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General Pricing Information

Port St. Lucie Hospital 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.

 

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 (772) 238-7734 and one of our admissions representatives will be happy to assist you. OR got to Pricing Estimate on your right.

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.

Uninsured

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 (772) 238-7734.

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 (772) 238-7734.

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.

Pricing Estimate

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

    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

    Below is a link to the Agency’s pricing websites that provides information on payments made to the facility for defined service bundles.  The service bundle information provided is a non-personalized estimate of costs that may be incurred by the patient for anticipated services and the actual costs will be based on services actually provided to the patient.

    Physicians

    Please feel free to contact our health care practitioners regarding a personalized estimate, billing practices and participation with any insurance provider or Health Maintenance Organization (HMO) as the practitioners may not participate with the same health insurances or HMO as the center.

    Rafael Munne, MD – Medical Director
    2550 SE Walton Rd
    Port St. Lucie, FL 34952
    (772) 238-7734

    Ney Andujar, MD – Medical Services
    2550 SE Walton Rd
    Port St. Lucie, FL 34952
    (772) 238-7734

    Pierre Montrose, MD – Medical Services
    2550 SE Walton Rd
    Port St. Lucie, FL 34952
    (772) 238-7734

    Muhanned Kassawat, MD – Medical Services
    2550 SE Walton Rd
    Port St. Lucie, FL 34952
    (772) 238-7734

    Financial Disclosure

    Port St. Lucie Hospital 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 Port St. Lucie Hospital 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 Port St. Lucie Hospital may differ substantially from the information provided by this website, and Port St. Lucie Hospital shall not be liable for any inaccuracies.

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