Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC HIGH FLOW JET VENT

Facility

$1,023.00

Hospital Charge Code	27000699
Hospital Revenue Code	270
Min. Negotiated Rate	$644.49
Max. Negotiated Rate	$920.70
Rate for Payer: Aetna Commercial	$869.55
Rate for Payer: Aetna New Business (MI Preferred)	$664.95
Rate for Payer: Cash Price	$818.40
Rate for Payer: Cofinity Commercial	$716.10
Rate for Payer: Cofinity Commercial	$879.78
Rate for Payer: Healthscope Commercial	$920.70
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$869.55
Rate for Payer: PHP Commercial	$869.55
Rate for Payer: Priority Health Cigna Priority Health	$716.10
Rate for Payer: Priority Health SBD	$644.49

HC HIGH FLOW JET VENT

Facility

$1,023.00

Hospital Charge Code	27000699
Hospital Revenue Code	270
Min. Negotiated Rate	$409.20
Max. Negotiated Rate	$920.70
Rate for Payer: Aetna Commercial	$869.55
Rate for Payer: Aetna New Business (MI Preferred)	$664.95
Rate for Payer: BCBS Complete	$409.20
Rate for Payer: Cash Price	$818.40
Rate for Payer: Cofinity Commercial	$716.10
Rate for Payer: Cofinity Commercial	$879.78
Rate for Payer: Healthscope Commercial	$920.70
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$869.55
Rate for Payer: PHP Commercial	$869.55
Rate for Payer: Priority Health Cigna Priority Health	$716.10
Rate for Payer: Priority Health SBD	$644.49

HC HIGH FLOW OXYGEN THERAPY

Facility

$213.13

Hospital Charge Code	27000632
Hospital Revenue Code	270
Min. Negotiated Rate	$134.27
Max. Negotiated Rate	$191.82
Rate for Payer: Aetna Commercial	$181.16
Rate for Payer: Aetna New Business (MI Preferred)	$138.53
Rate for Payer: Cash Price	$170.50
Rate for Payer: Cofinity Commercial	$149.19
Rate for Payer: Cofinity Commercial	$183.29
Rate for Payer: Healthscope Commercial	$191.82
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$181.16
Rate for Payer: PHP Commercial	$181.16
Rate for Payer: Priority Health Cigna Priority Health	$149.19
Rate for Payer: Priority Health SBD	$134.27

HC HIGH FLOW OXYGEN THERAPY

Facility

$213.13

Hospital Charge Code	27000632
Hospital Revenue Code	270
Min. Negotiated Rate	$85.25
Max. Negotiated Rate	$191.82
Rate for Payer: Aetna Commercial	$181.16
Rate for Payer: Aetna New Business (MI Preferred)	$138.53
Rate for Payer: BCBS Complete	$85.25
Rate for Payer: Cash Price	$170.50
Rate for Payer: Cofinity Commercial	$149.19
Rate for Payer: Cofinity Commercial	$183.29
Rate for Payer: Healthscope Commercial	$191.82
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$181.16
Rate for Payer: PHP Commercial	$181.16
Rate for Payer: Priority Health Cigna Priority Health	$149.19
Rate for Payer: Priority Health SBD	$134.27

HC HINGE EXTENSION/FLEX WRIST/F

Facility

$1,511.64

Service Code	HCPCS L3900
Hospital Charge Code	27400048
Hospital Revenue Code	274
Min. Negotiated Rate	$952.33
Max. Negotiated Rate	$1,360.48
Rate for Payer: Aetna Commercial	$1,284.89
Rate for Payer: Aetna New Business (MI Preferred)	$982.57
Rate for Payer: Cash Price	$1,209.31
Rate for Payer: Cofinity Commercial	$1,300.01
Rate for Payer: Cofinity Commercial	$1,058.15
Rate for Payer: Healthscope Commercial	$1,360.48
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,284.89
Rate for Payer: PHP Commercial	$1,284.89
Rate for Payer: Priority Health Cigna Priority Health	$1,058.15
Rate for Payer: Priority Health SBD	$952.33

HC HINGE EXTENSION/FLEX WRIST/F

Facility

$1,511.64

Service Code	HCPCS L3900
Hospital Charge Code	27400048
Hospital Revenue Code	274
Min. Negotiated Rate	$604.66
Max. Negotiated Rate	$4,912.75
Rate for Payer: Aetna Commercial	$1,284.89
Rate for Payer: Aetna New Business (MI Preferred)	$982.57
Rate for Payer: BCBS Complete	$604.66
Rate for Payer: BCBS Trust/PPO	$4,912.75
Rate for Payer: Cash Price	$1,209.31
Rate for Payer: Cash Price	$1,209.31
Rate for Payer: Cofinity Commercial	$1,058.15
Rate for Payer: Cofinity Commercial	$1,300.01
Rate for Payer: Healthscope Commercial	$1,360.48
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,284.89
Rate for Payer: PHP Commercial	$1,284.89
Rate for Payer: Priority Health Cigna Priority Health	$1,058.15
Rate for Payer: Priority Health SBD	$952.33
Rate for Payer: UHC All Payor (Choice/PPO)	$2,228.88
Rate for Payer: UHC Exchange	$1,857.40

HC HIPS BIL WITH PELVIS IF PERFORMED 2 VIEWS

Facility

$383.75

Service Code	CPT 73521
Hospital Charge Code	32000312
Hospital Revenue Code	320
Min. Negotiated Rate	$40.60
Max. Negotiated Rate	$345.38
Rate for Payer: Aetna Commercial	$326.19
Rate for Payer: Aetna Medicare	$101.73
Rate for Payer: Aetna New Business (MI Preferred)	$249.44
Rate for Payer: Allen County Amish Medical Aid Commercial	$122.28
Rate for Payer: Amish Plain Church Group Commercial	$122.28
Rate for Payer: BCBS Complete	$56.19
Rate for Payer: BCBS MAPPO	$97.82
Rate for Payer: BCBS Trust/PPO	$50.74
Rate for Payer: BCN Medicare Advantage	$97.82
Rate for Payer: Cash Price	$307.00
Rate for Payer: Cash Price	$307.00
Rate for Payer: Cofinity Commercial	$330.02
Rate for Payer: Cofinity Commercial	$268.62
Rate for Payer: Health Alliance Plan Medicare Advantage	$97.82
Rate for Payer: Healthscope Commercial	$345.38
Rate for Payer: Mclaren Medicaid	$53.51
Rate for Payer: Mclaren Medicare	$97.82
Rate for Payer: Meridian Medicaid	$56.19
Rate for Payer: Meridian Wellcare - Medicare Advantage	$102.71
Rate for Payer: MI Amish Medical Board Commercial	$112.49
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$326.19
Rate for Payer: PACE Medicare	$92.93
Rate for Payer: PACE SWMI	$97.82
Rate for Payer: PHP Commercial	$326.19
Rate for Payer: PHP Medicare Advantage	$97.82
Rate for Payer: Priority Health Choice Medicaid	$53.51
Rate for Payer: Priority Health Cigna Priority Health	$268.62
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$320.48
Rate for Payer: Priority Health Medicare	$97.82
Rate for Payer: Priority Health Narrow Network	$256.38
Rate for Payer: Priority Health SBD	$241.76
Rate for Payer: Railroad Medicare Medicare	$97.82
Rate for Payer: UHC All Payor (Choice/PPO)	$44.66
Rate for Payer: UHC Dual Complete DSNP	$97.82
Rate for Payer: UHC Exchange	$40.60
Rate for Payer: UHC Medicare Advantage	$100.75
Rate for Payer: VA VA	$97.82

HC HIPS BIL WITH PELVIS IF PERFORMED 2 VIEWS

Facility

$383.75

Service Code	CPT 73521
Hospital Charge Code	32000312
Hospital Revenue Code	320
Min. Negotiated Rate	$241.76
Max. Negotiated Rate	$345.38
Rate for Payer: Aetna Commercial	$326.19
Rate for Payer: Aetna New Business (MI Preferred)	$249.44
Rate for Payer: Cash Price	$307.00
Rate for Payer: Cofinity Commercial	$268.62
Rate for Payer: Cofinity Commercial	$330.02
Rate for Payer: Healthscope Commercial	$345.38
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$326.19
Rate for Payer: PHP Commercial	$326.19
Rate for Payer: Priority Health Cigna Priority Health	$268.62
Rate for Payer: Priority Health SBD	$241.76

HC HIPS BIL WITH PELVIS IF PERFORMED 3 TO 4 VIEWS

Facility

$472.31

Service Code	CPT 73522
Hospital Charge Code	32000313
Hospital Revenue Code	320
Min. Negotiated Rate	$53.05
Max. Negotiated Rate	$425.08
Rate for Payer: Aetna Commercial	$401.46
Rate for Payer: Aetna Medicare	$101.73
Rate for Payer: Aetna New Business (MI Preferred)	$307.00
Rate for Payer: Allen County Amish Medical Aid Commercial	$122.28
Rate for Payer: Amish Plain Church Group Commercial	$122.28
Rate for Payer: BCBS Complete	$56.19
Rate for Payer: BCBS MAPPO	$97.82
Rate for Payer: BCBS Trust/PPO	$65.64
Rate for Payer: BCN Medicare Advantage	$97.82
Rate for Payer: Cash Price	$377.85
Rate for Payer: Cash Price	$377.85
Rate for Payer: Cofinity Commercial	$330.62
Rate for Payer: Cofinity Commercial	$406.19
Rate for Payer: Health Alliance Plan Medicare Advantage	$97.82
Rate for Payer: Healthscope Commercial	$425.08
Rate for Payer: Mclaren Medicaid	$53.51
Rate for Payer: Mclaren Medicare	$97.82
Rate for Payer: Meridian Medicaid	$56.19
Rate for Payer: Meridian Wellcare - Medicare Advantage	$102.71
Rate for Payer: MI Amish Medical Board Commercial	$112.49
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$401.46
Rate for Payer: PACE Medicare	$92.93
Rate for Payer: PACE SWMI	$97.82
Rate for Payer: PHP Commercial	$401.46
Rate for Payer: PHP Medicare Advantage	$97.82
Rate for Payer: Priority Health Choice Medicaid	$53.51
Rate for Payer: Priority Health Cigna Priority Health	$330.62
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$320.48
Rate for Payer: Priority Health Medicare	$97.82
Rate for Payer: Priority Health Narrow Network	$256.38
Rate for Payer: Priority Health SBD	$297.56
Rate for Payer: Railroad Medicare Medicare	$97.82
Rate for Payer: UHC All Payor (Choice/PPO)	$58.36
Rate for Payer: UHC Dual Complete DSNP	$97.82
Rate for Payer: UHC Exchange	$53.05
Rate for Payer: UHC Medicare Advantage	$100.75
Rate for Payer: VA VA	$97.82

HC HIPS BIL WITH PELVIS IF PERFORMED 3 TO 4 VIEWS

Facility

$472.31

Service Code	CPT 73522
Hospital Charge Code	32000313
Hospital Revenue Code	320
Min. Negotiated Rate	$297.56
Max. Negotiated Rate	$425.08
Rate for Payer: Aetna Commercial	$401.46
Rate for Payer: Aetna New Business (MI Preferred)	$307.00
Rate for Payer: Cash Price	$377.85
Rate for Payer: Cofinity Commercial	$330.62
Rate for Payer: Cofinity Commercial	$406.19
Rate for Payer: Healthscope Commercial	$425.08
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$401.46
Rate for Payer: PHP Commercial	$401.46
Rate for Payer: Priority Health Cigna Priority Health	$330.62
Rate for Payer: Priority Health SBD	$297.56

HC HIPS BIL WITH PELVIS IF PERFORMED MIN 5 VIEWS

Facility

$531.36

Service Code	CPT 73523
Hospital Charge Code	32000314
Hospital Revenue Code	320
Min. Negotiated Rate	$53.51
Max. Negotiated Rate	$478.22
Rate for Payer: Aetna Commercial	$451.66
Rate for Payer: Aetna Medicare	$101.73
Rate for Payer: Aetna New Business (MI Preferred)	$345.38
Rate for Payer: Allen County Amish Medical Aid Commercial	$122.28
Rate for Payer: Amish Plain Church Group Commercial	$122.28
Rate for Payer: BCBS Complete	$56.19
Rate for Payer: BCBS MAPPO	$97.82
Rate for Payer: BCBS Trust/PPO	$77.78
Rate for Payer: BCN Medicare Advantage	$97.82
Rate for Payer: Cash Price	$425.09
Rate for Payer: Cash Price	$425.09
Rate for Payer: Cofinity Commercial	$371.95
Rate for Payer: Cofinity Commercial	$456.97
Rate for Payer: Health Alliance Plan Medicare Advantage	$97.82
Rate for Payer: Healthscope Commercial	$478.22
Rate for Payer: Mclaren Medicaid	$53.51
Rate for Payer: Mclaren Medicare	$97.82
Rate for Payer: Meridian Medicaid	$56.19
Rate for Payer: Meridian Wellcare - Medicare Advantage	$102.71
Rate for Payer: MI Amish Medical Board Commercial	$112.49
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$451.66
Rate for Payer: PACE Medicare	$92.93
Rate for Payer: PACE SWMI	$97.82
Rate for Payer: PHP Commercial	$451.66
Rate for Payer: PHP Medicare Advantage	$97.82
Rate for Payer: Priority Health Choice Medicaid	$53.51
Rate for Payer: Priority Health Cigna Priority Health	$371.95
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$320.48
Rate for Payer: Priority Health Medicare	$97.82
Rate for Payer: Priority Health Narrow Network	$256.38
Rate for Payer: Priority Health SBD	$334.76
Rate for Payer: Railroad Medicare Medicare	$97.82
Rate for Payer: UHC All Payor (Choice/PPO)	$66.99
Rate for Payer: UHC Dual Complete DSNP	$97.82
Rate for Payer: UHC Exchange	$60.90
Rate for Payer: UHC Medicare Advantage	$100.75
Rate for Payer: VA VA	$97.82

HC HIPS BIL WITH PELVIS IF PERFORMED MIN 5 VIEWS

Facility

$531.36

Service Code	CPT 73523
Hospital Charge Code	32000314
Hospital Revenue Code	320
Min. Negotiated Rate	$334.76
Max. Negotiated Rate	$478.22
Rate for Payer: Aetna Commercial	$451.66
Rate for Payer: Aetna New Business (MI Preferred)	$345.38
Rate for Payer: Cash Price	$425.09
Rate for Payer: Cofinity Commercial	$371.95
Rate for Payer: Cofinity Commercial	$456.97
Rate for Payer: Healthscope Commercial	$478.22
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$451.66
Rate for Payer: PHP Commercial	$451.66
Rate for Payer: Priority Health Cigna Priority Health	$371.95
Rate for Payer: Priority Health SBD	$334.76

HC HIP UNI W PELVIS IF PERFORMED 1 VIEW

Facility

$147.59

Service Code	CPT 73501
Hospital Charge Code	32000309
Hospital Revenue Code	320
Min. Negotiated Rate	$92.98
Max. Negotiated Rate	$132.83
Rate for Payer: Aetna Commercial	$125.45
Rate for Payer: Aetna New Business (MI Preferred)	$95.93
Rate for Payer: Cash Price	$118.07
Rate for Payer: Cofinity Commercial	$103.31
Rate for Payer: Cofinity Commercial	$126.93
Rate for Payer: Healthscope Commercial	$132.83
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$125.45
Rate for Payer: PHP Commercial	$125.45
Rate for Payer: Priority Health Cigna Priority Health	$103.31
Rate for Payer: Priority Health SBD	$92.98

HC HIP UNI W PELVIS IF PERFORMED 1 VIEW

Facility

$147.59

Service Code	CPT 73501
Hospital Charge Code	32000309
Hospital Revenue Code	320
Min. Negotiated Rate	$32.42
Max. Negotiated Rate	$260.51
Rate for Payer: Aetna Commercial	$125.45
Rate for Payer: Aetna Medicare	$84.09
Rate for Payer: Aetna New Business (MI Preferred)	$95.93
Rate for Payer: Allen County Amish Medical Aid Commercial	$101.08
Rate for Payer: Amish Plain Church Group Commercial	$101.08
Rate for Payer: BCBS Complete	$46.45
Rate for Payer: BCBS MAPPO	$80.86
Rate for Payer: BCBS Trust/PPO	$39.72
Rate for Payer: BCN Medicare Advantage	$80.86
Rate for Payer: Cash Price	$118.07
Rate for Payer: Cash Price	$118.07
Rate for Payer: Cofinity Commercial	$126.93
Rate for Payer: Cofinity Commercial	$103.31
Rate for Payer: Health Alliance Plan Medicare Advantage	$80.86
Rate for Payer: Healthscope Commercial	$132.83
Rate for Payer: Mclaren Medicaid	$44.23
Rate for Payer: Mclaren Medicare	$80.86
Rate for Payer: Meridian Medicaid	$46.45
Rate for Payer: Meridian Wellcare - Medicare Advantage	$84.90
Rate for Payer: MI Amish Medical Board Commercial	$92.99
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$125.45
Rate for Payer: PACE Medicare	$76.82
Rate for Payer: PACE SWMI	$80.86
Rate for Payer: PHP Commercial	$125.45
Rate for Payer: PHP Medicare Advantage	$80.86
Rate for Payer: Priority Health Choice Medicaid	$44.23
Rate for Payer: Priority Health Cigna Priority Health	$103.31
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$260.51
Rate for Payer: Priority Health Medicare	$80.86
Rate for Payer: Priority Health Narrow Network	$208.41
Rate for Payer: Priority Health SBD	$92.98
Rate for Payer: Railroad Medicare Medicare	$80.86
Rate for Payer: UHC All Payor (Choice/PPO)	$35.66
Rate for Payer: UHC Dual Complete DSNP	$80.86
Rate for Payer: UHC Exchange	$32.42
Rate for Payer: UHC Medicare Advantage	$83.29
Rate for Payer: VA VA	$80.86

HC HIP UNI W PELVIS IF PERFORMED 2 OR 3 VIEWS

Facility

$295.20

Service Code	CPT 73502
Hospital Charge Code	32000310
Hospital Revenue Code	320
Min. Negotiated Rate	$44.23
Max. Negotiated Rate	$265.68
Rate for Payer: Aetna Commercial	$250.92
Rate for Payer: Aetna Medicare	$84.09
Rate for Payer: Aetna New Business (MI Preferred)	$191.88
Rate for Payer: Allen County Amish Medical Aid Commercial	$101.08
Rate for Payer: Amish Plain Church Group Commercial	$101.08
Rate for Payer: BCBS Complete	$46.45
Rate for Payer: BCBS MAPPO	$80.86
Rate for Payer: BCBS Trust/PPO	$60.12
Rate for Payer: BCN Medicare Advantage	$80.86
Rate for Payer: Cash Price	$236.16
Rate for Payer: Cash Price	$236.16
Rate for Payer: Cofinity Commercial	$206.64
Rate for Payer: Cofinity Commercial	$253.87
Rate for Payer: Health Alliance Plan Medicare Advantage	$80.86
Rate for Payer: Healthscope Commercial	$265.68
Rate for Payer: Mclaren Medicaid	$44.23
Rate for Payer: Mclaren Medicare	$80.86
Rate for Payer: Meridian Medicaid	$46.45
Rate for Payer: Meridian Wellcare - Medicare Advantage	$84.90
Rate for Payer: MI Amish Medical Board Commercial	$92.99
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$250.92
Rate for Payer: PACE Medicare	$76.82
Rate for Payer: PACE SWMI	$80.86
Rate for Payer: PHP Commercial	$250.92
Rate for Payer: PHP Medicare Advantage	$80.86
Rate for Payer: Priority Health Choice Medicaid	$44.23
Rate for Payer: Priority Health Cigna Priority Health	$206.64
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$260.51
Rate for Payer: Priority Health Medicare	$80.86
Rate for Payer: Priority Health Narrow Network	$208.41
Rate for Payer: Priority Health SBD	$185.98
Rate for Payer: Railroad Medicare Medicare	$80.86
Rate for Payer: UHC All Payor (Choice/PPO)	$51.50
Rate for Payer: UHC Dual Complete DSNP	$80.86
Rate for Payer: UHC Exchange	$46.82
Rate for Payer: UHC Medicare Advantage	$83.29
Rate for Payer: VA VA	$80.86

HC HIP UNI W PELVIS IF PERFORMED 2 OR 3 VIEWS

Facility

$295.20

Service Code	CPT 73502
Hospital Charge Code	32000310
Hospital Revenue Code	320
Min. Negotiated Rate	$185.98
Max. Negotiated Rate	$265.68
Rate for Payer: Aetna Commercial	$250.92
Rate for Payer: Aetna New Business (MI Preferred)	$191.88
Rate for Payer: Cash Price	$236.16
Rate for Payer: Cofinity Commercial	$206.64
Rate for Payer: Cofinity Commercial	$253.87
Rate for Payer: Healthscope Commercial	$265.68
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$250.92
Rate for Payer: PHP Commercial	$250.92
Rate for Payer: Priority Health Cigna Priority Health	$206.64
Rate for Payer: Priority Health SBD	$185.98

HC HIP UNI W PELVIS IF PERFORMED MIN 4 VIEWS

Facility

$383.75

Service Code	CPT 73503
Hospital Charge Code	32000311
Hospital Revenue Code	320
Min. Negotiated Rate	$241.76
Max. Negotiated Rate	$345.38
Rate for Payer: Aetna Commercial	$326.19
Rate for Payer: Aetna New Business (MI Preferred)	$249.44
Rate for Payer: Cash Price	$307.00
Rate for Payer: Cofinity Commercial	$268.62
Rate for Payer: Cofinity Commercial	$330.02
Rate for Payer: Healthscope Commercial	$345.38
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$326.19
Rate for Payer: PHP Commercial	$326.19
Rate for Payer: Priority Health Cigna Priority Health	$268.62
Rate for Payer: Priority Health SBD	$241.76

HC HIP UNI W PELVIS IF PERFORMED MIN 4 VIEWS

Facility

$383.75

Service Code	CPT 73503
Hospital Charge Code	32000311
Hospital Revenue Code	320
Min. Negotiated Rate	$53.51
Max. Negotiated Rate	$345.38
Rate for Payer: Aetna Commercial	$326.19
Rate for Payer: Aetna Medicare	$101.73
Rate for Payer: Aetna New Business (MI Preferred)	$249.44
Rate for Payer: Allen County Amish Medical Aid Commercial	$122.28
Rate for Payer: Amish Plain Church Group Commercial	$122.28
Rate for Payer: BCBS Complete	$56.19
Rate for Payer: BCBS MAPPO	$97.82
Rate for Payer: BCBS Trust/PPO	$76.67
Rate for Payer: BCN Medicare Advantage	$97.82
Rate for Payer: Cash Price	$307.00
Rate for Payer: Cash Price	$307.00
Rate for Payer: Cofinity Commercial	$330.02
Rate for Payer: Cofinity Commercial	$268.62
Rate for Payer: Health Alliance Plan Medicare Advantage	$97.82
Rate for Payer: Healthscope Commercial	$345.38
Rate for Payer: Mclaren Medicaid	$53.51
Rate for Payer: Mclaren Medicare	$97.82
Rate for Payer: Meridian Medicaid	$56.19
Rate for Payer: Meridian Wellcare - Medicare Advantage	$102.71
Rate for Payer: MI Amish Medical Board Commercial	$112.49
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$326.19
Rate for Payer: PACE Medicare	$92.93
Rate for Payer: PACE SWMI	$97.82
Rate for Payer: PHP Commercial	$326.19
Rate for Payer: PHP Medicare Advantage	$97.82
Rate for Payer: Priority Health Choice Medicaid	$53.51
Rate for Payer: Priority Health Cigna Priority Health	$268.62
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$320.48
Rate for Payer: Priority Health Medicare	$97.82
Rate for Payer: Priority Health Narrow Network	$256.38
Rate for Payer: Priority Health SBD	$241.76
Rate for Payer: Railroad Medicare Medicare	$97.82
Rate for Payer: UHC All Payor (Choice/PPO)	$64.83
Rate for Payer: UHC Dual Complete DSNP	$97.82
Rate for Payer: UHC Exchange	$58.94
Rate for Payer: UHC Medicare Advantage	$100.75
Rate for Payer: VA VA	$97.82

HC HIS LEAD

Facility

$1,413.72

Service Code	HCPCS C1898
Hospital Charge Code	27800121
Hospital Revenue Code	278
Min. Negotiated Rate	$565.49
Max. Negotiated Rate	$1,272.35
Rate for Payer: Aetna Commercial	$1,201.66
Rate for Payer: Aetna New Business (MI Preferred)	$918.92
Rate for Payer: BCBS Complete	$565.49
Rate for Payer: Cash Price	$1,130.98
Rate for Payer: Cofinity Commercial	$1,215.80
Rate for Payer: Cofinity Commercial	$989.60
Rate for Payer: Healthscope Commercial	$1,272.35
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,201.66
Rate for Payer: PHP Commercial	$1,201.66
Rate for Payer: Priority Health Cigna Priority Health	$989.60
Rate for Payer: Priority Health SBD	$890.64

HC HIS LEAD

Facility

$1,413.72

Service Code	HCPCS C1898
Hospital Charge Code	27800121
Hospital Revenue Code	278
Min. Negotiated Rate	$890.64
Max. Negotiated Rate	$1,272.35
Rate for Payer: Aetna Commercial	$1,201.66
Rate for Payer: Aetna New Business (MI Preferred)	$918.92
Rate for Payer: Cash Price	$1,130.98
Rate for Payer: Cofinity Commercial	$1,215.80
Rate for Payer: Cofinity Commercial	$989.60
Rate for Payer: Healthscope Commercial	$1,272.35
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,201.66
Rate for Payer: PHP Commercial	$1,201.66
Rate for Payer: Priority Health Cigna Priority Health	$989.60
Rate for Payer: Priority Health SBD	$890.64

HC HISTONE AUTOANTIBODIES, S

Facility

$51.00

Service Code	CPT 83516
Hospital Charge Code	30100601
Hospital Revenue Code	301
Min. Negotiated Rate	$6.31
Max. Negotiated Rate	$45.90
Rate for Payer: Aetna Commercial	$43.35
Rate for Payer: Aetna Medicare	$11.99
Rate for Payer: Aetna New Business (MI Preferred)	$33.15
Rate for Payer: Allen County Amish Medical Aid Commercial	$14.41
Rate for Payer: Amish Plain Church Group Commercial	$14.41
Rate for Payer: BCBS Complete	$6.62
Rate for Payer: BCBS MAPPO	$11.53
Rate for Payer: BCBS Trust/PPO	$9.03
Rate for Payer: BCN Medicare Advantage	$11.53
Rate for Payer: Cash Price	$40.80
Rate for Payer: Cash Price	$40.80
Rate for Payer: Cofinity Commercial	$43.86
Rate for Payer: Cofinity Commercial	$35.70
Rate for Payer: Health Alliance Plan Medicare Advantage	$11.53
Rate for Payer: Healthscope Commercial	$45.90
Rate for Payer: Mclaren Medicaid	$6.31
Rate for Payer: Mclaren Medicare	$11.53
Rate for Payer: Meridian Medicaid	$6.62
Rate for Payer: Meridian Wellcare - Medicare Advantage	$12.11
Rate for Payer: MI Amish Medical Board Commercial	$13.26
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$43.35
Rate for Payer: PACE Medicare	$10.95
Rate for Payer: PACE SWMI	$11.53
Rate for Payer: PHP Commercial	$43.35
Rate for Payer: PHP Medicare Advantage	$11.53
Rate for Payer: Priority Health Choice Medicaid	$6.31
Rate for Payer: Priority Health Cigna Priority Health	$35.70
Rate for Payer: Priority Health Medicare	$11.53
Rate for Payer: Priority Health SBD	$32.13
Rate for Payer: Railroad Medicare Medicare	$11.53
Rate for Payer: UHC All Payor (Choice/PPO)	$13.84
Rate for Payer: UHC Core	$19.61
Rate for Payer: UHC Dual Complete DSNP	$11.53
Rate for Payer: UHC Exchange	$11.53
Rate for Payer: UHC Medicare Advantage	$11.88
Rate for Payer: VA VA	$11.53

HC HISTONE AUTOANTIBODIES, S

Facility

$51.00

Service Code	CPT 83516
Hospital Charge Code	30100601
Hospital Revenue Code	301
Min. Negotiated Rate	$32.13
Max. Negotiated Rate	$45.90
Rate for Payer: Aetna Commercial	$43.35
Rate for Payer: Aetna New Business (MI Preferred)	$33.15
Rate for Payer: Cash Price	$40.80
Rate for Payer: Cofinity Commercial	$35.70
Rate for Payer: Cofinity Commercial	$43.86
Rate for Payer: Healthscope Commercial	$45.90
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$43.35
Rate for Payer: PHP Commercial	$43.35
Rate for Payer: Priority Health Cigna Priority Health	$35.70
Rate for Payer: Priority Health SBD	$32.13

HC HISTOPLASMA AB

Facility

$59.00

Service Code	CPT 86698
Hospital Charge Code	30200286
Hospital Revenue Code	302
Min. Negotiated Rate	$7.54
Max. Negotiated Rate	$53.10
Rate for Payer: Aetna Commercial	$50.15
Rate for Payer: Aetna Medicare	$14.34
Rate for Payer: Aetna New Business (MI Preferred)	$38.35
Rate for Payer: Allen County Amish Medical Aid Commercial	$17.24
Rate for Payer: Amish Plain Church Group Commercial	$17.24
Rate for Payer: BCBS Complete	$7.92
Rate for Payer: BCBS MAPPO	$13.79
Rate for Payer: BCBS Trust/PPO	$10.80
Rate for Payer: BCN Medicare Advantage	$13.79
Rate for Payer: Cash Price	$47.20
Rate for Payer: Cash Price	$47.20
Rate for Payer: Cofinity Commercial	$50.74
Rate for Payer: Cofinity Commercial	$41.30
Rate for Payer: Health Alliance Plan Medicare Advantage	$13.79
Rate for Payer: Healthscope Commercial	$53.10
Rate for Payer: Mclaren Medicaid	$7.54
Rate for Payer: Mclaren Medicare	$13.79
Rate for Payer: Meridian Medicaid	$7.92
Rate for Payer: Meridian Wellcare - Medicare Advantage	$14.48
Rate for Payer: MI Amish Medical Board Commercial	$15.86
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$50.15
Rate for Payer: PACE Medicare	$13.10
Rate for Payer: PACE SWMI	$13.79
Rate for Payer: PHP Commercial	$50.15
Rate for Payer: PHP Medicare Advantage	$13.79
Rate for Payer: Priority Health Choice Medicaid	$7.54
Rate for Payer: Priority Health Cigna Priority Health	$41.30
Rate for Payer: Priority Health Medicare	$13.79
Rate for Payer: Priority Health SBD	$37.17
Rate for Payer: Railroad Medicare Medicare	$13.79
Rate for Payer: UHC All Payor (Choice/PPO)	$16.55
Rate for Payer: UHC Core	$21.25
Rate for Payer: UHC Dual Complete DSNP	$13.79
Rate for Payer: UHC Exchange	$13.79
Rate for Payer: UHC Medicare Advantage	$14.20
Rate for Payer: VA VA	$13.79

HC HISTOPLASMA AB

Facility

$59.00

Service Code	CPT 86698
Hospital Charge Code	30200286
Hospital Revenue Code	302
Min. Negotiated Rate	$37.17
Max. Negotiated Rate	$53.10
Rate for Payer: Aetna Commercial	$50.15
Rate for Payer: Aetna New Business (MI Preferred)	$38.35
Rate for Payer: Cash Price	$47.20
Rate for Payer: Cofinity Commercial	$41.30
Rate for Payer: Cofinity Commercial	$50.74
Rate for Payer: Healthscope Commercial	$53.10
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$50.15
Rate for Payer: PHP Commercial	$50.15
Rate for Payer: Priority Health Cigna Priority Health	$41.30
Rate for Payer: Priority Health SBD	$37.17

HC HISTOPLASMA AB CMPT

Facility

$21.17

Service Code	CPT 86698
Hospital Charge Code	30200289
Hospital Revenue Code	302
Min. Negotiated Rate	$7.54
Max. Negotiated Rate	$21.25
Rate for Payer: Aetna Commercial	$17.99
Rate for Payer: Aetna Medicare	$14.34
Rate for Payer: Aetna New Business (MI Preferred)	$13.76
Rate for Payer: Allen County Amish Medical Aid Commercial	$17.24
Rate for Payer: Amish Plain Church Group Commercial	$17.24
Rate for Payer: BCBS Complete	$7.92
Rate for Payer: BCBS MAPPO	$13.79
Rate for Payer: BCBS Trust/PPO	$10.80
Rate for Payer: BCN Medicare Advantage	$13.79
Rate for Payer: Cash Price	$16.94
Rate for Payer: Cash Price	$16.94
Rate for Payer: Cofinity Commercial	$18.21
Rate for Payer: Cofinity Commercial	$14.82
Rate for Payer: Health Alliance Plan Medicare Advantage	$13.79
Rate for Payer: Healthscope Commercial	$19.05
Rate for Payer: Mclaren Medicaid	$7.54
Rate for Payer: Mclaren Medicare	$13.79
Rate for Payer: Meridian Medicaid	$7.92
Rate for Payer: Meridian Wellcare - Medicare Advantage	$14.48
Rate for Payer: MI Amish Medical Board Commercial	$15.86
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$17.99
Rate for Payer: PACE Medicare	$13.10
Rate for Payer: PACE SWMI	$13.79
Rate for Payer: PHP Commercial	$17.99
Rate for Payer: PHP Medicare Advantage	$13.79
Rate for Payer: Priority Health Choice Medicaid	$7.54
Rate for Payer: Priority Health Cigna Priority Health	$14.82
Rate for Payer: Priority Health Medicare	$13.79
Rate for Payer: Priority Health SBD	$13.34
Rate for Payer: Railroad Medicare Medicare	$13.79
Rate for Payer: UHC All Payor (Choice/PPO)	$16.55
Rate for Payer: UHC Core	$21.25
Rate for Payer: UHC Dual Complete DSNP	$13.79
Rate for Payer: UHC Exchange	$13.79
Rate for Payer: UHC Medicare Advantage	$14.20
Rate for Payer: VA VA	$13.79

Know your out-of-pocket cost for care.

All Charges