Financial Resources

VISIONS at Heroes' Mile

At Heroes’ Mile, we are here to help you make informed decisions about your mental health care and the financial obligations associated with mental health services.

 

Here You Can Learn About:

  • Obtaining a pricing estimate for our most frequently used healthcare services
  • Payment options and alternatives available to patients without healthcare coverage
  • Contact information to call us directly for a pricing estimate
  • Other bills you might receive for services besides your hospital bill
  • How our billing process works
  • Frequently Asked Questions

Billing FAQ 

WHAT IS PRICING TRANSPARENCY?

“Pricing Transparency” is the term used to describe initiatives in the healthcare industry to provide meaningful pricing information to consumers. The healthcare industry is often complex and difficult for consumers to navigate. Price transparency is a means of providing consumers price information on common services. Our hospital is committed to presenting pricing information on its website in a way that will be easy for the consumer to access and understand, as well as providing other useful information about financial assistance available, definitions of key terminology, and key financial policies.

WHAT SERVICES ARE INCLUDED IN MY HOSPITAL BILL?

If you are viewing estimates provided on this website, the pricing includes estimated room and board, supplies, nursing care, equipment use, nutritional services, and any services handled by the staff of the hospital within the walls of the hospital. It does not include services from outside providers such as lab or doctors fees.

WHAT SERVICES ARE EXCLUDED FROM MY HOSPITAL BILL ESTIMATE?

Your personal physician or other physicians providing you with services related to your hospital stay or visit will bill you separately. Independent laboratory will also bill you separately for lab work. If ambulatory services were used those would also be separately.

HOW OFTEN IS THE PRICING ESTIMATE DATA REFRESHED?

We plan to refresh the data used on our website and by our Service Representatives at least annually.

WHAT DOES UNINSURED MEAN?

It means that you have to pay for your services and that you do not have coverage for the hospital services by a third party like Medicare, Medicaid, Workers Compensation or an insurance company. Other common terms used when referring to Uninsured patients are: Self Pay and Private Pay.

WHY CAN’T I RELY ON THE PRICING ESTIMATES POSTED ON THIS WEBSITE?

Those figures are estimates of what an Uninsured Patient would have to pay. If you have insurance or some form of medical coverage, your out of pocket typically can include a deductible, coinsurance, co-payment or even non-covered services. The prices for your services are based on the contract terms negotiated by your insurance company with the hospital. In order to give you a more accurate estimate, we need to evaluate your coverage and specific plan. To do that, please give us a call at 386-337-7957.

WHAT IF THE SERVICE I NEED IS NOT LISTED HERE?

Please give us a call at 386-337-7957. We will be happy to try to provide you with a price estimate.

WHAT INFORMATION SHOULD I HAVE WHEN CALLING FOR A PRICE ESTIMATE?

If you are insured, prior to your call, it is important that you contact your insurance company to ensure that the services required are “covered services”. In the event that they are not a covered service under your plan, please refer back to our Uninsured information.If you have insurance, you will also need:

  • Your Insurance Card – please have your card available so that if needed, we can get the following information from you: name of insurance company, type of policy (e.g. HMO, PPO, POS, Indemnity), policy holder’s name, group name and number, policy number, insurance company phone number.
  • Policyholder’s Personal Information – it is possible that the insurance company will want us to verify the Social Security Number and date of birth of the person who is named as the primary insurance policy holder.

During your call, we will attempt to verify your specific insurance benefits to provide the most accurate representation of your estimated financial obligation based on your specific coverage.

CAN I GET AN EXACT PRICING QUOTE?

Unfortunately, no. We will do our best to provide you with a pricing range based on our hospital’s historical pricing for comparable services. Price quotes are not guaranteed since the services used to compute the quote can vary from services you receive due to treatment decisions, unforeseen complications, additional tests or services ordered by your physician, and variation in the clinical needs of each patient.

WHAT IS EXPECTED OF PATIENTS IN TERMS OF PAYMENT?

Similar to your visits to your physician’s office, we expect payment at time of service. If you have insurance or other coverage, we will expect you to pay your co-payment, coinsurance and/or deductible upon arrival at the hospital. After your insurance company pays us, we will send you information about any amount you may still owe.If you are uninsured, we expect payment at time of service (or will work with you to arrange monthly payments) for the estimated price of your services. If, after your services are received, any additional payment is due, we will send you information about any amount you may still owe. If you receive emergency care and cannot pay for your services, with your cooperation, our financial counselors will evaluate whether you qualify for Local and State programs, including County Assistance and Medicaid, or our Charity Discount Policy. We accept major credit cards, checks, money orders and cash. Failure to meet payment arrangements may lead to collections involvement per company policy.

HOW DOES THE INSURANCE BILLING PROCESS WORK?

If you are insured, a claim will be sent to your insurance company. After they receive the claim, the insurance company may contact you for additional information. Please respond to your insurance company’s questions as quickly as possible so their payment is not delayed. It usually takes 30-45 days for your insurance company to pay your claim. After they pay us, we will provide you with information about any amount you may owe that you did not already pay upon arrival at our facility. Please keep in mind that your policy is a binder between you and your insurance company. If you did not follow your insurance plan’s terms, they may not pay for all or part of your care.

Contact Billing

Can I Get an Exact Pricing Quote?

Unfortunately, no. We will do our best to provide you with a pricing range based on our hospital’s historical pricing for comparable services. Price quotes are not guaranteed. This is because the services used to compute the quote can differ from services you receive due to treatment decisions, unforeseen complications, additional tests or services ordered by your physician, and variation in the clinical needs of each patient. Price Estimate

What Is Not Included in Our Estimates?

The estimates provided are only related to your hospital bill. Your personal physician or other physicians providing you with services related to your hospital stay or visit will bill you separately.

Independent laboratory services will also bill you separately for lab work. If you have questions about those bills, please call the number printed on their statements.

In order to provide you with the most accurate estimate based on your specific financial situation and prospective services, please contact our Service Center at (888) 838-6692, and one of our Financial Representatives will be happy to assist you.

If you are insured, prior to your call, it is important that you contact your insurance company to ensure that the services required are “covered services.” In the event that they are not covered under your plan, please refer back to our Uninsured information.

If you have insurance, you will also need:

  • Your Insurance Card – please have your card available so that if needed, we can get the following information from you: name of insurance company, type of policy (e.g. HMO, PPO, POS, Indemnity), policy holder’s name, group name and number, policy number, and insurance company phone number.
  • Policyholder’s Personal Information – it is possible that the insurance company will want us to verify the Social Security Number and date of birth of the person who is named as the primary insurance policy holder.

During your call, we will attempt to verify your specific insurance benefits to provide the most accurate representation of your estimated financial obligation based on your specific coverage.

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Pricing Information

Heroes’ Mile is committed to providing meaningful information to our patients related to financial obligations for healthcare services. It is our intent with this website to publish our financial assistance policies and the pricing ranges for our most common services. In order to provide you with information that is helpful based on your personal healthcare coverage, we must first differentiate between patients with some form of insurance or governmental coverage, like Medicare or Medicaid, and patients without insurance or coverage. If you have some form of insurance coverage please click insured.

Obtaining an Estimate
In order to provide insured patients with the most accurate estimate based on your specific plan coverage and prospective services, please contact our admissions department at 386-337-7957 and one of our admissions representatives will be happy to assist you.

Prior To Your Call
Prior to your call, it is important that you contact your insurance company to ensure that the services required are “covered services”. In the event that they are not a covered service under your plan, please refer back to our uninsured information.

You will also need to contact your physician’s office to get the specific diagnosis or procedure description.

When you call our admissions department, please have the following information available, so that we can provide you with the most accurate estimate possible:

  • Your Insurance Card – please have your card available so that if needed, we can get the following information from you: name of insurance company, type of policy (e.g. HMO, PPO, POS, Indemnity), policy holder’s name, group name and number, policy number, insurance company phone number.
  • Policyholder’s Personal Information – it is possible that the insurance company will want us to verify the Social Security Number and date of birth of the person who is named as the primary insurance policy holder.

Financial Disclosure
Similar to your visits to your physician’s office, we will ask you for your co-payment, coinsurance and/or deductible payment at time of your services based on your specific insurance benefits. We accept major credit cards, checks, money orders and cash.

Financial Disclosure
Your personal physician or other physicians providing you with services related to your hospital stay or visit will bill you separately. Independent laboratory will also bill you separately for lab work. If ambulatory services were used those would also be separately.

During your call, we will attempt to verify your specific insurance benefits to provide the most accurate representation of your estimated financial obligation based on your specific coverage.

Your Hospital Bill
This is how our billing process usually works. A claim will be sent to your insurance company shortly after your services are complete.

After your insurance company receives the claim, the insurance company may contact you for additional information. Please respond to your insurance company’s questions as quickly as possible so their payment to us is not delayed.

It usually takes 30 – 45 days for your insurance company to pay your claim. After your insurance company pays us, we will provide you with information about any amount you may still owe.

Please keep in mind that your policy is a binder between you and your insurance company. If you did not follow your insurance plan’s terms, they may not pay for all or part of your care.

Below is a list of services which our recovery center may provide. Note that we may not administer all of the programs below; this is simply pricing information on what our rates would be for each service, if it is offered. For more clarification on what programs we provide, please visit our services page or call our friendly admissions specialists at 888-838-6692.

Inpatient

  • Detox $1,500 per day
  • Residential Treatment $1,500 per day
  • Psychiatric Treatment $1,500 per day
  • Dual Diagnosis $1,500 per day

Outpatient

  • Partial Hospitalization Program $660 per day
  • Intensive Outpatient $165 per session

What is not included in our estimates
Your personal physician or other physicians providing you with services related to your hospital stay or visit will bill you separately. Independent laboratory will also bill you separately for lab work. If ambulatory services were used those would also be separately.

Advanced Estimates
More detailed pricing information is available. If our estimated pricing information does not appear to cover your service, or if you feel you will have complicating factors requiring a more detailed query, you may call our representatives for a good faith estimate at 386-337-7957.

Where did this data come from?
We pulled data from the most recent calendar year to determine pricing on our most common services.
If the hospital has not had at least 5 patients in the past year utilizing that service, “N/A” will appear in the pricing range. “Hospital Stay range” refers to an average length of stay in the hospital. Any hospital advertised prices or flat rates will supersede these rates.

Patient Payment Estimator

Instructions
1. Select your insurance plan and the services using the dropdown boxes below.
2. To update your calculations, kindly refresh this page.

    Gross Charge: $0

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    De-Identified (high rate): $960

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    Billing Code: #124

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    Billing Code: #128

    De-Identified (low rate): $100

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    Billing Code: #128

    De-Identified (low rate): $538

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    Gross Charge: $0

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    Billing Code: #0

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    Billing Code: #126

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    AETNA BETTER rate: $0

    Gross Charge: $2,200.00

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    Billing Code: #126

    De-Identified (low rate): $690

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    Billing Code: #124

    De-Identified (low rate): $100

    De-Identified (high rate): $110

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    Gross Charge: $2,200.00

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    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.00

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    Billing Code: #124

    De-Identified (low rate): $110

    De-Identified (high rate): $110

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    Billing Code: #124

    De-Identified (low rate): $650

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    Billing Code: #128

    De-Identified (low rate): $100

    De-Identified (high rate): $110

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    Billing Code: #128

    De-Identified (low rate): $538

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    ALL SAVERS rate: $0

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    De-Identified (low rate): $100

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    Billing Code: #124

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    Billing Code: #124

    De-Identified (low rate): $110

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    ALL SAVERS rate: $0

    Gross Charge: $2,200

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    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

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    Gross Charge: $2,200

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    Billing Code: #128

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    ALL SAVERS rate: $0

    Gross Charge: $2,200

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    Billing Code: #128

    De-Identified (low rate): $538

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    De-Identified (low rate): $830

    De-Identified (high rate): $960

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    De-Identified (low rate): $960

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    Gross Charge: $2,200

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    Billing Code: #126

    De-Identified (low rate): $100

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    AMBETTER COMMERCIAL rate: $0

    Gross Charge: $2,200

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    Billing Code: #126

    De-Identified (low rate): $690

    De-Identified (high rate): $1,160.10

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    Gross Charge: $2,200

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    Billing Code: #124

    De-Identified (low rate): $100

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    Gross Charge: $2,200

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    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    AMBETTER COMMERCIAL rate: $650

    Gross Charge: $2,200

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    Billing Code: #124

    De-Identified (low rate): $110

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    Gross Charge: $2,200

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    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    AMBETTER COMMERCIAL rate: $650

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    AMBETTER COMMERCIAL rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $538

    De-Identified (high rate): $1,160.10

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    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $830

    De-Identified (high rate): $960

    BCBS MEDICARE rate: $960

    Gross Charge: $0

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    Billing Code: #0

    De-Identified (low rate): $960

    De-Identified (high rate): $960

    BCBS MEDICARE rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    BCBS MEDICARE rate: $0

    Gross Charge: $2,200

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    Billing Code: #126

    De-Identified (low rate): $690

    De-Identified (high rate): $1,160.10

    BCBS MEDICARE rate: $908.10

    Gross Charge: $2,200

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    Billing Code: #124

    De-Identified (low rate): $100

    De-Identified (high rate): $110

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    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

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    Gross Charge: $2,200

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    Billing Code: #124

    De-Identified (low rate): $110

    De-Identified (high rate): $110

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    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

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    Gross Charge: $2,200

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    Billing Code: #128

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    BCBS MEDICARE rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $538

    De-Identified (high rate): $1,160.10

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    Gross Charge: $0

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    Billing Code: #0

    De-Identified (low rate): $830

    De-Identified (high rate): $960

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    De-Identified (low rate): $960

    De-Identified (high rate): $960

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    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    BEACON HEALTH STRATE rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $690

    De-Identified (high rate): $1,160.10

    BEACON HEALTH STRATE rate: $690

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    BEACON HEALTH STRATE rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    BEACON HEALTH STRATE rate: $769

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $110

    De-Identified (high rate): $110

    BEACON HEALTH STRATE rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    BEACON HEALTH STRATE rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    BEACON HEALTH STRATE rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $538

    De-Identified (high rate): $1,160.10

    BEACON HEALTH STRATE rate: $769

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $830

    De-Identified (high rate): $960

    BEACON HLTH OPTIONS rate: $0

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $960

    De-Identified (high rate): $960

    BEACON HLTH OPTIONS rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    BEACON HLTH OPTIONS rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $690

    De-Identified (high rate): $1,160.10

    BEACON HLTH OPTIONS rate: $690

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    BEACON HLTH OPTIONS rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    BEACON HLTH OPTIONS rate: $769

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $110

    De-Identified (high rate): $110

    BEACON HLTH OPTIONS rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    BEACON HLTH OPTIONS rate: $769

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    BEACON HLTH OPTIONS rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $538

    De-Identified (high rate): $1,160.10

    BEACON HLTH OPTIONS rate: $769

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $830

    De-Identified (high rate): $960

    BLUE CROSS rate: $0

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $960

    De-Identified (high rate): $960

    BLUE CROSS rate: $960

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    BLUE CROSS rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $690

    De-Identified (high rate): $1,160.10

    BLUE CROSS rate: $908.10

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    BLUE CROSS rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    BLUE CROSS rate: $908.10

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $110

    De-Identified (high rate): $110

    BLUE CROSS rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    BLUE CROSS rate: $908.10

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    BLUE CROSS rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $538

    De-Identified (high rate): $1,160.10

    BLUE CROSS rate: $605.40

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $830

    De-Identified (high rate): $960

    BLUE CROSS NEW DIREC rate: $0

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $960

    De-Identified (high rate): $960

    BLUE CROSS NEW DIREC rate: $960

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    BLUE CROSS NEW DIREC rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $690

    De-Identified (high rate): $1,160.10

    BLUE CROSS NEW DIREC rate: $908.10

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    BLUE CROSS NEW DIREC rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    BLUE CROSS NEW DIREC rate: $908.10

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $110

    De-Identified (high rate): $110

    BLUE CROSS NEW DIREC rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    BLUE CROSS NEW DIREC rate: $908.10

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    BLUE CROSS NEW DIREC rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $538

    De-Identified (high rate): $1,160.10

    BLUE CROSS NEW DIREC rate: $605.40

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $830

    De-Identified (high rate): $960

    BRIGHT HEALTH rate: $0

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $960

    De-Identified (high rate): $960

    BRIGHT HEALTH rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    BRIGHT HEALTH rate: $110

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $690

    De-Identified (high rate): $1,160.10

    BRIGHT HEALTH rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    BRIGHT HEALTH rate: $110

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    BRIGHT HEALTH rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $110

    De-Identified (high rate): $110

    BRIGHT HEALTH rate: $110

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    BRIGHT HEALTH rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    BRIGHT HEALTH rate: $110

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $538

    De-Identified (high rate): $1,160.10

    BRIGHT HEALTH rate: $0

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $830

    De-Identified (high rate): $960

    CAREPLUS-MAGELLANH rate: $0

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $960

    De-Identified (high rate): $960

    CAREPLUS-MAGELLANH rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    CAREPLUS-MAGELLANH rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $690

    De-Identified (high rate): $1,160.10

    CAREPLUS-MAGELLANH rate: $1,699

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    CAREPLUS-MAGELLANH rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    CAREPLUS-MAGELLANH rate: $1,699

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $110

    De-Identified (high rate): $110

    CAREPLUS-MAGELLANH rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    CAREPLUS-MAGELLANH rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    CAREPLUS-MAGELLANH rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $538

    De-Identified (high rate): $1,160.10

    CAREPLUS-MAGELLANH rate: $1,699

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $830

    De-Identified (high rate): $960

    CENPATICO rate: $0

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $960

    De-Identified (high rate): $960

    CENPATICO rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    CENPATICO rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $690

    De-Identified (high rate): $1,160.10

    CENPATICO rate: $750

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    CENPATICO rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    CENPATICO rate: $1,468

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $110

    De-Identified (high rate): $110

    CENPATICO rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    CENPATICO rate: $1,468

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    CENPATICO rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $538

    De-Identified (high rate): $1,160.10

    CENPATICO rate: $718

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $830

    De-Identified (high rate): $960

    CIGNA rate: $0

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $960

    De-Identified (high rate): $960

    CIGNA rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    CIGNA rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $690

    De-Identified (high rate): $1,160.10

    CIGNA rate: $890

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    CIGNA rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    CIGNA rate: $890

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $110

    De-Identified (high rate): $110

    CIGNA rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    CIGNA rate: $890

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    CIGNA rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $538

    De-Identified (high rate): $1,160.10

    CIGNA rate: $890

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $830

    De-Identified (high rate): $960

    CIGNA HEALTHSPRING rate: $0

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $960

    De-Identified (high rate): $960

    CIGNA HEALTHSPRING rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    CIGNA HEALTHSPRING rate: $100

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $690

    De-Identified (high rate): $1,160.10

    CIGNA HEALTHSPRING rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    CIGNA HEALTHSPRING rate: $100

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    CIGNA HEALTHSPRING rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $110

    De-Identified (high rate): $110

    CIGNA HEALTHSPRING rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    CIGNA HEALTHSPRING rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    CIGNA HEALTHSPRING rate: $100

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $538

    De-Identified (high rate): $1,160.10

    CIGNA HEALTHSPRING rate: $890

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $830

    De-Identified (high rate): $960

    COMPSYCH rate: $0

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $960

    De-Identified (high rate): $960

    COMPSYCH rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    COMPSYCH rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $690

    De-Identified (high rate): $1,160.10

    COMPSYCH rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    COMPSYCH rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    COMPSYCH rate: $775

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $110

    De-Identified (high rate): $110

    COMPSYCH rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    COMPSYCH rate: $775

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    COMPSYCH rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $538

    De-Identified (high rate): $1,160.10

    COMPSYCH rate: $0

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $830

    De-Identified (high rate): $960

    GEHA rate: $0

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $960

    De-Identified (high rate): $960

    GEHA rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    GEHA rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $690

    De-Identified (high rate): $1,160.10

    GEHA rate: $727

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    GEHA rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    GEHA rate: $796

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $110

    De-Identified (high rate): $110

    GEHA rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    GEHA rate: $796

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    GEHA rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $538

    De-Identified (high rate): $1,160.10

    GEHA rate: $700

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $830

    De-Identified (high rate): $960

    GHI rate: $0

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $960

    De-Identified (high rate): $960

    GHI rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    GHI rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $690

    De-Identified (high rate): $1,160.10

    GHI rate: $700

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    GHI rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    GHI rate: $700

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $110

    De-Identified (high rate): $110

    GHI rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    GHI rate: $700

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    GHI rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $538

    De-Identified (high rate): $1,160.10

    GHI rate: $538

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $830

    De-Identified (high rate): $960

    HUMANA COMMERCIAL rate: $0

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $960

    De-Identified (high rate): $960

    HUMANA COMMERCIAL rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    HUMANA COMMERCIAL rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $690

    De-Identified (high rate): $1,160.10

    HUMANA COMMERCIAL rate: $900

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    HUMANA COMMERCIAL rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    HUMANA COMMERCIAL rate: $900

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $110

    De-Identified (high rate): $110

    HUMANA COMMERCIAL rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    HUMANA COMMERCIAL rate: $900

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    HUMANA COMMERCIAL rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $538

    De-Identified (high rate): $1,160.10

    HUMANA COMMERCIAL rate: $900

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $830

    De-Identified (high rate): $960

    HUMANA MEDICARE rate: $0

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $960

    De-Identified (high rate): $960

    HUMANA MEDICARE rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    HUMANA MEDICARE rate: $100

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $690

    De-Identified (high rate): $1,160.10

    HUMANA MEDICARE rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    HUMANA MEDICARE rate: $100

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    HUMANA MEDICARE rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $110

    De-Identified (high rate): $110

    HUMANA MEDICARE rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    HUMANA MEDICARE rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    HUMANA MEDICARE rate: $100

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $538

    De-Identified (high rate): $1,160.10

    HUMANA MEDICARE rate: $0

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $830

    De-Identified (high rate): $960

    MAGELLAN PINNACLE rate: $0

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $960

    De-Identified (high rate): $960

    MAGELLAN PINNACLE rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    MAGELLAN PINNACLE rate: $100

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $690

    De-Identified (high rate): $1,160.10

    MAGELLAN PINNACLE rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    MAGELLAN PINNACLE rate: $100

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    MAGELLAN PINNACLE rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $110

    De-Identified (high rate): $110

    MAGELLAN PINNACLE rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    MAGELLAN PINNACLE rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    MAGELLAN PINNACLE rate: $100

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $538

    De-Identified (high rate): $1,160.10

    MAGELLAN PINNACLE rate: $0

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $830

    De-Identified (high rate): $960

    MAGELLAN PINNACLE rate: $0

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $960

    De-Identified (high rate): $960

    MAGELLAN PINNACLE rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    MAGELLAN PINNACLE rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $690

    De-Identified (high rate): $1,160.10

    MAGELLAN PINNACLE rate: $1,699

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    MAGELLAN PINNACLE rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    MAGELLAN PINNACLE rate: $1,699

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $110

    De-Identified (high rate): $110

    MAGELLAN PINNACLE rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    MAGELLAN PINNACLE rate: $1,699

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    MAGELLAN PINNACLE rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $538

    De-Identified (high rate): $1,160.10

    MAGELLAN PINNACLE rate: $1,699

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $830

    De-Identified (high rate): $960

    MAGELLAN SUMMIT rate: $0

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $960

    De-Identified (high rate): $960

    MAGELLAN SUMMIT rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    MAGELLAN SUMMIT rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $690

    De-Identified (high rate): $1,160.10

    MAGELLAN SUMMIT rate: $1,699

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    MAGELLAN SUMMIT rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    MAGELLAN SUMMIT rate: $1,699

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $110

    De-Identified (high rate): $110

    MAGELLAN SUMMIT rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    MAGELLAN SUMMIT rate: $1,699

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    MAGELLAN SUMMIT rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $538

    De-Identified (high rate): $1,160.10

    MAGELLAN SUMMIT rate: $1,699

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $830

    De-Identified (high rate): $960

    MOLINA HEALTHCARE rate: $0

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $960

    De-Identified (high rate): $960

    MOLINA HEALTHCARE rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    MOLINA HEALTHCARE rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $690

    De-Identified (high rate): $1,160.10

    MOLINA HEALTHCARE rate: $750

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    MOLINA HEALTHCARE rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    MOLINA HEALTHCARE rate: $750

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $110

    De-Identified (high rate): $110

    MOLINA HEALTHCARE rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    MOLINA HEALTHCARE rate: $750

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    MOLINA HEALTHCARE rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $538

    De-Identified (high rate): $1,160.10

    MOLINA HEALTHCARE rate: $750

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $830

    De-Identified (high rate): $960

    STUDENT RESOURCES rate: $0

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $960

    De-Identified (high rate): $960

    STUDENT RESOURCES rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    STUDENT RESOURCES rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $690

    De-Identified (high rate): $1,160.10

    STUDENT RESOURCES rate: $730

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    STUDENT RESOURCES rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    STUDENT RESOURCES rate: $707

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $110

    De-Identified (high rate): $110

    STUDENT RESOURCES rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    STUDENT RESOURCES rate: $707

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    STUDENT RESOURCES rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $538

    De-Identified (high rate): $1,160.10

    STUDENT RESOURCES rate: $707

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $830

    De-Identified (high rate): $960

    TRICARE EAST rate: $0

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $960

    De-Identified (high rate): $960

    TRICARE EAST rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    TRICARE EAST rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $690

    De-Identified (high rate): $1,160.10

    TRICARE EAST rate: $1,160.10

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    TRICARE EAST rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    TRICARE EAST rate: $1,160.10

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $110

    De-Identified (high rate): $110

    TRICARE EAST rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    TRICARE EAST rate: $1,160.10

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    TRICARE EAST rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $538

    De-Identified (high rate): $1,160.10

    TRICARE EAST rate: $1,160.10

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $830

    De-Identified (high rate): $960

    UBH/OPTUM MCAID rate: $0

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $960

    De-Identified (high rate): $960

    UBH/OPTUM MCAID rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    UBH/OPTUM MCAID rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $690

    De-Identified (high rate): $1,160.10

    UBH/OPTUM MCAID rate: $700

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    UBH/OPTUM MCAID rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    UBH/OPTUM MCAID rate: $660

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $110

    De-Identified (high rate): $110

    UBH/OPTUM MCAID rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    UBH/OPTUM MCAID rate: $660

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    UBH/OPTUM MCAID rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $538

    De-Identified (high rate): $1,160.10

    UBH/OPTUM MCAID rate: $660

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $830

    De-Identified (high rate): $960

    UBH/OPTUM MEDICARE rate: $830

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $960

    De-Identified (high rate): $960

    UBH/OPTUM MEDICARE rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    UBH/OPTUM MEDICARE rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $690

    De-Identified (high rate): $1,160.10

    UBH/OPTUM MEDICARE rate: $785

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    UBH/OPTUM MEDICARE rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    UBH/OPTUM MEDICARE rate: $785

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $110

    De-Identified (high rate): $110

    UBH/OPTUM MEDICARE rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    UBH/OPTUM MEDICARE rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    UBH/OPTUM MEDICARE rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $538

    De-Identified (high rate): $1,160.10

    UBH/OPTUM MEDICARE rate: $785

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $830

    De-Identified (high rate): $960

    UMR rate: $0

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $960

    De-Identified (high rate): $960

    UMR rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    UMR rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $690

    De-Identified (high rate): $1,160.10

    UMR rate: $730

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    UMR rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    UMR rate: $707

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $110

    De-Identified (high rate): $110

    UMR rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    UMR rate: $707

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    UMR rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $538

    De-Identified (high rate): $1,160.10

    UMR rate: $707

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $830

    De-Identified (high rate): $960

    UMR ORLANDO HEALTH rate: $0

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $960

    De-Identified (high rate): $960

    UMR ORLANDO HEALTH rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    UMR ORLANDO HEALTH rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $690

    De-Identified (high rate): $1,160.10

    UMR ORLANDO HEALTH rate: $775

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    UMR ORLANDO HEALTH rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    UMR ORLANDO HEALTH rate: $775

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $110

    De-Identified (high rate): $110

    UMR ORLANDO HEALTH rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    UMR ORLANDO HEALTH rate: $775

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    UMR ORLANDO HEALTH rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $538

    De-Identified (high rate): $1,160.10

    UMR ORLANDO HEALTH rate: $775

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $830

    De-Identified (high rate): $960

    UNITED BEHAVIORAL rate: $0

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $960

    De-Identified (high rate): $960

    UNITED BEHAVIORAL rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    UNITED BEHAVIORAL rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $690

    De-Identified (high rate): $1,160.10

    UNITED BEHAVIORAL rate: $730

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    UNITED BEHAVIORAL rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    UNITED BEHAVIORAL rate: $707

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $110

    De-Identified (high rate): $110

    UNITED BEHAVIORAL rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    UNITED BEHAVIORAL rate: $707

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    UNITED BEHAVIORAL rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $538

    De-Identified (high rate): $1,160.10

    UNITED BEHAVIORAL rate: $707

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $830

    De-Identified (high rate): $960

    VALUE OPTIONS rate: $0

    Gross Charge: $0

    Cash Price: $0

    Billing Code: #0

    De-Identified (low rate): $960

    De-Identified (high rate): $960

    VALUE OPTIONS rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    VALUE OPTIONS rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #126

    De-Identified (low rate): $690

    De-Identified (high rate): $1,160.10

    VALUE OPTIONS rate: $750

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    VALUE OPTIONS rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    VALUE OPTIONS rate: $772

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $110

    De-Identified (high rate): $110

    VALUE OPTIONS rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #124

    De-Identified (low rate): $650

    De-Identified (high rate): $1,160.10

    VALUE OPTIONS rate: $772

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $100

    De-Identified (high rate): $110

    VALUE OPTIONS rate: $0

    Gross Charge: $2,200

    Cash Price: $2,200

    Billing Code: #128

    De-Identified (low rate): $538

    De-Identified (high rate): $1,160.10

    VALUE OPTIONS rate: $650

    Pricing Estimate

    It is important to note, a hospital “charge” is not the same as “expected payment.” A charge is the amount billed for a service. In the vast majority of cases, hospitals are paid considerably less than the billed amount. Hospital charges are based on the type of care provided and can differ from patient to patient for the same service. The differences between patients are related to complications or varying treatments needed due to the patient’s health.

    Even though the hospital’s prices on our list are the same for all patients, actual charges for each specific patient may vary from the listed standard charges due to a combination of factors.

    The Healthcare Financial Management Association has published a booklet, “Understanding Healthcare Prices: A Consumer Guide,” which can help you better understand where to get answers to your questions about healthcare prices, how to compare prices among providers and how to manage your out-of-pocket costs. View the guidebook online →

    View the Florida Health Price Finder →

     

    Payment Estimate

    Instructions
    1. Select your insurance plan and the services using the dropdown boxes below.
    2. To update your calculations, kindly refresh this page.

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $830

      De-Identified (high rate): $960

      AETNA rate: $0

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $960

      De-Identified (high rate): $960

      AETNA rate: $0

      Gross Charge: $2,200.00

      Cash Price: $2,200.00

      Billing Code: #0

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      AETNA rate: $0

      Gross Charge: $2,200.00

      Cash Price: $2,200.00

      Billing Code: #126

      De-Identified (low rate): $690

      De-Identified (high rate): $1,160.00

      AETNA rate: $771

      Gross Charge: $2,200.00

      Cash Price: $2,200.00

      Billing Code: #124

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      AETNA rate: $0

      Gross Charge: $2,200.00

      Cash Price: $2,200.00

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      AETNA rate: $857

      Gross Charge: $2,200.00

      Cash Price: $2,200.00

      Billing Code: #124

      De-Identified (low rate): $110

      De-Identified (high rate): $110

      AETNA rate: $0

      Gross Charge: $2,200.00

      Cash Price: $2,200.00

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      AETNA rate: $857

      Gross Charge: $2,200.00

      Cash Price: $2,200.00

      Billing Code: #128

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      AETNA rate: $0

      Gross Charge: $2,200.00

      Cash Price: $2,200.00

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      AETNA rate: $857

      Gross Charge: $2,200.00

      Cash Price: $2,200.00

      Billing Code: #128

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      AETNA rate: $0

      Gross Charge: $2,200.00

      Cash Price: $2,200.00

      Billing Code: #128

      De-Identified (low rate): $538

      De-Identified (high rate): $1,160.10

      AETNA rate: $788

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $830

      De-Identified (high rate): $960

      AETNA BETTER rate: $0

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $960

      De-Identified (high rate): $960

      AETNA BETTER rate: $0

      Gross Charge: $2,200.00

      Cash Price: $2,200.00

      Billing Code: #126

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      AETNA BETTER rate: $0

      Gross Charge: $2,200.00

      Cash Price: $2,200.00

      Billing Code: #126

      De-Identified (low rate): $690

      De-Identified (high rate): $1,160.00

      AETNA BETTER rate: $883

      Gross Charge: $2,200.00

      Cash Price: $2,200.00

      Billing Code: #124

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      AETNA BETTER rate: $0

      Gross Charge: $2,200.00

      Cash Price: $2,200.00

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.00

      AETNA BETTER rate: $883

      Gross Charge: $2,200.00

      Cash Price: $2,200.00

      Billing Code: #124

      De-Identified (low rate): $110

      De-Identified (high rate): $110

      AETNA BETTER rate: $0

      Gross Charge: $2,200.00

      Cash Price: $2,200.00

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160

      AETNA BETTER rate: $883

      Gross Charge: $2,200.00

      Cash Price: $2,200.00

      Billing Code: #128

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      AETNA BETTER rate: $0

      Gross Charge: $2,200.00

      Cash Price: $2,200.00

      Billing Code: #128

      De-Identified (low rate): $538

      De-Identified (high rate): $1,160.10

      AETNA BETTER rate: $883

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $830

      De-Identified (high rate): $960

      ALL SAVERS rate: $0

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $960

      De-Identified (high rate): $960

      ALL SAVERS rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      ALL SAVERS rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $690

      De-Identified (high rate): $1,160.10

      ALL SAVERS rate: $730

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $100

      De-Identified (high rate): $100

      ALL SAVERS rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      ALL SAVERS rate: $707

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $110

      De-Identified (high rate): $110

      ALL SAVERS rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      ALL SAVERS rate: $707

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      ALL SAVERS rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $538

      De-Identified (high rate): $1,160.10

      ALL SAVERS rate: $0

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $830

      De-Identified (high rate): $960

      AMBETTER COMMERCIAL rate: $0

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $960

      De-Identified (high rate): $960

      AMBETTER COMMERCIAL rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      AMBETTER COMMERCIAL rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $690

      De-Identified (high rate): $1,160.10

      AMBETTER COMMERCIAL rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      AMBETTER COMMERCIAL rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      AMBETTER COMMERCIAL rate: $650

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $110

      De-Identified (high rate): $110

      AMBETTER COMMERCIAL rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      AMBETTER COMMERCIAL rate: $650

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      AMBETTER COMMERCIAL rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $538

      De-Identified (high rate): $1,160.10

      AMBETTER COMMERCIAL rate: $0

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $830

      De-Identified (high rate): $960

      BCBS MEDICARE rate: $960

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $960

      De-Identified (high rate): $960

      BCBS MEDICARE rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      BCBS MEDICARE rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $690

      De-Identified (high rate): $1,160.10

      BCBS MEDICARE rate: $908.10

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      BCBS MEDICARE rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      BCBS MEDICARE rate: $908.10

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $110

      De-Identified (high rate): $110

      BCBS MEDICARE rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      BCBS MEDICARE rate: $908.10

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      BCBS MEDICARE rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $538

      De-Identified (high rate): $1,160.10

      BCBS MEDICARE rate: $605.40

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $830

      De-Identified (high rate): $960

      BEACON HEALTH STRATE rate: $0

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $960

      De-Identified (high rate): $960

      BEACON HEALTH STRATE rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      BEACON HEALTH STRATE rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $690

      De-Identified (high rate): $1,160.10

      BEACON HEALTH STRATE rate: $690

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      BEACON HEALTH STRATE rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      BEACON HEALTH STRATE rate: $769

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $110

      De-Identified (high rate): $110

      BEACON HEALTH STRATE rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      BEACON HEALTH STRATE rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      BEACON HEALTH STRATE rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $538

      De-Identified (high rate): $1,160.10

      BEACON HEALTH STRATE rate: $769

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $830

      De-Identified (high rate): $960

      BEACON HLTH OPTIONS rate: $0

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $960

      De-Identified (high rate): $960

      BEACON HLTH OPTIONS rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      BEACON HLTH OPTIONS rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $690

      De-Identified (high rate): $1,160.10

      BEACON HLTH OPTIONS rate: $690

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      BEACON HLTH OPTIONS rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      BEACON HLTH OPTIONS rate: $769

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $110

      De-Identified (high rate): $110

      BEACON HLTH OPTIONS rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      BEACON HLTH OPTIONS rate: $769

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      BEACON HLTH OPTIONS rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $538

      De-Identified (high rate): $1,160.10

      BEACON HLTH OPTIONS rate: $769

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $830

      De-Identified (high rate): $960

      BLUE CROSS rate: $0

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $960

      De-Identified (high rate): $960

      BLUE CROSS rate: $960

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      BLUE CROSS rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $690

      De-Identified (high rate): $1,160.10

      BLUE CROSS rate: $908.10

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      BLUE CROSS rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      BLUE CROSS rate: $908.10

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $110

      De-Identified (high rate): $110

      BLUE CROSS rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      BLUE CROSS rate: $908.10

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      BLUE CROSS rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $538

      De-Identified (high rate): $1,160.10

      BLUE CROSS rate: $605.40

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $830

      De-Identified (high rate): $960

      BLUE CROSS NEW DIREC rate: $0

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $960

      De-Identified (high rate): $960

      BLUE CROSS NEW DIREC rate: $960

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      BLUE CROSS NEW DIREC rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $690

      De-Identified (high rate): $1,160.10

      BLUE CROSS NEW DIREC rate: $908.10

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      BLUE CROSS NEW DIREC rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      BLUE CROSS NEW DIREC rate: $908.10

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $110

      De-Identified (high rate): $110

      BLUE CROSS NEW DIREC rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      BLUE CROSS NEW DIREC rate: $908.10

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      BLUE CROSS NEW DIREC rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $538

      De-Identified (high rate): $1,160.10

      BLUE CROSS NEW DIREC rate: $605.40

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $830

      De-Identified (high rate): $960

      BRIGHT HEALTH rate: $0

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $960

      De-Identified (high rate): $960

      BRIGHT HEALTH rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      BRIGHT HEALTH rate: $110

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $690

      De-Identified (high rate): $1,160.10

      BRIGHT HEALTH rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      BRIGHT HEALTH rate: $110

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      BRIGHT HEALTH rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $110

      De-Identified (high rate): $110

      BRIGHT HEALTH rate: $110

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      BRIGHT HEALTH rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      BRIGHT HEALTH rate: $110

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $538

      De-Identified (high rate): $1,160.10

      BRIGHT HEALTH rate: $0

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $830

      De-Identified (high rate): $960

      CAREPLUS-MAGELLANH rate: $0

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $960

      De-Identified (high rate): $960

      CAREPLUS-MAGELLANH rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      CAREPLUS-MAGELLANH rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $690

      De-Identified (high rate): $1,160.10

      CAREPLUS-MAGELLANH rate: $1,699

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      CAREPLUS-MAGELLANH rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      CAREPLUS-MAGELLANH rate: $1,699

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $110

      De-Identified (high rate): $110

      CAREPLUS-MAGELLANH rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      CAREPLUS-MAGELLANH rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      CAREPLUS-MAGELLANH rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $538

      De-Identified (high rate): $1,160.10

      CAREPLUS-MAGELLANH rate: $1,699

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $830

      De-Identified (high rate): $960

      CENPATICO rate: $0

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $960

      De-Identified (high rate): $960

      CENPATICO rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      CENPATICO rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $690

      De-Identified (high rate): $1,160.10

      CENPATICO rate: $750

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      CENPATICO rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      CENPATICO rate: $1,468

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $110

      De-Identified (high rate): $110

      CENPATICO rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      CENPATICO rate: $1,468

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      CENPATICO rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $538

      De-Identified (high rate): $1,160.10

      CENPATICO rate: $718

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $830

      De-Identified (high rate): $960

      CIGNA rate: $0

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $960

      De-Identified (high rate): $960

      CIGNA rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      CIGNA rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $690

      De-Identified (high rate): $1,160.10

      CIGNA rate: $890

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      CIGNA rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      CIGNA rate: $890

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $110

      De-Identified (high rate): $110

      CIGNA rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      CIGNA rate: $890

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      CIGNA rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $538

      De-Identified (high rate): $1,160.10

      CIGNA rate: $890

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $830

      De-Identified (high rate): $960

      CIGNA HEALTHSPRING rate: $0

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $960

      De-Identified (high rate): $960

      CIGNA HEALTHSPRING rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      CIGNA HEALTHSPRING rate: $100

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $690

      De-Identified (high rate): $1,160.10

      CIGNA HEALTHSPRING rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      CIGNA HEALTHSPRING rate: $100

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      CIGNA HEALTHSPRING rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $110

      De-Identified (high rate): $110

      CIGNA HEALTHSPRING rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      CIGNA HEALTHSPRING rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      CIGNA HEALTHSPRING rate: $100

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $538

      De-Identified (high rate): $1,160.10

      CIGNA HEALTHSPRING rate: $890

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $830

      De-Identified (high rate): $960

      COMPSYCH rate: $0

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $960

      De-Identified (high rate): $960

      COMPSYCH rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      COMPSYCH rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $690

      De-Identified (high rate): $1,160.10

      COMPSYCH rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      COMPSYCH rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      COMPSYCH rate: $775

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $110

      De-Identified (high rate): $110

      COMPSYCH rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      COMPSYCH rate: $775

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      COMPSYCH rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $538

      De-Identified (high rate): $1,160.10

      COMPSYCH rate: $0

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $830

      De-Identified (high rate): $960

      GEHA rate: $0

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $960

      De-Identified (high rate): $960

      GEHA rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      GEHA rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $690

      De-Identified (high rate): $1,160.10

      GEHA rate: $727

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      GEHA rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      GEHA rate: $796

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $110

      De-Identified (high rate): $110

      GEHA rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      GEHA rate: $796

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      GEHA rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $538

      De-Identified (high rate): $1,160.10

      GEHA rate: $700

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $830

      De-Identified (high rate): $960

      GHI rate: $0

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $960

      De-Identified (high rate): $960

      GHI rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      GHI rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $690

      De-Identified (high rate): $1,160.10

      GHI rate: $700

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      GHI rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      GHI rate: $700

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $110

      De-Identified (high rate): $110

      GHI rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      GHI rate: $700

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      GHI rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $538

      De-Identified (high rate): $1,160.10

      GHI rate: $538

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $830

      De-Identified (high rate): $960

      HUMANA COMMERCIAL rate: $0

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $960

      De-Identified (high rate): $960

      HUMANA COMMERCIAL rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      HUMANA COMMERCIAL rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $690

      De-Identified (high rate): $1,160.10

      HUMANA COMMERCIAL rate: $900

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      HUMANA COMMERCIAL rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      HUMANA COMMERCIAL rate: $900

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $110

      De-Identified (high rate): $110

      HUMANA COMMERCIAL rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      HUMANA COMMERCIAL rate: $900

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      HUMANA COMMERCIAL rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $538

      De-Identified (high rate): $1,160.10

      HUMANA COMMERCIAL rate: $900

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $830

      De-Identified (high rate): $960

      HUMANA MEDICARE rate: $0

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $960

      De-Identified (high rate): $960

      HUMANA MEDICARE rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      HUMANA MEDICARE rate: $100

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $690

      De-Identified (high rate): $1,160.10

      HUMANA MEDICARE rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      HUMANA MEDICARE rate: $100

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      HUMANA MEDICARE rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $110

      De-Identified (high rate): $110

      HUMANA MEDICARE rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      HUMANA MEDICARE rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      HUMANA MEDICARE rate: $100

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $538

      De-Identified (high rate): $1,160.10

      HUMANA MEDICARE rate: $0

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $830

      De-Identified (high rate): $960

      MAGELLAN PINNACLE rate: $0

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $960

      De-Identified (high rate): $960

      MAGELLAN PINNACLE rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      MAGELLAN PINNACLE rate: $100

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $690

      De-Identified (high rate): $1,160.10

      MAGELLAN PINNACLE rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      MAGELLAN PINNACLE rate: $100

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      MAGELLAN PINNACLE rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $110

      De-Identified (high rate): $110

      MAGELLAN PINNACLE rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      MAGELLAN PINNACLE rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      MAGELLAN PINNACLE rate: $100

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $538

      De-Identified (high rate): $1,160.10

      MAGELLAN PINNACLE rate: $0

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $830

      De-Identified (high rate): $960

      MAGELLAN PINNACLE rate: $0

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $960

      De-Identified (high rate): $960

      MAGELLAN PINNACLE rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      MAGELLAN PINNACLE rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $690

      De-Identified (high rate): $1,160.10

      MAGELLAN PINNACLE rate: $1,699

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      MAGELLAN PINNACLE rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      MAGELLAN PINNACLE rate: $1,699

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $110

      De-Identified (high rate): $110

      MAGELLAN PINNACLE rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      MAGELLAN PINNACLE rate: $1,699

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      MAGELLAN PINNACLE rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $538

      De-Identified (high rate): $1,160.10

      MAGELLAN PINNACLE rate: $1,699

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $830

      De-Identified (high rate): $960

      MAGELLAN SUMMIT rate: $0

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $960

      De-Identified (high rate): $960

      MAGELLAN SUMMIT rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      MAGELLAN SUMMIT rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $690

      De-Identified (high rate): $1,160.10

      MAGELLAN SUMMIT rate: $1,699

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      MAGELLAN SUMMIT rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      MAGELLAN SUMMIT rate: $1,699

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $110

      De-Identified (high rate): $110

      MAGELLAN SUMMIT rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      MAGELLAN SUMMIT rate: $1,699

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      MAGELLAN SUMMIT rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $538

      De-Identified (high rate): $1,160.10

      MAGELLAN SUMMIT rate: $1,699

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $830

      De-Identified (high rate): $960

      MOLINA HEALTHCARE rate: $0

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $960

      De-Identified (high rate): $960

      MOLINA HEALTHCARE rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      MOLINA HEALTHCARE rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $690

      De-Identified (high rate): $1,160.10

      MOLINA HEALTHCARE rate: $750

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      MOLINA HEALTHCARE rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      MOLINA HEALTHCARE rate: $750

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $110

      De-Identified (high rate): $110

      MOLINA HEALTHCARE rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      MOLINA HEALTHCARE rate: $750

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      MOLINA HEALTHCARE rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $538

      De-Identified (high rate): $1,160.10

      MOLINA HEALTHCARE rate: $750

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $830

      De-Identified (high rate): $960

      STUDENT RESOURCES rate: $0

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $960

      De-Identified (high rate): $960

      STUDENT RESOURCES rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      STUDENT RESOURCES rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $690

      De-Identified (high rate): $1,160.10

      STUDENT RESOURCES rate: $730

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      STUDENT RESOURCES rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      STUDENT RESOURCES rate: $707

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $110

      De-Identified (high rate): $110

      STUDENT RESOURCES rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      STUDENT RESOURCES rate: $707

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      STUDENT RESOURCES rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $538

      De-Identified (high rate): $1,160.10

      STUDENT RESOURCES rate: $707

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $830

      De-Identified (high rate): $960

      TRICARE EAST rate: $0

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $960

      De-Identified (high rate): $960

      TRICARE EAST rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      TRICARE EAST rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $690

      De-Identified (high rate): $1,160.10

      TRICARE EAST rate: $1,160.10

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      TRICARE EAST rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      TRICARE EAST rate: $1,160.10

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $110

      De-Identified (high rate): $110

      TRICARE EAST rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      TRICARE EAST rate: $1,160.10

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      TRICARE EAST rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $538

      De-Identified (high rate): $1,160.10

      TRICARE EAST rate: $1,160.10

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $830

      De-Identified (high rate): $960

      UBH/OPTUM MCAID rate: $0

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $960

      De-Identified (high rate): $960

      UBH/OPTUM MCAID rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      UBH/OPTUM MCAID rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $690

      De-Identified (high rate): $1,160.10

      UBH/OPTUM MCAID rate: $700

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      UBH/OPTUM MCAID rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      UBH/OPTUM MCAID rate: $660

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $110

      De-Identified (high rate): $110

      UBH/OPTUM MCAID rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      UBH/OPTUM MCAID rate: $660

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      UBH/OPTUM MCAID rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $538

      De-Identified (high rate): $1,160.10

      UBH/OPTUM MCAID rate: $660

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $830

      De-Identified (high rate): $960

      UBH/OPTUM MEDICARE rate: $830

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $960

      De-Identified (high rate): $960

      UBH/OPTUM MEDICARE rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      UBH/OPTUM MEDICARE rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $690

      De-Identified (high rate): $1,160.10

      UBH/OPTUM MEDICARE rate: $785

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      UBH/OPTUM MEDICARE rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      UBH/OPTUM MEDICARE rate: $785

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $110

      De-Identified (high rate): $110

      UBH/OPTUM MEDICARE rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      UBH/OPTUM MEDICARE rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      UBH/OPTUM MEDICARE rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $538

      De-Identified (high rate): $1,160.10

      UBH/OPTUM MEDICARE rate: $785

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $830

      De-Identified (high rate): $960

      UMR rate: $0

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $960

      De-Identified (high rate): $960

      UMR rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      UMR rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $690

      De-Identified (high rate): $1,160.10

      UMR rate: $730

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      UMR rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      UMR rate: $707

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $110

      De-Identified (high rate): $110

      UMR rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      UMR rate: $707

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      UMR rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $538

      De-Identified (high rate): $1,160.10

      UMR rate: $707

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $830

      De-Identified (high rate): $960

      UMR ORLANDO HEALTH rate: $0

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $960

      De-Identified (high rate): $960

      UMR ORLANDO HEALTH rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      UMR ORLANDO HEALTH rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $690

      De-Identified (high rate): $1,160.10

      UMR ORLANDO HEALTH rate: $775

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      UMR ORLANDO HEALTH rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      UMR ORLANDO HEALTH rate: $775

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $110

      De-Identified (high rate): $110

      UMR ORLANDO HEALTH rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      UMR ORLANDO HEALTH rate: $775

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      UMR ORLANDO HEALTH rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $538

      De-Identified (high rate): $1,160.10

      UMR ORLANDO HEALTH rate: $775

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $830

      De-Identified (high rate): $960

      UNITED BEHAVIORAL rate: $0

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $960

      De-Identified (high rate): $960

      UNITED BEHAVIORAL rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      UNITED BEHAVIORAL rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $690

      De-Identified (high rate): $1,160.10

      UNITED BEHAVIORAL rate: $730

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      UNITED BEHAVIORAL rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      UNITED BEHAVIORAL rate: $707

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $110

      De-Identified (high rate): $110

      UNITED BEHAVIORAL rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      UNITED BEHAVIORAL rate: $707

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      UNITED BEHAVIORAL rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $538

      De-Identified (high rate): $1,160.10

      UNITED BEHAVIORAL rate: $707

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $830

      De-Identified (high rate): $960

      VALUE OPTIONS rate: $0

      Gross Charge: $0

      Cash Price: $0

      Billing Code: #0

      De-Identified (low rate): $960

      De-Identified (high rate): $960

      VALUE OPTIONS rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      VALUE OPTIONS rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #126

      De-Identified (low rate): $690

      De-Identified (high rate): $1,160.10

      VALUE OPTIONS rate: $750

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      VALUE OPTIONS rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      VALUE OPTIONS rate: $772

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $110

      De-Identified (high rate): $110

      VALUE OPTIONS rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #124

      De-Identified (low rate): $650

      De-Identified (high rate): $1,160.10

      VALUE OPTIONS rate: $772

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $100

      De-Identified (high rate): $110

      VALUE OPTIONS rate: $0

      Gross Charge: $2,200

      Cash Price: $2,200

      Billing Code: #128

      De-Identified (low rate): $538

      De-Identified (high rate): $1,160.10

      VALUE OPTIONS rate: $650

      Financial Disclosure

      Heroes’ Mile makes no guarantees regarding the accuracy of the pricing information provided herein. The pricing information provided by this website is strictly an estimate of prices, and Heroes’ Mile cannot guarantee the accuracy of any estimates. All estimates are based on information provided by a prospective patient and do not include, among other things, any unforeseen complications, additional tests or procedures, and non-hospital related charges, any of which may increase the ultimate cost of the services provided. Any prospective patient should understand that a final bill for services rendered at Heroes’ Mile may differ substantially from the information provided by this website, and Heroes’ Mile shall not be liable for any inaccuracies.

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