Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC INFUSION CATH LVL 10

Facility

$1,006.71

Service Code	HCPCS C1751
Hospital Charge Code	27200310
Hospital Revenue Code	272
Min. Negotiated Rate	$634.23
Max. Negotiated Rate	$906.04
Rate for Payer: Aetna Commercial	$855.70
Rate for Payer: Aetna New Business (MI Preferred)	$654.36
Rate for Payer: Cash Price	$805.37
Rate for Payer: Cofinity Commercial	$704.70
Rate for Payer: Cofinity Commercial	$865.77
Rate for Payer: Healthscope Commercial	$906.04
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$855.70
Rate for Payer: PHP Commercial	$855.70
Rate for Payer: Priority Health Cigna Priority Health	$704.70
Rate for Payer: Priority Health SBD	$634.23

HC INFUSION CATH LVL 10

Facility

$1,006.71

Service Code	HCPCS C1751
Hospital Charge Code	27200310
Hospital Revenue Code	272
Min. Negotiated Rate	$402.68
Max. Negotiated Rate	$906.04
Rate for Payer: Aetna Commercial	$855.70
Rate for Payer: Aetna New Business (MI Preferred)	$654.36
Rate for Payer: BCBS Complete	$402.68
Rate for Payer: Cash Price	$805.37
Rate for Payer: Cofinity Commercial	$704.70
Rate for Payer: Cofinity Commercial	$865.77
Rate for Payer: Healthscope Commercial	$906.04
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$855.70
Rate for Payer: PHP Commercial	$855.70
Rate for Payer: Priority Health Cigna Priority Health	$704.70
Rate for Payer: Priority Health SBD	$634.23

HC INFUSION CATH LVL 11

Facility

$1,120.87

Service Code	HCPCS C1751
Hospital Charge Code	27200311
Hospital Revenue Code	272
Min. Negotiated Rate	$448.35
Max. Negotiated Rate	$1,008.78
Rate for Payer: Aetna Commercial	$952.74
Rate for Payer: Aetna New Business (MI Preferred)	$728.57
Rate for Payer: BCBS Complete	$448.35
Rate for Payer: Cash Price	$896.70
Rate for Payer: Cofinity Commercial	$784.61
Rate for Payer: Cofinity Commercial	$963.95
Rate for Payer: Healthscope Commercial	$1,008.78
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$952.74
Rate for Payer: PHP Commercial	$952.74
Rate for Payer: Priority Health Cigna Priority Health	$784.61
Rate for Payer: Priority Health SBD	$706.15

HC INFUSION CATH LVL 11

Facility

$1,120.87

Service Code	HCPCS C1751
Hospital Charge Code	27200311
Hospital Revenue Code	272
Min. Negotiated Rate	$706.15
Max. Negotiated Rate	$1,008.78
Rate for Payer: Aetna Commercial	$952.74
Rate for Payer: Aetna New Business (MI Preferred)	$728.57
Rate for Payer: Cash Price	$896.70
Rate for Payer: Cofinity Commercial	$784.61
Rate for Payer: Cofinity Commercial	$963.95
Rate for Payer: Healthscope Commercial	$1,008.78
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$952.74
Rate for Payer: PHP Commercial	$952.74
Rate for Payer: Priority Health Cigna Priority Health	$784.61
Rate for Payer: Priority Health SBD	$706.15

HC INFUSION CATH LVL 12

Facility

$1,247.97

Service Code	HCPCS C1751
Hospital Charge Code	27200312
Hospital Revenue Code	272
Min. Negotiated Rate	$786.22
Max. Negotiated Rate	$1,123.17
Rate for Payer: Aetna Commercial	$1,060.77
Rate for Payer: Aetna New Business (MI Preferred)	$811.18
Rate for Payer: Cash Price	$998.38
Rate for Payer: Cofinity Commercial	$1,073.25
Rate for Payer: Cofinity Commercial	$873.58
Rate for Payer: Healthscope Commercial	$1,123.17
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,060.77
Rate for Payer: PHP Commercial	$1,060.77
Rate for Payer: Priority Health Cigna Priority Health	$873.58
Rate for Payer: Priority Health SBD	$786.22

HC INFUSION CATH LVL 12

Facility

$1,247.97

Service Code	HCPCS C1751
Hospital Charge Code	27200312
Hospital Revenue Code	272
Min. Negotiated Rate	$499.19
Max. Negotiated Rate	$1,123.17
Rate for Payer: Aetna Commercial	$1,060.77
Rate for Payer: Aetna New Business (MI Preferred)	$811.18
Rate for Payer: BCBS Complete	$499.19
Rate for Payer: Cash Price	$998.38
Rate for Payer: Cofinity Commercial	$1,073.25
Rate for Payer: Cofinity Commercial	$873.58
Rate for Payer: Healthscope Commercial	$1,123.17
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,060.77
Rate for Payer: PHP Commercial	$1,060.77
Rate for Payer: Priority Health Cigna Priority Health	$873.58
Rate for Payer: Priority Health SBD	$786.22

HC INFUSION CATH LVL 13

Facility

$1,353.00

Service Code	HCPCS C1751
Hospital Charge Code	27200313
Hospital Revenue Code	272
Min. Negotiated Rate	$852.39
Max. Negotiated Rate	$1,217.70
Rate for Payer: Aetna Commercial	$1,150.05
Rate for Payer: Aetna New Business (MI Preferred)	$879.45
Rate for Payer: Cash Price	$1,082.40
Rate for Payer: Cofinity Commercial	$1,163.58
Rate for Payer: Cofinity Commercial	$947.10
Rate for Payer: Healthscope Commercial	$1,217.70
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,150.05
Rate for Payer: PHP Commercial	$1,150.05
Rate for Payer: Priority Health Cigna Priority Health	$947.10
Rate for Payer: Priority Health SBD	$852.39

HC INFUSION CATH LVL 13

Facility

$1,353.00

Service Code	HCPCS C1751
Hospital Charge Code	27200313
Hospital Revenue Code	272
Min. Negotiated Rate	$541.20
Max. Negotiated Rate	$1,217.70
Rate for Payer: Aetna Commercial	$1,150.05
Rate for Payer: Aetna New Business (MI Preferred)	$879.45
Rate for Payer: BCBS Complete	$541.20
Rate for Payer: Cash Price	$1,082.40
Rate for Payer: Cofinity Commercial	$1,163.58
Rate for Payer: Cofinity Commercial	$947.10
Rate for Payer: Healthscope Commercial	$1,217.70
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,150.05
Rate for Payer: PHP Commercial	$1,150.05
Rate for Payer: Priority Health Cigna Priority Health	$947.10
Rate for Payer: Priority Health SBD	$852.39

HC INFUSION CATH LVL 14

Facility

$1,446.90

Service Code	HCPCS C1751
Hospital Charge Code	27200267
Hospital Revenue Code	272
Min. Negotiated Rate	$911.55
Max. Negotiated Rate	$1,302.21
Rate for Payer: Aetna Commercial	$1,229.86
Rate for Payer: Aetna New Business (MI Preferred)	$940.48
Rate for Payer: Cash Price	$1,157.52
Rate for Payer: Cofinity Commercial	$1,012.83
Rate for Payer: Cofinity Commercial	$1,244.33
Rate for Payer: Healthscope Commercial	$1,302.21
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,229.86
Rate for Payer: PHP Commercial	$1,229.86
Rate for Payer: Priority Health Cigna Priority Health	$1,012.83
Rate for Payer: Priority Health SBD	$911.55

HC INFUSION CATH LVL 14

Facility

$1,446.90

Service Code	HCPCS C1751
Hospital Charge Code	27200267
Hospital Revenue Code	272
Min. Negotiated Rate	$578.76
Max. Negotiated Rate	$1,302.21
Rate for Payer: Aetna Commercial	$1,229.86
Rate for Payer: Aetna New Business (MI Preferred)	$940.48
Rate for Payer: BCBS Complete	$578.76
Rate for Payer: Cash Price	$1,157.52
Rate for Payer: Cofinity Commercial	$1,244.33
Rate for Payer: Cofinity Commercial	$1,012.83
Rate for Payer: Healthscope Commercial	$1,302.21
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,229.86
Rate for Payer: PHP Commercial	$1,229.86
Rate for Payer: Priority Health Cigna Priority Health	$1,012.83
Rate for Payer: Priority Health SBD	$911.55

HC INFUSION CATH LVL 4

Facility

$450.00

Service Code	HCPCS C1751
Hospital Charge Code	27200093
Hospital Revenue Code	272
Min. Negotiated Rate	$180.00
Max. Negotiated Rate	$405.00
Rate for Payer: Aetna Commercial	$382.50
Rate for Payer: Aetna New Business (MI Preferred)	$292.50
Rate for Payer: BCBS Complete	$180.00
Rate for Payer: Cash Price	$360.00
Rate for Payer: Cofinity Commercial	$315.00
Rate for Payer: Cofinity Commercial	$387.00
Rate for Payer: Healthscope Commercial	$405.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$382.50
Rate for Payer: PHP Commercial	$382.50
Rate for Payer: Priority Health Cigna Priority Health	$315.00
Rate for Payer: Priority Health SBD	$283.50

HC INFUSION CATH LVL 4

Facility

$450.00

Service Code	HCPCS C1751
Hospital Charge Code	27200093
Hospital Revenue Code	272
Min. Negotiated Rate	$283.50
Max. Negotiated Rate	$405.00
Rate for Payer: Aetna Commercial	$382.50
Rate for Payer: Aetna New Business (MI Preferred)	$292.50
Rate for Payer: Cash Price	$360.00
Rate for Payer: Cofinity Commercial	$315.00
Rate for Payer: Cofinity Commercial	$387.00
Rate for Payer: Healthscope Commercial	$405.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$382.50
Rate for Payer: PHP Commercial	$382.50
Rate for Payer: Priority Health Cigna Priority Health	$315.00
Rate for Payer: Priority Health SBD	$283.50

HC INFUSION CATH LVL 5

Facility

$595.35

Service Code	CPT C1751
Hospital Charge Code	27200296
Hospital Revenue Code	272
Min. Negotiated Rate	$375.07
Max. Negotiated Rate	$535.82
Rate for Payer: Aetna Commercial	$506.05
Rate for Payer: Aetna New Business (MI Preferred)	$386.98
Rate for Payer: Cash Price	$476.28
Rate for Payer: Cofinity Commercial	$416.74
Rate for Payer: Cofinity Commercial	$512.00
Rate for Payer: Healthscope Commercial	$535.82
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$506.05
Rate for Payer: PHP Commercial	$506.05
Rate for Payer: Priority Health Cigna Priority Health	$416.74
Rate for Payer: Priority Health SBD	$375.07

HC INFUSION CATH LVL 5

Facility

$595.35

Service Code	CPT C1751
Hospital Charge Code	27200296
Hospital Revenue Code	272
Min. Negotiated Rate	$238.14
Max. Negotiated Rate	$535.82
Rate for Payer: Aetna Commercial	$506.05
Rate for Payer: Aetna New Business (MI Preferred)	$386.98
Rate for Payer: BCBS Complete	$238.14
Rate for Payer: Cash Price	$476.28
Rate for Payer: Cofinity Commercial	$416.74
Rate for Payer: Cofinity Commercial	$512.00
Rate for Payer: Healthscope Commercial	$535.82
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$506.05
Rate for Payer: PHP Commercial	$506.05
Rate for Payer: Priority Health Cigna Priority Health	$416.74
Rate for Payer: Priority Health SBD	$375.07

HC INFUSION CATH LVL 8

Facility

$826.97

Service Code	CPT C1751
Hospital Charge Code	27200309
Hospital Revenue Code	272
Min. Negotiated Rate	$330.79
Max. Negotiated Rate	$744.27
Rate for Payer: Aetna Commercial	$702.92
Rate for Payer: Aetna New Business (MI Preferred)	$537.53
Rate for Payer: BCBS Complete	$330.79
Rate for Payer: Cash Price	$661.58
Rate for Payer: Cofinity Commercial	$578.88
Rate for Payer: Cofinity Commercial	$711.19
Rate for Payer: Healthscope Commercial	$744.27
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$702.92
Rate for Payer: PHP Commercial	$702.92
Rate for Payer: Priority Health Cigna Priority Health	$578.88
Rate for Payer: Priority Health SBD	$520.99

HC INFUSION CATH LVL 8

Facility

$826.97

Service Code	CPT C1751
Hospital Charge Code	27200309
Hospital Revenue Code	272
Min. Negotiated Rate	$520.99
Max. Negotiated Rate	$744.27
Rate for Payer: Aetna Commercial	$702.92
Rate for Payer: Aetna New Business (MI Preferred)	$537.53
Rate for Payer: Cash Price	$661.58
Rate for Payer: Cofinity Commercial	$578.88
Rate for Payer: Cofinity Commercial	$711.19
Rate for Payer: Healthscope Commercial	$744.27
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$702.92
Rate for Payer: PHP Commercial	$702.92
Rate for Payer: Priority Health Cigna Priority Health	$578.88
Rate for Payer: Priority Health SBD	$520.99

HC INGESTION CHALLENGE TEST EA ADDL 60 MIN

Facility

$220.00

Service Code	CPT 95079
Hospital Charge Code	51000115
Hospital Revenue Code	510
Min. Negotiated Rate	$138.60
Max. Negotiated Rate	$198.00
Rate for Payer: Aetna Commercial	$187.00
Rate for Payer: Aetna New Business (MI Preferred)	$143.00
Rate for Payer: Cash Price	$176.00
Rate for Payer: Cofinity Commercial	$154.00
Rate for Payer: Cofinity Commercial	$189.20
Rate for Payer: Healthscope Commercial	$198.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$187.00
Rate for Payer: PHP Commercial	$187.00
Rate for Payer: Priority Health Cigna Priority Health	$154.00
Rate for Payer: Priority Health SBD	$138.60

HC INGESTION CHALLENGE TEST EA ADDL 60 MIN

Facility

$220.00

Service Code	CPT 95079
Hospital Charge Code	51000115
Hospital Revenue Code	510
Min. Negotiated Rate	$65.82
Max. Negotiated Rate	$198.00
Rate for Payer: Aetna Commercial	$187.00
Rate for Payer: Aetna New Business (MI Preferred)	$143.00
Rate for Payer: BCBS Complete	$88.00
Rate for Payer: BCBS Trust/PPO	$103.84
Rate for Payer: Cash Price	$176.00
Rate for Payer: Cash Price	$176.00
Rate for Payer: Cofinity Commercial	$154.00
Rate for Payer: Cofinity Commercial	$189.20
Rate for Payer: Healthscope Commercial	$198.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$187.00
Rate for Payer: PHP Commercial	$187.00
Rate for Payer: Priority Health Cigna Priority Health	$154.00
Rate for Payer: Priority Health SBD	$138.60
Rate for Payer: UHC All Payor (Choice/PPO)	$72.40
Rate for Payer: UHC Exchange	$65.82

HC INGESTION CHALLENGE TEST INIT 120 MIN

Facility

$1,401.95

Service Code	CPT 95076
Hospital Charge Code	51000114
Hospital Revenue Code	510
Min. Negotiated Rate	$883.23
Max. Negotiated Rate	$1,261.76
Rate for Payer: Aetna Commercial	$1,191.66
Rate for Payer: Aetna New Business (MI Preferred)	$911.27
Rate for Payer: Cash Price	$1,121.56
Rate for Payer: Cofinity Commercial	$1,205.68
Rate for Payer: Cofinity Commercial	$981.36
Rate for Payer: Healthscope Commercial	$1,261.76
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,191.66
Rate for Payer: PHP Commercial	$1,191.66
Rate for Payer: Priority Health Cigna Priority Health	$981.36
Rate for Payer: Priority Health SBD	$883.23

HC INGESTION CHALLENGE TEST INIT 120 MIN

Facility

$1,401.95

Service Code	CPT 95076
Hospital Charge Code	51000114
Hospital Revenue Code	510
Min. Negotiated Rate	$71.38
Max. Negotiated Rate	$1,261.76
Rate for Payer: Aetna Commercial	$1,191.66
Rate for Payer: Aetna Medicare	$495.99
Rate for Payer: Aetna New Business (MI Preferred)	$911.27
Rate for Payer: Allen County Amish Medical Aid Commercial	$596.14
Rate for Payer: Amish Plain Church Group Commercial	$596.14
Rate for Payer: BCBS Complete	$273.94
Rate for Payer: BCBS MAPPO	$476.91
Rate for Payer: BCBS Trust/PPO	$148.93
Rate for Payer: BCN Medicare Advantage	$476.91
Rate for Payer: Cash Price	$1,121.56
Rate for Payer: Cash Price	$1,121.56
Rate for Payer: Cofinity Commercial	$981.36
Rate for Payer: Cofinity Commercial	$1,205.68
Rate for Payer: Health Alliance Plan Medicare Advantage	$476.91
Rate for Payer: Healthscope Commercial	$1,261.76
Rate for Payer: Mclaren Medicaid	$260.87
Rate for Payer: Mclaren Medicare	$476.91
Rate for Payer: Meridian Medicaid	$273.94
Rate for Payer: Meridian Wellcare - Medicare Advantage	$500.76
Rate for Payer: MI Amish Medical Board Commercial	$548.45
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,191.66
Rate for Payer: PACE Medicare	$453.06
Rate for Payer: PACE SWMI	$476.91
Rate for Payer: PHP Commercial	$1,191.66
Rate for Payer: PHP Medicare Advantage	$476.91
Rate for Payer: Priority Health Choice Medicaid	$260.87
Rate for Payer: Priority Health Cigna Priority Health	$981.36
Rate for Payer: Priority Health Medicare	$476.91
Rate for Payer: Priority Health SBD	$883.23
Rate for Payer: Railroad Medicare Medicare	$476.91
Rate for Payer: UHC All Payor (Choice/PPO)	$78.52
Rate for Payer: UHC Dual Complete DSNP	$476.91
Rate for Payer: UHC Exchange	$71.38
Rate for Payer: UHC Medicare Advantage	$491.22
Rate for Payer: VA VA	$476.91

HC INHALATION BRONCHIAL CHALLENGE TESTING

Facility

$485.34

Service Code	CPT 95070
Hospital Charge Code	46000028
Hospital Revenue Code	460
Min. Negotiated Rate	$34.38
Max. Negotiated Rate	$596.14
Rate for Payer: Aetna Commercial	$412.54
Rate for Payer: Aetna Medicare	$495.99
Rate for Payer: Aetna New Business (MI Preferred)	$315.47
Rate for Payer: Allen County Amish Medical Aid Commercial	$596.14
Rate for Payer: Amish Plain Church Group Commercial	$596.14
Rate for Payer: BCBS Complete	$273.94
Rate for Payer: BCBS MAPPO	$476.91
Rate for Payer: BCBS Trust/PPO	$42.61
Rate for Payer: BCN Medicare Advantage	$476.91
Rate for Payer: Cash Price	$388.27
Rate for Payer: Cash Price	$388.27
Rate for Payer: Cofinity Commercial	$339.74
Rate for Payer: Cofinity Commercial	$417.39
Rate for Payer: Health Alliance Plan Medicare Advantage	$476.91
Rate for Payer: Healthscope Commercial	$436.81
Rate for Payer: Mclaren Medicaid	$260.87
Rate for Payer: Mclaren Medicare	$476.91
Rate for Payer: Meridian Medicaid	$273.94
Rate for Payer: Meridian Wellcare - Medicare Advantage	$500.76
Rate for Payer: MI Amish Medical Board Commercial	$548.45
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$412.54
Rate for Payer: PACE Medicare	$453.06
Rate for Payer: PACE SWMI	$476.91
Rate for Payer: PHP Commercial	$412.54
Rate for Payer: PHP Medicare Advantage	$476.91
Rate for Payer: Priority Health Choice Medicaid	$260.87
Rate for Payer: Priority Health Cigna Priority Health	$339.74
Rate for Payer: Priority Health Medicare	$476.91
Rate for Payer: Priority Health SBD	$305.76
Rate for Payer: Railroad Medicare Medicare	$476.91
Rate for Payer: UHC All Payor (Choice/PPO)	$37.82
Rate for Payer: UHC Dual Complete DSNP	$476.91
Rate for Payer: UHC Exchange	$34.38
Rate for Payer: UHC Medicare Advantage	$491.22
Rate for Payer: VA VA	$476.91

HC INHALATION BRONCHIAL CHALLENGE TESTING

Facility

$485.34

Service Code	CPT 95070
Hospital Charge Code	46000028
Hospital Revenue Code	460
Min. Negotiated Rate	$305.76
Max. Negotiated Rate	$436.81
Rate for Payer: Aetna Commercial	$412.54
Rate for Payer: Aetna New Business (MI Preferred)	$315.47
Rate for Payer: Cash Price	$388.27
Rate for Payer: Cofinity Commercial	$339.74
Rate for Payer: Cofinity Commercial	$417.39
Rate for Payer: Healthscope Commercial	$436.81
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$412.54
Rate for Payer: PHP Commercial	$412.54
Rate for Payer: Priority Health Cigna Priority Health	$339.74
Rate for Payer: Priority Health SBD	$305.76

HC INHIBIN A, TUMOR MARKER, S

Facility

$72.00

Service Code	CPT 86336
Hospital Charge Code	30200460
Hospital Revenue Code	302
Min. Negotiated Rate	$8.53
Max. Negotiated Rate	$64.80
Rate for Payer: Aetna Commercial	$61.20
Rate for Payer: Aetna Medicare	$16.21
Rate for Payer: Aetna New Business (MI Preferred)	$46.80
Rate for Payer: Allen County Amish Medical Aid Commercial	$19.49
Rate for Payer: Amish Plain Church Group Commercial	$19.49
Rate for Payer: BCBS Complete	$8.95
Rate for Payer: BCBS MAPPO	$15.59
Rate for Payer: BCBS Trust/PPO	$12.21
Rate for Payer: BCN Medicare Advantage	$15.59
Rate for Payer: Cash Price	$57.60
Rate for Payer: Cash Price	$57.60
Rate for Payer: Cofinity Commercial	$50.40
Rate for Payer: Cofinity Commercial	$61.92
Rate for Payer: Health Alliance Plan Medicare Advantage	$15.59
Rate for Payer: Healthscope Commercial	$64.80
Rate for Payer: Mclaren Medicaid	$8.53
Rate for Payer: Mclaren Medicare	$15.59
Rate for Payer: Meridian Medicaid	$8.95
Rate for Payer: Meridian Wellcare - Medicare Advantage	$16.37
Rate for Payer: MI Amish Medical Board Commercial	$17.93
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$61.20
Rate for Payer: PACE Medicare	$14.81
Rate for Payer: PACE SWMI	$15.59
Rate for Payer: PHP Commercial	$61.20
Rate for Payer: PHP Medicare Advantage	$15.59
Rate for Payer: Priority Health Choice Medicaid	$8.53
Rate for Payer: Priority Health Cigna Priority Health	$50.40
Rate for Payer: Priority Health Medicare	$15.59
Rate for Payer: Priority Health SBD	$45.36
Rate for Payer: Railroad Medicare Medicare	$15.59
Rate for Payer: UHC All Payor (Choice/PPO)	$18.71
Rate for Payer: UHC Core	$26.48
Rate for Payer: UHC Dual Complete DSNP	$15.59
Rate for Payer: UHC Exchange	$15.59
Rate for Payer: UHC Medicare Advantage	$16.06
Rate for Payer: VA VA	$15.59

HC INHIBIN A, TUMOR MARKER, S

Facility

$72.00

Service Code	CPT 86336
Hospital Charge Code	30200460
Hospital Revenue Code	302
Min. Negotiated Rate	$45.36
Max. Negotiated Rate	$64.80
Rate for Payer: Aetna Commercial	$61.20
Rate for Payer: Aetna New Business (MI Preferred)	$46.80
Rate for Payer: Cash Price	$57.60
Rate for Payer: Cofinity Commercial	$50.40
Rate for Payer: Cofinity Commercial	$61.92
Rate for Payer: Healthscope Commercial	$64.80
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$61.20
Rate for Payer: PHP Commercial	$61.20
Rate for Payer: Priority Health Cigna Priority Health	$50.40
Rate for Payer: Priority Health SBD	$45.36

HC INHIBIN B, CMPT

Facility

$48.96

Service Code	CPT 83520
Hospital Charge Code	30100693
Hospital Revenue Code	301
Min. Negotiated Rate	$30.84
Max. Negotiated Rate	$44.06
Rate for Payer: Aetna Commercial	$41.62
Rate for Payer: Aetna New Business (MI Preferred)	$31.82
Rate for Payer: Cash Price	$39.17
Rate for Payer: Cofinity Commercial	$34.27
Rate for Payer: Cofinity Commercial	$42.11
Rate for Payer: Healthscope Commercial	$44.06
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$41.62
Rate for Payer: PHP Commercial	$41.62
Rate for Payer: Priority Health Cigna Priority Health	$34.27
Rate for Payer: Priority Health SBD	$30.84

Know your out-of-pocket cost for care.

All Charges