Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC CONNECTIVE TISSUE CASCADE ANA & CCP

Facility

$31.21

Service Code	CPT 86200
Hospital Charge Code	30200156
Hospital Revenue Code	302
Min. Negotiated Rate	$19.66
Max. Negotiated Rate	$28.09
Rate for Payer: Aetna Commercial	$26.53
Rate for Payer: Aetna New Business (MI Preferred)	$20.29
Rate for Payer: Cash Price	$24.97
Rate for Payer: Cofinity Commercial	$21.85
Rate for Payer: Cofinity Commercial	$26.84
Rate for Payer: Healthscope Commercial	$28.09
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$26.53
Rate for Payer: PHP Commercial	$26.53
Rate for Payer: Priority Health Cigna Priority Health	$21.85
Rate for Payer: Priority Health SBD	$19.66

HC CONNECTOR 3/8 W/ LL

Facility

$5.25

Hospital Charge Code	27000448
Hospital Revenue Code	270
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$4.72
Rate for Payer: Aetna Commercial	$4.46
Rate for Payer: Aetna New Business (MI Preferred)	$3.41
Rate for Payer: BCBS Complete	$2.10
Rate for Payer: Cash Price	$4.20
Rate for Payer: Cofinity Commercial	$3.68
Rate for Payer: Cofinity Commercial	$4.52
Rate for Payer: Healthscope Commercial	$4.72
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$4.46
Rate for Payer: PHP Commercial	$4.46
Rate for Payer: Priority Health Cigna Priority Health	$3.68
Rate for Payer: Priority Health SBD	$3.31

HC CONNECTOR 3/8 W/ LL

Facility

$5.25

Hospital Charge Code	27000448
Hospital Revenue Code	270
Min. Negotiated Rate	$3.31
Max. Negotiated Rate	$4.72
Rate for Payer: Aetna Commercial	$4.46
Rate for Payer: Aetna New Business (MI Preferred)	$3.41
Rate for Payer: Cash Price	$4.20
Rate for Payer: Cofinity Commercial	$3.68
Rate for Payer: Cofinity Commercial	$4.52
Rate for Payer: Healthscope Commercial	$4.72
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$4.46
Rate for Payer: PHP Commercial	$4.46
Rate for Payer: Priority Health Cigna Priority Health	$3.68
Rate for Payer: Priority Health SBD	$3.31

HC CONNECTOR REDUCER

Facility

$5.25

Hospital Charge Code	27000651
Hospital Revenue Code	270
Min. Negotiated Rate	$3.31
Max. Negotiated Rate	$4.72
Rate for Payer: Aetna Commercial	$4.46
Rate for Payer: Aetna New Business (MI Preferred)	$3.41
Rate for Payer: Cash Price	$4.20
Rate for Payer: Cofinity Commercial	$3.68
Rate for Payer: Cofinity Commercial	$4.52
Rate for Payer: Healthscope Commercial	$4.72
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$4.46
Rate for Payer: PHP Commercial	$4.46
Rate for Payer: Priority Health Cigna Priority Health	$3.68
Rate for Payer: Priority Health SBD	$3.31

HC CONNECTOR REDUCER

Facility

$5.25

Hospital Charge Code	27000651
Hospital Revenue Code	270
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$4.72
Rate for Payer: Aetna Commercial	$4.46
Rate for Payer: Aetna New Business (MI Preferred)	$3.41
Rate for Payer: BCBS Complete	$2.10
Rate for Payer: Cash Price	$4.20
Rate for Payer: Cofinity Commercial	$3.68
Rate for Payer: Cofinity Commercial	$4.52
Rate for Payer: Healthscope Commercial	$4.72
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$4.46
Rate for Payer: PHP Commercial	$4.46
Rate for Payer: Priority Health Cigna Priority Health	$3.68
Rate for Payer: Priority Health SBD	$3.31

HC CONNECTOR ST 1/2 X 1/2

Facility

$7.50

Hospital Charge Code	27000047
Hospital Revenue Code	270
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$6.75
Rate for Payer: Aetna Commercial	$6.38
Rate for Payer: Aetna New Business (MI Preferred)	$4.88
Rate for Payer: BCBS Complete	$3.00
Rate for Payer: Cash Price	$6.00
Rate for Payer: Cofinity Commercial	$5.25
Rate for Payer: Cofinity Commercial	$6.45
Rate for Payer: Healthscope Commercial	$6.75
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$6.38
Rate for Payer: PHP Commercial	$6.38
Rate for Payer: Priority Health Cigna Priority Health	$5.25
Rate for Payer: Priority Health SBD	$4.72

HC CONNECTOR ST 1/2 X 1/2

Facility

$7.50

Hospital Charge Code	27000047
Hospital Revenue Code	270
Min. Negotiated Rate	$4.72
Max. Negotiated Rate	$6.75
Rate for Payer: Aetna Commercial	$6.38
Rate for Payer: Aetna New Business (MI Preferred)	$4.88
Rate for Payer: Cash Price	$6.00
Rate for Payer: Cofinity Commercial	$5.25
Rate for Payer: Cofinity Commercial	$6.45
Rate for Payer: Healthscope Commercial	$6.75
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$6.38
Rate for Payer: PHP Commercial	$6.38
Rate for Payer: Priority Health Cigna Priority Health	$5.25
Rate for Payer: Priority Health SBD	$4.72

HC CONNECTOR ST 3/8 OR 1/4

Facility

$5.25

Hospital Charge Code	27000685
Hospital Revenue Code	270
Min. Negotiated Rate	$3.31
Max. Negotiated Rate	$4.72
Rate for Payer: Aetna Commercial	$4.46
Rate for Payer: Aetna New Business (MI Preferred)	$3.41
Rate for Payer: Cash Price	$4.20
Rate for Payer: Cofinity Commercial	$3.68
Rate for Payer: Cofinity Commercial	$4.52
Rate for Payer: Healthscope Commercial	$4.72
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$4.46
Rate for Payer: PHP Commercial	$4.46
Rate for Payer: Priority Health Cigna Priority Health	$3.68
Rate for Payer: Priority Health SBD	$3.31

HC CONNECTOR ST 3/8 OR 1/4

Facility

$5.25

Hospital Charge Code	27000685
Hospital Revenue Code	270
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$4.72
Rate for Payer: Aetna Commercial	$4.46
Rate for Payer: Aetna New Business (MI Preferred)	$3.41
Rate for Payer: BCBS Complete	$2.10
Rate for Payer: Cash Price	$4.20
Rate for Payer: Cofinity Commercial	$3.68
Rate for Payer: Cofinity Commercial	$4.52
Rate for Payer: Healthscope Commercial	$4.72
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$4.46
Rate for Payer: PHP Commercial	$4.46
Rate for Payer: Priority Health Cigna Priority Health	$3.68
Rate for Payer: Priority Health SBD	$3.31

HC CONNECTOR V

Facility

$7.50

Hospital Charge Code	27000678
Hospital Revenue Code	270
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$6.75
Rate for Payer: Aetna Commercial	$6.38
Rate for Payer: Aetna New Business (MI Preferred)	$4.88
Rate for Payer: BCBS Complete	$3.00
Rate for Payer: Cash Price	$6.00
Rate for Payer: Cofinity Commercial	$5.25
Rate for Payer: Cofinity Commercial	$6.45
Rate for Payer: Healthscope Commercial	$6.75
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$6.38
Rate for Payer: PHP Commercial	$6.38
Rate for Payer: Priority Health Cigna Priority Health	$5.25
Rate for Payer: Priority Health SBD	$4.72

HC CONNECTOR V

Facility

$7.50

Hospital Charge Code	27000678
Hospital Revenue Code	270
Min. Negotiated Rate	$4.72
Max. Negotiated Rate	$6.75
Rate for Payer: Aetna Commercial	$6.38
Rate for Payer: Aetna New Business (MI Preferred)	$4.88
Rate for Payer: Cash Price	$6.00
Rate for Payer: Cofinity Commercial	$5.25
Rate for Payer: Cofinity Commercial	$6.45
Rate for Payer: Healthscope Commercial	$6.75
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$6.38
Rate for Payer: PHP Commercial	$6.38
Rate for Payer: Priority Health Cigna Priority Health	$5.25
Rate for Payer: Priority Health SBD	$4.72

HC CONNECTOR Y

Facility

$5.25

Hospital Charge Code	27000048
Hospital Revenue Code	270
Min. Negotiated Rate	$3.31
Max. Negotiated Rate	$4.72
Rate for Payer: Aetna Commercial	$4.46
Rate for Payer: Aetna New Business (MI Preferred)	$3.41
Rate for Payer: Cash Price	$4.20
Rate for Payer: Cofinity Commercial	$3.68
Rate for Payer: Cofinity Commercial	$4.52
Rate for Payer: Healthscope Commercial	$4.72
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$4.46
Rate for Payer: PHP Commercial	$4.46
Rate for Payer: Priority Health Cigna Priority Health	$3.68
Rate for Payer: Priority Health SBD	$3.31

HC CONNECTOR Y

Facility

$5.25

Hospital Charge Code	27000048
Hospital Revenue Code	270
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$4.72
Rate for Payer: Aetna Commercial	$4.46
Rate for Payer: Aetna New Business (MI Preferred)	$3.41
Rate for Payer: BCBS Complete	$2.10
Rate for Payer: Cash Price	$4.20
Rate for Payer: Cofinity Commercial	$3.68
Rate for Payer: Cofinity Commercial	$4.52
Rate for Payer: Healthscope Commercial	$4.72
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$4.46
Rate for Payer: PHP Commercial	$4.46
Rate for Payer: Priority Health Cigna Priority Health	$3.68
Rate for Payer: Priority Health SBD	$3.31

HC CONSULT NUTRITIONAL

Facility

$34.27

Hospital Charge Code	94200010
Hospital Revenue Code	942
Min. Negotiated Rate	$13.71
Max. Negotiated Rate	$30.84
Rate for Payer: Aetna Commercial	$29.13
Rate for Payer: Aetna New Business (MI Preferred)	$22.28
Rate for Payer: BCBS Complete	$13.71
Rate for Payer: Cash Price	$27.42
Rate for Payer: Cofinity Commercial	$23.99
Rate for Payer: Cofinity Commercial	$29.47
Rate for Payer: Healthscope Commercial	$30.84
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$29.13
Rate for Payer: PHP Commercial	$29.13
Rate for Payer: Priority Health Cigna Priority Health	$23.99
Rate for Payer: Priority Health SBD	$21.59
Rate for Payer: UHC Core	$25.36

HC CONSULT NUTRITIONAL

Facility

$34.27

Hospital Charge Code	94200010
Hospital Revenue Code	942
Min. Negotiated Rate	$21.59
Max. Negotiated Rate	$30.84
Rate for Payer: Aetna Commercial	$29.13
Rate for Payer: Aetna New Business (MI Preferred)	$22.28
Rate for Payer: Cash Price	$27.42
Rate for Payer: Cofinity Commercial	$23.99
Rate for Payer: Cofinity Commercial	$29.47
Rate for Payer: Healthscope Commercial	$30.84
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$29.13
Rate for Payer: PHP Commercial	$29.13
Rate for Payer: Priority Health Cigna Priority Health	$23.99
Rate for Payer: Priority Health SBD	$21.59

HC CONT GLUCOSE MONITOR OFFICE EQUIP

Facility

$965.28

Service Code	CPT 95250
Hospital Charge Code	94200001
Hospital Revenue Code	942
Min. Negotiated Rate	$608.13
Max. Negotiated Rate	$868.75
Rate for Payer: Aetna Commercial	$820.49
Rate for Payer: Aetna New Business (MI Preferred)	$627.43
Rate for Payer: Cash Price	$772.22
Rate for Payer: Cofinity Commercial	$675.70
Rate for Payer: Cofinity Commercial	$830.14
Rate for Payer: Healthscope Commercial	$868.75
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$820.49
Rate for Payer: PHP Commercial	$820.49
Rate for Payer: Priority Health Cigna Priority Health	$675.70
Rate for Payer: Priority Health SBD	$608.13

HC CONT GLUCOSE MONITOR OFFICE EQUIP

Facility

$965.28

Service Code	CPT 95250
Hospital Charge Code	94200001
Hospital Revenue Code	942
Min. Negotiated Rate	$64.34
Max. Negotiated Rate	$868.75
Rate for Payer: Aetna Commercial	$820.49
Rate for Payer: Aetna Medicare	$122.32
Rate for Payer: Aetna New Business (MI Preferred)	$627.43
Rate for Payer: Allen County Amish Medical Aid Commercial	$147.02
Rate for Payer: Amish Plain Church Group Commercial	$147.02
Rate for Payer: BCBS Complete	$67.56
Rate for Payer: BCBS MAPPO	$117.62
Rate for Payer: BCBS Trust/PPO	$660.09
Rate for Payer: BCN Medicare Advantage	$117.62
Rate for Payer: Cash Price	$772.22
Rate for Payer: Cash Price	$772.22
Rate for Payer: Cofinity Commercial	$830.14
Rate for Payer: Cofinity Commercial	$675.70
Rate for Payer: Health Alliance Plan Medicare Advantage	$117.62
Rate for Payer: Healthscope Commercial	$868.75
Rate for Payer: Mclaren Medicaid	$64.34
Rate for Payer: Mclaren Medicare	$117.62
Rate for Payer: Meridian Medicaid	$67.56
Rate for Payer: Meridian Wellcare - Medicare Advantage	$123.50
Rate for Payer: MI Amish Medical Board Commercial	$135.26
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$820.49
Rate for Payer: PACE Medicare	$111.74
Rate for Payer: PACE SWMI	$117.62
Rate for Payer: PHP Commercial	$820.49
Rate for Payer: PHP Medicare Advantage	$117.62
Rate for Payer: Priority Health Choice Medicaid	$64.34
Rate for Payer: Priority Health Cigna Priority Health	$675.70
Rate for Payer: Priority Health Medicare	$117.62
Rate for Payer: Priority Health SBD	$608.13
Rate for Payer: Railroad Medicare Medicare	$117.62
Rate for Payer: UHC All Payor (Choice/PPO)	$159.57
Rate for Payer: UHC Dual Complete DSNP	$117.62
Rate for Payer: UHC Exchange	$145.06
Rate for Payer: UHC Medicare Advantage	$121.15
Rate for Payer: VA VA	$117.62

HC CONT GLUCOSE MONITOR PATIENT EQUIP

Facility

$376.90

Service Code	CPT 95249
Hospital Charge Code	94200038
Hospital Revenue Code	942
Min. Negotiated Rate	$29.77
Max. Negotiated Rate	$339.21
Rate for Payer: Aetna Commercial	$320.36
Rate for Payer: Aetna Medicare	$56.61
Rate for Payer: Aetna New Business (MI Preferred)	$244.98
Rate for Payer: Allen County Amish Medical Aid Commercial	$68.04
Rate for Payer: Amish Plain Church Group Commercial	$68.04
Rate for Payer: BCBS Complete	$31.26
Rate for Payer: BCBS MAPPO	$54.43
Rate for Payer: BCBS Trust/PPO	$273.25
Rate for Payer: BCN Medicare Advantage	$54.43
Rate for Payer: Cash Price	$301.52
Rate for Payer: Cash Price	$301.52
Rate for Payer: Cofinity Commercial	$324.13
Rate for Payer: Cofinity Commercial	$263.83
Rate for Payer: Health Alliance Plan Medicare Advantage	$54.43
Rate for Payer: Healthscope Commercial	$339.21
Rate for Payer: Mclaren Medicaid	$29.77
Rate for Payer: Mclaren Medicare	$54.43
Rate for Payer: Meridian Medicaid	$31.26
Rate for Payer: Meridian Wellcare - Medicare Advantage	$57.15
Rate for Payer: MI Amish Medical Board Commercial	$62.59
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$320.36
Rate for Payer: PACE Medicare	$51.71
Rate for Payer: PACE SWMI	$54.43
Rate for Payer: PHP Commercial	$320.36
Rate for Payer: PHP Medicare Advantage	$54.43
Rate for Payer: Priority Health Choice Medicaid	$29.77
Rate for Payer: Priority Health Cigna Priority Health	$263.83
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$173.33
Rate for Payer: Priority Health Medicare	$54.43
Rate for Payer: Priority Health Narrow Network	$138.66
Rate for Payer: Priority Health SBD	$237.45
Rate for Payer: Railroad Medicare Medicare	$54.43
Rate for Payer: UHC All Payor (Choice/PPO)	$70.60
Rate for Payer: UHC Dual Complete DSNP	$54.43
Rate for Payer: UHC Exchange	$64.18
Rate for Payer: UHC Medicare Advantage	$56.06
Rate for Payer: VA VA	$54.43

HC CONT GLUCOSE MONITOR PATIENT EQUIP

Facility

$376.90

Service Code	CPT 95249
Hospital Charge Code	94200038
Hospital Revenue Code	942
Min. Negotiated Rate	$237.45
Max. Negotiated Rate	$339.21
Rate for Payer: Aetna Commercial	$320.36
Rate for Payer: Aetna New Business (MI Preferred)	$244.98
Rate for Payer: Cash Price	$301.52
Rate for Payer: Cofinity Commercial	$324.13
Rate for Payer: Cofinity Commercial	$263.83
Rate for Payer: Healthscope Commercial	$339.21
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$320.36
Rate for Payer: PHP Commercial	$320.36
Rate for Payer: Priority Health Cigna Priority Health	$263.83
Rate for Payer: Priority Health SBD	$237.45

HC CONTINUOUS NEB SUBSEQUENT HR

Facility

$102.48

Service Code	CPT 94645
Hospital Charge Code	41000007
Hospital Revenue Code	410
Min. Negotiated Rate	$16.04
Max. Negotiated Rate	$92.23
Rate for Payer: Aetna Commercial	$87.11
Rate for Payer: Aetna New Business (MI Preferred)	$66.61
Rate for Payer: BCBS Complete	$40.99
Rate for Payer: BCBS Trust/PPO	$70.61
Rate for Payer: Cash Price	$81.98
Rate for Payer: Cash Price	$81.98
Rate for Payer: Cofinity Commercial	$88.13
Rate for Payer: Cofinity Commercial	$71.74
Rate for Payer: Healthscope Commercial	$92.23
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$87.11
Rate for Payer: PHP Commercial	$87.11
Rate for Payer: Priority Health Cigna Priority Health	$71.74
Rate for Payer: Priority Health SBD	$64.56
Rate for Payer: UHC All Payor (Choice/PPO)	$17.64
Rate for Payer: UHC Exchange	$16.04

HC CONTINUOUS NEB SUBSEQUENT HR

Facility

$102.48

Service Code	CPT 94645
Hospital Charge Code	41000007
Hospital Revenue Code	410
Min. Negotiated Rate	$64.56
Max. Negotiated Rate	$92.23
Rate for Payer: Aetna Commercial	$87.11
Rate for Payer: Aetna New Business (MI Preferred)	$66.61
Rate for Payer: Cash Price	$81.98
Rate for Payer: Cofinity Commercial	$71.74
Rate for Payer: Cofinity Commercial	$88.13
Rate for Payer: Healthscope Commercial	$92.23
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$87.11
Rate for Payer: PHP Commercial	$87.11
Rate for Payer: Priority Health Cigna Priority Health	$71.74
Rate for Payer: Priority Health SBD	$64.56

HC CONTINUOUS NEB TX INITIAL HOUR

Facility

$368.06

Service Code	CPT 94644
Hospital Charge Code	41000006
Hospital Revenue Code	410
Min. Negotiated Rate	$231.88
Max. Negotiated Rate	$331.25
Rate for Payer: Aetna Commercial	$312.85
Rate for Payer: Aetna New Business (MI Preferred)	$239.24
Rate for Payer: Cash Price	$294.45
Rate for Payer: Cofinity Commercial	$257.64
Rate for Payer: Cofinity Commercial	$316.53
Rate for Payer: Healthscope Commercial	$331.25
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$312.85
Rate for Payer: PHP Commercial	$312.85
Rate for Payer: Priority Health Cigna Priority Health	$257.64
Rate for Payer: Priority Health SBD	$231.88

HC CONTINUOUS NEB TX INITIAL HOUR

Facility

$368.06

Service Code	CPT 94644
Hospital Charge Code	41000006
Hospital Revenue Code	410
Min. Negotiated Rate	$58.61
Max. Negotiated Rate	$351.10
Rate for Payer: Aetna Commercial	$312.85
Rate for Payer: Aetna Medicare	$118.21
Rate for Payer: Aetna New Business (MI Preferred)	$239.24
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	$271.71
Rate for Payer: BCN Medicare Advantage	$113.66
Rate for Payer: Cash Price	$294.45
Rate for Payer: Cash Price	$294.45
Rate for Payer: Cofinity Commercial	$316.53
Rate for Payer: Cofinity Commercial	$257.64
Rate for Payer: Health Alliance Plan Medicare Advantage	$113.66
Rate for Payer: Healthscope Commercial	$331.25
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	$312.85
Rate for Payer: PACE Medicare	$107.98
Rate for Payer: PACE SWMI	$113.66
Rate for Payer: PHP Commercial	$312.85
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	$257.64
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	$231.88
Rate for Payer: Railroad Medicare Medicare	$113.66
Rate for Payer: UHC All Payor (Choice/PPO)	$64.47
Rate for Payer: UHC Dual Complete DSNP	$113.66
Rate for Payer: UHC Exchange	$58.61
Rate for Payer: UHC Medicare Advantage	$117.07
Rate for Payer: VA VA	$113.66

HC CONT PHYSICS CONSULT

Facility

$661.00

Service Code	CPT 77336
Hospital Charge Code	33300015
Hospital Revenue Code	333
Min. Negotiated Rate	$66.04
Max. Negotiated Rate	$594.90
Rate for Payer: Aetna Commercial	$561.85
Rate for Payer: Aetna Commercial	$487.25
Rate for Payer: Aetna Medicare	$125.56
Rate for Payer: Aetna Medicare	$125.56
Rate for Payer: Aetna New Business (MI Preferred)	$372.61
Rate for Payer: Aetna New Business (MI Preferred)	$429.65
Rate for Payer: Allen County Amish Medical Aid Commercial	$150.91
Rate for Payer: Allen County Amish Medical Aid Commercial	$150.91
Rate for Payer: Amish Plain Church Group Commercial	$150.91
Rate for Payer: Amish Plain Church Group Commercial	$150.91
Rate for Payer: BCBS Complete	$69.35
Rate for Payer: BCBS Complete	$69.35
Rate for Payer: BCBS MAPPO	$120.73
Rate for Payer: BCBS MAPPO	$120.73
Rate for Payer: BCBS Trust/PPO	$142.31
Rate for Payer: BCBS Trust/PPO	$142.31
Rate for Payer: BCN Medicare Advantage	$120.73
Rate for Payer: BCN Medicare Advantage	$120.73
Rate for Payer: Cash Price	$528.80
Rate for Payer: Cash Price	$458.59
Rate for Payer: Cash Price	$528.80
Rate for Payer: Cash Price	$458.59
Rate for Payer: Cofinity Commercial	$568.46
Rate for Payer: Cofinity Commercial	$492.99
Rate for Payer: Cofinity Commercial	$401.27
Rate for Payer: Cofinity Commercial	$462.70
Rate for Payer: Health Alliance Plan Medicare Advantage	$120.73
Rate for Payer: Health Alliance Plan Medicare Advantage	$120.73
Rate for Payer: Healthscope Commercial	$515.92
Rate for Payer: Healthscope Commercial	$594.90
Rate for Payer: Mclaren Medicaid	$66.04
Rate for Payer: Mclaren Medicaid	$66.04
Rate for Payer: Mclaren Medicare	$120.73
Rate for Payer: Mclaren Medicare	$120.73
Rate for Payer: Meridian Medicaid	$69.35
Rate for Payer: Meridian Medicaid	$69.35
Rate for Payer: Meridian Wellcare - Medicare Advantage	$126.77
Rate for Payer: Meridian Wellcare - Medicare Advantage	$126.77
Rate for Payer: MI Amish Medical Board Commercial	$138.84
Rate for Payer: MI Amish Medical Board Commercial	$138.84
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$561.85
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$487.25
Rate for Payer: PACE Medicare	$114.69
Rate for Payer: PACE Medicare	$114.69
Rate for Payer: PACE SWMI	$120.73
Rate for Payer: PACE SWMI	$120.73
Rate for Payer: PHP Commercial	$487.25
Rate for Payer: PHP Commercial	$561.85
Rate for Payer: PHP Medicare Advantage	$120.73
Rate for Payer: PHP Medicare Advantage	$120.73
Rate for Payer: Priority Health Choice Medicaid	$66.04
Rate for Payer: Priority Health Choice Medicaid	$66.04
Rate for Payer: Priority Health Cigna Priority Health	$462.70
Rate for Payer: Priority Health Cigna Priority Health	$401.27
Rate for Payer: Priority Health Medicare	$120.73
Rate for Payer: Priority Health Medicare	$120.73
Rate for Payer: Priority Health SBD	$361.14
Rate for Payer: Priority Health SBD	$416.43
Rate for Payer: Railroad Medicare Medicare	$120.73
Rate for Payer: Railroad Medicare Medicare	$120.73
Rate for Payer: UHC All Payor (Choice/PPO)	$96.17
Rate for Payer: UHC All Payor (Choice/PPO)	$96.17
Rate for Payer: UHC Dual Complete DSNP	$120.73
Rate for Payer: UHC Dual Complete DSNP	$120.73
Rate for Payer: UHC Exchange	$87.43
Rate for Payer: UHC Exchange	$87.43
Rate for Payer: UHC Medicare Advantage	$124.35
Rate for Payer: UHC Medicare Advantage	$124.35
Rate for Payer: VA VA	$120.73
Rate for Payer: VA VA	$120.73

HC CONT PHYSICS CONSULT

Facility

$573.24

Service Code	CPT 77336
Hospital Charge Code	33300015
Hospital Revenue Code	333
Min. Negotiated Rate	$361.14
Max. Negotiated Rate	$515.92
Rate for Payer: Aetna Commercial	$487.25
Rate for Payer: Aetna Commercial	$561.85
Rate for Payer: Aetna New Business (MI Preferred)	$372.61
Rate for Payer: Aetna New Business (MI Preferred)	$429.65
Rate for Payer: Cash Price	$528.80
Rate for Payer: Cash Price	$458.59
Rate for Payer: Cofinity Commercial	$401.27
Rate for Payer: Cofinity Commercial	$568.46
Rate for Payer: Cofinity Commercial	$462.70
Rate for Payer: Cofinity Commercial	$492.99
Rate for Payer: Healthscope Commercial	$594.90
Rate for Payer: Healthscope Commercial	$515.92
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$487.25
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$561.85
Rate for Payer: PHP Commercial	$561.85
Rate for Payer: PHP Commercial	$487.25
Rate for Payer: Priority Health Cigna Priority Health	$401.27
Rate for Payer: Priority Health Cigna Priority Health	$462.70
Rate for Payer: Priority Health SBD	$361.14
Rate for Payer: Priority Health SBD	$416.43

Know your out-of-pocket cost for care.

All Charges