Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC COLPOSCOPY, VULVA

Facility

$328.77

Service Code	CPT 56820
Hospital Charge Code	76100258
Hospital Revenue Code	761
Min. Negotiated Rate	$207.13
Max. Negotiated Rate	$295.89
Rate for Payer: Aetna Commercial	$279.45
Rate for Payer: Aetna New Business (MI Preferred)	$213.70
Rate for Payer: Cash Price	$263.02
Rate for Payer: Cofinity Commercial	$230.14
Rate for Payer: Cofinity Commercial	$282.74
Rate for Payer: Cofinity Medicare Advantage	$230.14
Rate for Payer: Encore Health Key Benefits Commercial	$263.02
Rate for Payer: Healthscope Commercial	$295.89
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$279.45
Rate for Payer: PHP Commercial	$279.45
Rate for Payer: Priority Health Cigna Priority Health	$213.70
Rate for Payer: Priority Health SBD	$207.13

HC COLPOSCOPY VULVA W/BIOPSY

Facility

$854.17

Service Code	CPT 56821
Hospital Charge Code	76100332
Hospital Revenue Code	761
Min. Negotiated Rate	$50.68
Max. Negotiated Rate	$936.74
Rate for Payer: Aetna Commercial	$726.04
Rate for Payer: Aetna Medicare	$309.96
Rate for Payer: Aetna New Business (MI Preferred)	$555.21
Rate for Payer: Allen County Amish Medical Aid Commercial	$372.55
Rate for Payer: Amish Plain Church Group Commercial	$372.55
Rate for Payer: BCBS Complete	$167.74
Rate for Payer: BCBS MAPPO	$298.04
Rate for Payer: BCBS Trust/PPO	$50.68
Rate for Payer: BCN Commercial	$50.68
Rate for Payer: BCN Medicare Advantage	$298.04
Rate for Payer: Cash Price	$683.34
Rate for Payer: Cash Price	$683.34
Rate for Payer: Cash Price	$683.34
Rate for Payer: Cofinity Commercial	$734.59
Rate for Payer: Cofinity Commercial	$597.92
Rate for Payer: Cofinity Medicare Advantage	$597.92
Rate for Payer: Encore Health Key Benefits Commercial	$683.34
Rate for Payer: Health Alliance Plan Medicare Advantage	$298.04
Rate for Payer: Healthscope Commercial	$768.75
Rate for Payer: Mclaren Medicaid	$159.75
Rate for Payer: Mclaren Medicare	$298.04
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$312.94
Rate for Payer: Meridian Medicaid	$167.74
Rate for Payer: MI Amish Medical Board Commercial	$342.75
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$726.04
Rate for Payer: Nomi Health Commercial	$625.88
Rate for Payer: PACE Medicare	$283.14
Rate for Payer: PACE SWMI	$298.04
Rate for Payer: PHP Commercial	$726.04
Rate for Payer: PHP Medicare Advantage	$298.04
Rate for Payer: Priority Health Choice Medicaid	$159.75
Rate for Payer: Priority Health Cigna Priority Health	$555.21
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$936.74
Rate for Payer: Priority Health Medicare	$298.04
Rate for Payer: Priority Health Narrow Network	$749.39
Rate for Payer: Priority Health SBD	$538.13
Rate for Payer: Railroad Medicare Medicare	$298.04
Rate for Payer: UHC All Payor (Choice/PPO)	$121.44
Rate for Payer: UHC Core	$878.00
Rate for Payer: UHC Dual Complete DSNP	$298.04
Rate for Payer: UHC Medicare Advantage	$298.04
Rate for Payer: UHCCP Medicaid	$167.80
Rate for Payer: VA VA	$298.04

HC COLPOSCOPY VULVA W/BIOPSY

Facility

$854.17

Service Code	CPT 56821
Hospital Charge Code	76100332
Hospital Revenue Code	761
Min. Negotiated Rate	$538.13
Max. Negotiated Rate	$768.75
Rate for Payer: Aetna Commercial	$726.04
Rate for Payer: Aetna New Business (MI Preferred)	$555.21
Rate for Payer: Cash Price	$683.34
Rate for Payer: Cofinity Commercial	$597.92
Rate for Payer: Cofinity Commercial	$734.59
Rate for Payer: Cofinity Medicare Advantage	$597.92
Rate for Payer: Encore Health Key Benefits Commercial	$683.34
Rate for Payer: Healthscope Commercial	$768.75
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$726.04
Rate for Payer: PHP Commercial	$726.04
Rate for Payer: Priority Health Cigna Priority Health	$555.21
Rate for Payer: Priority Health SBD	$538.13

HC COMBI CATH SUPPLY

Facility

$123.46

Hospital Charge Code	27200116
Hospital Revenue Code	272
Min. Negotiated Rate	$49.38
Max. Negotiated Rate	$111.11
Rate for Payer: Aetna Commercial	$104.94
Rate for Payer: Aetna Medicare	$61.73
Rate for Payer: Aetna New Business (MI Preferred)	$80.25
Rate for Payer: BCBS Complete	$49.38
Rate for Payer: Cash Price	$98.77
Rate for Payer: Cofinity Commercial	$106.18
Rate for Payer: Cofinity Commercial	$86.42
Rate for Payer: Cofinity Medicare Advantage	$86.42
Rate for Payer: Encore Health Key Benefits Commercial	$98.77
Rate for Payer: Healthscope Commercial	$111.11
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$104.94
Rate for Payer: PHP Commercial	$104.94
Rate for Payer: Priority Health Cigna Priority Health	$80.25
Rate for Payer: Priority Health SBD	$77.78

HC COMBI CATH SUPPLY

Facility

$123.46

Hospital Charge Code	27200116
Hospital Revenue Code	272
Min. Negotiated Rate	$77.78
Max. Negotiated Rate	$111.11
Rate for Payer: Aetna Commercial	$104.94
Rate for Payer: Aetna New Business (MI Preferred)	$80.25
Rate for Payer: Cash Price	$98.77
Rate for Payer: Cofinity Commercial	$106.18
Rate for Payer: Cofinity Commercial	$86.42
Rate for Payer: Cofinity Medicare Advantage	$86.42
Rate for Payer: Encore Health Key Benefits Commercial	$98.77
Rate for Payer: Healthscope Commercial	$111.11
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$104.94
Rate for Payer: PHP Commercial	$104.94
Rate for Payer: Priority Health Cigna Priority Health	$80.25
Rate for Payer: Priority Health SBD	$77.78

HC COMBINED VACCINE, MMR+VARICELLA, SUBQ

Facility

$213.28

Service Code	CPT 90710
Hospital Charge Code	63600206
Hospital Revenue Code	636
Min. Negotiated Rate	$134.37
Max. Negotiated Rate	$191.95
Rate for Payer: Aetna Commercial	$181.29
Rate for Payer: Aetna New Business (MI Preferred)	$138.63
Rate for Payer: Cash Price	$170.62
Rate for Payer: Cofinity Commercial	$149.30
Rate for Payer: Cofinity Commercial	$183.42
Rate for Payer: Cofinity Medicare Advantage	$149.30
Rate for Payer: Encore Health Key Benefits Commercial	$170.62
Rate for Payer: Healthscope Commercial	$191.95
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$181.29
Rate for Payer: PHP Commercial	$181.29
Rate for Payer: Priority Health Cigna Priority Health	$138.63
Rate for Payer: Priority Health SBD	$134.37

HC COMBINED VACCINE, MMR+VARICELLA, SUBQ

Facility

$213.28

Service Code	CPT 90710
Hospital Charge Code	63600206
Hospital Revenue Code	636
Min. Negotiated Rate	$85.31
Max. Negotiated Rate	$757.47
Rate for Payer: Aetna Commercial	$181.29
Rate for Payer: Aetna Medicare	$106.64
Rate for Payer: Aetna New Business (MI Preferred)	$138.63
Rate for Payer: BCBS Complete	$85.31
Rate for Payer: BCBS Trust/PPO	$757.47
Rate for Payer: BCN Commercial	$757.47
Rate for Payer: Cash Price	$170.62
Rate for Payer: Cash Price	$170.62
Rate for Payer: Cofinity Commercial	$149.30
Rate for Payer: Cofinity Commercial	$183.42
Rate for Payer: Cofinity Medicare Advantage	$149.30
Rate for Payer: Encore Health Key Benefits Commercial	$170.62
Rate for Payer: Healthscope Commercial	$191.95
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$181.29
Rate for Payer: PHP Commercial	$181.29
Rate for Payer: Priority Health Cigna Priority Health	$138.63
Rate for Payer: Priority Health SBD	$134.37

HC COMMON REED IGE

Facility

$25.39

Service Code	CPT 86003
Hospital Charge Code	30200080
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	$6.52
Rate for Payer: Amish Plain Church Group Commercial	$6.52
Rate for Payer: BCBS Complete	$2.94
Rate for Payer: BCBS MAPPO	$5.22
Rate for Payer: BCBS Trust/PPO	$4.63
Rate for Payer: BCN Commercial	$4.63
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: Nomi Health Commercial	$7.83
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 HMO/PPO/Tiered Network	$5.37
Rate for Payer: Priority Health Medicare	$5.22
Rate for Payer: Priority Health Narrow Network	$4.30
Rate for Payer: Priority Health SBD	$16.00
Rate for Payer: Railroad Medicare Medicare	$5.22
Rate for Payer: UHC All Payor (Choice/PPO)	$6.26
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 COMMON REED IGE

Facility

$25.39

Service Code	CPT 86003
Hospital Charge Code	30200080
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 COMM WORK REINTEGRATION EA 15 MIN

Facility

$96.90

Service Code	CPT 97537
Hospital Charge Code	42000031
Hospital Revenue Code	420
Min. Negotiated Rate	$21.60
Max. Negotiated Rate	$135.00
Rate for Payer: Aetna Commercial	$82.36
Rate for Payer: Aetna Medicare	$48.45
Rate for Payer: Aetna New Business (MI Preferred)	$62.98
Rate for Payer: BCBS Complete	$38.76
Rate for Payer: BCBS Trust/PPO	$26.09
Rate for Payer: BCN Commercial	$26.09
Rate for Payer: Cash Price	$77.52
Rate for Payer: Cash Price	$77.52
Rate for Payer: Cash Price	$77.52
Rate for Payer: Cofinity Commercial	$67.83
Rate for Payer: Cofinity Commercial	$83.33
Rate for Payer: Cofinity Medicare Advantage	$67.83
Rate for Payer: Encore Health Key Benefits Commercial	$77.52
Rate for Payer: Healthscope Commercial	$87.21
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$82.36
Rate for Payer: Nomi Health Commercial	$135.00
Rate for Payer: PHP Commercial	$82.36
Rate for Payer: Priority Health Cigna Priority Health	$62.98
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$27.00
Rate for Payer: Priority Health Narrow Network	$21.60
Rate for Payer: Priority Health SBD	$61.05
Rate for Payer: UHC All Payor (Choice/PPO)	$32.80
Rate for Payer: UHC Exchange	$71.71

HC COMM WORK REINTEGRATION EA 15 MIN

Facility

$96.90

Service Code	CPT 97537
Hospital Charge Code	42000031
Hospital Revenue Code	420
Min. Negotiated Rate	$61.05
Max. Negotiated Rate	$87.21
Rate for Payer: Aetna Commercial	$82.36
Rate for Payer: Aetna New Business (MI Preferred)	$62.98
Rate for Payer: Cash Price	$77.52
Rate for Payer: Cofinity Commercial	$67.83
Rate for Payer: Cofinity Commercial	$83.33
Rate for Payer: Cofinity Medicare Advantage	$67.83
Rate for Payer: Encore Health Key Benefits Commercial	$77.52
Rate for Payer: Healthscope Commercial	$87.21
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$82.36
Rate for Payer: PHP Commercial	$82.36
Rate for Payer: Priority Health Cigna Priority Health	$62.98
Rate for Payer: Priority Health SBD	$61.05

HC COMPARTMENT PRESSURE CHECK

Facility

$658.62

Hospital Charge Code	27000045
Hospital Revenue Code	270
Min. Negotiated Rate	$414.93
Max. Negotiated Rate	$592.76
Rate for Payer: Aetna Commercial	$559.83
Rate for Payer: Aetna New Business (MI Preferred)	$428.10
Rate for Payer: Cash Price	$526.90
Rate for Payer: Cofinity Commercial	$461.03
Rate for Payer: Cofinity Commercial	$566.41
Rate for Payer: Cofinity Medicare Advantage	$461.03
Rate for Payer: Encore Health Key Benefits Commercial	$526.90
Rate for Payer: Healthscope Commercial	$592.76
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$559.83
Rate for Payer: PHP Commercial	$559.83
Rate for Payer: Priority Health Cigna Priority Health	$428.10
Rate for Payer: Priority Health SBD	$414.93

HC COMPARTMENT PRESSURE CHECK

Facility

$658.62

Hospital Charge Code	27000045
Hospital Revenue Code	270
Min. Negotiated Rate	$263.45
Max. Negotiated Rate	$592.76
Rate for Payer: Aetna Commercial	$559.83
Rate for Payer: Aetna Medicare	$329.31
Rate for Payer: Aetna New Business (MI Preferred)	$428.10
Rate for Payer: BCBS Complete	$263.45
Rate for Payer: Cash Price	$526.90
Rate for Payer: Cofinity Commercial	$461.03
Rate for Payer: Cofinity Commercial	$566.41
Rate for Payer: Cofinity Medicare Advantage	$461.03
Rate for Payer: Encore Health Key Benefits Commercial	$526.90
Rate for Payer: Healthscope Commercial	$592.76
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$559.83
Rate for Payer: PHP Commercial	$559.83
Rate for Payer: Priority Health Cigna Priority Health	$428.10
Rate for Payer: Priority Health SBD	$414.93

HC COMP BURN GARM 2 LEGS-WAIST

Facility

$238.68

Service Code	HCPCS A6511
Hospital Charge Code	98300142
Hospital Revenue Code	270
Min. Negotiated Rate	$95.47
Max. Negotiated Rate	$299.43
Rate for Payer: Aetna Commercial	$202.88
Rate for Payer: Aetna Medicare	$119.34
Rate for Payer: Aetna New Business (MI Preferred)	$155.14
Rate for Payer: BCBS Complete	$95.47
Rate for Payer: BCBS Trust/PPO	$299.43
Rate for Payer: BCN Commercial	$299.43
Rate for Payer: Cash Price	$190.94
Rate for Payer: Cash Price	$190.94
Rate for Payer: Cofinity Commercial	$167.08
Rate for Payer: Cofinity Commercial	$205.26
Rate for Payer: Cofinity Medicare Advantage	$167.08
Rate for Payer: Encore Health Key Benefits Commercial	$190.94
Rate for Payer: Healthscope Commercial	$214.81
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$202.88
Rate for Payer: PHP Commercial	$202.88
Rate for Payer: Priority Health Cigna Priority Health	$155.14
Rate for Payer: Priority Health SBD	$150.37

HC COMP BURN GARM 2 LEGS-WAIST

Facility

$238.68

Service Code	HCPCS A6511
Hospital Charge Code	98300142
Hospital Revenue Code	270
Min. Negotiated Rate	$150.37
Max. Negotiated Rate	$214.81
Rate for Payer: Aetna Commercial	$202.88
Rate for Payer: Aetna New Business (MI Preferred)	$155.14
Rate for Payer: Cash Price	$190.94
Rate for Payer: Cofinity Commercial	$167.08
Rate for Payer: Cofinity Commercial	$205.26
Rate for Payer: Cofinity Medicare Advantage	$167.08
Rate for Payer: Encore Health Key Benefits Commercial	$190.94
Rate for Payer: Healthscope Commercial	$214.81
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$202.88
Rate for Payer: PHP Commercial	$202.88
Rate for Payer: Priority Health Cigna Priority Health	$155.14
Rate for Payer: Priority Health SBD	$150.37

HC COMP BURN GARM 2 OR MORE FAB/C

Facility

$12.24

Service Code	HCPCS A6512
Hospital Charge Code	98300143
Hospital Revenue Code	270
Min. Negotiated Rate	$4.90
Max. Negotiated Rate	$434.17
Rate for Payer: Aetna Commercial	$10.40
Rate for Payer: Aetna Medicare	$6.12
Rate for Payer: Aetna New Business (MI Preferred)	$7.96
Rate for Payer: BCBS Complete	$4.90
Rate for Payer: BCBS Trust/PPO	$434.17
Rate for Payer: BCN Commercial	$434.17
Rate for Payer: Cash Price	$9.79
Rate for Payer: Cash Price	$9.79
Rate for Payer: Cofinity Commercial	$10.53
Rate for Payer: Cofinity Commercial	$8.57
Rate for Payer: Cofinity Medicare Advantage	$8.57
Rate for Payer: Encore Health Key Benefits Commercial	$9.79
Rate for Payer: Healthscope Commercial	$11.02
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$10.40
Rate for Payer: PHP Commercial	$10.40
Rate for Payer: Priority Health Cigna Priority Health	$7.96
Rate for Payer: Priority Health SBD	$7.71

HC COMP BURN GARM 2 OR MORE FAB/C

Facility

$12.24

Service Code	HCPCS A6512
Hospital Charge Code	98300143
Hospital Revenue Code	270
Min. Negotiated Rate	$7.71
Max. Negotiated Rate	$11.02
Rate for Payer: Aetna Commercial	$10.40
Rate for Payer: Aetna New Business (MI Preferred)	$7.96
Rate for Payer: Cash Price	$9.79
Rate for Payer: Cofinity Commercial	$10.53
Rate for Payer: Cofinity Commercial	$8.57
Rate for Payer: Cofinity Medicare Advantage	$8.57
Rate for Payer: Encore Health Key Benefits Commercial	$9.79
Rate for Payer: Healthscope Commercial	$11.02
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$10.40
Rate for Payer: PHP Commercial	$10.40
Rate for Payer: Priority Health Cigna Priority Health	$7.96
Rate for Payer: Priority Health SBD	$7.71

HC COMP BURN GARM ABD REINFOR DBL

Facility

$16.32

Service Code	HCPCS A6512
Hospital Charge Code	98300144
Hospital Revenue Code	270
Min. Negotiated Rate	$10.28
Max. Negotiated Rate	$14.69
Rate for Payer: Aetna Commercial	$13.87
Rate for Payer: Aetna New Business (MI Preferred)	$10.61
Rate for Payer: Cash Price	$13.06
Rate for Payer: Cofinity Commercial	$11.42
Rate for Payer: Cofinity Commercial	$14.04
Rate for Payer: Cofinity Medicare Advantage	$11.42
Rate for Payer: Encore Health Key Benefits Commercial	$13.06
Rate for Payer: Healthscope Commercial	$14.69
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$13.87
Rate for Payer: PHP Commercial	$13.87
Rate for Payer: Priority Health Cigna Priority Health	$10.61
Rate for Payer: Priority Health SBD	$10.28

HC COMP BURN GARM ABD REINFOR DBL

Facility

$16.32

Service Code	HCPCS A6512
Hospital Charge Code	98300144
Hospital Revenue Code	270
Min. Negotiated Rate	$6.53
Max. Negotiated Rate	$434.17
Rate for Payer: Aetna Commercial	$13.87
Rate for Payer: Aetna Medicare	$8.16
Rate for Payer: Aetna New Business (MI Preferred)	$10.61
Rate for Payer: BCBS Complete	$6.53
Rate for Payer: BCBS Trust/PPO	$434.17
Rate for Payer: BCN Commercial	$434.17
Rate for Payer: Cash Price	$13.06
Rate for Payer: Cash Price	$13.06
Rate for Payer: Cofinity Commercial	$11.42
Rate for Payer: Cofinity Commercial	$14.04
Rate for Payer: Cofinity Medicare Advantage	$11.42
Rate for Payer: Encore Health Key Benefits Commercial	$13.06
Rate for Payer: Healthscope Commercial	$14.69
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$13.87
Rate for Payer: PHP Commercial	$13.87
Rate for Payer: Priority Health Cigna Priority Health	$10.61
Rate for Payer: Priority Health SBD	$10.28

HC COMP BURN GARM ANKLET

Facility

$63.24

Service Code	HCPCS A6512
Hospital Charge Code	98300145
Hospital Revenue Code	270
Min. Negotiated Rate	$25.30
Max. Negotiated Rate	$434.17
Rate for Payer: Aetna Commercial	$53.75
Rate for Payer: Aetna Medicare	$31.62
Rate for Payer: Aetna New Business (MI Preferred)	$41.11
Rate for Payer: BCBS Complete	$25.30
Rate for Payer: BCBS Trust/PPO	$434.17
Rate for Payer: BCN Commercial	$434.17
Rate for Payer: Cash Price	$50.59
Rate for Payer: Cash Price	$50.59
Rate for Payer: Cofinity Commercial	$44.27
Rate for Payer: Cofinity Commercial	$54.39
Rate for Payer: Cofinity Medicare Advantage	$44.27
Rate for Payer: Encore Health Key Benefits Commercial	$50.59
Rate for Payer: Healthscope Commercial	$56.92
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$53.75
Rate for Payer: PHP Commercial	$53.75
Rate for Payer: Priority Health Cigna Priority Health	$41.11
Rate for Payer: Priority Health SBD	$39.84

HC COMP BURN GARM ANKLET

Facility

$63.24

Service Code	HCPCS A6512
Hospital Charge Code	98300145
Hospital Revenue Code	270
Min. Negotiated Rate	$39.84
Max. Negotiated Rate	$56.92
Rate for Payer: Aetna Commercial	$53.75
Rate for Payer: Aetna New Business (MI Preferred)	$41.11
Rate for Payer: Cash Price	$50.59
Rate for Payer: Cofinity Commercial	$44.27
Rate for Payer: Cofinity Commercial	$54.39
Rate for Payer: Cofinity Medicare Advantage	$44.27
Rate for Payer: Encore Health Key Benefits Commercial	$50.59
Rate for Payer: Healthscope Commercial	$56.92
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$53.75
Rate for Payer: PHP Commercial	$53.75
Rate for Payer: Priority Health Cigna Priority Health	$41.11
Rate for Payer: Priority Health SBD	$39.84

HC COMP BURN GARM BDY BRF SLVD LE

Facility

$338.64

Service Code	HCPCS A6510
Hospital Charge Code	98300146
Hospital Revenue Code	270
Min. Negotiated Rate	$135.46
Max. Negotiated Rate	$548.96
Rate for Payer: Aetna Commercial	$287.84
Rate for Payer: Aetna Medicare	$169.32
Rate for Payer: Aetna New Business (MI Preferred)	$220.12
Rate for Payer: BCBS Complete	$135.46
Rate for Payer: BCBS Trust/PPO	$548.96
Rate for Payer: BCN Commercial	$548.96
Rate for Payer: Cash Price	$270.91
Rate for Payer: Cash Price	$270.91
Rate for Payer: Cofinity Commercial	$237.05
Rate for Payer: Cofinity Commercial	$291.23
Rate for Payer: Cofinity Medicare Advantage	$237.05
Rate for Payer: Encore Health Key Benefits Commercial	$270.91
Rate for Payer: Healthscope Commercial	$304.78
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$287.84
Rate for Payer: PHP Commercial	$287.84
Rate for Payer: Priority Health Cigna Priority Health	$220.12
Rate for Payer: Priority Health SBD	$213.34

HC COMP BURN GARM BDY BRF SLVD LE

Facility

$338.64

Service Code	HCPCS A6510
Hospital Charge Code	98300146
Hospital Revenue Code	270
Min. Negotiated Rate	$213.34
Max. Negotiated Rate	$304.78
Rate for Payer: Aetna Commercial	$287.84
Rate for Payer: Aetna New Business (MI Preferred)	$220.12
Rate for Payer: Cash Price	$270.91
Rate for Payer: Cofinity Commercial	$237.05
Rate for Payer: Cofinity Commercial	$291.23
Rate for Payer: Cofinity Medicare Advantage	$237.05
Rate for Payer: Encore Health Key Benefits Commercial	$270.91
Rate for Payer: Healthscope Commercial	$304.78
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$287.84
Rate for Payer: PHP Commercial	$287.84
Rate for Payer: Priority Health Cigna Priority Health	$220.12
Rate for Payer: Priority Health SBD	$213.34

HC COMP BURN GARM BELLY BAND

Facility

$40.80

Service Code	HCPCS A6512
Hospital Charge Code	98300147
Hospital Revenue Code	270
Min. Negotiated Rate	$25.70
Max. Negotiated Rate	$36.72
Rate for Payer: Aetna Commercial	$34.68
Rate for Payer: Aetna New Business (MI Preferred)	$26.52
Rate for Payer: Cash Price	$32.64
Rate for Payer: Cofinity Commercial	$28.56
Rate for Payer: Cofinity Commercial	$35.09
Rate for Payer: Cofinity Medicare Advantage	$28.56
Rate for Payer: Encore Health Key Benefits Commercial	$32.64
Rate for Payer: Healthscope Commercial	$36.72
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$34.68
Rate for Payer: PHP Commercial	$34.68
Rate for Payer: Priority Health Cigna Priority Health	$26.52
Rate for Payer: Priority Health SBD	$25.70

HC COMP BURN GARM BELLY BAND

Facility

$40.80

Service Code	HCPCS A6512
Hospital Charge Code	98300147
Hospital Revenue Code	270
Min. Negotiated Rate	$16.32
Max. Negotiated Rate	$434.17
Rate for Payer: Aetna Commercial	$34.68
Rate for Payer: Aetna Medicare	$20.40
Rate for Payer: Aetna New Business (MI Preferred)	$26.52
Rate for Payer: BCBS Complete	$16.32
Rate for Payer: BCBS Trust/PPO	$434.17
Rate for Payer: BCN Commercial	$434.17
Rate for Payer: Cash Price	$32.64
Rate for Payer: Cash Price	$32.64
Rate for Payer: Cofinity Commercial	$28.56
Rate for Payer: Cofinity Commercial	$35.09
Rate for Payer: Cofinity Medicare Advantage	$28.56
Rate for Payer: Encore Health Key Benefits Commercial	$32.64
Rate for Payer: Healthscope Commercial	$36.72
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$34.68
Rate for Payer: PHP Commercial	$34.68
Rate for Payer: Priority Health Cigna Priority Health	$26.52
Rate for Payer: Priority Health SBD	$25.70

Know your out-of-pocket cost for care.

All Charges