Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC ENDOSC INJ IMPLT MATRL URT &/BLDR NECK

Facility

$9,288.24

Service Code	CPT 51715
Hospital Charge Code	76100356
Hospital Revenue Code	761
Min. Negotiated Rate	$5,851.59
Max. Negotiated Rate	$8,359.42
Rate for Payer: Aetna Commercial	$7,895.00
Rate for Payer: Aetna New Business (MI Preferred)	$6,037.36
Rate for Payer: Cash Price	$7,430.59
Rate for Payer: Cofinity Commercial	$6,501.77
Rate for Payer: Cofinity Commercial	$7,987.89
Rate for Payer: Healthscope Commercial	$8,359.42
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$7,895.00
Rate for Payer: PHP Commercial	$7,895.00
Rate for Payer: Priority Health Cigna Priority Health	$6,501.77
Rate for Payer: Priority Health SBD	$5,851.59

HC ENDOSCOPE SINGLE USE URINARY TRACT

Facility

$495.00

Service Code	HCPCS C1747
Hospital Charge Code	27200351
Hospital Revenue Code	272
Min. Negotiated Rate	$174.24
Max. Negotiated Rate	$445.50
Rate for Payer: Aetna Commercial	$420.75
Rate for Payer: Aetna New Business (MI Preferred)	$321.75
Rate for Payer: BCBS Complete	$198.00
Rate for Payer: Cash Price	$396.00
Rate for Payer: Cofinity Commercial	$346.50
Rate for Payer: Cofinity Commercial	$425.70
Rate for Payer: Healthscope Commercial	$445.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$420.75
Rate for Payer: PHP Commercial	$420.75
Rate for Payer: Priority Health Cigna Priority Health	$346.50
Rate for Payer: Priority Health SBD	$311.85
Rate for Payer: UHC All Payor (Choice/PPO)	$174.24
Rate for Payer: UHC Exchange	$202.95

HC ENDOSCOPE SINGLE USE URINARY TRACT

Facility

$495.00

Service Code	HCPCS C1747
Hospital Charge Code	27200351
Hospital Revenue Code	272
Min. Negotiated Rate	$311.85
Max. Negotiated Rate	$445.50
Rate for Payer: Aetna Commercial	$420.75
Rate for Payer: Aetna New Business (MI Preferred)	$321.75
Rate for Payer: Cash Price	$396.00
Rate for Payer: Cofinity Commercial	$346.50
Rate for Payer: Cofinity Commercial	$425.70
Rate for Payer: Healthscope Commercial	$445.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$420.75
Rate for Payer: PHP Commercial	$420.75
Rate for Payer: Priority Health Cigna Priority Health	$346.50
Rate for Payer: Priority Health SBD	$311.85

HC ENDOSCOPIC CATHJ PANCREATIC DUCTAL SYS

Facility

$275.00

Service Code	CPT 74329
Hospital Charge Code	32000342
Hospital Revenue Code	320
Min. Negotiated Rate	$173.25
Max. Negotiated Rate	$247.50
Rate for Payer: Aetna Commercial	$233.75
Rate for Payer: Aetna New Business (MI Preferred)	$178.75
Rate for Payer: Cash Price	$220.00
Rate for Payer: Cofinity Commercial	$192.50
Rate for Payer: Cofinity Commercial	$236.50
Rate for Payer: Healthscope Commercial	$247.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$233.75
Rate for Payer: PHP Commercial	$233.75
Rate for Payer: Priority Health Cigna Priority Health	$192.50
Rate for Payer: Priority Health SBD	$173.25

HC ENDOSCOPIC CATHJ PANCREATIC DUCTAL SYS

Facility

$275.00

Service Code	CPT 74329
Hospital Charge Code	32000342
Hospital Revenue Code	320
Min. Negotiated Rate	$110.00
Max. Negotiated Rate	$247.50
Rate for Payer: Aetna Commercial	$233.75
Rate for Payer: Aetna New Business (MI Preferred)	$178.75
Rate for Payer: BCBS Complete	$110.00
Rate for Payer: BCBS Trust/PPO	$131.83
Rate for Payer: Cash Price	$220.00
Rate for Payer: Cash Price	$220.00
Rate for Payer: Cofinity Commercial	$192.50
Rate for Payer: Cofinity Commercial	$236.50
Rate for Payer: Healthscope Commercial	$247.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$233.75
Rate for Payer: PHP Commercial	$233.75
Rate for Payer: Priority Health Cigna Priority Health	$192.50
Rate for Payer: Priority Health SBD	$173.25

HC ENDOSCOPIC MUCOSAL RESECTION

Facility

$2,717.00

Hospital Charge Code	36000118
Hospital Revenue Code	360
Min. Negotiated Rate	$1,711.71
Max. Negotiated Rate	$2,445.30
Rate for Payer: Aetna Commercial	$2,309.45
Rate for Payer: Aetna New Business (MI Preferred)	$1,766.05
Rate for Payer: Cash Price	$2,173.60
Rate for Payer: Cofinity Commercial	$1,901.90
Rate for Payer: Cofinity Commercial	$2,336.62
Rate for Payer: Healthscope Commercial	$2,445.30
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,309.45
Rate for Payer: PHP Commercial	$2,309.45
Rate for Payer: Priority Health Cigna Priority Health	$1,901.90
Rate for Payer: Priority Health SBD	$1,711.71

HC ENDOSCOPIC MUCOSAL RESECTION

Facility

$2,717.00

Hospital Charge Code	36000118
Hospital Revenue Code	360
Min. Negotiated Rate	$1,086.80
Max. Negotiated Rate	$2,445.30
Rate for Payer: Aetna Commercial	$2,309.45
Rate for Payer: Aetna New Business (MI Preferred)	$1,766.05
Rate for Payer: BCBS Complete	$1,086.80
Rate for Payer: Cash Price	$2,173.60
Rate for Payer: Cofinity Commercial	$1,901.90
Rate for Payer: Cofinity Commercial	$2,336.62
Rate for Payer: Healthscope Commercial	$2,445.30
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,309.45
Rate for Payer: PHP Commercial	$2,309.45
Rate for Payer: Priority Health Cigna Priority Health	$1,901.90
Rate for Payer: Priority Health SBD	$1,711.71

HC ENDOSCOPIC SUBMUCOSAL DISSECTION

Facility

$5,002.00

Hospital Charge Code	36000119
Hospital Revenue Code	360
Min. Negotiated Rate	$2,000.80
Max. Negotiated Rate	$4,501.80
Rate for Payer: Aetna Commercial	$4,251.70
Rate for Payer: Aetna New Business (MI Preferred)	$3,251.30
Rate for Payer: BCBS Complete	$2,000.80
Rate for Payer: Cash Price	$4,001.60
Rate for Payer: Cofinity Commercial	$3,501.40
Rate for Payer: Cofinity Commercial	$4,301.72
Rate for Payer: Healthscope Commercial	$4,501.80
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$4,251.70
Rate for Payer: PHP Commercial	$4,251.70
Rate for Payer: Priority Health Cigna Priority Health	$3,501.40
Rate for Payer: Priority Health SBD	$3,151.26

HC ENDOSCOPIC SUBMUCOSAL DISSECTION

Facility

$5,002.00

Hospital Charge Code	36000119
Hospital Revenue Code	360
Min. Negotiated Rate	$3,151.26
Max. Negotiated Rate	$4,501.80
Rate for Payer: Aetna Commercial	$4,251.70
Rate for Payer: Aetna New Business (MI Preferred)	$3,251.30
Rate for Payer: Cash Price	$4,001.60
Rate for Payer: Cofinity Commercial	$3,501.40
Rate for Payer: Cofinity Commercial	$4,301.72
Rate for Payer: Healthscope Commercial	$4,501.80
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$4,251.70
Rate for Payer: PHP Commercial	$4,251.70
Rate for Payer: Priority Health Cigna Priority Health	$3,501.40
Rate for Payer: Priority Health SBD	$3,151.26

HC ENDO STENT PLACEMENT

Facility

$773.00

Hospital Charge Code	36000114
Hospital Revenue Code	360
Min. Negotiated Rate	$486.99
Max. Negotiated Rate	$695.70
Rate for Payer: Aetna Commercial	$657.05
Rate for Payer: Aetna New Business (MI Preferred)	$502.45
Rate for Payer: Cash Price	$618.40
Rate for Payer: Cofinity Commercial	$541.10
Rate for Payer: Cofinity Commercial	$664.78
Rate for Payer: Healthscope Commercial	$695.70
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$657.05
Rate for Payer: PHP Commercial	$657.05
Rate for Payer: Priority Health Cigna Priority Health	$541.10
Rate for Payer: Priority Health SBD	$486.99

HC ENDO STENT PLACEMENT

Facility

$773.00

Hospital Charge Code	36000114
Hospital Revenue Code	360
Min. Negotiated Rate	$309.20
Max. Negotiated Rate	$695.70
Rate for Payer: Aetna Commercial	$657.05
Rate for Payer: Aetna New Business (MI Preferred)	$502.45
Rate for Payer: BCBS Complete	$309.20
Rate for Payer: Cash Price	$618.40
Rate for Payer: Cofinity Commercial	$541.10
Rate for Payer: Cofinity Commercial	$664.78
Rate for Payer: Healthscope Commercial	$695.70
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$657.05
Rate for Payer: PHP Commercial	$657.05
Rate for Payer: Priority Health Cigna Priority Health	$541.10
Rate for Payer: Priority Health SBD	$486.99

HC ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 2ND+ VEINS

Facility

$2,938.00

Service Code	CPT 36479
Hospital Charge Code	76100407
Hospital Revenue Code	761
Min. Negotiated Rate	$1,850.94
Max. Negotiated Rate	$2,644.20
Rate for Payer: Aetna Commercial	$2,497.30
Rate for Payer: Aetna New Business (MI Preferred)	$1,909.70
Rate for Payer: Cash Price	$2,350.40
Rate for Payer: Cofinity Commercial	$2,056.60
Rate for Payer: Cofinity Commercial	$2,526.68
Rate for Payer: Healthscope Commercial	$2,644.20
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,497.30
Rate for Payer: PHP Commercial	$2,497.30
Rate for Payer: Priority Health Cigna Priority Health	$2,056.60
Rate for Payer: Priority Health SBD	$1,850.94

HC ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 2ND+ VEINS

Facility

$2,938.00

Service Code	CPT 36479
Hospital Charge Code	76100407
Hospital Revenue Code	761
Min. Negotiated Rate	$130.32
Max. Negotiated Rate	$2,644.20
Rate for Payer: Aetna Commercial	$2,497.30
Rate for Payer: Aetna New Business (MI Preferred)	$1,909.70
Rate for Payer: BCBS Complete	$1,175.20
Rate for Payer: BCBS Trust/PPO	$620.37
Rate for Payer: Cash Price	$2,350.40
Rate for Payer: Cash Price	$2,350.40
Rate for Payer: Cofinity Commercial	$2,056.60
Rate for Payer: Cofinity Commercial	$2,526.68
Rate for Payer: Healthscope Commercial	$2,644.20
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,497.30
Rate for Payer: PHP Commercial	$2,497.30
Rate for Payer: Priority Health Cigna Priority Health	$2,056.60
Rate for Payer: Priority Health SBD	$1,850.94
Rate for Payer: UHC All Payor (Choice/PPO)	$143.35
Rate for Payer: UHC Exchange	$130.32

HC ENDOVENOUS ABLAT EXTR W IMAGING PERC FIRST VEIN

Facility

$3,998.90

Service Code	CPT 36473
Hospital Charge Code	36100523
Hospital Revenue Code	361
Min. Negotiated Rate	$174.20
Max. Negotiated Rate	$8,913.25
Rate for Payer: Aetna Commercial	$3,399.06
Rate for Payer: Aetna Medicare	$2,949.65
Rate for Payer: Aetna New Business (MI Preferred)	$2,599.28
Rate for Payer: Allen County Amish Medical Aid Commercial	$3,545.25
Rate for Payer: Amish Plain Church Group Commercial	$3,545.25
Rate for Payer: BCBS Complete	$1,629.11
Rate for Payer: BCBS MAPPO	$2,836.20
Rate for Payer: BCN Medicare Advantage	$2,836.20
Rate for Payer: Cash Price	$3,199.12
Rate for Payer: Cash Price	$3,199.12
Rate for Payer: Cofinity Commercial	$2,799.23
Rate for Payer: Cofinity Commercial	$3,439.05
Rate for Payer: Health Alliance Plan Medicare Advantage	$2,836.20
Rate for Payer: Healthscope Commercial	$3,599.01
Rate for Payer: Mclaren Medicaid	$1,551.40
Rate for Payer: Mclaren Medicare	$2,836.20
Rate for Payer: Meridian Medicaid	$1,629.11
Rate for Payer: Meridian Wellcare - Medicare Advantage	$2,978.01
Rate for Payer: MI Amish Medical Board Commercial	$3,261.63
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3,399.06
Rate for Payer: PACE Medicare	$2,694.39
Rate for Payer: PACE SWMI	$2,836.20
Rate for Payer: PHP Commercial	$3,399.06
Rate for Payer: PHP Medicare Advantage	$2,836.20
Rate for Payer: Priority Health Choice Medicaid	$1,551.40
Rate for Payer: Priority Health Cigna Priority Health	$2,799.23
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$8,913.25
Rate for Payer: Priority Health Medicare	$2,836.20
Rate for Payer: Priority Health Narrow Network	$7,130.60
Rate for Payer: Priority Health SBD	$2,519.31
Rate for Payer: Railroad Medicare Medicare	$2,836.20
Rate for Payer: UHC All Payor (Choice/PPO)	$191.62
Rate for Payer: UHC Core	$5,427.00
Rate for Payer: UHC Dual Complete DSNP	$2,836.20
Rate for Payer: UHC Exchange	$174.20
Rate for Payer: UHC Medicare Advantage	$2,921.29
Rate for Payer: VA VA	$2,836.20

HC ENDOVENOUS ABLAT EXTR W IMAGING PERC FIRST VEIN

Facility

$3,998.90

Service Code	CPT 36473
Hospital Charge Code	36100523
Hospital Revenue Code	361
Min. Negotiated Rate	$2,519.31
Max. Negotiated Rate	$3,599.01
Rate for Payer: Aetna Commercial	$3,399.06
Rate for Payer: Aetna New Business (MI Preferred)	$2,599.28
Rate for Payer: Cash Price	$3,199.12
Rate for Payer: Cofinity Commercial	$2,799.23
Rate for Payer: Cofinity Commercial	$3,439.05
Rate for Payer: Healthscope Commercial	$3,599.01
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3,399.06
Rate for Payer: PHP Commercial	$3,399.06
Rate for Payer: Priority Health Cigna Priority Health	$2,799.23
Rate for Payer: Priority Health SBD	$2,519.31

HC ENDOVENOUS ABLAT SUBS VEIN SEP ACCESS SITE EXTR

Facility

$256.40

Service Code	CPT 36474
Hospital Charge Code	36100524
Hospital Revenue Code	361
Min. Negotiated Rate	$161.53
Max. Negotiated Rate	$230.76
Rate for Payer: Aetna Commercial	$217.94
Rate for Payer: Aetna New Business (MI Preferred)	$166.66
Rate for Payer: Cash Price	$205.12
Rate for Payer: Cofinity Commercial	$179.48
Rate for Payer: Cofinity Commercial	$220.50
Rate for Payer: Healthscope Commercial	$230.76
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$217.94
Rate for Payer: PHP Commercial	$217.94
Rate for Payer: Priority Health Cigna Priority Health	$179.48
Rate for Payer: Priority Health SBD	$161.53

HC ENDOVENOUS ABLAT SUBS VEIN SEP ACCESS SITE EXTR

Facility

$256.40

Service Code	CPT 36474
Hospital Charge Code	36100524
Hospital Revenue Code	361
Min. Negotiated Rate	$85.13
Max. Negotiated Rate	$878.00
Rate for Payer: Aetna Commercial	$217.94
Rate for Payer: Aetna New Business (MI Preferred)	$166.66
Rate for Payer: BCBS Complete	$102.56
Rate for Payer: Cash Price	$205.12
Rate for Payer: Cash Price	$205.12
Rate for Payer: Cofinity Commercial	$179.48
Rate for Payer: Cofinity Commercial	$220.50
Rate for Payer: Healthscope Commercial	$230.76
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$217.94
Rate for Payer: PHP Commercial	$217.94
Rate for Payer: Priority Health Cigna Priority Health	$179.48
Rate for Payer: Priority Health SBD	$161.53
Rate for Payer: UHC All Payor (Choice/PPO)	$93.64
Rate for Payer: UHC Core	$878.00
Rate for Payer: UHC Exchange	$85.13

HC ENDOVENOUS LASER 1ST VEIN

Facility

$4,041.53

Service Code	CPT 36478
Hospital Charge Code	76100184
Hospital Revenue Code	761
Min. Negotiated Rate	$2,546.16
Max. Negotiated Rate	$3,637.38
Rate for Payer: Aetna Commercial	$3,435.30
Rate for Payer: Aetna New Business (MI Preferred)	$2,626.99
Rate for Payer: Cash Price	$3,233.22
Rate for Payer: Cofinity Commercial	$2,829.07
Rate for Payer: Cofinity Commercial	$3,475.72
Rate for Payer: Healthscope Commercial	$3,637.38
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3,435.30
Rate for Payer: PHP Commercial	$3,435.30
Rate for Payer: Priority Health Cigna Priority Health	$2,829.07
Rate for Payer: Priority Health SBD	$2,546.16

HC ENDOVENOUS LASER 1ST VEIN

Facility

$4,041.53

Service Code	CPT 36478
Hospital Charge Code	76100184
Hospital Revenue Code	761
Min. Negotiated Rate	$266.87
Max. Negotiated Rate	$8,913.25
Rate for Payer: Aetna Commercial	$3,435.30
Rate for Payer: Aetna Medicare	$2,949.65
Rate for Payer: Aetna New Business (MI Preferred)	$2,626.99
Rate for Payer: Allen County Amish Medical Aid Commercial	$3,545.25
Rate for Payer: Amish Plain Church Group Commercial	$3,545.25
Rate for Payer: BCBS Complete	$1,629.11
Rate for Payer: BCBS MAPPO	$2,836.20
Rate for Payer: BCBS Trust/PPO	$1,444.81
Rate for Payer: BCN Medicare Advantage	$2,836.20
Rate for Payer: Cash Price	$3,233.22
Rate for Payer: Cash Price	$3,233.22
Rate for Payer: Cofinity Commercial	$3,475.72
Rate for Payer: Cofinity Commercial	$2,829.07
Rate for Payer: Health Alliance Plan Medicare Advantage	$2,836.20
Rate for Payer: Healthscope Commercial	$3,637.38
Rate for Payer: Mclaren Medicaid	$1,551.40
Rate for Payer: Mclaren Medicare	$2,836.20
Rate for Payer: Meridian Medicaid	$1,629.11
Rate for Payer: Meridian Wellcare - Medicare Advantage	$2,978.01
Rate for Payer: MI Amish Medical Board Commercial	$3,261.63
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3,435.30
Rate for Payer: PACE Medicare	$2,694.39
Rate for Payer: PACE SWMI	$2,836.20
Rate for Payer: PHP Commercial	$3,435.30
Rate for Payer: PHP Medicare Advantage	$2,836.20
Rate for Payer: Priority Health Choice Medicaid	$1,551.40
Rate for Payer: Priority Health Cigna Priority Health	$2,829.07
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$8,913.25
Rate for Payer: Priority Health Medicare	$2,836.20
Rate for Payer: Priority Health Narrow Network	$7,130.60
Rate for Payer: Priority Health SBD	$2,546.16
Rate for Payer: Railroad Medicare Medicare	$2,836.20
Rate for Payer: UHC All Payor (Choice/PPO)	$293.56
Rate for Payer: UHC Dual Complete DSNP	$2,836.20
Rate for Payer: UHC Exchange	$266.87
Rate for Payer: UHC Medicare Advantage	$2,921.29
Rate for Payer: VA VA	$2,836.20

HC ENDOVENT

Facility

$4,711.31

Hospital Charge Code	27000099
Hospital Revenue Code	270
Min. Negotiated Rate	$1,884.52
Max. Negotiated Rate	$4,240.18
Rate for Payer: Aetna Commercial	$4,004.61
Rate for Payer: Aetna New Business (MI Preferred)	$3,062.35
Rate for Payer: BCBS Complete	$1,884.52
Rate for Payer: Cash Price	$3,769.05
Rate for Payer: Cofinity Commercial	$3,297.92
Rate for Payer: Cofinity Commercial	$4,051.73
Rate for Payer: Healthscope Commercial	$4,240.18
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$4,004.61
Rate for Payer: PHP Commercial	$4,004.61
Rate for Payer: Priority Health Cigna Priority Health	$3,297.92
Rate for Payer: Priority Health SBD	$2,968.13

HC ENDOVENT

Facility

$4,711.31

Hospital Charge Code	27000099
Hospital Revenue Code	270
Min. Negotiated Rate	$2,968.13
Max. Negotiated Rate	$4,240.18
Rate for Payer: Aetna Commercial	$4,004.61
Rate for Payer: Aetna New Business (MI Preferred)	$3,062.35
Rate for Payer: Cash Price	$3,769.05
Rate for Payer: Cofinity Commercial	$3,297.92
Rate for Payer: Cofinity Commercial	$4,051.73
Rate for Payer: Healthscope Commercial	$4,240.18
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$4,004.61
Rate for Payer: PHP Commercial	$4,004.61
Rate for Payer: Priority Health Cigna Priority Health	$3,297.92
Rate for Payer: Priority Health SBD	$2,968.13

HC ENGLISH PLANTAIN IGE

Facility

$24.89

Service Code	CPT 86003
Hospital Charge Code	30200084
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	$17.42
Rate for Payer: Cofinity Commercial	$21.41
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 ENGLISH PLANTAIN IGE

Facility

$24.89

Service Code	CPT 86003
Hospital Charge Code	30200084
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 ENSITE NAVX KIT

Facility

$4,707.00

Hospital Charge Code	27200121
Hospital Revenue Code	272
Min. Negotiated Rate	$1,882.80
Max. Negotiated Rate	$4,236.30
Rate for Payer: Aetna Commercial	$4,000.95
Rate for Payer: Aetna New Business (MI Preferred)	$3,059.55
Rate for Payer: BCBS Complete	$1,882.80
Rate for Payer: Cash Price	$3,765.60
Rate for Payer: Cofinity Commercial	$3,294.90
Rate for Payer: Cofinity Commercial	$4,048.02
Rate for Payer: Healthscope Commercial	$4,236.30
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$4,000.95
Rate for Payer: PHP Commercial	$4,000.95
Rate for Payer: Priority Health Cigna Priority Health	$3,294.90
Rate for Payer: Priority Health SBD	$2,965.41

HC ENSITE NAVX KIT

Facility

$4,707.00

Hospital Charge Code	27200121
Hospital Revenue Code	272
Min. Negotiated Rate	$2,965.41
Max. Negotiated Rate	$4,236.30
Rate for Payer: Aetna Commercial	$4,000.95
Rate for Payer: Aetna New Business (MI Preferred)	$3,059.55
Rate for Payer: Cash Price	$3,765.60
Rate for Payer: Cofinity Commercial	$3,294.90
Rate for Payer: Cofinity Commercial	$4,048.02
Rate for Payer: Healthscope Commercial	$4,236.30
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$4,000.95
Rate for Payer: PHP Commercial	$4,000.95
Rate for Payer: Priority Health Cigna Priority Health	$3,294.90
Rate for Payer: Priority Health SBD	$2,965.41

Know your out-of-pocket cost for care.

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