Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC BRONCHIAL NAVIGATION

Facility

$3,042.82

Hospital Charge Code	36000102
Hospital Revenue Code	360
Min. Negotiated Rate	$1,217.13
Max. Negotiated Rate	$2,738.54
Rate for Payer: Aetna Commercial	$2,586.40
Rate for Payer: Aetna New Business (MI Preferred)	$1,977.83
Rate for Payer: BCBS Complete	$1,217.13
Rate for Payer: Cash Price	$2,434.26
Rate for Payer: Cofinity Commercial	$2,129.97
Rate for Payer: Cofinity Commercial	$2,616.83
Rate for Payer: Healthscope Commercial	$2,738.54
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,586.40
Rate for Payer: PHP Commercial	$2,586.40
Rate for Payer: Priority Health Cigna Priority Health	$2,129.97
Rate for Payer: Priority Health SBD	$1,916.98

HC BRONCHIAL NAVIGATION

Facility

$3,042.82

Hospital Charge Code	36000102
Hospital Revenue Code	360
Min. Negotiated Rate	$1,916.98
Max. Negotiated Rate	$2,738.54
Rate for Payer: Aetna Commercial	$2,586.40
Rate for Payer: Aetna New Business (MI Preferred)	$1,977.83
Rate for Payer: Cash Price	$2,434.26
Rate for Payer: Cofinity Commercial	$2,129.97
Rate for Payer: Cofinity Commercial	$2,616.83
Rate for Payer: Healthscope Commercial	$2,738.54
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,586.40
Rate for Payer: PHP Commercial	$2,586.40
Rate for Payer: Priority Health Cigna Priority Health	$2,129.97
Rate for Payer: Priority Health SBD	$1,916.98

HC BRONCHO HYGIENE INITIAL

Facility

$268.39

Service Code	CPT 94667
Hospital Charge Code	41000010
Hospital Revenue Code	410
Min. Negotiated Rate	$169.09
Max. Negotiated Rate	$241.55
Rate for Payer: Aetna Commercial	$228.13
Rate for Payer: Aetna New Business (MI Preferred)	$174.45
Rate for Payer: Cash Price	$214.71
Rate for Payer: Cofinity Commercial	$230.82
Rate for Payer: Cofinity Commercial	$187.87
Rate for Payer: Healthscope Commercial	$241.55
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$228.13
Rate for Payer: PHP Commercial	$228.13
Rate for Payer: Priority Health Cigna Priority Health	$187.87
Rate for Payer: Priority Health SBD	$169.09

HC BRONCHO HYGIENE INITIAL

Facility

$268.39

Service Code	CPT 94667
Hospital Charge Code	41000010
Hospital Revenue Code	410
Min. Negotiated Rate	$24.56
Max. Negotiated Rate	$351.10
Rate for Payer: Aetna Commercial	$228.13
Rate for Payer: Aetna Medicare	$118.21
Rate for Payer: Aetna New Business (MI Preferred)	$174.45
Rate for Payer: Allen County Amish Medical Aid Commercial	$142.08
Rate for Payer: Amish Plain Church Group Commercial	$142.08
Rate for Payer: BCBS Complete	$65.29
Rate for Payer: BCBS MAPPO	$113.66
Rate for Payer: BCBS Trust/PPO	$104.37
Rate for Payer: BCN Medicare Advantage	$113.66
Rate for Payer: Cash Price	$214.71
Rate for Payer: Cash Price	$214.71
Rate for Payer: Cofinity Commercial	$187.87
Rate for Payer: Cofinity Commercial	$230.82
Rate for Payer: Health Alliance Plan Medicare Advantage	$113.66
Rate for Payer: Healthscope Commercial	$241.55
Rate for Payer: Mclaren Medicaid	$62.17
Rate for Payer: Mclaren Medicare	$113.66
Rate for Payer: Meridian Medicaid	$65.29
Rate for Payer: Meridian Wellcare - Medicare Advantage	$119.34
Rate for Payer: MI Amish Medical Board Commercial	$130.71
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$228.13
Rate for Payer: PACE Medicare	$107.98
Rate for Payer: PACE SWMI	$113.66
Rate for Payer: PHP Commercial	$228.13
Rate for Payer: PHP Medicare Advantage	$113.66
Rate for Payer: Priority Health Choice Medicaid	$62.17
Rate for Payer: Priority Health Cigna Priority Health	$187.87
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$351.10
Rate for Payer: Priority Health Medicare	$113.66
Rate for Payer: Priority Health Narrow Network	$280.88
Rate for Payer: Priority Health SBD	$169.09
Rate for Payer: Railroad Medicare Medicare	$113.66
Rate for Payer: UHC All Payor (Choice/PPO)	$27.02
Rate for Payer: UHC Dual Complete DSNP	$113.66
Rate for Payer: UHC Exchange	$24.56
Rate for Payer: UHC Medicare Advantage	$117.07
Rate for Payer: VA VA	$113.66

HC BRONCHO HYGIENE SUBS

Facility

$257.96

Service Code	CPT 94668
Hospital Charge Code	41000011
Hospital Revenue Code	410
Min. Negotiated Rate	$38.64
Max. Negotiated Rate	$351.10
Rate for Payer: Aetna Commercial	$219.27
Rate for Payer: Aetna Medicare	$118.21
Rate for Payer: Aetna New Business (MI Preferred)	$167.67
Rate for Payer: Allen County Amish Medical Aid Commercial	$142.08
Rate for Payer: Amish Plain Church Group Commercial	$142.08
Rate for Payer: BCBS Complete	$65.29
Rate for Payer: BCBS MAPPO	$113.66
Rate for Payer: BCBS Trust/PPO	$164.26
Rate for Payer: BCN Medicare Advantage	$113.66
Rate for Payer: Cash Price	$206.37
Rate for Payer: Cash Price	$206.37
Rate for Payer: Cofinity Commercial	$221.85
Rate for Payer: Cofinity Commercial	$180.57
Rate for Payer: Health Alliance Plan Medicare Advantage	$113.66
Rate for Payer: Healthscope Commercial	$232.16
Rate for Payer: Mclaren Medicaid	$62.17
Rate for Payer: Mclaren Medicare	$113.66
Rate for Payer: Meridian Medicaid	$65.29
Rate for Payer: Meridian Wellcare - Medicare Advantage	$119.34
Rate for Payer: MI Amish Medical Board Commercial	$130.71
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$219.27
Rate for Payer: PACE Medicare	$107.98
Rate for Payer: PACE SWMI	$113.66
Rate for Payer: PHP Commercial	$219.27
Rate for Payer: PHP Medicare Advantage	$113.66
Rate for Payer: Priority Health Choice Medicaid	$62.17
Rate for Payer: Priority Health Cigna Priority Health	$180.57
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$351.10
Rate for Payer: Priority Health Medicare	$113.66
Rate for Payer: Priority Health Narrow Network	$280.88
Rate for Payer: Priority Health SBD	$162.51
Rate for Payer: Railroad Medicare Medicare	$113.66
Rate for Payer: UHC All Payor (Choice/PPO)	$42.50
Rate for Payer: UHC Dual Complete DSNP	$113.66
Rate for Payer: UHC Exchange	$38.64
Rate for Payer: UHC Medicare Advantage	$117.07
Rate for Payer: VA VA	$113.66

HC BRONCHO HYGIENE SUBS

Facility

$257.96

Service Code	CPT 94668
Hospital Charge Code	41000011
Hospital Revenue Code	410
Min. Negotiated Rate	$162.51
Max. Negotiated Rate	$232.16
Rate for Payer: Aetna Commercial	$219.27
Rate for Payer: Aetna New Business (MI Preferred)	$167.67
Rate for Payer: Cash Price	$206.37
Rate for Payer: Cofinity Commercial	$180.57
Rate for Payer: Cofinity Commercial	$221.85
Rate for Payer: Healthscope Commercial	$232.16
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$219.27
Rate for Payer: PHP Commercial	$219.27
Rate for Payer: Priority Health Cigna Priority Health	$180.57
Rate for Payer: Priority Health SBD	$162.51

HC BRONCHOSCOPY

Facility

$2,514.51

Hospital Charge Code	36000014
Hospital Revenue Code	360
Min. Negotiated Rate	$1,584.14
Max. Negotiated Rate	$2,263.06
Rate for Payer: Aetna Commercial	$2,137.33
Rate for Payer: Aetna New Business (MI Preferred)	$1,634.43
Rate for Payer: Cash Price	$2,011.61
Rate for Payer: Cofinity Commercial	$1,760.16
Rate for Payer: Cofinity Commercial	$2,162.48
Rate for Payer: Healthscope Commercial	$2,263.06
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,137.33
Rate for Payer: PHP Commercial	$2,137.33
Rate for Payer: Priority Health Cigna Priority Health	$1,760.16
Rate for Payer: Priority Health SBD	$1,584.14

HC BRONCHOSCOPY

Facility

$2,514.51

Hospital Charge Code	36000014
Hospital Revenue Code	360
Min. Negotiated Rate	$1,005.80
Max. Negotiated Rate	$2,263.06
Rate for Payer: Aetna Commercial	$2,137.33
Rate for Payer: Aetna New Business (MI Preferred)	$1,634.43
Rate for Payer: BCBS Complete	$1,005.80
Rate for Payer: Cash Price	$2,011.61
Rate for Payer: Cofinity Commercial	$1,760.16
Rate for Payer: Cofinity Commercial	$2,162.48
Rate for Payer: Healthscope Commercial	$2,263.06
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,137.33
Rate for Payer: PHP Commercial	$2,137.33
Rate for Payer: Priority Health Cigna Priority Health	$1,760.16
Rate for Payer: Priority Health SBD	$1,584.14

HC BRONCHOSCOPY W EBUS EXAM

Facility

$3,115.71

Hospital Charge Code	36000015
Hospital Revenue Code	360
Min. Negotiated Rate	$1,246.28
Max. Negotiated Rate	$2,804.14
Rate for Payer: Aetna Commercial	$2,648.35
Rate for Payer: Aetna New Business (MI Preferred)	$2,025.21
Rate for Payer: BCBS Complete	$1,246.28
Rate for Payer: Cash Price	$2,492.57
Rate for Payer: Cofinity Commercial	$2,181.00
Rate for Payer: Cofinity Commercial	$2,679.51
Rate for Payer: Healthscope Commercial	$2,804.14
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,648.35
Rate for Payer: PHP Commercial	$2,648.35
Rate for Payer: Priority Health Cigna Priority Health	$2,181.00
Rate for Payer: Priority Health SBD	$1,962.90

HC BRONCHOSCOPY W EBUS EXAM

Facility

$3,115.71

Hospital Charge Code	36000015
Hospital Revenue Code	360
Min. Negotiated Rate	$1,962.90
Max. Negotiated Rate	$2,804.14
Rate for Payer: Aetna Commercial	$2,648.35
Rate for Payer: Aetna New Business (MI Preferred)	$2,025.21
Rate for Payer: Cash Price	$2,492.57
Rate for Payer: Cofinity Commercial	$2,181.00
Rate for Payer: Cofinity Commercial	$2,679.51
Rate for Payer: Healthscope Commercial	$2,804.14
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,648.35
Rate for Payer: PHP Commercial	$2,648.35
Rate for Payer: Priority Health Cigna Priority Health	$2,181.00
Rate for Payer: Priority Health SBD	$1,962.90

HC BRONCHOSPASM PROVOCATION (METHACHOLINE CHALLENGE)

Facility

$694.78

Service Code	CPT 94070
Hospital Charge Code	46000003
Hospital Revenue Code	460
Min. Negotiated Rate	$437.71
Max. Negotiated Rate	$625.30
Rate for Payer: Aetna Commercial	$590.56
Rate for Payer: Aetna New Business (MI Preferred)	$451.61
Rate for Payer: Cash Price	$555.82
Rate for Payer: Cofinity Commercial	$486.35
Rate for Payer: Cofinity Commercial	$597.51
Rate for Payer: Healthscope Commercial	$625.30
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$590.56
Rate for Payer: PHP Commercial	$590.56
Rate for Payer: Priority Health Cigna Priority Health	$486.35
Rate for Payer: Priority Health SBD	$437.71

HC BRONCHOSPASM PROVOCATION (METHACHOLINE CHALLENGE)

Facility

$694.78

Service Code	CPT 94070
Hospital Charge Code	46000003
Hospital Revenue Code	460
Min. Negotiated Rate	$61.89
Max. Negotiated Rate	$625.30
Rate for Payer: Aetna Commercial	$590.56
Rate for Payer: Aetna Medicare	$290.46
Rate for Payer: Aetna New Business (MI Preferred)	$451.61
Rate for Payer: Allen County Amish Medical Aid Commercial	$349.11
Rate for Payer: Amish Plain Church Group Commercial	$349.11
Rate for Payer: BCBS Complete	$160.42
Rate for Payer: BCBS MAPPO	$279.29
Rate for Payer: BCBS Trust/PPO	$155.05
Rate for Payer: BCN Medicare Advantage	$279.29
Rate for Payer: Cash Price	$555.82
Rate for Payer: Cash Price	$555.82
Rate for Payer: Cofinity Commercial	$597.51
Rate for Payer: Cofinity Commercial	$486.35
Rate for Payer: Health Alliance Plan Medicare Advantage	$279.29
Rate for Payer: Healthscope Commercial	$625.30
Rate for Payer: Mclaren Medicaid	$152.77
Rate for Payer: Mclaren Medicare	$279.29
Rate for Payer: Meridian Medicaid	$160.42
Rate for Payer: Meridian Wellcare - Medicare Advantage	$293.25
Rate for Payer: MI Amish Medical Board Commercial	$321.18
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$590.56
Rate for Payer: PACE Medicare	$265.33
Rate for Payer: PACE SWMI	$279.29
Rate for Payer: PHP Commercial	$590.56
Rate for Payer: PHP Medicare Advantage	$279.29
Rate for Payer: Priority Health Choice Medicaid	$152.77
Rate for Payer: Priority Health Cigna Priority Health	$486.35
Rate for Payer: Priority Health Medicare	$279.29
Rate for Payer: Priority Health SBD	$437.71
Rate for Payer: Railroad Medicare Medicare	$279.29
Rate for Payer: UHC All Payor (Choice/PPO)	$68.08
Rate for Payer: UHC Dual Complete DSNP	$279.29
Rate for Payer: UHC Exchange	$61.89
Rate for Payer: UHC Medicare Advantage	$287.67
Rate for Payer: VA VA	$279.29

HC BRUCELLA ANTIBODY

Facility

$72.00

Service Code	CPT 86622
Hospital Charge Code	30200236
Hospital Revenue Code	302
Min. Negotiated Rate	$45.36
Max. Negotiated Rate	$64.80
Rate for Payer: Aetna Commercial	$61.20
Rate for Payer: Aetna New Business (MI Preferred)	$46.80
Rate for Payer: Cash Price	$57.60
Rate for Payer: Cofinity Commercial	$50.40
Rate for Payer: Cofinity Commercial	$61.92
Rate for Payer: Healthscope Commercial	$64.80
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$61.20
Rate for Payer: PHP Commercial	$61.20
Rate for Payer: Priority Health Cigna Priority Health	$50.40
Rate for Payer: Priority Health SBD	$45.36

HC BRUCELLA ANTIBODY

Facility

$72.00

Service Code	CPT 86622
Hospital Charge Code	30200236
Hospital Revenue Code	302
Min. Negotiated Rate	$4.88
Max. Negotiated Rate	$64.80
Rate for Payer: Aetna Commercial	$61.20
Rate for Payer: Aetna Medicare	$9.29
Rate for Payer: Aetna New Business (MI Preferred)	$46.80
Rate for Payer: Allen County Amish Medical Aid Commercial	$11.16
Rate for Payer: Amish Plain Church Group Commercial	$11.16
Rate for Payer: BCBS Complete	$5.13
Rate for Payer: BCBS MAPPO	$8.93
Rate for Payer: BCBS Trust/PPO	$7.00
Rate for Payer: BCN Medicare Advantage	$8.93
Rate for Payer: Cash Price	$57.60
Rate for Payer: Cash Price	$57.60
Rate for Payer: Cofinity Commercial	$61.92
Rate for Payer: Cofinity Commercial	$50.40
Rate for Payer: Health Alliance Plan Medicare Advantage	$8.93
Rate for Payer: Healthscope Commercial	$64.80
Rate for Payer: Mclaren Medicaid	$4.88
Rate for Payer: Mclaren Medicare	$8.93
Rate for Payer: Meridian Medicaid	$5.13
Rate for Payer: Meridian Wellcare - Medicare Advantage	$9.38
Rate for Payer: MI Amish Medical Board Commercial	$10.27
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$61.20
Rate for Payer: PACE Medicare	$8.48
Rate for Payer: PACE SWMI	$8.93
Rate for Payer: PHP Commercial	$61.20
Rate for Payer: PHP Medicare Advantage	$8.93
Rate for Payer: Priority Health Choice Medicaid	$4.88
Rate for Payer: Priority Health Cigna Priority Health	$50.40
Rate for Payer: Priority Health Medicare	$8.93
Rate for Payer: Priority Health SBD	$45.36
Rate for Payer: Railroad Medicare Medicare	$8.93
Rate for Payer: UHC All Payor (Choice/PPO)	$10.72
Rate for Payer: UHC Core	$15.18
Rate for Payer: UHC Dual Complete DSNP	$8.93
Rate for Payer: UHC Exchange	$8.93
Rate for Payer: UHC Medicare Advantage	$9.20
Rate for Payer: VA VA	$8.93

HC BRUCELLA ANTIBODY CMPT

Facility

$72.00

Service Code	CPT 86622
Hospital Charge Code	30200238
Hospital Revenue Code	302
Min. Negotiated Rate	$45.36
Max. Negotiated Rate	$64.80
Rate for Payer: Aetna Commercial	$61.20
Rate for Payer: Aetna New Business (MI Preferred)	$46.80
Rate for Payer: Cash Price	$57.60
Rate for Payer: Cofinity Commercial	$50.40
Rate for Payer: Cofinity Commercial	$61.92
Rate for Payer: Healthscope Commercial	$64.80
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$61.20
Rate for Payer: PHP Commercial	$61.20
Rate for Payer: Priority Health Cigna Priority Health	$50.40
Rate for Payer: Priority Health SBD	$45.36

HC BRUCELLA ANTIBODY CMPT

Facility

$72.00

Service Code	CPT 86622
Hospital Charge Code	30200238
Hospital Revenue Code	302
Min. Negotiated Rate	$4.88
Max. Negotiated Rate	$64.80
Rate for Payer: Aetna Commercial	$61.20
Rate for Payer: Aetna Medicare	$9.29
Rate for Payer: Aetna New Business (MI Preferred)	$46.80
Rate for Payer: Allen County Amish Medical Aid Commercial	$11.16
Rate for Payer: Amish Plain Church Group Commercial	$11.16
Rate for Payer: BCBS Complete	$5.13
Rate for Payer: BCBS MAPPO	$8.93
Rate for Payer: BCBS Trust/PPO	$7.00
Rate for Payer: BCN Medicare Advantage	$8.93
Rate for Payer: Cash Price	$57.60
Rate for Payer: Cash Price	$57.60
Rate for Payer: Cofinity Commercial	$61.92
Rate for Payer: Cofinity Commercial	$50.40
Rate for Payer: Health Alliance Plan Medicare Advantage	$8.93
Rate for Payer: Healthscope Commercial	$64.80
Rate for Payer: Mclaren Medicaid	$4.88
Rate for Payer: Mclaren Medicare	$8.93
Rate for Payer: Meridian Medicaid	$5.13
Rate for Payer: Meridian Wellcare - Medicare Advantage	$9.38
Rate for Payer: MI Amish Medical Board Commercial	$10.27
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$61.20
Rate for Payer: PACE Medicare	$8.48
Rate for Payer: PACE SWMI	$8.93
Rate for Payer: PHP Commercial	$61.20
Rate for Payer: PHP Medicare Advantage	$8.93
Rate for Payer: Priority Health Choice Medicaid	$4.88
Rate for Payer: Priority Health Cigna Priority Health	$50.40
Rate for Payer: Priority Health Medicare	$8.93
Rate for Payer: Priority Health SBD	$45.36
Rate for Payer: Railroad Medicare Medicare	$8.93
Rate for Payer: UHC All Payor (Choice/PPO)	$10.72
Rate for Payer: UHC Core	$15.18
Rate for Payer: UHC Dual Complete DSNP	$8.93
Rate for Payer: UHC Exchange	$8.93
Rate for Payer: UHC Medicare Advantage	$9.20
Rate for Payer: VA VA	$8.93

HC BRUCELLA ANTIBODY CONFIRMATION

Facility

$52.00

Service Code	CPT 86622
Hospital Charge Code	30200237
Hospital Revenue Code	302
Min. Negotiated Rate	$4.88
Max. Negotiated Rate	$46.80
Rate for Payer: Aetna Commercial	$44.20
Rate for Payer: Aetna Medicare	$9.29
Rate for Payer: Aetna New Business (MI Preferred)	$33.80
Rate for Payer: Allen County Amish Medical Aid Commercial	$11.16
Rate for Payer: Amish Plain Church Group Commercial	$11.16
Rate for Payer: BCBS Complete	$5.13
Rate for Payer: BCBS MAPPO	$8.93
Rate for Payer: BCBS Trust/PPO	$7.00
Rate for Payer: BCN Medicare Advantage	$8.93
Rate for Payer: Cash Price	$41.60
Rate for Payer: Cash Price	$41.60
Rate for Payer: Cofinity Commercial	$44.72
Rate for Payer: Cofinity Commercial	$36.40
Rate for Payer: Health Alliance Plan Medicare Advantage	$8.93
Rate for Payer: Healthscope Commercial	$46.80
Rate for Payer: Mclaren Medicaid	$4.88
Rate for Payer: Mclaren Medicare	$8.93
Rate for Payer: Meridian Medicaid	$5.13
Rate for Payer: Meridian Wellcare - Medicare Advantage	$9.38
Rate for Payer: MI Amish Medical Board Commercial	$10.27
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$44.20
Rate for Payer: PACE Medicare	$8.48
Rate for Payer: PACE SWMI	$8.93
Rate for Payer: PHP Commercial	$44.20
Rate for Payer: PHP Medicare Advantage	$8.93
Rate for Payer: Priority Health Choice Medicaid	$4.88
Rate for Payer: Priority Health Cigna Priority Health	$36.40
Rate for Payer: Priority Health Medicare	$8.93
Rate for Payer: Priority Health SBD	$32.76
Rate for Payer: Railroad Medicare Medicare	$8.93
Rate for Payer: UHC All Payor (Choice/PPO)	$10.72
Rate for Payer: UHC Core	$15.18
Rate for Payer: UHC Dual Complete DSNP	$8.93
Rate for Payer: UHC Exchange	$8.93
Rate for Payer: UHC Medicare Advantage	$9.20
Rate for Payer: VA VA	$8.93

HC BRUCELLA ANTIBODY CONFIRMATION

Facility

$52.00

Service Code	CPT 86622
Hospital Charge Code	30200237
Hospital Revenue Code	302
Min. Negotiated Rate	$32.76
Max. Negotiated Rate	$46.80
Rate for Payer: Aetna Commercial	$44.20
Rate for Payer: Aetna New Business (MI Preferred)	$33.80
Rate for Payer: Cash Price	$41.60
Rate for Payer: Cofinity Commercial	$44.72
Rate for Payer: Cofinity Commercial	$36.40
Rate for Payer: Healthscope Commercial	$46.80
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$44.20
Rate for Payer: PHP Commercial	$44.20
Rate for Payer: Priority Health Cigna Priority Health	$36.40
Rate for Payer: Priority Health SBD	$32.76

HC BUNDLE OF HIS RECORDING

Facility

$3,942.53

Service Code	CPT 93600
Hospital Charge Code	48100029
Hospital Revenue Code	481
Min. Negotiated Rate	$2,483.79
Max. Negotiated Rate	$19,563.35
Rate for Payer: Aetna Commercial	$3,351.15
Rate for Payer: Aetna Medicare	$6,910.95
Rate for Payer: Aetna New Business (MI Preferred)	$2,562.64
Rate for Payer: Allen County Amish Medical Aid Commercial	$8,306.42
Rate for Payer: Amish Plain Church Group Commercial	$8,306.42
Rate for Payer: BCBS Complete	$3,816.97
Rate for Payer: BCBS MAPPO	$6,645.14
Rate for Payer: BCBS Trust/PPO	$19,563.35
Rate for Payer: BCN Medicare Advantage	$6,645.14
Rate for Payer: Cash Price	$3,154.02
Rate for Payer: Cash Price	$3,154.02
Rate for Payer: Cofinity Commercial	$3,390.58
Rate for Payer: Cofinity Commercial	$2,759.77
Rate for Payer: Health Alliance Plan Medicare Advantage	$6,645.14
Rate for Payer: Healthscope Commercial	$3,548.28
Rate for Payer: Mclaren Medicaid	$3,634.89
Rate for Payer: Mclaren Medicare	$6,645.14
Rate for Payer: Meridian Medicaid	$3,816.97
Rate for Payer: Meridian Wellcare - Medicare Advantage	$6,977.40
Rate for Payer: MI Amish Medical Board Commercial	$7,641.91
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3,351.15
Rate for Payer: PACE Medicare	$6,312.88
Rate for Payer: PACE SWMI	$6,645.14
Rate for Payer: PHP Commercial	$3,351.15
Rate for Payer: PHP Medicare Advantage	$6,645.14
Rate for Payer: Priority Health Choice Medicaid	$3,634.89
Rate for Payer: Priority Health Cigna Priority Health	$2,759.77
Rate for Payer: Priority Health Medicare	$6,645.14
Rate for Payer: Priority Health SBD	$2,483.79
Rate for Payer: Railroad Medicare Medicare	$6,645.14
Rate for Payer: UHC Core	$3,138.00
Rate for Payer: UHC Dual Complete DSNP	$6,645.14
Rate for Payer: UHC Medicare Advantage	$6,844.49
Rate for Payer: VA VA	$6,645.14

HC BUNDLE OF HIS RECORDING

Facility

$3,942.53

Service Code	CPT 93600
Hospital Charge Code	48100029
Hospital Revenue Code	481
Min. Negotiated Rate	$2,483.79
Max. Negotiated Rate	$3,548.28
Rate for Payer: Aetna Commercial	$3,351.15
Rate for Payer: Aetna New Business (MI Preferred)	$2,562.64
Rate for Payer: Cash Price	$3,154.02
Rate for Payer: Cofinity Commercial	$2,759.77
Rate for Payer: Cofinity Commercial	$3,390.58
Rate for Payer: Healthscope Commercial	$3,548.28
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3,351.15
Rate for Payer: PHP Commercial	$3,351.15
Rate for Payer: Priority Health Cigna Priority Health	$2,759.77
Rate for Payer: Priority Health SBD	$2,483.79

HC BUPIVACAINE 0.5 MG

Facility

$1.48

Service Code	HCPCS J0665
Hospital Charge Code	25000016
Hospital Revenue Code	636
Min. Negotiated Rate	$0.93
Max. Negotiated Rate	$1.33
Rate for Payer: Aetna Commercial	$1.26
Rate for Payer: Aetna New Business (MI Preferred)	$0.96
Rate for Payer: Cash Price	$1.18
Rate for Payer: Cofinity Commercial	$1.04
Rate for Payer: Cofinity Commercial	$1.27
Rate for Payer: Healthscope Commercial	$1.33
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1.26
Rate for Payer: PHP Commercial	$1.26
Rate for Payer: Priority Health Cigna Priority Health	$1.04
Rate for Payer: Priority Health SBD	$0.93

HC BUPIVACAINE 0.5 MG

Facility

$1.48

Service Code	HCPCS J0665
Hospital Charge Code	25000016
Hospital Revenue Code	636
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$1.33
Rate for Payer: Aetna Commercial	$1.26
Rate for Payer: Aetna Medicare	$0.01
Rate for Payer: Aetna New Business (MI Preferred)	$0.96
Rate for Payer: Allen County Amish Medical Aid Commercial	$0.02
Rate for Payer: Amish Plain Church Group Commercial	$0.02
Rate for Payer: BCBS Complete	$0.01
Rate for Payer: BCBS MAPPO	$0.01
Rate for Payer: BCBS Trust/PPO	$0.03
Rate for Payer: BCN Medicare Advantage	$0.01
Rate for Payer: Cash Price	$1.18
Rate for Payer: Cash Price	$1.18
Rate for Payer: Cofinity Commercial	$1.04
Rate for Payer: Cofinity Commercial	$1.27
Rate for Payer: Health Alliance Plan Medicare Advantage	$0.01
Rate for Payer: Healthscope Commercial	$1.33
Rate for Payer: Mclaren Medicaid	$0.01
Rate for Payer: Mclaren Medicare	$0.01
Rate for Payer: Meridian Medicaid	$0.01
Rate for Payer: Meridian Wellcare - Medicare Advantage	$0.01
Rate for Payer: MI Amish Medical Board Commercial	$0.02
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1.26
Rate for Payer: PACE Medicare	$0.01
Rate for Payer: PACE SWMI	$0.01
Rate for Payer: PHP Commercial	$1.26
Rate for Payer: PHP Medicare Advantage	$0.01
Rate for Payer: Priority Health Choice Medicaid	$0.01
Rate for Payer: Priority Health Cigna Priority Health	$1.04
Rate for Payer: Priority Health Medicare	$0.01
Rate for Payer: Priority Health SBD	$0.93
Rate for Payer: Railroad Medicare Medicare	$0.01
Rate for Payer: UHC Dual Complete DSNP	$0.01
Rate for Payer: UHC Medicare Advantage	$0.01
Rate for Payer: VA VA	$0.01

HC BUPRENORPHINE & MET QUANT, UR

Facility

$174.00

Service Code	CPT 80348
Hospital Charge Code	30100598
Hospital Revenue Code	301
Min. Negotiated Rate	$19.44
Max. Negotiated Rate	$156.60
Rate for Payer: Aetna Commercial	$147.90
Rate for Payer: Aetna New Business (MI Preferred)	$113.10
Rate for Payer: BCBS Complete	$69.60
Rate for Payer: Cash Price	$139.20
Rate for Payer: Cash Price	$139.20
Rate for Payer: Cofinity Commercial	$149.64
Rate for Payer: Cofinity Commercial	$121.80
Rate for Payer: Healthscope Commercial	$156.60
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$147.90
Rate for Payer: PHP Commercial	$147.90
Rate for Payer: Priority Health Cigna Priority Health	$121.80
Rate for Payer: Priority Health SBD	$109.62
Rate for Payer: UHC Core	$19.44

HC BUPRENORPHINE & MET QUANT, UR

Facility

$174.00

Service Code	CPT 80348
Hospital Charge Code	30100598
Hospital Revenue Code	301
Min. Negotiated Rate	$109.62
Max. Negotiated Rate	$156.60
Rate for Payer: Aetna Commercial	$147.90
Rate for Payer: Aetna New Business (MI Preferred)	$113.10
Rate for Payer: Cash Price	$139.20
Rate for Payer: Cofinity Commercial	$121.80
Rate for Payer: Cofinity Commercial	$149.64
Rate for Payer: Healthscope Commercial	$156.60
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$147.90
Rate for Payer: PHP Commercial	$147.90
Rate for Payer: Priority Health Cigna Priority Health	$121.80
Rate for Payer: Priority Health SBD	$109.62

HC BUPRENORPHINE SCRN URN

Facility

$40.80

Service Code	CPT 80305
Hospital Charge Code	30000116
Hospital Revenue Code	300
Min. Negotiated Rate	$6.89
Max. Negotiated Rate	$36.72
Rate for Payer: Aetna Commercial	$34.68
Rate for Payer: Aetna Medicare	$13.10
Rate for Payer: Aetna New Business (MI Preferred)	$26.52
Rate for Payer: Allen County Amish Medical Aid Commercial	$15.75
Rate for Payer: Amish Plain Church Group Commercial	$15.75
Rate for Payer: BCBS Complete	$7.24
Rate for Payer: BCBS MAPPO	$12.60
Rate for Payer: BCBS Trust/PPO	$9.87
Rate for Payer: BCN Medicare Advantage	$12.60
Rate for Payer: Cash Price	$32.64
Rate for Payer: Cash Price	$32.64
Rate for Payer: Cofinity Commercial	$28.56
Rate for Payer: Cofinity Commercial	$35.09
Rate for Payer: Health Alliance Plan Medicare Advantage	$12.60
Rate for Payer: Healthscope Commercial	$36.72
Rate for Payer: Mclaren Medicaid	$6.89
Rate for Payer: Mclaren Medicare	$12.60
Rate for Payer: Meridian Medicaid	$7.24
Rate for Payer: Meridian Wellcare - Medicare Advantage	$13.23
Rate for Payer: MI Amish Medical Board Commercial	$14.49
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$34.68
Rate for Payer: PACE Medicare	$11.97
Rate for Payer: PACE SWMI	$12.60
Rate for Payer: PHP Commercial	$34.68
Rate for Payer: PHP Medicare Advantage	$12.60
Rate for Payer: Priority Health Choice Medicaid	$6.89
Rate for Payer: Priority Health Cigna Priority Health	$28.56
Rate for Payer: Priority Health Medicare	$12.60
Rate for Payer: Priority Health SBD	$25.70
Rate for Payer: Railroad Medicare Medicare	$12.60
Rate for Payer: UHC All Payor (Choice/PPO)	$15.12
Rate for Payer: UHC Core	$17.95
Rate for Payer: UHC Dual Complete DSNP	$12.60
Rate for Payer: UHC Exchange	$12.60
Rate for Payer: UHC Medicare Advantage	$12.98
Rate for Payer: VA VA	$12.60

Know your out-of-pocket cost for care.

All Charges