Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC CONNECTOR 3/8 W/ LL

Facility

$5.36

Hospital Charge Code	27000448
Hospital Revenue Code	270
Min. Negotiated Rate	$3.38
Max. Negotiated Rate	$4.82
Rate for Payer: Aetna Commercial	$4.56
Rate for Payer: Aetna New Business (MI Preferred)	$3.48
Rate for Payer: Cash Price	$4.29
Rate for Payer: Cofinity Commercial	$3.75
Rate for Payer: Cofinity Commercial	$4.61
Rate for Payer: Cofinity Medicare Advantage	$3.75
Rate for Payer: Encore Health Key Benefits Commercial	$4.29
Rate for Payer: Healthscope Commercial	$4.82
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4.56
Rate for Payer: PHP Commercial	$4.56
Rate for Payer: Priority Health Cigna Priority Health	$3.48
Rate for Payer: Priority Health SBD	$3.38

HC CONNECTOR 3/8 W/ LL

Facility

$5.36

Hospital Charge Code	27000448
Hospital Revenue Code	270
Min. Negotiated Rate	$2.14
Max. Negotiated Rate	$4.82
Rate for Payer: Aetna Commercial	$4.56
Rate for Payer: Aetna Medicare	$2.68
Rate for Payer: Aetna New Business (MI Preferred)	$3.48
Rate for Payer: BCBS Complete	$2.14
Rate for Payer: Cash Price	$4.29
Rate for Payer: Cofinity Commercial	$3.75
Rate for Payer: Cofinity Commercial	$4.61
Rate for Payer: Cofinity Medicare Advantage	$3.75
Rate for Payer: Encore Health Key Benefits Commercial	$4.29
Rate for Payer: Healthscope Commercial	$4.82
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4.56
Rate for Payer: PHP Commercial	$4.56
Rate for Payer: Priority Health Cigna Priority Health	$3.48
Rate for Payer: Priority Health SBD	$3.38

HC CONNECTOR REDUCER

Facility

$5.36

Hospital Charge Code	27000651
Hospital Revenue Code	270
Min. Negotiated Rate	$3.38
Max. Negotiated Rate	$4.82
Rate for Payer: Aetna Commercial	$4.56
Rate for Payer: Aetna New Business (MI Preferred)	$3.48
Rate for Payer: Cash Price	$4.29
Rate for Payer: Cofinity Commercial	$3.75
Rate for Payer: Cofinity Commercial	$4.61
Rate for Payer: Cofinity Medicare Advantage	$3.75
Rate for Payer: Encore Health Key Benefits Commercial	$4.29
Rate for Payer: Healthscope Commercial	$4.82
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4.56
Rate for Payer: PHP Commercial	$4.56
Rate for Payer: Priority Health Cigna Priority Health	$3.48
Rate for Payer: Priority Health SBD	$3.38

HC CONNECTOR REDUCER

Facility

$5.36

Hospital Charge Code	27000651
Hospital Revenue Code	270
Min. Negotiated Rate	$2.14
Max. Negotiated Rate	$4.82
Rate for Payer: Aetna Commercial	$4.56
Rate for Payer: Aetna Medicare	$2.68
Rate for Payer: Aetna New Business (MI Preferred)	$3.48
Rate for Payer: BCBS Complete	$2.14
Rate for Payer: Cash Price	$4.29
Rate for Payer: Cofinity Commercial	$3.75
Rate for Payer: Cofinity Commercial	$4.61
Rate for Payer: Cofinity Medicare Advantage	$3.75
Rate for Payer: Encore Health Key Benefits Commercial	$4.29
Rate for Payer: Healthscope Commercial	$4.82
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4.56
Rate for Payer: PHP Commercial	$4.56
Rate for Payer: Priority Health Cigna Priority Health	$3.48
Rate for Payer: Priority Health SBD	$3.38

HC CONNECTOR ST 1/2 X 1/2

Facility

$7.65

Hospital Charge Code	27000047
Hospital Revenue Code	270
Min. Negotiated Rate	$4.82
Max. Negotiated Rate	$6.88
Rate for Payer: Aetna Commercial	$6.50
Rate for Payer: Aetna New Business (MI Preferred)	$4.97
Rate for Payer: Cash Price	$6.12
Rate for Payer: Cofinity Commercial	$5.36
Rate for Payer: Cofinity Commercial	$6.58
Rate for Payer: Cofinity Medicare Advantage	$5.36
Rate for Payer: Encore Health Key Benefits Commercial	$6.12
Rate for Payer: Healthscope Commercial	$6.88
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$6.50
Rate for Payer: PHP Commercial	$6.50
Rate for Payer: Priority Health Cigna Priority Health	$4.97
Rate for Payer: Priority Health SBD	$4.82

HC CONNECTOR ST 1/2 X 1/2

Facility

$7.65

Hospital Charge Code	27000047
Hospital Revenue Code	270
Min. Negotiated Rate	$3.06
Max. Negotiated Rate	$6.88
Rate for Payer: Aetna Commercial	$6.50
Rate for Payer: Aetna Medicare	$3.82
Rate for Payer: Aetna New Business (MI Preferred)	$4.97
Rate for Payer: BCBS Complete	$3.06
Rate for Payer: Cash Price	$6.12
Rate for Payer: Cofinity Commercial	$5.36
Rate for Payer: Cofinity Commercial	$6.58
Rate for Payer: Cofinity Medicare Advantage	$5.36
Rate for Payer: Encore Health Key Benefits Commercial	$6.12
Rate for Payer: Healthscope Commercial	$6.88
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$6.50
Rate for Payer: PHP Commercial	$6.50
Rate for Payer: Priority Health Cigna Priority Health	$4.97
Rate for Payer: Priority Health SBD	$4.82

HC CONNECTOR ST 3/8 OR 1/4

Facility

$5.36

Hospital Charge Code	27000685
Hospital Revenue Code	270
Min. Negotiated Rate	$3.38
Max. Negotiated Rate	$4.82
Rate for Payer: Aetna Commercial	$4.56
Rate for Payer: Aetna New Business (MI Preferred)	$3.48
Rate for Payer: Cash Price	$4.29
Rate for Payer: Cofinity Commercial	$3.75
Rate for Payer: Cofinity Commercial	$4.61
Rate for Payer: Cofinity Medicare Advantage	$3.75
Rate for Payer: Encore Health Key Benefits Commercial	$4.29
Rate for Payer: Healthscope Commercial	$4.82
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4.56
Rate for Payer: PHP Commercial	$4.56
Rate for Payer: Priority Health Cigna Priority Health	$3.48
Rate for Payer: Priority Health SBD	$3.38

HC CONNECTOR ST 3/8 OR 1/4

Facility

$5.36

Hospital Charge Code	27000685
Hospital Revenue Code	270
Min. Negotiated Rate	$2.14
Max. Negotiated Rate	$4.82
Rate for Payer: Aetna Commercial	$4.56
Rate for Payer: Aetna Medicare	$2.68
Rate for Payer: Aetna New Business (MI Preferred)	$3.48
Rate for Payer: BCBS Complete	$2.14
Rate for Payer: Cash Price	$4.29
Rate for Payer: Cofinity Commercial	$3.75
Rate for Payer: Cofinity Commercial	$4.61
Rate for Payer: Cofinity Medicare Advantage	$3.75
Rate for Payer: Encore Health Key Benefits Commercial	$4.29
Rate for Payer: Healthscope Commercial	$4.82
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4.56
Rate for Payer: PHP Commercial	$4.56
Rate for Payer: Priority Health Cigna Priority Health	$3.48
Rate for Payer: Priority Health SBD	$3.38

HC CONNECTOR V

Facility

$7.65

Hospital Charge Code	27000678
Hospital Revenue Code	270
Min. Negotiated Rate	$3.06
Max. Negotiated Rate	$6.88
Rate for Payer: Aetna Commercial	$6.50
Rate for Payer: Aetna Medicare	$3.82
Rate for Payer: Aetna New Business (MI Preferred)	$4.97
Rate for Payer: BCBS Complete	$3.06
Rate for Payer: Cash Price	$6.12
Rate for Payer: Cofinity Commercial	$5.36
Rate for Payer: Cofinity Commercial	$6.58
Rate for Payer: Cofinity Medicare Advantage	$5.36
Rate for Payer: Encore Health Key Benefits Commercial	$6.12
Rate for Payer: Healthscope Commercial	$6.88
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$6.50
Rate for Payer: PHP Commercial	$6.50
Rate for Payer: Priority Health Cigna Priority Health	$4.97
Rate for Payer: Priority Health SBD	$4.82

HC CONNECTOR V

Facility

$7.65

Hospital Charge Code	27000678
Hospital Revenue Code	270
Min. Negotiated Rate	$4.82
Max. Negotiated Rate	$6.88
Rate for Payer: Aetna Commercial	$6.50
Rate for Payer: Aetna New Business (MI Preferred)	$4.97
Rate for Payer: Cash Price	$6.12
Rate for Payer: Cofinity Commercial	$5.36
Rate for Payer: Cofinity Commercial	$6.58
Rate for Payer: Cofinity Medicare Advantage	$5.36
Rate for Payer: Encore Health Key Benefits Commercial	$6.12
Rate for Payer: Healthscope Commercial	$6.88
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$6.50
Rate for Payer: PHP Commercial	$6.50
Rate for Payer: Priority Health Cigna Priority Health	$4.97
Rate for Payer: Priority Health SBD	$4.82

HC CONNECTOR Y

Facility

$5.36

Hospital Charge Code	27000048
Hospital Revenue Code	270
Min. Negotiated Rate	$2.14
Max. Negotiated Rate	$4.82
Rate for Payer: Aetna Commercial	$4.56
Rate for Payer: Aetna Medicare	$2.68
Rate for Payer: Aetna New Business (MI Preferred)	$3.48
Rate for Payer: BCBS Complete	$2.14
Rate for Payer: Cash Price	$4.29
Rate for Payer: Cofinity Commercial	$3.75
Rate for Payer: Cofinity Commercial	$4.61
Rate for Payer: Cofinity Medicare Advantage	$3.75
Rate for Payer: Encore Health Key Benefits Commercial	$4.29
Rate for Payer: Healthscope Commercial	$4.82
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4.56
Rate for Payer: PHP Commercial	$4.56
Rate for Payer: Priority Health Cigna Priority Health	$3.48
Rate for Payer: Priority Health SBD	$3.38

HC CONNECTOR Y

Facility

$5.36

Hospital Charge Code	27000048
Hospital Revenue Code	270
Min. Negotiated Rate	$3.38
Max. Negotiated Rate	$4.82
Rate for Payer: Aetna Commercial	$4.56
Rate for Payer: Aetna New Business (MI Preferred)	$3.48
Rate for Payer: Cash Price	$4.29
Rate for Payer: Cofinity Commercial	$3.75
Rate for Payer: Cofinity Commercial	$4.61
Rate for Payer: Cofinity Medicare Advantage	$3.75
Rate for Payer: Encore Health Key Benefits Commercial	$4.29
Rate for Payer: Healthscope Commercial	$4.82
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4.56
Rate for Payer: PHP Commercial	$4.56
Rate for Payer: Priority Health Cigna Priority Health	$3.48
Rate for Payer: Priority Health SBD	$3.38

HC CONSULT NUTRITIONAL

Facility

$34.96

Hospital Charge Code	94200010
Hospital Revenue Code	942
Min. Negotiated Rate	$13.98
Max. Negotiated Rate	$31.46
Rate for Payer: Aetna Commercial	$29.72
Rate for Payer: Aetna Medicare	$17.48
Rate for Payer: Aetna New Business (MI Preferred)	$22.72
Rate for Payer: BCBS Complete	$13.98
Rate for Payer: Cash Price	$27.97
Rate for Payer: Cofinity Commercial	$24.47
Rate for Payer: Cofinity Commercial	$30.07
Rate for Payer: Cofinity Medicare Advantage	$24.47
Rate for Payer: Encore Health Key Benefits Commercial	$27.97
Rate for Payer: Healthscope Commercial	$31.46
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$29.72
Rate for Payer: PHP Commercial	$29.72
Rate for Payer: Priority Health Cigna Priority Health	$22.72
Rate for Payer: Priority Health SBD	$22.02
Rate for Payer: UHC Core	$25.87
Rate for Payer: UHC Exchange	$25.87

HC CONSULT NUTRITIONAL

Facility

$34.96

Hospital Charge Code	94200010
Hospital Revenue Code	942
Min. Negotiated Rate	$22.02
Max. Negotiated Rate	$31.46
Rate for Payer: Aetna Commercial	$29.72
Rate for Payer: Aetna New Business (MI Preferred)	$22.72
Rate for Payer: Cash Price	$27.97
Rate for Payer: Cofinity Commercial	$24.47
Rate for Payer: Cofinity Commercial	$30.07
Rate for Payer: Cofinity Medicare Advantage	$24.47
Rate for Payer: Encore Health Key Benefits Commercial	$27.97
Rate for Payer: Healthscope Commercial	$31.46
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$29.72
Rate for Payer: PHP Commercial	$29.72
Rate for Payer: Priority Health Cigna Priority Health	$22.72
Rate for Payer: Priority Health SBD	$22.02

HC CONT GLUCOSE MONITOR OFFICE EQUIP

Facility

$984.59

Service Code	CPT 95250
Hospital Charge Code	94200001
Hospital Revenue Code	942
Min. Negotiated Rate	$620.29
Max. Negotiated Rate	$886.13
Rate for Payer: Aetna Commercial	$836.90
Rate for Payer: Aetna New Business (MI Preferred)	$639.98
Rate for Payer: Cash Price	$787.67
Rate for Payer: Cofinity Commercial	$689.21
Rate for Payer: Cofinity Commercial	$846.75
Rate for Payer: Cofinity Medicare Advantage	$689.21
Rate for Payer: Encore Health Key Benefits Commercial	$787.67
Rate for Payer: Healthscope Commercial	$886.13
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$836.90
Rate for Payer: PHP Commercial	$836.90
Rate for Payer: Priority Health Cigna Priority Health	$639.98
Rate for Payer: Priority Health SBD	$620.29

HC CONT GLUCOSE MONITOR OFFICE EQUIP

Facility

$984.59

Service Code	CPT 95250
Hospital Charge Code	94200001
Hospital Revenue Code	942
Min. Negotiated Rate	$67.68
Max. Negotiated Rate	$886.13
Rate for Payer: Aetna Commercial	$836.90
Rate for Payer: Aetna Medicare	$131.31
Rate for Payer: Aetna New Business (MI Preferred)	$639.98
Rate for Payer: Allen County Amish Medical Aid Commercial	$157.82
Rate for Payer: Amish Plain Church Group Commercial	$157.82
Rate for Payer: BCBS Complete	$71.06
Rate for Payer: BCBS MAPPO	$126.26
Rate for Payer: BCBS Trust/PPO	$648.24
Rate for Payer: BCN Commercial	$648.24
Rate for Payer: BCN Medicare Advantage	$126.26
Rate for Payer: Cash Price	$787.67
Rate for Payer: Cash Price	$787.67
Rate for Payer: Cofinity Commercial	$689.21
Rate for Payer: Cofinity Commercial	$846.75
Rate for Payer: Cofinity Medicare Advantage	$689.21
Rate for Payer: Encore Health Key Benefits Commercial	$787.67
Rate for Payer: Health Alliance Plan Medicare Advantage	$126.26
Rate for Payer: Healthscope Commercial	$886.13
Rate for Payer: Mclaren Medicaid	$67.68
Rate for Payer: Mclaren Medicare	$126.26
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$132.57
Rate for Payer: Meridian Medicaid	$71.06
Rate for Payer: MI Amish Medical Board Commercial	$145.20
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$836.90
Rate for Payer: Nomi Health Commercial	$378.78
Rate for Payer: PACE Medicare	$119.95
Rate for Payer: PACE SWMI	$126.26
Rate for Payer: PHP Commercial	$836.90
Rate for Payer: PHP Medicare Advantage	$126.26
Rate for Payer: Priority Health Choice Medicaid	$67.68
Rate for Payer: Priority Health Cigna Priority Health	$639.98
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$396.84
Rate for Payer: Priority Health Medicare	$126.26
Rate for Payer: Priority Health Narrow Network	$317.47
Rate for Payer: Priority Health SBD	$620.29
Rate for Payer: Railroad Medicare Medicare	$126.26
Rate for Payer: UHC All Payor (Choice/PPO)	$145.74
Rate for Payer: UHC Dual Complete DSNP	$126.26
Rate for Payer: UHC Exchange	$728.60
Rate for Payer: UHC Medicare Advantage	$126.26
Rate for Payer: UHCCP Medicaid	$71.08
Rate for Payer: VA VA	$126.26

HC CONT GLUCOSE MONITOR PATIENT EQUIP

Facility

$384.44

Service Code	CPT 95249
Hospital Charge Code	94200038
Hospital Revenue Code	942
Min. Negotiated Rate	$31.20
Max. Negotiated Rate	$346.00
Rate for Payer: Aetna Commercial	$326.77
Rate for Payer: Aetna Medicare	$60.53
Rate for Payer: Aetna New Business (MI Preferred)	$249.89
Rate for Payer: Allen County Amish Medical Aid Commercial	$72.75
Rate for Payer: Amish Plain Church Group Commercial	$72.75
Rate for Payer: BCBS Complete	$32.75
Rate for Payer: BCBS MAPPO	$58.20
Rate for Payer: BCBS Trust/PPO	$283.52
Rate for Payer: BCN Commercial	$283.52
Rate for Payer: BCN Medicare Advantage	$58.20
Rate for Payer: Cash Price	$307.55
Rate for Payer: Cash Price	$307.55
Rate for Payer: Cofinity Commercial	$330.62
Rate for Payer: Cofinity Commercial	$269.11
Rate for Payer: Cofinity Medicare Advantage	$269.11
Rate for Payer: Encore Health Key Benefits Commercial	$307.55
Rate for Payer: Health Alliance Plan Medicare Advantage	$58.20
Rate for Payer: Healthscope Commercial	$346.00
Rate for Payer: Mclaren Medicaid	$31.20
Rate for Payer: Mclaren Medicare	$58.20
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$61.11
Rate for Payer: Meridian Medicaid	$32.75
Rate for Payer: MI Amish Medical Board Commercial	$66.93
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$326.77
Rate for Payer: Nomi Health Commercial	$174.60
Rate for Payer: PACE Medicare	$55.29
Rate for Payer: PACE SWMI	$58.20
Rate for Payer: PHP Commercial	$326.77
Rate for Payer: PHP Medicare Advantage	$58.20
Rate for Payer: Priority Health Choice Medicaid	$31.20
Rate for Payer: Priority Health Cigna Priority Health	$249.89
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$182.90
Rate for Payer: Priority Health Medicare	$58.20
Rate for Payer: Priority Health Narrow Network	$146.32
Rate for Payer: Priority Health SBD	$242.20
Rate for Payer: Railroad Medicare Medicare	$58.20
Rate for Payer: UHC All Payor (Choice/PPO)	$64.69
Rate for Payer: UHC Dual Complete DSNP	$58.20
Rate for Payer: UHC Exchange	$284.49
Rate for Payer: UHC Medicare Advantage	$58.20
Rate for Payer: UHCCP Medicaid	$32.77
Rate for Payer: VA VA	$58.20

HC CONT GLUCOSE MONITOR PATIENT EQUIP

Facility

$384.44

Service Code	CPT 95249
Hospital Charge Code	94200038
Hospital Revenue Code	942
Min. Negotiated Rate	$242.20
Max. Negotiated Rate	$346.00
Rate for Payer: Aetna Commercial	$326.77
Rate for Payer: Aetna New Business (MI Preferred)	$249.89
Rate for Payer: Cash Price	$307.55
Rate for Payer: Cofinity Commercial	$269.11
Rate for Payer: Cofinity Commercial	$330.62
Rate for Payer: Cofinity Medicare Advantage	$269.11
Rate for Payer: Encore Health Key Benefits Commercial	$307.55
Rate for Payer: Healthscope Commercial	$346.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$326.77
Rate for Payer: PHP Commercial	$326.77
Rate for Payer: Priority Health Cigna Priority Health	$249.89
Rate for Payer: Priority Health SBD	$242.20

HC CONTINUOUS NEB SUBSEQUENT HR

Facility

$104.53

Service Code	CPT 94645
Hospital Charge Code	41000007
Hospital Revenue Code	410
Min. Negotiated Rate	$16.17
Max. Negotiated Rate	$94.08
Rate for Payer: Aetna Commercial	$88.85
Rate for Payer: Aetna Medicare	$52.26
Rate for Payer: Aetna New Business (MI Preferred)	$67.94
Rate for Payer: BCBS Complete	$41.81
Rate for Payer: BCBS Trust/PPO	$70.87
Rate for Payer: BCN Commercial	$70.87
Rate for Payer: Cash Price	$83.62
Rate for Payer: Cash Price	$83.62
Rate for Payer: Cofinity Commercial	$73.17
Rate for Payer: Cofinity Commercial	$89.90
Rate for Payer: Cofinity Medicare Advantage	$73.17
Rate for Payer: Encore Health Key Benefits Commercial	$83.62
Rate for Payer: Healthscope Commercial	$94.08
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$88.85
Rate for Payer: PHP Commercial	$88.85
Rate for Payer: Priority Health Cigna Priority Health	$67.94
Rate for Payer: Priority Health SBD	$65.85
Rate for Payer: UHC All Payor (Choice/PPO)	$16.17
Rate for Payer: UHC Exchange	$77.35

HC CONTINUOUS NEB SUBSEQUENT HR

Facility

$104.53

Service Code	CPT 94645
Hospital Charge Code	41000007
Hospital Revenue Code	410
Min. Negotiated Rate	$65.85
Max. Negotiated Rate	$94.08
Rate for Payer: Aetna Commercial	$88.85
Rate for Payer: Aetna New Business (MI Preferred)	$67.94
Rate for Payer: Cash Price	$83.62
Rate for Payer: Cofinity Commercial	$73.17
Rate for Payer: Cofinity Commercial	$89.90
Rate for Payer: Cofinity Medicare Advantage	$73.17
Rate for Payer: Encore Health Key Benefits Commercial	$83.62
Rate for Payer: Healthscope Commercial	$94.08
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$88.85
Rate for Payer: PHP Commercial	$88.85
Rate for Payer: Priority Health Cigna Priority Health	$67.94
Rate for Payer: Priority Health SBD	$65.85

HC CONTINUOUS NEB TX INITIAL HOUR

Facility

$375.42

Service Code	CPT 94644
Hospital Charge Code	41000006
Hospital Revenue Code	410
Min. Negotiated Rate	$236.51
Max. Negotiated Rate	$337.88
Rate for Payer: Aetna Commercial	$319.11
Rate for Payer: Aetna New Business (MI Preferred)	$244.02
Rate for Payer: Cash Price	$300.34
Rate for Payer: Cofinity Commercial	$262.79
Rate for Payer: Cofinity Commercial	$322.86
Rate for Payer: Cofinity Medicare Advantage	$262.79
Rate for Payer: Encore Health Key Benefits Commercial	$300.34
Rate for Payer: Healthscope Commercial	$337.88
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$319.11
Rate for Payer: PHP Commercial	$319.11
Rate for Payer: Priority Health Cigna Priority Health	$244.02
Rate for Payer: Priority Health SBD	$236.51

HC CONTINUOUS NEB TX INITIAL HOUR

Facility

$375.42

Service Code	CPT 94644
Hospital Charge Code	41000006
Hospital Revenue Code	410
Min. Negotiated Rate	$58.93
Max. Negotiated Rate	$396.95
Rate for Payer: Aetna Commercial	$319.11
Rate for Payer: Aetna Medicare	$131.34
Rate for Payer: Aetna New Business (MI Preferred)	$244.02
Rate for Payer: Allen County Amish Medical Aid Commercial	$157.86
Rate for Payer: Amish Plain Church Group Commercial	$157.86
Rate for Payer: BCBS Complete	$71.08
Rate for Payer: BCBS MAPPO	$126.29
Rate for Payer: BCBS Trust/PPO	$261.36
Rate for Payer: BCN Commercial	$261.36
Rate for Payer: BCN Medicare Advantage	$126.29
Rate for Payer: Cash Price	$300.34
Rate for Payer: Cash Price	$300.34
Rate for Payer: Cofinity Commercial	$322.86
Rate for Payer: Cofinity Commercial	$262.79
Rate for Payer: Cofinity Medicare Advantage	$262.79
Rate for Payer: Encore Health Key Benefits Commercial	$300.34
Rate for Payer: Health Alliance Plan Medicare Advantage	$126.29
Rate for Payer: Healthscope Commercial	$337.88
Rate for Payer: Mclaren Medicaid	$67.69
Rate for Payer: Mclaren Medicare	$126.29
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$132.60
Rate for Payer: Meridian Medicaid	$71.08
Rate for Payer: MI Amish Medical Board Commercial	$145.23
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$319.11
Rate for Payer: Nomi Health Commercial	$378.87
Rate for Payer: PACE Medicare	$119.98
Rate for Payer: PACE SWMI	$126.29
Rate for Payer: PHP Commercial	$319.11
Rate for Payer: PHP Medicare Advantage	$126.29
Rate for Payer: Priority Health Choice Medicaid	$67.69
Rate for Payer: Priority Health Cigna Priority Health	$244.02
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$396.95
Rate for Payer: Priority Health Medicare	$126.29
Rate for Payer: Priority Health Narrow Network	$317.56
Rate for Payer: Priority Health SBD	$236.51
Rate for Payer: Railroad Medicare Medicare	$126.29
Rate for Payer: UHC All Payor (Choice/PPO)	$58.93
Rate for Payer: UHC Dual Complete DSNP	$126.29
Rate for Payer: UHC Exchange	$277.81
Rate for Payer: UHC Medicare Advantage	$126.29
Rate for Payer: UHCCP Medicaid	$71.10
Rate for Payer: VA VA	$126.29

HC CONT PHYSICS CONSULT

Facility

$584.70

Service Code	CPT 77336
Hospital Charge Code	33300015
Hospital Revenue Code	333
Min. Negotiated Rate	$368.36
Max. Negotiated Rate	$526.23
Rate for Payer: Aetna Commercial	$497.00
Rate for Payer: Aetna New Business (MI Preferred)	$380.06
Rate for Payer: Cash Price	$467.76
Rate for Payer: Cofinity Commercial	$409.29
Rate for Payer: Cofinity Commercial	$502.84
Rate for Payer: Cofinity Medicare Advantage	$409.29
Rate for Payer: Encore Health Key Benefits Commercial	$467.76
Rate for Payer: Healthscope Commercial	$526.23
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$497.00
Rate for Payer: PHP Commercial	$497.00
Rate for Payer: Priority Health Cigna Priority Health	$380.06
Rate for Payer: Priority Health SBD	$368.36

HC CONT PHYSICS CONSULT

Facility

$584.70

Service Code	CPT 77336
Hospital Charge Code	33300015
Hospital Revenue Code	333
Min. Negotiated Rate	$69.73
Max. Negotiated Rate	$526.23
Rate for Payer: Aetna Commercial	$497.00
Rate for Payer: Aetna Medicare	$135.29
Rate for Payer: Aetna New Business (MI Preferred)	$380.06
Rate for Payer: Allen County Amish Medical Aid Commercial	$162.61
Rate for Payer: Amish Plain Church Group Commercial	$162.61
Rate for Payer: BCBS Complete	$73.21
Rate for Payer: BCBS MAPPO	$130.09
Rate for Payer: BCBS Trust/PPO	$167.84
Rate for Payer: BCN Commercial	$167.84
Rate for Payer: BCN Medicare Advantage	$130.09
Rate for Payer: Cash Price	$467.76
Rate for Payer: Cash Price	$467.76
Rate for Payer: Cofinity Commercial	$502.84
Rate for Payer: Cofinity Commercial	$409.29
Rate for Payer: Cofinity Medicare Advantage	$409.29
Rate for Payer: Encore Health Key Benefits Commercial	$467.76
Rate for Payer: Health Alliance Plan Medicare Advantage	$130.09
Rate for Payer: Healthscope Commercial	$526.23
Rate for Payer: Mclaren Medicaid	$69.73
Rate for Payer: Mclaren Medicare	$130.09
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$136.59
Rate for Payer: Meridian Medicaid	$73.21
Rate for Payer: MI Amish Medical Board Commercial	$149.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$497.00
Rate for Payer: Nomi Health Commercial	$390.27
Rate for Payer: PACE Medicare	$123.59
Rate for Payer: PACE SWMI	$130.09
Rate for Payer: PHP Commercial	$497.00
Rate for Payer: PHP Medicare Advantage	$130.09
Rate for Payer: Priority Health Choice Medicaid	$69.73
Rate for Payer: Priority Health Cigna Priority Health	$380.06
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$408.86
Rate for Payer: Priority Health Medicare	$130.09
Rate for Payer: Priority Health Narrow Network	$327.09
Rate for Payer: Priority Health SBD	$368.36
Rate for Payer: Railroad Medicare Medicare	$130.09
Rate for Payer: UHC All Payor (Choice/PPO)	$88.36
Rate for Payer: UHC Dual Complete DSNP	$130.09
Rate for Payer: UHC Exchange	$432.68
Rate for Payer: UHC Medicare Advantage	$130.09
Rate for Payer: UHCCP Medicaid	$73.24
Rate for Payer: VA VA	$130.09

HC CONTRAST BATHS EACH 15 MIN

Facility

$105.77

Service Code	CPT 97034
Hospital Charge Code	42000017
Hospital Revenue Code	420
Min. Negotiated Rate	$11.20
Max. Negotiated Rate	$135.00
Rate for Payer: Aetna Commercial	$89.90
Rate for Payer: Aetna Medicare	$52.88
Rate for Payer: Aetna New Business (MI Preferred)	$68.75
Rate for Payer: BCBS Complete	$42.31
Rate for Payer: BCBS Trust/PPO	$11.53
Rate for Payer: BCN Commercial	$11.53
Rate for Payer: Cash Price	$84.62
Rate for Payer: Cash Price	$84.62
Rate for Payer: Cash Price	$84.62
Rate for Payer: Cofinity Commercial	$74.04
Rate for Payer: Cofinity Commercial	$90.96
Rate for Payer: Cofinity Medicare Advantage	$74.04
Rate for Payer: Encore Health Key Benefits Commercial	$84.62
Rate for Payer: Healthscope Commercial	$95.19
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$89.90
Rate for Payer: Nomi Health Commercial	$135.00
Rate for Payer: PHP Commercial	$89.90
Rate for Payer: Priority Health Cigna Priority Health	$68.75
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$14.00
Rate for Payer: Priority Health Narrow Network	$11.20
Rate for Payer: Priority Health SBD	$66.64
Rate for Payer: UHC All Payor (Choice/PPO)	$14.55
Rate for Payer: UHC Exchange	$78.27

Know your out-of-pocket cost for care.

All Charges