Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC CATH BALLOON

Facility

$1,289.14

Service Code	HCPCS C1725
Hospital Charge Code	27200001
Hospital Revenue Code	272
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$1,160.23
Rate for Payer: Aetna Commercial	$1,095.77
Rate for Payer: Aetna New Business (MI Preferred)	$837.94
Rate for Payer: BCBS Complete	$515.66
Rate for Payer: BCBS Trust/PPO	$0.03
Rate for Payer: Cash Price	$1,031.31
Rate for Payer: Cash Price	$1,031.31
Rate for Payer: Cofinity Commercial	$1,108.66
Rate for Payer: Cofinity Commercial	$902.40
Rate for Payer: Healthscope Commercial	$1,160.23
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,095.77
Rate for Payer: PHP Commercial	$1,095.77
Rate for Payer: Priority Health Cigna Priority Health	$902.40
Rate for Payer: Priority Health SBD	$812.16

HC CATH BALLOON

Facility

$1,289.14

Service Code	HCPCS C1725
Hospital Charge Code	27200001
Hospital Revenue Code	272
Min. Negotiated Rate	$812.16
Max. Negotiated Rate	$1,160.23
Rate for Payer: Aetna Commercial	$1,095.77
Rate for Payer: Aetna New Business (MI Preferred)	$837.94
Rate for Payer: Cash Price	$1,031.31
Rate for Payer: Cofinity Commercial	$1,108.66
Rate for Payer: Cofinity Commercial	$902.40
Rate for Payer: Healthscope Commercial	$1,160.23
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,095.77
Rate for Payer: PHP Commercial	$1,095.77
Rate for Payer: Priority Health Cigna Priority Health	$902.40
Rate for Payer: Priority Health SBD	$812.16

HC CATHETER BALLOON DILAT NON VASC LVL 1

Facility

$145.26

Service Code	HCPCS C1726
Hospital Charge Code	27200353
Hospital Revenue Code	272
Min. Negotiated Rate	$91.51
Max. Negotiated Rate	$130.73
Rate for Payer: Aetna Commercial	$123.47
Rate for Payer: Aetna New Business (MI Preferred)	$94.42
Rate for Payer: Cash Price	$116.21
Rate for Payer: Cofinity Commercial	$101.68
Rate for Payer: Cofinity Commercial	$124.92
Rate for Payer: Healthscope Commercial	$130.73
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$123.47
Rate for Payer: PHP Commercial	$123.47
Rate for Payer: Priority Health Cigna Priority Health	$101.68
Rate for Payer: Priority Health SBD	$91.51

HC CATHETER BALLOON DILAT NON VASC LVL 1

Facility

$145.26

Service Code	HCPCS C1726
Hospital Charge Code	27200353
Hospital Revenue Code	272
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$130.73
Rate for Payer: Aetna Commercial	$123.47
Rate for Payer: Aetna New Business (MI Preferred)	$94.42
Rate for Payer: BCBS Complete	$58.10
Rate for Payer: BCBS Trust/PPO	$0.03
Rate for Payer: Cash Price	$116.21
Rate for Payer: Cash Price	$116.21
Rate for Payer: Cofinity Commercial	$101.68
Rate for Payer: Cofinity Commercial	$124.92
Rate for Payer: Healthscope Commercial	$130.73
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$123.47
Rate for Payer: PHP Commercial	$123.47
Rate for Payer: Priority Health Cigna Priority Health	$101.68
Rate for Payer: Priority Health SBD	$91.51

HC CATHETER BALLOON DILAT NON VASC LVL 7

Facility

$792.81

Service Code	HCPCS C1726
Hospital Charge Code	27200295
Hospital Revenue Code	272
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$713.53
Rate for Payer: Aetna Commercial	$673.89
Rate for Payer: Aetna New Business (MI Preferred)	$515.33
Rate for Payer: BCBS Complete	$317.12
Rate for Payer: BCBS Trust/PPO	$0.03
Rate for Payer: Cash Price	$634.25
Rate for Payer: Cash Price	$634.25
Rate for Payer: Cofinity Commercial	$554.97
Rate for Payer: Cofinity Commercial	$681.82
Rate for Payer: Healthscope Commercial	$713.53
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$673.89
Rate for Payer: PHP Commercial	$673.89
Rate for Payer: Priority Health Cigna Priority Health	$554.97
Rate for Payer: Priority Health SBD	$499.47

HC CATHETER BALLOON DILAT NON VASC LVL 7

Facility

$792.81

Service Code	HCPCS C1726
Hospital Charge Code	27200295
Hospital Revenue Code	272
Min. Negotiated Rate	$499.47
Max. Negotiated Rate	$713.53
Rate for Payer: Aetna Commercial	$673.89
Rate for Payer: Aetna New Business (MI Preferred)	$515.33
Rate for Payer: Cash Price	$634.25
Rate for Payer: Cofinity Commercial	$554.97
Rate for Payer: Cofinity Commercial	$681.82
Rate for Payer: Healthscope Commercial	$713.53
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$673.89
Rate for Payer: PHP Commercial	$673.89
Rate for Payer: Priority Health Cigna Priority Health	$554.97
Rate for Payer: Priority Health SBD	$499.47

HC CATHETER INTRADISCAL

Facility

$1,502.05

Service Code	CPT C1754
Hospital Charge Code	27200357
Hospital Revenue Code	272
Min. Negotiated Rate	$600.82
Max. Negotiated Rate	$1,351.84
Rate for Payer: Aetna Commercial	$1,276.74
Rate for Payer: Aetna New Business (MI Preferred)	$976.33
Rate for Payer: BCBS Complete	$600.82
Rate for Payer: Cash Price	$1,201.64
Rate for Payer: Cofinity Commercial	$1,051.44
Rate for Payer: Cofinity Commercial	$1,291.76
Rate for Payer: Healthscope Commercial	$1,351.84
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,276.74
Rate for Payer: PHP Commercial	$1,276.74
Rate for Payer: Priority Health Cigna Priority Health	$1,051.44
Rate for Payer: Priority Health SBD	$946.29

HC CATHETER INTRADISCAL

Facility

$1,502.05

Service Code	CPT C1754
Hospital Charge Code	27200357
Hospital Revenue Code	272
Min. Negotiated Rate	$946.29
Max. Negotiated Rate	$1,351.84
Rate for Payer: Aetna Commercial	$1,276.74
Rate for Payer: Aetna New Business (MI Preferred)	$976.33
Rate for Payer: Cash Price	$1,201.64
Rate for Payer: Cofinity Commercial	$1,051.44
Rate for Payer: Cofinity Commercial	$1,291.76
Rate for Payer: Healthscope Commercial	$1,351.84
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,276.74
Rate for Payer: PHP Commercial	$1,276.74
Rate for Payer: Priority Health Cigna Priority Health	$1,051.44
Rate for Payer: Priority Health SBD	$946.29

HC CATHETERIZATION FOR COLLECTION OF SPECIMEN

Facility

$29.58

Service Code	CPT P9612
Hospital Charge Code	30000114
Hospital Revenue Code	300
Min. Negotiated Rate	$18.64
Max. Negotiated Rate	$26.62
Rate for Payer: Aetna Commercial	$25.14
Rate for Payer: Aetna New Business (MI Preferred)	$19.23
Rate for Payer: Cash Price	$23.66
Rate for Payer: Cofinity Commercial	$25.44
Rate for Payer: Cofinity Commercial	$20.71
Rate for Payer: Healthscope Commercial	$26.62
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$25.14
Rate for Payer: PHP Commercial	$25.14
Rate for Payer: Priority Health Cigna Priority Health	$20.71
Rate for Payer: Priority Health SBD	$18.64

HC CATHETERIZATION FOR COLLECTION OF SPECIMEN

Facility

$29.58

Service Code	CPT P9612
Hospital Charge Code	30000114
Hospital Revenue Code	300
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$26.62
Rate for Payer: Aetna Commercial	$25.14
Rate for Payer: Aetna Medicare	$9.18
Rate for Payer: Aetna New Business (MI Preferred)	$19.23
Rate for Payer: Allen County Amish Medical Aid Commercial	$11.04
Rate for Payer: Amish Plain Church Group Commercial	$11.04
Rate for Payer: BCBS Complete	$5.07
Rate for Payer: BCBS MAPPO	$8.83
Rate for Payer: BCN Medicare Advantage	$8.83
Rate for Payer: Cash Price	$23.66
Rate for Payer: Cash Price	$23.66
Rate for Payer: Cofinity Commercial	$25.44
Rate for Payer: Cofinity Commercial	$20.71
Rate for Payer: Health Alliance Plan Medicare Advantage	$8.83
Rate for Payer: Healthscope Commercial	$26.62
Rate for Payer: Mclaren Medicaid	$4.83
Rate for Payer: Mclaren Medicare	$8.83
Rate for Payer: Meridian Medicaid	$5.07
Rate for Payer: Meridian Wellcare - Medicare Advantage	$9.27
Rate for Payer: MI Amish Medical Board Commercial	$10.15
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$25.14
Rate for Payer: PACE Medicare	$8.39
Rate for Payer: PACE SWMI	$8.83
Rate for Payer: PHP Commercial	$25.14
Rate for Payer: PHP Medicare Advantage	$8.83
Rate for Payer: Priority Health Choice Medicaid	$4.83
Rate for Payer: Priority Health Cigna Priority Health	$20.71
Rate for Payer: Priority Health Medicare	$8.83
Rate for Payer: Priority Health SBD	$18.64
Rate for Payer: Railroad Medicare Medicare	$8.83
Rate for Payer: UHC All Payor (Choice/PPO)	$10.60
Rate for Payer: UHC Core	$3.60
Rate for Payer: UHC Dual Complete DSNP	$8.83
Rate for Payer: UHC Exchange	$8.83
Rate for Payer: UHC Medicare Advantage	$9.09
Rate for Payer: VA VA	$8.83

HC CATHETER NOS LVL 1

Facility

$66.00

Service Code	HCPCS C1889
Hospital Charge Code	27800126
Hospital Revenue Code	278
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$59.40
Rate for Payer: Aetna Commercial	$56.10
Rate for Payer: Aetna New Business (MI Preferred)	$42.90
Rate for Payer: BCBS Complete	$26.40
Rate for Payer: BCBS Trust/PPO	$0.03
Rate for Payer: Cash Price	$52.80
Rate for Payer: Cash Price	$52.80
Rate for Payer: Cofinity Commercial	$56.76
Rate for Payer: Cofinity Commercial	$46.20
Rate for Payer: Healthscope Commercial	$59.40
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$56.10
Rate for Payer: PHP Commercial	$56.10
Rate for Payer: Priority Health Cigna Priority Health	$46.20
Rate for Payer: Priority Health SBD	$41.58

HC CATHETER NOS LVL 1

Facility

$66.00

Service Code	HCPCS C1889
Hospital Charge Code	27800126
Hospital Revenue Code	278
Min. Negotiated Rate	$41.58
Max. Negotiated Rate	$59.40
Rate for Payer: Aetna Commercial	$56.10
Rate for Payer: Aetna New Business (MI Preferred)	$42.90
Rate for Payer: Cash Price	$52.80
Rate for Payer: Cofinity Commercial	$46.20
Rate for Payer: Cofinity Commercial	$56.76
Rate for Payer: Healthscope Commercial	$59.40
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$56.10
Rate for Payer: PHP Commercial	$56.10
Rate for Payer: Priority Health Cigna Priority Health	$46.20
Rate for Payer: Priority Health SBD	$41.58

HC CATHETER NOS LVL 2

Facility

$350.00

Service Code	HCPCS C1889
Hospital Charge Code	27800127
Hospital Revenue Code	278
Min. Negotiated Rate	$220.50
Max. Negotiated Rate	$315.00
Rate for Payer: Aetna Commercial	$297.50
Rate for Payer: Aetna New Business (MI Preferred)	$227.50
Rate for Payer: Cash Price	$280.00
Rate for Payer: Cofinity Commercial	$301.00
Rate for Payer: Cofinity Commercial	$245.00
Rate for Payer: Healthscope Commercial	$315.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$297.50
Rate for Payer: PHP Commercial	$297.50
Rate for Payer: Priority Health Cigna Priority Health	$245.00
Rate for Payer: Priority Health SBD	$220.50

HC CATHETER NOS LVL 2

Facility

$350.00

Service Code	HCPCS C1889
Hospital Charge Code	27800127
Hospital Revenue Code	278
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$315.00
Rate for Payer: Aetna Commercial	$297.50
Rate for Payer: Aetna New Business (MI Preferred)	$227.50
Rate for Payer: BCBS Complete	$140.00
Rate for Payer: BCBS Trust/PPO	$0.03
Rate for Payer: Cash Price	$280.00
Rate for Payer: Cash Price	$280.00
Rate for Payer: Cofinity Commercial	$245.00
Rate for Payer: Cofinity Commercial	$301.00
Rate for Payer: Healthscope Commercial	$315.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$297.50
Rate for Payer: PHP Commercial	$297.50
Rate for Payer: Priority Health Cigna Priority Health	$245.00
Rate for Payer: Priority Health SBD	$220.50

HC CATHETER PRESSURE GENERATING ONE WAY INTERMED OCCLUSIVE

Facility

$11,625.00

Service Code	CPT C1982
Hospital Charge Code	27800147
Hospital Revenue Code	278
Min. Negotiated Rate	$7,323.75
Max. Negotiated Rate	$10,462.50
Rate for Payer: Aetna Commercial	$9,881.25
Rate for Payer: Aetna New Business (MI Preferred)	$7,556.25
Rate for Payer: Cash Price	$9,300.00
Rate for Payer: Cofinity Commercial	$8,137.50
Rate for Payer: Cofinity Commercial	$9,997.50
Rate for Payer: Healthscope Commercial	$10,462.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$9,881.25
Rate for Payer: PHP Commercial	$9,881.25
Rate for Payer: Priority Health Cigna Priority Health	$8,137.50
Rate for Payer: Priority Health SBD	$7,323.75

HC CATHETER PRESSURE GENERATING ONE WAY INTERMED OCCLUSIVE

Facility

$11,625.00

Service Code	CPT C1982
Hospital Charge Code	27800147
Hospital Revenue Code	278
Min. Negotiated Rate	$4,092.00
Max. Negotiated Rate	$10,462.50
Rate for Payer: Aetna Commercial	$9,881.25
Rate for Payer: Aetna New Business (MI Preferred)	$7,556.25
Rate for Payer: BCBS Complete	$4,650.00
Rate for Payer: Cash Price	$9,300.00
Rate for Payer: Cofinity Commercial	$8,137.50
Rate for Payer: Cofinity Commercial	$9,997.50
Rate for Payer: Healthscope Commercial	$10,462.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$9,881.25
Rate for Payer: PHP Commercial	$9,881.25
Rate for Payer: Priority Health Cigna Priority Health	$8,137.50
Rate for Payer: Priority Health SBD	$7,323.75
Rate for Payer: UHC All Payor (Choice/PPO)	$4,092.00
Rate for Payer: UHC Exchange	$4,766.25

HC CATHETER SINGLE

Facility

$186.82

Service Code	HCPCS C1881
Hospital Charge Code	27200018
Hospital Revenue Code	272
Min. Negotiated Rate	$117.70
Max. Negotiated Rate	$168.14
Rate for Payer: Aetna Commercial	$158.80
Rate for Payer: Aetna New Business (MI Preferred)	$121.43
Rate for Payer: Cash Price	$149.46
Rate for Payer: Cofinity Commercial	$130.77
Rate for Payer: Cofinity Commercial	$160.67
Rate for Payer: Healthscope Commercial	$168.14
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$158.80
Rate for Payer: PHP Commercial	$158.80
Rate for Payer: Priority Health Cigna Priority Health	$130.77
Rate for Payer: Priority Health SBD	$117.70

HC CATHETER SINGLE

Facility

$186.82

Service Code	HCPCS C1881
Hospital Charge Code	27200018
Hospital Revenue Code	272
Min. Negotiated Rate	$74.73
Max. Negotiated Rate	$168.14
Rate for Payer: Aetna Commercial	$158.80
Rate for Payer: Aetna New Business (MI Preferred)	$121.43
Rate for Payer: BCBS Complete	$74.73
Rate for Payer: Cash Price	$149.46
Rate for Payer: Cofinity Commercial	$130.77
Rate for Payer: Cofinity Commercial	$160.67
Rate for Payer: Healthscope Commercial	$168.14
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$158.80
Rate for Payer: PHP Commercial	$158.80
Rate for Payer: Priority Health Cigna Priority Health	$130.77
Rate for Payer: Priority Health SBD	$117.70

HC CATHETER TLA DRUG COATED NON LASER

Facility

$1,606.50

Service Code	HCPCS C2623
Hospital Charge Code	27200302
Hospital Revenue Code	272
Min. Negotiated Rate	$1,012.10
Max. Negotiated Rate	$1,445.85
Rate for Payer: Aetna Commercial	$1,365.52
Rate for Payer: Aetna New Business (MI Preferred)	$1,044.22
Rate for Payer: Cash Price	$1,285.20
Rate for Payer: Cofinity Commercial	$1,124.55
Rate for Payer: Cofinity Commercial	$1,381.59
Rate for Payer: Healthscope Commercial	$1,445.85
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,365.52
Rate for Payer: PHP Commercial	$1,365.52
Rate for Payer: Priority Health Cigna Priority Health	$1,124.55
Rate for Payer: Priority Health SBD	$1,012.10

HC CATHETER TLA DRUG COATED NON LASER

Facility

$1,606.50

Service Code	HCPCS C2623
Hospital Charge Code	27200302
Hospital Revenue Code	272
Min. Negotiated Rate	$642.60
Max. Negotiated Rate	$1,445.85
Rate for Payer: Aetna Commercial	$1,365.52
Rate for Payer: Aetna New Business (MI Preferred)	$1,044.22
Rate for Payer: BCBS Complete	$642.60
Rate for Payer: Cash Price	$1,285.20
Rate for Payer: Cofinity Commercial	$1,124.55
Rate for Payer: Cofinity Commercial	$1,381.59
Rate for Payer: Healthscope Commercial	$1,445.85
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,365.52
Rate for Payer: PHP Commercial	$1,365.52
Rate for Payer: Priority Health Cigna Priority Health	$1,124.55
Rate for Payer: Priority Health SBD	$1,012.10

HC CATHETER TRANSLUM ATHERECT DIRECTIONAL

Facility

$7,545.17

Service Code	HCPCS C1714
Hospital Charge Code	27200294
Hospital Revenue Code	272
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$6,790.65
Rate for Payer: Aetna Commercial	$6,413.39
Rate for Payer: Aetna New Business (MI Preferred)	$4,904.36
Rate for Payer: BCBS Complete	$3,018.07
Rate for Payer: BCBS Trust/PPO	$0.03
Rate for Payer: Cash Price	$6,036.14
Rate for Payer: Cash Price	$6,036.14
Rate for Payer: Cofinity Commercial	$5,281.62
Rate for Payer: Cofinity Commercial	$6,488.85
Rate for Payer: Healthscope Commercial	$6,790.65
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$6,413.39
Rate for Payer: PHP Commercial	$6,413.39
Rate for Payer: Priority Health Cigna Priority Health	$5,281.62
Rate for Payer: Priority Health SBD	$4,753.46

HC CATHETER TRANSLUM ATHERECT DIRECTIONAL

Facility

$7,545.17

Service Code	HCPCS C1714
Hospital Charge Code	27200294
Hospital Revenue Code	272
Min. Negotiated Rate	$4,753.46
Max. Negotiated Rate	$6,790.65
Rate for Payer: Aetna Commercial	$6,413.39
Rate for Payer: Aetna New Business (MI Preferred)	$4,904.36
Rate for Payer: Cash Price	$6,036.14
Rate for Payer: Cofinity Commercial	$5,281.62
Rate for Payer: Cofinity Commercial	$6,488.85
Rate for Payer: Healthscope Commercial	$6,790.65
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$6,413.39
Rate for Payer: PHP Commercial	$6,413.39
Rate for Payer: Priority Health Cigna Priority Health	$5,281.62
Rate for Payer: Priority Health SBD	$4,753.46

HC CATHETER, TRANSLUMIN NON-LASER

Facility

$2,400.00

Service Code	HCPCS C1725
Hospital Charge Code	27200024
Hospital Revenue Code	272
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$2,160.00
Rate for Payer: Aetna Commercial	$2,040.00
Rate for Payer: Aetna New Business (MI Preferred)	$1,560.00
Rate for Payer: BCBS Complete	$960.00
Rate for Payer: BCBS Trust/PPO	$0.03
Rate for Payer: Cash Price	$1,920.00
Rate for Payer: Cash Price	$1,920.00
Rate for Payer: Cofinity Commercial	$1,680.00
Rate for Payer: Cofinity Commercial	$2,064.00
Rate for Payer: Healthscope Commercial	$2,160.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,040.00
Rate for Payer: PHP Commercial	$2,040.00
Rate for Payer: Priority Health Cigna Priority Health	$1,680.00
Rate for Payer: Priority Health SBD	$1,512.00

HC CATHETER, TRANSLUMIN NON-LASER

Facility

$2,400.00

Service Code	HCPCS C1725
Hospital Charge Code	27200024
Hospital Revenue Code	272
Min. Negotiated Rate	$1,512.00
Max. Negotiated Rate	$2,160.00
Rate for Payer: Aetna Commercial	$2,040.00
Rate for Payer: Aetna New Business (MI Preferred)	$1,560.00
Rate for Payer: Cash Price	$1,920.00
Rate for Payer: Cofinity Commercial	$1,680.00
Rate for Payer: Cofinity Commercial	$2,064.00
Rate for Payer: Healthscope Commercial	$2,160.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,040.00
Rate for Payer: PHP Commercial	$2,040.00
Rate for Payer: Priority Health Cigna Priority Health	$1,680.00
Rate for Payer: Priority Health SBD	$1,512.00

HC CATHETER TRANSLUM INTRAVAS LITHOTRIPSY CORONARY

Facility

$9,520.00

Service Code	CPT C1761
Hospital Charge Code	27200350
Hospital Revenue Code	278
Min. Negotiated Rate	$5,997.60
Max. Negotiated Rate	$8,568.00
Rate for Payer: Aetna Commercial	$8,092.00
Rate for Payer: Aetna New Business (MI Preferred)	$6,188.00
Rate for Payer: Cash Price	$7,616.00
Rate for Payer: Cofinity Commercial	$6,664.00
Rate for Payer: Cofinity Commercial	$8,187.20
Rate for Payer: Healthscope Commercial	$8,568.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$8,092.00
Rate for Payer: PHP Commercial	$8,092.00
Rate for Payer: Priority Health Cigna Priority Health	$6,664.00
Rate for Payer: Priority Health SBD	$5,997.60

Know your out-of-pocket cost for care.

All Charges