Note: If a dropdown option appears grayed out, it means that provider will not cover that service based on your current selections.
| Description | Insurer | Code | Code Type | Gross | Discounted Cash |
Payor Specific Charge
The charge that a hospital has negotiated with a third-party payer for the shoppable service.
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Min | Max | Methodology |
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Note: All services are for adults only. The information provided is the retail published rate and may not reflect your actual cost. If you have insurance or are covered by Medicaid/Medicare, your benefits will determine your out-of-pocket costs (including deductibles, co-pays, co-insurance, and out-of-pocket maximums). Physician charges are not included. Rates are reviewed and updated annually as required. Pricing data updated on November 13, 2025.