Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC CVC ACCESS TRAY

Facility

$131.94

Hospital Charge Code	27000052
Hospital Revenue Code	270
Min. Negotiated Rate	$83.12
Max. Negotiated Rate	$118.75
Rate for Payer: Aetna Commercial	$112.15
Rate for Payer: Aetna New Business (MI Preferred)	$85.76
Rate for Payer: Cash Price	$105.55
Rate for Payer: Cofinity Commercial	$113.47
Rate for Payer: Cofinity Commercial	$92.36
Rate for Payer: Healthscope Commercial	$118.75
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$112.15
Rate for Payer: PHP Commercial	$112.15
Rate for Payer: Priority Health Cigna Priority Health	$92.36
Rate for Payer: Priority Health SBD	$83.12

HC CVC ACCESS TRAY

Facility

$131.94

Hospital Charge Code	27000052
Hospital Revenue Code	270
Min. Negotiated Rate	$52.78
Max. Negotiated Rate	$118.75
Rate for Payer: Aetna Commercial	$112.15
Rate for Payer: Aetna New Business (MI Preferred)	$85.76
Rate for Payer: BCBS Complete	$52.78
Rate for Payer: Cash Price	$105.55
Rate for Payer: Cofinity Commercial	$113.47
Rate for Payer: Cofinity Commercial	$92.36
Rate for Payer: Healthscope Commercial	$118.75
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$112.15
Rate for Payer: PHP Commercial	$112.15
Rate for Payer: Priority Health Cigna Priority Health	$92.36
Rate for Payer: Priority Health SBD	$83.12

HC CVC INSERT

Facility

$2,495.63

Hospital Charge Code	45000036
Hospital Revenue Code	361
Min. Negotiated Rate	$1,572.25
Max. Negotiated Rate	$2,246.07
Rate for Payer: Aetna Commercial	$2,121.29
Rate for Payer: Aetna New Business (MI Preferred)	$1,622.16
Rate for Payer: Cash Price	$1,996.50
Rate for Payer: Cofinity Commercial	$1,746.94
Rate for Payer: Cofinity Commercial	$2,146.24
Rate for Payer: Healthscope Commercial	$2,246.07
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,121.29
Rate for Payer: PHP Commercial	$2,121.29
Rate for Payer: Priority Health Cigna Priority Health	$1,746.94
Rate for Payer: Priority Health SBD	$1,572.25

HC CVC INSERT

Facility

$2,495.63

Hospital Charge Code	45000036
Hospital Revenue Code	361
Min. Negotiated Rate	$998.25
Max. Negotiated Rate	$2,246.07
Rate for Payer: Aetna Commercial	$2,121.29
Rate for Payer: Aetna New Business (MI Preferred)	$1,622.16
Rate for Payer: BCBS Complete	$998.25
Rate for Payer: Cash Price	$1,996.50
Rate for Payer: Cofinity Commercial	$1,746.94
Rate for Payer: Cofinity Commercial	$2,146.24
Rate for Payer: Healthscope Commercial	$2,246.07
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,121.29
Rate for Payer: PHP Commercial	$2,121.29
Rate for Payer: Priority Health Cigna Priority Health	$1,746.94
Rate for Payer: Priority Health SBD	$1,572.25

HC CVS PSEUDOANEURYSM COMPRESSION

Facility

$800.53

Service Code	CPT 76936
Hospital Charge Code	40200042
Hospital Revenue Code	402
Min. Negotiated Rate	$152.77
Max. Negotiated Rate	$824.04
Rate for Payer: Aetna Commercial	$680.45
Rate for Payer: Aetna Medicare	$290.46
Rate for Payer: Aetna New Business (MI Preferred)	$520.34
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	$275.80
Rate for Payer: BCN Medicare Advantage	$279.29
Rate for Payer: Cash Price	$640.42
Rate for Payer: Cash Price	$640.42
Rate for Payer: Cofinity Commercial	$688.46
Rate for Payer: Cofinity Commercial	$560.37
Rate for Payer: Health Alliance Plan Medicare Advantage	$279.29
Rate for Payer: Healthscope Commercial	$720.48
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	$680.45
Rate for Payer: PACE Medicare	$265.33
Rate for Payer: PACE SWMI	$279.29
Rate for Payer: PHP Commercial	$680.45
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	$560.37
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$824.04
Rate for Payer: Priority Health Medicare	$279.29
Rate for Payer: Priority Health Narrow Network	$659.23
Rate for Payer: Priority Health SBD	$504.33
Rate for Payer: Railroad Medicare Medicare	$279.29
Rate for Payer: UHC All Payor (Choice/PPO)	$281.30
Rate for Payer: UHC Dual Complete DSNP	$279.29
Rate for Payer: UHC Exchange	$255.73
Rate for Payer: UHC Medicare Advantage	$287.67
Rate for Payer: VA VA	$279.29

HC CVS PSEUDOANEURYSM COMPRESSION

Facility

$800.53

Service Code	CPT 76936
Hospital Charge Code	40200042
Hospital Revenue Code	402
Min. Negotiated Rate	$504.33
Max. Negotiated Rate	$720.48
Rate for Payer: Aetna Commercial	$680.45
Rate for Payer: Aetna New Business (MI Preferred)	$520.34
Rate for Payer: Cash Price	$640.42
Rate for Payer: Cofinity Commercial	$560.37
Rate for Payer: Cofinity Commercial	$688.46
Rate for Payer: Healthscope Commercial	$720.48
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$680.45
Rate for Payer: PHP Commercial	$680.45
Rate for Payer: Priority Health Cigna Priority Health	$560.37
Rate for Payer: Priority Health SBD	$504.33

HC CVVHD INSERTION

Facility

$408.67

Hospital Charge Code	27000053
Hospital Revenue Code	270
Min. Negotiated Rate	$257.46
Max. Negotiated Rate	$367.80
Rate for Payer: Aetna Commercial	$347.37
Rate for Payer: Aetna New Business (MI Preferred)	$265.64
Rate for Payer: Cash Price	$326.94
Rate for Payer: Cofinity Commercial	$286.07
Rate for Payer: Cofinity Commercial	$351.46
Rate for Payer: Healthscope Commercial	$367.80
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$347.37
Rate for Payer: PHP Commercial	$347.37
Rate for Payer: Priority Health Cigna Priority Health	$286.07
Rate for Payer: Priority Health SBD	$257.46

HC CVVHD INSERTION

Facility

$408.67

Hospital Charge Code	27000053
Hospital Revenue Code	270
Min. Negotiated Rate	$163.47
Max. Negotiated Rate	$367.80
Rate for Payer: Aetna Commercial	$347.37
Rate for Payer: Aetna New Business (MI Preferred)	$265.64
Rate for Payer: BCBS Complete	$163.47
Rate for Payer: Cash Price	$326.94
Rate for Payer: Cofinity Commercial	$286.07
Rate for Payer: Cofinity Commercial	$351.46
Rate for Payer: Healthscope Commercial	$367.80
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$347.37
Rate for Payer: PHP Commercial	$347.37
Rate for Payer: Priority Health Cigna Priority Health	$286.07
Rate for Payer: Priority Health SBD	$257.46

HC CVVH SUBSEQUENT CARTRIDGE

Facility

$619.07

Hospital Charge Code	27000611
Hospital Revenue Code	270
Min. Negotiated Rate	$390.01
Max. Negotiated Rate	$557.16
Rate for Payer: Aetna Commercial	$526.21
Rate for Payer: Aetna New Business (MI Preferred)	$402.40
Rate for Payer: Cash Price	$495.26
Rate for Payer: Cofinity Commercial	$433.35
Rate for Payer: Cofinity Commercial	$532.40
Rate for Payer: Healthscope Commercial	$557.16
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$526.21
Rate for Payer: PHP Commercial	$526.21
Rate for Payer: Priority Health Cigna Priority Health	$433.35
Rate for Payer: Priority Health SBD	$390.01

HC CVVH SUBSEQUENT CARTRIDGE

Facility

$619.07

Hospital Charge Code	27000611
Hospital Revenue Code	270
Min. Negotiated Rate	$247.63
Max. Negotiated Rate	$557.16
Rate for Payer: Aetna Commercial	$526.21
Rate for Payer: Aetna New Business (MI Preferred)	$402.40
Rate for Payer: BCBS Complete	$247.63
Rate for Payer: Cash Price	$495.26
Rate for Payer: Cofinity Commercial	$433.35
Rate for Payer: Cofinity Commercial	$532.40
Rate for Payer: Healthscope Commercial	$557.16
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$526.21
Rate for Payer: PHP Commercial	$526.21
Rate for Payer: Priority Health Cigna Priority Health	$433.35
Rate for Payer: Priority Health SBD	$390.01

HC CX ID BY PCR AMP, ENTEROBACTERIACEA

Facility

$56.35

Service Code	CPT 87150
Hospital Charge Code	30600240
Hospital Revenue Code	306
Min. Negotiated Rate	$35.50
Max. Negotiated Rate	$50.72
Rate for Payer: Aetna Commercial	$47.90
Rate for Payer: Aetna New Business (MI Preferred)	$36.63
Rate for Payer: Cash Price	$45.08
Rate for Payer: Cofinity Commercial	$48.46
Rate for Payer: Cofinity Commercial	$39.44
Rate for Payer: Healthscope Commercial	$50.72
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$47.90
Rate for Payer: PHP Commercial	$47.90
Rate for Payer: Priority Health Cigna Priority Health	$39.44
Rate for Payer: Priority Health SBD	$35.50

HC CX ID BY PCR AMP, ENTEROBACTERIACEA

Facility

$56.35

Service Code	CPT 87150
Hospital Charge Code	30600240
Hospital Revenue Code	306
Min. Negotiated Rate	$19.19
Max. Negotiated Rate	$59.65
Rate for Payer: Aetna Commercial	$47.90
Rate for Payer: Aetna Medicare	$36.49
Rate for Payer: Aetna New Business (MI Preferred)	$36.63
Rate for Payer: Allen County Amish Medical Aid Commercial	$43.86
Rate for Payer: Amish Plain Church Group Commercial	$43.86
Rate for Payer: BCBS Complete	$20.16
Rate for Payer: BCBS MAPPO	$35.09
Rate for Payer: BCBS Trust/PPO	$27.48
Rate for Payer: BCN Medicare Advantage	$35.09
Rate for Payer: Cash Price	$45.08
Rate for Payer: Cash Price	$45.08
Rate for Payer: Cofinity Commercial	$39.44
Rate for Payer: Cofinity Commercial	$48.46
Rate for Payer: Health Alliance Plan Medicare Advantage	$35.09
Rate for Payer: Healthscope Commercial	$50.72
Rate for Payer: Mclaren Medicaid	$19.19
Rate for Payer: Mclaren Medicare	$35.09
Rate for Payer: Meridian Medicaid	$20.16
Rate for Payer: Meridian Wellcare - Medicare Advantage	$36.84
Rate for Payer: MI Amish Medical Board Commercial	$40.35
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$47.90
Rate for Payer: PACE Medicare	$33.34
Rate for Payer: PACE SWMI	$35.09
Rate for Payer: PHP Commercial	$47.90
Rate for Payer: PHP Medicare Advantage	$35.09
Rate for Payer: Priority Health Choice Medicaid	$19.19
Rate for Payer: Priority Health Cigna Priority Health	$39.44
Rate for Payer: Priority Health Medicare	$35.09
Rate for Payer: Priority Health SBD	$35.50
Rate for Payer: Railroad Medicare Medicare	$35.09
Rate for Payer: UHC All Payor (Choice/PPO)	$42.11
Rate for Payer: UHC Core	$59.65
Rate for Payer: UHC Dual Complete DSNP	$35.09
Rate for Payer: UHC Exchange	$35.09
Rate for Payer: UHC Medicare Advantage	$36.14
Rate for Payer: VA VA	$35.09

HC CX ID BY PCR AMPLIFED, C GLA

Facility

$56.35

Service Code	CPT 87150
Hospital Charge Code	30600248
Hospital Revenue Code	306
Min. Negotiated Rate	$35.50
Max. Negotiated Rate	$50.72
Rate for Payer: Aetna Commercial	$47.90
Rate for Payer: Aetna New Business (MI Preferred)	$36.63
Rate for Payer: Cash Price	$45.08
Rate for Payer: Cofinity Commercial	$39.44
Rate for Payer: Cofinity Commercial	$48.46
Rate for Payer: Healthscope Commercial	$50.72
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$47.90
Rate for Payer: PHP Commercial	$47.90
Rate for Payer: Priority Health Cigna Priority Health	$39.44
Rate for Payer: Priority Health SBD	$35.50

HC CX ID BY PCR AMPLIFED, C GLA

Facility

$56.35

Service Code	CPT 87150
Hospital Charge Code	30600248
Hospital Revenue Code	306
Min. Negotiated Rate	$19.19
Max. Negotiated Rate	$59.65
Rate for Payer: Aetna Commercial	$47.90
Rate for Payer: Aetna Medicare	$36.49
Rate for Payer: Aetna New Business (MI Preferred)	$36.63
Rate for Payer: Allen County Amish Medical Aid Commercial	$43.86
Rate for Payer: Amish Plain Church Group Commercial	$43.86
Rate for Payer: BCBS Complete	$20.16
Rate for Payer: BCBS MAPPO	$35.09
Rate for Payer: BCBS Trust/PPO	$27.48
Rate for Payer: BCN Medicare Advantage	$35.09
Rate for Payer: Cash Price	$45.08
Rate for Payer: Cash Price	$45.08
Rate for Payer: Cofinity Commercial	$48.46
Rate for Payer: Cofinity Commercial	$39.44
Rate for Payer: Health Alliance Plan Medicare Advantage	$35.09
Rate for Payer: Healthscope Commercial	$50.72
Rate for Payer: Mclaren Medicaid	$19.19
Rate for Payer: Mclaren Medicare	$35.09
Rate for Payer: Meridian Medicaid	$20.16
Rate for Payer: Meridian Wellcare - Medicare Advantage	$36.84
Rate for Payer: MI Amish Medical Board Commercial	$40.35
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$47.90
Rate for Payer: PACE Medicare	$33.34
Rate for Payer: PACE SWMI	$35.09
Rate for Payer: PHP Commercial	$47.90
Rate for Payer: PHP Medicare Advantage	$35.09
Rate for Payer: Priority Health Choice Medicaid	$19.19
Rate for Payer: Priority Health Cigna Priority Health	$39.44
Rate for Payer: Priority Health Medicare	$35.09
Rate for Payer: Priority Health SBD	$35.50
Rate for Payer: Railroad Medicare Medicare	$35.09
Rate for Payer: UHC All Payor (Choice/PPO)	$42.11
Rate for Payer: UHC Core	$59.65
Rate for Payer: UHC Dual Complete DSNP	$35.09
Rate for Payer: UHC Exchange	$35.09
Rate for Payer: UHC Medicare Advantage	$36.14
Rate for Payer: VA VA	$35.09

HC CX ID BY PCR AMPLIFIED, ACIN

Facility

$56.35

Service Code	CPT 87150
Hospital Charge Code	30600236
Hospital Revenue Code	306
Min. Negotiated Rate	$19.19
Max. Negotiated Rate	$59.65
Rate for Payer: Aetna Commercial	$47.90
Rate for Payer: Aetna Medicare	$36.49
Rate for Payer: Aetna New Business (MI Preferred)	$36.63
Rate for Payer: Allen County Amish Medical Aid Commercial	$43.86
Rate for Payer: Amish Plain Church Group Commercial	$43.86
Rate for Payer: BCBS Complete	$20.16
Rate for Payer: BCBS MAPPO	$35.09
Rate for Payer: BCBS Trust/PPO	$27.48
Rate for Payer: BCN Medicare Advantage	$35.09
Rate for Payer: Cash Price	$45.08
Rate for Payer: Cash Price	$45.08
Rate for Payer: Cofinity Commercial	$48.46
Rate for Payer: Cofinity Commercial	$39.44
Rate for Payer: Health Alliance Plan Medicare Advantage	$35.09
Rate for Payer: Healthscope Commercial	$50.72
Rate for Payer: Mclaren Medicaid	$19.19
Rate for Payer: Mclaren Medicare	$35.09
Rate for Payer: Meridian Medicaid	$20.16
Rate for Payer: Meridian Wellcare - Medicare Advantage	$36.84
Rate for Payer: MI Amish Medical Board Commercial	$40.35
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$47.90
Rate for Payer: PACE Medicare	$33.34
Rate for Payer: PACE SWMI	$35.09
Rate for Payer: PHP Commercial	$47.90
Rate for Payer: PHP Medicare Advantage	$35.09
Rate for Payer: Priority Health Choice Medicaid	$19.19
Rate for Payer: Priority Health Cigna Priority Health	$39.44
Rate for Payer: Priority Health Medicare	$35.09
Rate for Payer: Priority Health SBD	$35.50
Rate for Payer: Railroad Medicare Medicare	$35.09
Rate for Payer: UHC All Payor (Choice/PPO)	$42.11
Rate for Payer: UHC Core	$59.65
Rate for Payer: UHC Dual Complete DSNP	$35.09
Rate for Payer: UHC Exchange	$35.09
Rate for Payer: UHC Medicare Advantage	$36.14
Rate for Payer: VA VA	$35.09

HC CX ID BY PCR AMPLIFIED, ACIN

Facility

$56.35

Service Code	CPT 87150
Hospital Charge Code	30600236
Hospital Revenue Code	306
Min. Negotiated Rate	$35.50
Max. Negotiated Rate	$50.72
Rate for Payer: Aetna Commercial	$47.90
Rate for Payer: Aetna New Business (MI Preferred)	$36.63
Rate for Payer: Cash Price	$45.08
Rate for Payer: Cofinity Commercial	$39.44
Rate for Payer: Cofinity Commercial	$48.46
Rate for Payer: Healthscope Commercial	$50.72
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$47.90
Rate for Payer: PHP Commercial	$47.90
Rate for Payer: Priority Health Cigna Priority Health	$39.44
Rate for Payer: Priority Health SBD	$35.50

HC CX ID BY PCR AMPLIFIED, BSA

Facility

$56.35

Service Code	CPT 87150
Hospital Charge Code	30600235
Hospital Revenue Code	306
Min. Negotiated Rate	$19.19
Max. Negotiated Rate	$59.65
Rate for Payer: Aetna Commercial	$47.90
Rate for Payer: Aetna Medicare	$36.49
Rate for Payer: Aetna New Business (MI Preferred)	$36.63
Rate for Payer: Allen County Amish Medical Aid Commercial	$43.86
Rate for Payer: Amish Plain Church Group Commercial	$43.86
Rate for Payer: BCBS Complete	$20.16
Rate for Payer: BCBS MAPPO	$35.09
Rate for Payer: BCBS Trust/PPO	$27.48
Rate for Payer: BCN Medicare Advantage	$35.09
Rate for Payer: Cash Price	$45.08
Rate for Payer: Cash Price	$45.08
Rate for Payer: Cofinity Commercial	$39.44
Rate for Payer: Cofinity Commercial	$48.46
Rate for Payer: Health Alliance Plan Medicare Advantage	$35.09
Rate for Payer: Healthscope Commercial	$50.72
Rate for Payer: Mclaren Medicaid	$19.19
Rate for Payer: Mclaren Medicare	$35.09
Rate for Payer: Meridian Medicaid	$20.16
Rate for Payer: Meridian Wellcare - Medicare Advantage	$36.84
Rate for Payer: MI Amish Medical Board Commercial	$40.35
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$47.90
Rate for Payer: PACE Medicare	$33.34
Rate for Payer: PACE SWMI	$35.09
Rate for Payer: PHP Commercial	$47.90
Rate for Payer: PHP Medicare Advantage	$35.09
Rate for Payer: Priority Health Choice Medicaid	$19.19
Rate for Payer: Priority Health Cigna Priority Health	$39.44
Rate for Payer: Priority Health Medicare	$35.09
Rate for Payer: Priority Health SBD	$35.50
Rate for Payer: Railroad Medicare Medicare	$35.09
Rate for Payer: UHC All Payor (Choice/PPO)	$42.11
Rate for Payer: UHC Core	$59.65
Rate for Payer: UHC Dual Complete DSNP	$35.09
Rate for Payer: UHC Exchange	$35.09
Rate for Payer: UHC Medicare Advantage	$36.14
Rate for Payer: VA VA	$35.09

HC CX ID BY PCR AMPLIFIED, BSA

Facility

$56.35

Service Code	CPT 87150
Hospital Charge Code	30600235
Hospital Revenue Code	306
Min. Negotiated Rate	$35.50
Max. Negotiated Rate	$50.72
Rate for Payer: Aetna Commercial	$47.90
Rate for Payer: Aetna New Business (MI Preferred)	$36.63
Rate for Payer: Cash Price	$45.08
Rate for Payer: Cofinity Commercial	$39.44
Rate for Payer: Cofinity Commercial	$48.46
Rate for Payer: Healthscope Commercial	$50.72
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$47.90
Rate for Payer: PHP Commercial	$47.90
Rate for Payer: Priority Health Cigna Priority Health	$39.44
Rate for Payer: Priority Health SBD	$35.50

HC CX ID BY PCR AMPLIFIED, BSB

Facility

$56.35

Service Code	CPT 87150
Hospital Charge Code	30600234
Hospital Revenue Code	306
Min. Negotiated Rate	$19.19
Max. Negotiated Rate	$59.65
Rate for Payer: Aetna Commercial	$47.90
Rate for Payer: Aetna Medicare	$36.49
Rate for Payer: Aetna New Business (MI Preferred)	$36.63
Rate for Payer: Allen County Amish Medical Aid Commercial	$43.86
Rate for Payer: Amish Plain Church Group Commercial	$43.86
Rate for Payer: BCBS Complete	$20.16
Rate for Payer: BCBS MAPPO	$35.09
Rate for Payer: BCBS Trust/PPO	$27.48
Rate for Payer: BCN Medicare Advantage	$35.09
Rate for Payer: Cash Price	$45.08
Rate for Payer: Cash Price	$45.08
Rate for Payer: Cofinity Commercial	$39.44
Rate for Payer: Cofinity Commercial	$48.46
Rate for Payer: Health Alliance Plan Medicare Advantage	$35.09
Rate for Payer: Healthscope Commercial	$50.72
Rate for Payer: Mclaren Medicaid	$19.19
Rate for Payer: Mclaren Medicare	$35.09
Rate for Payer: Meridian Medicaid	$20.16
Rate for Payer: Meridian Wellcare - Medicare Advantage	$36.84
Rate for Payer: MI Amish Medical Board Commercial	$40.35
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$47.90
Rate for Payer: PACE Medicare	$33.34
Rate for Payer: PACE SWMI	$35.09
Rate for Payer: PHP Commercial	$47.90
Rate for Payer: PHP Medicare Advantage	$35.09
Rate for Payer: Priority Health Choice Medicaid	$19.19
Rate for Payer: Priority Health Cigna Priority Health	$39.44
Rate for Payer: Priority Health Medicare	$35.09
Rate for Payer: Priority Health SBD	$35.50
Rate for Payer: Railroad Medicare Medicare	$35.09
Rate for Payer: UHC All Payor (Choice/PPO)	$42.11
Rate for Payer: UHC Core	$59.65
Rate for Payer: UHC Dual Complete DSNP	$35.09
Rate for Payer: UHC Exchange	$35.09
Rate for Payer: UHC Medicare Advantage	$36.14
Rate for Payer: VA VA	$35.09

HC CX ID BY PCR AMPLIFIED, BSB

Facility

$56.35

Service Code	CPT 87150
Hospital Charge Code	30600234
Hospital Revenue Code	306
Min. Negotiated Rate	$35.50
Max. Negotiated Rate	$50.72
Rate for Payer: Aetna Commercial	$47.90
Rate for Payer: Aetna New Business (MI Preferred)	$36.63
Rate for Payer: Cash Price	$45.08
Rate for Payer: Cofinity Commercial	$39.44
Rate for Payer: Cofinity Commercial	$48.46
Rate for Payer: Healthscope Commercial	$50.72
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$47.90
Rate for Payer: PHP Commercial	$47.90
Rate for Payer: Priority Health Cigna Priority Health	$39.44
Rate for Payer: Priority Health SBD	$35.50

HC CX ID BY PCR AMPLIFIED, C ALB

Facility

$56.35

Service Code	CPT 87150
Hospital Charge Code	30600247
Hospital Revenue Code	306
Min. Negotiated Rate	$35.50
Max. Negotiated Rate	$50.72
Rate for Payer: Aetna Commercial	$47.90
Rate for Payer: Aetna New Business (MI Preferred)	$36.63
Rate for Payer: Cash Price	$45.08
Rate for Payer: Cofinity Commercial	$39.44
Rate for Payer: Cofinity Commercial	$48.46
Rate for Payer: Healthscope Commercial	$50.72
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$47.90
Rate for Payer: PHP Commercial	$47.90
Rate for Payer: Priority Health Cigna Priority Health	$39.44
Rate for Payer: Priority Health SBD	$35.50

HC CX ID BY PCR AMPLIFIED, C ALB

Facility

$56.35

Service Code	CPT 87150
Hospital Charge Code	30600247
Hospital Revenue Code	306
Min. Negotiated Rate	$19.19
Max. Negotiated Rate	$59.65
Rate for Payer: Aetna Commercial	$47.90
Rate for Payer: Aetna Medicare	$36.49
Rate for Payer: Aetna New Business (MI Preferred)	$36.63
Rate for Payer: Allen County Amish Medical Aid Commercial	$43.86
Rate for Payer: Amish Plain Church Group Commercial	$43.86
Rate for Payer: BCBS Complete	$20.16
Rate for Payer: BCBS MAPPO	$35.09
Rate for Payer: BCBS Trust/PPO	$27.48
Rate for Payer: BCN Medicare Advantage	$35.09
Rate for Payer: Cash Price	$45.08
Rate for Payer: Cash Price	$45.08
Rate for Payer: Cofinity Commercial	$39.44
Rate for Payer: Cofinity Commercial	$48.46
Rate for Payer: Health Alliance Plan Medicare Advantage	$35.09
Rate for Payer: Healthscope Commercial	$50.72
Rate for Payer: Mclaren Medicaid	$19.19
Rate for Payer: Mclaren Medicare	$35.09
Rate for Payer: Meridian Medicaid	$20.16
Rate for Payer: Meridian Wellcare - Medicare Advantage	$36.84
Rate for Payer: MI Amish Medical Board Commercial	$40.35
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$47.90
Rate for Payer: PACE Medicare	$33.34
Rate for Payer: PACE SWMI	$35.09
Rate for Payer: PHP Commercial	$47.90
Rate for Payer: PHP Medicare Advantage	$35.09
Rate for Payer: Priority Health Choice Medicaid	$19.19
Rate for Payer: Priority Health Cigna Priority Health	$39.44
Rate for Payer: Priority Health Medicare	$35.09
Rate for Payer: Priority Health SBD	$35.50
Rate for Payer: Railroad Medicare Medicare	$35.09
Rate for Payer: UHC All Payor (Choice/PPO)	$42.11
Rate for Payer: UHC Core	$59.65
Rate for Payer: UHC Dual Complete DSNP	$35.09
Rate for Payer: UHC Exchange	$35.09
Rate for Payer: UHC Medicare Advantage	$36.14
Rate for Payer: VA VA	$35.09

HC CX ID BY PCR AMPLIFIED, C KRU

Facility

$56.35

Service Code	CPT 87150
Hospital Charge Code	30600249
Hospital Revenue Code	306
Min. Negotiated Rate	$19.19
Max. Negotiated Rate	$59.65
Rate for Payer: Aetna Commercial	$47.90
Rate for Payer: Aetna Medicare	$36.49
Rate for Payer: Aetna New Business (MI Preferred)	$36.63
Rate for Payer: Allen County Amish Medical Aid Commercial	$43.86
Rate for Payer: Amish Plain Church Group Commercial	$43.86
Rate for Payer: BCBS Complete	$20.16
Rate for Payer: BCBS MAPPO	$35.09
Rate for Payer: BCBS Trust/PPO	$27.48
Rate for Payer: BCN Medicare Advantage	$35.09
Rate for Payer: Cash Price	$45.08
Rate for Payer: Cash Price	$45.08
Rate for Payer: Cofinity Commercial	$48.46
Rate for Payer: Cofinity Commercial	$39.44
Rate for Payer: Health Alliance Plan Medicare Advantage	$35.09
Rate for Payer: Healthscope Commercial	$50.72
Rate for Payer: Mclaren Medicaid	$19.19
Rate for Payer: Mclaren Medicare	$35.09
Rate for Payer: Meridian Medicaid	$20.16
Rate for Payer: Meridian Wellcare - Medicare Advantage	$36.84
Rate for Payer: MI Amish Medical Board Commercial	$40.35
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$47.90
Rate for Payer: PACE Medicare	$33.34
Rate for Payer: PACE SWMI	$35.09
Rate for Payer: PHP Commercial	$47.90
Rate for Payer: PHP Medicare Advantage	$35.09
Rate for Payer: Priority Health Choice Medicaid	$19.19
Rate for Payer: Priority Health Cigna Priority Health	$39.44
Rate for Payer: Priority Health Medicare	$35.09
Rate for Payer: Priority Health SBD	$35.50
Rate for Payer: Railroad Medicare Medicare	$35.09
Rate for Payer: UHC All Payor (Choice/PPO)	$42.11
Rate for Payer: UHC Core	$59.65
Rate for Payer: UHC Dual Complete DSNP	$35.09
Rate for Payer: UHC Exchange	$35.09
Rate for Payer: UHC Medicare Advantage	$36.14
Rate for Payer: VA VA	$35.09

HC CX ID BY PCR AMPLIFIED, C KRU

Facility

$56.35

Service Code	CPT 87150
Hospital Charge Code	30600249
Hospital Revenue Code	306
Min. Negotiated Rate	$35.50
Max. Negotiated Rate	$50.72
Rate for Payer: Aetna Commercial	$47.90
Rate for Payer: Aetna New Business (MI Preferred)	$36.63
Rate for Payer: Cash Price	$45.08
Rate for Payer: Cofinity Commercial	$48.46
Rate for Payer: Cofinity Commercial	$39.44
Rate for Payer: Healthscope Commercial	$50.72
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$47.90
Rate for Payer: PHP Commercial	$47.90
Rate for Payer: Priority Health Cigna Priority Health	$39.44
Rate for Payer: Priority Health SBD	$35.50

HC CX ID BY PCR AMPLIFIED, C PARA

Facility

$56.35

Service Code	CPT 87150
Hospital Charge Code	30600250
Hospital Revenue Code	306
Min. Negotiated Rate	$19.19
Max. Negotiated Rate	$59.65
Rate for Payer: Aetna Commercial	$47.90
Rate for Payer: Aetna Medicare	$36.49
Rate for Payer: Aetna New Business (MI Preferred)	$36.63
Rate for Payer: Allen County Amish Medical Aid Commercial	$43.86
Rate for Payer: Amish Plain Church Group Commercial	$43.86
Rate for Payer: BCBS Complete	$20.16
Rate for Payer: BCBS MAPPO	$35.09
Rate for Payer: BCBS Trust/PPO	$27.48
Rate for Payer: BCN Medicare Advantage	$35.09
Rate for Payer: Cash Price	$45.08
Rate for Payer: Cash Price	$45.08
Rate for Payer: Cofinity Commercial	$48.46
Rate for Payer: Cofinity Commercial	$39.44
Rate for Payer: Health Alliance Plan Medicare Advantage	$35.09
Rate for Payer: Healthscope Commercial	$50.72
Rate for Payer: Mclaren Medicaid	$19.19
Rate for Payer: Mclaren Medicare	$35.09
Rate for Payer: Meridian Medicaid	$20.16
Rate for Payer: Meridian Wellcare - Medicare Advantage	$36.84
Rate for Payer: MI Amish Medical Board Commercial	$40.35
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$47.90
Rate for Payer: PACE Medicare	$33.34
Rate for Payer: PACE SWMI	$35.09
Rate for Payer: PHP Commercial	$47.90
Rate for Payer: PHP Medicare Advantage	$35.09
Rate for Payer: Priority Health Choice Medicaid	$19.19
Rate for Payer: Priority Health Cigna Priority Health	$39.44
Rate for Payer: Priority Health Medicare	$35.09
Rate for Payer: Priority Health SBD	$35.50
Rate for Payer: Railroad Medicare Medicare	$35.09
Rate for Payer: UHC All Payor (Choice/PPO)	$42.11
Rate for Payer: UHC Core	$59.65
Rate for Payer: UHC Dual Complete DSNP	$35.09
Rate for Payer: UHC Exchange	$35.09
Rate for Payer: UHC Medicare Advantage	$36.14
Rate for Payer: VA VA	$35.09

Know your out-of-pocket cost for care.

All Charges