Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

SODIUM ZIRCONIUM CYCLOSILICATE 10 GRAM ORAL POWDER PACKET

Facility

$32.61

Service Code	NDC 00310111001
Hospital Charge Code	188049
Hospital Revenue Code	637
Min. Negotiated Rate	$13.04
Max. Negotiated Rate	$29.35
Rate for Payer: Aetna Commercial	$27.72
Rate for Payer: Aetna Medicare	$16.30
Rate for Payer: Aetna New Business (MI Preferred)	$21.20
Rate for Payer: BCBS Complete	$13.04
Rate for Payer: Cash Price	$26.09
Rate for Payer: Cofinity Commercial	$22.83
Rate for Payer: Cofinity Commercial	$28.04
Rate for Payer: Cofinity Medicare Advantage	$22.83
Rate for Payer: Encore Health Key Benefits Commercial	$26.09
Rate for Payer: Healthscope Commercial	$29.35
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$27.72
Rate for Payer: PHP Commercial	$27.72
Rate for Payer: Priority Health Cigna Priority Health	$21.20
Rate for Payer: Priority Health SBD	$20.54

SODIUM ZIRCONIUM CYCLOSILICATE 10 GRAM ORAL POWDER PACKET

Facility

$978.25

Service Code	NDC 00310111030
Hospital Charge Code	188049
Hospital Revenue Code	637
Min. Negotiated Rate	$616.30
Max. Negotiated Rate	$880.42
Rate for Payer: Aetna Commercial	$831.51
Rate for Payer: Aetna New Business (MI Preferred)	$635.86
Rate for Payer: Cash Price	$782.60
Rate for Payer: Cofinity Commercial	$684.78
Rate for Payer: Cofinity Commercial	$841.30
Rate for Payer: Cofinity Medicare Advantage	$684.78
Rate for Payer: Encore Health Key Benefits Commercial	$782.60
Rate for Payer: Healthscope Commercial	$880.42
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$831.51
Rate for Payer: PHP Commercial	$831.51
Rate for Payer: Priority Health Cigna Priority Health	$635.86
Rate for Payer: Priority Health SBD	$616.30

SODIUM ZIRCONIUM CYCLOSILICATE 10 GRAM ORAL POWDER PACKET

Facility

$32.61

Service Code	NDC 00310111001
Hospital Charge Code	188049
Hospital Revenue Code	637
Min. Negotiated Rate	$20.54
Max. Negotiated Rate	$29.35
Rate for Payer: Aetna Commercial	$27.72
Rate for Payer: Aetna New Business (MI Preferred)	$21.20
Rate for Payer: Cash Price	$26.09
Rate for Payer: Cofinity Commercial	$22.83
Rate for Payer: Cofinity Commercial	$28.04
Rate for Payer: Cofinity Medicare Advantage	$22.83
Rate for Payer: Encore Health Key Benefits Commercial	$26.09
Rate for Payer: Healthscope Commercial	$29.35
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$27.72
Rate for Payer: PHP Commercial	$27.72
Rate for Payer: Priority Health Cigna Priority Health	$21.20
Rate for Payer: Priority Health SBD	$20.54

SODIUM ZIRCONIUM CYCLOSILICATE 5 GRAM ORAL POWDER PACKET

Facility

$358.69

Service Code	NDC 00310110539
Hospital Charge Code	188048
Hospital Revenue Code	637
Min. Negotiated Rate	$143.48
Max. Negotiated Rate	$322.82
Rate for Payer: Aetna Commercial	$304.89
Rate for Payer: Aetna Medicare	$179.34
Rate for Payer: Aetna New Business (MI Preferred)	$233.15
Rate for Payer: BCBS Complete	$143.48
Rate for Payer: Cash Price	$286.95
Rate for Payer: Cofinity Commercial	$251.08
Rate for Payer: Cofinity Commercial	$308.47
Rate for Payer: Cofinity Medicare Advantage	$251.08
Rate for Payer: Encore Health Key Benefits Commercial	$286.95
Rate for Payer: Healthscope Commercial	$322.82
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$304.89
Rate for Payer: PHP Commercial	$304.89
Rate for Payer: Priority Health Cigna Priority Health	$233.15
Rate for Payer: Priority Health SBD	$225.97

SODIUM ZIRCONIUM CYCLOSILICATE 5 GRAM ORAL POWDER PACKET

Facility

$358.69

Service Code	NDC 00310110539
Hospital Charge Code	188048
Hospital Revenue Code	637
Min. Negotiated Rate	$225.97
Max. Negotiated Rate	$322.82
Rate for Payer: Aetna Commercial	$304.89
Rate for Payer: Aetna New Business (MI Preferred)	$233.15
Rate for Payer: Cash Price	$286.95
Rate for Payer: Cofinity Commercial	$251.08
Rate for Payer: Cofinity Commercial	$308.47
Rate for Payer: Cofinity Medicare Advantage	$251.08
Rate for Payer: Encore Health Key Benefits Commercial	$286.95
Rate for Payer: Healthscope Commercial	$322.82
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$304.89
Rate for Payer: PHP Commercial	$304.89
Rate for Payer: Priority Health Cigna Priority Health	$233.15
Rate for Payer: Priority Health SBD	$225.97

SODIUM ZIRCONIUM CYCLOSILICATE 5 GRAM ORAL POWDER PACKET

Facility

$32.61

Service Code	NDC 00310110501
Hospital Charge Code	188048
Hospital Revenue Code	637
Min. Negotiated Rate	$20.54
Max. Negotiated Rate	$29.35
Rate for Payer: Aetna Commercial	$27.72
Rate for Payer: Aetna New Business (MI Preferred)	$21.20
Rate for Payer: Cash Price	$26.09
Rate for Payer: Cofinity Commercial	$22.83
Rate for Payer: Cofinity Commercial	$28.04
Rate for Payer: Cofinity Medicare Advantage	$22.83
Rate for Payer: Encore Health Key Benefits Commercial	$26.09
Rate for Payer: Healthscope Commercial	$29.35
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$27.72
Rate for Payer: PHP Commercial	$27.72
Rate for Payer: Priority Health Cigna Priority Health	$21.20
Rate for Payer: Priority Health SBD	$20.54

SODIUM ZIRCONIUM CYCLOSILICATE 5 GRAM ORAL POWDER PACKET

Facility

$32.61

Service Code	NDC 00310110501
Hospital Charge Code	188048
Hospital Revenue Code	637
Min. Negotiated Rate	$13.04
Max. Negotiated Rate	$29.35
Rate for Payer: Aetna Commercial	$27.72
Rate for Payer: Aetna Medicare	$16.30
Rate for Payer: Aetna New Business (MI Preferred)	$21.20
Rate for Payer: BCBS Complete	$13.04
Rate for Payer: Cash Price	$26.09
Rate for Payer: Cofinity Commercial	$22.83
Rate for Payer: Cofinity Commercial	$28.04
Rate for Payer: Cofinity Medicare Advantage	$22.83
Rate for Payer: Encore Health Key Benefits Commercial	$26.09
Rate for Payer: Healthscope Commercial	$29.35
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$27.72
Rate for Payer: PHP Commercial	$27.72
Rate for Payer: Priority Health Cigna Priority Health	$21.20
Rate for Payer: Priority Health SBD	$20.54

SORBITOL 70 % SOLUTION

Facility

$29.76

Service Code	NDC 00802391316
Hospital Charge Code	7413
Hospital Revenue Code	637
Min. Negotiated Rate	$11.90
Max. Negotiated Rate	$26.78
Rate for Payer: Aetna Commercial	$25.30
Rate for Payer: Aetna Medicare	$14.88
Rate for Payer: Aetna New Business (MI Preferred)	$19.34
Rate for Payer: BCBS Complete	$11.90
Rate for Payer: Cash Price	$23.81
Rate for Payer: Cofinity Commercial	$20.83
Rate for Payer: Cofinity Commercial	$25.59
Rate for Payer: Cofinity Medicare Advantage	$20.83
Rate for Payer: Encore Health Key Benefits Commercial	$23.81
Rate for Payer: Healthscope Commercial	$26.78
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$25.30
Rate for Payer: PHP Commercial	$25.30
Rate for Payer: Priority Health Cigna Priority Health	$19.34
Rate for Payer: Priority Health SBD	$18.75

SORBITOL 70 % SOLUTION

Facility

$29.76

Service Code	NDC 00802391316
Hospital Charge Code	7413
Hospital Revenue Code	637
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$26.78
Rate for Payer: Aetna Commercial	$25.30
Rate for Payer: Aetna New Business (MI Preferred)	$19.34
Rate for Payer: Cash Price	$23.81
Rate for Payer: Cofinity Commercial	$20.83
Rate for Payer: Cofinity Commercial	$25.59
Rate for Payer: Cofinity Medicare Advantage	$20.83
Rate for Payer: Encore Health Key Benefits Commercial	$23.81
Rate for Payer: Healthscope Commercial	$26.78
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$25.30
Rate for Payer: PHP Commercial	$25.30
Rate for Payer: Priority Health Cigna Priority Health	$19.34
Rate for Payer: Priority Health SBD	$18.75

SORBITOL 70 % SOLUTION

Facility

$45.51

Service Code	NDC 46287050001
Hospital Charge Code	7413
Hospital Revenue Code	637
Min. Negotiated Rate	$18.20
Max. Negotiated Rate	$40.96
Rate for Payer: Aetna Commercial	$38.68
Rate for Payer: Aetna Medicare	$22.76
Rate for Payer: Aetna New Business (MI Preferred)	$29.58
Rate for Payer: BCBS Complete	$18.20
Rate for Payer: Cash Price	$36.41
Rate for Payer: Cofinity Commercial	$31.86
Rate for Payer: Cofinity Commercial	$39.14
Rate for Payer: Cofinity Medicare Advantage	$31.86
Rate for Payer: Encore Health Key Benefits Commercial	$36.41
Rate for Payer: Healthscope Commercial	$40.96
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$38.68
Rate for Payer: PHP Commercial	$38.68
Rate for Payer: Priority Health Cigna Priority Health	$29.58
Rate for Payer: Priority Health SBD	$28.67

SORBITOL 70 % SOLUTION

Facility

$10.51

Service Code	NDC 57896043516
Hospital Charge Code	7413
Hospital Revenue Code	637
Min. Negotiated Rate	$6.62
Max. Negotiated Rate	$9.46
Rate for Payer: Aetna Commercial	$8.93
Rate for Payer: Aetna New Business (MI Preferred)	$6.83
Rate for Payer: Cash Price	$8.41
Rate for Payer: Cofinity Commercial	$7.36
Rate for Payer: Cofinity Commercial	$9.04
Rate for Payer: Cofinity Medicare Advantage	$7.36
Rate for Payer: Encore Health Key Benefits Commercial	$8.41
Rate for Payer: Healthscope Commercial	$9.46
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$8.93
Rate for Payer: PHP Commercial	$8.93
Rate for Payer: Priority Health Cigna Priority Health	$6.83
Rate for Payer: Priority Health SBD	$6.62

SORBITOL 70 % SOLUTION

Facility

$10.51

Service Code	NDC 57896043516
Hospital Charge Code	7413
Hospital Revenue Code	637
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$9.46
Rate for Payer: Aetna Commercial	$8.93
Rate for Payer: Aetna Medicare	$5.26
Rate for Payer: Aetna New Business (MI Preferred)	$6.83
Rate for Payer: BCBS Complete	$4.20
Rate for Payer: Cash Price	$8.41
Rate for Payer: Cofinity Commercial	$7.36
Rate for Payer: Cofinity Commercial	$9.04
Rate for Payer: Cofinity Medicare Advantage	$7.36
Rate for Payer: Encore Health Key Benefits Commercial	$8.41
Rate for Payer: Healthscope Commercial	$9.46
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$8.93
Rate for Payer: PHP Commercial	$8.93
Rate for Payer: Priority Health Cigna Priority Health	$6.83
Rate for Payer: Priority Health SBD	$6.62

SORBITOL 70 % SOLUTION

Facility

$45.51

Service Code	NDC 46287050001
Hospital Charge Code	7413
Hospital Revenue Code	637
Min. Negotiated Rate	$28.67
Max. Negotiated Rate	$40.96
Rate for Payer: Aetna Commercial	$38.68
Rate for Payer: Aetna New Business (MI Preferred)	$29.58
Rate for Payer: Cash Price	$36.41
Rate for Payer: Cofinity Commercial	$31.86
Rate for Payer: Cofinity Commercial	$39.14
Rate for Payer: Cofinity Medicare Advantage	$31.86
Rate for Payer: Encore Health Key Benefits Commercial	$36.41
Rate for Payer: Healthscope Commercial	$40.96
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$38.68
Rate for Payer: PHP Commercial	$38.68
Rate for Payer: Priority Health Cigna Priority Health	$29.58
Rate for Payer: Priority Health SBD	$28.67

SOTALOL 80 MG TABLET

Facility

$122.20

Service Code	NDC 60505008000
Hospital Charge Code	11421
Hospital Revenue Code	637
Min. Negotiated Rate	$76.99
Max. Negotiated Rate	$109.98
Rate for Payer: Aetna Commercial	$103.87
Rate for Payer: Aetna New Business (MI Preferred)	$79.43
Rate for Payer: Cash Price	$97.76
Rate for Payer: Cofinity Commercial	$105.09
Rate for Payer: Cofinity Commercial	$85.54
Rate for Payer: Cofinity Medicare Advantage	$85.54
Rate for Payer: Encore Health Key Benefits Commercial	$97.76
Rate for Payer: Healthscope Commercial	$109.98
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$103.87
Rate for Payer: PHP Commercial	$103.87
Rate for Payer: Priority Health Cigna Priority Health	$79.43
Rate for Payer: Priority Health SBD	$76.99

SOTALOL 80 MG TABLET

Facility

$4.44

Service Code	NDC 00245001289
Hospital Charge Code	11421
Hospital Revenue Code	637
Min. Negotiated Rate	$1.78
Max. Negotiated Rate	$4.00
Rate for Payer: Aetna Commercial	$3.77
Rate for Payer: Aetna Medicare	$2.22
Rate for Payer: Aetna New Business (MI Preferred)	$2.89
Rate for Payer: BCBS Complete	$1.78
Rate for Payer: Cash Price	$3.55
Rate for Payer: Cofinity Commercial	$3.11
Rate for Payer: Cofinity Commercial	$3.82
Rate for Payer: Cofinity Medicare Advantage	$3.11
Rate for Payer: Encore Health Key Benefits Commercial	$3.55
Rate for Payer: Healthscope Commercial	$4.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3.77
Rate for Payer: PHP Commercial	$3.77
Rate for Payer: Priority Health Cigna Priority Health	$2.89
Rate for Payer: Priority Health SBD	$2.80

SOTALOL 80 MG TABLET

Facility

$4.44

Service Code	NDC 00245001289
Hospital Charge Code	11421
Hospital Revenue Code	637
Min. Negotiated Rate	$2.80
Max. Negotiated Rate	$4.00
Rate for Payer: Aetna Commercial	$3.77
Rate for Payer: Aetna New Business (MI Preferred)	$2.89
Rate for Payer: Cash Price	$3.55
Rate for Payer: Cofinity Commercial	$3.11
Rate for Payer: Cofinity Commercial	$3.82
Rate for Payer: Cofinity Medicare Advantage	$3.11
Rate for Payer: Encore Health Key Benefits Commercial	$3.55
Rate for Payer: Healthscope Commercial	$4.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3.77
Rate for Payer: PHP Commercial	$3.77
Rate for Payer: Priority Health Cigna Priority Health	$2.89
Rate for Payer: Priority Health SBD	$2.80

SOTALOL 80 MG TABLET

Facility

$122.20

Service Code	NDC 60505008000
Hospital Charge Code	11421
Hospital Revenue Code	637
Min. Negotiated Rate	$48.88
Max. Negotiated Rate	$109.98
Rate for Payer: Aetna Commercial	$103.87
Rate for Payer: Aetna Medicare	$61.10
Rate for Payer: Aetna New Business (MI Preferred)	$79.43
Rate for Payer: BCBS Complete	$48.88
Rate for Payer: Cash Price	$97.76
Rate for Payer: Cofinity Commercial	$105.09
Rate for Payer: Cofinity Commercial	$85.54
Rate for Payer: Cofinity Medicare Advantage	$85.54
Rate for Payer: Encore Health Key Benefits Commercial	$97.76
Rate for Payer: Healthscope Commercial	$109.98
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$103.87
Rate for Payer: PHP Commercial	$103.87
Rate for Payer: Priority Health Cigna Priority Health	$79.43
Rate for Payer: Priority Health SBD	$76.99

SOTALOL 80 MG TABLET

Facility

$499.68

Service Code	NDC 68084065401
Hospital Charge Code	11421
Hospital Revenue Code	637
Min. Negotiated Rate	$314.80
Max. Negotiated Rate	$449.71
Rate for Payer: Aetna Commercial	$424.73
Rate for Payer: Aetna New Business (MI Preferred)	$324.79
Rate for Payer: Cash Price	$399.74
Rate for Payer: Cofinity Commercial	$349.78
Rate for Payer: Cofinity Commercial	$429.72
Rate for Payer: Cofinity Medicare Advantage	$349.78
Rate for Payer: Encore Health Key Benefits Commercial	$399.74
Rate for Payer: Healthscope Commercial	$449.71
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$424.73
Rate for Payer: PHP Commercial	$424.73
Rate for Payer: Priority Health Cigna Priority Health	$324.79
Rate for Payer: Priority Health SBD	$314.80

SOTALOL 80 MG TABLET

Facility

$444.00

Service Code	NDC 00245001201
Hospital Charge Code	11421
Hospital Revenue Code	637
Min. Negotiated Rate	$279.72
Max. Negotiated Rate	$399.60
Rate for Payer: Aetna Commercial	$377.40
Rate for Payer: Aetna New Business (MI Preferred)	$288.60
Rate for Payer: Cash Price	$355.20
Rate for Payer: Cofinity Commercial	$310.80
Rate for Payer: Cofinity Commercial	$381.84
Rate for Payer: Cofinity Medicare Advantage	$310.80
Rate for Payer: Encore Health Key Benefits Commercial	$355.20
Rate for Payer: Healthscope Commercial	$399.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$377.40
Rate for Payer: PHP Commercial	$377.40
Rate for Payer: Priority Health Cigna Priority Health	$288.60
Rate for Payer: Priority Health SBD	$279.72

SOTALOL 80 MG TABLET

Facility

$5.00

Service Code	NDC 68084065411
Hospital Charge Code	11421
Hospital Revenue Code	637
Min. Negotiated Rate	$3.15
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$4.25
Rate for Payer: Aetna New Business (MI Preferred)	$3.25
Rate for Payer: Cash Price	$4.00
Rate for Payer: Cofinity Commercial	$3.50
Rate for Payer: Cofinity Commercial	$4.30
Rate for Payer: Cofinity Medicare Advantage	$3.50
Rate for Payer: Encore Health Key Benefits Commercial	$4.00
Rate for Payer: Healthscope Commercial	$4.50
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4.25
Rate for Payer: PHP Commercial	$4.25
Rate for Payer: Priority Health Cigna Priority Health	$3.25
Rate for Payer: Priority Health SBD	$3.15

SOTALOL 80 MG TABLET

Facility

$5.00

Service Code	NDC 68084065411
Hospital Charge Code	11421
Hospital Revenue Code	637
Min. Negotiated Rate	$2.00
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$4.25
Rate for Payer: Aetna Medicare	$2.50
Rate for Payer: Aetna New Business (MI Preferred)	$3.25
Rate for Payer: BCBS Complete	$2.00
Rate for Payer: Cash Price	$4.00
Rate for Payer: Cofinity Commercial	$3.50
Rate for Payer: Cofinity Commercial	$4.30
Rate for Payer: Cofinity Medicare Advantage	$3.50
Rate for Payer: Encore Health Key Benefits Commercial	$4.00
Rate for Payer: Healthscope Commercial	$4.50
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4.25
Rate for Payer: PHP Commercial	$4.25
Rate for Payer: Priority Health Cigna Priority Health	$3.25
Rate for Payer: Priority Health SBD	$3.15

SOTALOL 80 MG TABLET

Facility

$499.68

Service Code	NDC 68084065401
Hospital Charge Code	11421
Hospital Revenue Code	637
Min. Negotiated Rate	$199.87
Max. Negotiated Rate	$449.71
Rate for Payer: Aetna Commercial	$424.73
Rate for Payer: Aetna Medicare	$249.84
Rate for Payer: Aetna New Business (MI Preferred)	$324.79
Rate for Payer: BCBS Complete	$199.87
Rate for Payer: Cash Price	$399.74
Rate for Payer: Cofinity Commercial	$349.78
Rate for Payer: Cofinity Commercial	$429.72
Rate for Payer: Cofinity Medicare Advantage	$349.78
Rate for Payer: Encore Health Key Benefits Commercial	$399.74
Rate for Payer: Healthscope Commercial	$449.71
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$424.73
Rate for Payer: PHP Commercial	$424.73
Rate for Payer: Priority Health Cigna Priority Health	$324.79
Rate for Payer: Priority Health SBD	$314.80

SOTALOL 80 MG TABLET

Facility

$444.00

Service Code	NDC 00245001201
Hospital Charge Code	11421
Hospital Revenue Code	637
Min. Negotiated Rate	$177.60
Max. Negotiated Rate	$399.60
Rate for Payer: Aetna Commercial	$377.40
Rate for Payer: Aetna Medicare	$222.00
Rate for Payer: Aetna New Business (MI Preferred)	$288.60
Rate for Payer: BCBS Complete	$177.60
Rate for Payer: Cash Price	$355.20
Rate for Payer: Cofinity Commercial	$310.80
Rate for Payer: Cofinity Commercial	$381.84
Rate for Payer: Cofinity Medicare Advantage	$310.80
Rate for Payer: Encore Health Key Benefits Commercial	$355.20
Rate for Payer: Healthscope Commercial	$399.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$377.40
Rate for Payer: PHP Commercial	$377.40
Rate for Payer: Priority Health Cigna Priority Health	$288.60
Rate for Payer: Priority Health SBD	$279.72

SPHINCTEROTOMY, ANAL, DIVISION OF SPHINCTER (SEPARATE PROCEDURE)

Facility

$8,445.02

Service Code	CPT 46080
Hospital Revenue Code	360
Min. Negotiated Rate	$168.56
Max. Negotiated Rate	$8,445.02
Rate for Payer: Aetna Medicare	$2,794.42
Rate for Payer: Allen County Amish Medical Aid Commercial	$3,358.68
Rate for Payer: Amish Plain Church Group Commercial	$3,358.68
Rate for Payer: BCBS Complete	$1,512.21
Rate for Payer: BCBS MAPPO	$2,686.94
Rate for Payer: BCBS Trust/PPO	$1,284.61
Rate for Payer: BCN Commercial	$1,284.61
Rate for Payer: BCN Medicare Advantage	$2,686.94
Rate for Payer: Health Alliance Plan Medicare Advantage	$2,686.94
Rate for Payer: Mclaren Medicaid	$1,440.20
Rate for Payer: Mclaren Medicare	$2,686.94
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$2,821.29
Rate for Payer: Meridian Medicaid	$1,512.21
Rate for Payer: MI Amish Medical Board Commercial	$3,089.98
Rate for Payer: Nomi Health Commercial	$5,642.57
Rate for Payer: PACE Medicare	$2,552.59
Rate for Payer: PACE SWMI	$2,686.94
Rate for Payer: PHP Medicare Advantage	$2,686.94
Rate for Payer: Priority Health Choice Medicaid	$1,440.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$8,445.02
Rate for Payer: Priority Health Medicare	$2,686.94
Rate for Payer: Priority Health Narrow Network	$6,756.02
Rate for Payer: Railroad Medicare Medicare	$2,686.94
Rate for Payer: UHC All Payor (Choice/PPO)	$168.56
Rate for Payer: UHC Core	$3,138.00
Rate for Payer: UHC Dual Complete DSNP	$2,686.94
Rate for Payer: UHC Exchange	$3,362.00
Rate for Payer: UHC Medicare Advantage	$2,686.94
Rate for Payer: UHCCP Medicaid	$1,512.75
Rate for Payer: VA VA	$2,686.94

SPINAL PUNCTURE, LUMBAR, DIAGNOSTIC;

Facility

$2,132.58

Service Code	CPT 62270
Hospital Revenue Code	361
Min. Negotiated Rate	$68.80
Max. Negotiated Rate	$2,132.58
Rate for Payer: Aetna Medicare	$705.66
Rate for Payer: Allen County Amish Medical Aid Commercial	$848.15
Rate for Payer: Amish Plain Church Group Commercial	$848.15
Rate for Payer: BCBS Complete	$381.87
Rate for Payer: BCBS MAPPO	$678.52
Rate for Payer: BCBS Trust/PPO	$545.99
Rate for Payer: BCN Commercial	$545.99
Rate for Payer: BCN Medicare Advantage	$678.52
Rate for Payer: Health Alliance Plan Medicare Advantage	$678.52
Rate for Payer: Mclaren Medicaid	$363.69
Rate for Payer: Mclaren Medicare	$678.52
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$712.45
Rate for Payer: Meridian Medicaid	$381.87
Rate for Payer: MI Amish Medical Board Commercial	$780.30
Rate for Payer: Nomi Health Commercial	$1,424.89
Rate for Payer: PACE Medicare	$644.59
Rate for Payer: PACE SWMI	$678.52
Rate for Payer: PHP Medicare Advantage	$678.52
Rate for Payer: Priority Health Choice Medicaid	$363.69
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,132.58
Rate for Payer: Priority Health Medicare	$678.52
Rate for Payer: Priority Health Narrow Network	$1,706.06
Rate for Payer: Railroad Medicare Medicare	$678.52
Rate for Payer: UHC All Payor (Choice/PPO)	$68.80
Rate for Payer: UHC Core	$1,463.00
Rate for Payer: UHC Dual Complete DSNP	$678.52
Rate for Payer: UHC Exchange	$1,566.00
Rate for Payer: UHC Medicare Advantage	$678.52
Rate for Payer: UHCCP Medicaid	$382.01
Rate for Payer: VA VA	$678.52

Know your out-of-pocket cost for care.

All Charges