Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC DSMA TC 99M PER STUDY

Facility

$381.09

Service Code	HCPCS A9551
Hospital Charge Code	34300004
Hospital Revenue Code	343
Min. Negotiated Rate	$152.44
Max. Negotiated Rate	$342.98
Rate for Payer: Aetna Commercial	$323.93
Rate for Payer: Aetna New Business (MI Preferred)	$247.71
Rate for Payer: BCBS Complete	$152.44
Rate for Payer: BCBS Trust/PPO	$163.39
Rate for Payer: Cash Price	$304.87
Rate for Payer: Cash Price	$304.87
Rate for Payer: Cofinity Commercial	$327.74
Rate for Payer: Cofinity Commercial	$266.76
Rate for Payer: Healthscope Commercial	$342.98
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$323.93
Rate for Payer: PHP Commercial	$323.93
Rate for Payer: Priority Health Cigna Priority Health	$266.76
Rate for Payer: Priority Health SBD	$240.09

HC DTAP HEPB IPV VACCINE INTRAMUSCULAR

Facility

$172.74

Service Code	CPT 90723
Hospital Charge Code	63600137
Hospital Revenue Code	636
Min. Negotiated Rate	$69.10
Max. Negotiated Rate	$261.28
Rate for Payer: Aetna Commercial	$146.83
Rate for Payer: Aetna New Business (MI Preferred)	$112.28
Rate for Payer: BCBS Complete	$69.10
Rate for Payer: BCBS Trust/PPO	$261.28
Rate for Payer: Cash Price	$138.19
Rate for Payer: Cash Price	$138.19
Rate for Payer: Cofinity Commercial	$148.56
Rate for Payer: Cofinity Commercial	$120.92
Rate for Payer: Healthscope Commercial	$155.47
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$146.83
Rate for Payer: PHP Commercial	$146.83
Rate for Payer: Priority Health Cigna Priority Health	$120.92
Rate for Payer: Priority Health SBD	$108.83

HC DTAP HEPB IPV VACCINE INTRAMUSCULAR

Facility

$172.74

Service Code	CPT 90723
Hospital Charge Code	63600137
Hospital Revenue Code	636
Min. Negotiated Rate	$108.83
Max. Negotiated Rate	$155.47
Rate for Payer: Aetna Commercial	$146.83
Rate for Payer: Aetna New Business (MI Preferred)	$112.28
Rate for Payer: Cash Price	$138.19
Rate for Payer: Cofinity Commercial	$120.92
Rate for Payer: Cofinity Commercial	$148.56
Rate for Payer: Healthscope Commercial	$155.47
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$146.83
Rate for Payer: PHP Commercial	$146.83
Rate for Payer: Priority Health Cigna Priority Health	$120.92
Rate for Payer: Priority Health SBD	$108.83

HC DTAP-IPV VACCINE 4-6 YEARS IM

Facility

$75.17

Service Code	CPT 90696
Hospital Charge Code	63600120
Hospital Revenue Code	636
Min. Negotiated Rate	$30.07
Max. Negotiated Rate	$174.08
Rate for Payer: Aetna Commercial	$63.89
Rate for Payer: Aetna New Business (MI Preferred)	$48.86
Rate for Payer: BCBS Complete	$30.07
Rate for Payer: BCBS Trust/PPO	$174.08
Rate for Payer: Cash Price	$60.14
Rate for Payer: Cash Price	$60.14
Rate for Payer: Cofinity Commercial	$64.65
Rate for Payer: Cofinity Commercial	$52.62
Rate for Payer: Healthscope Commercial	$67.65
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$63.89
Rate for Payer: PHP Commercial	$63.89
Rate for Payer: Priority Health Cigna Priority Health	$52.62
Rate for Payer: Priority Health SBD	$47.36

HC DTAP-IPV VACCINE 4-6 YEARS IM

Facility

$75.17

Service Code	CPT 90696
Hospital Charge Code	63600120
Hospital Revenue Code	636
Min. Negotiated Rate	$47.36
Max. Negotiated Rate	$67.65
Rate for Payer: Aetna Commercial	$63.89
Rate for Payer: Aetna New Business (MI Preferred)	$48.86
Rate for Payer: Cash Price	$60.14
Rate for Payer: Cofinity Commercial	$52.62
Rate for Payer: Cofinity Commercial	$64.65
Rate for Payer: Healthscope Commercial	$67.65
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$63.89
Rate for Payer: PHP Commercial	$63.89
Rate for Payer: Priority Health Cigna Priority Health	$52.62
Rate for Payer: Priority Health SBD	$47.36

HC DTAP-IVP-HIB-HEPB INTRAMUSCULAR

Facility

$163.20

Service Code	CPT 90697
Hospital Charge Code	63600207
Hospital Revenue Code	636
Min. Negotiated Rate	$102.82
Max. Negotiated Rate	$146.88
Rate for Payer: Aetna Commercial	$138.72
Rate for Payer: Aetna New Business (MI Preferred)	$106.08
Rate for Payer: Cash Price	$130.56
Rate for Payer: Cofinity Commercial	$114.24
Rate for Payer: Cofinity Commercial	$140.35
Rate for Payer: Healthscope Commercial	$146.88
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$138.72
Rate for Payer: PHP Commercial	$138.72
Rate for Payer: Priority Health Cigna Priority Health	$114.24
Rate for Payer: Priority Health SBD	$102.82

HC DTAP-IVP-HIB-HEPB INTRAMUSCULAR

Facility

$163.20

Service Code	CPT 90697
Hospital Charge Code	63600207
Hospital Revenue Code	636
Min. Negotiated Rate	$65.28
Max. Negotiated Rate	$508.53
Rate for Payer: Aetna Commercial	$138.72
Rate for Payer: Aetna New Business (MI Preferred)	$106.08
Rate for Payer: BCBS Complete	$65.28
Rate for Payer: BCBS Trust/PPO	$508.53
Rate for Payer: Cash Price	$130.56
Rate for Payer: Cash Price	$130.56
Rate for Payer: Cofinity Commercial	$114.24
Rate for Payer: Cofinity Commercial	$140.35
Rate for Payer: Healthscope Commercial	$146.88
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$138.72
Rate for Payer: PHP Commercial	$138.72
Rate for Payer: Priority Health Cigna Priority Health	$114.24
Rate for Payer: Priority Health SBD	$102.82

HC DTPA PER STUDY

Facility

$166.83

Service Code	HCPCS A9539
Hospital Charge Code	34300005
Hospital Revenue Code	343
Min. Negotiated Rate	$59.80
Max. Negotiated Rate	$150.15
Rate for Payer: Aetna Commercial	$141.81
Rate for Payer: Aetna New Business (MI Preferred)	$108.44
Rate for Payer: BCBS Complete	$66.73
Rate for Payer: BCBS Trust/PPO	$59.80
Rate for Payer: Cash Price	$133.46
Rate for Payer: Cash Price	$133.46
Rate for Payer: Cofinity Commercial	$116.78
Rate for Payer: Cofinity Commercial	$143.47
Rate for Payer: Healthscope Commercial	$150.15
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$141.81
Rate for Payer: PHP Commercial	$141.81
Rate for Payer: Priority Health Cigna Priority Health	$116.78
Rate for Payer: Priority Health SBD	$105.10

HC DTPA PER STUDY

Facility

$166.83

Service Code	HCPCS A9539
Hospital Charge Code	34300005
Hospital Revenue Code	343
Min. Negotiated Rate	$105.10
Max. Negotiated Rate	$150.15
Rate for Payer: Aetna Commercial	$141.81
Rate for Payer: Aetna New Business (MI Preferred)	$108.44
Rate for Payer: Cash Price	$133.46
Rate for Payer: Cofinity Commercial	$116.78
Rate for Payer: Cofinity Commercial	$143.47
Rate for Payer: Healthscope Commercial	$150.15
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$141.81
Rate for Payer: PHP Commercial	$141.81
Rate for Payer: Priority Health Cigna Priority Health	$116.78
Rate for Payer: Priority Health SBD	$105.10

HC DUAL LEAD INSERTION

Facility

$12,461.13

Service Code	CPT 33217
Hospital Charge Code	36100066
Hospital Revenue Code	361
Min. Negotiated Rate	$7,850.51
Max. Negotiated Rate	$11,215.02
Rate for Payer: Aetna Commercial	$10,591.96
Rate for Payer: Aetna New Business (MI Preferred)	$8,099.73
Rate for Payer: Cash Price	$9,968.90
Rate for Payer: Cofinity Commercial	$10,716.57
Rate for Payer: Cofinity Commercial	$8,722.79
Rate for Payer: Healthscope Commercial	$11,215.02
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$10,591.96
Rate for Payer: PHP Commercial	$10,591.96
Rate for Payer: Priority Health Cigna Priority Health	$8,722.79
Rate for Payer: Priority Health SBD	$7,850.51

HC DUAL LEAD INSERTION

Facility

$12,461.13

Service Code	CPT 33217
Hospital Charge Code	36100066
Hospital Revenue Code	361
Min. Negotiated Rate	$356.91
Max. Negotiated Rate	$25,402.85
Rate for Payer: Aetna Commercial	$10,591.96
Rate for Payer: Aetna Medicare	$7,861.77
Rate for Payer: Aetna New Business (MI Preferred)	$8,099.73
Rate for Payer: Allen County Amish Medical Aid Commercial	$9,449.24
Rate for Payer: Amish Plain Church Group Commercial	$9,449.24
Rate for Payer: BCBS Complete	$4,342.11
Rate for Payer: BCBS MAPPO	$7,559.39
Rate for Payer: BCBS Trust/PPO	$4,741.70
Rate for Payer: BCN Medicare Advantage	$7,559.39
Rate for Payer: Cash Price	$9,968.90
Rate for Payer: Cash Price	$9,968.90
Rate for Payer: Cofinity Commercial	$8,722.79
Rate for Payer: Cofinity Commercial	$10,716.57
Rate for Payer: Health Alliance Plan Medicare Advantage	$7,559.39
Rate for Payer: Healthscope Commercial	$11,215.02
Rate for Payer: Mclaren Medicaid	$4,134.99
Rate for Payer: Mclaren Medicare	$7,559.39
Rate for Payer: Meridian Medicaid	$4,342.11
Rate for Payer: Meridian Wellcare - Medicare Advantage	$7,937.36
Rate for Payer: MI Amish Medical Board Commercial	$8,693.30
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$10,591.96
Rate for Payer: PACE Medicare	$7,181.42
Rate for Payer: PACE SWMI	$7,559.39
Rate for Payer: PHP Commercial	$10,591.96
Rate for Payer: PHP Medicare Advantage	$7,559.39
Rate for Payer: Priority Health Choice Medicaid	$4,134.99
Rate for Payer: Priority Health Cigna Priority Health	$8,722.79
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$25,402.85
Rate for Payer: Priority Health Medicare	$7,559.39
Rate for Payer: Priority Health Narrow Network	$20,322.28
Rate for Payer: Priority Health SBD	$7,850.51
Rate for Payer: Railroad Medicare Medicare	$7,559.39
Rate for Payer: UHC All Payor (Choice/PPO)	$392.60
Rate for Payer: UHC Core	$7,632.00
Rate for Payer: UHC Dual Complete DSNP	$7,559.39
Rate for Payer: UHC Exchange	$356.91
Rate for Payer: UHC Medicare Advantage	$7,786.17
Rate for Payer: VA VA	$7,559.39

HC DUCK FEATHERS IGE

Facility

$24.89

Service Code	CPT 86003
Hospital Charge Code	30200083
Hospital Revenue Code	302
Min. Negotiated Rate	$2.86
Max. Negotiated Rate	$22.40
Rate for Payer: Aetna Commercial	$21.16
Rate for Payer: Aetna Medicare	$5.43
Rate for Payer: Aetna New Business (MI Preferred)	$16.18
Rate for Payer: Allen County Amish Medical Aid Commercial	$6.52
Rate for Payer: Amish Plain Church Group Commercial	$6.52
Rate for Payer: BCBS Complete	$3.00
Rate for Payer: BCBS MAPPO	$5.22
Rate for Payer: BCBS Trust/PPO	$4.09
Rate for Payer: BCN Medicare Advantage	$5.22
Rate for Payer: Cash Price	$19.91
Rate for Payer: Cash Price	$19.91
Rate for Payer: Cofinity Commercial	$21.41
Rate for Payer: Cofinity Commercial	$17.42
Rate for Payer: Health Alliance Plan Medicare Advantage	$5.22
Rate for Payer: Healthscope Commercial	$22.40
Rate for Payer: Mclaren Medicaid	$2.86
Rate for Payer: Mclaren Medicare	$5.22
Rate for Payer: Meridian Medicaid	$3.00
Rate for Payer: Meridian Wellcare - Medicare Advantage	$5.48
Rate for Payer: MI Amish Medical Board Commercial	$6.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$21.16
Rate for Payer: PACE Medicare	$4.96
Rate for Payer: PACE SWMI	$5.22
Rate for Payer: PHP Commercial	$21.16
Rate for Payer: PHP Medicare Advantage	$5.22
Rate for Payer: Priority Health Choice Medicaid	$2.86
Rate for Payer: Priority Health Cigna Priority Health	$17.42
Rate for Payer: Priority Health Medicare	$5.22
Rate for Payer: Priority Health SBD	$15.68
Rate for Payer: Railroad Medicare Medicare	$5.22
Rate for Payer: UHC All Payor (Choice/PPO)	$6.26
Rate for Payer: UHC Core	$8.87
Rate for Payer: UHC Dual Complete DSNP	$5.22
Rate for Payer: UHC Exchange	$5.22
Rate for Payer: UHC Medicare Advantage	$5.38
Rate for Payer: VA VA	$5.22

HC DUCK FEATHERS IGE

Facility

$24.89

Service Code	CPT 86003
Hospital Charge Code	30200083
Hospital Revenue Code	302
Min. Negotiated Rate	$15.68
Max. Negotiated Rate	$22.40
Rate for Payer: Aetna Commercial	$21.16
Rate for Payer: Aetna New Business (MI Preferred)	$16.18
Rate for Payer: Cash Price	$19.91
Rate for Payer: Cofinity Commercial	$21.41
Rate for Payer: Cofinity Commercial	$17.42
Rate for Payer: Healthscope Commercial	$22.40
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$21.16
Rate for Payer: PHP Commercial	$21.16
Rate for Payer: Priority Health Cigna Priority Health	$17.42
Rate for Payer: Priority Health SBD	$15.68

HC DUODENOSCOPY/COLONOSCOPY

Facility

$4,313.50

Hospital Charge Code	36000033
Hospital Revenue Code	360
Min. Negotiated Rate	$2,717.50
Max. Negotiated Rate	$3,882.15
Rate for Payer: Aetna Commercial	$3,666.48
Rate for Payer: Aetna New Business (MI Preferred)	$2,803.78
Rate for Payer: Cash Price	$3,450.80
Rate for Payer: Cofinity Commercial	$3,709.61
Rate for Payer: Cofinity Commercial	$3,019.45
Rate for Payer: Healthscope Commercial	$3,882.15
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3,666.48
Rate for Payer: PHP Commercial	$3,666.48
Rate for Payer: Priority Health Cigna Priority Health	$3,019.45
Rate for Payer: Priority Health SBD	$2,717.50

HC DUODENOSCOPY/COLONOSCOPY

Facility

$4,313.50

Hospital Charge Code	36000033
Hospital Revenue Code	360
Min. Negotiated Rate	$1,725.40
Max. Negotiated Rate	$3,882.15
Rate for Payer: Aetna Commercial	$3,666.48
Rate for Payer: Aetna New Business (MI Preferred)	$2,803.78
Rate for Payer: BCBS Complete	$1,725.40
Rate for Payer: Cash Price	$3,450.80
Rate for Payer: Cofinity Commercial	$3,019.45
Rate for Payer: Cofinity Commercial	$3,709.61
Rate for Payer: Healthscope Commercial	$3,882.15
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3,666.48
Rate for Payer: PHP Commercial	$3,666.48
Rate for Payer: Priority Health Cigna Priority Health	$3,019.45
Rate for Payer: Priority Health SBD	$2,717.50

HC DUODENOSCOPY (EGD)

Facility

$2,150.57

Hospital Charge Code	36000029
Hospital Revenue Code	360
Min. Negotiated Rate	$1,354.86
Max. Negotiated Rate	$1,935.51
Rate for Payer: Aetna Commercial	$1,827.98
Rate for Payer: Aetna New Business (MI Preferred)	$1,397.87
Rate for Payer: Cash Price	$1,720.46
Rate for Payer: Cofinity Commercial	$1,505.40
Rate for Payer: Cofinity Commercial	$1,849.49
Rate for Payer: Healthscope Commercial	$1,935.51
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,827.98
Rate for Payer: PHP Commercial	$1,827.98
Rate for Payer: Priority Health Cigna Priority Health	$1,505.40
Rate for Payer: Priority Health SBD	$1,354.86

HC DUODENOSCOPY (EGD)

Facility

$2,150.57

Hospital Charge Code	36000029
Hospital Revenue Code	360
Min. Negotiated Rate	$860.23
Max. Negotiated Rate	$1,935.51
Rate for Payer: Aetna Commercial	$1,827.98
Rate for Payer: Aetna New Business (MI Preferred)	$1,397.87
Rate for Payer: BCBS Complete	$860.23
Rate for Payer: Cash Price	$1,720.46
Rate for Payer: Cofinity Commercial	$1,505.40
Rate for Payer: Cofinity Commercial	$1,849.49
Rate for Payer: Healthscope Commercial	$1,935.51
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,827.98
Rate for Payer: PHP Commercial	$1,827.98
Rate for Payer: Priority Health Cigna Priority Health	$1,505.40
Rate for Payer: Priority Health SBD	$1,354.86

HC DUODENUM/FLEX SIGMOID

Facility

$1,679.56

Hospital Charge Code	36000034
Hospital Revenue Code	360
Min. Negotiated Rate	$671.82
Max. Negotiated Rate	$1,511.60
Rate for Payer: Aetna Commercial	$1,427.63
Rate for Payer: Aetna New Business (MI Preferred)	$1,091.71
Rate for Payer: BCBS Complete	$671.82
Rate for Payer: Cash Price	$1,343.65
Rate for Payer: Cofinity Commercial	$1,175.69
Rate for Payer: Cofinity Commercial	$1,444.42
Rate for Payer: Healthscope Commercial	$1,511.60
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,427.63
Rate for Payer: PHP Commercial	$1,427.63
Rate for Payer: Priority Health Cigna Priority Health	$1,175.69
Rate for Payer: Priority Health SBD	$1,058.12

HC DUODENUM/FLEX SIGMOID

Facility

$1,679.56

Hospital Charge Code	36000034
Hospital Revenue Code	360
Min. Negotiated Rate	$1,058.12
Max. Negotiated Rate	$1,511.60
Rate for Payer: Aetna Commercial	$1,427.63
Rate for Payer: Aetna New Business (MI Preferred)	$1,091.71
Rate for Payer: Cash Price	$1,343.65
Rate for Payer: Cofinity Commercial	$1,175.69
Rate for Payer: Cofinity Commercial	$1,444.42
Rate for Payer: Healthscope Commercial	$1,511.60
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,427.63
Rate for Payer: PHP Commercial	$1,427.63
Rate for Payer: Priority Health Cigna Priority Health	$1,175.69
Rate for Payer: Priority Health SBD	$1,058.12

HC DUODERM CGF 4X4

Facility

$46.79

Hospital Charge Code	27100010
Hospital Revenue Code	271
Min. Negotiated Rate	$29.48
Max. Negotiated Rate	$42.11
Rate for Payer: Aetna Commercial	$39.77
Rate for Payer: Aetna New Business (MI Preferred)	$30.41
Rate for Payer: Cash Price	$37.43
Rate for Payer: Cofinity Commercial	$32.75
Rate for Payer: Cofinity Commercial	$40.24
Rate for Payer: Healthscope Commercial	$42.11
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$39.77
Rate for Payer: PHP Commercial	$39.77
Rate for Payer: Priority Health Cigna Priority Health	$32.75
Rate for Payer: Priority Health SBD	$29.48

HC DUODERM CGF 4X4

Facility

$46.79

Hospital Charge Code	27100010
Hospital Revenue Code	271
Min. Negotiated Rate	$18.72
Max. Negotiated Rate	$42.11
Rate for Payer: Aetna Commercial	$39.77
Rate for Payer: Aetna New Business (MI Preferred)	$30.41
Rate for Payer: BCBS Complete	$18.72
Rate for Payer: Cash Price	$37.43
Rate for Payer: Cofinity Commercial	$32.75
Rate for Payer: Cofinity Commercial	$40.24
Rate for Payer: Healthscope Commercial	$42.11
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$39.77
Rate for Payer: PHP Commercial	$39.77
Rate for Payer: Priority Health Cigna Priority Health	$32.75
Rate for Payer: Priority Health SBD	$29.48

HC DUODERM CGF 6X6

Facility

$74.12

Hospital Charge Code	27100011
Hospital Revenue Code	271
Min. Negotiated Rate	$46.70
Max. Negotiated Rate	$66.71
Rate for Payer: Aetna Commercial	$63.00
Rate for Payer: Aetna New Business (MI Preferred)	$48.18
Rate for Payer: Cash Price	$59.30
Rate for Payer: Cofinity Commercial	$51.88
Rate for Payer: Cofinity Commercial	$63.74
Rate for Payer: Healthscope Commercial	$66.71
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$63.00
Rate for Payer: PHP Commercial	$63.00
Rate for Payer: Priority Health Cigna Priority Health	$51.88
Rate for Payer: Priority Health SBD	$46.70

HC DUODERM CGF 6X6

Facility

$74.12

Hospital Charge Code	27100011
Hospital Revenue Code	271
Min. Negotiated Rate	$29.65
Max. Negotiated Rate	$66.71
Rate for Payer: Aetna Commercial	$63.00
Rate for Payer: Aetna New Business (MI Preferred)	$48.18
Rate for Payer: BCBS Complete	$29.65
Rate for Payer: Cash Price	$59.30
Rate for Payer: Cofinity Commercial	$51.88
Rate for Payer: Cofinity Commercial	$63.74
Rate for Payer: Healthscope Commercial	$66.71
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$63.00
Rate for Payer: PHP Commercial	$63.00
Rate for Payer: Priority Health Cigna Priority Health	$51.88
Rate for Payer: Priority Health SBD	$46.70

HC DUODERM CGF 8X8

Facility

$103.46

Hospital Charge Code	27100012
Hospital Revenue Code	271
Min. Negotiated Rate	$41.38
Max. Negotiated Rate	$93.11
Rate for Payer: Aetna Commercial	$87.94
Rate for Payer: Aetna New Business (MI Preferred)	$67.25
Rate for Payer: BCBS Complete	$41.38
Rate for Payer: Cash Price	$82.77
Rate for Payer: Cofinity Commercial	$72.42
Rate for Payer: Cofinity Commercial	$88.98
Rate for Payer: Healthscope Commercial	$93.11
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$87.94
Rate for Payer: PHP Commercial	$87.94
Rate for Payer: Priority Health Cigna Priority Health	$72.42
Rate for Payer: Priority Health SBD	$65.18

HC DUODERM CGF 8X8

Facility

$103.46

Hospital Charge Code	27100012
Hospital Revenue Code	271
Min. Negotiated Rate	$65.18
Max. Negotiated Rate	$93.11
Rate for Payer: Aetna Commercial	$87.94
Rate for Payer: Aetna New Business (MI Preferred)	$67.25
Rate for Payer: Cash Price	$82.77
Rate for Payer: Cofinity Commercial	$72.42
Rate for Payer: Cofinity Commercial	$88.98
Rate for Payer: Healthscope Commercial	$93.11
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$87.94
Rate for Payer: PHP Commercial	$87.94
Rate for Payer: Priority Health Cigna Priority Health	$72.42
Rate for Payer: Priority Health SBD	$65.18

Know your out-of-pocket cost for care.

All Charges