Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC CANCER ANTIGEN 15-3

Facility

$47.94

Service Code	CPT 86300
Hospital Charge Code	30200182
Hospital Revenue Code	302
Min. Negotiated Rate	$30.20
Max. Negotiated Rate	$43.15
Rate for Payer: Aetna Commercial	$40.75
Rate for Payer: Aetna New Business (MI Preferred)	$31.16
Rate for Payer: Cash Price	$38.35
Rate for Payer: Cofinity Commercial	$33.56
Rate for Payer: Cofinity Commercial	$41.23
Rate for Payer: Healthscope Commercial	$43.15
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$40.75
Rate for Payer: PHP Commercial	$40.75
Rate for Payer: Priority Health Cigna Priority Health	$33.56
Rate for Payer: Priority Health SBD	$30.20

HC CANCER ANTIGEN 15-3

Facility

$47.94

Service Code	CPT 86300
Hospital Charge Code	30200182
Hospital Revenue Code	302
Min. Negotiated Rate	$11.38
Max. Negotiated Rate	$43.15
Rate for Payer: Aetna Commercial	$40.75
Rate for Payer: Aetna Medicare	$21.64
Rate for Payer: Aetna New Business (MI Preferred)	$31.16
Rate for Payer: Allen County Amish Medical Aid Commercial	$26.01
Rate for Payer: Amish Plain Church Group Commercial	$26.01
Rate for Payer: BCBS Complete	$11.95
Rate for Payer: BCBS MAPPO	$20.81
Rate for Payer: BCBS Trust/PPO	$16.30
Rate for Payer: BCN Medicare Advantage	$20.81
Rate for Payer: Cash Price	$38.35
Rate for Payer: Cash Price	$38.35
Rate for Payer: Cofinity Commercial	$41.23
Rate for Payer: Cofinity Commercial	$33.56
Rate for Payer: Health Alliance Plan Medicare Advantage	$20.81
Rate for Payer: Healthscope Commercial	$43.15
Rate for Payer: Mclaren Medicaid	$11.38
Rate for Payer: Mclaren Medicare	$20.81
Rate for Payer: Meridian Medicaid	$11.95
Rate for Payer: Meridian Wellcare - Medicare Advantage	$21.85
Rate for Payer: MI Amish Medical Board Commercial	$23.93
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$40.75
Rate for Payer: PACE Medicare	$19.77
Rate for Payer: PACE SWMI	$20.81
Rate for Payer: PHP Commercial	$40.75
Rate for Payer: PHP Medicare Advantage	$20.81
Rate for Payer: Priority Health Choice Medicaid	$11.38
Rate for Payer: Priority Health Cigna Priority Health	$33.56
Rate for Payer: Priority Health Medicare	$20.81
Rate for Payer: Priority Health SBD	$30.20
Rate for Payer: Railroad Medicare Medicare	$20.81
Rate for Payer: UHC All Payor (Choice/PPO)	$24.97
Rate for Payer: UHC Core	$35.38
Rate for Payer: UHC Dual Complete DSNP	$20.81
Rate for Payer: UHC Exchange	$20.81
Rate for Payer: UHC Medicare Advantage	$21.43
Rate for Payer: VA VA	$20.81

HC CANCER ANTIGEN 19-9

Facility

$44.88

Service Code	CPT 86301
Hospital Charge Code	30200184
Hospital Revenue Code	302
Min. Negotiated Rate	$11.38
Max. Negotiated Rate	$40.39
Rate for Payer: Aetna Commercial	$38.15
Rate for Payer: Aetna Medicare	$21.64
Rate for Payer: Aetna New Business (MI Preferred)	$29.17
Rate for Payer: Allen County Amish Medical Aid Commercial	$26.01
Rate for Payer: Amish Plain Church Group Commercial	$26.01
Rate for Payer: BCBS Complete	$11.95
Rate for Payer: BCBS MAPPO	$20.81
Rate for Payer: BCBS Trust/PPO	$16.30
Rate for Payer: BCN Medicare Advantage	$20.81
Rate for Payer: Cash Price	$35.90
Rate for Payer: Cash Price	$35.90
Rate for Payer: Cofinity Commercial	$38.60
Rate for Payer: Cofinity Commercial	$31.42
Rate for Payer: Health Alliance Plan Medicare Advantage	$20.81
Rate for Payer: Healthscope Commercial	$40.39
Rate for Payer: Mclaren Medicaid	$11.38
Rate for Payer: Mclaren Medicare	$20.81
Rate for Payer: Meridian Medicaid	$11.95
Rate for Payer: Meridian Wellcare - Medicare Advantage	$21.85
Rate for Payer: MI Amish Medical Board Commercial	$23.93
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$38.15
Rate for Payer: PACE Medicare	$19.77
Rate for Payer: PACE SWMI	$20.81
Rate for Payer: PHP Commercial	$38.15
Rate for Payer: PHP Medicare Advantage	$20.81
Rate for Payer: Priority Health Choice Medicaid	$11.38
Rate for Payer: Priority Health Cigna Priority Health	$31.42
Rate for Payer: Priority Health Medicare	$20.81
Rate for Payer: Priority Health SBD	$28.27
Rate for Payer: Railroad Medicare Medicare	$20.81
Rate for Payer: UHC All Payor (Choice/PPO)	$24.97
Rate for Payer: UHC Core	$35.38
Rate for Payer: UHC Dual Complete DSNP	$20.81
Rate for Payer: UHC Exchange	$20.81
Rate for Payer: UHC Medicare Advantage	$21.43
Rate for Payer: VA VA	$20.81

HC CANCER ANTIGEN 19-9

Facility

$44.88

Service Code	CPT 86301
Hospital Charge Code	30200184
Hospital Revenue Code	302
Min. Negotiated Rate	$28.27
Max. Negotiated Rate	$40.39
Rate for Payer: Aetna Commercial	$38.15
Rate for Payer: Aetna New Business (MI Preferred)	$29.17
Rate for Payer: Cash Price	$35.90
Rate for Payer: Cofinity Commercial	$31.42
Rate for Payer: Cofinity Commercial	$38.60
Rate for Payer: Healthscope Commercial	$40.39
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$38.15
Rate for Payer: PHP Commercial	$38.15
Rate for Payer: Priority Health Cigna Priority Health	$31.42
Rate for Payer: Priority Health SBD	$28.27

HC CANCER ANTIGEN 2729

Facility

$40.39

Service Code	CPT 86300
Hospital Charge Code	30200183
Hospital Revenue Code	302
Min. Negotiated Rate	$11.38
Max. Negotiated Rate	$36.35
Rate for Payer: Aetna Commercial	$34.33
Rate for Payer: Aetna Medicare	$21.64
Rate for Payer: Aetna New Business (MI Preferred)	$26.25
Rate for Payer: Allen County Amish Medical Aid Commercial	$26.01
Rate for Payer: Amish Plain Church Group Commercial	$26.01
Rate for Payer: BCBS Complete	$11.95
Rate for Payer: BCBS MAPPO	$20.81
Rate for Payer: BCBS Trust/PPO	$16.30
Rate for Payer: BCN Medicare Advantage	$20.81
Rate for Payer: Cash Price	$32.31
Rate for Payer: Cash Price	$32.31
Rate for Payer: Cofinity Commercial	$34.74
Rate for Payer: Cofinity Commercial	$28.27
Rate for Payer: Health Alliance Plan Medicare Advantage	$20.81
Rate for Payer: Healthscope Commercial	$36.35
Rate for Payer: Mclaren Medicaid	$11.38
Rate for Payer: Mclaren Medicare	$20.81
Rate for Payer: Meridian Medicaid	$11.95
Rate for Payer: Meridian Wellcare - Medicare Advantage	$21.85
Rate for Payer: MI Amish Medical Board Commercial	$23.93
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$34.33
Rate for Payer: PACE Medicare	$19.77
Rate for Payer: PACE SWMI	$20.81
Rate for Payer: PHP Commercial	$34.33
Rate for Payer: PHP Medicare Advantage	$20.81
Rate for Payer: Priority Health Choice Medicaid	$11.38
Rate for Payer: Priority Health Cigna Priority Health	$28.27
Rate for Payer: Priority Health Medicare	$20.81
Rate for Payer: Priority Health SBD	$25.45
Rate for Payer: Railroad Medicare Medicare	$20.81
Rate for Payer: UHC All Payor (Choice/PPO)	$24.97
Rate for Payer: UHC Core	$35.38
Rate for Payer: UHC Dual Complete DSNP	$20.81
Rate for Payer: UHC Exchange	$20.81
Rate for Payer: UHC Medicare Advantage	$21.43
Rate for Payer: VA VA	$20.81

HC CANCER ANTIGEN 2729

Facility

$40.39

Service Code	CPT 86300
Hospital Charge Code	30200183
Hospital Revenue Code	302
Min. Negotiated Rate	$25.45
Max. Negotiated Rate	$36.35
Rate for Payer: Aetna Commercial	$34.33
Rate for Payer: Aetna New Business (MI Preferred)	$26.25
Rate for Payer: Cash Price	$32.31
Rate for Payer: Cofinity Commercial	$28.27
Rate for Payer: Cofinity Commercial	$34.74
Rate for Payer: Healthscope Commercial	$36.35
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$34.33
Rate for Payer: PHP Commercial	$34.33
Rate for Payer: Priority Health Cigna Priority Health	$28.27
Rate for Payer: Priority Health SBD	$25.45

HC CANDIDA ALBICANS IGE

Facility

$24.89

Service Code	CPT 86003
Hospital Charge Code	30200077
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 CANDIDA ALBICANS IGE

Facility

$24.89

Service Code	CPT 86003
Hospital Charge Code	30200077
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	$21.41
Rate for Payer: Cofinity Commercial	$17.42
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 CANNABINOID URIN

Facility

$92.68

Service Code	CPT 80307
Hospital Charge Code	30000125
Hospital Revenue Code	300
Min. Negotiated Rate	$33.99
Max. Negotiated Rate	$95.77
Rate for Payer: Aetna Commercial	$78.78
Rate for Payer: Aetna Medicare	$64.63
Rate for Payer: Aetna New Business (MI Preferred)	$60.24
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	$74.14
Rate for Payer: Cash Price	$74.14
Rate for Payer: Cofinity Commercial	$64.88
Rate for Payer: Cofinity Commercial	$79.70
Rate for Payer: Health Alliance Plan Medicare Advantage	$62.14
Rate for Payer: Healthscope Commercial	$83.41
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	$78.78
Rate for Payer: PACE Medicare	$59.03
Rate for Payer: PACE SWMI	$62.14
Rate for Payer: PHP Commercial	$78.78
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	$64.88
Rate for Payer: Priority Health Medicare	$62.14
Rate for Payer: Priority Health SBD	$58.39
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 CANNABINOID URIN

Facility

$92.68

Service Code	CPT 80307
Hospital Charge Code	30000125
Hospital Revenue Code	300
Min. Negotiated Rate	$58.39
Max. Negotiated Rate	$83.41
Rate for Payer: Aetna Commercial	$78.78
Rate for Payer: Aetna New Business (MI Preferred)	$60.24
Rate for Payer: Cash Price	$74.14
Rate for Payer: Cofinity Commercial	$64.88
Rate for Payer: Cofinity Commercial	$79.70
Rate for Payer: Healthscope Commercial	$83.41
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$78.78
Rate for Payer: PHP Commercial	$78.78
Rate for Payer: Priority Health Cigna Priority Health	$64.88
Rate for Payer: Priority Health SBD	$58.39

HC CANN/INTRO FEM ART 17,19,21 FR

Facility

$867.00

Hospital Charge Code	27000274
Hospital Revenue Code	270
Min. Negotiated Rate	$546.21
Max. Negotiated Rate	$780.30
Rate for Payer: Aetna Commercial	$736.95
Rate for Payer: Aetna New Business (MI Preferred)	$563.55
Rate for Payer: Cash Price	$693.60
Rate for Payer: Cofinity Commercial	$606.90
Rate for Payer: Cofinity Commercial	$745.62
Rate for Payer: Healthscope Commercial	$780.30
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$736.95
Rate for Payer: PHP Commercial	$736.95
Rate for Payer: Priority Health Cigna Priority Health	$606.90
Rate for Payer: Priority Health SBD	$546.21

HC CANN/INTRO FEM ART 17,19,21 FR

Facility

$867.00

Hospital Charge Code	27000274
Hospital Revenue Code	270
Min. Negotiated Rate	$346.80
Max. Negotiated Rate	$780.30
Rate for Payer: Aetna Commercial	$736.95
Rate for Payer: Aetna New Business (MI Preferred)	$563.55
Rate for Payer: BCBS Complete	$346.80
Rate for Payer: Cash Price	$693.60
Rate for Payer: Cofinity Commercial	$606.90
Rate for Payer: Cofinity Commercial	$745.62
Rate for Payer: Healthscope Commercial	$780.30
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$736.95
Rate for Payer: PHP Commercial	$736.95
Rate for Payer: Priority Health Cigna Priority Health	$606.90
Rate for Payer: Priority Health SBD	$546.21

HC CANN RT ANG BALLOON 4-6MM

Facility

$297.00

Hospital Charge Code	27000446
Hospital Revenue Code	270
Min. Negotiated Rate	$187.11
Max. Negotiated Rate	$267.30
Rate for Payer: Aetna Commercial	$252.45
Rate for Payer: Aetna New Business (MI Preferred)	$193.05
Rate for Payer: Cash Price	$237.60
Rate for Payer: Cofinity Commercial	$207.90
Rate for Payer: Cofinity Commercial	$255.42
Rate for Payer: Healthscope Commercial	$267.30
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$252.45
Rate for Payer: PHP Commercial	$252.45
Rate for Payer: Priority Health Cigna Priority Health	$207.90
Rate for Payer: Priority Health SBD	$187.11

HC CANN RT ANG BALLOON 4-6MM

Facility

$297.00

Hospital Charge Code	27000446
Hospital Revenue Code	270
Min. Negotiated Rate	$118.80
Max. Negotiated Rate	$267.30
Rate for Payer: Aetna Commercial	$252.45
Rate for Payer: Aetna New Business (MI Preferred)	$193.05
Rate for Payer: BCBS Complete	$118.80
Rate for Payer: Cash Price	$237.60
Rate for Payer: Cofinity Commercial	$207.90
Rate for Payer: Cofinity Commercial	$255.42
Rate for Payer: Healthscope Commercial	$267.30
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$252.45
Rate for Payer: PHP Commercial	$252.45
Rate for Payer: Priority Health Cigna Priority Health	$207.90
Rate for Payer: Priority Health SBD	$187.11

HC CANNULA ARTERIAL 21, 24 FR

Facility

$114.00

Hospital Charge Code	27000449
Hospital Revenue Code	270
Min. Negotiated Rate	$45.60
Max. Negotiated Rate	$102.60
Rate for Payer: Aetna Commercial	$96.90
Rate for Payer: Aetna New Business (MI Preferred)	$74.10
Rate for Payer: BCBS Complete	$45.60
Rate for Payer: Cash Price	$91.20
Rate for Payer: Cofinity Commercial	$79.80
Rate for Payer: Cofinity Commercial	$98.04
Rate for Payer: Healthscope Commercial	$102.60
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$96.90
Rate for Payer: PHP Commercial	$96.90
Rate for Payer: Priority Health Cigna Priority Health	$79.80
Rate for Payer: Priority Health SBD	$71.82

HC CANNULA ARTERIAL 21, 24 FR

Facility

$114.00

Hospital Charge Code	27000449
Hospital Revenue Code	270
Min. Negotiated Rate	$71.82
Max. Negotiated Rate	$102.60
Rate for Payer: Aetna Commercial	$96.90
Rate for Payer: Aetna New Business (MI Preferred)	$74.10
Rate for Payer: Cash Price	$91.20
Rate for Payer: Cofinity Commercial	$79.80
Rate for Payer: Cofinity Commercial	$98.04
Rate for Payer: Healthscope Commercial	$102.60
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$96.90
Rate for Payer: PHP Commercial	$96.90
Rate for Payer: Priority Health Cigna Priority Health	$79.80
Rate for Payer: Priority Health SBD	$71.82

HC CANNULA ARTERIOTOMY 2 MM

Facility

$24.00

Hospital Charge Code	27000675
Hospital Revenue Code	270
Min. Negotiated Rate	$9.60
Max. Negotiated Rate	$21.60
Rate for Payer: Aetna Commercial	$20.40
Rate for Payer: Aetna New Business (MI Preferred)	$15.60
Rate for Payer: BCBS Complete	$9.60
Rate for Payer: Cash Price	$19.20
Rate for Payer: Cofinity Commercial	$16.80
Rate for Payer: Cofinity Commercial	$20.64
Rate for Payer: Healthscope Commercial	$21.60
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$20.40
Rate for Payer: PHP Commercial	$20.40
Rate for Payer: Priority Health Cigna Priority Health	$16.80
Rate for Payer: Priority Health SBD	$15.12

HC CANNULA ARTERIOTOMY 2 MM

Facility

$24.00

Hospital Charge Code	27000675
Hospital Revenue Code	270
Min. Negotiated Rate	$15.12
Max. Negotiated Rate	$21.60
Rate for Payer: Aetna Commercial	$20.40
Rate for Payer: Aetna New Business (MI Preferred)	$15.60
Rate for Payer: Cash Price	$19.20
Rate for Payer: Cofinity Commercial	$16.80
Rate for Payer: Cofinity Commercial	$20.64
Rate for Payer: Healthscope Commercial	$21.60
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$20.40
Rate for Payer: PHP Commercial	$20.40
Rate for Payer: Priority Health Cigna Priority Health	$16.80
Rate for Payer: Priority Health SBD	$15.12

HC CANNULA BIOMEDICUS

Facility

$1,444.58

Hospital Charge Code	27006715
Hospital Revenue Code	270
Min. Negotiated Rate	$577.83
Max. Negotiated Rate	$1,300.12
Rate for Payer: Aetna Commercial	$1,227.89
Rate for Payer: Aetna New Business (MI Preferred)	$938.98
Rate for Payer: BCBS Complete	$577.83
Rate for Payer: Cash Price	$1,155.66
Rate for Payer: Cofinity Commercial	$1,011.21
Rate for Payer: Cofinity Commercial	$1,242.34
Rate for Payer: Healthscope Commercial	$1,300.12
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,227.89
Rate for Payer: PHP Commercial	$1,227.89
Rate for Payer: Priority Health Cigna Priority Health	$1,011.21
Rate for Payer: Priority Health SBD	$910.09

HC CANNULA BIOMEDICUS

Facility

$1,444.58

Hospital Charge Code	27006715
Hospital Revenue Code	270
Min. Negotiated Rate	$910.09
Max. Negotiated Rate	$1,300.12
Rate for Payer: Aetna Commercial	$1,227.89
Rate for Payer: Aetna New Business (MI Preferred)	$938.98
Rate for Payer: Cash Price	$1,155.66
Rate for Payer: Cofinity Commercial	$1,011.21
Rate for Payer: Cofinity Commercial	$1,242.34
Rate for Payer: Healthscope Commercial	$1,300.12
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,227.89
Rate for Payer: PHP Commercial	$1,227.89
Rate for Payer: Priority Health Cigna Priority Health	$1,011.21
Rate for Payer: Priority Health SBD	$910.09

HC CANNULA CARDIOPLEGIA

Facility

$46.50

Hospital Charge Code	27000092
Hospital Revenue Code	270
Min. Negotiated Rate	$18.60
Max. Negotiated Rate	$41.85
Rate for Payer: Aetna Commercial	$39.52
Rate for Payer: Aetna New Business (MI Preferred)	$30.22
Rate for Payer: BCBS Complete	$18.60
Rate for Payer: Cash Price	$37.20
Rate for Payer: Cofinity Commercial	$32.55
Rate for Payer: Cofinity Commercial	$39.99
Rate for Payer: Healthscope Commercial	$41.85
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$39.52
Rate for Payer: PHP Commercial	$39.52
Rate for Payer: Priority Health Cigna Priority Health	$32.55
Rate for Payer: Priority Health SBD	$29.30

HC CANNULA CARDIOPLEGIA

Facility

$46.50

Hospital Charge Code	27000092
Hospital Revenue Code	270
Min. Negotiated Rate	$29.30
Max. Negotiated Rate	$41.85
Rate for Payer: Aetna Commercial	$39.52
Rate for Payer: Aetna New Business (MI Preferred)	$30.22
Rate for Payer: Cash Price	$37.20
Rate for Payer: Cofinity Commercial	$32.55
Rate for Payer: Cofinity Commercial	$39.99
Rate for Payer: Healthscope Commercial	$41.85
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$39.52
Rate for Payer: PHP Commercial	$39.52
Rate for Payer: Priority Health Cigna Priority Health	$32.55
Rate for Payer: Priority Health SBD	$29.30

HC CANNULA COR ART 7MM ST

Facility

$316.73

Hospital Charge Code	27006707
Hospital Revenue Code	270
Min. Negotiated Rate	$126.69
Max. Negotiated Rate	$285.06
Rate for Payer: Aetna Commercial	$269.22
Rate for Payer: Aetna New Business (MI Preferred)	$205.87
Rate for Payer: BCBS Complete	$126.69
Rate for Payer: Cash Price	$253.38
Rate for Payer: Cofinity Commercial	$221.71
Rate for Payer: Cofinity Commercial	$272.39
Rate for Payer: Healthscope Commercial	$285.06
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$269.22
Rate for Payer: PHP Commercial	$269.22
Rate for Payer: Priority Health Cigna Priority Health	$221.71
Rate for Payer: Priority Health SBD	$199.54

HC CANNULA COR ART 7MM ST

Facility

$316.73

Hospital Charge Code	27006707
Hospital Revenue Code	270
Min. Negotiated Rate	$199.54
Max. Negotiated Rate	$285.06
Rate for Payer: Aetna Commercial	$269.22
Rate for Payer: Aetna New Business (MI Preferred)	$205.87
Rate for Payer: Cash Price	$253.38
Rate for Payer: Cofinity Commercial	$221.71
Rate for Payer: Cofinity Commercial	$272.39
Rate for Payer: Healthscope Commercial	$285.06
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$269.22
Rate for Payer: PHP Commercial	$269.22
Rate for Payer: Priority Health Cigna Priority Health	$221.71
Rate for Payer: Priority Health SBD	$199.54

HC CANNULA COR ART 8 MM ST

Facility

$307.50

Hospital Charge Code	27006708
Hospital Revenue Code	270
Min. Negotiated Rate	$193.72
Max. Negotiated Rate	$276.75
Rate for Payer: Aetna Commercial	$261.38
Rate for Payer: Aetna New Business (MI Preferred)	$199.88
Rate for Payer: Cash Price	$246.00
Rate for Payer: Cofinity Commercial	$215.25
Rate for Payer: Cofinity Commercial	$264.45
Rate for Payer: Healthscope Commercial	$276.75
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$261.38
Rate for Payer: PHP Commercial	$261.38
Rate for Payer: Priority Health Cigna Priority Health	$215.25
Rate for Payer: Priority Health SBD	$193.72

Know your out-of-pocket cost for care.

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