Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC BOSTON SCI ICD DUAL

Facility

$18,889.50

Service Code	HCPCS C1721
Hospital Charge Code	27800002
Hospital Revenue Code	278
Min. Negotiated Rate	$11,900.39
Max. Negotiated Rate	$17,000.55
Rate for Payer: Aetna Commercial	$16,056.08
Rate for Payer: Aetna New Business (MI Preferred)	$12,278.17
Rate for Payer: Cash Price	$15,111.60
Rate for Payer: Cofinity Advantage	$13,222.65
Rate for Payer: Cofinity Commercial	$16,244.97
Rate for Payer: Encore Health Key Benefits Commercial	$15,111.60
Rate for Payer: Healthscope Commercial	$17,000.55
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$16,056.08
Rate for Payer: Opus (Opus Packaging Group) HMA	$14,167.12
Rate for Payer: PHP Commercial	$16,056.08
Rate for Payer: Priority Health SBD	$11,900.39

HC BOSTON SCI ICD SINGLE

Facility

$22,497.61

Service Code	HCPCS C1722
Hospital Charge Code	27800003
Hospital Revenue Code	278
Min. Negotiated Rate	$14,173.49
Max. Negotiated Rate	$20,247.85
Rate for Payer: Aetna Commercial	$19,122.97
Rate for Payer: Aetna New Business (MI Preferred)	$14,623.45
Rate for Payer: Cash Price	$17,998.09
Rate for Payer: Cofinity Advantage	$15,748.33
Rate for Payer: Cofinity Commercial	$19,347.94
Rate for Payer: Encore Health Key Benefits Commercial	$17,998.09
Rate for Payer: Healthscope Commercial	$20,247.85
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$19,122.97
Rate for Payer: Opus (Opus Packaging Group) HMA	$16,873.21
Rate for Payer: PHP Commercial	$19,122.97
Rate for Payer: Priority Health SBD	$14,173.49

HC BOSTON SCI ICD SINGLE

Facility

$22,497.61

Service Code	HCPCS C1722
Hospital Charge Code	27800003
Hospital Revenue Code	278
Min. Negotiated Rate	$8,841.56
Max. Negotiated Rate	$20,247.85
Rate for Payer: Aetna Commercial	$19,122.97
Rate for Payer: Aetna Medicare	$11,248.81
Rate for Payer: Aetna New Business (MI Preferred)	$14,623.45
Rate for Payer: BCBS Complete	$8,999.04
Rate for Payer: Cash Price	$17,998.09
Rate for Payer: Cofinity Advantage	$15,748.33
Rate for Payer: Cofinity Commercial	$19,347.94
Rate for Payer: Encore Health Key Benefits Commercial	$17,998.09
Rate for Payer: Healthscope Commercial	$20,247.85
Rate for Payer: MI Amish Medical Board Commercial	$17,998.09
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$19,122.97
Rate for Payer: Opus (Opus Packaging Group) HMA	$16,873.21
Rate for Payer: PHP Commercial	$19,122.97
Rate for Payer: Priority Health SBD	$14,173.49
Rate for Payer: UHC All Payor (Choice/PPO)	$14,623.45
Rate for Payer: UHC Core	$11,721.25
Rate for Payer: UHC Exchange	$8,841.56

HC BOSTON SCI PACEMAKER LEAD

Facility

$2,302.92

Service Code	HCPCS C1898
Hospital Charge Code	27800074
Hospital Revenue Code	278
Min. Negotiated Rate	$905.05
Max. Negotiated Rate	$2,072.63
Rate for Payer: Aetna Commercial	$1,957.48
Rate for Payer: Aetna Medicare	$1,151.46
Rate for Payer: Aetna New Business (MI Preferred)	$1,496.90
Rate for Payer: BCBS Complete	$921.17
Rate for Payer: Cash Price	$1,842.34
Rate for Payer: Cofinity Advantage	$1,612.04
Rate for Payer: Cofinity Commercial	$1,980.51
Rate for Payer: Encore Health Key Benefits Commercial	$1,842.34
Rate for Payer: Healthscope Commercial	$2,072.63
Rate for Payer: MI Amish Medical Board Commercial	$1,842.34
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,957.48
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,727.19
Rate for Payer: PHP Commercial	$1,957.48
Rate for Payer: Priority Health SBD	$1,450.84
Rate for Payer: UHC All Payor (Choice/PPO)	$1,496.90
Rate for Payer: UHC Core	$1,199.82
Rate for Payer: UHC Exchange	$905.05

HC BOSTON SCI PACEMAKER LEAD

Facility

$2,302.92

Service Code	HCPCS C1898
Hospital Charge Code	27800074
Hospital Revenue Code	278
Min. Negotiated Rate	$1,450.84
Max. Negotiated Rate	$2,072.63
Rate for Payer: Aetna Commercial	$1,957.48
Rate for Payer: Aetna New Business (MI Preferred)	$1,496.90
Rate for Payer: Cash Price	$1,842.34
Rate for Payer: Cofinity Advantage	$1,612.04
Rate for Payer: Cofinity Commercial	$1,980.51
Rate for Payer: Encore Health Key Benefits Commercial	$1,842.34
Rate for Payer: Healthscope Commercial	$2,072.63
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,957.48
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,727.19
Rate for Payer: PHP Commercial	$1,957.48
Rate for Payer: Priority Health SBD	$1,450.84

HC BOSTON SCI SINGLE PACEMAKER

Facility

$14,510.97

Service Code	HCPCS C1786
Hospital Charge Code	27500005
Hospital Revenue Code	275
Min. Negotiated Rate	$9,141.91
Max. Negotiated Rate	$13,059.87
Rate for Payer: Aetna Commercial	$12,334.32
Rate for Payer: Aetna New Business (MI Preferred)	$9,432.13
Rate for Payer: Cash Price	$11,608.78
Rate for Payer: Cofinity Advantage	$10,157.68
Rate for Payer: Cofinity Commercial	$12,479.43
Rate for Payer: Encore Health Key Benefits Commercial	$11,608.78
Rate for Payer: Healthscope Commercial	$13,059.87
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$12,334.32
Rate for Payer: Opus (Opus Packaging Group) HMA	$10,883.23
Rate for Payer: PHP Commercial	$12,334.32
Rate for Payer: Priority Health SBD	$9,141.91

HC BOSTON SCI SINGLE PACEMAKER

Facility

$14,510.97

Service Code	HCPCS C1786
Hospital Charge Code	27500005
Hospital Revenue Code	275
Min. Negotiated Rate	$5,702.81
Max. Negotiated Rate	$13,059.87
Rate for Payer: Aetna Commercial	$12,334.32
Rate for Payer: Aetna Medicare	$7,255.48
Rate for Payer: Aetna New Business (MI Preferred)	$9,432.13
Rate for Payer: BCBS Complete	$5,804.39
Rate for Payer: Cash Price	$11,608.78
Rate for Payer: Cofinity Advantage	$10,157.68
Rate for Payer: Cofinity Commercial	$12,479.43
Rate for Payer: Encore Health Key Benefits Commercial	$11,608.78
Rate for Payer: Healthscope Commercial	$13,059.87
Rate for Payer: MI Amish Medical Board Commercial	$11,608.78
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$12,334.32
Rate for Payer: Opus (Opus Packaging Group) HMA	$10,883.23
Rate for Payer: PHP Commercial	$12,334.32
Rate for Payer: Priority Health SBD	$9,141.91
Rate for Payer: UHC All Payor (Choice/PPO)	$9,432.13
Rate for Payer: UHC Core	$7,560.22
Rate for Payer: UHC Exchange	$5,702.81

HC BOSTON SCI TACHY (ICD) LEAD

Facility

$8,948.46

Service Code	HCPCS C1895
Hospital Charge Code	27800075
Hospital Revenue Code	278
Min. Negotiated Rate	$5,637.53
Max. Negotiated Rate	$8,053.61
Rate for Payer: Aetna Commercial	$7,606.19
Rate for Payer: Aetna New Business (MI Preferred)	$5,816.50
Rate for Payer: Cash Price	$7,158.77
Rate for Payer: Cofinity Advantage	$6,263.92
Rate for Payer: Cofinity Commercial	$7,695.68
Rate for Payer: Encore Health Key Benefits Commercial	$7,158.77
Rate for Payer: Healthscope Commercial	$8,053.61
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$7,606.19
Rate for Payer: Opus (Opus Packaging Group) HMA	$6,711.35
Rate for Payer: PHP Commercial	$7,606.19
Rate for Payer: Priority Health SBD	$5,637.53

HC BOSTON SCI TACHY (ICD) LEAD

Facility

$8,948.46

Service Code	HCPCS C1895
Hospital Charge Code	27800075
Hospital Revenue Code	278
Min. Negotiated Rate	$3,516.74
Max. Negotiated Rate	$8,053.61
Rate for Payer: Aetna Commercial	$7,606.19
Rate for Payer: Aetna Medicare	$4,474.23
Rate for Payer: Aetna New Business (MI Preferred)	$5,816.50
Rate for Payer: BCBS Complete	$3,579.38
Rate for Payer: Cash Price	$7,158.77
Rate for Payer: Cofinity Advantage	$6,263.92
Rate for Payer: Cofinity Commercial	$7,695.68
Rate for Payer: Encore Health Key Benefits Commercial	$7,158.77
Rate for Payer: Healthscope Commercial	$8,053.61
Rate for Payer: MI Amish Medical Board Commercial	$7,158.77
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$7,606.19
Rate for Payer: Opus (Opus Packaging Group) HMA	$6,711.35
Rate for Payer: PHP Commercial	$7,606.19
Rate for Payer: Priority Health SBD	$5,637.53
Rate for Payer: UHC All Payor (Choice/PPO)	$5,816.50
Rate for Payer: UHC Core	$4,662.15
Rate for Payer: UHC Exchange	$3,516.74

HC BOTRYTIS CINEREA IGE

Facility

$25.90

Service Code	CPT 86003
Hospital Charge Code	30200075
Hospital Revenue Code	302
Min. Negotiated Rate	$2.73
Max. Negotiated Rate	$23.31
Rate for Payer: Aetna Commercial	$22.02
Rate for Payer: Aetna Medicare	$5.43
Rate for Payer: Aetna New Business (MI Preferred)	$16.84
Rate for Payer: Allen County Amish Medical Aid Commercial	$6.53
Rate for Payer: Amish Plain Church Group Commercial	$6.53
Rate for Payer: BCBS Complete	$2.87
Rate for Payer: BCBS MAPPO	$5.22
Rate for Payer: BCBS Trust/PPO	$5.57
Rate for Payer: BCN Commercial	$5.57
Rate for Payer: BCN Medicare Advantage	$5.22
Rate for Payer: Cash Price	$20.72
Rate for Payer: Cash Price	$20.72
Rate for Payer: Cofinity Advantage	$18.13
Rate for Payer: Cofinity Commercial	$22.27
Rate for Payer: Encore Health Key Benefits Commercial	$20.72
Rate for Payer: Health Alliance Plan Medicare Advantage	$5.22
Rate for Payer: Healthscope Commercial	$23.31
Rate for Payer: Mclaren Medicaid	$2.73
Rate for Payer: Mclaren Medicare	$5.22
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$5.48
Rate for Payer: Meridian Medicaid	$5.48
Rate for Payer: MI Amish Medical Board Commercial	$6.00
Rate for Payer: Molina Medicare/Medicaid	$5.74
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$22.02
Rate for Payer: Nomi Health Commercial	$7.83
Rate for Payer: Opus (Opus Packaging Group) HMA	$19.43
Rate for Payer: PACE Medicare	$4.96
Rate for Payer: PACE SWMI	$5.22
Rate for Payer: PHP Commercial	$22.02
Rate for Payer: PHP Medicare Advantage	$5.22
Rate for Payer: Priority Health Choice Medicaid	$2.73
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$5.22
Rate for Payer: Priority Health Medicare	$5.22
Rate for Payer: Priority Health SBD	$16.32
Rate for Payer: Priority Health Tiered Network	$4.18
Rate for Payer: Railroad Medicare Medicare	$5.22
Rate for Payer: UHC All Payor (Choice/PPO)	$7.83
Rate for Payer: UHC Core	$7.83
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$5.22
Rate for Payer: UHC Exchange	$7.83
Rate for Payer: UHC Medicaid	$2.73
Rate for Payer: UHCCP Medicaid	$2.73
Rate for Payer: VA VA	$5.22

HC BOTRYTIS CINEREA IGE

Facility

$25.90

Service Code	CPT 86003
Hospital Charge Code	30200075
Hospital Revenue Code	302
Min. Negotiated Rate	$16.32
Max. Negotiated Rate	$23.31
Rate for Payer: Aetna Commercial	$22.02
Rate for Payer: Aetna New Business (MI Preferred)	$16.84
Rate for Payer: Cash Price	$20.72
Rate for Payer: Cofinity Advantage	$18.13
Rate for Payer: Cofinity Commercial	$22.27
Rate for Payer: Encore Health Key Benefits Commercial	$20.72
Rate for Payer: Healthscope Commercial	$23.31
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$22.02
Rate for Payer: Opus (Opus Packaging Group) HMA	$19.43
Rate for Payer: PHP Commercial	$22.02
Rate for Payer: Priority Health SBD	$16.32

HC BOTTLE A/B CDI 500

Facility

$206.00

Hospital Charge Code	27000684
Hospital Revenue Code	270
Min. Negotiated Rate	$80.96
Max. Negotiated Rate	$185.40
Rate for Payer: Aetna Commercial	$175.10
Rate for Payer: Aetna Medicare	$103.00
Rate for Payer: Aetna New Business (MI Preferred)	$133.90
Rate for Payer: BCBS Complete	$82.40
Rate for Payer: Cash Price	$164.80
Rate for Payer: Cofinity Advantage	$144.20
Rate for Payer: Cofinity Commercial	$177.16
Rate for Payer: Encore Health Key Benefits Commercial	$164.80
Rate for Payer: Healthscope Commercial	$185.40
Rate for Payer: MI Amish Medical Board Commercial	$164.80
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$175.10
Rate for Payer: Opus (Opus Packaging Group) HMA	$154.50
Rate for Payer: PHP Commercial	$175.10
Rate for Payer: Priority Health SBD	$129.78
Rate for Payer: UHC All Payor (Choice/PPO)	$133.90
Rate for Payer: UHC Core	$107.33
Rate for Payer: UHC Exchange	$80.96

HC BOTTLE A/B CDI 500

Facility

$206.00

Hospital Charge Code	27000684
Hospital Revenue Code	270
Min. Negotiated Rate	$129.78
Max. Negotiated Rate	$185.40
Rate for Payer: Aetna Commercial	$175.10
Rate for Payer: Aetna New Business (MI Preferred)	$133.90
Rate for Payer: Cash Price	$164.80
Rate for Payer: Cofinity Advantage	$144.20
Rate for Payer: Cofinity Commercial	$177.16
Rate for Payer: Encore Health Key Benefits Commercial	$164.80
Rate for Payer: Healthscope Commercial	$185.40
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$175.10
Rate for Payer: Opus (Opus Packaging Group) HMA	$154.50
Rate for Payer: PHP Commercial	$175.10
Rate for Payer: Priority Health SBD	$129.78

HC BOWL

Facility

$234.09

Hospital Charge Code	27000091
Hospital Revenue Code	270
Min. Negotiated Rate	$147.48
Max. Negotiated Rate	$210.68
Rate for Payer: Aetna Commercial	$198.98
Rate for Payer: Aetna New Business (MI Preferred)	$152.16
Rate for Payer: Cash Price	$187.27
Rate for Payer: Cofinity Advantage	$163.86
Rate for Payer: Cofinity Commercial	$201.32
Rate for Payer: Encore Health Key Benefits Commercial	$187.27
Rate for Payer: Healthscope Commercial	$210.68
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$198.98
Rate for Payer: Opus (Opus Packaging Group) HMA	$175.57
Rate for Payer: PHP Commercial	$198.98
Rate for Payer: Priority Health SBD	$147.48

HC BOWL

Facility

$234.09

Hospital Charge Code	27000091
Hospital Revenue Code	270
Min. Negotiated Rate	$92.00
Max. Negotiated Rate	$210.68
Rate for Payer: Aetna Commercial	$198.98
Rate for Payer: Aetna Medicare	$117.05
Rate for Payer: Aetna New Business (MI Preferred)	$152.16
Rate for Payer: BCBS Complete	$93.64
Rate for Payer: Cash Price	$187.27
Rate for Payer: Cofinity Advantage	$163.86
Rate for Payer: Cofinity Commercial	$201.32
Rate for Payer: Encore Health Key Benefits Commercial	$187.27
Rate for Payer: Healthscope Commercial	$210.68
Rate for Payer: MI Amish Medical Board Commercial	$187.27
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$198.98
Rate for Payer: Opus (Opus Packaging Group) HMA	$175.57
Rate for Payer: PHP Commercial	$198.98
Rate for Payer: Priority Health SBD	$147.48
Rate for Payer: UHC All Payor (Choice/PPO)	$152.16
Rate for Payer: UHC Core	$121.96
Rate for Payer: UHC Exchange	$92.00

HC BOWL ATS 55 ML

Facility

$258.54

Hospital Charge Code	27000283
Hospital Revenue Code	270
Min. Negotiated Rate	$101.61
Max. Negotiated Rate	$232.69
Rate for Payer: Aetna Commercial	$219.76
Rate for Payer: Aetna Medicare	$129.27
Rate for Payer: Aetna New Business (MI Preferred)	$168.05
Rate for Payer: BCBS Complete	$103.42
Rate for Payer: Cash Price	$206.83
Rate for Payer: Cofinity Advantage	$180.98
Rate for Payer: Cofinity Commercial	$222.34
Rate for Payer: Encore Health Key Benefits Commercial	$206.83
Rate for Payer: Healthscope Commercial	$232.69
Rate for Payer: MI Amish Medical Board Commercial	$206.83
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$219.76
Rate for Payer: Opus (Opus Packaging Group) HMA	$193.91
Rate for Payer: PHP Commercial	$219.76
Rate for Payer: Priority Health SBD	$162.88
Rate for Payer: UHC All Payor (Choice/PPO)	$168.05
Rate for Payer: UHC Core	$134.70
Rate for Payer: UHC Exchange	$101.61

HC BOWL ATS 55 ML

Facility

$258.54

Hospital Charge Code	27000283
Hospital Revenue Code	270
Min. Negotiated Rate	$162.88
Max. Negotiated Rate	$232.69
Rate for Payer: Aetna Commercial	$219.76
Rate for Payer: Aetna New Business (MI Preferred)	$168.05
Rate for Payer: Cash Price	$206.83
Rate for Payer: Cofinity Advantage	$180.98
Rate for Payer: Cofinity Commercial	$222.34
Rate for Payer: Encore Health Key Benefits Commercial	$206.83
Rate for Payer: Healthscope Commercial	$232.69
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$219.76
Rate for Payer: Opus (Opus Packaging Group) HMA	$193.91
Rate for Payer: PHP Commercial	$219.76
Rate for Payer: Priority Health SBD	$162.88

HC B. PARAPERTUSSIS BY PCR CMPT

Facility

$53.49

Service Code	CPT 87798
Hospital Charge Code	30600219
Hospital Revenue Code	306
Min. Negotiated Rate	$18.35
Max. Negotiated Rate	$52.64
Rate for Payer: Aetna Commercial	$45.47
Rate for Payer: Aetna Medicare	$36.49
Rate for Payer: Aetna New Business (MI Preferred)	$34.77
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	$19.27
Rate for Payer: BCBS MAPPO	$35.09
Rate for Payer: BCBS Trust/PPO	$37.42
Rate for Payer: BCN Commercial	$37.42
Rate for Payer: BCN Medicare Advantage	$35.09
Rate for Payer: Cash Price	$42.79
Rate for Payer: Cash Price	$42.79
Rate for Payer: Cofinity Advantage	$37.44
Rate for Payer: Cofinity Commercial	$46.00
Rate for Payer: Encore Health Key Benefits Commercial	$42.79
Rate for Payer: Health Alliance Plan Medicare Advantage	$35.09
Rate for Payer: Healthscope Commercial	$48.14
Rate for Payer: Mclaren Medicaid	$18.35
Rate for Payer: Mclaren Medicare	$35.09
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$36.84
Rate for Payer: Meridian Medicaid	$36.84
Rate for Payer: MI Amish Medical Board Commercial	$40.35
Rate for Payer: Molina Medicare/Medicaid	$38.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$45.47
Rate for Payer: Nomi Health Commercial	$52.63
Rate for Payer: Opus (Opus Packaging Group) HMA	$40.12
Rate for Payer: PACE Medicare	$33.34
Rate for Payer: PACE SWMI	$35.09
Rate for Payer: PHP Commercial	$45.47
Rate for Payer: PHP Medicare Advantage	$35.09
Rate for Payer: Priority Health Choice Medicaid	$18.35
Rate for Payer: Priority Health Medicare	$35.09
Rate for Payer: Priority Health SBD	$33.70
Rate for Payer: Railroad Medicare Medicare	$35.09
Rate for Payer: UHC All Payor (Choice/PPO)	$52.64
Rate for Payer: UHC Core	$52.64
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$35.09
Rate for Payer: UHC Exchange	$52.64
Rate for Payer: UHC Medicaid	$18.35
Rate for Payer: UHCCP Medicaid	$18.35
Rate for Payer: VA VA	$35.09

HC B. PARAPERTUSSIS BY PCR CMPT

Facility

$53.49

Service Code	CPT 87798
Hospital Charge Code	30600219
Hospital Revenue Code	306
Min. Negotiated Rate	$33.70
Max. Negotiated Rate	$48.14
Rate for Payer: Aetna Commercial	$45.47
Rate for Payer: Aetna New Business (MI Preferred)	$34.77
Rate for Payer: Cash Price	$42.79
Rate for Payer: Cofinity Advantage	$37.44
Rate for Payer: Cofinity Commercial	$46.00
Rate for Payer: Encore Health Key Benefits Commercial	$42.79
Rate for Payer: Healthscope Commercial	$48.14
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$45.47
Rate for Payer: Opus (Opus Packaging Group) HMA	$40.12
Rate for Payer: PHP Commercial	$45.47
Rate for Payer: Priority Health SBD	$33.70

HC B.PERTUSSIS BY PCR

Facility

$62.82

Service Code	CPT 87798
Hospital Charge Code	30600218
Hospital Revenue Code	306
Min. Negotiated Rate	$18.35
Max. Negotiated Rate	$56.54
Rate for Payer: Aetna Commercial	$53.40
Rate for Payer: Aetna Medicare	$36.49
Rate for Payer: Aetna New Business (MI Preferred)	$40.83
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	$19.27
Rate for Payer: BCBS MAPPO	$35.09
Rate for Payer: BCBS Trust/PPO	$37.42
Rate for Payer: BCN Commercial	$37.42
Rate for Payer: BCN Medicare Advantage	$35.09
Rate for Payer: Cash Price	$50.26
Rate for Payer: Cash Price	$50.26
Rate for Payer: Cofinity Advantage	$43.97
Rate for Payer: Cofinity Commercial	$54.03
Rate for Payer: Encore Health Key Benefits Commercial	$50.26
Rate for Payer: Health Alliance Plan Medicare Advantage	$35.09
Rate for Payer: Healthscope Commercial	$56.54
Rate for Payer: Mclaren Medicaid	$18.35
Rate for Payer: Mclaren Medicare	$35.09
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$36.84
Rate for Payer: Meridian Medicaid	$36.84
Rate for Payer: MI Amish Medical Board Commercial	$40.35
Rate for Payer: Molina Medicare/Medicaid	$38.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$53.40
Rate for Payer: Nomi Health Commercial	$52.63
Rate for Payer: Opus (Opus Packaging Group) HMA	$47.12
Rate for Payer: PACE Medicare	$33.34
Rate for Payer: PACE SWMI	$35.09
Rate for Payer: PHP Commercial	$53.40
Rate for Payer: PHP Medicare Advantage	$35.09
Rate for Payer: Priority Health Choice Medicaid	$18.35
Rate for Payer: Priority Health Medicare	$35.09
Rate for Payer: Priority Health SBD	$39.58
Rate for Payer: Railroad Medicare Medicare	$35.09
Rate for Payer: UHC All Payor (Choice/PPO)	$52.64
Rate for Payer: UHC Core	$52.64
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$35.09
Rate for Payer: UHC Exchange	$52.64
Rate for Payer: UHC Medicaid	$18.35
Rate for Payer: UHCCP Medicaid	$18.35
Rate for Payer: VA VA	$35.09

HC B.PERTUSSIS BY PCR

Facility

$62.82

Service Code	CPT 87798
Hospital Charge Code	30600218
Hospital Revenue Code	306
Min. Negotiated Rate	$39.58
Max. Negotiated Rate	$56.54
Rate for Payer: Aetna Commercial	$53.40
Rate for Payer: Aetna New Business (MI Preferred)	$40.83
Rate for Payer: Cash Price	$50.26
Rate for Payer: Cofinity Advantage	$43.97
Rate for Payer: Cofinity Commercial	$54.03
Rate for Payer: Encore Health Key Benefits Commercial	$50.26
Rate for Payer: Healthscope Commercial	$56.54
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$53.40
Rate for Payer: Opus (Opus Packaging Group) HMA	$47.12
Rate for Payer: PHP Commercial	$53.40
Rate for Payer: Priority Health SBD	$39.58

HC BRACE ADD TO LE PELVIC CONTROL HIP JOINT

Facility

$991.54

Service Code	HCPCS L2624
Hospital Charge Code	27400039
Hospital Revenue Code	274
Min. Negotiated Rate	$383.62
Max. Negotiated Rate	$1,306.79
Rate for Payer: Aetna Commercial	$842.81
Rate for Payer: Aetna Medicare	$495.77
Rate for Payer: Aetna New Business (MI Preferred)	$644.50
Rate for Payer: BCBS Complete	$396.62
Rate for Payer: BCBS Trust/PPO	$1,306.79
Rate for Payer: BCN Commercial	$1,306.79
Rate for Payer: Cash Price	$793.23
Rate for Payer: Cash Price	$793.23
Rate for Payer: Cofinity Advantage	$694.08
Rate for Payer: Cofinity Commercial	$852.72
Rate for Payer: Encore Health Key Benefits Commercial	$793.23
Rate for Payer: Healthscope Commercial	$892.39
Rate for Payer: MI Amish Medical Board Commercial	$793.23
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$842.81
Rate for Payer: Opus (Opus Packaging Group) HMA	$743.65
Rate for Payer: PHP Commercial	$842.81
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$479.52
Rate for Payer: Priority Health SBD	$624.67
Rate for Payer: Priority Health Tiered Network	$383.62
Rate for Payer: UHC All Payor (Choice/PPO)	$644.50
Rate for Payer: UHC Core	$516.59
Rate for Payer: UHC Exchange	$389.68

HC BRACE ADD TO LE PELVIC CONTROL HIP JOINT

Facility

$991.54

Service Code	HCPCS L2624
Hospital Charge Code	27400039
Hospital Revenue Code	274
Min. Negotiated Rate	$624.67
Max. Negotiated Rate	$892.39
Rate for Payer: Aetna Commercial	$842.81
Rate for Payer: Aetna New Business (MI Preferred)	$644.50
Rate for Payer: Cash Price	$793.23
Rate for Payer: Cofinity Advantage	$694.08
Rate for Payer: Cofinity Commercial	$852.72
Rate for Payer: Encore Health Key Benefits Commercial	$793.23
Rate for Payer: Healthscope Commercial	$892.39
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$842.81
Rate for Payer: Opus (Opus Packaging Group) HMA	$743.65
Rate for Payer: PHP Commercial	$842.81
Rate for Payer: Priority Health SBD	$624.67

HC BRACE AFO

Facility

$608.06

Service Code	HCPCS L1930
Hospital Charge Code	27000002
Hospital Revenue Code	274
Min. Negotiated Rate	$383.08
Max. Negotiated Rate	$547.25
Rate for Payer: Aetna Commercial	$516.85
Rate for Payer: Aetna New Business (MI Preferred)	$395.24
Rate for Payer: Cash Price	$486.45
Rate for Payer: Cofinity Advantage	$425.64
Rate for Payer: Cofinity Commercial	$522.93
Rate for Payer: Encore Health Key Benefits Commercial	$486.45
Rate for Payer: Healthscope Commercial	$547.25
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$516.85
Rate for Payer: Opus (Opus Packaging Group) HMA	$456.05
Rate for Payer: PHP Commercial	$516.85
Rate for Payer: Priority Health SBD	$383.08

HC BRACE AFO

Facility

$608.06

Service Code	HCPCS L1930
Hospital Charge Code	27000002
Hospital Revenue Code	274
Min. Negotiated Rate	$238.97
Max. Negotiated Rate	$843.72
Rate for Payer: Aetna Commercial	$516.85
Rate for Payer: Aetna Medicare	$304.03
Rate for Payer: Aetna New Business (MI Preferred)	$395.24
Rate for Payer: BCBS Complete	$243.22
Rate for Payer: BCBS Trust/PPO	$843.72
Rate for Payer: BCN Commercial	$843.72
Rate for Payer: Cash Price	$486.45
Rate for Payer: Cash Price	$486.45
Rate for Payer: Cofinity Advantage	$425.64
Rate for Payer: Cofinity Commercial	$522.93
Rate for Payer: Encore Health Key Benefits Commercial	$486.45
Rate for Payer: Healthscope Commercial	$547.25
Rate for Payer: MI Amish Medical Board Commercial	$486.45
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$516.85
Rate for Payer: Opus (Opus Packaging Group) HMA	$456.05
Rate for Payer: PHP Commercial	$516.85
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$309.60
Rate for Payer: Priority Health SBD	$383.08
Rate for Payer: Priority Health Tiered Network	$247.68
Rate for Payer: UHC All Payor (Choice/PPO)	$395.24
Rate for Payer: UHC Core	$316.80
Rate for Payer: UHC Exchange	$238.97

Know your out-of-pocket cost for care.

All Charges