Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

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

HC 1/2 X 1/2 STERILE W/LL

Facility

$6.75

Hospital Charge Code	27000680
Hospital Revenue Code	270
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$6.08
Rate for Payer: Aetna Commercial	$5.74
Rate for Payer: Aetna New Business (MI Preferred)	$4.39
Rate for Payer: BCBS Complete	$2.70
Rate for Payer: Cash Price	$5.40
Rate for Payer: Cofinity Commercial	$4.72
Rate for Payer: Cofinity Commercial	$5.80
Rate for Payer: Healthscope Commercial	$6.08
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$5.74
Rate for Payer: PHP Commercial	$5.74
Rate for Payer: Priority Health Cigna Priority Health	$4.72
Rate for Payer: Priority Health SBD	$4.25

HC 1/2 X 1/2 STERILE W/LL

Facility

$6.75

Hospital Charge Code	27000680
Hospital Revenue Code	270
Min. Negotiated Rate	$4.25
Max. Negotiated Rate	$6.08
Rate for Payer: Aetna Commercial	$5.74
Rate for Payer: Aetna New Business (MI Preferred)	$4.39
Rate for Payer: Cash Price	$5.40
Rate for Payer: Cofinity Commercial	$4.72
Rate for Payer: Cofinity Commercial	$5.80
Rate for Payer: Healthscope Commercial	$6.08
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$5.74
Rate for Payer: PHP Commercial	$5.74
Rate for Payer: Priority Health Cigna Priority Health	$4.72
Rate for Payer: Priority Health SBD	$4.25

HC 20CM TL CATHETER

Facility

$272.95

Service Code	HCPCS C1751
Hospital Charge Code	27200007
Hospital Revenue Code	272
Min. Negotiated Rate	$109.18
Max. Negotiated Rate	$245.66
Rate for Payer: Aetna Commercial	$232.01
Rate for Payer: Aetna New Business (MI Preferred)	$177.42
Rate for Payer: BCBS Complete	$109.18
Rate for Payer: Cash Price	$218.36
Rate for Payer: Cofinity Commercial	$191.06
Rate for Payer: Cofinity Commercial	$234.74
Rate for Payer: Healthscope Commercial	$245.66
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$232.01
Rate for Payer: PHP Commercial	$232.01
Rate for Payer: Priority Health Cigna Priority Health	$191.06
Rate for Payer: Priority Health SBD	$171.96

HC 20CM TL CATHETER

Facility

$272.95

Service Code	HCPCS C1751
Hospital Charge Code	27200007
Hospital Revenue Code	272
Min. Negotiated Rate	$171.96
Max. Negotiated Rate	$245.66
Rate for Payer: Aetna Commercial	$232.01
Rate for Payer: Aetna New Business (MI Preferred)	$177.42
Rate for Payer: Cash Price	$218.36
Rate for Payer: Cofinity Commercial	$191.06
Rate for Payer: Cofinity Commercial	$234.74
Rate for Payer: Healthscope Commercial	$245.66
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$232.01
Rate for Payer: PHP Commercial	$232.01
Rate for Payer: Priority Health Cigna Priority Health	$191.06
Rate for Payer: Priority Health SBD	$171.96

HC 23BPG, U

Facility

$73.44

Service Code	CPT 84150
Hospital Charge Code	30100714
Hospital Revenue Code	301
Min. Negotiated Rate	$22.85
Max. Negotiated Rate	$66.10
Rate for Payer: Aetna Commercial	$62.42
Rate for Payer: Aetna Medicare	$43.44
Rate for Payer: Aetna New Business (MI Preferred)	$47.74
Rate for Payer: Allen County Amish Medical Aid Commercial	$52.21
Rate for Payer: Amish Plain Church Group Commercial	$52.21
Rate for Payer: BCBS Complete	$23.99
Rate for Payer: BCBS MAPPO	$41.77
Rate for Payer: BCBS Trust/PPO	$32.71
Rate for Payer: BCN Medicare Advantage	$41.77
Rate for Payer: Cash Price	$58.75
Rate for Payer: Cash Price	$58.75
Rate for Payer: Cofinity Commercial	$51.41
Rate for Payer: Cofinity Commercial	$63.16
Rate for Payer: Health Alliance Plan Medicare Advantage	$41.77
Rate for Payer: Healthscope Commercial	$66.10
Rate for Payer: Mclaren Medicaid	$22.85
Rate for Payer: Mclaren Medicare	$41.77
Rate for Payer: Meridian Medicaid	$23.99
Rate for Payer: Meridian Wellcare - Medicare Advantage	$43.86
Rate for Payer: MI Amish Medical Board Commercial	$48.04
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$62.42
Rate for Payer: PACE Medicare	$39.68
Rate for Payer: PACE SWMI	$41.77
Rate for Payer: PHP Commercial	$62.42
Rate for Payer: PHP Medicare Advantage	$41.77
Rate for Payer: Priority Health Choice Medicaid	$22.85
Rate for Payer: Priority Health Cigna Priority Health	$51.41
Rate for Payer: Priority Health Medicare	$41.77
Rate for Payer: Priority Health SBD	$46.27
Rate for Payer: Railroad Medicare Medicare	$41.77
Rate for Payer: UHC All Payor (Choice/PPO)	$50.12
Rate for Payer: UHC Core	$42.42
Rate for Payer: UHC Dual Complete DSNP	$41.77
Rate for Payer: UHC Exchange	$41.77
Rate for Payer: UHC Medicare Advantage	$43.02
Rate for Payer: VA VA	$41.77

HC 23BPG, U

Facility

$73.44

Service Code	CPT 84150
Hospital Charge Code	30100714
Hospital Revenue Code	301
Min. Negotiated Rate	$46.27
Max. Negotiated Rate	$66.10
Rate for Payer: Aetna Commercial	$62.42
Rate for Payer: Aetna New Business (MI Preferred)	$47.74
Rate for Payer: Cash Price	$58.75
Rate for Payer: Cofinity Commercial	$51.41
Rate for Payer: Cofinity Commercial	$63.16
Rate for Payer: Healthscope Commercial	$66.10
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$62.42
Rate for Payer: PHP Commercial	$62.42
Rate for Payer: Priority Health Cigna Priority Health	$51.41
Rate for Payer: Priority Health SBD	$46.27

HC 23BPR URINE

Facility

$85.21

Service Code	CPT 84150
Hospital Charge Code	30100735
Hospital Revenue Code	301
Min. Negotiated Rate	$53.68
Max. Negotiated Rate	$76.69
Rate for Payer: Aetna Commercial	$72.43
Rate for Payer: Aetna New Business (MI Preferred)	$55.39
Rate for Payer: Cash Price	$68.17
Rate for Payer: Cofinity Commercial	$59.65
Rate for Payer: Cofinity Commercial	$73.28
Rate for Payer: Healthscope Commercial	$76.69
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$72.43
Rate for Payer: PHP Commercial	$72.43
Rate for Payer: Priority Health Cigna Priority Health	$59.65
Rate for Payer: Priority Health SBD	$53.68

HC 23BPR URINE

Facility

$85.21

Service Code	CPT 84150
Hospital Charge Code	30100735
Hospital Revenue Code	301
Min. Negotiated Rate	$22.85
Max. Negotiated Rate	$76.69
Rate for Payer: Aetna Commercial	$72.43
Rate for Payer: Aetna Medicare	$43.44
Rate for Payer: Aetna New Business (MI Preferred)	$55.39
Rate for Payer: Allen County Amish Medical Aid Commercial	$52.21
Rate for Payer: Amish Plain Church Group Commercial	$52.21
Rate for Payer: BCBS Complete	$23.99
Rate for Payer: BCBS MAPPO	$41.77
Rate for Payer: BCBS Trust/PPO	$32.71
Rate for Payer: BCN Medicare Advantage	$41.77
Rate for Payer: Cash Price	$68.17
Rate for Payer: Cash Price	$68.17
Rate for Payer: Cofinity Commercial	$73.28
Rate for Payer: Cofinity Commercial	$59.65
Rate for Payer: Health Alliance Plan Medicare Advantage	$41.77
Rate for Payer: Healthscope Commercial	$76.69
Rate for Payer: Mclaren Medicaid	$22.85
Rate for Payer: Mclaren Medicare	$41.77
Rate for Payer: Meridian Medicaid	$23.99
Rate for Payer: Meridian Wellcare - Medicare Advantage	$43.86
Rate for Payer: MI Amish Medical Board Commercial	$48.04
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$72.43
Rate for Payer: PACE Medicare	$39.68
Rate for Payer: PACE SWMI	$41.77
Rate for Payer: PHP Commercial	$72.43
Rate for Payer: PHP Medicare Advantage	$41.77
Rate for Payer: Priority Health Choice Medicaid	$22.85
Rate for Payer: Priority Health Cigna Priority Health	$59.65
Rate for Payer: Priority Health Medicare	$41.77
Rate for Payer: Priority Health SBD	$53.68
Rate for Payer: Railroad Medicare Medicare	$41.77
Rate for Payer: UHC All Payor (Choice/PPO)	$50.12
Rate for Payer: UHC Core	$42.42
Rate for Payer: UHC Dual Complete DSNP	$41.77
Rate for Payer: UHC Exchange	$41.77
Rate for Payer: UHC Medicare Advantage	$43.02
Rate for Payer: VA VA	$41.77

HC 24 HOUR PH MONITOR

Facility

$1,521.71

Service Code	CPT 91034
Hospital Charge Code	75000001
Hospital Revenue Code	750
Min. Negotiated Rate	$187.95
Max. Negotiated Rate	$1,369.54
Rate for Payer: Aetna Commercial	$1,293.45
Rate for Payer: Aetna Medicare	$495.99
Rate for Payer: Aetna New Business (MI Preferred)	$989.11
Rate for Payer: Allen County Amish Medical Aid Commercial	$596.14
Rate for Payer: Amish Plain Church Group Commercial	$596.14
Rate for Payer: BCBS Complete	$273.94
Rate for Payer: BCBS MAPPO	$476.91
Rate for Payer: BCBS Trust/PPO	$661.63
Rate for Payer: BCN Medicare Advantage	$476.91
Rate for Payer: Cash Price	$1,217.37
Rate for Payer: Cash Price	$1,217.37
Rate for Payer: Cofinity Commercial	$1,308.67
Rate for Payer: Cofinity Commercial	$1,065.20
Rate for Payer: Health Alliance Plan Medicare Advantage	$476.91
Rate for Payer: Healthscope Commercial	$1,369.54
Rate for Payer: Mclaren Medicaid	$260.87
Rate for Payer: Mclaren Medicare	$476.91
Rate for Payer: Meridian Medicaid	$273.94
Rate for Payer: Meridian Wellcare - Medicare Advantage	$500.76
Rate for Payer: MI Amish Medical Board Commercial	$548.45
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,293.45
Rate for Payer: PACE Medicare	$453.06
Rate for Payer: PACE SWMI	$476.91
Rate for Payer: PHP Commercial	$1,293.45
Rate for Payer: PHP Medicare Advantage	$476.91
Rate for Payer: Priority Health Choice Medicaid	$260.87
Rate for Payer: Priority Health Cigna Priority Health	$1,065.20
Rate for Payer: Priority Health Medicare	$476.91
Rate for Payer: Priority Health SBD	$958.68
Rate for Payer: Railroad Medicare Medicare	$476.91
Rate for Payer: UHC All Payor (Choice/PPO)	$206.74
Rate for Payer: UHC Core	$878.00
Rate for Payer: UHC Dual Complete DSNP	$476.91
Rate for Payer: UHC Exchange	$187.95
Rate for Payer: UHC Medicare Advantage	$491.22
Rate for Payer: VA VA	$476.91

HC 24 HOUR PH MONITOR

Facility

$1,521.71

Service Code	CPT 91034
Hospital Charge Code	75000001
Hospital Revenue Code	750
Min. Negotiated Rate	$958.68
Max. Negotiated Rate	$1,369.54
Rate for Payer: Aetna Commercial	$1,293.45
Rate for Payer: Aetna New Business (MI Preferred)	$989.11
Rate for Payer: Cash Price	$1,217.37
Rate for Payer: Cofinity Commercial	$1,065.20
Rate for Payer: Cofinity Commercial	$1,308.67
Rate for Payer: Healthscope Commercial	$1,369.54
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,293.45
Rate for Payer: PHP Commercial	$1,293.45
Rate for Payer: Priority Health Cigna Priority Health	$1,065.20
Rate for Payer: Priority Health SBD	$958.68

HC 2D ECHOCARDIOGRAM LIMITED STUDY

Facility

$809.36

Service Code	CPT 93308
Hospital Charge Code	48300002
Hospital Revenue Code	483
Min. Negotiated Rate	$509.90
Max. Negotiated Rate	$728.42
Rate for Payer: Aetna Commercial	$687.96
Rate for Payer: Aetna New Business (MI Preferred)	$526.08
Rate for Payer: Cash Price	$647.49
Rate for Payer: Cofinity Commercial	$566.55
Rate for Payer: Cofinity Commercial	$696.05
Rate for Payer: Healthscope Commercial	$728.42
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$687.96
Rate for Payer: PHP Commercial	$687.96
Rate for Payer: Priority Health Cigna Priority Health	$566.55
Rate for Payer: Priority Health SBD	$509.90

HC 2D ECHOCARDIOGRAM LIMITED STUDY

Facility

$809.36

Service Code	CPT 93308
Hospital Charge Code	48300002
Hospital Revenue Code	483
Min. Negotiated Rate	$96.92
Max. Negotiated Rate	$728.42
Rate for Payer: Aetna Commercial	$687.96
Rate for Payer: Aetna Medicare	$226.75
Rate for Payer: Aetna New Business (MI Preferred)	$526.08
Rate for Payer: Allen County Amish Medical Aid Commercial	$272.54
Rate for Payer: Amish Plain Church Group Commercial	$272.54
Rate for Payer: BCBS Complete	$125.24
Rate for Payer: BCBS MAPPO	$218.03
Rate for Payer: BCBS Trust/PPO	$339.24
Rate for Payer: BCN Medicare Advantage	$218.03
Rate for Payer: Cash Price	$647.49
Rate for Payer: Cash Price	$647.49
Rate for Payer: Cofinity Commercial	$566.55
Rate for Payer: Cofinity Commercial	$696.05
Rate for Payer: Health Alliance Plan Medicare Advantage	$218.03
Rate for Payer: Healthscope Commercial	$728.42
Rate for Payer: Mclaren Medicaid	$119.26
Rate for Payer: Mclaren Medicare	$218.03
Rate for Payer: Meridian Medicaid	$125.24
Rate for Payer: Meridian Wellcare - Medicare Advantage	$228.93
Rate for Payer: MI Amish Medical Board Commercial	$250.73
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$687.96
Rate for Payer: PACE Medicare	$207.13
Rate for Payer: PACE SWMI	$218.03
Rate for Payer: PHP Commercial	$687.96
Rate for Payer: PHP Medicare Advantage	$218.03
Rate for Payer: Priority Health Choice Medicaid	$119.26
Rate for Payer: Priority Health Cigna Priority Health	$566.55
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$716.43
Rate for Payer: Priority Health Medicare	$218.03
Rate for Payer: Priority Health Narrow Network	$573.14
Rate for Payer: Priority Health SBD	$509.90
Rate for Payer: Railroad Medicare Medicare	$218.03
Rate for Payer: UHC All Payor (Choice/PPO)	$106.61
Rate for Payer: UHC Dual Complete DSNP	$218.03
Rate for Payer: UHC Exchange	$96.92
Rate for Payer: UHC Medicare Advantage	$224.57
Rate for Payer: VA VA	$218.03

HC 2 PIECE WAFER

Facility

$13.16

Hospital Charge Code	27100001
Hospital Revenue Code	271
Min. Negotiated Rate	$8.29
Max. Negotiated Rate	$11.84
Rate for Payer: Aetna Commercial	$11.19
Rate for Payer: Aetna New Business (MI Preferred)	$8.55
Rate for Payer: Cash Price	$10.53
Rate for Payer: Cofinity Commercial	$11.32
Rate for Payer: Cofinity Commercial	$9.21
Rate for Payer: Healthscope Commercial	$11.84
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$11.19
Rate for Payer: PHP Commercial	$11.19
Rate for Payer: Priority Health Cigna Priority Health	$9.21
Rate for Payer: Priority Health SBD	$8.29

HC 2 PIECE WAFER

Facility

$13.16

Hospital Charge Code	27100001
Hospital Revenue Code	271
Min. Negotiated Rate	$5.26
Max. Negotiated Rate	$11.84
Rate for Payer: Aetna Commercial	$11.19
Rate for Payer: Aetna New Business (MI Preferred)	$8.55
Rate for Payer: BCBS Complete	$5.26
Rate for Payer: Cash Price	$10.53
Rate for Payer: Cofinity Commercial	$11.32
Rate for Payer: Cofinity Commercial	$9.21
Rate for Payer: Healthscope Commercial	$11.84
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$11.19
Rate for Payer: PHP Commercial	$11.19
Rate for Payer: Priority Health Cigna Priority Health	$9.21
Rate for Payer: Priority Health SBD	$8.29

HC 3D ECHO RENDERING

Facility

$656.07

Service Code	CPT 76376
Hospital Charge Code	32000282
Hospital Revenue Code	320
Min. Negotiated Rate	$413.32
Max. Negotiated Rate	$590.46
Rate for Payer: Aetna Commercial	$557.66
Rate for Payer: Aetna New Business (MI Preferred)	$426.45
Rate for Payer: Cash Price	$524.86
Rate for Payer: Cofinity Commercial	$459.25
Rate for Payer: Cofinity Commercial	$564.22
Rate for Payer: Healthscope Commercial	$590.46
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$557.66
Rate for Payer: PHP Commercial	$557.66
Rate for Payer: Priority Health Cigna Priority Health	$459.25
Rate for Payer: Priority Health SBD	$413.32

HC 3D ECHO RENDERING

Facility

$656.07

Service Code	CPT 76376
Hospital Charge Code	32000282
Hospital Revenue Code	320
Min. Negotiated Rate	$24.28
Max. Negotiated Rate	$590.46
Rate for Payer: Aetna Commercial	$557.66
Rate for Payer: Aetna New Business (MI Preferred)	$426.45
Rate for Payer: BCBS Complete	$262.43
Rate for Payer: BCBS Trust/PPO	$24.28
Rate for Payer: Cash Price	$524.86
Rate for Payer: Cash Price	$524.86
Rate for Payer: Cofinity Commercial	$459.25
Rate for Payer: Cofinity Commercial	$564.22
Rate for Payer: Healthscope Commercial	$590.46
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$557.66
Rate for Payer: PHP Commercial	$557.66
Rate for Payer: Priority Health Cigna Priority Health	$459.25
Rate for Payer: Priority Health SBD	$413.32
Rate for Payer: UHC All Payor (Choice/PPO)	$27.02
Rate for Payer: UHC Exchange	$24.56

HC 3D ECHO REND W/WORKSTATION

Facility

$625.36

Service Code	CPT 76377
Hospital Charge Code	32000283
Hospital Revenue Code	320
Min. Negotiated Rate	$393.98
Max. Negotiated Rate	$562.82
Rate for Payer: Aetna Commercial	$531.56
Rate for Payer: Aetna New Business (MI Preferred)	$406.48
Rate for Payer: Cash Price	$500.29
Rate for Payer: Cofinity Commercial	$437.75
Rate for Payer: Cofinity Commercial	$537.81
Rate for Payer: Healthscope Commercial	$562.82
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$531.56
Rate for Payer: PHP Commercial	$531.56
Rate for Payer: Priority Health Cigna Priority Health	$437.75
Rate for Payer: Priority Health SBD	$393.98

HC 3D ECHO REND W/WORKSTATION

Facility

$625.36

Service Code	CPT 76377
Hospital Charge Code	32000283
Hospital Revenue Code	320
Min. Negotiated Rate	$63.43
Max. Negotiated Rate	$562.82
Rate for Payer: Aetna Commercial	$531.56
Rate for Payer: Aetna New Business (MI Preferred)	$406.48
Rate for Payer: BCBS Complete	$250.14
Rate for Payer: BCBS Trust/PPO	$63.43
Rate for Payer: Cash Price	$500.29
Rate for Payer: Cash Price	$500.29
Rate for Payer: Cofinity Commercial	$537.81
Rate for Payer: Cofinity Commercial	$437.75
Rate for Payer: Healthscope Commercial	$562.82
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$531.56
Rate for Payer: PHP Commercial	$531.56
Rate for Payer: Priority Health Cigna Priority Health	$437.75
Rate for Payer: Priority Health SBD	$393.98
Rate for Payer: UHC All Payor (Choice/PPO)	$84.28
Rate for Payer: UHC Exchange	$76.62

HC 4X4 WAFER

Facility

$24.03

Hospital Charge Code	27000023
Hospital Revenue Code	270
Min. Negotiated Rate	$15.14
Max. Negotiated Rate	$21.63
Rate for Payer: Aetna Commercial	$20.43
Rate for Payer: Aetna New Business (MI Preferred)	$15.62
Rate for Payer: Cash Price	$19.22
Rate for Payer: Cofinity Commercial	$16.82
Rate for Payer: Cofinity Commercial	$20.67
Rate for Payer: Healthscope Commercial	$21.63
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$20.43
Rate for Payer: PHP Commercial	$20.43
Rate for Payer: Priority Health Cigna Priority Health	$16.82
Rate for Payer: Priority Health SBD	$15.14

HC 4X4 WAFER

Facility

$24.03

Hospital Charge Code	27000023
Hospital Revenue Code	270
Min. Negotiated Rate	$9.61
Max. Negotiated Rate	$21.63
Rate for Payer: Aetna Commercial	$20.43
Rate for Payer: Aetna New Business (MI Preferred)	$15.62
Rate for Payer: BCBS Complete	$9.61
Rate for Payer: Cash Price	$19.22
Rate for Payer: Cofinity Commercial	$16.82
Rate for Payer: Cofinity Commercial	$20.67
Rate for Payer: Healthscope Commercial	$21.63
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$20.43
Rate for Payer: PHP Commercial	$20.43
Rate for Payer: Priority Health Cigna Priority Health	$16.82
Rate for Payer: Priority Health SBD	$15.14

HC 5 FR SOLO 3CG POWER PICC

Facility

$1,104.48

Service Code	HCPCS C1751
Hospital Charge Code	27200169
Hospital Revenue Code	272
Min. Negotiated Rate	$695.82
Max. Negotiated Rate	$994.03
Rate for Payer: Aetna Commercial	$938.81
Rate for Payer: Aetna New Business (MI Preferred)	$717.91
Rate for Payer: Cash Price	$883.58
Rate for Payer: Cofinity Commercial	$773.14
Rate for Payer: Cofinity Commercial	$949.85
Rate for Payer: Healthscope Commercial	$994.03
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$938.81
Rate for Payer: PHP Commercial	$938.81
Rate for Payer: Priority Health Cigna Priority Health	$773.14
Rate for Payer: Priority Health SBD	$695.82

HC 5 FR SOLO 3CG POWER PICC

Facility

$1,104.48

Service Code	HCPCS C1751
Hospital Charge Code	27200169
Hospital Revenue Code	272
Min. Negotiated Rate	$441.79
Max. Negotiated Rate	$994.03
Rate for Payer: Aetna Commercial	$938.81
Rate for Payer: Aetna New Business (MI Preferred)	$717.91
Rate for Payer: BCBS Complete	$441.79
Rate for Payer: Cash Price	$883.58
Rate for Payer: Cofinity Commercial	$773.14
Rate for Payer: Cofinity Commercial	$949.85
Rate for Payer: Healthscope Commercial	$994.03
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$938.81
Rate for Payer: PHP Commercial	$938.81
Rate for Payer: Priority Health Cigna Priority Health	$773.14
Rate for Payer: Priority Health SBD	$695.82

HC 5FR SOLO POWER PICC

Facility

$957.12

Service Code	HCPCS C1751
Hospital Charge Code	27200108
Hospital Revenue Code	272
Min. Negotiated Rate	$602.99
Max. Negotiated Rate	$861.41
Rate for Payer: Aetna Commercial	$813.55
Rate for Payer: Aetna New Business (MI Preferred)	$622.13
Rate for Payer: Cash Price	$765.70
Rate for Payer: Cofinity Commercial	$669.98
Rate for Payer: Cofinity Commercial	$823.12
Rate for Payer: Healthscope Commercial	$861.41
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$813.55
Rate for Payer: PHP Commercial	$813.55
Rate for Payer: Priority Health Cigna Priority Health	$669.98
Rate for Payer: Priority Health SBD	$602.99

HC 5FR SOLO POWER PICC

Facility

$957.12

Service Code	HCPCS C1751
Hospital Charge Code	27200108
Hospital Revenue Code	272
Min. Negotiated Rate	$382.85
Max. Negotiated Rate	$861.41
Rate for Payer: Aetna Commercial	$813.55
Rate for Payer: Aetna New Business (MI Preferred)	$622.13
Rate for Payer: BCBS Complete	$382.85
Rate for Payer: Cash Price	$765.70
Rate for Payer: Cofinity Commercial	$669.98
Rate for Payer: Cofinity Commercial	$823.12
Rate for Payer: Healthscope Commercial	$861.41
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$813.55
Rate for Payer: PHP Commercial	$813.55
Rate for Payer: Priority Health Cigna Priority Health	$669.98
Rate for Payer: Priority Health SBD	$602.99

Know your out-of-pocket cost for care.

All Charges