Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC FLEX SHEATH INTRO

Facility

$249.93

Service Code	HCPCS C1894
Hospital Charge Code	27200041
Hospital Revenue Code	272
Min. Negotiated Rate	$99.97
Max. Negotiated Rate	$224.94
Rate for Payer: Aetna Commercial	$212.44
Rate for Payer: Aetna New Business (MI Preferred)	$162.45
Rate for Payer: BCBS Complete	$99.97
Rate for Payer: Cash Price	$199.94
Rate for Payer: Cofinity Commercial	$174.95
Rate for Payer: Cofinity Commercial	$214.94
Rate for Payer: Healthscope Commercial	$224.94
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$212.44
Rate for Payer: PHP Commercial	$212.44
Rate for Payer: Priority Health Cigna Priority Health	$174.95
Rate for Payer: Priority Health SBD	$157.46

HC FLOSEAL HEMOSTATIC MATRIX

Facility

$730.90

Hospital Charge Code	27200123
Hospital Revenue Code	272
Min. Negotiated Rate	$292.36
Max. Negotiated Rate	$657.81
Rate for Payer: Aetna Commercial	$621.26
Rate for Payer: Aetna New Business (MI Preferred)	$475.08
Rate for Payer: BCBS Complete	$292.36
Rate for Payer: Cash Price	$584.72
Rate for Payer: Cofinity Commercial	$511.63
Rate for Payer: Cofinity Commercial	$628.57
Rate for Payer: Healthscope Commercial	$657.81
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$621.26
Rate for Payer: PHP Commercial	$621.26
Rate for Payer: Priority Health Cigna Priority Health	$511.63
Rate for Payer: Priority Health SBD	$460.47

HC FLOSEAL HEMOSTATIC MATRIX

Facility

$730.90

Hospital Charge Code	27200123
Hospital Revenue Code	272
Min. Negotiated Rate	$460.47
Max. Negotiated Rate	$657.81
Rate for Payer: Aetna Commercial	$621.26
Rate for Payer: Aetna New Business (MI Preferred)	$475.08
Rate for Payer: Cash Price	$584.72
Rate for Payer: Cofinity Commercial	$511.63
Rate for Payer: Cofinity Commercial	$628.57
Rate for Payer: Healthscope Commercial	$657.81
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$621.26
Rate for Payer: PHP Commercial	$621.26
Rate for Payer: Priority Health Cigna Priority Health	$511.63
Rate for Payer: Priority Health SBD	$460.47

HC FLOW CYTOMETRY, CELL SURFACE, ADDL

Facility

$53.75

Service Code	CPT 88185
Hospital Charge Code	31100041
Hospital Revenue Code	311
Min. Negotiated Rate	$33.86
Max. Negotiated Rate	$48.38
Rate for Payer: Aetna Commercial	$45.69
Rate for Payer: Aetna New Business (MI Preferred)	$34.94
Rate for Payer: Cash Price	$43.00
Rate for Payer: Cofinity Commercial	$37.62
Rate for Payer: Cofinity Commercial	$46.22
Rate for Payer: Healthscope Commercial	$48.38
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$45.69
Rate for Payer: PHP Commercial	$45.69
Rate for Payer: Priority Health Cigna Priority Health	$37.62
Rate for Payer: Priority Health SBD	$33.86

HC FLOW CYTOMETRY, CELL SURFACE, ADDL

Facility

$53.75

Service Code	CPT 88185
Hospital Charge Code	31100041
Hospital Revenue Code	311
Min. Negotiated Rate	$20.50
Max. Negotiated Rate	$48.38
Rate for Payer: Aetna Commercial	$45.69
Rate for Payer: Aetna New Business (MI Preferred)	$34.94
Rate for Payer: BCBS Complete	$21.50
Rate for Payer: BCBS Trust/PPO	$29.37
Rate for Payer: Cash Price	$43.00
Rate for Payer: Cash Price	$43.00
Rate for Payer: Cofinity Commercial	$37.62
Rate for Payer: Cofinity Commercial	$46.22
Rate for Payer: Healthscope Commercial	$48.38
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$45.69
Rate for Payer: PHP Commercial	$45.69
Rate for Payer: Priority Health Cigna Priority Health	$37.62
Rate for Payer: Priority Health SBD	$33.86
Rate for Payer: UHC All Payor (Choice/PPO)	$25.58
Rate for Payer: UHC Core	$20.50
Rate for Payer: UHC Exchange	$23.25

HC FLOW CYTOMETRY, CELL SURFACE, FIRST

Facility

$180.00

Service Code	CPT 88184
Hospital Charge Code	31100040
Hospital Revenue Code	311
Min. Negotiated Rate	$20.50
Max. Negotiated Rate	$906.83
Rate for Payer: Aetna Commercial	$153.00
Rate for Payer: Aetna Medicare	$332.63
Rate for Payer: Aetna New Business (MI Preferred)	$117.00
Rate for Payer: Allen County Amish Medical Aid Commercial	$399.80
Rate for Payer: Amish Plain Church Group Commercial	$399.80
Rate for Payer: BCBS Complete	$183.72
Rate for Payer: BCBS MAPPO	$319.84
Rate for Payer: BCBS Trust/PPO	$91.84
Rate for Payer: BCN Medicare Advantage	$319.84
Rate for Payer: Cash Price	$144.00
Rate for Payer: Cash Price	$144.00
Rate for Payer: Cofinity Commercial	$126.00
Rate for Payer: Cofinity Commercial	$154.80
Rate for Payer: Health Alliance Plan Medicare Advantage	$319.84
Rate for Payer: Healthscope Commercial	$162.00
Rate for Payer: Mclaren Medicaid	$174.95
Rate for Payer: Mclaren Medicare	$319.84
Rate for Payer: Meridian Medicaid	$183.72
Rate for Payer: Meridian Wellcare - Medicare Advantage	$335.83
Rate for Payer: MI Amish Medical Board Commercial	$367.82
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$153.00
Rate for Payer: PACE Medicare	$303.85
Rate for Payer: PACE SWMI	$319.84
Rate for Payer: PHP Commercial	$153.00
Rate for Payer: PHP Medicare Advantage	$319.84
Rate for Payer: Priority Health Choice Medicaid	$174.95
Rate for Payer: Priority Health Cigna Priority Health	$126.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$906.83
Rate for Payer: Priority Health Medicare	$319.84
Rate for Payer: Priority Health Narrow Network	$725.46
Rate for Payer: Priority Health SBD	$113.40
Rate for Payer: Railroad Medicare Medicare	$319.84
Rate for Payer: UHC All Payor (Choice/PPO)	$84.28
Rate for Payer: UHC Core	$20.50
Rate for Payer: UHC Dual Complete DSNP	$319.84
Rate for Payer: UHC Exchange	$76.62
Rate for Payer: UHC Medicare Advantage	$329.44
Rate for Payer: VA VA	$319.84

HC FLOW CYTOMETRY, CELL SURFACE, FIRST

Facility

$180.00

Service Code	CPT 88184
Hospital Charge Code	31100040
Hospital Revenue Code	311
Min. Negotiated Rate	$113.40
Max. Negotiated Rate	$162.00
Rate for Payer: Aetna Commercial	$153.00
Rate for Payer: Aetna New Business (MI Preferred)	$117.00
Rate for Payer: Cash Price	$144.00
Rate for Payer: Cofinity Commercial	$154.80
Rate for Payer: Cofinity Commercial	$126.00
Rate for Payer: Healthscope Commercial	$162.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$153.00
Rate for Payer: PHP Commercial	$153.00
Rate for Payer: Priority Health Cigna Priority Health	$126.00
Rate for Payer: Priority Health SBD	$113.40

HC FLUID CREATININE

Facility

$20.40

Service Code	CPT 82570
Hospital Charge Code	30100498
Hospital Revenue Code	301
Min. Negotiated Rate	$12.85
Max. Negotiated Rate	$18.36
Rate for Payer: Aetna Commercial	$17.34
Rate for Payer: Aetna New Business (MI Preferred)	$13.26
Rate for Payer: Cash Price	$16.32
Rate for Payer: Cofinity Commercial	$14.28
Rate for Payer: Cofinity Commercial	$17.54
Rate for Payer: Healthscope Commercial	$18.36
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$17.34
Rate for Payer: PHP Commercial	$17.34
Rate for Payer: Priority Health Cigna Priority Health	$14.28
Rate for Payer: Priority Health SBD	$12.85

HC FLUID CREATININE

Facility

$20.40

Service Code	CPT 82570
Hospital Charge Code	30100498
Hospital Revenue Code	301
Min. Negotiated Rate	$2.83
Max. Negotiated Rate	$18.36
Rate for Payer: Aetna Commercial	$17.34
Rate for Payer: Aetna Medicare	$5.39
Rate for Payer: Aetna New Business (MI Preferred)	$13.26
Rate for Payer: Allen County Amish Medical Aid Commercial	$6.48
Rate for Payer: Amish Plain Church Group Commercial	$6.48
Rate for Payer: BCBS Complete	$2.98
Rate for Payer: BCBS MAPPO	$5.18
Rate for Payer: BCBS Trust/PPO	$4.06
Rate for Payer: BCN Medicare Advantage	$5.18
Rate for Payer: Cash Price	$16.32
Rate for Payer: Cash Price	$16.32
Rate for Payer: Cofinity Commercial	$17.54
Rate for Payer: Cofinity Commercial	$14.28
Rate for Payer: Health Alliance Plan Medicare Advantage	$5.18
Rate for Payer: Healthscope Commercial	$18.36
Rate for Payer: Mclaren Medicaid	$2.83
Rate for Payer: Mclaren Medicare	$5.18
Rate for Payer: Meridian Medicaid	$2.98
Rate for Payer: Meridian Wellcare - Medicare Advantage	$5.44
Rate for Payer: MI Amish Medical Board Commercial	$5.96
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$17.34
Rate for Payer: PACE Medicare	$4.92
Rate for Payer: PACE SWMI	$5.18
Rate for Payer: PHP Commercial	$17.34
Rate for Payer: PHP Medicare Advantage	$5.18
Rate for Payer: Priority Health Choice Medicaid	$2.83
Rate for Payer: Priority Health Cigna Priority Health	$14.28
Rate for Payer: Priority Health Medicare	$5.18
Rate for Payer: Priority Health SBD	$12.85
Rate for Payer: Railroad Medicare Medicare	$5.18
Rate for Payer: UHC All Payor (Choice/PPO)	$6.22
Rate for Payer: UHC Core	$8.80
Rate for Payer: UHC Dual Complete DSNP	$5.18
Rate for Payer: UHC Exchange	$5.18
Rate for Payer: UHC Medicare Advantage	$5.34
Rate for Payer: VA VA	$5.18

HC FLUIDOTHERAPY

Facility

$106.08

Service Code	CPT 97022
Hospital Charge Code	42000051
Hospital Revenue Code	420
Min. Negotiated Rate	$11.39
Max. Negotiated Rate	$95.47
Rate for Payer: Aetna Commercial	$90.17
Rate for Payer: Aetna New Business (MI Preferred)	$68.95
Rate for Payer: BCBS Complete	$42.43
Rate for Payer: BCBS Trust/PPO	$11.39
Rate for Payer: Cash Price	$84.86
Rate for Payer: Cash Price	$84.86
Rate for Payer: Cofinity Commercial	$91.23
Rate for Payer: Cofinity Commercial	$74.26
Rate for Payer: Healthscope Commercial	$95.47
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$90.17
Rate for Payer: PHP Commercial	$90.17
Rate for Payer: Priority Health Cigna Priority Health	$74.26
Rate for Payer: Priority Health SBD	$66.83
Rate for Payer: UHC All Payor (Choice/PPO)	$18.37
Rate for Payer: UHC Exchange	$16.70

HC FLUIDOTHERAPY

Facility

$106.08

Service Code	CPT 97022
Hospital Charge Code	42000051
Hospital Revenue Code	420
Min. Negotiated Rate	$66.83
Max. Negotiated Rate	$95.47
Rate for Payer: Aetna Commercial	$90.17
Rate for Payer: Aetna New Business (MI Preferred)	$68.95
Rate for Payer: Cash Price	$84.86
Rate for Payer: Cofinity Commercial	$74.26
Rate for Payer: Cofinity Commercial	$91.23
Rate for Payer: Healthscope Commercial	$95.47
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$90.17
Rate for Payer: PHP Commercial	$90.17
Rate for Payer: Priority Health Cigna Priority Health	$74.26
Rate for Payer: Priority Health SBD	$66.83

HC FLUID SMEAR AND INTERPRETATION

Facility

$109.75

Service Code	CPT 88108
Hospital Charge Code	31100002
Hospital Revenue Code	311
Min. Negotiated Rate	$19.52
Max. Negotiated Rate	$105.40
Rate for Payer: Aetna Commercial	$93.29
Rate for Payer: Aetna Medicare	$37.11
Rate for Payer: Aetna New Business (MI Preferred)	$71.34
Rate for Payer: Allen County Amish Medical Aid Commercial	$44.60
Rate for Payer: Amish Plain Church Group Commercial	$44.60
Rate for Payer: BCBS Complete	$20.49
Rate for Payer: BCBS MAPPO	$35.68
Rate for Payer: BCBS Trust/PPO	$54.62
Rate for Payer: BCN Medicare Advantage	$35.68
Rate for Payer: Cash Price	$87.80
Rate for Payer: Cash Price	$87.80
Rate for Payer: Cofinity Commercial	$76.82
Rate for Payer: Cofinity Commercial	$94.38
Rate for Payer: Health Alliance Plan Medicare Advantage	$35.68
Rate for Payer: Healthscope Commercial	$98.78
Rate for Payer: Mclaren Medicaid	$19.52
Rate for Payer: Mclaren Medicare	$35.68
Rate for Payer: Meridian Medicaid	$20.49
Rate for Payer: Meridian Wellcare - Medicare Advantage	$37.46
Rate for Payer: MI Amish Medical Board Commercial	$41.03
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$93.29
Rate for Payer: PACE Medicare	$33.90
Rate for Payer: PACE SWMI	$35.68
Rate for Payer: PHP Commercial	$93.29
Rate for Payer: PHP Medicare Advantage	$35.68
Rate for Payer: Priority Health Choice Medicaid	$19.52
Rate for Payer: Priority Health Cigna Priority Health	$76.82
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$105.40
Rate for Payer: Priority Health Medicare	$35.68
Rate for Payer: Priority Health Narrow Network	$84.32
Rate for Payer: Priority Health SBD	$69.14
Rate for Payer: Railroad Medicare Medicare	$35.68
Rate for Payer: UHC All Payor (Choice/PPO)	$74.20
Rate for Payer: UHC Core	$20.50
Rate for Payer: UHC Dual Complete DSNP	$35.68
Rate for Payer: UHC Exchange	$67.45
Rate for Payer: UHC Medicare Advantage	$36.75
Rate for Payer: VA VA	$35.68

HC FLUID SMEAR AND INTERPRETATION

Facility

$109.75

Service Code	CPT 88108
Hospital Charge Code	31100002
Hospital Revenue Code	311
Min. Negotiated Rate	$69.14
Max. Negotiated Rate	$98.78
Rate for Payer: Aetna Commercial	$93.29
Rate for Payer: Aetna New Business (MI Preferred)	$71.34
Rate for Payer: Cash Price	$87.80
Rate for Payer: Cofinity Commercial	$76.82
Rate for Payer: Cofinity Commercial	$94.38
Rate for Payer: Healthscope Commercial	$98.78
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$93.29
Rate for Payer: PHP Commercial	$93.29
Rate for Payer: Priority Health Cigna Priority Health	$76.82
Rate for Payer: Priority Health SBD	$69.14

HC FLUID SMEAR WITH INTERPRETATION

Facility

$109.75

Service Code	CPT 88108
Hospital Charge Code	31100030
Hospital Revenue Code	311
Min. Negotiated Rate	$19.52
Max. Negotiated Rate	$105.40
Rate for Payer: Aetna Commercial	$93.29
Rate for Payer: Aetna Medicare	$37.11
Rate for Payer: Aetna New Business (MI Preferred)	$71.34
Rate for Payer: Allen County Amish Medical Aid Commercial	$44.60
Rate for Payer: Amish Plain Church Group Commercial	$44.60
Rate for Payer: BCBS Complete	$20.49
Rate for Payer: BCBS MAPPO	$35.68
Rate for Payer: BCBS Trust/PPO	$54.62
Rate for Payer: BCN Medicare Advantage	$35.68
Rate for Payer: Cash Price	$87.80
Rate for Payer: Cash Price	$87.80
Rate for Payer: Cofinity Commercial	$94.38
Rate for Payer: Cofinity Commercial	$76.82
Rate for Payer: Health Alliance Plan Medicare Advantage	$35.68
Rate for Payer: Healthscope Commercial	$98.78
Rate for Payer: Mclaren Medicaid	$19.52
Rate for Payer: Mclaren Medicare	$35.68
Rate for Payer: Meridian Medicaid	$20.49
Rate for Payer: Meridian Wellcare - Medicare Advantage	$37.46
Rate for Payer: MI Amish Medical Board Commercial	$41.03
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$93.29
Rate for Payer: PACE Medicare	$33.90
Rate for Payer: PACE SWMI	$35.68
Rate for Payer: PHP Commercial	$93.29
Rate for Payer: PHP Medicare Advantage	$35.68
Rate for Payer: Priority Health Choice Medicaid	$19.52
Rate for Payer: Priority Health Cigna Priority Health	$76.82
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$105.40
Rate for Payer: Priority Health Medicare	$35.68
Rate for Payer: Priority Health Narrow Network	$84.32
Rate for Payer: Priority Health SBD	$69.14
Rate for Payer: Railroad Medicare Medicare	$35.68
Rate for Payer: UHC All Payor (Choice/PPO)	$74.20
Rate for Payer: UHC Core	$20.50
Rate for Payer: UHC Dual Complete DSNP	$35.68
Rate for Payer: UHC Exchange	$67.45
Rate for Payer: UHC Medicare Advantage	$36.75
Rate for Payer: VA VA	$35.68

HC FLUID SMEAR WITH INTERPRETATION

Facility

$109.75

Service Code	CPT 88108
Hospital Charge Code	31100030
Hospital Revenue Code	311
Min. Negotiated Rate	$69.14
Max. Negotiated Rate	$98.78
Rate for Payer: Aetna Commercial	$93.29
Rate for Payer: Aetna New Business (MI Preferred)	$71.34
Rate for Payer: Cash Price	$87.80
Rate for Payer: Cofinity Commercial	$76.82
Rate for Payer: Cofinity Commercial	$94.38
Rate for Payer: Healthscope Commercial	$98.78
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$93.29
Rate for Payer: PHP Commercial	$93.29
Rate for Payer: Priority Health Cigna Priority Health	$76.82
Rate for Payer: Priority Health SBD	$69.14

HC FLUTTER VALVE SUPPLY

Facility

$116.36

Hospital Charge Code	27000078
Hospital Revenue Code	270
Min. Negotiated Rate	$73.31
Max. Negotiated Rate	$104.72
Rate for Payer: Aetna Commercial	$98.91
Rate for Payer: Aetna New Business (MI Preferred)	$75.63
Rate for Payer: Cash Price	$93.09
Rate for Payer: Cofinity Commercial	$100.07
Rate for Payer: Cofinity Commercial	$81.45
Rate for Payer: Healthscope Commercial	$104.72
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$98.91
Rate for Payer: PHP Commercial	$98.91
Rate for Payer: Priority Health Cigna Priority Health	$81.45
Rate for Payer: Priority Health SBD	$73.31

HC FLUTTER VALVE SUPPLY

Facility

$116.36

Hospital Charge Code	27000078
Hospital Revenue Code	270
Min. Negotiated Rate	$46.54
Max. Negotiated Rate	$104.72
Rate for Payer: Aetna Commercial	$98.91
Rate for Payer: Aetna New Business (MI Preferred)	$75.63
Rate for Payer: BCBS Complete	$46.54
Rate for Payer: Cash Price	$93.09
Rate for Payer: Cofinity Commercial	$100.07
Rate for Payer: Cofinity Commercial	$81.45
Rate for Payer: Healthscope Commercial	$104.72
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$98.91
Rate for Payer: PHP Commercial	$98.91
Rate for Payer: Priority Health Cigna Priority Health	$81.45
Rate for Payer: Priority Health SBD	$73.31

HC FLU VAC,SPLIT VIRUS, PT 3 YRS OR OLDER, IM

Facility

$25.50

Service Code	CPT Q2038
Hospital Charge Code	63600113
Hospital Revenue Code	636
Min. Negotiated Rate	$10.20
Max. Negotiated Rate	$49.40
Rate for Payer: Aetna Commercial	$21.68
Rate for Payer: Aetna New Business (MI Preferred)	$16.58
Rate for Payer: BCBS Complete	$10.20
Rate for Payer: BCBS Trust/PPO	$49.40
Rate for Payer: Cash Price	$20.40
Rate for Payer: Cash Price	$20.40
Rate for Payer: Cofinity Commercial	$17.85
Rate for Payer: Cofinity Commercial	$21.93
Rate for Payer: Healthscope Commercial	$22.95
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$21.68
Rate for Payer: PHP Commercial	$21.68
Rate for Payer: Priority Health Cigna Priority Health	$17.85
Rate for Payer: Priority Health SBD	$16.06

HC FLU VAC,SPLIT VIRUS, PT 3 YRS OR OLDER, IM

Facility

$25.50

Service Code	CPT Q2038
Hospital Charge Code	63600113
Hospital Revenue Code	636
Min. Negotiated Rate	$16.06
Max. Negotiated Rate	$22.95
Rate for Payer: Aetna Commercial	$21.68
Rate for Payer: Aetna New Business (MI Preferred)	$16.58
Rate for Payer: Cash Price	$20.40
Rate for Payer: Cofinity Commercial	$17.85
Rate for Payer: Cofinity Commercial	$21.93
Rate for Payer: Healthscope Commercial	$22.95
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$21.68
Rate for Payer: PHP Commercial	$21.68
Rate for Payer: Priority Health Cigna Priority Health	$17.85
Rate for Payer: Priority Health SBD	$16.06

HC FNA BX 1ST LESION CT GUIDE

Facility

$890.46

Service Code	CPT 10009
Hospital Charge Code	36100558
Hospital Revenue Code	361
Min. Negotiated Rate	$560.99
Max. Negotiated Rate	$801.41
Rate for Payer: Aetna Commercial	$756.89
Rate for Payer: Aetna New Business (MI Preferred)	$578.80
Rate for Payer: Cash Price	$712.37
Rate for Payer: Cofinity Commercial	$623.32
Rate for Payer: Cofinity Commercial	$765.80
Rate for Payer: Healthscope Commercial	$801.41
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$756.89
Rate for Payer: PHP Commercial	$756.89
Rate for Payer: Priority Health Cigna Priority Health	$623.32
Rate for Payer: Priority Health SBD	$560.99

HC FNA BX 1ST LESION CT GUIDE

Facility

$890.46

Service Code	CPT 10009
Hospital Charge Code	36100558
Hospital Revenue Code	361
Min. Negotiated Rate	$104.78
Max. Negotiated Rate	$1,945.97
Rate for Payer: Aetna Commercial	$756.89
Rate for Payer: Aetna Medicare	$651.08
Rate for Payer: Aetna New Business (MI Preferred)	$578.80
Rate for Payer: Allen County Amish Medical Aid Commercial	$782.55
Rate for Payer: Amish Plain Church Group Commercial	$782.55
Rate for Payer: BCBS Complete	$359.60
Rate for Payer: BCBS MAPPO	$626.04
Rate for Payer: BCBS Trust/PPO	$360.03
Rate for Payer: BCCCP Commercial	$445.03
Rate for Payer: BCN Medicare Advantage	$626.04
Rate for Payer: Cash Price	$712.37
Rate for Payer: Cash Price	$712.37
Rate for Payer: Cofinity Commercial	$623.32
Rate for Payer: Cofinity Commercial	$765.80
Rate for Payer: Health Alliance Plan Medicare Advantage	$626.04
Rate for Payer: Healthscope Commercial	$801.41
Rate for Payer: Mclaren Medicaid	$342.44
Rate for Payer: Mclaren Medicare	$626.04
Rate for Payer: Meridian Medicaid	$359.60
Rate for Payer: Meridian Wellcare - Medicare Advantage	$657.34
Rate for Payer: MI Amish Medical Board Commercial	$719.95
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$756.89
Rate for Payer: PACE Medicare	$594.74
Rate for Payer: PACE SWMI	$626.04
Rate for Payer: PHP Commercial	$756.89
Rate for Payer: PHP Medicare Advantage	$626.04
Rate for Payer: Priority Health Choice Medicaid	$342.44
Rate for Payer: Priority Health Cigna Priority Health	$623.32
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,945.97
Rate for Payer: Priority Health Medicare	$626.04
Rate for Payer: Priority Health Narrow Network	$1,556.78
Rate for Payer: Priority Health SBD	$560.99
Rate for Payer: Railroad Medicare Medicare	$626.04
Rate for Payer: UHC All Payor (Choice/PPO)	$115.26
Rate for Payer: UHC Core	$1,463.00
Rate for Payer: UHC Dual Complete DSNP	$626.04
Rate for Payer: UHC Exchange	$104.78
Rate for Payer: UHC Medicare Advantage	$644.82
Rate for Payer: VA VA	$626.04

HC FNA BX 1ST LESION FLUORO GUIDE

Facility

$890.46

Service Code	CPT 10007
Hospital Charge Code	36100556
Hospital Revenue Code	361
Min. Negotiated Rate	$560.99
Max. Negotiated Rate	$801.41
Rate for Payer: Aetna Commercial	$756.89
Rate for Payer: Aetna New Business (MI Preferred)	$578.80
Rate for Payer: Cash Price	$712.37
Rate for Payer: Cofinity Commercial	$623.32
Rate for Payer: Cofinity Commercial	$765.80
Rate for Payer: Healthscope Commercial	$801.41
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$756.89
Rate for Payer: PHP Commercial	$756.89
Rate for Payer: Priority Health Cigna Priority Health	$623.32
Rate for Payer: Priority Health SBD	$560.99

HC FNA BX 1ST LESION FLUORO GUIDE

Facility

$890.46

Service Code	CPT 10007
Hospital Charge Code	36100556
Hospital Revenue Code	361
Min. Negotiated Rate	$86.77
Max. Negotiated Rate	$1,463.00
Rate for Payer: Aetna Commercial	$756.89
Rate for Payer: Aetna Medicare	$651.08
Rate for Payer: Aetna New Business (MI Preferred)	$578.80
Rate for Payer: Allen County Amish Medical Aid Commercial	$782.55
Rate for Payer: Amish Plain Church Group Commercial	$782.55
Rate for Payer: BCBS Complete	$359.60
Rate for Payer: BCBS MAPPO	$626.04
Rate for Payer: BCBS Trust/PPO	$264.76
Rate for Payer: BCCCP Commercial	$304.04
Rate for Payer: BCN Medicare Advantage	$626.04
Rate for Payer: Cash Price	$712.37
Rate for Payer: Cash Price	$712.37
Rate for Payer: Cofinity Commercial	$765.80
Rate for Payer: Cofinity Commercial	$623.32
Rate for Payer: Health Alliance Plan Medicare Advantage	$626.04
Rate for Payer: Healthscope Commercial	$801.41
Rate for Payer: Mclaren Medicaid	$342.44
Rate for Payer: Mclaren Medicare	$626.04
Rate for Payer: Meridian Medicaid	$359.60
Rate for Payer: Meridian Wellcare - Medicare Advantage	$657.34
Rate for Payer: MI Amish Medical Board Commercial	$719.95
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$756.89
Rate for Payer: PACE Medicare	$594.74
Rate for Payer: PACE SWMI	$626.04
Rate for Payer: PHP Commercial	$756.89
Rate for Payer: PHP Medicare Advantage	$626.04
Rate for Payer: Priority Health Choice Medicaid	$342.44
Rate for Payer: Priority Health Cigna Priority Health	$623.32
Rate for Payer: Priority Health Medicare	$626.04
Rate for Payer: Priority Health SBD	$560.99
Rate for Payer: Railroad Medicare Medicare	$626.04
Rate for Payer: UHC All Payor (Choice/PPO)	$95.45
Rate for Payer: UHC Core	$1,463.00
Rate for Payer: UHC Dual Complete DSNP	$626.04
Rate for Payer: UHC Exchange	$86.77
Rate for Payer: UHC Medicare Advantage	$644.82
Rate for Payer: VA VA	$626.04

HC FNA BX 1ST LESION MR GUIDE

Facility

$890.46

Service Code	CPT 10011
Hospital Charge Code	36100560
Hospital Revenue Code	361
Min. Negotiated Rate	$342.44
Max. Negotiated Rate	$1,945.97
Rate for Payer: Aetna Commercial	$756.89
Rate for Payer: Aetna Medicare	$651.08
Rate for Payer: Aetna New Business (MI Preferred)	$578.80
Rate for Payer: Allen County Amish Medical Aid Commercial	$782.55
Rate for Payer: Amish Plain Church Group Commercial	$782.55
Rate for Payer: BCBS Complete	$359.60
Rate for Payer: BCBS MAPPO	$626.04
Rate for Payer: BCBS Trust/PPO	$360.03
Rate for Payer: BCCCP Commercial	$445.03
Rate for Payer: BCN Medicare Advantage	$626.04
Rate for Payer: Cash Price	$712.37
Rate for Payer: Cash Price	$712.37
Rate for Payer: Cofinity Commercial	$623.32
Rate for Payer: Cofinity Commercial	$765.80
Rate for Payer: Health Alliance Plan Medicare Advantage	$626.04
Rate for Payer: Healthscope Commercial	$801.41
Rate for Payer: Mclaren Medicaid	$342.44
Rate for Payer: Mclaren Medicare	$626.04
Rate for Payer: Meridian Medicaid	$359.60
Rate for Payer: Meridian Wellcare - Medicare Advantage	$657.34
Rate for Payer: MI Amish Medical Board Commercial	$719.95
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$756.89
Rate for Payer: PACE Medicare	$594.74
Rate for Payer: PACE SWMI	$626.04
Rate for Payer: PHP Commercial	$756.89
Rate for Payer: PHP Medicare Advantage	$626.04
Rate for Payer: Priority Health Choice Medicaid	$342.44
Rate for Payer: Priority Health Cigna Priority Health	$623.32
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,945.97
Rate for Payer: Priority Health Medicare	$626.04
Rate for Payer: Priority Health Narrow Network	$1,556.78
Rate for Payer: Priority Health SBD	$560.99
Rate for Payer: Railroad Medicare Medicare	$626.04
Rate for Payer: UHC Core	$1,463.00
Rate for Payer: UHC Dual Complete DSNP	$626.04
Rate for Payer: UHC Medicare Advantage	$644.82
Rate for Payer: VA VA	$626.04

HC FNA BX 1ST LESION MR GUIDE

Facility

$890.46

Service Code	CPT 10011
Hospital Charge Code	36100560
Hospital Revenue Code	361
Min. Negotiated Rate	$560.99
Max. Negotiated Rate	$801.41
Rate for Payer: Aetna Commercial	$756.89
Rate for Payer: Aetna New Business (MI Preferred)	$578.80
Rate for Payer: Cash Price	$712.37
Rate for Payer: Cofinity Commercial	$623.32
Rate for Payer: Cofinity Commercial	$765.80
Rate for Payer: Healthscope Commercial	$801.41
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$756.89
Rate for Payer: PHP Commercial	$756.89
Rate for Payer: Priority Health Cigna Priority Health	$623.32
Rate for Payer: Priority Health SBD	$560.99

Know your out-of-pocket cost for care.

All Charges