Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC ACB NEW PT LEVEL 4

Facility

$874.52

Service Code	CPT 99204
Hospital Charge Code	51000103
Hospital Revenue Code	510
Min. Negotiated Rate	$550.95
Max. Negotiated Rate	$787.07
Rate for Payer: Aetna Commercial	$743.34
Rate for Payer: Aetna New Business (MI Preferred)	$568.44
Rate for Payer: Cash Price	$699.62
Rate for Payer: Cofinity Commercial	$612.16
Rate for Payer: Cofinity Commercial	$752.09
Rate for Payer: Cofinity Medicare Advantage	$612.16
Rate for Payer: Encore Health Key Benefits Commercial	$699.62
Rate for Payer: Healthscope Commercial	$787.07
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$743.34
Rate for Payer: PHP Commercial	$743.34
Rate for Payer: Priority Health Cigna Priority Health	$568.44
Rate for Payer: Priority Health SBD	$550.95

HC ACB NEW PT LEVEL 5

Facility

$1,042.88

Service Code	CPT 99205
Hospital Charge Code	51000104
Hospital Revenue Code	510
Min. Negotiated Rate	$115.00
Max. Negotiated Rate	$938.59
Rate for Payer: Aetna Commercial	$886.45
Rate for Payer: Aetna Medicare	$521.44
Rate for Payer: Aetna New Business (MI Preferred)	$677.87
Rate for Payer: BCBS Complete	$417.15
Rate for Payer: BCBS Trust/PPO	$257.70
Rate for Payer: BCCCP Commercial	$115.00
Rate for Payer: BCN Commercial	$257.70
Rate for Payer: Cash Price	$834.30
Rate for Payer: Cash Price	$834.30
Rate for Payer: Cofinity Commercial	$896.88
Rate for Payer: Cofinity Commercial	$730.02
Rate for Payer: Cofinity Medicare Advantage	$730.02
Rate for Payer: Encore Health Key Benefits Commercial	$834.30
Rate for Payer: Healthscope Commercial	$938.59
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$886.45
Rate for Payer: PHP Commercial	$886.45
Rate for Payer: Priority Health Cigna Priority Health	$677.87
Rate for Payer: Priority Health SBD	$657.01
Rate for Payer: UHC All Payor (Choice/PPO)	$191.52

HC ACB NEW PT LEVEL 5

Facility

$1,042.88

Service Code	CPT 99205
Hospital Charge Code	51000104
Hospital Revenue Code	510
Min. Negotiated Rate	$657.01
Max. Negotiated Rate	$938.59
Rate for Payer: Aetna Commercial	$886.45
Rate for Payer: Aetna New Business (MI Preferred)	$677.87
Rate for Payer: Cash Price	$834.30
Rate for Payer: Cofinity Commercial	$730.02
Rate for Payer: Cofinity Commercial	$896.88
Rate for Payer: Cofinity Medicare Advantage	$730.02
Rate for Payer: Encore Health Key Benefits Commercial	$834.30
Rate for Payer: Healthscope Commercial	$938.59
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$886.45
Rate for Payer: PHP Commercial	$886.45
Rate for Payer: Priority Health Cigna Priority Health	$677.87
Rate for Payer: Priority Health SBD	$657.01

HC ACCESS AORTA

Facility

$3,920.31

Service Code	CPT 36200
Hospital Charge Code	36100105
Hospital Revenue Code	361
Min. Negotiated Rate	$148.18
Max. Negotiated Rate	$3,528.28
Rate for Payer: Aetna Commercial	$3,332.26
Rate for Payer: Aetna Medicare	$1,960.16
Rate for Payer: Aetna New Business (MI Preferred)	$2,548.20
Rate for Payer: BCBS Complete	$1,568.12
Rate for Payer: BCBS Trust/PPO	$1,103.64
Rate for Payer: BCN Commercial	$1,103.64
Rate for Payer: Cash Price	$3,136.25
Rate for Payer: Cash Price	$3,136.25
Rate for Payer: Cash Price	$3,136.25
Rate for Payer: Cofinity Commercial	$2,744.22
Rate for Payer: Cofinity Commercial	$3,371.47
Rate for Payer: Cofinity Medicare Advantage	$2,744.22
Rate for Payer: Encore Health Key Benefits Commercial	$3,136.25
Rate for Payer: Healthscope Commercial	$3,528.28
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3,332.26
Rate for Payer: PHP Commercial	$3,332.26
Rate for Payer: Priority Health Cigna Priority Health	$2,548.20
Rate for Payer: Priority Health SBD	$2,469.80
Rate for Payer: UHC All Payor (Choice/PPO)	$148.18
Rate for Payer: UHC Core	$878.00
Rate for Payer: UHC Exchange	$940.00

HC ACCESS AORTA

Facility

$3,920.31

Service Code	CPT 36200
Hospital Charge Code	36100105
Hospital Revenue Code	361
Min. Negotiated Rate	$2,469.80
Max. Negotiated Rate	$3,528.28
Rate for Payer: Aetna Commercial	$3,332.26
Rate for Payer: Aetna New Business (MI Preferred)	$2,548.20
Rate for Payer: Cash Price	$3,136.25
Rate for Payer: Cofinity Commercial	$2,744.22
Rate for Payer: Cofinity Commercial	$3,371.47
Rate for Payer: Cofinity Medicare Advantage	$2,744.22
Rate for Payer: Encore Health Key Benefits Commercial	$3,136.25
Rate for Payer: Healthscope Commercial	$3,528.28
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3,332.26
Rate for Payer: PHP Commercial	$3,332.26
Rate for Payer: Priority Health Cigna Priority Health	$2,548.20
Rate for Payer: Priority Health SBD	$2,469.80

HC ACCESS EXTREMITY ARTERY

Facility

$500.92

Service Code	CPT 36140
Hospital Charge Code	36100102
Hospital Revenue Code	761
Min. Negotiated Rate	$315.58
Max. Negotiated Rate	$450.83
Rate for Payer: Aetna Commercial	$425.78
Rate for Payer: Aetna New Business (MI Preferred)	$325.60
Rate for Payer: Cash Price	$400.74
Rate for Payer: Cofinity Commercial	$350.64
Rate for Payer: Cofinity Commercial	$430.79
Rate for Payer: Cofinity Medicare Advantage	$350.64
Rate for Payer: Encore Health Key Benefits Commercial	$400.74
Rate for Payer: Healthscope Commercial	$450.83
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$425.78
Rate for Payer: PHP Commercial	$425.78
Rate for Payer: Priority Health Cigna Priority Health	$325.60
Rate for Payer: Priority Health SBD	$315.58

HC ACCESS EXTREMITY ARTERY

Facility

$500.92

Service Code	CPT 36140
Hospital Charge Code	36100102
Hospital Revenue Code	761
Min. Negotiated Rate	$94.36
Max. Negotiated Rate	$878.00
Rate for Payer: Aetna Commercial	$425.78
Rate for Payer: Aetna Medicare	$250.46
Rate for Payer: Aetna New Business (MI Preferred)	$325.60
Rate for Payer: BCBS Complete	$200.37
Rate for Payer: BCBS Trust/PPO	$869.43
Rate for Payer: BCN Commercial	$869.43
Rate for Payer: Cash Price	$400.74
Rate for Payer: Cash Price	$400.74
Rate for Payer: Cash Price	$400.74
Rate for Payer: Cofinity Commercial	$350.64
Rate for Payer: Cofinity Commercial	$430.79
Rate for Payer: Cofinity Medicare Advantage	$350.64
Rate for Payer: Encore Health Key Benefits Commercial	$400.74
Rate for Payer: Healthscope Commercial	$450.83
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$425.78
Rate for Payer: PHP Commercial	$425.78
Rate for Payer: Priority Health Cigna Priority Health	$325.60
Rate for Payer: Priority Health SBD	$315.58
Rate for Payer: UHC All Payor (Choice/PPO)	$94.36
Rate for Payer: UHC Core	$878.00

HC ACCESS MAIN PULMONARY

Facility

$427.58

Service Code	CPT 36013
Hospital Charge Code	36100099
Hospital Revenue Code	361
Min. Negotiated Rate	$269.38
Max. Negotiated Rate	$384.82
Rate for Payer: Aetna Commercial	$363.44
Rate for Payer: Aetna New Business (MI Preferred)	$277.93
Rate for Payer: Cash Price	$342.06
Rate for Payer: Cofinity Commercial	$299.31
Rate for Payer: Cofinity Commercial	$367.72
Rate for Payer: Cofinity Medicare Advantage	$299.31
Rate for Payer: Encore Health Key Benefits Commercial	$342.06
Rate for Payer: Healthscope Commercial	$384.82
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$363.44
Rate for Payer: PHP Commercial	$363.44
Rate for Payer: Priority Health Cigna Priority Health	$277.93
Rate for Payer: Priority Health SBD	$269.38

HC ACCESS MAIN PULMONARY

Facility

$427.58

Service Code	CPT 36013
Hospital Charge Code	36100099
Hospital Revenue Code	361
Min. Negotiated Rate	$131.80
Max. Negotiated Rate	$1,582.22
Rate for Payer: Aetna Commercial	$363.44
Rate for Payer: Aetna Medicare	$213.79
Rate for Payer: Aetna New Business (MI Preferred)	$277.93
Rate for Payer: BCBS Complete	$171.03
Rate for Payer: BCBS Trust/PPO	$1,582.22
Rate for Payer: BCN Commercial	$1,582.22
Rate for Payer: Cash Price	$342.06
Rate for Payer: Cash Price	$342.06
Rate for Payer: Cash Price	$342.06
Rate for Payer: Cofinity Commercial	$299.31
Rate for Payer: Cofinity Commercial	$367.72
Rate for Payer: Cofinity Medicare Advantage	$299.31
Rate for Payer: Encore Health Key Benefits Commercial	$342.06
Rate for Payer: Healthscope Commercial	$384.82
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$363.44
Rate for Payer: PHP Commercial	$363.44
Rate for Payer: Priority Health Cigna Priority Health	$277.93
Rate for Payer: Priority Health SBD	$269.38
Rate for Payer: UHC All Payor (Choice/PPO)	$131.80
Rate for Payer: UHC Core	$878.00
Rate for Payer: UHC Exchange	$940.00

HC ACCESS VEIN

Facility

$388.71

Service Code	CPT 36000
Hospital Charge Code	36100093
Hospital Revenue Code	361
Min. Negotiated Rate	$244.89
Max. Negotiated Rate	$349.84
Rate for Payer: Aetna Commercial	$330.40
Rate for Payer: Aetna New Business (MI Preferred)	$252.66
Rate for Payer: Cash Price	$310.97
Rate for Payer: Cofinity Commercial	$272.10
Rate for Payer: Cofinity Commercial	$334.29
Rate for Payer: Cofinity Medicare Advantage	$272.10
Rate for Payer: Encore Health Key Benefits Commercial	$310.97
Rate for Payer: Healthscope Commercial	$349.84
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$330.40
Rate for Payer: PHP Commercial	$330.40
Rate for Payer: Priority Health Cigna Priority Health	$252.66
Rate for Payer: Priority Health SBD	$244.89

HC ACCESS VEIN

Facility

$388.71

Service Code	CPT 36000
Hospital Charge Code	36100093
Hospital Revenue Code	361
Min. Negotiated Rate	$82.66
Max. Negotiated Rate	$940.00
Rate for Payer: Aetna Commercial	$330.40
Rate for Payer: Aetna Medicare	$194.36
Rate for Payer: Aetna New Business (MI Preferred)	$252.66
Rate for Payer: BCBS Complete	$155.48
Rate for Payer: BCBS Trust/PPO	$82.66
Rate for Payer: BCN Commercial	$82.66
Rate for Payer: Cash Price	$310.97
Rate for Payer: Cash Price	$310.97
Rate for Payer: Cash Price	$310.97
Rate for Payer: Cofinity Commercial	$272.10
Rate for Payer: Cofinity Commercial	$334.29
Rate for Payer: Cofinity Medicare Advantage	$272.10
Rate for Payer: Encore Health Key Benefits Commercial	$310.97
Rate for Payer: Healthscope Commercial	$349.84
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$330.40
Rate for Payer: PHP Commercial	$330.40
Rate for Payer: Priority Health Cigna Priority Health	$252.66
Rate for Payer: Priority Health SBD	$244.89
Rate for Payer: UHC Core	$878.00
Rate for Payer: UHC Exchange	$940.00

HC ACCESS VEIN ORGAN BLOOD SAMPLING

Facility

$1,069.35

Service Code	CPT 36500
Hospital Charge Code	36100118
Hospital Revenue Code	361
Min. Negotiated Rate	$673.69
Max. Negotiated Rate	$962.42
Rate for Payer: Aetna Commercial	$908.95
Rate for Payer: Aetna New Business (MI Preferred)	$695.08
Rate for Payer: Cash Price	$855.48
Rate for Payer: Cofinity Commercial	$748.54
Rate for Payer: Cofinity Commercial	$919.64
Rate for Payer: Cofinity Medicare Advantage	$748.54
Rate for Payer: Encore Health Key Benefits Commercial	$855.48
Rate for Payer: Healthscope Commercial	$962.42
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$908.95
Rate for Payer: PHP Commercial	$908.95
Rate for Payer: Priority Health Cigna Priority Health	$695.08
Rate for Payer: Priority Health SBD	$673.69

HC ACCESS VEIN ORGAN BLOOD SAMPLING

Facility

$1,069.35

Service Code	CPT 36500
Hospital Charge Code	36100118
Hospital Revenue Code	361
Min. Negotiated Rate	$192.47
Max. Negotiated Rate	$1,119.36
Rate for Payer: Aetna Commercial	$908.95
Rate for Payer: Aetna Medicare	$534.68
Rate for Payer: Aetna New Business (MI Preferred)	$695.08
Rate for Payer: BCBS Complete	$427.74
Rate for Payer: BCBS Trust/PPO	$1,119.36
Rate for Payer: BCN Commercial	$1,119.36
Rate for Payer: Cash Price	$855.48
Rate for Payer: Cash Price	$855.48
Rate for Payer: Cash Price	$855.48
Rate for Payer: Cofinity Commercial	$748.54
Rate for Payer: Cofinity Commercial	$919.64
Rate for Payer: Cofinity Medicare Advantage	$748.54
Rate for Payer: Encore Health Key Benefits Commercial	$855.48
Rate for Payer: Healthscope Commercial	$962.42
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$908.95
Rate for Payer: PHP Commercial	$908.95
Rate for Payer: Priority Health Cigna Priority Health	$695.08
Rate for Payer: Priority Health SBD	$673.69
Rate for Payer: UHC All Payor (Choice/PPO)	$192.47
Rate for Payer: UHC Core	$878.00
Rate for Payer: UHC Exchange	$940.00

HC ACCESS VENA CAVA

Facility

$3,128.58

Service Code	CPT 36010
Hospital Charge Code	36100096
Hospital Revenue Code	361
Min. Negotiated Rate	$114.78
Max. Negotiated Rate	$2,815.72
Rate for Payer: Aetna Commercial	$2,659.29
Rate for Payer: Aetna Medicare	$1,564.29
Rate for Payer: Aetna New Business (MI Preferred)	$2,033.58
Rate for Payer: BCBS Complete	$1,251.43
Rate for Payer: BCBS Trust/PPO	$994.14
Rate for Payer: BCN Commercial	$994.14
Rate for Payer: Cash Price	$2,502.86
Rate for Payer: Cash Price	$2,502.86
Rate for Payer: Cash Price	$2,502.86
Rate for Payer: Cofinity Commercial	$2,190.01
Rate for Payer: Cofinity Commercial	$2,690.58
Rate for Payer: Cofinity Medicare Advantage	$2,190.01
Rate for Payer: Encore Health Key Benefits Commercial	$2,502.86
Rate for Payer: Healthscope Commercial	$2,815.72
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2,659.29
Rate for Payer: PHP Commercial	$2,659.29
Rate for Payer: Priority Health Cigna Priority Health	$2,033.58
Rate for Payer: Priority Health SBD	$1,971.01
Rate for Payer: UHC All Payor (Choice/PPO)	$114.78
Rate for Payer: UHC Core	$878.00
Rate for Payer: UHC Exchange	$940.00

HC ACCESS VENA CAVA

Facility

$3,128.58

Service Code	CPT 36010
Hospital Charge Code	36100096
Hospital Revenue Code	361
Min. Negotiated Rate	$1,971.01
Max. Negotiated Rate	$2,815.72
Rate for Payer: Aetna Commercial	$2,659.29
Rate for Payer: Aetna New Business (MI Preferred)	$2,033.58
Rate for Payer: Cash Price	$2,502.86
Rate for Payer: Cofinity Commercial	$2,190.01
Rate for Payer: Cofinity Commercial	$2,690.58
Rate for Payer: Cofinity Medicare Advantage	$2,190.01
Rate for Payer: Encore Health Key Benefits Commercial	$2,502.86
Rate for Payer: Healthscope Commercial	$2,815.72
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2,659.29
Rate for Payer: PHP Commercial	$2,659.29
Rate for Payer: Priority Health Cigna Priority Health	$2,033.58
Rate for Payer: Priority Health SBD	$1,971.01

HC ACCESS WINDOW

Facility

$38.93

Hospital Charge Code	27000624
Hospital Revenue Code	270
Min. Negotiated Rate	$24.53
Max. Negotiated Rate	$35.04
Rate for Payer: Aetna Commercial	$33.09
Rate for Payer: Aetna New Business (MI Preferred)	$25.30
Rate for Payer: Cash Price	$31.14
Rate for Payer: Cofinity Commercial	$27.25
Rate for Payer: Cofinity Commercial	$33.48
Rate for Payer: Cofinity Medicare Advantage	$27.25
Rate for Payer: Encore Health Key Benefits Commercial	$31.14
Rate for Payer: Healthscope Commercial	$35.04
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$33.09
Rate for Payer: PHP Commercial	$33.09
Rate for Payer: Priority Health Cigna Priority Health	$25.30
Rate for Payer: Priority Health SBD	$24.53

HC ACCESS WINDOW

Facility

$38.93

Hospital Charge Code	27000624
Hospital Revenue Code	270
Min. Negotiated Rate	$15.57
Max. Negotiated Rate	$35.04
Rate for Payer: Aetna Commercial	$33.09
Rate for Payer: Aetna Medicare	$19.46
Rate for Payer: Aetna New Business (MI Preferred)	$25.30
Rate for Payer: BCBS Complete	$15.57
Rate for Payer: Cash Price	$31.14
Rate for Payer: Cofinity Commercial	$27.25
Rate for Payer: Cofinity Commercial	$33.48
Rate for Payer: Cofinity Medicare Advantage	$27.25
Rate for Payer: Encore Health Key Benefits Commercial	$31.14
Rate for Payer: Healthscope Commercial	$35.04
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$33.09
Rate for Payer: PHP Commercial	$33.09
Rate for Payer: Priority Health Cigna Priority Health	$25.30
Rate for Payer: Priority Health SBD	$24.53

HC ACCUNET EMBOLIC PROTECTION

Facility

$4,011.59

Hospital Charge Code	27200110
Hospital Revenue Code	272
Min. Negotiated Rate	$2,527.30
Max. Negotiated Rate	$3,610.43
Rate for Payer: Aetna Commercial	$3,409.85
Rate for Payer: Aetna New Business (MI Preferred)	$2,607.53
Rate for Payer: Cash Price	$3,209.27
Rate for Payer: Cofinity Commercial	$2,808.11
Rate for Payer: Cofinity Commercial	$3,449.97
Rate for Payer: Cofinity Medicare Advantage	$2,808.11
Rate for Payer: Encore Health Key Benefits Commercial	$3,209.27
Rate for Payer: Healthscope Commercial	$3,610.43
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3,409.85
Rate for Payer: PHP Commercial	$3,409.85
Rate for Payer: Priority Health Cigna Priority Health	$2,607.53
Rate for Payer: Priority Health SBD	$2,527.30

HC ACCUNET EMBOLIC PROTECTION

Facility

$4,011.59

Hospital Charge Code	27200110
Hospital Revenue Code	272
Min. Negotiated Rate	$1,604.64
Max. Negotiated Rate	$3,610.43
Rate for Payer: Aetna Commercial	$3,409.85
Rate for Payer: Aetna Medicare	$2,005.80
Rate for Payer: Aetna New Business (MI Preferred)	$2,607.53
Rate for Payer: BCBS Complete	$1,604.64
Rate for Payer: Cash Price	$3,209.27
Rate for Payer: Cofinity Commercial	$2,808.11
Rate for Payer: Cofinity Commercial	$3,449.97
Rate for Payer: Cofinity Medicare Advantage	$2,808.11
Rate for Payer: Encore Health Key Benefits Commercial	$3,209.27
Rate for Payer: Healthscope Commercial	$3,610.43
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3,409.85
Rate for Payer: PHP Commercial	$3,409.85
Rate for Payer: Priority Health Cigna Priority Health	$2,607.53
Rate for Payer: Priority Health SBD	$2,527.30

HC ACETAMINOPHEN LVL.

Facility

$129.11

Service Code	CPT 80307
Hospital Charge Code	30100648
Hospital Revenue Code	301
Min. Negotiated Rate	$33.31
Max. Negotiated Rate	$116.20
Rate for Payer: Aetna Commercial	$109.74
Rate for Payer: Aetna Medicare	$64.63
Rate for Payer: Aetna New Business (MI Preferred)	$83.92
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	$34.97
Rate for Payer: BCBS MAPPO	$62.14
Rate for Payer: BCBS Trust/PPO	$55.01
Rate for Payer: BCN Commercial	$55.01
Rate for Payer: BCN Medicare Advantage	$62.14
Rate for Payer: Cash Price	$103.29
Rate for Payer: Cash Price	$103.29
Rate for Payer: Cofinity Commercial	$90.38
Rate for Payer: Cofinity Commercial	$111.03
Rate for Payer: Cofinity Medicare Advantage	$90.38
Rate for Payer: Encore Health Key Benefits Commercial	$103.29
Rate for Payer: Health Alliance Plan Medicare Advantage	$62.14
Rate for Payer: Healthscope Commercial	$116.20
Rate for Payer: Mclaren Medicaid	$33.31
Rate for Payer: Mclaren Medicare	$62.14
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$65.25
Rate for Payer: Meridian Medicaid	$34.97
Rate for Payer: MI Amish Medical Board Commercial	$71.46
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$109.74
Rate for Payer: Nomi Health Commercial	$93.21
Rate for Payer: PACE Medicare	$59.03
Rate for Payer: PACE SWMI	$62.14
Rate for Payer: PHP Commercial	$109.74
Rate for Payer: PHP Medicare Advantage	$62.14
Rate for Payer: Priority Health Choice Medicaid	$33.31
Rate for Payer: Priority Health Cigna Priority Health	$83.92
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$62.14
Rate for Payer: Priority Health Medicare	$62.14
Rate for Payer: Priority Health Narrow Network	$49.71
Rate for Payer: Priority Health SBD	$81.34
Rate for Payer: Railroad Medicare Medicare	$62.14
Rate for Payer: UHC All Payor (Choice/PPO)	$74.57
Rate for Payer: UHC Dual Complete DSNP	$62.14
Rate for Payer: UHC Medicare Advantage	$62.14
Rate for Payer: UHCCP Medicaid	$34.98
Rate for Payer: VA VA	$62.14

HC ACETAMINOPHEN LVL.

Facility

$129.11

Service Code	CPT 80307
Hospital Charge Code	30100648
Hospital Revenue Code	301
Min. Negotiated Rate	$81.34
Max. Negotiated Rate	$116.20
Rate for Payer: Aetna Commercial	$109.74
Rate for Payer: Aetna New Business (MI Preferred)	$83.92
Rate for Payer: Cash Price	$103.29
Rate for Payer: Cofinity Commercial	$111.03
Rate for Payer: Cofinity Commercial	$90.38
Rate for Payer: Cofinity Medicare Advantage	$90.38
Rate for Payer: Encore Health Key Benefits Commercial	$103.29
Rate for Payer: Healthscope Commercial	$116.20
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$109.74
Rate for Payer: PHP Commercial	$109.74
Rate for Payer: Priority Health Cigna Priority Health	$83.92
Rate for Payer: Priority Health SBD	$81.34

HC ACETOMINOPHEN THERAPEUTIC DRUG ASSAY

Facility

$41.62

Service Code	CPT 80143
Hospital Charge Code	30100729
Hospital Revenue Code	301
Min. Negotiated Rate	$26.22
Max. Negotiated Rate	$37.46
Rate for Payer: Aetna Commercial	$35.38
Rate for Payer: Aetna New Business (MI Preferred)	$27.05
Rate for Payer: Cash Price	$33.30
Rate for Payer: Cofinity Commercial	$29.13
Rate for Payer: Cofinity Commercial	$35.79
Rate for Payer: Cofinity Medicare Advantage	$29.13
Rate for Payer: Encore Health Key Benefits Commercial	$33.30
Rate for Payer: Healthscope Commercial	$37.46
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$35.38
Rate for Payer: PHP Commercial	$35.38
Rate for Payer: Priority Health Cigna Priority Health	$27.05
Rate for Payer: Priority Health SBD	$26.22

HC ACETOMINOPHEN THERAPEUTIC DRUG ASSAY

Facility

$41.62

Service Code	CPT 80143
Hospital Charge Code	30100729
Hospital Revenue Code	301
Min. Negotiated Rate	$9.99
Max. Negotiated Rate	$37.46
Rate for Payer: Aetna Commercial	$35.38
Rate for Payer: Aetna Medicare	$19.39
Rate for Payer: Aetna New Business (MI Preferred)	$27.05
Rate for Payer: Allen County Amish Medical Aid Commercial	$23.30
Rate for Payer: Amish Plain Church Group Commercial	$23.30
Rate for Payer: BCBS Complete	$10.49
Rate for Payer: BCBS MAPPO	$18.64
Rate for Payer: BCBS Trust/PPO	$16.50
Rate for Payer: BCN Commercial	$16.50
Rate for Payer: BCN Medicare Advantage	$18.64
Rate for Payer: Cash Price	$33.30
Rate for Payer: Cash Price	$33.30
Rate for Payer: Cofinity Commercial	$35.79
Rate for Payer: Cofinity Commercial	$29.13
Rate for Payer: Cofinity Medicare Advantage	$29.13
Rate for Payer: Encore Health Key Benefits Commercial	$33.30
Rate for Payer: Health Alliance Plan Medicare Advantage	$18.64
Rate for Payer: Healthscope Commercial	$37.46
Rate for Payer: Mclaren Medicaid	$9.99
Rate for Payer: Mclaren Medicare	$18.64
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$19.57
Rate for Payer: Meridian Medicaid	$10.49
Rate for Payer: MI Amish Medical Board Commercial	$21.44
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$35.38
Rate for Payer: Nomi Health Commercial	$27.96
Rate for Payer: PACE Medicare	$17.71
Rate for Payer: PACE SWMI	$18.64
Rate for Payer: PHP Commercial	$35.38
Rate for Payer: PHP Medicare Advantage	$18.64
Rate for Payer: Priority Health Choice Medicaid	$9.99
Rate for Payer: Priority Health Cigna Priority Health	$27.05
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$18.64
Rate for Payer: Priority Health Medicare	$18.64
Rate for Payer: Priority Health Narrow Network	$14.91
Rate for Payer: Priority Health SBD	$26.22
Rate for Payer: Railroad Medicare Medicare	$18.64
Rate for Payer: UHC All Payor (Choice/PPO)	$22.37
Rate for Payer: UHC Dual Complete DSNP	$18.64
Rate for Payer: UHC Medicare Advantage	$18.64
Rate for Payer: UHCCP Medicaid	$10.49
Rate for Payer: VA VA	$18.64

HC ACETYLCHOLINE RECEPTOR AB

Facility

$76.99

Service Code	CPT 86041
Hospital Charge Code	30100254
Hospital Revenue Code	300
Min. Negotiated Rate	$9.86
Max. Negotiated Rate	$69.29
Rate for Payer: Aetna Commercial	$65.44
Rate for Payer: Aetna Medicare	$19.14
Rate for Payer: Aetna New Business (MI Preferred)	$50.04
Rate for Payer: Allen County Amish Medical Aid Commercial	$23.00
Rate for Payer: Amish Plain Church Group Commercial	$23.00
Rate for Payer: BCBS Complete	$10.36
Rate for Payer: BCBS MAPPO	$18.40
Rate for Payer: BCBS Trust/PPO	$16.29
Rate for Payer: BCN Commercial	$16.29
Rate for Payer: BCN Medicare Advantage	$18.40
Rate for Payer: Cash Price	$61.59
Rate for Payer: Cash Price	$61.59
Rate for Payer: Cofinity Commercial	$66.21
Rate for Payer: Cofinity Commercial	$53.89
Rate for Payer: Cofinity Medicare Advantage	$53.89
Rate for Payer: Encore Health Key Benefits Commercial	$61.59
Rate for Payer: Health Alliance Plan Medicare Advantage	$18.40
Rate for Payer: Healthscope Commercial	$69.29
Rate for Payer: Mclaren Medicaid	$9.86
Rate for Payer: Mclaren Medicare	$18.40
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$19.32
Rate for Payer: Meridian Medicaid	$10.36
Rate for Payer: MI Amish Medical Board Commercial	$21.16
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$65.44
Rate for Payer: Nomi Health Commercial	$27.60
Rate for Payer: PACE Medicare	$17.48
Rate for Payer: PACE SWMI	$18.40
Rate for Payer: PHP Commercial	$65.44
Rate for Payer: PHP Medicare Advantage	$18.40
Rate for Payer: Priority Health Choice Medicaid	$9.86
Rate for Payer: Priority Health Cigna Priority Health	$50.04
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$18.40
Rate for Payer: Priority Health Medicare	$18.40
Rate for Payer: Priority Health Narrow Network	$14.72
Rate for Payer: Priority Health SBD	$48.50
Rate for Payer: Railroad Medicare Medicare	$18.40
Rate for Payer: UHC All Payor (Choice/PPO)	$22.08
Rate for Payer: UHC Dual Complete DSNP	$18.40
Rate for Payer: UHC Medicare Advantage	$18.40
Rate for Payer: UHCCP Medicaid	$10.36
Rate for Payer: VA VA	$18.40

HC ACETYLCHOLINE RECEPTOR AB

Facility

$76.99

Service Code	CPT 86041
Hospital Charge Code	30100254
Hospital Revenue Code	300
Min. Negotiated Rate	$48.50
Max. Negotiated Rate	$69.29
Rate for Payer: Aetna Commercial	$65.44
Rate for Payer: Aetna New Business (MI Preferred)	$50.04
Rate for Payer: Cash Price	$61.59
Rate for Payer: Cofinity Commercial	$53.89
Rate for Payer: Cofinity Commercial	$66.21
Rate for Payer: Cofinity Medicare Advantage	$53.89
Rate for Payer: Encore Health Key Benefits Commercial	$61.59
Rate for Payer: Healthscope Commercial	$69.29
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$65.44
Rate for Payer: PHP Commercial	$65.44
Rate for Payer: Priority Health Cigna Priority Health	$50.04
Rate for Payer: Priority Health SBD	$48.50

Know your out-of-pocket cost for care.

All Charges