Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC CANDIDA ALBICANS IGE

Facility

$25.39

Service Code	CPT 86003
Hospital Charge Code	30200077
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 CANDIDA ALBICANS IGE

Facility

$25.39

Service Code	CPT 86003
Hospital Charge Code	30200077
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 CANNABINOID URIN

Facility

$101.66

Service Code	CPT 80307
Hospital Charge Code	30000125
Hospital Revenue Code	300
Min. Negotiated Rate	$33.31
Max. Negotiated Rate	$174.92
Rate for Payer: Aetna Commercial	$86.41
Rate for Payer: Aetna Medicare	$64.63
Rate for Payer: Aetna New Business (MI Preferred)	$66.08
Rate for Payer: Allen County Amish Medical Aid Commercial	$77.67
Rate for Payer: Amish Plain Church Group Commercial	$77.67
Rate for Payer: BCBS Complete	$34.97
Rate for Payer: BCBS MAPPO	$62.14
Rate for Payer: BCN Medicare Advantage	$62.14
Rate for Payer: Cash Price	$81.33
Rate for Payer: Cash Price	$81.33
Rate for Payer: Cofinity Commercial	$87.43
Rate for Payer: Cofinity Commercial	$71.16
Rate for Payer: Cofinity Medicare Advantage	$71.16
Rate for Payer: Encore Health Key Benefits Commercial	$81.33
Rate for Payer: Health Alliance Plan Medicare Advantage	$62.14
Rate for Payer: Healthscope Commercial	$91.49
Rate for Payer: Mclaren Medicaid	$33.31
Rate for Payer: Mclaren Medicare	$62.14
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$65.25
Rate for Payer: Meridian Medicaid	$34.97
Rate for Payer: MI Amish Medical Board Commercial	$71.46
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$86.41
Rate for Payer: PACE Medicare	$59.03
Rate for Payer: PACE SWMI	$62.14
Rate for Payer: PHP Commercial	$86.41
Rate for Payer: PHP Medicare Advantage	$62.14
Rate for Payer: Priority Health Choice Medicaid	$33.31
Rate for Payer: Priority Health Cigna Priority Health	$66.08
Rate for Payer: Priority Health Medicare	$62.14
Rate for Payer: Priority Health SBD	$64.05
Rate for Payer: Railroad Medicare Medicare	$62.14
Rate for Payer: UHC All Payor (Choice/PPO)	$174.92
Rate for Payer: UHC Dual Complete DSNP	$62.14
Rate for Payer: UHC Medicare Advantage	$62.14
Rate for Payer: UHCCP Medicaid	$34.98
Rate for Payer: VA VA	$62.14

HC CANNABINOID URIN

Facility

$101.66

Service Code	CPT 80307
Hospital Charge Code	30000125
Hospital Revenue Code	300
Min. Negotiated Rate	$64.05
Max. Negotiated Rate	$91.49
Rate for Payer: Aetna Commercial	$86.41
Rate for Payer: Aetna New Business (MI Preferred)	$66.08
Rate for Payer: Cash Price	$81.33
Rate for Payer: Cofinity Commercial	$71.16
Rate for Payer: Cofinity Commercial	$87.43
Rate for Payer: Cofinity Medicare Advantage	$71.16
Rate for Payer: Encore Health Key Benefits Commercial	$81.33
Rate for Payer: Healthscope Commercial	$91.49
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$86.41
Rate for Payer: PHP Commercial	$86.41
Rate for Payer: Priority Health Cigna Priority Health	$66.08
Rate for Payer: Priority Health SBD	$64.05

HC CANN/INTRO FEM ART 17,19,21 FR

Facility

$884.34

Hospital Charge Code	27000274
Hospital Revenue Code	270
Min. Negotiated Rate	$557.13
Max. Negotiated Rate	$795.91
Rate for Payer: Aetna Commercial	$751.69
Rate for Payer: Aetna New Business (MI Preferred)	$574.82
Rate for Payer: Cash Price	$707.47
Rate for Payer: Cofinity Commercial	$619.04
Rate for Payer: Cofinity Commercial	$760.53
Rate for Payer: Cofinity Medicare Advantage	$619.04
Rate for Payer: Encore Health Key Benefits Commercial	$707.47
Rate for Payer: Healthscope Commercial	$795.91
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$751.69
Rate for Payer: PHP Commercial	$751.69
Rate for Payer: Priority Health Cigna Priority Health	$574.82
Rate for Payer: Priority Health SBD	$557.13

HC CANN/INTRO FEM ART 17,19,21 FR

Facility

$884.34

Hospital Charge Code	27000274
Hospital Revenue Code	270
Min. Negotiated Rate	$353.74
Max. Negotiated Rate	$795.91
Rate for Payer: Aetna Commercial	$751.69
Rate for Payer: Aetna Medicare	$442.17
Rate for Payer: Aetna New Business (MI Preferred)	$574.82
Rate for Payer: BCBS Complete	$353.74
Rate for Payer: Cash Price	$707.47
Rate for Payer: Cofinity Commercial	$619.04
Rate for Payer: Cofinity Commercial	$760.53
Rate for Payer: Cofinity Medicare Advantage	$619.04
Rate for Payer: Encore Health Key Benefits Commercial	$707.47
Rate for Payer: Healthscope Commercial	$795.91
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$751.69
Rate for Payer: PHP Commercial	$751.69
Rate for Payer: Priority Health Cigna Priority Health	$574.82
Rate for Payer: Priority Health SBD	$557.13

HC CANN RT ANG BALLOON 4-6MM

Facility

$302.94

Hospital Charge Code	27000446
Hospital Revenue Code	270
Min. Negotiated Rate	$190.85
Max. Negotiated Rate	$272.65
Rate for Payer: Aetna Commercial	$257.50
Rate for Payer: Aetna New Business (MI Preferred)	$196.91
Rate for Payer: Cash Price	$242.35
Rate for Payer: Cofinity Commercial	$212.06
Rate for Payer: Cofinity Commercial	$260.53
Rate for Payer: Cofinity Medicare Advantage	$212.06
Rate for Payer: Encore Health Key Benefits Commercial	$242.35
Rate for Payer: Healthscope Commercial	$272.65
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$257.50
Rate for Payer: PHP Commercial	$257.50
Rate for Payer: Priority Health Cigna Priority Health	$196.91
Rate for Payer: Priority Health SBD	$190.85

HC CANN RT ANG BALLOON 4-6MM

Facility

$302.94

Hospital Charge Code	27000446
Hospital Revenue Code	270
Min. Negotiated Rate	$121.18
Max. Negotiated Rate	$272.65
Rate for Payer: Aetna Commercial	$257.50
Rate for Payer: Aetna Medicare	$151.47
Rate for Payer: Aetna New Business (MI Preferred)	$196.91
Rate for Payer: BCBS Complete	$121.18
Rate for Payer: Cash Price	$242.35
Rate for Payer: Cofinity Commercial	$212.06
Rate for Payer: Cofinity Commercial	$260.53
Rate for Payer: Cofinity Medicare Advantage	$212.06
Rate for Payer: Encore Health Key Benefits Commercial	$242.35
Rate for Payer: Healthscope Commercial	$272.65
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$257.50
Rate for Payer: PHP Commercial	$257.50
Rate for Payer: Priority Health Cigna Priority Health	$196.91
Rate for Payer: Priority Health SBD	$190.85

HC CANNULA ARTERIAL 21, 24 FR

Facility

$116.28

Hospital Charge Code	27000449
Hospital Revenue Code	270
Min. Negotiated Rate	$73.26
Max. Negotiated Rate	$104.65
Rate for Payer: Aetna Commercial	$98.84
Rate for Payer: Aetna New Business (MI Preferred)	$75.58
Rate for Payer: Cash Price	$93.02
Rate for Payer: Cofinity Commercial	$100.00
Rate for Payer: Cofinity Commercial	$81.40
Rate for Payer: Cofinity Medicare Advantage	$81.40
Rate for Payer: Encore Health Key Benefits Commercial	$93.02
Rate for Payer: Healthscope Commercial	$104.65
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$98.84
Rate for Payer: PHP Commercial	$98.84
Rate for Payer: Priority Health Cigna Priority Health	$75.58
Rate for Payer: Priority Health SBD	$73.26

HC CANNULA ARTERIAL 21, 24 FR

Facility

$116.28

Hospital Charge Code	27000449
Hospital Revenue Code	270
Min. Negotiated Rate	$46.51
Max. Negotiated Rate	$104.65
Rate for Payer: Aetna Commercial	$98.84
Rate for Payer: Aetna Medicare	$58.14
Rate for Payer: Aetna New Business (MI Preferred)	$75.58
Rate for Payer: BCBS Complete	$46.51
Rate for Payer: Cash Price	$93.02
Rate for Payer: Cofinity Commercial	$100.00
Rate for Payer: Cofinity Commercial	$81.40
Rate for Payer: Cofinity Medicare Advantage	$81.40
Rate for Payer: Encore Health Key Benefits Commercial	$93.02
Rate for Payer: Healthscope Commercial	$104.65
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$98.84
Rate for Payer: PHP Commercial	$98.84
Rate for Payer: Priority Health Cigna Priority Health	$75.58
Rate for Payer: Priority Health SBD	$73.26

HC CANNULA ARTERIOTOMY 2 MM

Facility

$24.48

Hospital Charge Code	27000675
Hospital Revenue Code	270
Min. Negotiated Rate	$9.79
Max. Negotiated Rate	$22.03
Rate for Payer: Aetna Commercial	$20.81
Rate for Payer: Aetna Medicare	$12.24
Rate for Payer: Aetna New Business (MI Preferred)	$15.91
Rate for Payer: BCBS Complete	$9.79
Rate for Payer: Cash Price	$19.58
Rate for Payer: Cofinity Commercial	$17.14
Rate for Payer: Cofinity Commercial	$21.05
Rate for Payer: Cofinity Medicare Advantage	$17.14
Rate for Payer: Encore Health Key Benefits Commercial	$19.58
Rate for Payer: Healthscope Commercial	$22.03
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$20.81
Rate for Payer: PHP Commercial	$20.81
Rate for Payer: Priority Health Cigna Priority Health	$15.91
Rate for Payer: Priority Health SBD	$15.42

HC CANNULA ARTERIOTOMY 2 MM

Facility

$24.48

Hospital Charge Code	27000675
Hospital Revenue Code	270
Min. Negotiated Rate	$15.42
Max. Negotiated Rate	$22.03
Rate for Payer: Aetna Commercial	$20.81
Rate for Payer: Aetna New Business (MI Preferred)	$15.91
Rate for Payer: Cash Price	$19.58
Rate for Payer: Cofinity Commercial	$17.14
Rate for Payer: Cofinity Commercial	$21.05
Rate for Payer: Cofinity Medicare Advantage	$17.14
Rate for Payer: Encore Health Key Benefits Commercial	$19.58
Rate for Payer: Healthscope Commercial	$22.03
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$20.81
Rate for Payer: PHP Commercial	$20.81
Rate for Payer: Priority Health Cigna Priority Health	$15.91
Rate for Payer: Priority Health SBD	$15.42

HC CANNULA BIOMEDICUS

Facility

$1,473.47

Hospital Charge Code	27006715
Hospital Revenue Code	270
Min. Negotiated Rate	$928.29
Max. Negotiated Rate	$1,326.12
Rate for Payer: Aetna Commercial	$1,252.45
Rate for Payer: Aetna New Business (MI Preferred)	$957.76
Rate for Payer: Cash Price	$1,178.78
Rate for Payer: Cofinity Commercial	$1,031.43
Rate for Payer: Cofinity Commercial	$1,267.18
Rate for Payer: Cofinity Medicare Advantage	$1,031.43
Rate for Payer: Encore Health Key Benefits Commercial	$1,178.78
Rate for Payer: Healthscope Commercial	$1,326.12
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,252.45
Rate for Payer: PHP Commercial	$1,252.45
Rate for Payer: Priority Health Cigna Priority Health	$957.76
Rate for Payer: Priority Health SBD	$928.29

HC CANNULA BIOMEDICUS

Facility

$1,473.47

Hospital Charge Code	27006715
Hospital Revenue Code	270
Min. Negotiated Rate	$589.39
Max. Negotiated Rate	$1,326.12
Rate for Payer: Aetna Commercial	$1,252.45
Rate for Payer: Aetna Medicare	$736.74
Rate for Payer: Aetna New Business (MI Preferred)	$957.76
Rate for Payer: BCBS Complete	$589.39
Rate for Payer: Cash Price	$1,178.78
Rate for Payer: Cofinity Commercial	$1,031.43
Rate for Payer: Cofinity Commercial	$1,267.18
Rate for Payer: Cofinity Medicare Advantage	$1,031.43
Rate for Payer: Encore Health Key Benefits Commercial	$1,178.78
Rate for Payer: Healthscope Commercial	$1,326.12
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,252.45
Rate for Payer: PHP Commercial	$1,252.45
Rate for Payer: Priority Health Cigna Priority Health	$957.76
Rate for Payer: Priority Health SBD	$928.29

HC CANNULA CARDIOPLEGIA

Facility

$47.43

Hospital Charge Code	27000092
Hospital Revenue Code	270
Min. Negotiated Rate	$29.88
Max. Negotiated Rate	$42.69
Rate for Payer: Aetna Commercial	$40.32
Rate for Payer: Aetna New Business (MI Preferred)	$30.83
Rate for Payer: Cash Price	$37.94
Rate for Payer: Cofinity Commercial	$33.20
Rate for Payer: Cofinity Commercial	$40.79
Rate for Payer: Cofinity Medicare Advantage	$33.20
Rate for Payer: Encore Health Key Benefits Commercial	$37.94
Rate for Payer: Healthscope Commercial	$42.69
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$40.32
Rate for Payer: PHP Commercial	$40.32
Rate for Payer: Priority Health Cigna Priority Health	$30.83
Rate for Payer: Priority Health SBD	$29.88

HC CANNULA CARDIOPLEGIA

Facility

$47.43

Hospital Charge Code	27000092
Hospital Revenue Code	270
Min. Negotiated Rate	$18.97
Max. Negotiated Rate	$42.69
Rate for Payer: Aetna Commercial	$40.32
Rate for Payer: Aetna Medicare	$23.71
Rate for Payer: Aetna New Business (MI Preferred)	$30.83
Rate for Payer: BCBS Complete	$18.97
Rate for Payer: Cash Price	$37.94
Rate for Payer: Cofinity Commercial	$33.20
Rate for Payer: Cofinity Commercial	$40.79
Rate for Payer: Cofinity Medicare Advantage	$33.20
Rate for Payer: Encore Health Key Benefits Commercial	$37.94
Rate for Payer: Healthscope Commercial	$42.69
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$40.32
Rate for Payer: PHP Commercial	$40.32
Rate for Payer: Priority Health Cigna Priority Health	$30.83
Rate for Payer: Priority Health SBD	$29.88

HC CANNULA COR ART 7MM ST

Facility

$323.06

Hospital Charge Code	27006707
Hospital Revenue Code	270
Min. Negotiated Rate	$203.53
Max. Negotiated Rate	$290.75
Rate for Payer: Aetna Commercial	$274.60
Rate for Payer: Aetna New Business (MI Preferred)	$209.99
Rate for Payer: Cash Price	$258.45
Rate for Payer: Cofinity Commercial	$226.14
Rate for Payer: Cofinity Commercial	$277.83
Rate for Payer: Cofinity Medicare Advantage	$226.14
Rate for Payer: Encore Health Key Benefits Commercial	$258.45
Rate for Payer: Healthscope Commercial	$290.75
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$274.60
Rate for Payer: PHP Commercial	$274.60
Rate for Payer: Priority Health Cigna Priority Health	$209.99
Rate for Payer: Priority Health SBD	$203.53

HC CANNULA COR ART 7MM ST

Facility

$323.06

Hospital Charge Code	27006707
Hospital Revenue Code	270
Min. Negotiated Rate	$129.22
Max. Negotiated Rate	$290.75
Rate for Payer: Aetna Commercial	$274.60
Rate for Payer: Aetna Medicare	$161.53
Rate for Payer: Aetna New Business (MI Preferred)	$209.99
Rate for Payer: BCBS Complete	$129.22
Rate for Payer: Cash Price	$258.45
Rate for Payer: Cofinity Commercial	$226.14
Rate for Payer: Cofinity Commercial	$277.83
Rate for Payer: Cofinity Medicare Advantage	$226.14
Rate for Payer: Encore Health Key Benefits Commercial	$258.45
Rate for Payer: Healthscope Commercial	$290.75
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$274.60
Rate for Payer: PHP Commercial	$274.60
Rate for Payer: Priority Health Cigna Priority Health	$209.99
Rate for Payer: Priority Health SBD	$203.53

HC CANNULA COR ART 8 MM ST

Facility

$313.65

Hospital Charge Code	27006708
Hospital Revenue Code	270
Min. Negotiated Rate	$125.46
Max. Negotiated Rate	$282.29
Rate for Payer: Aetna Commercial	$266.60
Rate for Payer: Aetna Medicare	$156.82
Rate for Payer: Aetna New Business (MI Preferred)	$203.87
Rate for Payer: BCBS Complete	$125.46
Rate for Payer: Cash Price	$250.92
Rate for Payer: Cofinity Commercial	$219.56
Rate for Payer: Cofinity Commercial	$269.74
Rate for Payer: Cofinity Medicare Advantage	$219.56
Rate for Payer: Encore Health Key Benefits Commercial	$250.92
Rate for Payer: Healthscope Commercial	$282.29
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$266.60
Rate for Payer: PHP Commercial	$266.60
Rate for Payer: Priority Health Cigna Priority Health	$203.87
Rate for Payer: Priority Health SBD	$197.60

HC CANNULA COR ART 8 MM ST

Facility

$313.65

Hospital Charge Code	27006708
Hospital Revenue Code	270
Min. Negotiated Rate	$197.60
Max. Negotiated Rate	$282.29
Rate for Payer: Aetna Commercial	$266.60
Rate for Payer: Aetna New Business (MI Preferred)	$203.87
Rate for Payer: Cash Price	$250.92
Rate for Payer: Cofinity Commercial	$219.56
Rate for Payer: Cofinity Commercial	$269.74
Rate for Payer: Cofinity Medicare Advantage	$219.56
Rate for Payer: Encore Health Key Benefits Commercial	$250.92
Rate for Payer: Healthscope Commercial	$282.29
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$266.60
Rate for Payer: PHP Commercial	$266.60
Rate for Payer: Priority Health Cigna Priority Health	$203.87
Rate for Payer: Priority Health SBD	$197.60

HC CANNULA COR OSTIA CONCAVE

Facility

$76.50

Hospital Charge Code	27000265
Hospital Revenue Code	270
Min. Negotiated Rate	$48.20
Max. Negotiated Rate	$68.85
Rate for Payer: Aetna Commercial	$65.03
Rate for Payer: Aetna New Business (MI Preferred)	$49.73
Rate for Payer: Cash Price	$61.20
Rate for Payer: Cofinity Commercial	$53.55
Rate for Payer: Cofinity Commercial	$65.79
Rate for Payer: Cofinity Medicare Advantage	$53.55
Rate for Payer: Encore Health Key Benefits Commercial	$61.20
Rate for Payer: Healthscope Commercial	$68.85
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$65.03
Rate for Payer: PHP Commercial	$65.03
Rate for Payer: Priority Health Cigna Priority Health	$49.73
Rate for Payer: Priority Health SBD	$48.20

HC CANNULA COR OSTIA CONCAVE

Facility

$76.50

Hospital Charge Code	27000265
Hospital Revenue Code	270
Min. Negotiated Rate	$30.60
Max. Negotiated Rate	$68.85
Rate for Payer: Aetna Commercial	$65.03
Rate for Payer: Aetna Medicare	$38.25
Rate for Payer: Aetna New Business (MI Preferred)	$49.73
Rate for Payer: BCBS Complete	$30.60
Rate for Payer: Cash Price	$61.20
Rate for Payer: Cofinity Commercial	$53.55
Rate for Payer: Cofinity Commercial	$65.79
Rate for Payer: Cofinity Medicare Advantage	$53.55
Rate for Payer: Encore Health Key Benefits Commercial	$61.20
Rate for Payer: Healthscope Commercial	$68.85
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$65.03
Rate for Payer: PHP Commercial	$65.03
Rate for Payer: Priority Health Cigna Priority Health	$49.73
Rate for Payer: Priority Health SBD	$48.20

HC CANNULA COR OSTIA LPG 4MM

Facility

$341.19

Hospital Charge Code	27006704
Hospital Revenue Code	270
Min. Negotiated Rate	$136.48
Max. Negotiated Rate	$307.07
Rate for Payer: Aetna Commercial	$290.01
Rate for Payer: Aetna Medicare	$170.59
Rate for Payer: Aetna New Business (MI Preferred)	$221.77
Rate for Payer: BCBS Complete	$136.48
Rate for Payer: Cash Price	$272.95
Rate for Payer: Cofinity Commercial	$238.83
Rate for Payer: Cofinity Commercial	$293.42
Rate for Payer: Cofinity Medicare Advantage	$238.83
Rate for Payer: Encore Health Key Benefits Commercial	$272.95
Rate for Payer: Healthscope Commercial	$307.07
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$290.01
Rate for Payer: PHP Commercial	$290.01
Rate for Payer: Priority Health Cigna Priority Health	$221.77
Rate for Payer: Priority Health SBD	$214.95

HC CANNULA COR OSTIA LPG 4MM

Facility

$341.19

Hospital Charge Code	27006704
Hospital Revenue Code	270
Min. Negotiated Rate	$214.95
Max. Negotiated Rate	$307.07
Rate for Payer: Aetna Commercial	$290.01
Rate for Payer: Aetna New Business (MI Preferred)	$221.77
Rate for Payer: Cash Price	$272.95
Rate for Payer: Cofinity Commercial	$238.83
Rate for Payer: Cofinity Commercial	$293.42
Rate for Payer: Cofinity Medicare Advantage	$238.83
Rate for Payer: Encore Health Key Benefits Commercial	$272.95
Rate for Payer: Healthscope Commercial	$307.07
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$290.01
Rate for Payer: PHP Commercial	$290.01
Rate for Payer: Priority Health Cigna Priority Health	$221.77
Rate for Payer: Priority Health SBD	$214.95

HC CANNULA COR OSTIA LPG 5MM

Facility

$341.19

Hospital Charge Code	27006705
Hospital Revenue Code	270
Min. Negotiated Rate	$214.95
Max. Negotiated Rate	$307.07
Rate for Payer: Aetna Commercial	$290.01
Rate for Payer: Aetna New Business (MI Preferred)	$221.77
Rate for Payer: Cash Price	$272.95
Rate for Payer: Cofinity Commercial	$238.83
Rate for Payer: Cofinity Commercial	$293.42
Rate for Payer: Cofinity Medicare Advantage	$238.83
Rate for Payer: Encore Health Key Benefits Commercial	$272.95
Rate for Payer: Healthscope Commercial	$307.07
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$290.01
Rate for Payer: PHP Commercial	$290.01
Rate for Payer: Priority Health Cigna Priority Health	$221.77
Rate for Payer: Priority Health SBD	$214.95

Know your out-of-pocket cost for care.

All Charges