Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC BALLOON CATH TRANSLUMINAL LVL 4

Facility

$421.04

Service Code	HCPCS C1725
Hospital Charge Code	27200053
Hospital Revenue Code	272
Min. Negotiated Rate	$168.42
Max. Negotiated Rate	$378.94
Rate for Payer: Aetna Commercial	$357.88
Rate for Payer: Aetna Medicare	$210.52
Rate for Payer: Aetna New Business (MI Preferred)	$273.68
Rate for Payer: BCBS Complete	$168.42
Rate for Payer: Cash Price	$336.83
Rate for Payer: Cofinity Commercial	$294.73
Rate for Payer: Cofinity Commercial	$362.09
Rate for Payer: Cofinity Medicare Advantage	$294.73
Rate for Payer: Encore Health Key Benefits Commercial	$336.83
Rate for Payer: Healthscope Commercial	$378.94
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$357.88
Rate for Payer: PHP Commercial	$357.88
Rate for Payer: Priority Health Cigna Priority Health	$273.68
Rate for Payer: Priority Health SBD	$265.26

HC BALLOON CATH TRANSLUMINAL LVL 5

Facility

$588.11

Service Code	HCPCS C1725
Hospital Charge Code	27200078
Hospital Revenue Code	272
Min. Negotiated Rate	$370.51
Max. Negotiated Rate	$529.30
Rate for Payer: Aetna Commercial	$499.89
Rate for Payer: Aetna New Business (MI Preferred)	$382.27
Rate for Payer: Cash Price	$470.49
Rate for Payer: Cofinity Commercial	$411.68
Rate for Payer: Cofinity Commercial	$505.77
Rate for Payer: Cofinity Medicare Advantage	$411.68
Rate for Payer: Encore Health Key Benefits Commercial	$470.49
Rate for Payer: Healthscope Commercial	$529.30
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$499.89
Rate for Payer: PHP Commercial	$499.89
Rate for Payer: Priority Health Cigna Priority Health	$382.27
Rate for Payer: Priority Health SBD	$370.51

HC BALLOON CATH TRANSLUMINAL LVL 5

Facility

$588.11

Service Code	HCPCS C1725
Hospital Charge Code	27200078
Hospital Revenue Code	272
Min. Negotiated Rate	$235.24
Max. Negotiated Rate	$529.30
Rate for Payer: Aetna Commercial	$499.89
Rate for Payer: Aetna Medicare	$294.06
Rate for Payer: Aetna New Business (MI Preferred)	$382.27
Rate for Payer: BCBS Complete	$235.24
Rate for Payer: Cash Price	$470.49
Rate for Payer: Cofinity Commercial	$411.68
Rate for Payer: Cofinity Commercial	$505.77
Rate for Payer: Cofinity Medicare Advantage	$411.68
Rate for Payer: Encore Health Key Benefits Commercial	$470.49
Rate for Payer: Healthscope Commercial	$529.30
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$499.89
Rate for Payer: PHP Commercial	$499.89
Rate for Payer: Priority Health Cigna Priority Health	$382.27
Rate for Payer: Priority Health SBD	$370.51

HC BALLOON CATH TRANSLUMINAL LVL 6

Facility

$691.56

Service Code	HCPCS C1725
Hospital Charge Code	27200016
Hospital Revenue Code	272
Min. Negotiated Rate	$276.62
Max. Negotiated Rate	$622.40
Rate for Payer: Aetna Commercial	$587.83
Rate for Payer: Aetna Medicare	$345.78
Rate for Payer: Aetna New Business (MI Preferred)	$449.51
Rate for Payer: BCBS Complete	$276.62
Rate for Payer: Cash Price	$553.25
Rate for Payer: Cofinity Commercial	$484.09
Rate for Payer: Cofinity Commercial	$594.74
Rate for Payer: Cofinity Medicare Advantage	$484.09
Rate for Payer: Encore Health Key Benefits Commercial	$553.25
Rate for Payer: Healthscope Commercial	$622.40
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$587.83
Rate for Payer: PHP Commercial	$587.83
Rate for Payer: Priority Health Cigna Priority Health	$449.51
Rate for Payer: Priority Health SBD	$435.68

HC BALLOON CATH TRANSLUMINAL LVL 6

Facility

$691.56

Service Code	HCPCS C1725
Hospital Charge Code	27200016
Hospital Revenue Code	272
Min. Negotiated Rate	$435.68
Max. Negotiated Rate	$622.40
Rate for Payer: Aetna Commercial	$587.83
Rate for Payer: Aetna New Business (MI Preferred)	$449.51
Rate for Payer: Cash Price	$553.25
Rate for Payer: Cofinity Commercial	$484.09
Rate for Payer: Cofinity Commercial	$594.74
Rate for Payer: Cofinity Medicare Advantage	$484.09
Rate for Payer: Encore Health Key Benefits Commercial	$553.25
Rate for Payer: Healthscope Commercial	$622.40
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$587.83
Rate for Payer: PHP Commercial	$587.83
Rate for Payer: Priority Health Cigna Priority Health	$449.51
Rate for Payer: Priority Health SBD	$435.68

HC BALLOON CATH TRANSLUMINAL LVL 69

Facility

$6,937.70

Service Code	HCPCS C1725
Hospital Charge Code	27200064
Hospital Revenue Code	272
Min. Negotiated Rate	$4,370.75
Max. Negotiated Rate	$6,243.93
Rate for Payer: Aetna Commercial	$5,897.05
Rate for Payer: Aetna New Business (MI Preferred)	$4,509.51
Rate for Payer: Cash Price	$5,550.16
Rate for Payer: Cofinity Commercial	$4,856.39
Rate for Payer: Cofinity Commercial	$5,966.42
Rate for Payer: Cofinity Medicare Advantage	$4,856.39
Rate for Payer: Encore Health Key Benefits Commercial	$5,550.16
Rate for Payer: Healthscope Commercial	$6,243.93
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$5,897.05
Rate for Payer: PHP Commercial	$5,897.05
Rate for Payer: Priority Health Cigna Priority Health	$4,509.51
Rate for Payer: Priority Health SBD	$4,370.75

HC BALLOON CATH TRANSLUMINAL LVL 69

Facility

$6,937.70

Service Code	HCPCS C1725
Hospital Charge Code	27200064
Hospital Revenue Code	272
Min. Negotiated Rate	$2,775.08
Max. Negotiated Rate	$6,243.93
Rate for Payer: Aetna Commercial	$5,897.05
Rate for Payer: Aetna Medicare	$3,468.85
Rate for Payer: Aetna New Business (MI Preferred)	$4,509.51
Rate for Payer: BCBS Complete	$2,775.08
Rate for Payer: Cash Price	$5,550.16
Rate for Payer: Cofinity Commercial	$4,856.39
Rate for Payer: Cofinity Commercial	$5,966.42
Rate for Payer: Cofinity Medicare Advantage	$4,856.39
Rate for Payer: Encore Health Key Benefits Commercial	$5,550.16
Rate for Payer: Healthscope Commercial	$6,243.93
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$5,897.05
Rate for Payer: PHP Commercial	$5,897.05
Rate for Payer: Priority Health Cigna Priority Health	$4,509.51
Rate for Payer: Priority Health SBD	$4,370.75

HC BALLOON CATH TRANSLUMINAL LVL 7

Facility

$734.40

Service Code	HCPCS C1725
Hospital Charge Code	27200044
Hospital Revenue Code	272
Min. Negotiated Rate	$293.76
Max. Negotiated Rate	$660.96
Rate for Payer: Aetna Commercial	$624.24
Rate for Payer: Aetna Medicare	$367.20
Rate for Payer: Aetna New Business (MI Preferred)	$477.36
Rate for Payer: BCBS Complete	$293.76
Rate for Payer: Cash Price	$587.52
Rate for Payer: Cofinity Commercial	$514.08
Rate for Payer: Cofinity Commercial	$631.58
Rate for Payer: Cofinity Medicare Advantage	$514.08
Rate for Payer: Encore Health Key Benefits Commercial	$587.52
Rate for Payer: Healthscope Commercial	$660.96
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$624.24
Rate for Payer: PHP Commercial	$624.24
Rate for Payer: Priority Health Cigna Priority Health	$477.36
Rate for Payer: Priority Health SBD	$462.67

HC BALLOON CATH TRANSLUMINAL LVL 7

Facility

$734.40

Service Code	HCPCS C1725
Hospital Charge Code	27200044
Hospital Revenue Code	272
Min. Negotiated Rate	$462.67
Max. Negotiated Rate	$660.96
Rate for Payer: Aetna Commercial	$624.24
Rate for Payer: Aetna New Business (MI Preferred)	$477.36
Rate for Payer: Cash Price	$587.52
Rate for Payer: Cofinity Commercial	$514.08
Rate for Payer: Cofinity Commercial	$631.58
Rate for Payer: Cofinity Medicare Advantage	$514.08
Rate for Payer: Encore Health Key Benefits Commercial	$587.52
Rate for Payer: Healthscope Commercial	$660.96
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$624.24
Rate for Payer: PHP Commercial	$624.24
Rate for Payer: Priority Health Cigna Priority Health	$477.36
Rate for Payer: Priority Health SBD	$462.67

HC BALLOON CATH TRANSLUMINAL LVL 8

Facility

$886.79

Service Code	HCPCS C1725
Hospital Charge Code	27200264
Hospital Revenue Code	272
Min. Negotiated Rate	$354.72
Max. Negotiated Rate	$798.11
Rate for Payer: Aetna Commercial	$753.77
Rate for Payer: Aetna Medicare	$443.39
Rate for Payer: Aetna New Business (MI Preferred)	$576.41
Rate for Payer: BCBS Complete	$354.72
Rate for Payer: Cash Price	$709.43
Rate for Payer: Cofinity Commercial	$620.75
Rate for Payer: Cofinity Commercial	$762.64
Rate for Payer: Cofinity Medicare Advantage	$620.75
Rate for Payer: Encore Health Key Benefits Commercial	$709.43
Rate for Payer: Healthscope Commercial	$798.11
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$753.77
Rate for Payer: PHP Commercial	$753.77
Rate for Payer: Priority Health Cigna Priority Health	$576.41
Rate for Payer: Priority Health SBD	$558.68

HC BALLOON CATH TRANSLUMINAL LVL 8

Facility

$886.79

Service Code	HCPCS C1725
Hospital Charge Code	27200264
Hospital Revenue Code	272
Min. Negotiated Rate	$558.68
Max. Negotiated Rate	$798.11
Rate for Payer: Aetna Commercial	$753.77
Rate for Payer: Aetna New Business (MI Preferred)	$576.41
Rate for Payer: Cash Price	$709.43
Rate for Payer: Cofinity Commercial	$620.75
Rate for Payer: Cofinity Commercial	$762.64
Rate for Payer: Cofinity Medicare Advantage	$620.75
Rate for Payer: Encore Health Key Benefits Commercial	$709.43
Rate for Payer: Healthscope Commercial	$798.11
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$753.77
Rate for Payer: PHP Commercial	$753.77
Rate for Payer: Priority Health Cigna Priority Health	$576.41
Rate for Payer: Priority Health SBD	$558.68

HC BALLOON DILITATION URETER

Facility

$748.54

Service Code	CPT 50706
Hospital Charge Code	36100512
Hospital Revenue Code	361
Min. Negotiated Rate	$471.58
Max. Negotiated Rate	$673.69
Rate for Payer: Aetna Commercial	$636.26
Rate for Payer: Aetna New Business (MI Preferred)	$486.55
Rate for Payer: Cash Price	$598.83
Rate for Payer: Cofinity Commercial	$523.98
Rate for Payer: Cofinity Commercial	$643.74
Rate for Payer: Cofinity Medicare Advantage	$523.98
Rate for Payer: Encore Health Key Benefits Commercial	$598.83
Rate for Payer: Healthscope Commercial	$673.69
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$636.26
Rate for Payer: PHP Commercial	$636.26
Rate for Payer: Priority Health Cigna Priority Health	$486.55
Rate for Payer: Priority Health SBD	$471.58

HC BALLOON DILITATION URETER

Facility

$748.54

Service Code	CPT 50706
Hospital Charge Code	36100512
Hospital Revenue Code	361
Min. Negotiated Rate	$299.42
Max. Negotiated Rate	$673.69
Rate for Payer: Aetna Commercial	$636.26
Rate for Payer: Aetna Medicare	$374.27
Rate for Payer: Aetna New Business (MI Preferred)	$486.55
Rate for Payer: BCBS Complete	$299.42
Rate for Payer: Cash Price	$598.83
Rate for Payer: Cofinity Commercial	$523.98
Rate for Payer: Cofinity Commercial	$643.74
Rate for Payer: Cofinity Medicare Advantage	$523.98
Rate for Payer: Encore Health Key Benefits Commercial	$598.83
Rate for Payer: Healthscope Commercial	$673.69
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$636.26
Rate for Payer: PHP Commercial	$636.26
Rate for Payer: Priority Health Cigna Priority Health	$486.55
Rate for Payer: Priority Health SBD	$471.58

HC BALLOON PUMP SETUP

Facility

$1,925.03

Hospital Charge Code	27000090
Hospital Revenue Code	270
Min. Negotiated Rate	$1,212.77
Max. Negotiated Rate	$1,732.53
Rate for Payer: Aetna Commercial	$1,636.28
Rate for Payer: Aetna New Business (MI Preferred)	$1,251.27
Rate for Payer: Cash Price	$1,540.02
Rate for Payer: Cofinity Commercial	$1,347.52
Rate for Payer: Cofinity Commercial	$1,655.53
Rate for Payer: Cofinity Medicare Advantage	$1,347.52
Rate for Payer: Encore Health Key Benefits Commercial	$1,540.02
Rate for Payer: Healthscope Commercial	$1,732.53
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,636.28
Rate for Payer: PHP Commercial	$1,636.28
Rate for Payer: Priority Health Cigna Priority Health	$1,251.27
Rate for Payer: Priority Health SBD	$1,212.77

HC BALLOON PUMP SETUP

Facility

$1,925.03

Hospital Charge Code	27000090
Hospital Revenue Code	270
Min. Negotiated Rate	$770.01
Max. Negotiated Rate	$1,732.53
Rate for Payer: Aetna Commercial	$1,636.28
Rate for Payer: Aetna Medicare	$962.51
Rate for Payer: Aetna New Business (MI Preferred)	$1,251.27
Rate for Payer: BCBS Complete	$770.01
Rate for Payer: Cash Price	$1,540.02
Rate for Payer: Cofinity Commercial	$1,347.52
Rate for Payer: Cofinity Commercial	$1,655.53
Rate for Payer: Cofinity Medicare Advantage	$1,347.52
Rate for Payer: Encore Health Key Benefits Commercial	$1,540.02
Rate for Payer: Healthscope Commercial	$1,732.53
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,636.28
Rate for Payer: PHP Commercial	$1,636.28
Rate for Payer: Priority Health Cigna Priority Health	$1,251.27
Rate for Payer: Priority Health SBD	$1,212.77

HC BALLOONS CATH TRANSLUMINAL LVL 1

Facility

$82.47

Service Code	HCPCS C1725
Hospital Charge Code	27200262
Hospital Revenue Code	272
Min. Negotiated Rate	$51.96
Max. Negotiated Rate	$74.22
Rate for Payer: Aetna Commercial	$70.10
Rate for Payer: Aetna New Business (MI Preferred)	$53.61
Rate for Payer: Cash Price	$65.98
Rate for Payer: Cofinity Commercial	$57.73
Rate for Payer: Cofinity Commercial	$70.92
Rate for Payer: Cofinity Medicare Advantage	$57.73
Rate for Payer: Encore Health Key Benefits Commercial	$65.98
Rate for Payer: Healthscope Commercial	$74.22
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$70.10
Rate for Payer: PHP Commercial	$70.10
Rate for Payer: Priority Health Cigna Priority Health	$53.61
Rate for Payer: Priority Health SBD	$51.96

HC BALLOONS CATH TRANSLUMINAL LVL 1

Facility

$82.47

Service Code	HCPCS C1725
Hospital Charge Code	27200262
Hospital Revenue Code	272
Min. Negotiated Rate	$32.99
Max. Negotiated Rate	$74.22
Rate for Payer: Aetna Commercial	$70.10
Rate for Payer: Aetna Medicare	$41.23
Rate for Payer: Aetna New Business (MI Preferred)	$53.61
Rate for Payer: BCBS Complete	$32.99
Rate for Payer: Cash Price	$65.98
Rate for Payer: Cofinity Commercial	$57.73
Rate for Payer: Cofinity Commercial	$70.92
Rate for Payer: Cofinity Medicare Advantage	$57.73
Rate for Payer: Encore Health Key Benefits Commercial	$65.98
Rate for Payer: Healthscope Commercial	$74.22
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$70.10
Rate for Payer: PHP Commercial	$70.10
Rate for Payer: Priority Health Cigna Priority Health	$53.61
Rate for Payer: Priority Health SBD	$51.96

HC BALLOONS CATH TRANSLUMINAL LVL 2

Facility

$249.07

Service Code	HCPCS C1725
Hospital Charge Code	27200263
Hospital Revenue Code	272
Min. Negotiated Rate	$156.91
Max. Negotiated Rate	$224.16
Rate for Payer: Aetna Commercial	$211.71
Rate for Payer: Aetna New Business (MI Preferred)	$161.90
Rate for Payer: Cash Price	$199.26
Rate for Payer: Cofinity Commercial	$174.35
Rate for Payer: Cofinity Commercial	$214.20
Rate for Payer: Cofinity Medicare Advantage	$174.35
Rate for Payer: Encore Health Key Benefits Commercial	$199.26
Rate for Payer: Healthscope Commercial	$224.16
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$211.71
Rate for Payer: PHP Commercial	$211.71
Rate for Payer: Priority Health Cigna Priority Health	$161.90
Rate for Payer: Priority Health SBD	$156.91

HC BALLOONS CATH TRANSLUMINAL LVL 2

Facility

$249.07

Service Code	HCPCS C1725
Hospital Charge Code	27200263
Hospital Revenue Code	272
Min. Negotiated Rate	$99.63
Max. Negotiated Rate	$224.16
Rate for Payer: Aetna Commercial	$211.71
Rate for Payer: Aetna Medicare	$124.53
Rate for Payer: Aetna New Business (MI Preferred)	$161.90
Rate for Payer: BCBS Complete	$99.63
Rate for Payer: Cash Price	$199.26
Rate for Payer: Cofinity Commercial	$174.35
Rate for Payer: Cofinity Commercial	$214.20
Rate for Payer: Cofinity Medicare Advantage	$174.35
Rate for Payer: Encore Health Key Benefits Commercial	$199.26
Rate for Payer: Healthscope Commercial	$224.16
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$211.71
Rate for Payer: PHP Commercial	$211.71
Rate for Payer: Priority Health Cigna Priority Health	$161.90
Rate for Payer: Priority Health SBD	$156.91

HC BALLOON STONE EXTRACTION

Facility

$3,189.23

Hospital Charge Code	36000008
Hospital Revenue Code	360
Min. Negotiated Rate	$2,009.21
Max. Negotiated Rate	$2,870.31
Rate for Payer: Aetna Commercial	$2,710.85
Rate for Payer: Aetna New Business (MI Preferred)	$2,073.00
Rate for Payer: Cash Price	$2,551.38
Rate for Payer: Cofinity Commercial	$2,232.46
Rate for Payer: Cofinity Commercial	$2,742.74
Rate for Payer: Cofinity Medicare Advantage	$2,232.46
Rate for Payer: Encore Health Key Benefits Commercial	$2,551.38
Rate for Payer: Healthscope Commercial	$2,870.31
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2,710.85
Rate for Payer: PHP Commercial	$2,710.85
Rate for Payer: Priority Health Cigna Priority Health	$2,073.00
Rate for Payer: Priority Health SBD	$2,009.21

HC BALLOON STONE EXTRACTION

Facility

$3,189.23

Hospital Charge Code	36000008
Hospital Revenue Code	360
Min. Negotiated Rate	$1,275.69
Max. Negotiated Rate	$2,870.31
Rate for Payer: Aetna Commercial	$2,710.85
Rate for Payer: Aetna Medicare	$1,594.62
Rate for Payer: Aetna New Business (MI Preferred)	$2,073.00
Rate for Payer: BCBS Complete	$1,275.69
Rate for Payer: Cash Price	$2,551.38
Rate for Payer: Cofinity Commercial	$2,232.46
Rate for Payer: Cofinity Commercial	$2,742.74
Rate for Payer: Cofinity Medicare Advantage	$2,232.46
Rate for Payer: Encore Health Key Benefits Commercial	$2,551.38
Rate for Payer: Healthscope Commercial	$2,870.31
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2,710.85
Rate for Payer: PHP Commercial	$2,710.85
Rate for Payer: Priority Health Cigna Priority Health	$2,073.00
Rate for Payer: Priority Health SBD	$2,009.21

HC BANANA IGE

Facility

$25.39

Service Code	CPT 86003
Hospital Charge Code	30200073
Hospital Revenue Code	302
Min. Negotiated Rate	$2.80
Max. Negotiated Rate	$22.85
Rate for Payer: Aetna Commercial	$21.58
Rate for Payer: Aetna Medicare	$5.43
Rate for Payer: Aetna New Business (MI Preferred)	$16.50
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	$2.94
Rate for Payer: BCBS MAPPO	$5.22
Rate for Payer: BCN Medicare Advantage	$5.22
Rate for Payer: Cash Price	$20.31
Rate for Payer: Cash Price	$20.31
Rate for Payer: Cofinity Commercial	$21.84
Rate for Payer: Cofinity Commercial	$17.77
Rate for Payer: Cofinity Medicare Advantage	$17.77
Rate for Payer: Encore Health Key Benefits Commercial	$20.31
Rate for Payer: Health Alliance Plan Medicare Advantage	$5.22
Rate for Payer: Healthscope Commercial	$22.85
Rate for Payer: Mclaren Medicaid	$2.80
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	$2.94
Rate for Payer: MI Amish Medical Board Commercial	$6.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$21.58
Rate for Payer: PACE Medicare	$4.96
Rate for Payer: PACE SWMI	$5.22
Rate for Payer: PHP Commercial	$21.58
Rate for Payer: PHP Medicare Advantage	$5.22
Rate for Payer: Priority Health Choice Medicaid	$2.80
Rate for Payer: Priority Health Cigna Priority Health	$16.50
Rate for Payer: Priority Health Medicare	$5.22
Rate for Payer: Priority Health SBD	$16.00
Rate for Payer: Railroad Medicare Medicare	$5.22
Rate for Payer: UHC All Payor (Choice/PPO)	$14.69
Rate for Payer: UHC Dual Complete DSNP	$5.22
Rate for Payer: UHC Medicare Advantage	$5.22
Rate for Payer: UHCCP Medicaid	$2.94
Rate for Payer: VA VA	$5.22

HC BANANA IGE

Facility

$25.39

Service Code	CPT 86003
Hospital Charge Code	30200073
Hospital Revenue Code	302
Min. Negotiated Rate	$16.00
Max. Negotiated Rate	$22.85
Rate for Payer: Aetna Commercial	$21.58
Rate for Payer: Aetna New Business (MI Preferred)	$16.50
Rate for Payer: Cash Price	$20.31
Rate for Payer: Cofinity Commercial	$17.77
Rate for Payer: Cofinity Commercial	$21.84
Rate for Payer: Cofinity Medicare Advantage	$17.77
Rate for Payer: Encore Health Key Benefits Commercial	$20.31
Rate for Payer: Healthscope Commercial	$22.85
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$21.58
Rate for Payer: PHP Commercial	$21.58
Rate for Payer: Priority Health Cigna Priority Health	$16.50
Rate for Payer: Priority Health SBD	$16.00

HC BANDAGE SCISSORS

Facility

$13.69

Hospital Charge Code	27000029
Hospital Revenue Code	270
Min. Negotiated Rate	$5.48
Max. Negotiated Rate	$12.32
Rate for Payer: Aetna Commercial	$11.64
Rate for Payer: Aetna Medicare	$6.84
Rate for Payer: Aetna New Business (MI Preferred)	$8.90
Rate for Payer: BCBS Complete	$5.48
Rate for Payer: Cash Price	$10.95
Rate for Payer: Cofinity Commercial	$11.77
Rate for Payer: Cofinity Commercial	$9.58
Rate for Payer: Cofinity Medicare Advantage	$9.58
Rate for Payer: Encore Health Key Benefits Commercial	$10.95
Rate for Payer: Healthscope Commercial	$12.32
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$11.64
Rate for Payer: PHP Commercial	$11.64
Rate for Payer: Priority Health Cigna Priority Health	$8.90
Rate for Payer: Priority Health SBD	$8.62

HC BANDAGE SCISSORS

Facility

$13.69

Hospital Charge Code	27000029
Hospital Revenue Code	270
Min. Negotiated Rate	$8.62
Max. Negotiated Rate	$12.32
Rate for Payer: Aetna Commercial	$11.64
Rate for Payer: Aetna New Business (MI Preferred)	$8.90
Rate for Payer: Cash Price	$10.95
Rate for Payer: Cofinity Commercial	$11.77
Rate for Payer: Cofinity Commercial	$9.58
Rate for Payer: Cofinity Medicare Advantage	$9.58
Rate for Payer: Encore Health Key Benefits Commercial	$10.95
Rate for Payer: Healthscope Commercial	$12.32
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$11.64
Rate for Payer: PHP Commercial	$11.64
Rate for Payer: Priority Health Cigna Priority Health	$8.90
Rate for Payer: Priority Health SBD	$8.62

Know your out-of-pocket cost for care.

All Charges