Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

GUANFACINE 1 MG TABLET

Facility

$189.65

Service Code	NDC 68094-019-62
Hospital Charge Code	10149
Hospital Revenue Code	637
Min. Negotiated Rate	$119.48
Max. Negotiated Rate	$170.68
Rate for Payer: Aetna Commercial	$161.20
Rate for Payer: Aetna New Business (MI Preferred)	$123.27
Rate for Payer: Cash Price	$151.72
Rate for Payer: Cofinity Commercial	$132.76
Rate for Payer: Cofinity Commercial	$163.10
Rate for Payer: Healthscope Commercial	$170.68
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$161.20
Rate for Payer: PHP Commercial	$161.20
Rate for Payer: Priority Health Cigna Priority Health	$132.76
Rate for Payer: Priority Health SBD	$119.48

GUAR GUM ORAL POWDER PACKET

Facility

$3.32

Service Code	NDC 4390097647
Hospital Charge Code	30538
Hospital Revenue Code	637
Min. Negotiated Rate	$2.09
Max. Negotiated Rate	$2.99
Rate for Payer: Aetna Commercial	$2.82
Rate for Payer: Aetna New Business (MI Preferred)	$2.16
Rate for Payer: Cash Price	$2.66
Rate for Payer: Cofinity Commercial	$2.32
Rate for Payer: Cofinity Commercial	$2.86
Rate for Payer: Healthscope Commercial	$2.99
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2.82
Rate for Payer: PHP Commercial	$2.82
Rate for Payer: Priority Health Cigna Priority Health	$2.32
Rate for Payer: Priority Health SBD	$2.09

HAEMOPHILUS B POLYSACCHARID CONJ-TETANUS TOX(PF) 10 MCG/0.5 ML IM SOLN

Facility

$49.19

Service Code	HCPCS 90648
Hospital Charge Code	11931
Hospital Revenue Code	636
Min. Negotiated Rate	$30.99
Max. Negotiated Rate	$44.27
Rate for Payer: Aetna Commercial	$41.81
Rate for Payer: Aetna New Business (MI Preferred)	$31.97
Rate for Payer: Cash Price	$39.35
Rate for Payer: Cofinity Commercial	$34.43
Rate for Payer: Cofinity Commercial	$42.30
Rate for Payer: Healthscope Commercial	$44.27
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$41.81
Rate for Payer: PHP Commercial	$41.81
Rate for Payer: Priority Health Cigna Priority Health	$34.43
Rate for Payer: Priority Health SBD	$30.99

HAEMOPHILUS B POLYSACCHARID CONJ-TETANUS TOX(PF) 10 MCG/0.5 ML IM SOLN

Facility

$49.19

Service Code	HCPCS 90648
Hospital Charge Code	11931
Hospital Revenue Code	636
Min. Negotiated Rate	$19.68
Max. Negotiated Rate	$53.96
Rate for Payer: Aetna Commercial	$41.81
Rate for Payer: Aetna New Business (MI Preferred)	$31.97
Rate for Payer: BCBS Complete	$19.68
Rate for Payer: BCBS Trust/PPO	$53.96
Rate for Payer: Cash Price	$39.35
Rate for Payer: Cash Price	$39.35
Rate for Payer: Cofinity Commercial	$42.30
Rate for Payer: Cofinity Commercial	$34.43
Rate for Payer: Healthscope Commercial	$44.27
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$41.81
Rate for Payer: PHP Commercial	$41.81
Rate for Payer: Priority Health Cigna Priority Health	$34.43
Rate for Payer: Priority Health SBD	$30.99

HAIR REMOVAL

Professional

Both

$80.00

Service Code	HCPCS 00170
Hospital Revenue Code	960
Min. Negotiated Rate	$32.00
Max. Negotiated Rate	$56.00
Rate for Payer: BCBS Complete	$32.00
Rate for Payer: Cash Price	$64.00
Rate for Payer: Priority Health Cigna Priority Health	$56.00

HALLUX RIGIDUS CORRECTION WITH CHEILECTOMY, DEBRIDEMENT AND CAPSULAR RELEASE OF THE FIRST METATARSOPHALANGEAL JOINT; WITHOUT IMPLANT

Facility

$4,155.00

Service Code	CPT 28289
Hospital Revenue Code	360
Min. Negotiated Rate	$457.76
Max. Negotiated Rate	$4,155.00
Rate for Payer: Aetna Medicare	$2,995.31
Rate for Payer: Allen County Amish Medical Aid Commercial	$3,600.14
Rate for Payer: Amish Plain Church Group Commercial	$3,600.14
Rate for Payer: BCBS Complete	$1,654.34
Rate for Payer: BCBS MAPPO	$2,880.11
Rate for Payer: BCBS Trust/PPO	$1,234.36
Rate for Payer: BCN Medicare Advantage	$2,880.11
Rate for Payer: Health Alliance Plan Medicare Advantage	$2,880.11
Rate for Payer: Mclaren Medicaid	$1,575.42
Rate for Payer: Mclaren Medicare	$2,880.11
Rate for Payer: Meridian Medicaid	$1,654.34
Rate for Payer: Meridian Wellcare - Medicare Advantage	$3,024.12
Rate for Payer: MI Amish Medical Board Commercial	$3,312.13
Rate for Payer: PACE Medicare	$2,736.10
Rate for Payer: PACE SWMI	$2,880.11
Rate for Payer: PHP Medicare Advantage	$2,880.11
Rate for Payer: Priority Health Choice Medicaid	$1,575.42
Rate for Payer: Priority Health Medicare	$2,880.11
Rate for Payer: Railroad Medicare Medicare	$2,880.11
Rate for Payer: UHC All Payor (Choice/PPO)	$503.54
Rate for Payer: UHC Core	$4,155.00
Rate for Payer: UHC Dual Complete DSNP	$2,880.11
Rate for Payer: UHC Exchange	$457.76
Rate for Payer: UHC Medicare Advantage	$2,966.51
Rate for Payer: VA VA	$2,880.11

HALOPERIDOL 0.5 MG TABLET

Facility

$2.56

Service Code	NDC 51079-733-01
Hospital Charge Code	3578
Hospital Revenue Code	637
Min. Negotiated Rate	$1.61
Max. Negotiated Rate	$2.30
Rate for Payer: Aetna Commercial	$2.18
Rate for Payer: Aetna New Business (MI Preferred)	$1.66
Rate for Payer: Cash Price	$2.05
Rate for Payer: Cofinity Commercial	$1.79
Rate for Payer: Cofinity Commercial	$2.20
Rate for Payer: Healthscope Commercial	$2.30
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2.18
Rate for Payer: PHP Commercial	$2.18
Rate for Payer: Priority Health Cigna Priority Health	$1.79
Rate for Payer: Priority Health SBD	$1.61

HALOPERIDOL 0.5 MG TABLET

Facility

$2,299.00

Service Code	NDC 0378-0351-10
Hospital Charge Code	3578
Hospital Revenue Code	637
Min. Negotiated Rate	$1,448.37
Max. Negotiated Rate	$2,069.10
Rate for Payer: Aetna Commercial	$1,954.15
Rate for Payer: Aetna New Business (MI Preferred)	$1,494.35
Rate for Payer: Cash Price	$1,839.20
Rate for Payer: Cofinity Commercial	$1,609.30
Rate for Payer: Cofinity Commercial	$1,977.14
Rate for Payer: Healthscope Commercial	$2,069.10
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,954.15
Rate for Payer: PHP Commercial	$1,954.15
Rate for Payer: Priority Health Cigna Priority Health	$1,609.30
Rate for Payer: Priority Health SBD	$1,448.37

HALOPERIDOL 0.5 MG TABLET

Facility

$255.55

Service Code	NDC 51079-733-20
Hospital Charge Code	3578
Hospital Revenue Code	637
Min. Negotiated Rate	$161.00
Max. Negotiated Rate	$230.00
Rate for Payer: Aetna Commercial	$217.22
Rate for Payer: Aetna New Business (MI Preferred)	$166.11
Rate for Payer: Cash Price	$204.44
Rate for Payer: Cofinity Commercial	$178.88
Rate for Payer: Cofinity Commercial	$219.77
Rate for Payer: Healthscope Commercial	$230.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$217.22
Rate for Payer: PHP Commercial	$217.22
Rate for Payer: Priority Health Cigna Priority Health	$178.88
Rate for Payer: Priority Health SBD	$161.00

HALOPERIDOL 2 MG TABLET

Facility

$2.51

Service Code	NDC 51079-735-01
Hospital Charge Code	3581
Hospital Revenue Code	637
Min. Negotiated Rate	$1.58
Max. Negotiated Rate	$2.26
Rate for Payer: Aetna Commercial	$2.13
Rate for Payer: Aetna New Business (MI Preferred)	$1.63
Rate for Payer: Cash Price	$2.01
Rate for Payer: Cofinity Commercial	$1.76
Rate for Payer: Cofinity Commercial	$2.16
Rate for Payer: Healthscope Commercial	$2.26
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2.13
Rate for Payer: PHP Commercial	$2.13
Rate for Payer: Priority Health Cigna Priority Health	$1.76
Rate for Payer: Priority Health SBD	$1.58

HALOPERIDOL 2 MG TABLET

Facility

$250.56

Service Code	NDC 51079-735-20
Hospital Charge Code	3581
Hospital Revenue Code	637
Min. Negotiated Rate	$157.85
Max. Negotiated Rate	$225.50
Rate for Payer: Aetna Commercial	$212.98
Rate for Payer: Aetna New Business (MI Preferred)	$162.86
Rate for Payer: Cash Price	$200.45
Rate for Payer: Cofinity Commercial	$175.39
Rate for Payer: Cofinity Commercial	$215.48
Rate for Payer: Healthscope Commercial	$225.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$212.98
Rate for Payer: PHP Commercial	$212.98
Rate for Payer: Priority Health Cigna Priority Health	$175.39
Rate for Payer: Priority Health SBD	$157.85

HALOPERIDOL 2 MG TABLET

Facility

$4,465.00

Service Code	NDC 0378-0214-10
Hospital Charge Code	3581
Hospital Revenue Code	637
Min. Negotiated Rate	$2,812.95
Max. Negotiated Rate	$4,018.50
Rate for Payer: Aetna Commercial	$3,795.25
Rate for Payer: Aetna New Business (MI Preferred)	$2,902.25
Rate for Payer: Cash Price	$3,572.00
Rate for Payer: Cofinity Commercial	$3,125.50
Rate for Payer: Cofinity Commercial	$3,839.90
Rate for Payer: Healthscope Commercial	$4,018.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3,795.25
Rate for Payer: PHP Commercial	$3,795.25
Rate for Payer: Priority Health Cigna Priority Health	$3,125.50
Rate for Payer: Priority Health SBD	$2,812.95

HALOPERIDOL 2 MG TABLET

Facility

$446.50

Service Code	NDC 0378-0214-01
Hospital Charge Code	3581
Hospital Revenue Code	637
Min. Negotiated Rate	$281.30
Max. Negotiated Rate	$401.85
Rate for Payer: Aetna Commercial	$379.52
Rate for Payer: Aetna New Business (MI Preferred)	$290.22
Rate for Payer: Cash Price	$357.20
Rate for Payer: Cofinity Commercial	$312.55
Rate for Payer: Cofinity Commercial	$383.99
Rate for Payer: Healthscope Commercial	$401.85
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$379.52
Rate for Payer: PHP Commercial	$379.52
Rate for Payer: Priority Health Cigna Priority Health	$312.55
Rate for Payer: Priority Health SBD	$281.30

HALOPERIDOL 5 MG TABLET

Facility

$346.75

Service Code	NDC 68382-079-01
Hospital Charge Code	3583
Hospital Revenue Code	637
Min. Negotiated Rate	$218.45
Max. Negotiated Rate	$312.08
Rate for Payer: Aetna Commercial	$294.74
Rate for Payer: Aetna New Business (MI Preferred)	$225.39
Rate for Payer: Cash Price	$277.40
Rate for Payer: Cofinity Commercial	$298.20
Rate for Payer: Cofinity Commercial	$242.72
Rate for Payer: Healthscope Commercial	$312.08
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$294.74
Rate for Payer: PHP Commercial	$294.74
Rate for Payer: Priority Health Cigna Priority Health	$242.72
Rate for Payer: Priority Health SBD	$218.45

HALOPERIDOL 5 MG TABLET

Facility

$2.72

Service Code	NDC 51079-736-01
Hospital Charge Code	3583
Hospital Revenue Code	637
Min. Negotiated Rate	$1.71
Max. Negotiated Rate	$2.45
Rate for Payer: Aetna Commercial	$2.31
Rate for Payer: Aetna New Business (MI Preferred)	$1.77
Rate for Payer: Cash Price	$2.18
Rate for Payer: Cofinity Commercial	$1.90
Rate for Payer: Cofinity Commercial	$2.34
Rate for Payer: Healthscope Commercial	$2.45
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2.31
Rate for Payer: PHP Commercial	$2.31
Rate for Payer: Priority Health Cigna Priority Health	$1.90
Rate for Payer: Priority Health SBD	$1.71

HALOPERIDOL 5 MG TABLET

Facility

$408.50

Service Code	NDC 0904-6782-61
Hospital Charge Code	3583
Hospital Revenue Code	637
Min. Negotiated Rate	$257.36
Max. Negotiated Rate	$367.65
Rate for Payer: Aetna Commercial	$347.22
Rate for Payer: Aetna New Business (MI Preferred)	$265.52
Rate for Payer: Cash Price	$326.80
Rate for Payer: Cofinity Commercial	$285.95
Rate for Payer: Cofinity Commercial	$351.31
Rate for Payer: Healthscope Commercial	$367.65
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$347.22
Rate for Payer: PHP Commercial	$347.22
Rate for Payer: Priority Health Cigna Priority Health	$285.95
Rate for Payer: Priority Health SBD	$257.36

HALOPERIDOL 5 MG TABLET

Facility

$367.68

Service Code	NDC 0781-1396-01
Hospital Charge Code	3583
Hospital Revenue Code	637
Min. Negotiated Rate	$231.64
Max. Negotiated Rate	$330.91
Rate for Payer: Aetna Commercial	$312.53
Rate for Payer: Aetna New Business (MI Preferred)	$238.99
Rate for Payer: Cash Price	$294.14
Rate for Payer: Cofinity Commercial	$257.38
Rate for Payer: Cofinity Commercial	$316.20
Rate for Payer: Healthscope Commercial	$330.91
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$312.53
Rate for Payer: PHP Commercial	$312.53
Rate for Payer: Priority Health Cigna Priority Health	$257.38
Rate for Payer: Priority Health SBD	$231.64

HALOPERIDOL 5 MG TABLET

Facility

$271.20

Service Code	NDC 51079-736-20
Hospital Charge Code	3583
Hospital Revenue Code	637
Min. Negotiated Rate	$170.86
Max. Negotiated Rate	$244.08
Rate for Payer: Aetna Commercial	$230.52
Rate for Payer: Aetna New Business (MI Preferred)	$176.28
Rate for Payer: Cash Price	$216.96
Rate for Payer: Cofinity Commercial	$189.84
Rate for Payer: Cofinity Commercial	$233.23
Rate for Payer: Healthscope Commercial	$244.08
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$230.52
Rate for Payer: PHP Commercial	$230.52
Rate for Payer: Priority Health Cigna Priority Health	$189.84
Rate for Payer: Priority Health SBD	$170.86

HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE

Facility

$243.96

Service Code	NDC 0121-0581-04
Hospital Charge Code	3585
Hospital Revenue Code	637
Min. Negotiated Rate	$153.69
Max. Negotiated Rate	$219.56
Rate for Payer: Aetna Commercial	$207.37
Rate for Payer: Aetna New Business (MI Preferred)	$158.57
Rate for Payer: Cash Price	$195.17
Rate for Payer: Cofinity Commercial	$170.77
Rate for Payer: Cofinity Commercial	$209.81
Rate for Payer: Healthscope Commercial	$219.56
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$207.37
Rate for Payer: PHP Commercial	$207.37
Rate for Payer: Priority Health Cigna Priority Health	$170.77
Rate for Payer: Priority Health SBD	$153.69

HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE

Facility

$425.82

Service Code	NDC 54838-501-40
Hospital Charge Code	3585
Hospital Revenue Code	637
Min. Negotiated Rate	$268.27
Max. Negotiated Rate	$383.24
Rate for Payer: Aetna Commercial	$361.95
Rate for Payer: Aetna New Business (MI Preferred)	$276.78
Rate for Payer: Cash Price	$340.66
Rate for Payer: Cofinity Commercial	$298.07
Rate for Payer: Cofinity Commercial	$366.21
Rate for Payer: Healthscope Commercial	$383.24
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$361.95
Rate for Payer: PHP Commercial	$361.95
Rate for Payer: Priority Health Cigna Priority Health	$298.07
Rate for Payer: Priority Health SBD	$268.27

HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION

Facility

$12.88

Service Code	HCPCS J1630
Hospital Charge Code	3584
Hospital Revenue Code	636
Min. Negotiated Rate	$8.11
Max. Negotiated Rate	$11.59
Rate for Payer: Aetna Commercial	$10.95
Rate for Payer: Aetna Commercial	$8.95
Rate for Payer: Aetna Commercial	$19.78
Rate for Payer: Aetna New Business (MI Preferred)	$8.37
Rate for Payer: Aetna New Business (MI Preferred)	$6.84
Rate for Payer: Aetna New Business (MI Preferred)	$15.13
Rate for Payer: Cash Price	$10.30
Rate for Payer: Cash Price	$8.42
Rate for Payer: Cash Price	$18.62
Rate for Payer: Cofinity Commercial	$9.06
Rate for Payer: Cofinity Commercial	$7.37
Rate for Payer: Cofinity Commercial	$11.08
Rate for Payer: Cofinity Commercial	$9.02
Rate for Payer: Cofinity Commercial	$16.29
Rate for Payer: Cofinity Commercial	$20.01
Rate for Payer: Healthscope Commercial	$9.48
Rate for Payer: Healthscope Commercial	$11.59
Rate for Payer: Healthscope Commercial	$20.94
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$10.95
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$8.95
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$19.78
Rate for Payer: PHP Commercial	$8.95
Rate for Payer: PHP Commercial	$10.95
Rate for Payer: PHP Commercial	$19.78
Rate for Payer: Priority Health Cigna Priority Health	$16.29
Rate for Payer: Priority Health Cigna Priority Health	$9.02
Rate for Payer: Priority Health Cigna Priority Health	$7.37
Rate for Payer: Priority Health SBD	$8.11
Rate for Payer: Priority Health SBD	$6.63
Rate for Payer: Priority Health SBD	$14.66

HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC

Facility

$24,726.73

Service Code	MS-DRG 513
Min. Negotiated Rate	$11,558.49
Max. Negotiated Rate	$24,726.73
Rate for Payer: Aetna Medicare	$12,653.50
Rate for Payer: Allen County Amish Medical Aid Commercial	$15,208.54
Rate for Payer: Amish Plain Church Group Commercial	$15,208.54
Rate for Payer: BCBS MAPPO	$12,166.83
Rate for Payer: BCBS Trust/PPO	$23,151.37
Rate for Payer: BCN Medicare Advantage	$12,166.83
Rate for Payer: Health Alliance Plan Medicare Advantage	$12,166.83
Rate for Payer: Mclaren Medicare	$12,166.83
Rate for Payer: Meridian Wellcare - Medicare Advantage	$12,775.17
Rate for Payer: MI Amish Medical Board Commercial	$13,991.85
Rate for Payer: PACE Medicare	$11,558.49
Rate for Payer: PACE SWMI	$12,166.83
Rate for Payer: PHP Medicare Advantage	$12,166.83
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$23,261.22
Rate for Payer: Priority Health Medicare	$12,166.83
Rate for Payer: Priority Health Narrow Network	$18,608.98
Rate for Payer: Railroad Medicare Medicare	$12,166.83
Rate for Payer: UHC All Payor (Choice/PPO)	$24,726.73
Rate for Payer: UHC Core	$15,172.56
Rate for Payer: UHC Dual Complete DSNP	$12,166.83
Rate for Payer: UHC Exchange	$16,250.53
Rate for Payer: UHC Medicare Advantage	$12,531.83
Rate for Payer: VA VA	$12,166.83

HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC

Facility

$16,155.24

Service Code	MS-DRG 514
Min. Negotiated Rate	$7,593.74
Max. Negotiated Rate	$16,155.24
Rate for Payer: Aetna Medicare	$8,313.15
Rate for Payer: Allen County Amish Medical Aid Commercial	$9,991.76
Rate for Payer: Amish Plain Church Group Commercial	$9,991.76
Rate for Payer: BCBS MAPPO	$7,993.41
Rate for Payer: BCBS Trust/PPO	$16,155.24
Rate for Payer: BCN Medicare Advantage	$7,993.41
Rate for Payer: Health Alliance Plan Medicare Advantage	$7,993.41
Rate for Payer: Mclaren Medicare	$7,993.41
Rate for Payer: Meridian Wellcare - Medicare Advantage	$8,393.08
Rate for Payer: MI Amish Medical Board Commercial	$9,192.42
Rate for Payer: PACE Medicare	$7,593.74
Rate for Payer: PACE SWMI	$7,993.41
Rate for Payer: PHP Medicare Advantage	$7,993.41
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$14,945.44
Rate for Payer: Priority Health Medicare	$7,993.41
Rate for Payer: Priority Health Narrow Network	$11,956.35
Rate for Payer: Railroad Medicare Medicare	$7,993.41
Rate for Payer: UHC All Payor (Choice/PPO)	$15,887.04
Rate for Payer: UHC Core	$9,748.44
Rate for Payer: UHC Dual Complete DSNP	$7,993.41
Rate for Payer: UHC Exchange	$10,441.04
Rate for Payer: UHC Medicare Advantage	$8,233.21
Rate for Payer: VA VA	$7,993.41

HAND PROCEDURES FOR INJURIES

Facility

$34,712.79

Service Code	MS-DRG 906
Min. Negotiated Rate	$13,341.43
Max. Negotiated Rate	$34,712.79
Rate for Payer: Aetna Medicare	$14,605.35
Rate for Payer: Allen County Amish Medical Aid Commercial	$17,554.51
Rate for Payer: Amish Plain Church Group Commercial	$17,554.51
Rate for Payer: BCBS MAPPO	$14,043.61
Rate for Payer: BCBS Trust/PPO	$34,712.79
Rate for Payer: BCN Medicare Advantage	$14,043.61
Rate for Payer: Health Alliance Plan Medicare Advantage	$14,043.61
Rate for Payer: Mclaren Medicare	$14,043.61
Rate for Payer: Meridian Wellcare - Medicare Advantage	$14,745.79
Rate for Payer: MI Amish Medical Board Commercial	$16,150.15
Rate for Payer: PACE Medicare	$13,341.43
Rate for Payer: PACE SWMI	$14,043.61
Rate for Payer: PHP Medicare Advantage	$14,043.61
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$27,000.81
Rate for Payer: Priority Health Medicare	$14,043.61
Rate for Payer: Priority Health Narrow Network	$21,600.65
Rate for Payer: Railroad Medicare Medicare	$14,043.61
Rate for Payer: UHC All Payor (Choice/PPO)	$28,701.93
Rate for Payer: UHC Core	$17,611.78
Rate for Payer: UHC Dual Complete DSNP	$14,043.61
Rate for Payer: UHC Exchange	$18,863.04
Rate for Payer: UHC Medicare Advantage	$14,464.92
Rate for Payer: VA VA	$14,043.61

HC 11 DEOXYCORTISOL

Facility

$64.26

Service Code	CPT 82634
Hospital Charge Code	30100189
Hospital Revenue Code	301
Min. Negotiated Rate	$16.02
Max. Negotiated Rate	$57.83
Rate for Payer: Aetna Commercial	$54.62
Rate for Payer: Aetna Medicare	$30.45
Rate for Payer: Aetna New Business (MI Preferred)	$41.77
Rate for Payer: Allen County Amish Medical Aid Commercial	$36.60
Rate for Payer: Amish Plain Church Group Commercial	$36.60
Rate for Payer: BCBS Complete	$16.82
Rate for Payer: BCBS MAPPO	$29.28
Rate for Payer: BCBS Trust/PPO	$22.93
Rate for Payer: BCN Medicare Advantage	$29.28
Rate for Payer: Cash Price	$51.41
Rate for Payer: Cash Price	$51.41
Rate for Payer: Cofinity Commercial	$55.26
Rate for Payer: Cofinity Commercial	$44.98
Rate for Payer: Health Alliance Plan Medicare Advantage	$29.28
Rate for Payer: Healthscope Commercial	$57.83
Rate for Payer: Mclaren Medicaid	$16.02
Rate for Payer: Mclaren Medicare	$29.28
Rate for Payer: Meridian Medicaid	$16.82
Rate for Payer: Meridian Wellcare - Medicare Advantage	$30.74
Rate for Payer: MI Amish Medical Board Commercial	$33.67
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$54.62
Rate for Payer: PACE Medicare	$27.82
Rate for Payer: PACE SWMI	$29.28
Rate for Payer: PHP Commercial	$54.62
Rate for Payer: PHP Medicare Advantage	$29.28
Rate for Payer: Priority Health Choice Medicaid	$16.02
Rate for Payer: Priority Health Cigna Priority Health	$44.98
Rate for Payer: Priority Health Medicare	$29.28
Rate for Payer: Priority Health SBD	$40.48
Rate for Payer: Railroad Medicare Medicare	$29.28
Rate for Payer: UHC All Payor (Choice/PPO)	$35.14
Rate for Payer: UHC Core	$49.75
Rate for Payer: UHC Dual Complete DSNP	$29.28
Rate for Payer: UHC Exchange	$29.28
Rate for Payer: UHC Medicare Advantage	$30.16
Rate for Payer: VA VA	$29.28

Know your out-of-pocket cost for care.

All Charges