Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC ELECTROACOUSTIC HEARNG AID TEST BINAURAL

Facility

$77.00

Service Code	CPT 92595
Hospital Charge Code	76100494
Hospital Revenue Code	471
Min. Negotiated Rate	$30.80
Max. Negotiated Rate	$69.30
Rate for Payer: Aetna Commercial	$65.45
Rate for Payer: Aetna New Business (MI Preferred)	$50.05
Rate for Payer: BCBS Complete	$30.80
Rate for Payer: Cash Price	$61.60
Rate for Payer: Cofinity Commercial	$53.90
Rate for Payer: Cofinity Commercial	$66.22
Rate for Payer: Healthscope Commercial	$69.30
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$65.45
Rate for Payer: PHP Commercial	$65.45
Rate for Payer: Priority Health Cigna Priority Health	$53.90
Rate for Payer: Priority Health SBD	$48.51

HC ELECTROACOUSTIC HEARNG AID TEST BINAURAL

Facility

$77.00

Service Code	CPT 92595
Hospital Charge Code	76100494
Hospital Revenue Code	471
Min. Negotiated Rate	$48.51
Max. Negotiated Rate	$69.30
Rate for Payer: Aetna Commercial	$65.45
Rate for Payer: Aetna New Business (MI Preferred)	$50.05
Rate for Payer: Cash Price	$61.60
Rate for Payer: Cofinity Commercial	$53.90
Rate for Payer: Cofinity Commercial	$66.22
Rate for Payer: Healthscope Commercial	$69.30
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$65.45
Rate for Payer: PHP Commercial	$65.45
Rate for Payer: Priority Health Cigna Priority Health	$53.90
Rate for Payer: Priority Health SBD	$48.51

HC ELECTROACOUSTIC HEARNG AID TEST MONAURAL

Facility

$88.00

Service Code	CPT 92594
Hospital Charge Code	76100493
Hospital Revenue Code	471
Min. Negotiated Rate	$35.20
Max. Negotiated Rate	$79.20
Rate for Payer: Aetna Commercial	$74.80
Rate for Payer: Aetna New Business (MI Preferred)	$57.20
Rate for Payer: BCBS Complete	$35.20
Rate for Payer: Cash Price	$70.40
Rate for Payer: Cofinity Commercial	$61.60
Rate for Payer: Cofinity Commercial	$75.68
Rate for Payer: Healthscope Commercial	$79.20
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$74.80
Rate for Payer: PHP Commercial	$74.80
Rate for Payer: Priority Health Cigna Priority Health	$61.60
Rate for Payer: Priority Health SBD	$55.44

HC ELECTROACOUSTIC HEARNG AID TEST MONAURAL

Facility

$88.00

Service Code	CPT 92594
Hospital Charge Code	76100493
Hospital Revenue Code	471
Min. Negotiated Rate	$55.44
Max. Negotiated Rate	$79.20
Rate for Payer: Aetna Commercial	$74.80
Rate for Payer: Aetna New Business (MI Preferred)	$57.20
Rate for Payer: Cash Price	$70.40
Rate for Payer: Cofinity Commercial	$61.60
Rate for Payer: Cofinity Commercial	$75.68
Rate for Payer: Healthscope Commercial	$79.20
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$74.80
Rate for Payer: PHP Commercial	$74.80
Rate for Payer: Priority Health Cigna Priority Health	$61.60
Rate for Payer: Priority Health SBD	$55.44

HC ELECTROCARDIOGRAM

Facility

$213.14

Service Code	CPT 93005
Hospital Charge Code	73000001
Hospital Revenue Code	730
Min. Negotiated Rate	$6.22
Max. Negotiated Rate	$191.83
Rate for Payer: Aetna Commercial	$181.17
Rate for Payer: Aetna Medicare	$56.61
Rate for Payer: Aetna New Business (MI Preferred)	$138.54
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	$22.20
Rate for Payer: BCN Medicare Advantage	$54.43
Rate for Payer: Cash Price	$170.51
Rate for Payer: Cash Price	$170.51
Rate for Payer: Cofinity Commercial	$183.30
Rate for Payer: Cofinity Commercial	$149.20
Rate for Payer: Health Alliance Plan Medicare Advantage	$54.43
Rate for Payer: Healthscope Commercial	$191.83
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	$181.17
Rate for Payer: PACE Medicare	$51.71
Rate for Payer: PACE SWMI	$54.43
Rate for Payer: PHP Commercial	$181.17
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	$149.20
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	$134.28
Rate for Payer: Railroad Medicare Medicare	$54.43
Rate for Payer: UHC All Payor (Choice/PPO)	$6.84
Rate for Payer: UHC Dual Complete DSNP	$54.43
Rate for Payer: UHC Exchange	$6.22
Rate for Payer: UHC Medicare Advantage	$56.06
Rate for Payer: VA VA	$54.43

HC ELECTROCARDIOGRAM

Facility

$213.14

Service Code	CPT 93005
Hospital Charge Code	73000001
Hospital Revenue Code	730
Min. Negotiated Rate	$134.28
Max. Negotiated Rate	$191.83
Rate for Payer: Aetna Commercial	$181.17
Rate for Payer: Aetna New Business (MI Preferred)	$138.54
Rate for Payer: Cash Price	$170.51
Rate for Payer: Cofinity Commercial	$149.20
Rate for Payer: Cofinity Commercial	$183.30
Rate for Payer: Healthscope Commercial	$191.83
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$181.17
Rate for Payer: PHP Commercial	$181.17
Rate for Payer: Priority Health Cigna Priority Health	$149.20
Rate for Payer: Priority Health SBD	$134.28

HC ELECTROCORTICOGRAM IMPLTD BRN NPGT <30 D

Facility

$74.46

Service Code	CPT 95836
Hospital Charge Code	74000033
Hospital Revenue Code	740
Min. Negotiated Rate	$46.91
Max. Negotiated Rate	$67.01
Rate for Payer: Aetna Commercial	$63.29
Rate for Payer: Aetna New Business (MI Preferred)	$48.40
Rate for Payer: Cash Price	$59.57
Rate for Payer: Cofinity Commercial	$52.12
Rate for Payer: Cofinity Commercial	$64.04
Rate for Payer: Healthscope Commercial	$67.01
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$63.29
Rate for Payer: PHP Commercial	$63.29
Rate for Payer: Priority Health Cigna Priority Health	$52.12
Rate for Payer: Priority Health SBD	$46.91

HC ELECTROCORTICOGRAM IMPLTD BRN NPGT <30 D

Facility

$74.46

Service Code	CPT 95836
Hospital Charge Code	74000033
Hospital Revenue Code	740
Min. Negotiated Rate	$18.35
Max. Negotiated Rate	$112.74
Rate for Payer: Aetna Commercial	$63.29
Rate for Payer: Aetna Medicare	$34.89
Rate for Payer: Aetna New Business (MI Preferred)	$48.40
Rate for Payer: Allen County Amish Medical Aid Commercial	$41.94
Rate for Payer: Amish Plain Church Group Commercial	$41.94
Rate for Payer: BCBS Complete	$19.27
Rate for Payer: BCBS MAPPO	$33.55
Rate for Payer: BCN Medicare Advantage	$33.55
Rate for Payer: Cash Price	$59.57
Rate for Payer: Cash Price	$59.57
Rate for Payer: Cofinity Commercial	$64.04
Rate for Payer: Cofinity Commercial	$52.12
Rate for Payer: Health Alliance Plan Medicare Advantage	$33.55
Rate for Payer: Healthscope Commercial	$67.01
Rate for Payer: Mclaren Medicaid	$18.35
Rate for Payer: Mclaren Medicare	$33.55
Rate for Payer: Meridian Medicaid	$19.27
Rate for Payer: Meridian Wellcare - Medicare Advantage	$35.23
Rate for Payer: MI Amish Medical Board Commercial	$38.58
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$63.29
Rate for Payer: PACE Medicare	$31.87
Rate for Payer: PACE SWMI	$33.55
Rate for Payer: PHP Commercial	$63.29
Rate for Payer: PHP Medicare Advantage	$33.55
Rate for Payer: Priority Health Choice Medicaid	$18.35
Rate for Payer: Priority Health Cigna Priority Health	$52.12
Rate for Payer: Priority Health Medicare	$33.55
Rate for Payer: Priority Health SBD	$46.91
Rate for Payer: Railroad Medicare Medicare	$33.55
Rate for Payer: UHC All Payor (Choice/PPO)	$112.74
Rate for Payer: UHC Dual Complete DSNP	$33.55
Rate for Payer: UHC Exchange	$102.49
Rate for Payer: UHC Medicare Advantage	$34.56
Rate for Payer: VA VA	$33.55

HC ELECTROLYTE PANEL

Facility

$27.54

Service Code	CPT 80051
Hospital Charge Code	30100012
Hospital Revenue Code	301
Min. Negotiated Rate	$3.83
Max. Negotiated Rate	$24.79
Rate for Payer: Aetna Commercial	$23.41
Rate for Payer: Aetna Medicare	$7.29
Rate for Payer: Aetna New Business (MI Preferred)	$17.90
Rate for Payer: Allen County Amish Medical Aid Commercial	$8.76
Rate for Payer: Amish Plain Church Group Commercial	$8.76
Rate for Payer: BCBS Complete	$4.03
Rate for Payer: BCBS MAPPO	$7.01
Rate for Payer: BCBS Trust/PPO	$4.53
Rate for Payer: BCN Medicare Advantage	$7.01
Rate for Payer: Cash Price	$22.03
Rate for Payer: Cash Price	$22.03
Rate for Payer: Cofinity Commercial	$23.68
Rate for Payer: Cofinity Commercial	$19.28
Rate for Payer: Health Alliance Plan Medicare Advantage	$7.01
Rate for Payer: Healthscope Commercial	$24.79
Rate for Payer: Mclaren Medicaid	$3.83
Rate for Payer: Mclaren Medicare	$7.01
Rate for Payer: Meridian Medicaid	$4.03
Rate for Payer: Meridian Wellcare - Medicare Advantage	$7.36
Rate for Payer: MI Amish Medical Board Commercial	$8.06
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$23.41
Rate for Payer: PACE Medicare	$6.66
Rate for Payer: PACE SWMI	$7.01
Rate for Payer: PHP Commercial	$23.41
Rate for Payer: PHP Medicare Advantage	$7.01
Rate for Payer: Priority Health Choice Medicaid	$3.83
Rate for Payer: Priority Health Cigna Priority Health	$19.28
Rate for Payer: Priority Health Medicare	$7.01
Rate for Payer: Priority Health SBD	$17.35
Rate for Payer: Railroad Medicare Medicare	$7.01
Rate for Payer: UHC All Payor (Choice/PPO)	$8.41
Rate for Payer: UHC Core	$11.93
Rate for Payer: UHC Dual Complete DSNP	$7.01
Rate for Payer: UHC Exchange	$7.01
Rate for Payer: UHC Medicare Advantage	$7.22
Rate for Payer: VA VA	$7.01

HC ELECTROLYTE PANEL

Facility

$27.54

Service Code	CPT 80051
Hospital Charge Code	30100012
Hospital Revenue Code	301
Min. Negotiated Rate	$17.35
Max. Negotiated Rate	$24.79
Rate for Payer: Aetna Commercial	$23.41
Rate for Payer: Aetna New Business (MI Preferred)	$17.90
Rate for Payer: Cash Price	$22.03
Rate for Payer: Cofinity Commercial	$19.28
Rate for Payer: Cofinity Commercial	$23.68
Rate for Payer: Healthscope Commercial	$24.79
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$23.41
Rate for Payer: PHP Commercial	$23.41
Rate for Payer: Priority Health Cigna Priority Health	$19.28
Rate for Payer: Priority Health SBD	$17.35

HC ELECTROLYTES WHOLE BLOOD

Facility

$86.10

Service Code	CPT 80051
Hospital Charge Code	30100490
Hospital Revenue Code	301
Min. Negotiated Rate	$54.24
Max. Negotiated Rate	$77.49
Rate for Payer: Aetna Commercial	$73.18
Rate for Payer: Aetna New Business (MI Preferred)	$55.96
Rate for Payer: Cash Price	$68.88
Rate for Payer: Cofinity Commercial	$60.27
Rate for Payer: Cofinity Commercial	$74.05
Rate for Payer: Healthscope Commercial	$77.49
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$73.18
Rate for Payer: PHP Commercial	$73.18
Rate for Payer: Priority Health Cigna Priority Health	$60.27
Rate for Payer: Priority Health SBD	$54.24

HC ELECTROLYTES WHOLE BLOOD

Facility

$86.10

Service Code	CPT 80051
Hospital Charge Code	30100490
Hospital Revenue Code	301
Min. Negotiated Rate	$3.83
Max. Negotiated Rate	$77.49
Rate for Payer: Aetna Commercial	$73.18
Rate for Payer: Aetna Medicare	$7.29
Rate for Payer: Aetna New Business (MI Preferred)	$55.96
Rate for Payer: Allen County Amish Medical Aid Commercial	$8.76
Rate for Payer: Amish Plain Church Group Commercial	$8.76
Rate for Payer: BCBS Complete	$4.03
Rate for Payer: BCBS MAPPO	$7.01
Rate for Payer: BCBS Trust/PPO	$4.53
Rate for Payer: BCN Medicare Advantage	$7.01
Rate for Payer: Cash Price	$68.88
Rate for Payer: Cash Price	$68.88
Rate for Payer: Cofinity Commercial	$60.27
Rate for Payer: Cofinity Commercial	$74.05
Rate for Payer: Health Alliance Plan Medicare Advantage	$7.01
Rate for Payer: Healthscope Commercial	$77.49
Rate for Payer: Mclaren Medicaid	$3.83
Rate for Payer: Mclaren Medicare	$7.01
Rate for Payer: Meridian Medicaid	$4.03
Rate for Payer: Meridian Wellcare - Medicare Advantage	$7.36
Rate for Payer: MI Amish Medical Board Commercial	$8.06
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$73.18
Rate for Payer: PACE Medicare	$6.66
Rate for Payer: PACE SWMI	$7.01
Rate for Payer: PHP Commercial	$73.18
Rate for Payer: PHP Medicare Advantage	$7.01
Rate for Payer: Priority Health Choice Medicaid	$3.83
Rate for Payer: Priority Health Cigna Priority Health	$60.27
Rate for Payer: Priority Health Medicare	$7.01
Rate for Payer: Priority Health SBD	$54.24
Rate for Payer: Railroad Medicare Medicare	$7.01
Rate for Payer: UHC All Payor (Choice/PPO)	$8.41
Rate for Payer: UHC Core	$11.93
Rate for Payer: UHC Dual Complete DSNP	$7.01
Rate for Payer: UHC Exchange	$7.01
Rate for Payer: UHC Medicare Advantage	$7.22
Rate for Payer: VA VA	$7.01

HC ELECTROPHYSIOLOGY CATHETET LEVEL 4

Facility

$3,200.00

Service Code	HCPCS C1730
Hospital Charge Code	27200304
Hospital Revenue Code	272
Min. Negotiated Rate	$2,016.00
Max. Negotiated Rate	$2,880.00
Rate for Payer: Aetna Commercial	$2,720.00
Rate for Payer: Aetna New Business (MI Preferred)	$2,080.00
Rate for Payer: Cash Price	$2,560.00
Rate for Payer: Cofinity Commercial	$2,240.00
Rate for Payer: Cofinity Commercial	$2,752.00
Rate for Payer: Healthscope Commercial	$2,880.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,720.00
Rate for Payer: PHP Commercial	$2,720.00
Rate for Payer: Priority Health Cigna Priority Health	$2,240.00
Rate for Payer: Priority Health SBD	$2,016.00

HC ELECTROPHYSIOLOGY CATHETET LEVEL 4

Facility

$3,200.00

Service Code	HCPCS C1730
Hospital Charge Code	27200304
Hospital Revenue Code	272
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$2,880.00
Rate for Payer: Aetna Commercial	$2,720.00
Rate for Payer: Aetna New Business (MI Preferred)	$2,080.00
Rate for Payer: BCBS Complete	$1,280.00
Rate for Payer: BCBS Trust/PPO	$0.03
Rate for Payer: Cash Price	$2,560.00
Rate for Payer: Cash Price	$2,560.00
Rate for Payer: Cofinity Commercial	$2,240.00
Rate for Payer: Cofinity Commercial	$2,752.00
Rate for Payer: Healthscope Commercial	$2,880.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,720.00
Rate for Payer: PHP Commercial	$2,720.00
Rate for Payer: Priority Health Cigna Priority Health	$2,240.00
Rate for Payer: Priority Health SBD	$2,016.00

HC ELECTROPHYSIOLOGY CATHS DIAG/ABLAT LEVEL 6

Facility

$6,560.00

Service Code	HCPCS C1733
Hospital Charge Code	27200300
Hospital Revenue Code	272
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$5,904.00
Rate for Payer: Aetna Commercial	$5,576.00
Rate for Payer: Aetna New Business (MI Preferred)	$4,264.00
Rate for Payer: BCBS Complete	$2,624.00
Rate for Payer: BCBS Trust/PPO	$0.03
Rate for Payer: Cash Price	$5,248.00
Rate for Payer: Cash Price	$5,248.00
Rate for Payer: Cofinity Commercial	$4,592.00
Rate for Payer: Cofinity Commercial	$5,641.60
Rate for Payer: Healthscope Commercial	$5,904.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$5,576.00
Rate for Payer: PHP Commercial	$5,576.00
Rate for Payer: Priority Health Cigna Priority Health	$4,592.00
Rate for Payer: Priority Health SBD	$4,132.80

HC ELECTROPHYSIOLOGY CATHS DIAG/ABLAT LEVEL 6

Facility

$6,560.00

Service Code	HCPCS C1733
Hospital Charge Code	27200300
Hospital Revenue Code	272
Min. Negotiated Rate	$4,132.80
Max. Negotiated Rate	$5,904.00
Rate for Payer: Aetna Commercial	$5,576.00
Rate for Payer: Aetna New Business (MI Preferred)	$4,264.00
Rate for Payer: Cash Price	$5,248.00
Rate for Payer: Cofinity Commercial	$4,592.00
Rate for Payer: Cofinity Commercial	$5,641.60
Rate for Payer: Healthscope Commercial	$5,904.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$5,576.00
Rate for Payer: PHP Commercial	$5,576.00
Rate for Payer: Priority Health Cigna Priority Health	$4,592.00
Rate for Payer: Priority Health SBD	$4,132.80

HC ELECTROPHYSIOLOGY CATHS LEVEL 1

Facility

$675.00

Service Code	HCPCS C1730
Hospital Charge Code	27200298
Hospital Revenue Code	272
Min. Negotiated Rate	$425.25
Max. Negotiated Rate	$607.50
Rate for Payer: Aetna Commercial	$573.75
Rate for Payer: Aetna New Business (MI Preferred)	$438.75
Rate for Payer: Cash Price	$540.00
Rate for Payer: Cofinity Commercial	$472.50
Rate for Payer: Cofinity Commercial	$580.50
Rate for Payer: Healthscope Commercial	$607.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$573.75
Rate for Payer: PHP Commercial	$573.75
Rate for Payer: Priority Health Cigna Priority Health	$472.50
Rate for Payer: Priority Health SBD	$425.25

HC ELECTROPHYSIOLOGY CATHS LEVEL 1

Facility

$675.00

Service Code	HCPCS C1730
Hospital Charge Code	27200298
Hospital Revenue Code	272
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$607.50
Rate for Payer: Aetna Commercial	$573.75
Rate for Payer: Aetna New Business (MI Preferred)	$438.75
Rate for Payer: BCBS Complete	$270.00
Rate for Payer: BCBS Trust/PPO	$0.03
Rate for Payer: Cash Price	$540.00
Rate for Payer: Cash Price	$540.00
Rate for Payer: Cofinity Commercial	$580.50
Rate for Payer: Cofinity Commercial	$472.50
Rate for Payer: Healthscope Commercial	$607.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$573.75
Rate for Payer: PHP Commercial	$573.75
Rate for Payer: Priority Health Cigna Priority Health	$472.50
Rate for Payer: Priority Health SBD	$425.25

HC ELECTROPHYSIOLOGY CATHS LEVEL 2

Facility

$1,208.70

Service Code	CPT C1730
Hospital Charge Code	27200325
Hospital Revenue Code	272
Min. Negotiated Rate	$761.48
Max. Negotiated Rate	$1,087.83
Rate for Payer: Aetna Commercial	$1,027.40
Rate for Payer: Aetna New Business (MI Preferred)	$785.66
Rate for Payer: Cash Price	$966.96
Rate for Payer: Cofinity Commercial	$1,039.48
Rate for Payer: Cofinity Commercial	$846.09
Rate for Payer: Healthscope Commercial	$1,087.83
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,027.40
Rate for Payer: PHP Commercial	$1,027.40
Rate for Payer: Priority Health Cigna Priority Health	$846.09
Rate for Payer: Priority Health SBD	$761.48

HC ELECTROPHYSIOLOGY CATHS LEVEL 2

Facility

$1,208.70

Service Code	CPT C1730
Hospital Charge Code	27200325
Hospital Revenue Code	272
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$1,087.83
Rate for Payer: Aetna Commercial	$1,027.40
Rate for Payer: Aetna New Business (MI Preferred)	$785.66
Rate for Payer: BCBS Complete	$483.48
Rate for Payer: BCBS Trust/PPO	$0.03
Rate for Payer: Cash Price	$966.96
Rate for Payer: Cash Price	$966.96
Rate for Payer: Cofinity Commercial	$1,039.48
Rate for Payer: Cofinity Commercial	$846.09
Rate for Payer: Healthscope Commercial	$1,087.83
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,027.40
Rate for Payer: PHP Commercial	$1,027.40
Rate for Payer: Priority Health Cigna Priority Health	$846.09
Rate for Payer: Priority Health SBD	$761.48

HC ELECTROPHYSIOLOGY CATHS LEVEL 3

Facility

$2,815.00

Service Code	HCPCS C1730
Hospital Charge Code	27200299
Hospital Revenue Code	272
Min. Negotiated Rate	$1,773.45
Max. Negotiated Rate	$2,533.50
Rate for Payer: Aetna Commercial	$2,392.75
Rate for Payer: Aetna New Business (MI Preferred)	$1,829.75
Rate for Payer: Cash Price	$2,252.00
Rate for Payer: Cofinity Commercial	$1,970.50
Rate for Payer: Cofinity Commercial	$2,420.90
Rate for Payer: Healthscope Commercial	$2,533.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,392.75
Rate for Payer: PHP Commercial	$2,392.75
Rate for Payer: Priority Health Cigna Priority Health	$1,970.50
Rate for Payer: Priority Health SBD	$1,773.45

HC ELECTROPHYSIOLOGY CATHS LEVEL 3

Facility

$2,815.00

Service Code	HCPCS C1730
Hospital Charge Code	27200299
Hospital Revenue Code	272
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$2,533.50
Rate for Payer: Aetna Commercial	$2,392.75
Rate for Payer: Aetna New Business (MI Preferred)	$1,829.75
Rate for Payer: BCBS Complete	$1,126.00
Rate for Payer: BCBS Trust/PPO	$0.03
Rate for Payer: Cash Price	$2,252.00
Rate for Payer: Cash Price	$2,252.00
Rate for Payer: Cofinity Commercial	$1,970.50
Rate for Payer: Cofinity Commercial	$2,420.90
Rate for Payer: Healthscope Commercial	$2,533.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,392.75
Rate for Payer: PHP Commercial	$2,392.75
Rate for Payer: Priority Health Cigna Priority Health	$1,970.50
Rate for Payer: Priority Health SBD	$1,773.45

HC ELECTROPHYSIOLOGY PACK

Facility

$261.70

Hospital Charge Code	62200002
Hospital Revenue Code	270
Min. Negotiated Rate	$104.68
Max. Negotiated Rate	$235.53
Rate for Payer: Aetna Commercial	$222.44
Rate for Payer: Aetna New Business (MI Preferred)	$170.10
Rate for Payer: BCBS Complete	$104.68
Rate for Payer: Cash Price	$209.36
Rate for Payer: Cofinity Commercial	$183.19
Rate for Payer: Cofinity Commercial	$225.06
Rate for Payer: Healthscope Commercial	$235.53
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$222.44
Rate for Payer: PHP Commercial	$222.44
Rate for Payer: Priority Health Cigna Priority Health	$183.19
Rate for Payer: Priority Health SBD	$164.87

HC ELECTROPHYSIOLOGY PACK

Facility

$261.70

Hospital Charge Code	62200002
Hospital Revenue Code	270
Min. Negotiated Rate	$164.87
Max. Negotiated Rate	$235.53
Rate for Payer: Aetna Commercial	$222.44
Rate for Payer: Aetna New Business (MI Preferred)	$170.10
Rate for Payer: Cash Price	$209.36
Rate for Payer: Cofinity Commercial	$183.19
Rate for Payer: Cofinity Commercial	$225.06
Rate for Payer: Healthscope Commercial	$235.53
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$222.44
Rate for Payer: PHP Commercial	$222.44
Rate for Payer: Priority Health Cigna Priority Health	$183.19
Rate for Payer: Priority Health SBD	$164.87

HC ELECTROPHYSIOLOGY STUDY

Facility

$26,484.59

Service Code	CPT 93620
Hospital Charge Code	48100037
Hospital Revenue Code	481
Min. Negotiated Rate	$16,685.29
Max. Negotiated Rate	$23,836.13
Rate for Payer: Aetna Commercial	$22,511.90
Rate for Payer: Aetna New Business (MI Preferred)	$17,214.98
Rate for Payer: Cash Price	$21,187.67
Rate for Payer: Cofinity Commercial	$18,539.21
Rate for Payer: Cofinity Commercial	$22,776.75
Rate for Payer: Healthscope Commercial	$23,836.13
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$22,511.90
Rate for Payer: PHP Commercial	$22,511.90
Rate for Payer: Priority Health Cigna Priority Health	$18,539.21
Rate for Payer: Priority Health SBD	$16,685.29

Know your out-of-pocket cost for care.

All Charges