Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC BALLOONS CATH TRANSLUMINAL LVL 6

Facility

$869.40

Service Code	HCPCS C1725
Hospital Charge Code	27200264
Hospital Revenue Code	272
Min. Negotiated Rate	$547.72
Max. Negotiated Rate	$782.46
Rate for Payer: Aetna Commercial	$738.99
Rate for Payer: Aetna New Business (MI Preferred)	$565.11
Rate for Payer: Cash Price	$695.52
Rate for Payer: Cofinity Commercial	$608.58
Rate for Payer: Cofinity Commercial	$747.68
Rate for Payer: Healthscope Commercial	$782.46
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$738.99
Rate for Payer: PHP Commercial	$738.99
Rate for Payer: Priority Health Cigna Priority Health	$608.58
Rate for Payer: Priority Health SBD	$547.72

HC BALLOONS CATH TRANSLUMINAL LVL 6

Facility

$869.40

Service Code	HCPCS C1725
Hospital Charge Code	27200264
Hospital Revenue Code	272
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$782.46
Rate for Payer: Aetna Commercial	$738.99
Rate for Payer: Aetna New Business (MI Preferred)	$565.11
Rate for Payer: BCBS Complete	$347.76
Rate for Payer: BCBS Trust/PPO	$0.03
Rate for Payer: Cash Price	$695.52
Rate for Payer: Cash Price	$695.52
Rate for Payer: Cofinity Commercial	$747.68
Rate for Payer: Cofinity Commercial	$608.58
Rate for Payer: Healthscope Commercial	$782.46
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$738.99
Rate for Payer: PHP Commercial	$738.99
Rate for Payer: Priority Health Cigna Priority Health	$608.58
Rate for Payer: Priority Health SBD	$547.72

HC BALLOON STONE EXTRACTION

Facility

$3,126.70

Hospital Charge Code	36000008
Hospital Revenue Code	360
Min. Negotiated Rate	$1,250.68
Max. Negotiated Rate	$2,814.03
Rate for Payer: Aetna Commercial	$2,657.70
Rate for Payer: Aetna New Business (MI Preferred)	$2,032.36
Rate for Payer: BCBS Complete	$1,250.68
Rate for Payer: Cash Price	$2,501.36
Rate for Payer: Cofinity Commercial	$2,188.69
Rate for Payer: Cofinity Commercial	$2,688.96
Rate for Payer: Healthscope Commercial	$2,814.03
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,657.70
Rate for Payer: PHP Commercial	$2,657.70
Rate for Payer: Priority Health Cigna Priority Health	$2,188.69
Rate for Payer: Priority Health SBD	$1,969.82

HC BALLOON STONE EXTRACTION

Facility

$3,126.70

Hospital Charge Code	36000008
Hospital Revenue Code	360
Min. Negotiated Rate	$1,969.82
Max. Negotiated Rate	$2,814.03
Rate for Payer: Aetna Commercial	$2,657.70
Rate for Payer: Aetna New Business (MI Preferred)	$2,032.36
Rate for Payer: Cash Price	$2,501.36
Rate for Payer: Cofinity Commercial	$2,188.69
Rate for Payer: Cofinity Commercial	$2,688.96
Rate for Payer: Healthscope Commercial	$2,814.03
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,657.70
Rate for Payer: PHP Commercial	$2,657.70
Rate for Payer: Priority Health Cigna Priority Health	$2,188.69
Rate for Payer: Priority Health SBD	$1,969.82

HC BANANA IGE

Facility

$24.89

Service Code	CPT 86003
Hospital Charge Code	30200073
Hospital Revenue Code	302
Min. Negotiated Rate	$2.86
Max. Negotiated Rate	$22.40
Rate for Payer: Aetna Commercial	$21.16
Rate for Payer: Aetna Medicare	$5.43
Rate for Payer: Aetna New Business (MI Preferred)	$16.18
Rate for Payer: Allen County Amish Medical Aid Commercial	$6.52
Rate for Payer: Amish Plain Church Group Commercial	$6.52
Rate for Payer: BCBS Complete	$3.00
Rate for Payer: BCBS MAPPO	$5.22
Rate for Payer: BCBS Trust/PPO	$4.09
Rate for Payer: BCN Medicare Advantage	$5.22
Rate for Payer: Cash Price	$19.91
Rate for Payer: Cash Price	$19.91
Rate for Payer: Cofinity Commercial	$17.42
Rate for Payer: Cofinity Commercial	$21.41
Rate for Payer: Health Alliance Plan Medicare Advantage	$5.22
Rate for Payer: Healthscope Commercial	$22.40
Rate for Payer: Mclaren Medicaid	$2.86
Rate for Payer: Mclaren Medicare	$5.22
Rate for Payer: Meridian Medicaid	$3.00
Rate for Payer: Meridian Wellcare - Medicare Advantage	$5.48
Rate for Payer: MI Amish Medical Board Commercial	$6.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$21.16
Rate for Payer: PACE Medicare	$4.96
Rate for Payer: PACE SWMI	$5.22
Rate for Payer: PHP Commercial	$21.16
Rate for Payer: PHP Medicare Advantage	$5.22
Rate for Payer: Priority Health Choice Medicaid	$2.86
Rate for Payer: Priority Health Cigna Priority Health	$17.42
Rate for Payer: Priority Health Medicare	$5.22
Rate for Payer: Priority Health SBD	$15.68
Rate for Payer: Railroad Medicare Medicare	$5.22
Rate for Payer: UHC All Payor (Choice/PPO)	$6.26
Rate for Payer: UHC Core	$8.87
Rate for Payer: UHC Dual Complete DSNP	$5.22
Rate for Payer: UHC Exchange	$5.22
Rate for Payer: UHC Medicare Advantage	$5.38
Rate for Payer: VA VA	$5.22

HC BANANA IGE

Facility

$24.89

Service Code	CPT 86003
Hospital Charge Code	30200073
Hospital Revenue Code	302
Min. Negotiated Rate	$15.68
Max. Negotiated Rate	$22.40
Rate for Payer: Aetna Commercial	$21.16
Rate for Payer: Aetna New Business (MI Preferred)	$16.18
Rate for Payer: Cash Price	$19.91
Rate for Payer: Cofinity Commercial	$17.42
Rate for Payer: Cofinity Commercial	$21.41
Rate for Payer: Healthscope Commercial	$22.40
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$21.16
Rate for Payer: PHP Commercial	$21.16
Rate for Payer: Priority Health Cigna Priority Health	$17.42
Rate for Payer: Priority Health SBD	$15.68

HC BANDAGE SCISSORS

Facility

$13.42

Hospital Charge Code	27000029
Hospital Revenue Code	270
Min. Negotiated Rate	$5.37
Max. Negotiated Rate	$12.08
Rate for Payer: Aetna Commercial	$11.41
Rate for Payer: Aetna New Business (MI Preferred)	$8.72
Rate for Payer: BCBS Complete	$5.37
Rate for Payer: Cash Price	$10.74
Rate for Payer: Cofinity Commercial	$11.54
Rate for Payer: Cofinity Commercial	$9.39
Rate for Payer: Healthscope Commercial	$12.08
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$11.41
Rate for Payer: PHP Commercial	$11.41
Rate for Payer: Priority Health Cigna Priority Health	$9.39
Rate for Payer: Priority Health SBD	$8.45

HC BANDAGE SCISSORS

Facility

$13.42

Hospital Charge Code	27000029
Hospital Revenue Code	270
Min. Negotiated Rate	$8.45
Max. Negotiated Rate	$12.08
Rate for Payer: Aetna Commercial	$11.41
Rate for Payer: Aetna New Business (MI Preferred)	$8.72
Rate for Payer: Cash Price	$10.74
Rate for Payer: Cofinity Commercial	$11.54
Rate for Payer: Cofinity Commercial	$9.39
Rate for Payer: Healthscope Commercial	$12.08
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$11.41
Rate for Payer: PHP Commercial	$11.41
Rate for Payer: Priority Health Cigna Priority Health	$9.39
Rate for Payer: Priority Health SBD	$8.45

HC BANDING

Facility

$946.71

Hospital Charge Code	36000009
Hospital Revenue Code	360
Min. Negotiated Rate	$596.43
Max. Negotiated Rate	$852.04
Rate for Payer: Aetna Commercial	$804.70
Rate for Payer: Aetna New Business (MI Preferred)	$615.36
Rate for Payer: Cash Price	$757.37
Rate for Payer: Cofinity Commercial	$662.70
Rate for Payer: Cofinity Commercial	$814.17
Rate for Payer: Healthscope Commercial	$852.04
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$804.70
Rate for Payer: PHP Commercial	$804.70
Rate for Payer: Priority Health Cigna Priority Health	$662.70
Rate for Payer: Priority Health SBD	$596.43

HC BANDING

Facility

$946.71

Hospital Charge Code	36000009
Hospital Revenue Code	360
Min. Negotiated Rate	$378.68
Max. Negotiated Rate	$852.04
Rate for Payer: Aetna Commercial	$804.70
Rate for Payer: Aetna New Business (MI Preferred)	$615.36
Rate for Payer: BCBS Complete	$378.68
Rate for Payer: Cash Price	$757.37
Rate for Payer: Cofinity Commercial	$662.70
Rate for Payer: Cofinity Commercial	$814.17
Rate for Payer: Healthscope Commercial	$852.04
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$804.70
Rate for Payer: PHP Commercial	$804.70
Rate for Payer: Priority Health Cigna Priority Health	$662.70
Rate for Payer: Priority Health SBD	$596.43

HC BARBITURATE URIN

Facility

$95.40

Service Code	CPT 80307
Hospital Charge Code	30000137
Hospital Revenue Code	300
Min. Negotiated Rate	$33.99
Max. Negotiated Rate	$95.77
Rate for Payer: Aetna Commercial	$81.09
Rate for Payer: Aetna Medicare	$64.63
Rate for Payer: Aetna New Business (MI Preferred)	$62.01
Rate for Payer: Allen County Amish Medical Aid Commercial	$77.68
Rate for Payer: Amish Plain Church Group Commercial	$77.68
Rate for Payer: BCBS Complete	$35.69
Rate for Payer: BCBS MAPPO	$62.14
Rate for Payer: BCBS Trust/PPO	$48.67
Rate for Payer: BCN Medicare Advantage	$62.14
Rate for Payer: Cash Price	$76.32
Rate for Payer: Cash Price	$76.32
Rate for Payer: Cofinity Commercial	$82.04
Rate for Payer: Cofinity Commercial	$66.78
Rate for Payer: Health Alliance Plan Medicare Advantage	$62.14
Rate for Payer: Healthscope Commercial	$85.86
Rate for Payer: Mclaren Medicaid	$33.99
Rate for Payer: Mclaren Medicare	$62.14
Rate for Payer: Meridian Medicaid	$35.69
Rate for Payer: Meridian Wellcare - Medicare Advantage	$65.25
Rate for Payer: MI Amish Medical Board Commercial	$71.46
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$81.09
Rate for Payer: PACE Medicare	$59.03
Rate for Payer: PACE SWMI	$62.14
Rate for Payer: PHP Commercial	$81.09
Rate for Payer: PHP Medicare Advantage	$62.14
Rate for Payer: Priority Health Choice Medicaid	$33.99
Rate for Payer: Priority Health Cigna Priority Health	$66.78
Rate for Payer: Priority Health Medicare	$62.14
Rate for Payer: Priority Health SBD	$60.10
Rate for Payer: Railroad Medicare Medicare	$62.14
Rate for Payer: UHC All Payor (Choice/PPO)	$74.57
Rate for Payer: UHC Core	$95.77
Rate for Payer: UHC Dual Complete DSNP	$62.14
Rate for Payer: UHC Exchange	$62.14
Rate for Payer: UHC Medicare Advantage	$64.00
Rate for Payer: VA VA	$62.14

HC BARBITURATE URIN

Facility

$95.40

Service Code	CPT 80307
Hospital Charge Code	30000137
Hospital Revenue Code	300
Min. Negotiated Rate	$60.10
Max. Negotiated Rate	$85.86
Rate for Payer: Aetna Commercial	$81.09
Rate for Payer: Aetna New Business (MI Preferred)	$62.01
Rate for Payer: Cash Price	$76.32
Rate for Payer: Cofinity Commercial	$66.78
Rate for Payer: Cofinity Commercial	$82.04
Rate for Payer: Healthscope Commercial	$85.86
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$81.09
Rate for Payer: PHP Commercial	$81.09
Rate for Payer: Priority Health Cigna Priority Health	$66.78
Rate for Payer: Priority Health SBD	$60.10

HC BARBITURATE URINE CONFIRM

Facility

$62.00

Service Code	CPT 80345
Hospital Charge Code	30100571
Hospital Revenue Code	301
Min. Negotiated Rate	$18.70
Max. Negotiated Rate	$55.80
Rate for Payer: Aetna Commercial	$52.70
Rate for Payer: Aetna New Business (MI Preferred)	$40.30
Rate for Payer: BCBS Complete	$24.80
Rate for Payer: Cash Price	$49.60
Rate for Payer: Cash Price	$49.60
Rate for Payer: Cofinity Commercial	$43.40
Rate for Payer: Cofinity Commercial	$53.32
Rate for Payer: Healthscope Commercial	$55.80
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$52.70
Rate for Payer: PHP Commercial	$52.70
Rate for Payer: Priority Health Cigna Priority Health	$43.40
Rate for Payer: Priority Health SBD	$39.06
Rate for Payer: UHC Core	$18.70

HC BARBITURATE URINE CONFIRM

Facility

$62.00

Service Code	CPT 80345
Hospital Charge Code	30100571
Hospital Revenue Code	301
Min. Negotiated Rate	$39.06
Max. Negotiated Rate	$55.80
Rate for Payer: Aetna Commercial	$52.70
Rate for Payer: Aetna New Business (MI Preferred)	$40.30
Rate for Payer: Cash Price	$49.60
Rate for Payer: Cofinity Commercial	$43.40
Rate for Payer: Cofinity Commercial	$53.32
Rate for Payer: Healthscope Commercial	$55.80
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$52.70
Rate for Payer: PHP Commercial	$52.70
Rate for Payer: Priority Health Cigna Priority Health	$43.40
Rate for Payer: Priority Health SBD	$39.06

HC BARRIER ADHESION

Facility

$578.39

Service Code	HCPCS C1765
Hospital Charge Code	27000463
Hospital Revenue Code	270
Min. Negotiated Rate	$231.36
Max. Negotiated Rate	$520.55
Rate for Payer: Aetna Commercial	$491.63
Rate for Payer: Aetna New Business (MI Preferred)	$375.95
Rate for Payer: BCBS Complete	$231.36
Rate for Payer: Cash Price	$462.71
Rate for Payer: Cofinity Commercial	$404.87
Rate for Payer: Cofinity Commercial	$497.42
Rate for Payer: Healthscope Commercial	$520.55
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$491.63
Rate for Payer: PHP Commercial	$491.63
Rate for Payer: Priority Health Cigna Priority Health	$404.87
Rate for Payer: Priority Health SBD	$364.39

HC BARRIER ADHESION

Facility

$578.39

Service Code	HCPCS C1765
Hospital Charge Code	27000463
Hospital Revenue Code	270
Min. Negotiated Rate	$364.39
Max. Negotiated Rate	$520.55
Rate for Payer: Aetna Commercial	$491.63
Rate for Payer: Aetna New Business (MI Preferred)	$375.95
Rate for Payer: Cash Price	$462.71
Rate for Payer: Cofinity Commercial	$404.87
Rate for Payer: Cofinity Commercial	$497.42
Rate for Payer: Healthscope Commercial	$520.55
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$491.63
Rate for Payer: PHP Commercial	$491.63
Rate for Payer: Priority Health Cigna Priority Health	$404.87
Rate for Payer: Priority Health SBD	$364.39

HC BARRX 360 EXPRESS CATH BALLOON

Facility

$5,608.69

Hospital Charge Code	27200286
Hospital Revenue Code	272
Min. Negotiated Rate	$3,533.47
Max. Negotiated Rate	$5,047.82
Rate for Payer: Aetna Commercial	$4,767.39
Rate for Payer: Aetna New Business (MI Preferred)	$3,645.65
Rate for Payer: Cash Price	$4,486.95
Rate for Payer: Cofinity Commercial	$3,926.08
Rate for Payer: Cofinity Commercial	$4,823.47
Rate for Payer: Healthscope Commercial	$5,047.82
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$4,767.39
Rate for Payer: PHP Commercial	$4,767.39
Rate for Payer: Priority Health Cigna Priority Health	$3,926.08
Rate for Payer: Priority Health SBD	$3,533.47

HC BARRX 360 EXPRESS CATH BALLOON

Facility

$5,608.69

Hospital Charge Code	27200286
Hospital Revenue Code	272
Min. Negotiated Rate	$2,243.48
Max. Negotiated Rate	$5,047.82
Rate for Payer: Aetna Commercial	$4,767.39
Rate for Payer: Aetna New Business (MI Preferred)	$3,645.65
Rate for Payer: BCBS Complete	$2,243.48
Rate for Payer: Cash Price	$4,486.95
Rate for Payer: Cofinity Commercial	$3,926.08
Rate for Payer: Cofinity Commercial	$4,823.47
Rate for Payer: Healthscope Commercial	$5,047.82
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$4,767.39
Rate for Payer: PHP Commercial	$4,767.39
Rate for Payer: Priority Health Cigna Priority Health	$3,926.08
Rate for Payer: Priority Health SBD	$3,533.47

HC BARRX 90 RFA FOCAL CATHETER

Facility

$4,265.57

Hospital Charge Code	27200287
Hospital Revenue Code	272
Min. Negotiated Rate	$2,687.31
Max. Negotiated Rate	$3,839.01
Rate for Payer: Aetna Commercial	$3,625.73
Rate for Payer: Aetna New Business (MI Preferred)	$2,772.62
Rate for Payer: Cash Price	$3,412.46
Rate for Payer: Cofinity Commercial	$2,985.90
Rate for Payer: Cofinity Commercial	$3,668.39
Rate for Payer: Healthscope Commercial	$3,839.01
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3,625.73
Rate for Payer: PHP Commercial	$3,625.73
Rate for Payer: Priority Health Cigna Priority Health	$2,985.90
Rate for Payer: Priority Health SBD	$2,687.31

HC BARRX 90 RFA FOCAL CATHETER

Facility

$4,265.57

Hospital Charge Code	27200287
Hospital Revenue Code	272
Min. Negotiated Rate	$1,706.23
Max. Negotiated Rate	$3,839.01
Rate for Payer: Aetna Commercial	$3,625.73
Rate for Payer: Aetna New Business (MI Preferred)	$2,772.62
Rate for Payer: BCBS Complete	$1,706.23
Rate for Payer: Cash Price	$3,412.46
Rate for Payer: Cofinity Commercial	$2,985.90
Rate for Payer: Cofinity Commercial	$3,668.39
Rate for Payer: Healthscope Commercial	$3,839.01
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3,625.73
Rate for Payer: PHP Commercial	$3,625.73
Rate for Payer: Priority Health Cigna Priority Health	$2,985.90
Rate for Payer: Priority Health SBD	$2,687.31

HC BARRX RFA

Facility

$2,004.30

Hospital Charge Code	36000101
Hospital Revenue Code	360
Min. Negotiated Rate	$1,262.71
Max. Negotiated Rate	$1,803.87
Rate for Payer: Aetna Commercial	$1,703.66
Rate for Payer: Aetna New Business (MI Preferred)	$1,302.80
Rate for Payer: Cash Price	$1,603.44
Rate for Payer: Cofinity Commercial	$1,403.01
Rate for Payer: Cofinity Commercial	$1,723.70
Rate for Payer: Healthscope Commercial	$1,803.87
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,703.66
Rate for Payer: PHP Commercial	$1,703.66
Rate for Payer: Priority Health Cigna Priority Health	$1,403.01
Rate for Payer: Priority Health SBD	$1,262.71

HC BARRX RFA

Facility

$2,004.30

Hospital Charge Code	36000101
Hospital Revenue Code	360
Min. Negotiated Rate	$801.72
Max. Negotiated Rate	$1,803.87
Rate for Payer: Aetna Commercial	$1,703.66
Rate for Payer: Aetna New Business (MI Preferred)	$1,302.80
Rate for Payer: BCBS Complete	$801.72
Rate for Payer: Cash Price	$1,603.44
Rate for Payer: Cofinity Commercial	$1,403.01
Rate for Payer: Cofinity Commercial	$1,723.70
Rate for Payer: Healthscope Commercial	$1,803.87
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,703.66
Rate for Payer: PHP Commercial	$1,703.66
Rate for Payer: Priority Health Cigna Priority Health	$1,403.01
Rate for Payer: Priority Health SBD	$1,262.71

HC BARRX ULTRA LONG RFA FOCAL CATHETER

Facility

$4,333.46

Hospital Charge Code	27200288
Hospital Revenue Code	272
Min. Negotiated Rate	$2,730.08
Max. Negotiated Rate	$3,900.11
Rate for Payer: Aetna Commercial	$3,683.44
Rate for Payer: Aetna New Business (MI Preferred)	$2,816.75
Rate for Payer: Cash Price	$3,466.77
Rate for Payer: Cofinity Commercial	$3,033.42
Rate for Payer: Cofinity Commercial	$3,726.78
Rate for Payer: Healthscope Commercial	$3,900.11
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3,683.44
Rate for Payer: PHP Commercial	$3,683.44
Rate for Payer: Priority Health Cigna Priority Health	$3,033.42
Rate for Payer: Priority Health SBD	$2,730.08

HC BARRX ULTRA LONG RFA FOCAL CATHETER

Facility

$4,333.46

Hospital Charge Code	27200288
Hospital Revenue Code	272
Min. Negotiated Rate	$1,733.38
Max. Negotiated Rate	$3,900.11
Rate for Payer: Aetna Commercial	$3,683.44
Rate for Payer: Aetna New Business (MI Preferred)	$2,816.75
Rate for Payer: BCBS Complete	$1,733.38
Rate for Payer: Cash Price	$3,466.77
Rate for Payer: Cofinity Commercial	$3,033.42
Rate for Payer: Cofinity Commercial	$3,726.78
Rate for Payer: Healthscope Commercial	$3,900.11
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3,683.44
Rate for Payer: PHP Commercial	$3,683.44
Rate for Payer: Priority Health Cigna Priority Health	$3,033.42
Rate for Payer: Priority Health SBD	$2,730.08

HC BARTONELLA HENSELAE CMPT

Facility

$16.32

Service Code	CPT 86611
Hospital Charge Code	30200227
Hospital Revenue Code	302
Min. Negotiated Rate	$5.57
Max. Negotiated Rate	$17.30
Rate for Payer: Aetna Commercial	$13.87
Rate for Payer: Aetna Medicare	$10.59
Rate for Payer: Aetna New Business (MI Preferred)	$10.61
Rate for Payer: Allen County Amish Medical Aid Commercial	$12.72
Rate for Payer: Amish Plain Church Group Commercial	$12.72
Rate for Payer: BCBS Complete	$5.85
Rate for Payer: BCBS MAPPO	$10.18
Rate for Payer: BCBS Trust/PPO	$7.98
Rate for Payer: BCN Medicare Advantage	$10.18
Rate for Payer: Cash Price	$13.06
Rate for Payer: Cash Price	$13.06
Rate for Payer: Cofinity Commercial	$11.42
Rate for Payer: Cofinity Commercial	$14.04
Rate for Payer: Health Alliance Plan Medicare Advantage	$10.18
Rate for Payer: Healthscope Commercial	$14.69
Rate for Payer: Mclaren Medicaid	$5.57
Rate for Payer: Mclaren Medicare	$10.18
Rate for Payer: Meridian Medicaid	$5.85
Rate for Payer: Meridian Wellcare - Medicare Advantage	$10.69
Rate for Payer: MI Amish Medical Board Commercial	$11.71
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$13.87
Rate for Payer: PACE Medicare	$9.67
Rate for Payer: PACE SWMI	$10.18
Rate for Payer: PHP Commercial	$13.87
Rate for Payer: PHP Medicare Advantage	$10.18
Rate for Payer: Priority Health Choice Medicaid	$5.57
Rate for Payer: Priority Health Cigna Priority Health	$11.42
Rate for Payer: Priority Health Medicare	$10.18
Rate for Payer: Priority Health SBD	$10.28
Rate for Payer: Railroad Medicare Medicare	$10.18
Rate for Payer: UHC All Payor (Choice/PPO)	$12.22
Rate for Payer: UHC Core	$17.30
Rate for Payer: UHC Dual Complete DSNP	$10.18
Rate for Payer: UHC Exchange	$10.18
Rate for Payer: UHC Medicare Advantage	$10.49
Rate for Payer: VA VA	$10.18

Know your out-of-pocket cost for care.

All Charges