White Rock Medical Center

All Charges

Charge

Type

Setting

Price

Behavioral, Qualitative Analysis Units

Facility

$521.00

Service Code	CPT 92524 GN
Hospital Charge Code	4450056
Hospital Revenue Code	444
Min. Negotiated Rate	$70.86
Max. Negotiated Rate	$338.65
Rate for Payer: Aetna Commercial	$221.00
Rate for Payer: Amerigroup CHIP/Medicaid	$80.00
Rate for Payer: BCBS of TX Blue Advantage	$157.40
Rate for Payer: BCBS of TX Blue Essentials	$188.16
Rate for Payer: BCBS of TX PPO	$209.87
Rate for Payer: Cash Price	$458.48
Rate for Payer: Cash Price	$458.48
Rate for Payer: Cash Price	$458.48
Rate for Payer: Cash Price	$458.48
Rate for Payer: Cigna Commercial	$200.00
Rate for Payer: Multiplan Auto	$338.65
Rate for Payer: Multiplan Commercial	$338.65
Rate for Payer: Multiplan Workers Comp	$338.65
Rate for Payer: Scott and White EPO/PPO	$180.00
Rate for Payer: Superior Health Plan EPO	$70.86

Behavioral, Qualitative Analysis Units BCE

Facility

$521.00

Service Code	CPT 92524 GN
Hospital Charge Code	4450056
Hospital Revenue Code	444
Rate for Payer: Cash Price	$458.48

Behavioral, Qualitative Analysis Units BCE

Facility

$521.00

Service Code	CPT 92524 GN
Hospital Charge Code	4450056
Hospital Revenue Code	444
Min. Negotiated Rate	$70.86
Max. Negotiated Rate	$338.65
Rate for Payer: Aetna Commercial	$221.00
Rate for Payer: Amerigroup CHIP/Medicaid	$80.00
Rate for Payer: BCBS of TX Blue Advantage	$157.40
Rate for Payer: BCBS of TX Blue Essentials	$188.16
Rate for Payer: BCBS of TX PPO	$209.87
Rate for Payer: Cash Price	$458.48
Rate for Payer: Cash Price	$458.48
Rate for Payer: Cash Price	$458.48
Rate for Payer: Cash Price	$458.48
Rate for Payer: Cigna Commercial	$200.00
Rate for Payer: Multiplan Auto	$338.65
Rate for Payer: Multiplan Commercial	$338.65
Rate for Payer: Multiplan Workers Comp	$338.65
Rate for Payer: Scott and White EPO/PPO	$180.00
Rate for Payer: Superior Health Plan EPO	$70.86

BELT GAIT -- DHF

Facility

$49.53

Hospital Charge Code	80313448
Hospital Revenue Code	270
Rate for Payer: Cash Price	$43.59

BELT GAIT -- DHF

Facility

$49.53

Hospital Charge Code	80313448
Hospital Revenue Code	270
Min. Negotiated Rate	$4.46
Max. Negotiated Rate	$32.19
Rate for Payer: Aetna Commercial	$27.24
Rate for Payer: Amerigroup CHIP/Medicaid	$4.46
Rate for Payer: BCBS of TX Blue Advantage	$14.86
Rate for Payer: BCBS of TX Blue Essentials	$17.83
Rate for Payer: BCBS of TX PPO	$19.81
Rate for Payer: Cash Price	$43.59
Rate for Payer: Multiplan Auto	$32.19
Rate for Payer: Multiplan Commercial	$32.19
Rate for Payer: Multiplan Workers Comp	$32.19
Rate for Payer: Scott and White EPO/PPO	$24.76
Rate for Payer: Superior Health Plan EPO	$6.74

BENIGN PROSTATIC HYPERTROPHY WITH MCC

Facility

$23,577.10

Service Code	MSDRG 725
Min. Negotiated Rate	$10,857.88
Max. Negotiated Rate	$23,577.10
Rate for Payer: Aetna Commercial	$13,960.12
Rate for Payer: Aetna Medicare	$17,564.86
Rate for Payer: Amerigroup Dual Medicare/Medicaid	$11,709.91
Rate for Payer: Amerigroup Medicare	$11,709.91
Rate for Payer: BCBS of TX Blue Advantage	$11,373.50
Rate for Payer: BCBS of TX Blue Essentials	$12,530.36
Rate for Payer: BCBS of TX Medicare	$11,709.91
Rate for Payer: BCBS of TX PPO	$13,923.16
Rate for Payer: Cigna Commercial	$15,982.79
Rate for Payer: Cigna Medicare	$11,709.91
Rate for Payer: Employer Direct Commercial	$11,709.91
Rate for Payer: Humana Medicare/TRICARE	$11,709.91
Rate for Payer: Molina Dual Medicare/Medicaid	$11,709.91
Rate for Payer: Molina Medicare	$11,709.91
Rate for Payer: Multiplan Auto	$23,577.10
Rate for Payer: Multiplan Commercial	$23,577.10
Rate for Payer: Multiplan Workers Comp	$23,577.10
Rate for Payer: Scott and White EPO/PPO	$10,857.88
Rate for Payer: Scott and White Medicare	$11,709.91
Rate for Payer: Superior Health Plan EPO	$11,709.91
Rate for Payer: Superior Health Plan Medicare	$11,709.91
Rate for Payer: Universal American Dual Medicare/Medicaid	$11,709.91
Rate for Payer: Universal American Medicare	$11,709.91
Rate for Payer: Wellcare Medicare	$11,709.91
Rate for Payer: Wellmed Medicare	$11,709.91

BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC

Facility

$13,887.10

Service Code	MSDRG 726
Min. Negotiated Rate	$6,220.38
Max. Negotiated Rate	$13,887.10
Rate for Payer: Aetna Commercial	$8,222.62
Rate for Payer: Aetna Medicare	$12,105.78
Rate for Payer: Amerigroup Dual Medicare/Medicaid	$8,070.52
Rate for Payer: Amerigroup Medicare	$8,070.52
Rate for Payer: BCBS of TX Blue Advantage	$6,220.38
Rate for Payer: BCBS of TX Blue Essentials	$7,888.88
Rate for Payer: BCBS of TX Medicare	$8,070.52
Rate for Payer: BCBS of TX PPO	$8,765.76
Rate for Payer: Cigna Commercial	$9,413.99
Rate for Payer: Cigna Medicare	$8,070.52
Rate for Payer: Employer Direct Commercial	$8,070.52
Rate for Payer: Humana Medicare/TRICARE	$8,070.52
Rate for Payer: Molina Dual Medicare/Medicaid	$8,070.52
Rate for Payer: Molina Medicare	$8,070.52
Rate for Payer: Multiplan Auto	$13,887.10
Rate for Payer: Multiplan Commercial	$13,887.10
Rate for Payer: Multiplan Workers Comp	$13,887.10
Rate for Payer: Scott and White EPO/PPO	$6,395.38
Rate for Payer: Scott and White Medicare	$8,070.52
Rate for Payer: Superior Health Plan EPO	$8,070.52
Rate for Payer: Superior Health Plan Medicare	$8,070.52
Rate for Payer: Universal American Dual Medicare/Medicaid	$8,070.52
Rate for Payer: Universal American Medicare	$8,070.52
Rate for Payer: Wellcare Medicare	$8,070.52
Rate for Payer: Wellmed Medicare	$8,070.52

benzocaine-menthol 15 mg-3.6 mg Lozenge

Facility

$7.65

Service Code	HCPCS J3490
Hospital Charge Code	77401187
Hospital Revenue Code	250
Rate for Payer: Cash Price	$5.20

benzocaine-menthol 15 mg-3.6 mg Lozenge

Facility

$7.65

Service Code	HCPCS J3490
Hospital Charge Code	77401187
Hospital Revenue Code	250
Min. Negotiated Rate	$0.69
Max. Negotiated Rate	$4.97
Rate for Payer: Amerigroup CHIP/Medicaid	$0.69
Rate for Payer: BCBS of TX Blue Advantage	$2.30
Rate for Payer: BCBS of TX Blue Essentials	$2.75
Rate for Payer: BCBS of TX PPO	$3.06
Rate for Payer: Cash Price	$5.20
Rate for Payer: Multiplan Auto	$4.97
Rate for Payer: Multiplan Commercial	$4.97
Rate for Payer: Multiplan Workers Comp	$4.97
Rate for Payer: Scott and White EPO/PPO	$3.82
Rate for Payer: Superior Health Plan EPO	$1.04

benzocaine-menthol topical 20%-0.5% Topical Spray

Facility

$8.00

Service Code	HCPCS J3490
Hospital Charge Code	78871664
Hospital Revenue Code	250
Rate for Payer: Cash Price	$5.44

benzocaine-menthol topical 20%-0.5% Topical Spray

Facility

$8.00

Service Code	HCPCS J3490
Hospital Charge Code	78871664
Hospital Revenue Code	250
Min. Negotiated Rate	$0.72
Max. Negotiated Rate	$5.20
Rate for Payer: Amerigroup CHIP/Medicaid	$0.72
Rate for Payer: BCBS of TX Blue Advantage	$2.40
Rate for Payer: BCBS of TX Blue Essentials	$2.88
Rate for Payer: BCBS of TX PPO	$3.20
Rate for Payer: Cash Price	$5.44
Rate for Payer: Multiplan Auto	$5.20
Rate for Payer: Multiplan Commercial	$5.20
Rate for Payer: Multiplan Workers Comp	$5.20
Rate for Payer: Scott and White EPO/PPO	$4.00
Rate for Payer: Superior Health Plan EPO	$1.09

Benzodiazepine Screen Urine

Facility

$317.00

Service Code	CPT 80307
Hospital Charge Code	1640117
Hospital Revenue Code	300
Rate for Payer: Cash Price	$278.96

Benzodiazepine Screen Urine

Facility

$317.00

Service Code	CPT 80307
Hospital Charge Code	1640117
Hospital Revenue Code	300
Min. Negotiated Rate	$24.23
Max. Negotiated Rate	$206.05
Rate for Payer: Aetna Commercial	$65.24
Rate for Payer: Aetna Medicare	$93.21
Rate for Payer: Amerigroup CHIP/Medicaid	$24.23
Rate for Payer: Amerigroup Dual Medicare/Medicaid	$62.14
Rate for Payer: Amerigroup Medicare	$62.14
Rate for Payer: BCBS of TX Blue Advantage	$102.53
Rate for Payer: BCBS of TX Blue Essentials	$123.04
Rate for Payer: BCBS of TX Medicare	$62.14
Rate for Payer: BCBS of TX PPO	$137.33
Rate for Payer: Cash Price	$278.96
Rate for Payer: Cash Price	$278.96
Rate for Payer: Cigna Medicaid	$62.14
Rate for Payer: Cigna Medicare	$62.14
Rate for Payer: Employer Direct Commercial	$62.14
Rate for Payer: Humana Medicare/TRICARE	$62.14
Rate for Payer: Molina CHIP/Medicaid	$62.14
Rate for Payer: Molina Dual Medicare/Medicaid	$62.14
Rate for Payer: Molina Medicare	$62.14
Rate for Payer: Multiplan Auto	$206.05
Rate for Payer: Multiplan Commercial	$206.05
Rate for Payer: Multiplan Workers Comp	$206.05
Rate for Payer: Parkland Medicaid	$62.14
Rate for Payer: Scott and White EPO/PPO	$77.68
Rate for Payer: Scott and White Medicare	$62.14
Rate for Payer: Superior Health Plan CHIP/Medicaid	$62.14
Rate for Payer: Superior Health Plan EPO	$62.14
Rate for Payer: Superior Health Plan Medicare	$62.14
Rate for Payer: Universal American Dual Medicare/Medicaid	$62.14
Rate for Payer: Universal American Medicare	$62.14
Rate for Payer: Wellcare Medicare	$62.14
Rate for Payer: Wellmed Medicare	$62.14

benzonatate 100 mg Cap

Facility

$9.52

Service Code	HCPCS J3490
Hospital Charge Code	77402472
Hospital Revenue Code	250
Rate for Payer: Cash Price	$6.47

benzonatate 100 mg Cap

Facility

$9.52

Service Code	HCPCS J3490
Hospital Charge Code	77402472
Hospital Revenue Code	250
Min. Negotiated Rate	$0.86
Max. Negotiated Rate	$6.19
Rate for Payer: Amerigroup CHIP/Medicaid	$0.86
Rate for Payer: BCBS of TX Blue Advantage	$2.86
Rate for Payer: BCBS of TX Blue Essentials	$3.43
Rate for Payer: BCBS of TX PPO	$3.81
Rate for Payer: Cash Price	$6.47
Rate for Payer: Multiplan Auto	$6.19
Rate for Payer: Multiplan Commercial	$6.19
Rate for Payer: Multiplan Workers Comp	$6.19
Rate for Payer: Scott and White EPO/PPO	$4.76
Rate for Payer: Superior Health Plan EPO	$1.29

BETA 2 GLYCOPROTEIN I AB EA

Facility

$65.00

Service Code	CPT 86146
Hospital Charge Code	1708171
Hospital Revenue Code	302
Min. Negotiated Rate	$9.93
Max. Negotiated Rate	$56.24
Rate for Payer: Aetna Commercial	$26.72
Rate for Payer: Aetna Medicare	$38.18
Rate for Payer: Amerigroup CHIP/Medicaid	$9.93
Rate for Payer: Amerigroup Dual Medicare/Medicaid	$25.45
Rate for Payer: Amerigroup Medicare	$25.45
Rate for Payer: BCBS of TX Blue Advantage	$41.99
Rate for Payer: BCBS of TX Blue Essentials	$50.39
Rate for Payer: BCBS of TX Medicare	$25.45
Rate for Payer: BCBS of TX PPO	$56.24
Rate for Payer: Cash Price	$57.20
Rate for Payer: Cash Price	$57.20
Rate for Payer: Cigna Medicaid	$25.45
Rate for Payer: Cigna Medicare	$25.45
Rate for Payer: Employer Direct Commercial	$25.45
Rate for Payer: Humana Medicare/TRICARE	$25.45
Rate for Payer: Molina CHIP/Medicaid	$25.45
Rate for Payer: Molina Dual Medicare/Medicaid	$25.45
Rate for Payer: Molina Medicare	$25.45
Rate for Payer: Multiplan Auto	$42.25
Rate for Payer: Multiplan Commercial	$42.25
Rate for Payer: Multiplan Workers Comp	$42.25
Rate for Payer: Parkland Medicaid	$25.45
Rate for Payer: Scott and White EPO/PPO	$31.81
Rate for Payer: Scott and White Medicare	$25.45
Rate for Payer: Superior Health Plan CHIP/Medicaid	$25.45
Rate for Payer: Superior Health Plan EPO	$25.45
Rate for Payer: Superior Health Plan Medicare	$25.45
Rate for Payer: Universal American Dual Medicare/Medicaid	$25.45
Rate for Payer: Universal American Medicare	$25.45
Rate for Payer: Wellcare Medicare	$25.45
Rate for Payer: Wellmed Medicare	$25.45

Beta-2 Glycoprotein I Ab,G,A,M SO

Facility

$65.00

Service Code	CPT 86146
Hospital Charge Code	1708171
Hospital Revenue Code	302
Rate for Payer: Cash Price	$57.20

Beta-2 Glycoprotein I Ab,G,A,M SO

Facility

$65.00

Service Code	CPT 86146
Hospital Charge Code	1708171
Hospital Revenue Code	302
Min. Negotiated Rate	$9.93
Max. Negotiated Rate	$56.24
Rate for Payer: Aetna Commercial	$26.72
Rate for Payer: Aetna Medicare	$38.18
Rate for Payer: Amerigroup CHIP/Medicaid	$9.93
Rate for Payer: Amerigroup Dual Medicare/Medicaid	$25.45
Rate for Payer: Amerigroup Medicare	$25.45
Rate for Payer: BCBS of TX Blue Advantage	$41.99
Rate for Payer: BCBS of TX Blue Essentials	$50.39
Rate for Payer: BCBS of TX Medicare	$25.45
Rate for Payer: BCBS of TX PPO	$56.24
Rate for Payer: Cash Price	$57.20
Rate for Payer: Cash Price	$57.20
Rate for Payer: Cigna Medicaid	$25.45
Rate for Payer: Cigna Medicare	$25.45
Rate for Payer: Employer Direct Commercial	$25.45
Rate for Payer: Humana Medicare/TRICARE	$25.45
Rate for Payer: Molina CHIP/Medicaid	$25.45
Rate for Payer: Molina Dual Medicare/Medicaid	$25.45
Rate for Payer: Molina Medicare	$25.45
Rate for Payer: Multiplan Auto	$42.25
Rate for Payer: Multiplan Commercial	$42.25
Rate for Payer: Multiplan Workers Comp	$42.25
Rate for Payer: Parkland Medicaid	$25.45
Rate for Payer: Scott and White EPO/PPO	$31.81
Rate for Payer: Scott and White Medicare	$25.45
Rate for Payer: Superior Health Plan CHIP/Medicaid	$25.45
Rate for Payer: Superior Health Plan EPO	$25.45
Rate for Payer: Superior Health Plan Medicare	$25.45
Rate for Payer: Universal American Dual Medicare/Medicaid	$25.45
Rate for Payer: Universal American Medicare	$25.45
Rate for Payer: Wellcare Medicare	$25.45
Rate for Payer: Wellmed Medicare	$25.45

Beta-2 Microglobulin, Serum SO

Facility

$85.00

Service Code	CPT 82232
Hospital Charge Code	1702265
Hospital Revenue Code	301
Rate for Payer: Cash Price	$74.80

Beta-2 Microglobulin, Serum SO

Facility

$85.00

Service Code	CPT 82232
Hospital Charge Code	1702265
Hospital Revenue Code	301
Min. Negotiated Rate	$6.31
Max. Negotiated Rate	$55.25
Rate for Payer: Aetna Commercial	$16.99
Rate for Payer: Aetna Medicare	$24.27
Rate for Payer: Amerigroup CHIP/Medicaid	$6.31
Rate for Payer: Amerigroup Dual Medicare/Medicaid	$16.18
Rate for Payer: Amerigroup Medicare	$16.18
Rate for Payer: BCBS of TX Blue Advantage	$26.70
Rate for Payer: BCBS of TX Blue Essentials	$32.04
Rate for Payer: BCBS of TX Medicare	$16.18
Rate for Payer: BCBS of TX PPO	$35.76
Rate for Payer: Cash Price	$74.80
Rate for Payer: Cash Price	$74.80
Rate for Payer: Cigna Medicaid	$16.18
Rate for Payer: Cigna Medicare	$16.18
Rate for Payer: Employer Direct Commercial	$16.18
Rate for Payer: Humana Medicare/TRICARE	$16.18
Rate for Payer: Molina CHIP/Medicaid	$16.18
Rate for Payer: Molina Dual Medicare/Medicaid	$16.18
Rate for Payer: Molina Medicare	$16.18
Rate for Payer: Multiplan Auto	$55.25
Rate for Payer: Multiplan Commercial	$55.25
Rate for Payer: Multiplan Workers Comp	$55.25
Rate for Payer: Parkland Medicaid	$16.18
Rate for Payer: Scott and White EPO/PPO	$20.22
Rate for Payer: Scott and White Medicare	$16.18
Rate for Payer: Superior Health Plan CHIP/Medicaid	$16.18
Rate for Payer: Superior Health Plan EPO	$16.18
Rate for Payer: Superior Health Plan Medicare	$16.18
Rate for Payer: Universal American Dual Medicare/Medicaid	$16.18
Rate for Payer: Universal American Medicare	$16.18
Rate for Payer: Wellcare Medicare	$16.18
Rate for Payer: Wellmed Medicare	$16.18

Beta Hydroxybutyrate

Facility

$174.00

Service Code	CPT 82010
Hospital Charge Code	1708809
Hospital Revenue Code	301
Min. Negotiated Rate	$3.19
Max. Negotiated Rate	$113.10
Rate for Payer: Aetna Commercial	$8.58
Rate for Payer: Aetna Medicare	$12.26
Rate for Payer: Amerigroup CHIP/Medicaid	$3.19
Rate for Payer: Amerigroup Dual Medicare/Medicaid	$8.17
Rate for Payer: Amerigroup Medicare	$8.17
Rate for Payer: BCBS of TX Blue Advantage	$13.48
Rate for Payer: BCBS of TX Blue Essentials	$16.18
Rate for Payer: BCBS of TX Medicare	$8.17
Rate for Payer: BCBS of TX PPO	$18.06
Rate for Payer: Cash Price	$153.12
Rate for Payer: Cash Price	$153.12
Rate for Payer: Cigna Medicaid	$8.17
Rate for Payer: Cigna Medicare	$8.17
Rate for Payer: Employer Direct Commercial	$8.17
Rate for Payer: Humana Medicare/TRICARE	$8.17
Rate for Payer: Molina CHIP/Medicaid	$8.17
Rate for Payer: Molina Dual Medicare/Medicaid	$8.17
Rate for Payer: Molina Medicare	$8.17
Rate for Payer: Multiplan Auto	$113.10
Rate for Payer: Multiplan Commercial	$113.10
Rate for Payer: Multiplan Workers Comp	$113.10
Rate for Payer: Parkland Medicaid	$8.17
Rate for Payer: Scott and White EPO/PPO	$10.21
Rate for Payer: Scott and White Medicare	$8.17
Rate for Payer: Superior Health Plan CHIP/Medicaid	$8.17
Rate for Payer: Superior Health Plan EPO	$8.17
Rate for Payer: Superior Health Plan Medicare	$8.17
Rate for Payer: Universal American Dual Medicare/Medicaid	$8.17
Rate for Payer: Universal American Medicare	$8.17
Rate for Payer: Wellcare Medicare	$8.17
Rate for Payer: Wellmed Medicare	$8.17

Beta Hydroxybutyrate

Facility

$174.00

Service Code	CPT 82010
Hospital Charge Code	1708809
Hospital Revenue Code	301
Rate for Payer: Cash Price	$153.12

Beta Lactamase

Facility

$114.00

Service Code	CPT 87185
Hospital Charge Code	4177036
Hospital Revenue Code	306
Min. Negotiated Rate	$1.85
Max. Negotiated Rate	$74.10
Rate for Payer: Aetna Commercial	$4.99
Rate for Payer: Aetna Medicare	$7.12
Rate for Payer: Amerigroup CHIP/Medicaid	$1.85
Rate for Payer: Amerigroup Dual Medicare/Medicaid	$4.75
Rate for Payer: Amerigroup Medicare	$4.75
Rate for Payer: BCBS of TX Blue Advantage	$7.84
Rate for Payer: BCBS of TX Blue Essentials	$9.40
Rate for Payer: BCBS of TX Medicare	$4.75
Rate for Payer: BCBS of TX PPO	$10.50
Rate for Payer: Cash Price	$100.32
Rate for Payer: Cash Price	$100.32
Rate for Payer: Cigna Medicaid	$4.75
Rate for Payer: Cigna Medicare	$4.75
Rate for Payer: Employer Direct Commercial	$4.75
Rate for Payer: Humana Medicare/TRICARE	$4.75
Rate for Payer: Molina CHIP/Medicaid	$4.75
Rate for Payer: Molina Dual Medicare/Medicaid	$4.75
Rate for Payer: Molina Medicare	$4.75
Rate for Payer: Multiplan Auto	$74.10
Rate for Payer: Multiplan Commercial	$74.10
Rate for Payer: Multiplan Workers Comp	$74.10
Rate for Payer: Parkland Medicaid	$4.75
Rate for Payer: Scott and White EPO/PPO	$5.94
Rate for Payer: Scott and White Medicare	$4.75
Rate for Payer: Superior Health Plan CHIP/Medicaid	$4.75
Rate for Payer: Superior Health Plan EPO	$4.75
Rate for Payer: Superior Health Plan Medicare	$4.75
Rate for Payer: Universal American Dual Medicare/Medicaid	$4.75
Rate for Payer: Universal American Medicare	$4.75
Rate for Payer: Wellcare Medicare	$4.75
Rate for Payer: Wellmed Medicare	$4.75

Beta Lactamase

Facility

$114.00

Service Code	CPT 87185
Hospital Charge Code	4177036
Hospital Revenue Code	306
Rate for Payer: Cash Price	$100.32

BG AMBU NEO -- DHF

Facility

$67.43

Hospital Charge Code	82015058
Hospital Revenue Code	270
Min. Negotiated Rate	$6.07
Max. Negotiated Rate	$43.83
Rate for Payer: Aetna Commercial	$37.09
Rate for Payer: Amerigroup CHIP/Medicaid	$6.07
Rate for Payer: BCBS of TX Blue Advantage	$20.23
Rate for Payer: BCBS of TX Blue Essentials	$24.27
Rate for Payer: BCBS of TX PPO	$26.97
Rate for Payer: Cash Price	$59.34
Rate for Payer: Multiplan Auto	$43.83
Rate for Payer: Multiplan Commercial	$43.83
Rate for Payer: Multiplan Workers Comp	$43.83
Rate for Payer: Scott and White EPO/PPO	$33.72
Rate for Payer: Superior Health Plan EPO	$9.17

Know your out-of-pocket cost for care.

All Charges