Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC DEVELOPMENTAL TESTING

Facility

$386.77

Service Code	CPT 96110
Hospital Charge Code	51000057
Hospital Revenue Code	761
Min. Negotiated Rate	$243.67
Max. Negotiated Rate	$348.09
Rate for Payer: Aetna Commercial	$328.75
Rate for Payer: Aetna New Business (MI Preferred)	$251.40
Rate for Payer: Cash Price	$309.42
Rate for Payer: Cofinity Advantage	$270.74
Rate for Payer: Cofinity Commercial	$332.62
Rate for Payer: Encore Health Key Benefits Commercial	$309.42
Rate for Payer: Healthscope Commercial	$348.09
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$328.75
Rate for Payer: Opus (Opus Packaging Group) HMA	$290.08
Rate for Payer: PHP Commercial	$328.75
Rate for Payer: Priority Health SBD	$243.67

HC DEVICE NOT RETURNED ACTIWATCH

Facility

$949.00

Hospital Charge Code	27000615
Hospital Revenue Code	270
Min. Negotiated Rate	$372.96
Max. Negotiated Rate	$854.10
Rate for Payer: Aetna Commercial	$806.65
Rate for Payer: Aetna Medicare	$474.50
Rate for Payer: Aetna New Business (MI Preferred)	$616.85
Rate for Payer: BCBS Complete	$379.60
Rate for Payer: Cash Price	$759.20
Rate for Payer: Cofinity Advantage	$664.30
Rate for Payer: Cofinity Commercial	$816.14
Rate for Payer: Encore Health Key Benefits Commercial	$759.20
Rate for Payer: Healthscope Commercial	$854.10
Rate for Payer: MI Amish Medical Board Commercial	$759.20
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$806.65
Rate for Payer: Opus (Opus Packaging Group) HMA	$711.75
Rate for Payer: PHP Commercial	$806.65
Rate for Payer: Priority Health SBD	$597.87
Rate for Payer: UHC All Payor (Choice/PPO)	$616.85
Rate for Payer: UHC Core	$494.43
Rate for Payer: UHC Exchange	$372.96

HC DEVICE NOT RETURNED ACTIWATCH

Professional

Both

$997.00

Hospital Charge Code	27000615
Hospital Revenue Code	270
Min. Negotiated Rate	$398.80
Max. Negotiated Rate	$747.75
Rate for Payer: Aetna Medicare	$498.50
Rate for Payer: BCBS Complete	$398.80
Rate for Payer: Cash Price	$797.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$648.05
Rate for Payer: Opus (Opus Packaging Group) HMA	$747.75

HC DEVICE NOT RETURNED ACTIWATCH

Professional

Both

$997.00

Hospital Revenue Code	270
Min. Negotiated Rate	$398.80
Max. Negotiated Rate	$747.75
Rate for Payer: Aetna Medicare	$498.50
Rate for Payer: BCBS Complete	$398.80
Rate for Payer: Cash Price	$797.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$648.05
Rate for Payer: Opus (Opus Packaging Group) HMA	$747.75

HC DEVICE NOT RETURNED ACTIWATCH

Facility

$949.00

Hospital Charge Code	27000615
Hospital Revenue Code	270
Min. Negotiated Rate	$597.87
Max. Negotiated Rate	$854.10
Rate for Payer: Aetna Commercial	$806.65
Rate for Payer: Aetna New Business (MI Preferred)	$616.85
Rate for Payer: Cash Price	$759.20
Rate for Payer: Cofinity Advantage	$664.30
Rate for Payer: Cofinity Commercial	$816.14
Rate for Payer: Encore Health Key Benefits Commercial	$759.20
Rate for Payer: Healthscope Commercial	$854.10
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$806.65
Rate for Payer: Opus (Opus Packaging Group) HMA	$711.75
Rate for Payer: PHP Commercial	$806.65
Rate for Payer: Priority Health SBD	$597.87

HC DEVICE NOT RETURNED AIR 10 OXIMETRY

Facility

$310.00

Hospital Charge Code	27000616
Hospital Revenue Code	270
Min. Negotiated Rate	$121.83
Max. Negotiated Rate	$279.00
Rate for Payer: Aetna Commercial	$263.50
Rate for Payer: Aetna Medicare	$155.00
Rate for Payer: Aetna New Business (MI Preferred)	$201.50
Rate for Payer: BCBS Complete	$124.00
Rate for Payer: Cash Price	$248.00
Rate for Payer: Cofinity Advantage	$217.00
Rate for Payer: Cofinity Commercial	$266.60
Rate for Payer: Encore Health Key Benefits Commercial	$248.00
Rate for Payer: Healthscope Commercial	$279.00
Rate for Payer: MI Amish Medical Board Commercial	$248.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$263.50
Rate for Payer: Opus (Opus Packaging Group) HMA	$232.50
Rate for Payer: PHP Commercial	$263.50
Rate for Payer: Priority Health SBD	$195.30
Rate for Payer: UHC All Payor (Choice/PPO)	$201.50
Rate for Payer: UHC Core	$161.51
Rate for Payer: UHC Exchange	$121.83

HC DEVICE NOT RETURNED AIR 10 OXIMETRY

Facility

$310.00

Hospital Charge Code	27000616
Hospital Revenue Code	270
Min. Negotiated Rate	$195.30
Max. Negotiated Rate	$279.00
Rate for Payer: Aetna Commercial	$263.50
Rate for Payer: Aetna New Business (MI Preferred)	$201.50
Rate for Payer: Cash Price	$248.00
Rate for Payer: Cofinity Advantage	$217.00
Rate for Payer: Cofinity Commercial	$266.60
Rate for Payer: Encore Health Key Benefits Commercial	$248.00
Rate for Payer: Healthscope Commercial	$279.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$263.50
Rate for Payer: Opus (Opus Packaging Group) HMA	$232.50
Rate for Payer: PHP Commercial	$263.50
Rate for Payer: Priority Health SBD	$195.30

HC DEVICE NOT RETURNED AIR 10 OXIMETRY

Professional

Both

$325.00

Hospital Charge Code	27000616
Hospital Revenue Code	270
Min. Negotiated Rate	$130.00
Max. Negotiated Rate	$243.75
Rate for Payer: Aetna Medicare	$162.50
Rate for Payer: BCBS Complete	$130.00
Rate for Payer: Cash Price	$260.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$211.25
Rate for Payer: Opus (Opus Packaging Group) HMA	$243.75

HC DEVICE NOT RETURNED AIR 10 OXIMETRY

Professional

Both

$325.00

Hospital Revenue Code	270
Min. Negotiated Rate	$130.00
Max. Negotiated Rate	$243.75
Rate for Payer: Aetna Medicare	$162.50
Rate for Payer: BCBS Complete	$130.00
Rate for Payer: Cash Price	$260.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$211.25
Rate for Payer: Opus (Opus Packaging Group) HMA	$243.75

HC DEVICE NOT RETURNED APNEALINK

Professional

Both

$870.00

Hospital Revenue Code	270
Min. Negotiated Rate	$348.00
Max. Negotiated Rate	$652.50
Rate for Payer: Aetna Medicare	$435.00
Rate for Payer: BCBS Complete	$348.00
Rate for Payer: Cash Price	$696.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$565.50
Rate for Payer: Opus (Opus Packaging Group) HMA	$652.50

HC DEVICE NOT RETURNED CADD PUMP

Facility

$3,723.00

Hospital Charge Code	27000642
Hospital Revenue Code	270
Min. Negotiated Rate	$2,345.49
Max. Negotiated Rate	$3,350.70
Rate for Payer: Aetna Commercial	$3,164.55
Rate for Payer: Aetna New Business (MI Preferred)	$2,419.95
Rate for Payer: Cash Price	$2,978.40
Rate for Payer: Cofinity Advantage	$2,606.10
Rate for Payer: Cofinity Commercial	$3,201.78
Rate for Payer: Encore Health Key Benefits Commercial	$2,978.40
Rate for Payer: Healthscope Commercial	$3,350.70
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3,164.55
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,792.25
Rate for Payer: PHP Commercial	$3,164.55
Rate for Payer: Priority Health SBD	$2,345.49

HC DEVICE NOT RETURNED CADD PUMP

Facility

$3,723.00

Hospital Charge Code	27000642
Hospital Revenue Code	270
Min. Negotiated Rate	$1,463.14
Max. Negotiated Rate	$3,350.70
Rate for Payer: Aetna Commercial	$3,164.55
Rate for Payer: Aetna Medicare	$1,861.50
Rate for Payer: Aetna New Business (MI Preferred)	$2,419.95
Rate for Payer: BCBS Complete	$1,489.20
Rate for Payer: Cash Price	$2,978.40
Rate for Payer: Cofinity Advantage	$2,606.10
Rate for Payer: Cofinity Commercial	$3,201.78
Rate for Payer: Encore Health Key Benefits Commercial	$2,978.40
Rate for Payer: Healthscope Commercial	$3,350.70
Rate for Payer: MI Amish Medical Board Commercial	$2,978.40
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3,164.55
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,792.25
Rate for Payer: PHP Commercial	$3,164.55
Rate for Payer: Priority Health SBD	$2,345.49
Rate for Payer: UHC All Payor (Choice/PPO)	$2,419.95
Rate for Payer: UHC Core	$1,939.68
Rate for Payer: UHC Exchange	$1,463.14

HC DEVICE NOT RETURNED HOLTER MONITOR

Facility

$652.00

Hospital Charge Code	27000705
Hospital Revenue Code	270
Min. Negotiated Rate	$410.76
Max. Negotiated Rate	$586.80
Rate for Payer: Aetna Commercial	$554.20
Rate for Payer: Aetna New Business (MI Preferred)	$423.80
Rate for Payer: Cash Price	$521.60
Rate for Payer: Cofinity Advantage	$456.40
Rate for Payer: Cofinity Commercial	$560.72
Rate for Payer: Encore Health Key Benefits Commercial	$521.60
Rate for Payer: Healthscope Commercial	$586.80
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$554.20
Rate for Payer: Opus (Opus Packaging Group) HMA	$489.00
Rate for Payer: PHP Commercial	$554.20
Rate for Payer: Priority Health SBD	$410.76

HC DEVICE NOT RETURNED HOLTER MONITOR

Facility

$652.00

Hospital Charge Code	27000705
Hospital Revenue Code	270
Min. Negotiated Rate	$256.24
Max. Negotiated Rate	$586.80
Rate for Payer: Aetna Commercial	$554.20
Rate for Payer: Aetna Medicare	$326.00
Rate for Payer: Aetna New Business (MI Preferred)	$423.80
Rate for Payer: BCBS Complete	$260.80
Rate for Payer: Cash Price	$521.60
Rate for Payer: Cofinity Advantage	$456.40
Rate for Payer: Cofinity Commercial	$560.72
Rate for Payer: Encore Health Key Benefits Commercial	$521.60
Rate for Payer: Healthscope Commercial	$586.80
Rate for Payer: MI Amish Medical Board Commercial	$521.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$554.20
Rate for Payer: Opus (Opus Packaging Group) HMA	$489.00
Rate for Payer: PHP Commercial	$554.20
Rate for Payer: Priority Health SBD	$410.76
Rate for Payer: UHC All Payor (Choice/PPO)	$423.80
Rate for Payer: UHC Core	$339.69
Rate for Payer: UHC Exchange	$256.24

HC DEVICE NOT RETURNED RU SLEEPING

Professional

Both

$520.00

Hospital Charge Code	27000614
Hospital Revenue Code	270
Min. Negotiated Rate	$208.00
Max. Negotiated Rate	$390.00
Rate for Payer: Aetna Medicare	$260.00
Rate for Payer: BCBS Complete	$208.00
Rate for Payer: Cash Price	$416.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$338.00
Rate for Payer: Opus (Opus Packaging Group) HMA	$390.00

HC DEVICE NOT RETURNED RU SLEEPING

Professional

Both

$520.00

Hospital Revenue Code	270
Min. Negotiated Rate	$208.00
Max. Negotiated Rate	$390.00
Rate for Payer: Aetna Medicare	$260.00
Rate for Payer: BCBS Complete	$208.00
Rate for Payer: Cash Price	$416.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$338.00
Rate for Payer: Opus (Opus Packaging Group) HMA	$390.00

HC DEVICE NOT RETURNED RU SLEEPING

Facility

$495.00

Hospital Charge Code	27000614
Hospital Revenue Code	270
Min. Negotiated Rate	$311.85
Max. Negotiated Rate	$445.50
Rate for Payer: Aetna Commercial	$420.75
Rate for Payer: Aetna New Business (MI Preferred)	$321.75
Rate for Payer: Cash Price	$396.00
Rate for Payer: Cofinity Advantage	$346.50
Rate for Payer: Cofinity Commercial	$425.70
Rate for Payer: Encore Health Key Benefits Commercial	$396.00
Rate for Payer: Healthscope Commercial	$445.50
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$420.75
Rate for Payer: Opus (Opus Packaging Group) HMA	$371.25
Rate for Payer: PHP Commercial	$420.75
Rate for Payer: Priority Health SBD	$311.85

HC DEVICE NOT RETURNED RU SLEEPING

Facility

$495.00

Hospital Charge Code	27000614
Hospital Revenue Code	270
Min. Negotiated Rate	$194.53
Max. Negotiated Rate	$445.50
Rate for Payer: Aetna Commercial	$420.75
Rate for Payer: Aetna Medicare	$247.50
Rate for Payer: Aetna New Business (MI Preferred)	$321.75
Rate for Payer: BCBS Complete	$198.00
Rate for Payer: Cash Price	$396.00
Rate for Payer: Cofinity Advantage	$346.50
Rate for Payer: Cofinity Commercial	$425.70
Rate for Payer: Encore Health Key Benefits Commercial	$396.00
Rate for Payer: Healthscope Commercial	$445.50
Rate for Payer: MI Amish Medical Board Commercial	$396.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$420.75
Rate for Payer: Opus (Opus Packaging Group) HMA	$371.25
Rate for Payer: PHP Commercial	$420.75
Rate for Payer: Priority Health SBD	$311.85
Rate for Payer: UHC All Payor (Choice/PPO)	$321.75
Rate for Payer: UHC Core	$257.89
Rate for Payer: UHC Exchange	$194.53

HC DEVICE NOT RETURNED TYPE III HOME STUDY

Professional

Both

$5,200.00

Hospital Revenue Code	270
Min. Negotiated Rate	$2,080.00
Max. Negotiated Rate	$3,900.00
Rate for Payer: Aetna Medicare	$2,600.00
Rate for Payer: BCBS Complete	$2,080.00
Rate for Payer: Cash Price	$4,160.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3,380.00
Rate for Payer: Opus (Opus Packaging Group) HMA	$3,900.00

HC DEVICE NOT RETURNED TYPE III HOME STUDY

Facility

$4,950.00

Hospital Charge Code	27000604
Hospital Revenue Code	270
Min. Negotiated Rate	$1,945.35
Max. Negotiated Rate	$4,455.00
Rate for Payer: Aetna Commercial	$4,207.50
Rate for Payer: Aetna Medicare	$2,475.00
Rate for Payer: Aetna New Business (MI Preferred)	$3,217.50
Rate for Payer: BCBS Complete	$1,980.00
Rate for Payer: Cash Price	$3,960.00
Rate for Payer: Cofinity Advantage	$3,465.00
Rate for Payer: Cofinity Commercial	$4,257.00
Rate for Payer: Encore Health Key Benefits Commercial	$3,960.00
Rate for Payer: Healthscope Commercial	$4,455.00
Rate for Payer: MI Amish Medical Board Commercial	$3,960.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4,207.50
Rate for Payer: Opus (Opus Packaging Group) HMA	$3,712.50
Rate for Payer: PHP Commercial	$4,207.50
Rate for Payer: Priority Health SBD	$3,118.50
Rate for Payer: UHC All Payor (Choice/PPO)	$3,217.50
Rate for Payer: UHC Core	$2,578.95
Rate for Payer: UHC Exchange	$1,945.35

HC DEVICE NOT RETURNED TYPE III HOME STUDY

Facility

$4,950.00

Hospital Charge Code	27000604
Hospital Revenue Code	270
Min. Negotiated Rate	$3,118.50
Max. Negotiated Rate	$4,455.00
Rate for Payer: Aetna Commercial	$4,207.50
Rate for Payer: Aetna New Business (MI Preferred)	$3,217.50
Rate for Payer: Cash Price	$3,960.00
Rate for Payer: Cofinity Advantage	$3,465.00
Rate for Payer: Cofinity Commercial	$4,257.00
Rate for Payer: Encore Health Key Benefits Commercial	$3,960.00
Rate for Payer: Healthscope Commercial	$4,455.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4,207.50
Rate for Payer: Opus (Opus Packaging Group) HMA	$3,712.50
Rate for Payer: PHP Commercial	$4,207.50
Rate for Payer: Priority Health SBD	$3,118.50

HC DEVICE NOT RETURNED TYPE III HOME STUDY

Professional

Both

$5,200.00

Hospital Charge Code	27000604
Hospital Revenue Code	270
Min. Negotiated Rate	$2,080.00
Max. Negotiated Rate	$3,900.00
Rate for Payer: Aetna Medicare	$2,600.00
Rate for Payer: BCBS Complete	$2,080.00
Rate for Payer: Cash Price	$4,160.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3,380.00
Rate for Payer: Opus (Opus Packaging Group) HMA	$3,900.00

HC DEVICE NOT RETURNED TYPE III HOME STUDY W/EFFORT & FLOW

Facility

$1,548.00

Hospital Charge Code	27000603
Hospital Revenue Code	270
Min. Negotiated Rate	$975.24
Max. Negotiated Rate	$1,393.20
Rate for Payer: Aetna Commercial	$1,315.80
Rate for Payer: Aetna New Business (MI Preferred)	$1,006.20
Rate for Payer: Cash Price	$1,238.40
Rate for Payer: Cofinity Advantage	$1,083.60
Rate for Payer: Cofinity Commercial	$1,331.28
Rate for Payer: Encore Health Key Benefits Commercial	$1,238.40
Rate for Payer: Healthscope Commercial	$1,393.20
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,315.80
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,161.00
Rate for Payer: PHP Commercial	$1,315.80
Rate for Payer: Priority Health SBD	$975.24

HC DEVICE NOT RETURNED TYPE III HOME STUDY W/EFFORT & FLOW

Professional

Both

$1,626.00

Hospital Revenue Code	270
Min. Negotiated Rate	$650.40
Max. Negotiated Rate	$1,219.50
Rate for Payer: Aetna Medicare	$813.00
Rate for Payer: BCBS Complete	$650.40
Rate for Payer: Cash Price	$1,300.80
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,056.90
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,219.50

HC DEVICE NOT RETURNED TYPE III HOME STUDY W/EFFORT & FLOW

Facility

$1,548.00

Hospital Charge Code	27000603
Hospital Revenue Code	270
Min. Negotiated Rate	$608.36
Max. Negotiated Rate	$1,393.20
Rate for Payer: Aetna Commercial	$1,315.80
Rate for Payer: Aetna Medicare	$774.00
Rate for Payer: Aetna New Business (MI Preferred)	$1,006.20
Rate for Payer: BCBS Complete	$619.20
Rate for Payer: Cash Price	$1,238.40
Rate for Payer: Cofinity Advantage	$1,083.60
Rate for Payer: Cofinity Commercial	$1,331.28
Rate for Payer: Encore Health Key Benefits Commercial	$1,238.40
Rate for Payer: Healthscope Commercial	$1,393.20
Rate for Payer: MI Amish Medical Board Commercial	$1,238.40
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,315.80
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,161.00
Rate for Payer: PHP Commercial	$1,315.80
Rate for Payer: Priority Health SBD	$975.24
Rate for Payer: UHC All Payor (Choice/PPO)	$1,006.20
Rate for Payer: UHC Core	$806.51
Rate for Payer: UHC Exchange	$608.36

Know your out-of-pocket cost for care.

All Charges