58

nitroglycerin 2% Top Oint [CQCH]

Facility

$1.98

Service Code	NDC 281032608
Hospital Charge Code	105934148
Hospital Revenue Code	251
Min. Negotiated Rate	$0.32
Max. Negotiated Rate	$1.78
Rate for Payer: Aetna of AZ Commercial	$1.78
Rate for Payer: Aetna of AZ Medicare	$0.55
Rate for Payer: Allwell Medicare	$0.32
Rate for Payer: Amerigroup Medicare	$0.32
Rate for Payer: APIPA Medicare/Medicaid	$0.74
Rate for Payer: AZCH Complete Medicare	$0.32
Rate for Payer: Banner UC Health Medicare	$0.32
Rate for Payer: Bisbee Police All Plans	$0.51
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1.35
Rate for Payer: Cash Price	$1.58
Rate for Payer: Cigna of AZ Commercial	$1.29
Rate for Payer: Copperpoint Commercial	$0.49
Rate for Payer: Health Net of AZ Commercial	$1.19
Rate for Payer: Health Net of AZ Medicare	$0.55
Rate for Payer: Humana of AZ Medicare	$0.32
Rate for Payer: Self Pay Self Pay	$1.58
Rate for Payer: TriWest Medicare	$0.32
Rate for Payer: UnitedHealth Group of AZ Commercial	$1.15
Rate for Payer: UnitedHealth Group of AZ Medicare	$0.36

nitroprusside 50 mg/ 2 mL IV Sol [CQCH]

Facility

$18.60

Service Code	NDC 409302401
Hospital Charge Code	105934276
Hospital Revenue Code	251
Min. Negotiated Rate	$2.98
Max. Negotiated Rate	$16.74
Rate for Payer: Aetna of AZ Commercial	$16.74
Rate for Payer: Aetna of AZ Medicare	$5.21
Rate for Payer: Allwell Medicare	$2.98
Rate for Payer: Amerigroup Medicare	$2.98
Rate for Payer: APIPA Medicare/Medicaid	$6.95
Rate for Payer: AZCH Complete Medicare	$2.98
Rate for Payer: Banner UC Health Medicare	$2.98
Rate for Payer: Bisbee Police All Plans	$4.84
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$12.65
Rate for Payer: Cash Price	$14.88
Rate for Payer: Cigna of AZ Commercial	$12.09
Rate for Payer: Copperpoint Commercial	$4.60
Rate for Payer: Health Net of AZ Commercial	$11.16
Rate for Payer: Health Net of AZ Medicare	$5.21
Rate for Payer: Humana of AZ Medicare	$2.98
Rate for Payer: Self Pay Self Pay	$14.88
Rate for Payer: TriWest Medicare	$2.98
Rate for Payer: UnitedHealth Group of AZ Commercial	$10.84
Rate for Payer: UnitedHealth Group of AZ Medicare	$3.35

nitroprusside 50 mg/ 2 mL IV Sol [CQCH]

Facility

$18.60

Service Code	NDC 409302401
Hospital Charge Code	105934276
Hospital Revenue Code	251
Min. Negotiated Rate	$4.84
Max. Negotiated Rate	$16.74
Rate for Payer: Aetna of AZ Commercial	$16.74
Rate for Payer: Bisbee Police All Plans	$4.84
Rate for Payer: Cash Price	$14.88
Rate for Payer: Self Pay Self Pay	$14.88

NMR LipoProfile LC

Facility

$217.00

Service Code	CPT 80061
Hospital Charge Code	2269488
Hospital Revenue Code	301
Min. Negotiated Rate	$34.72
Max. Negotiated Rate	$195.30
Rate for Payer: Aetna of AZ Commercial	$195.30
Rate for Payer: Aetna of AZ Medicare	$60.76
Rate for Payer: Allwell Medicare	$34.72
Rate for Payer: Amerigroup Medicare	$34.72
Rate for Payer: APIPA Medicare/Medicaid	$81.05
Rate for Payer: AZCH Complete Medicare	$34.72
Rate for Payer: Banner UC Health Medicare	$34.72
Rate for Payer: Bisbee Police All Plans	$56.42
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$147.56
Rate for Payer: Cash Price	$173.60
Rate for Payer: Cigna of AZ Commercial	$141.05
Rate for Payer: Copperpoint Commercial	$53.71
Rate for Payer: Health Net of AZ Commercial	$130.20
Rate for Payer: Health Net of AZ Medicare	$60.76
Rate for Payer: Humana of AZ Medicare	$34.72
Rate for Payer: Self Pay Self Pay	$173.60
Rate for Payer: TriWest Medicare	$34.72
Rate for Payer: UnitedHealth Group of AZ Commercial	$126.51
Rate for Payer: UnitedHealth Group of AZ Medicare	$39.06

NMR LipoProfile LC

Facility

$217.00

Service Code	CPT 80061
Hospital Charge Code	2269488
Hospital Revenue Code	301
Min. Negotiated Rate	$56.42
Max. Negotiated Rate	$195.30
Rate for Payer: Aetna of AZ Commercial	$195.30
Rate for Payer: Bisbee Police All Plans	$56.42
Rate for Payer: Cash Price	$173.60
Rate for Payer: Self Pay Self Pay	$173.60

NOMOLINE HH AIRWAY ADAPTER INF NEO

Facility

$81.51

Hospital Charge Code	27816998
Hospital Revenue Code	270
Min. Negotiated Rate	$13.04
Max. Negotiated Rate	$73.36
Rate for Payer: Aetna of AZ Commercial	$73.36
Rate for Payer: Aetna of AZ Medicare	$22.82
Rate for Payer: Allwell Medicare	$13.04
Rate for Payer: Amerigroup Medicare	$13.04
Rate for Payer: APIPA Medicare/Medicaid	$30.44
Rate for Payer: AZCH Complete Medicare	$13.04
Rate for Payer: Banner UC Health Medicare	$13.04
Rate for Payer: Bisbee Police All Plans	$21.19
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$55.43
Rate for Payer: Cash Price	$65.21
Rate for Payer: Cigna of AZ Commercial	$57.06
Rate for Payer: Copperpoint Commercial	$20.17
Rate for Payer: Health Net of AZ Commercial	$48.91
Rate for Payer: Health Net of AZ Medicare	$22.82
Rate for Payer: Humana of AZ Medicare	$13.04
Rate for Payer: Self Pay Self Pay	$65.21
Rate for Payer: TriWest Medicare	$13.04
Rate for Payer: UnitedHealth Group of AZ Commercial	$47.52
Rate for Payer: UnitedHealth Group of AZ Medicare	$14.67

Know your out-of-pocket cost for care.

All Charges