Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC DIAG ANGIO OF DIALYSIS CIRCUIT W STENT AND IMAGING

Facility

$18,905.74

Service Code	CPT 36903
Hospital Charge Code	36100527
Hospital Revenue Code	361
Min. Negotiated Rate	$11,910.62
Max. Negotiated Rate	$17,015.17
Rate for Payer: Aetna Commercial	$16,069.88
Rate for Payer: Aetna New Business (MI Preferred)	$12,288.73
Rate for Payer: Cash Price	$15,124.59
Rate for Payer: Cofinity Advantage	$13,234.02
Rate for Payer: Cofinity Commercial	$16,258.94
Rate for Payer: Encore Health Key Benefits Commercial	$15,124.59
Rate for Payer: Healthscope Commercial	$17,015.17
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$16,069.88
Rate for Payer: Opus (Opus Packaging Group) HMA	$14,179.31
Rate for Payer: PHP Commercial	$16,069.88
Rate for Payer: Priority Health SBD	$11,910.62

HC DIALYSIS CATH LVL 10 LONG TERM

Facility

$1,047.44

Service Code	HCPCS C1750
Hospital Charge Code	27200268
Hospital Revenue Code	272
Min. Negotiated Rate	$659.89
Max. Negotiated Rate	$942.70
Rate for Payer: Aetna Commercial	$890.32
Rate for Payer: Aetna New Business (MI Preferred)	$680.84
Rate for Payer: Cash Price	$837.95
Rate for Payer: Cofinity Advantage	$733.21
Rate for Payer: Cofinity Commercial	$900.80
Rate for Payer: Encore Health Key Benefits Commercial	$837.95
Rate for Payer: Healthscope Commercial	$942.70
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$890.32
Rate for Payer: Opus (Opus Packaging Group) HMA	$785.58
Rate for Payer: PHP Commercial	$890.32
Rate for Payer: Priority Health SBD	$659.89

HC DIALYSIS CATH LVL 10 LONG TERM

Facility

$1,047.44

Service Code	HCPCS C1750
Hospital Charge Code	27200268
Hospital Revenue Code	272
Min. Negotiated Rate	$411.64
Max. Negotiated Rate	$942.70
Rate for Payer: Aetna Commercial	$890.32
Rate for Payer: Aetna Medicare	$523.72
Rate for Payer: Aetna New Business (MI Preferred)	$680.84
Rate for Payer: BCBS Complete	$418.98
Rate for Payer: Cash Price	$837.95
Rate for Payer: Cofinity Advantage	$733.21
Rate for Payer: Cofinity Commercial	$900.80
Rate for Payer: Encore Health Key Benefits Commercial	$837.95
Rate for Payer: Healthscope Commercial	$942.70
Rate for Payer: MI Amish Medical Board Commercial	$837.95
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$890.32
Rate for Payer: Opus (Opus Packaging Group) HMA	$785.58
Rate for Payer: PHP Commercial	$890.32
Rate for Payer: Priority Health SBD	$659.89
Rate for Payer: UHC All Payor (Choice/PPO)	$680.84
Rate for Payer: UHC Core	$545.72
Rate for Payer: UHC Exchange	$411.64

HC DIALYSIS CATH LVL 11 LONG TERM

Facility

$1,171.97

Service Code	HCPCS C1750
Hospital Charge Code	27200269
Hospital Revenue Code	272
Min. Negotiated Rate	$738.34
Max. Negotiated Rate	$1,054.77
Rate for Payer: Aetna Commercial	$996.17
Rate for Payer: Aetna New Business (MI Preferred)	$761.78
Rate for Payer: Cash Price	$937.58
Rate for Payer: Cofinity Advantage	$820.38
Rate for Payer: Cofinity Commercial	$1,007.89
Rate for Payer: Encore Health Key Benefits Commercial	$937.58
Rate for Payer: Healthscope Commercial	$1,054.77
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$996.17
Rate for Payer: Opus (Opus Packaging Group) HMA	$878.98
Rate for Payer: PHP Commercial	$996.17
Rate for Payer: Priority Health SBD	$738.34

HC DIALYSIS CATH LVL 11 LONG TERM

Facility

$1,171.97

Service Code	HCPCS C1750
Hospital Charge Code	27200269
Hospital Revenue Code	272
Min. Negotiated Rate	$460.58
Max. Negotiated Rate	$1,054.77
Rate for Payer: Aetna Commercial	$996.17
Rate for Payer: Aetna Medicare	$585.99
Rate for Payer: Aetna New Business (MI Preferred)	$761.78
Rate for Payer: BCBS Complete	$468.79
Rate for Payer: Cash Price	$937.58
Rate for Payer: Cofinity Advantage	$820.38
Rate for Payer: Cofinity Commercial	$1,007.89
Rate for Payer: Encore Health Key Benefits Commercial	$937.58
Rate for Payer: Healthscope Commercial	$1,054.77
Rate for Payer: MI Amish Medical Board Commercial	$937.58
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$996.17
Rate for Payer: Opus (Opus Packaging Group) HMA	$878.98
Rate for Payer: PHP Commercial	$996.17
Rate for Payer: Priority Health SBD	$738.34
Rate for Payer: UHC All Payor (Choice/PPO)	$761.78
Rate for Payer: UHC Core	$610.60
Rate for Payer: UHC Exchange	$460.58

HC DIALYSIS CATH LVL 13 LONG TERM

Facility

$1,380.06

Service Code	HCPCS C1750
Hospital Charge Code	27200266
Hospital Revenue Code	272
Min. Negotiated Rate	$542.36
Max. Negotiated Rate	$1,242.05
Rate for Payer: Aetna Commercial	$1,173.05
Rate for Payer: Aetna Medicare	$690.03
Rate for Payer: Aetna New Business (MI Preferred)	$897.04
Rate for Payer: BCBS Complete	$552.02
Rate for Payer: Cash Price	$1,104.05
Rate for Payer: Cofinity Advantage	$966.04
Rate for Payer: Cofinity Commercial	$1,186.85
Rate for Payer: Encore Health Key Benefits Commercial	$1,104.05
Rate for Payer: Healthscope Commercial	$1,242.05
Rate for Payer: MI Amish Medical Board Commercial	$1,104.05
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,173.05
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,035.05
Rate for Payer: PHP Commercial	$1,173.05
Rate for Payer: Priority Health SBD	$869.44
Rate for Payer: UHC All Payor (Choice/PPO)	$897.04
Rate for Payer: UHC Core	$719.01
Rate for Payer: UHC Exchange	$542.36

HC DIALYSIS CATH LVL 13 LONG TERM

Facility

$1,380.06

Service Code	HCPCS C1750
Hospital Charge Code	27200266
Hospital Revenue Code	272
Min. Negotiated Rate	$869.44
Max. Negotiated Rate	$1,242.05
Rate for Payer: Aetna Commercial	$1,173.05
Rate for Payer: Aetna New Business (MI Preferred)	$897.04
Rate for Payer: Cash Price	$1,104.05
Rate for Payer: Cofinity Advantage	$966.04
Rate for Payer: Cofinity Commercial	$1,186.85
Rate for Payer: Encore Health Key Benefits Commercial	$1,104.05
Rate for Payer: Healthscope Commercial	$1,242.05
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,173.05
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,035.05
Rate for Payer: PHP Commercial	$1,173.05
Rate for Payer: Priority Health SBD	$869.44

HC DIALYSIS CATH LVL 2 SHORT TERM

Facility

$208.07

Service Code	HCPCS C1752
Hospital Charge Code	27200002
Hospital Revenue Code	272
Min. Negotiated Rate	$131.08
Max. Negotiated Rate	$187.26
Rate for Payer: Aetna Commercial	$176.86
Rate for Payer: Aetna New Business (MI Preferred)	$135.25
Rate for Payer: Cash Price	$166.46
Rate for Payer: Cofinity Advantage	$145.65
Rate for Payer: Cofinity Commercial	$178.94
Rate for Payer: Encore Health Key Benefits Commercial	$166.46
Rate for Payer: Healthscope Commercial	$187.26
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$176.86
Rate for Payer: Opus (Opus Packaging Group) HMA	$156.05
Rate for Payer: PHP Commercial	$176.86
Rate for Payer: Priority Health SBD	$131.08

HC DIALYSIS CATH LVL 2 SHORT TERM

Facility

$208.07

Service Code	HCPCS C1752
Hospital Charge Code	27200002
Hospital Revenue Code	272
Min. Negotiated Rate	$81.77
Max. Negotiated Rate	$187.26
Rate for Payer: Aetna Commercial	$176.86
Rate for Payer: Aetna Medicare	$104.03
Rate for Payer: Aetna New Business (MI Preferred)	$135.25
Rate for Payer: BCBS Complete	$83.23
Rate for Payer: Cash Price	$166.46
Rate for Payer: Cofinity Advantage	$145.65
Rate for Payer: Cofinity Commercial	$178.94
Rate for Payer: Encore Health Key Benefits Commercial	$166.46
Rate for Payer: Healthscope Commercial	$187.26
Rate for Payer: MI Amish Medical Board Commercial	$166.46
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$176.86
Rate for Payer: Opus (Opus Packaging Group) HMA	$156.05
Rate for Payer: PHP Commercial	$176.86
Rate for Payer: Priority Health SBD	$131.08
Rate for Payer: UHC All Payor (Choice/PPO)	$135.25
Rate for Payer: UHC Core	$108.40
Rate for Payer: UHC Exchange	$81.77

HC DIALYSIS CATH LVL 3 SHORT TERM

Facility

$315.17

Service Code	CPT C1752
Hospital Charge Code	27200317
Hospital Revenue Code	272
Min. Negotiated Rate	$198.56
Max. Negotiated Rate	$283.65
Rate for Payer: Aetna Commercial	$267.89
Rate for Payer: Aetna New Business (MI Preferred)	$204.86
Rate for Payer: Cash Price	$252.14
Rate for Payer: Cofinity Advantage	$220.62
Rate for Payer: Cofinity Commercial	$271.05
Rate for Payer: Encore Health Key Benefits Commercial	$252.14
Rate for Payer: Healthscope Commercial	$283.65
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$267.89
Rate for Payer: Opus (Opus Packaging Group) HMA	$236.38
Rate for Payer: PHP Commercial	$267.89
Rate for Payer: Priority Health SBD	$198.56

HC DIALYSIS CATH LVL 3 SHORT TERM

Facility

$315.17

Service Code	CPT C1752
Hospital Charge Code	27200317
Hospital Revenue Code	272
Min. Negotiated Rate	$123.86
Max. Negotiated Rate	$283.65
Rate for Payer: Aetna Commercial	$267.89
Rate for Payer: Aetna Medicare	$157.59
Rate for Payer: Aetna New Business (MI Preferred)	$204.86
Rate for Payer: BCBS Complete	$126.07
Rate for Payer: Cash Price	$252.14
Rate for Payer: Cofinity Advantage	$220.62
Rate for Payer: Cofinity Commercial	$271.05
Rate for Payer: Encore Health Key Benefits Commercial	$252.14
Rate for Payer: Healthscope Commercial	$283.65
Rate for Payer: MI Amish Medical Board Commercial	$252.14
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$267.89
Rate for Payer: Opus (Opus Packaging Group) HMA	$236.38
Rate for Payer: PHP Commercial	$267.89
Rate for Payer: Priority Health SBD	$198.56
Rate for Payer: UHC All Payor (Choice/PPO)	$204.86
Rate for Payer: UHC Core	$164.20
Rate for Payer: UHC Exchange	$123.86

HC DIALYSIS CATH LVL 4 SHORT TERM

Facility

$422.27

Service Code	HCPCS C1752
Hospital Charge Code	27200085
Hospital Revenue Code	272
Min. Negotiated Rate	$266.03
Max. Negotiated Rate	$380.04
Rate for Payer: Aetna Commercial	$358.93
Rate for Payer: Aetna New Business (MI Preferred)	$274.48
Rate for Payer: Cash Price	$337.82
Rate for Payer: Cofinity Advantage	$295.59
Rate for Payer: Cofinity Commercial	$363.15
Rate for Payer: Encore Health Key Benefits Commercial	$337.82
Rate for Payer: Healthscope Commercial	$380.04
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$358.93
Rate for Payer: Opus (Opus Packaging Group) HMA	$316.70
Rate for Payer: PHP Commercial	$358.93
Rate for Payer: Priority Health SBD	$266.03

HC DIALYSIS CATH LVL 4 SHORT TERM

Facility

$422.27

Service Code	HCPCS C1752
Hospital Charge Code	27200085
Hospital Revenue Code	272
Min. Negotiated Rate	$165.95
Max. Negotiated Rate	$380.04
Rate for Payer: Aetna Commercial	$358.93
Rate for Payer: Aetna Medicare	$211.13
Rate for Payer: Aetna New Business (MI Preferred)	$274.48
Rate for Payer: BCBS Complete	$168.91
Rate for Payer: Cash Price	$337.82
Rate for Payer: Cofinity Advantage	$295.59
Rate for Payer: Cofinity Commercial	$363.15
Rate for Payer: Encore Health Key Benefits Commercial	$337.82
Rate for Payer: Healthscope Commercial	$380.04
Rate for Payer: MI Amish Medical Board Commercial	$337.82
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$358.93
Rate for Payer: Opus (Opus Packaging Group) HMA	$316.70
Rate for Payer: PHP Commercial	$358.93
Rate for Payer: Priority Health SBD	$266.03
Rate for Payer: UHC All Payor (Choice/PPO)	$274.48
Rate for Payer: UHC Core	$220.00
Rate for Payer: UHC Exchange	$165.95

HC DIALYSIS CATH LVL 5 SHORT TERM

Facility

$529.37

Service Code	HCPCS C1752
Hospital Charge Code	27200318
Hospital Revenue Code	272
Min. Negotiated Rate	$208.04
Max. Negotiated Rate	$476.43
Rate for Payer: Aetna Commercial	$449.96
Rate for Payer: Aetna Medicare	$264.69
Rate for Payer: Aetna New Business (MI Preferred)	$344.09
Rate for Payer: BCBS Complete	$211.75
Rate for Payer: Cash Price	$423.50
Rate for Payer: Cofinity Advantage	$370.56
Rate for Payer: Cofinity Commercial	$455.26
Rate for Payer: Encore Health Key Benefits Commercial	$423.50
Rate for Payer: Healthscope Commercial	$476.43
Rate for Payer: MI Amish Medical Board Commercial	$423.50
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$449.96
Rate for Payer: Opus (Opus Packaging Group) HMA	$397.03
Rate for Payer: PHP Commercial	$449.96
Rate for Payer: Priority Health SBD	$333.50
Rate for Payer: UHC All Payor (Choice/PPO)	$344.09
Rate for Payer: UHC Core	$275.80
Rate for Payer: UHC Exchange	$208.04

HC DIALYSIS CATH LVL 5 SHORT TERM

Facility

$529.37

Service Code	HCPCS C1752
Hospital Charge Code	27200318
Hospital Revenue Code	272
Min. Negotiated Rate	$333.50
Max. Negotiated Rate	$476.43
Rate for Payer: Aetna Commercial	$449.96
Rate for Payer: Aetna New Business (MI Preferred)	$344.09
Rate for Payer: Cash Price	$423.50
Rate for Payer: Cofinity Advantage	$370.56
Rate for Payer: Cofinity Commercial	$455.26
Rate for Payer: Encore Health Key Benefits Commercial	$423.50
Rate for Payer: Healthscope Commercial	$476.43
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$449.96
Rate for Payer: Opus (Opus Packaging Group) HMA	$397.03
Rate for Payer: PHP Commercial	$449.96
Rate for Payer: Priority Health SBD	$333.50

HC DIALYSIS CATH LVL 7 LONG TERM

Facility

$743.57

Service Code	CPT C1750
Hospital Charge Code	27200319
Hospital Revenue Code	272
Min. Negotiated Rate	$468.45
Max. Negotiated Rate	$669.21
Rate for Payer: Aetna Commercial	$632.03
Rate for Payer: Aetna New Business (MI Preferred)	$483.32
Rate for Payer: Cash Price	$594.86
Rate for Payer: Cofinity Advantage	$520.50
Rate for Payer: Cofinity Commercial	$639.47
Rate for Payer: Encore Health Key Benefits Commercial	$594.86
Rate for Payer: Healthscope Commercial	$669.21
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$632.03
Rate for Payer: Opus (Opus Packaging Group) HMA	$557.68
Rate for Payer: PHP Commercial	$632.03
Rate for Payer: Priority Health SBD	$468.45

HC DIALYSIS CATH LVL 7 LONG TERM

Facility

$743.57

Service Code	CPT C1750
Hospital Charge Code	27200319
Hospital Revenue Code	272
Min. Negotiated Rate	$292.22
Max. Negotiated Rate	$669.21
Rate for Payer: Aetna Commercial	$632.03
Rate for Payer: Aetna Medicare	$371.79
Rate for Payer: Aetna New Business (MI Preferred)	$483.32
Rate for Payer: BCBS Complete	$297.43
Rate for Payer: Cash Price	$594.86
Rate for Payer: Cofinity Advantage	$520.50
Rate for Payer: Cofinity Commercial	$639.47
Rate for Payer: Encore Health Key Benefits Commercial	$594.86
Rate for Payer: Healthscope Commercial	$669.21
Rate for Payer: MI Amish Medical Board Commercial	$594.86
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$632.03
Rate for Payer: Opus (Opus Packaging Group) HMA	$557.68
Rate for Payer: PHP Commercial	$632.03
Rate for Payer: Priority Health SBD	$468.45
Rate for Payer: UHC All Payor (Choice/PPO)	$483.32
Rate for Payer: UHC Core	$387.40
Rate for Payer: UHC Exchange	$292.22

HC DIALYSIS CATH LVL 7 SHORT TERM

Facility

$793.31

Service Code	CPT C1752
Hospital Charge Code	27200347
Hospital Revenue Code	272
Min. Negotiated Rate	$311.77
Max. Negotiated Rate	$713.98
Rate for Payer: Aetna Commercial	$674.31
Rate for Payer: Aetna Medicare	$396.65
Rate for Payer: Aetna New Business (MI Preferred)	$515.65
Rate for Payer: BCBS Complete	$317.32
Rate for Payer: Cash Price	$634.65
Rate for Payer: Cofinity Advantage	$555.32
Rate for Payer: Cofinity Commercial	$682.25
Rate for Payer: Encore Health Key Benefits Commercial	$634.65
Rate for Payer: Healthscope Commercial	$713.98
Rate for Payer: MI Amish Medical Board Commercial	$634.65
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$674.31
Rate for Payer: Opus (Opus Packaging Group) HMA	$594.98
Rate for Payer: PHP Commercial	$674.31
Rate for Payer: Priority Health SBD	$499.79
Rate for Payer: UHC All Payor (Choice/PPO)	$515.65
Rate for Payer: UHC Core	$413.31
Rate for Payer: UHC Exchange	$311.77

HC DIALYSIS CATH LVL 7 SHORT TERM

Facility

$793.31

Service Code	CPT C1752
Hospital Charge Code	27200347
Hospital Revenue Code	272
Min. Negotiated Rate	$499.79
Max. Negotiated Rate	$713.98
Rate for Payer: Aetna Commercial	$674.31
Rate for Payer: Aetna New Business (MI Preferred)	$515.65
Rate for Payer: Cash Price	$634.65
Rate for Payer: Cofinity Advantage	$555.32
Rate for Payer: Cofinity Commercial	$682.25
Rate for Payer: Encore Health Key Benefits Commercial	$634.65
Rate for Payer: Healthscope Commercial	$713.98
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$674.31
Rate for Payer: Opus (Opus Packaging Group) HMA	$594.98
Rate for Payer: PHP Commercial	$674.31
Rate for Payer: Priority Health SBD	$499.79

HC DIALYSIS CATH LVL 8 SHORT TERM

Facility

$850.67

Service Code	HCPCS C1752
Hospital Charge Code	27200175
Hospital Revenue Code	272
Min. Negotiated Rate	$334.31
Max. Negotiated Rate	$765.60
Rate for Payer: Aetna Commercial	$723.07
Rate for Payer: Aetna Medicare	$425.33
Rate for Payer: Aetna New Business (MI Preferred)	$552.94
Rate for Payer: BCBS Complete	$340.27
Rate for Payer: Cash Price	$680.54
Rate for Payer: Cofinity Advantage	$595.47
Rate for Payer: Cofinity Commercial	$731.58
Rate for Payer: Encore Health Key Benefits Commercial	$680.54
Rate for Payer: Healthscope Commercial	$765.60
Rate for Payer: MI Amish Medical Board Commercial	$680.54
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$723.07
Rate for Payer: Opus (Opus Packaging Group) HMA	$638.00
Rate for Payer: PHP Commercial	$723.07
Rate for Payer: Priority Health SBD	$535.92
Rate for Payer: UHC All Payor (Choice/PPO)	$552.94
Rate for Payer: UHC Core	$443.20
Rate for Payer: UHC Exchange	$334.31

HC DIALYSIS CATH LVL 8 SHORT TERM

Facility

$850.67

Service Code	HCPCS C1752
Hospital Charge Code	27200175
Hospital Revenue Code	272
Min. Negotiated Rate	$535.92
Max. Negotiated Rate	$765.60
Rate for Payer: Aetna Commercial	$723.07
Rate for Payer: Aetna New Business (MI Preferred)	$552.94
Rate for Payer: Cash Price	$680.54
Rate for Payer: Cofinity Advantage	$595.47
Rate for Payer: Cofinity Commercial	$731.58
Rate for Payer: Encore Health Key Benefits Commercial	$680.54
Rate for Payer: Healthscope Commercial	$765.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$723.07
Rate for Payer: Opus (Opus Packaging Group) HMA	$638.00
Rate for Payer: PHP Commercial	$723.07
Rate for Payer: Priority Health SBD	$535.92

HC DIALYSIS CATH LVL 9 LONG TERM

Facility

$957.77

Service Code	HCPCS C1750
Hospital Charge Code	27200320
Hospital Revenue Code	272
Min. Negotiated Rate	$603.40
Max. Negotiated Rate	$861.99
Rate for Payer: Aetna Commercial	$814.10
Rate for Payer: Aetna New Business (MI Preferred)	$622.55
Rate for Payer: Cash Price	$766.22
Rate for Payer: Cofinity Advantage	$670.44
Rate for Payer: Cofinity Commercial	$823.68
Rate for Payer: Encore Health Key Benefits Commercial	$766.22
Rate for Payer: Healthscope Commercial	$861.99
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$814.10
Rate for Payer: Opus (Opus Packaging Group) HMA	$718.33
Rate for Payer: PHP Commercial	$814.10
Rate for Payer: Priority Health SBD	$603.40

HC DIALYSIS CATH LVL 9 LONG TERM

Facility

$957.77

Service Code	HCPCS C1750
Hospital Charge Code	27200320
Hospital Revenue Code	272
Min. Negotiated Rate	$376.40
Max. Negotiated Rate	$861.99
Rate for Payer: Aetna Commercial	$814.10
Rate for Payer: Aetna Medicare	$478.88
Rate for Payer: Aetna New Business (MI Preferred)	$622.55
Rate for Payer: BCBS Complete	$383.11
Rate for Payer: Cash Price	$766.22
Rate for Payer: Cofinity Advantage	$670.44
Rate for Payer: Cofinity Commercial	$823.68
Rate for Payer: Encore Health Key Benefits Commercial	$766.22
Rate for Payer: Healthscope Commercial	$861.99
Rate for Payer: MI Amish Medical Board Commercial	$766.22
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$814.10
Rate for Payer: Opus (Opus Packaging Group) HMA	$718.33
Rate for Payer: PHP Commercial	$814.10
Rate for Payer: Priority Health SBD	$603.40
Rate for Payer: UHC All Payor (Choice/PPO)	$622.55
Rate for Payer: UHC Core	$499.00
Rate for Payer: UHC Exchange	$376.40

HC DIFFUSION

Facility

$404.49

Service Code	CPT 94729
Hospital Charge Code	46000009
Hospital Revenue Code	460
Min. Negotiated Rate	$254.83
Max. Negotiated Rate	$364.04
Rate for Payer: Aetna Commercial	$343.82
Rate for Payer: Aetna New Business (MI Preferred)	$262.92
Rate for Payer: Cash Price	$323.59
Rate for Payer: Cofinity Advantage	$283.14
Rate for Payer: Cofinity Commercial	$347.86
Rate for Payer: Encore Health Key Benefits Commercial	$323.59
Rate for Payer: Healthscope Commercial	$364.04
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$343.82
Rate for Payer: Opus (Opus Packaging Group) HMA	$303.37
Rate for Payer: PHP Commercial	$343.82
Rate for Payer: Priority Health SBD	$254.83

HC DIFFUSION

Facility

$404.49

Service Code	CPT 94729
Hospital Charge Code	46000009
Hospital Revenue Code	460
Min. Negotiated Rate	$158.96
Max. Negotiated Rate	$364.04
Rate for Payer: Aetna Commercial	$343.82
Rate for Payer: Aetna Medicare	$202.25
Rate for Payer: Aetna New Business (MI Preferred)	$262.92
Rate for Payer: BCBS Complete	$161.80
Rate for Payer: BCBS Trust/PPO	$210.23
Rate for Payer: BCN Commercial	$210.23
Rate for Payer: Cash Price	$323.59
Rate for Payer: Cash Price	$323.59
Rate for Payer: Cofinity Advantage	$283.14
Rate for Payer: Cofinity Commercial	$347.86
Rate for Payer: Encore Health Key Benefits Commercial	$323.59
Rate for Payer: Healthscope Commercial	$364.04
Rate for Payer: MI Amish Medical Board Commercial	$323.59
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$343.82
Rate for Payer: Opus (Opus Packaging Group) HMA	$303.37
Rate for Payer: PHP Commercial	$343.82
Rate for Payer: Priority Health SBD	$254.83
Rate for Payer: UHC All Payor (Choice/PPO)	$262.92
Rate for Payer: UHC Core	$210.74
Rate for Payer: UHC Exchange	$158.96

Know your out-of-pocket cost for care.

All Charges