Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC CRRT INITIAL

Facility

$714.00

Hospital Charge Code	27000607
Hospital Revenue Code	270
Min. Negotiated Rate	$449.82
Max. Negotiated Rate	$642.60
Rate for Payer: Aetna Commercial	$606.90
Rate for Payer: Aetna New Business (MI Preferred)	$464.10
Rate for Payer: Cash Price	$571.20
Rate for Payer: Cofinity Commercial	$499.80
Rate for Payer: Cofinity Commercial	$614.04
Rate for Payer: Cofinity Medicare Advantage	$499.80
Rate for Payer: Encore Health Key Benefits Commercial	$571.20
Rate for Payer: Healthscope Commercial	$642.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$606.90
Rate for Payer: PHP Commercial	$606.90
Rate for Payer: Priority Health Cigna Priority Health	$464.10
Rate for Payer: Priority Health SBD	$449.82

HC CRRT INITIAL

Facility

$714.00

Hospital Charge Code	27000607
Hospital Revenue Code	270
Min. Negotiated Rate	$285.60
Max. Negotiated Rate	$642.60
Rate for Payer: Aetna Commercial	$606.90
Rate for Payer: Aetna Medicare	$357.00
Rate for Payer: Aetna New Business (MI Preferred)	$464.10
Rate for Payer: BCBS Complete	$285.60
Rate for Payer: Cash Price	$571.20
Rate for Payer: Cofinity Commercial	$499.80
Rate for Payer: Cofinity Commercial	$614.04
Rate for Payer: Cofinity Medicare Advantage	$499.80
Rate for Payer: Encore Health Key Benefits Commercial	$571.20
Rate for Payer: Healthscope Commercial	$642.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$606.90
Rate for Payer: PHP Commercial	$606.90
Rate for Payer: Priority Health Cigna Priority Health	$464.10
Rate for Payer: Priority Health SBD	$449.82

HC CRRT INITIATION/REINITIATION

Facility

$1,135.08

Service Code	CPT 90945
Hospital Charge Code	88000001
Hospital Revenue Code	809
Min. Negotiated Rate	$89.29
Max. Negotiated Rate	$1,311.28
Rate for Payer: Aetna Commercial	$964.82
Rate for Payer: Aetna Medicare	$433.90
Rate for Payer: Aetna New Business (MI Preferred)	$737.80
Rate for Payer: Allen County Amish Medical Aid Commercial	$521.51
Rate for Payer: Amish Plain Church Group Commercial	$521.51
Rate for Payer: BCBS Complete	$234.81
Rate for Payer: BCBS MAPPO	$417.21
Rate for Payer: BCN Medicare Advantage	$417.21
Rate for Payer: Cash Price	$908.06
Rate for Payer: Cash Price	$908.06
Rate for Payer: Cofinity Commercial	$794.56
Rate for Payer: Cofinity Commercial	$976.17
Rate for Payer: Cofinity Medicare Advantage	$794.56
Rate for Payer: Encore Health Key Benefits Commercial	$908.06
Rate for Payer: Health Alliance Plan Medicare Advantage	$417.21
Rate for Payer: Healthscope Commercial	$1,021.57
Rate for Payer: Mclaren Medicaid	$223.62
Rate for Payer: Mclaren Medicare	$417.21
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$438.07
Rate for Payer: Meridian Medicaid	$234.81
Rate for Payer: MI Amish Medical Board Commercial	$479.79
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$964.82
Rate for Payer: Nomi Health Commercial	$1,251.63
Rate for Payer: PACE Medicare	$396.35
Rate for Payer: PACE SWMI	$417.21
Rate for Payer: PHP Commercial	$964.82
Rate for Payer: PHP Medicare Advantage	$417.21
Rate for Payer: Priority Health Choice Medicaid	$223.62
Rate for Payer: Priority Health Cigna Priority Health	$737.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,311.28
Rate for Payer: Priority Health Medicare	$417.21
Rate for Payer: Priority Health Narrow Network	$1,049.02
Rate for Payer: Priority Health SBD	$715.10
Rate for Payer: Railroad Medicare Medicare	$417.21
Rate for Payer: UHC All Payor (Choice/PPO)	$89.29
Rate for Payer: UHC Dual Complete DSNP	$417.21
Rate for Payer: UHC Medicare Advantage	$417.21
Rate for Payer: UHCCP Medicaid	$234.89
Rate for Payer: VA VA	$417.21

HC CRRT INITIATION/REINITIATION

Facility

$1,135.08

Service Code	CPT 90945
Hospital Charge Code	88000001
Hospital Revenue Code	809
Min. Negotiated Rate	$715.10
Max. Negotiated Rate	$1,021.57
Rate for Payer: Aetna Commercial	$964.82
Rate for Payer: Aetna New Business (MI Preferred)	$737.80
Rate for Payer: Cash Price	$908.06
Rate for Payer: Cofinity Commercial	$794.56
Rate for Payer: Cofinity Commercial	$976.17
Rate for Payer: Cofinity Medicare Advantage	$794.56
Rate for Payer: Encore Health Key Benefits Commercial	$908.06
Rate for Payer: Healthscope Commercial	$1,021.57
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$964.82
Rate for Payer: PHP Commercial	$964.82
Rate for Payer: Priority Health Cigna Priority Health	$737.80
Rate for Payer: Priority Health SBD	$715.10

HC CRRT MONITOR FEE

Facility

$127.50

Hospital Charge Code	27000609
Hospital Revenue Code	270
Min. Negotiated Rate	$80.32
Max. Negotiated Rate	$114.75
Rate for Payer: Aetna Commercial	$108.38
Rate for Payer: Aetna New Business (MI Preferred)	$82.88
Rate for Payer: Cash Price	$102.00
Rate for Payer: Cofinity Commercial	$109.65
Rate for Payer: Cofinity Commercial	$89.25
Rate for Payer: Cofinity Medicare Advantage	$89.25
Rate for Payer: Encore Health Key Benefits Commercial	$102.00
Rate for Payer: Healthscope Commercial	$114.75
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$108.38
Rate for Payer: PHP Commercial	$108.38
Rate for Payer: Priority Health Cigna Priority Health	$82.88
Rate for Payer: Priority Health SBD	$80.32

HC CRRT MONITOR FEE

Facility

$127.50

Hospital Charge Code	27000609
Hospital Revenue Code	270
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$114.75
Rate for Payer: Aetna Commercial	$108.38
Rate for Payer: Aetna Medicare	$63.75
Rate for Payer: Aetna New Business (MI Preferred)	$82.88
Rate for Payer: BCBS Complete	$51.00
Rate for Payer: Cash Price	$102.00
Rate for Payer: Cofinity Commercial	$109.65
Rate for Payer: Cofinity Commercial	$89.25
Rate for Payer: Cofinity Medicare Advantage	$89.25
Rate for Payer: Encore Health Key Benefits Commercial	$102.00
Rate for Payer: Healthscope Commercial	$114.75
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$108.38
Rate for Payer: PHP Commercial	$108.38
Rate for Payer: Priority Health Cigna Priority Health	$82.88
Rate for Payer: Priority Health SBD	$80.32

HC CRRT MONITORING PER HOUR

Facility

$416.84

Hospital Charge Code	88000002
Hospital Revenue Code	809
Min. Negotiated Rate	$166.74
Max. Negotiated Rate	$375.16
Rate for Payer: Aetna Commercial	$354.31
Rate for Payer: Aetna Medicare	$208.42
Rate for Payer: Aetna New Business (MI Preferred)	$270.95
Rate for Payer: BCBS Complete	$166.74
Rate for Payer: Cash Price	$333.47
Rate for Payer: Cofinity Commercial	$291.79
Rate for Payer: Cofinity Commercial	$358.48
Rate for Payer: Cofinity Medicare Advantage	$291.79
Rate for Payer: Encore Health Key Benefits Commercial	$333.47
Rate for Payer: Healthscope Commercial	$375.16
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$354.31
Rate for Payer: PHP Commercial	$354.31
Rate for Payer: Priority Health Cigna Priority Health	$270.95
Rate for Payer: Priority Health SBD	$262.61

HC CRRT MONITORING PER HOUR

Facility

$416.84

Hospital Charge Code	88000002
Hospital Revenue Code	809
Min. Negotiated Rate	$262.61
Max. Negotiated Rate	$375.16
Rate for Payer: Aetna Commercial	$354.31
Rate for Payer: Aetna New Business (MI Preferred)	$270.95
Rate for Payer: Cash Price	$333.47
Rate for Payer: Cofinity Commercial	$291.79
Rate for Payer: Cofinity Commercial	$358.48
Rate for Payer: Cofinity Medicare Advantage	$291.79
Rate for Payer: Encore Health Key Benefits Commercial	$333.47
Rate for Payer: Healthscope Commercial	$375.16
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$354.31
Rate for Payer: PHP Commercial	$354.31
Rate for Payer: Priority Health Cigna Priority Health	$270.95
Rate for Payer: Priority Health SBD	$262.61

HC CRRT SUBSEQUENT CARTRIDGE

Facility

$280.50

Hospital Charge Code	27000608
Hospital Revenue Code	270
Min. Negotiated Rate	$176.72
Max. Negotiated Rate	$252.45
Rate for Payer: Aetna Commercial	$238.42
Rate for Payer: Aetna New Business (MI Preferred)	$182.32
Rate for Payer: Cash Price	$224.40
Rate for Payer: Cofinity Commercial	$196.35
Rate for Payer: Cofinity Commercial	$241.23
Rate for Payer: Cofinity Medicare Advantage	$196.35
Rate for Payer: Encore Health Key Benefits Commercial	$224.40
Rate for Payer: Healthscope Commercial	$252.45
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$238.42
Rate for Payer: PHP Commercial	$238.42
Rate for Payer: Priority Health Cigna Priority Health	$182.32
Rate for Payer: Priority Health SBD	$176.72

HC CRRT SUBSEQUENT CARTRIDGE

Facility

$280.50

Hospital Charge Code	27000608
Hospital Revenue Code	270
Min. Negotiated Rate	$112.20
Max. Negotiated Rate	$252.45
Rate for Payer: Aetna Commercial	$238.42
Rate for Payer: Aetna Medicare	$140.25
Rate for Payer: Aetna New Business (MI Preferred)	$182.32
Rate for Payer: BCBS Complete	$112.20
Rate for Payer: Cash Price	$224.40
Rate for Payer: Cofinity Commercial	$196.35
Rate for Payer: Cofinity Commercial	$241.23
Rate for Payer: Cofinity Medicare Advantage	$196.35
Rate for Payer: Encore Health Key Benefits Commercial	$224.40
Rate for Payer: Healthscope Commercial	$252.45
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$238.42
Rate for Payer: PHP Commercial	$238.42
Rate for Payer: Priority Health Cigna Priority Health	$182.32
Rate for Payer: Priority Health SBD	$176.72

HC CRUTCHES

Facility

$126.70

Hospital Charge Code	96000002
Hospital Revenue Code	270
Min. Negotiated Rate	$79.82
Max. Negotiated Rate	$114.03
Rate for Payer: Aetna Commercial	$107.70
Rate for Payer: Aetna New Business (MI Preferred)	$82.36
Rate for Payer: Cash Price	$101.36
Rate for Payer: Cofinity Commercial	$108.96
Rate for Payer: Cofinity Commercial	$88.69
Rate for Payer: Cofinity Medicare Advantage	$88.69
Rate for Payer: Encore Health Key Benefits Commercial	$101.36
Rate for Payer: Healthscope Commercial	$114.03
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$107.70
Rate for Payer: PHP Commercial	$107.70
Rate for Payer: Priority Health Cigna Priority Health	$82.36
Rate for Payer: Priority Health SBD	$79.82

HC CRUTCHES

Facility

$126.70

Hospital Charge Code	96000002
Hospital Revenue Code	270
Min. Negotiated Rate	$50.68
Max. Negotiated Rate	$114.03
Rate for Payer: Aetna Commercial	$107.70
Rate for Payer: Aetna Medicare	$63.35
Rate for Payer: Aetna New Business (MI Preferred)	$82.36
Rate for Payer: BCBS Complete	$50.68
Rate for Payer: Cash Price	$101.36
Rate for Payer: Cofinity Commercial	$108.96
Rate for Payer: Cofinity Commercial	$88.69
Rate for Payer: Cofinity Medicare Advantage	$88.69
Rate for Payer: Encore Health Key Benefits Commercial	$101.36
Rate for Payer: Healthscope Commercial	$114.03
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$107.70
Rate for Payer: PHP Commercial	$107.70
Rate for Payer: Priority Health Cigna Priority Health	$82.36
Rate for Payer: Priority Health SBD	$79.82

HC CRYOABLATION KIDNEY UNILATERAL

Facility

$12,081.12

Service Code	CPT 50593
Hospital Charge Code	36100572
Hospital Revenue Code	361
Min. Negotiated Rate	$7,611.11
Max. Negotiated Rate	$10,873.01
Rate for Payer: Aetna Commercial	$10,268.95
Rate for Payer: Aetna New Business (MI Preferred)	$7,852.73
Rate for Payer: Cash Price	$9,664.90
Rate for Payer: Cofinity Commercial	$10,389.76
Rate for Payer: Cofinity Commercial	$8,456.78
Rate for Payer: Cofinity Medicare Advantage	$8,456.78
Rate for Payer: Encore Health Key Benefits Commercial	$9,664.90
Rate for Payer: Healthscope Commercial	$10,873.01
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$10,268.95
Rate for Payer: PHP Commercial	$10,268.95
Rate for Payer: Priority Health Cigna Priority Health	$7,852.73
Rate for Payer: Priority Health SBD	$7,611.11

HC CRYOABLATION KIDNEY UNILATERAL

Facility

$12,081.12

Service Code	CPT 50593
Hospital Charge Code	36100572
Hospital Revenue Code	361
Min. Negotiated Rate	$476.51
Max. Negotiated Rate	$32,060.66
Rate for Payer: Aetna Commercial	$10,268.95
Rate for Payer: Aetna Medicare	$10,608.74
Rate for Payer: Aetna New Business (MI Preferred)	$7,852.73
Rate for Payer: Allen County Amish Medical Aid Commercial	$12,750.89
Rate for Payer: Amish Plain Church Group Commercial	$12,750.89
Rate for Payer: BCBS Complete	$5,740.96
Rate for Payer: BCBS MAPPO	$10,200.71
Rate for Payer: BCBS Trust/PPO	$3,600.81
Rate for Payer: BCN Commercial	$3,600.81
Rate for Payer: BCN Medicare Advantage	$10,200.71
Rate for Payer: Cash Price	$9,664.90
Rate for Payer: Cash Price	$9,664.90
Rate for Payer: Cash Price	$9,664.90
Rate for Payer: Cofinity Commercial	$10,389.76
Rate for Payer: Cofinity Commercial	$8,456.78
Rate for Payer: Cofinity Medicare Advantage	$8,456.78
Rate for Payer: Encore Health Key Benefits Commercial	$9,664.90
Rate for Payer: Health Alliance Plan Medicare Advantage	$10,200.71
Rate for Payer: Healthscope Commercial	$10,873.01
Rate for Payer: Mclaren Medicaid	$5,467.58
Rate for Payer: Mclaren Medicare	$10,200.71
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$10,710.75
Rate for Payer: Meridian Medicaid	$5,740.96
Rate for Payer: MI Amish Medical Board Commercial	$11,730.82
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$10,268.95
Rate for Payer: Nomi Health Commercial	$21,421.49
Rate for Payer: PACE Medicare	$9,690.67
Rate for Payer: PACE SWMI	$10,200.71
Rate for Payer: PHP Commercial	$10,268.95
Rate for Payer: PHP Medicare Advantage	$10,200.71
Rate for Payer: Priority Health Choice Medicaid	$5,467.58
Rate for Payer: Priority Health Cigna Priority Health	$7,852.73
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$32,060.66
Rate for Payer: Priority Health Medicare	$10,200.71
Rate for Payer: Priority Health Narrow Network	$25,648.53
Rate for Payer: Priority Health SBD	$7,611.11
Rate for Payer: Railroad Medicare Medicare	$10,200.71
Rate for Payer: UHC All Payor (Choice/PPO)	$476.51
Rate for Payer: UHC Core	$7,632.00
Rate for Payer: UHC Dual Complete DSNP	$10,200.71
Rate for Payer: UHC Exchange	$8,174.00
Rate for Payer: UHC Medicare Advantage	$10,200.71
Rate for Payer: UHCCP Medicaid	$5,743.00
Rate for Payer: VA VA	$10,200.71

HC CRYOABLATION LIVER TUMOR

Facility

$10,529.77

Service Code	CPT 47383
Hospital Charge Code	36100613
Hospital Revenue Code	361
Min. Negotiated Rate	$6,633.76
Max. Negotiated Rate	$9,476.79
Rate for Payer: Aetna Commercial	$8,950.30
Rate for Payer: Aetna New Business (MI Preferred)	$6,844.35
Rate for Payer: Cash Price	$8,423.82
Rate for Payer: Cofinity Commercial	$7,370.84
Rate for Payer: Cofinity Commercial	$9,055.60
Rate for Payer: Cofinity Medicare Advantage	$7,370.84
Rate for Payer: Encore Health Key Benefits Commercial	$8,423.82
Rate for Payer: Healthscope Commercial	$9,476.79
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$8,950.30
Rate for Payer: PHP Commercial	$8,950.30
Rate for Payer: Priority Health Cigna Priority Health	$6,844.35
Rate for Payer: Priority Health SBD	$6,633.76

HC CRYOABLATION LIVER TUMOR

Facility

$10,529.77

Service Code	CPT 47383
Hospital Charge Code	36100613
Hospital Revenue Code	361
Min. Negotiated Rate	$467.42
Max. Negotiated Rate	$32,060.66
Rate for Payer: Aetna Commercial	$8,950.30
Rate for Payer: Aetna Medicare	$10,608.74
Rate for Payer: Aetna New Business (MI Preferred)	$6,844.35
Rate for Payer: Allen County Amish Medical Aid Commercial	$12,750.89
Rate for Payer: Amish Plain Church Group Commercial	$12,750.89
Rate for Payer: BCBS Complete	$5,740.96
Rate for Payer: BCBS MAPPO	$10,200.71
Rate for Payer: BCBS Trust/PPO	$4,316.51
Rate for Payer: BCN Commercial	$4,316.51
Rate for Payer: BCN Medicare Advantage	$10,200.71
Rate for Payer: Cash Price	$8,423.82
Rate for Payer: Cash Price	$8,423.82
Rate for Payer: Cash Price	$8,423.82
Rate for Payer: Cofinity Commercial	$7,370.84
Rate for Payer: Cofinity Commercial	$9,055.60
Rate for Payer: Cofinity Medicare Advantage	$7,370.84
Rate for Payer: Encore Health Key Benefits Commercial	$8,423.82
Rate for Payer: Health Alliance Plan Medicare Advantage	$10,200.71
Rate for Payer: Healthscope Commercial	$9,476.79
Rate for Payer: Mclaren Medicaid	$5,467.58
Rate for Payer: Mclaren Medicare	$10,200.71
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$10,710.75
Rate for Payer: Meridian Medicaid	$5,740.96
Rate for Payer: MI Amish Medical Board Commercial	$11,730.82
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$8,950.30
Rate for Payer: Nomi Health Commercial	$21,421.49
Rate for Payer: PACE Medicare	$9,690.67
Rate for Payer: PACE SWMI	$10,200.71
Rate for Payer: PHP Commercial	$8,950.30
Rate for Payer: PHP Medicare Advantage	$10,200.71
Rate for Payer: Priority Health Choice Medicaid	$5,467.58
Rate for Payer: Priority Health Cigna Priority Health	$6,844.35
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$32,060.66
Rate for Payer: Priority Health Medicare	$10,200.71
Rate for Payer: Priority Health Narrow Network	$25,648.53
Rate for Payer: Priority Health SBD	$6,633.76
Rate for Payer: Railroad Medicare Medicare	$10,200.71
Rate for Payer: UHC All Payor (Choice/PPO)	$467.42
Rate for Payer: UHC Core	$7,632.00
Rate for Payer: UHC Dual Complete DSNP	$10,200.71
Rate for Payer: UHC Exchange	$8,174.00
Rate for Payer: UHC Medicare Advantage	$10,200.71
Rate for Payer: UHCCP Medicaid	$5,743.00
Rate for Payer: VA VA	$10,200.71

HC CRYOABLATION NASAL TISSUE OR NERVES UNI OR BIL

Facility

$10,891.56

Service Code	CPT 31243
Hospital Charge Code	76100399
Hospital Revenue Code	761
Min. Negotiated Rate	$6,861.68
Max. Negotiated Rate	$9,802.40
Rate for Payer: Aetna Commercial	$9,257.83
Rate for Payer: Aetna New Business (MI Preferred)	$7,079.51
Rate for Payer: Cash Price	$8,713.25
Rate for Payer: Cofinity Commercial	$7,624.09
Rate for Payer: Cofinity Commercial	$9,366.74
Rate for Payer: Cofinity Medicare Advantage	$7,624.09
Rate for Payer: Encore Health Key Benefits Commercial	$8,713.25
Rate for Payer: Healthscope Commercial	$9,802.40
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$9,257.83
Rate for Payer: PHP Commercial	$9,257.83
Rate for Payer: Priority Health Cigna Priority Health	$7,079.51
Rate for Payer: Priority Health SBD	$6,861.68

HC CRYOABLATION NASAL TISSUE OR NERVES UNI OR BIL

Facility

$10,891.56

Service Code	CPT 31243
Hospital Charge Code	76100399
Hospital Revenue Code	761
Min. Negotiated Rate	$167.31
Max. Negotiated Rate	$18,216.88
Rate for Payer: Aetna Commercial	$9,257.83
Rate for Payer: Aetna Medicare	$6,027.89
Rate for Payer: Aetna New Business (MI Preferred)	$7,079.51
Rate for Payer: Allen County Amish Medical Aid Commercial	$7,245.06
Rate for Payer: Amish Plain Church Group Commercial	$7,245.06
Rate for Payer: BCBS Complete	$3,262.02
Rate for Payer: BCBS MAPPO	$5,796.05
Rate for Payer: BCN Medicare Advantage	$5,796.05
Rate for Payer: Cash Price	$8,713.25
Rate for Payer: Cash Price	$8,713.25
Rate for Payer: Cash Price	$8,713.25
Rate for Payer: Cofinity Commercial	$9,366.74
Rate for Payer: Cofinity Commercial	$7,624.09
Rate for Payer: Cofinity Medicare Advantage	$7,624.09
Rate for Payer: Encore Health Key Benefits Commercial	$8,713.25
Rate for Payer: Health Alliance Plan Medicare Advantage	$5,796.05
Rate for Payer: Healthscope Commercial	$9,802.40
Rate for Payer: Mclaren Medicaid	$3,106.68
Rate for Payer: Mclaren Medicare	$5,796.05
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$6,085.85
Rate for Payer: Meridian Medicaid	$3,262.02
Rate for Payer: MI Amish Medical Board Commercial	$6,665.46
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$9,257.83
Rate for Payer: Nomi Health Commercial	$12,171.70
Rate for Payer: PACE Medicare	$5,506.25
Rate for Payer: PACE SWMI	$5,796.05
Rate for Payer: PHP Commercial	$9,257.83
Rate for Payer: PHP Medicare Advantage	$5,796.05
Rate for Payer: Priority Health Choice Medicaid	$3,106.68
Rate for Payer: Priority Health Cigna Priority Health	$7,079.51
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$18,216.88
Rate for Payer: Priority Health Medicare	$5,796.05
Rate for Payer: Priority Health Narrow Network	$14,573.50
Rate for Payer: Priority Health SBD	$6,861.68
Rate for Payer: Railroad Medicare Medicare	$5,796.05
Rate for Payer: UHC All Payor (Choice/PPO)	$167.31
Rate for Payer: UHC Core	$6,837.00
Rate for Payer: UHC Dual Complete DSNP	$5,796.05
Rate for Payer: UHC Medicare Advantage	$5,796.05
Rate for Payer: UHCCP Medicaid	$3,263.18
Rate for Payer: VA VA	$5,796.05

HC CRYOABLATION NEEDLE/PROBE

Facility

$3,526.96

Service Code	HCPCS C2618
Hospital Charge Code	27200244
Hospital Revenue Code	272
Min. Negotiated Rate	$2,221.98
Max. Negotiated Rate	$3,174.26
Rate for Payer: Aetna Commercial	$2,997.92
Rate for Payer: Aetna New Business (MI Preferred)	$2,292.52
Rate for Payer: Cash Price	$2,821.57
Rate for Payer: Cofinity Commercial	$2,468.87
Rate for Payer: Cofinity Commercial	$3,033.19
Rate for Payer: Cofinity Medicare Advantage	$2,468.87
Rate for Payer: Encore Health Key Benefits Commercial	$2,821.57
Rate for Payer: Healthscope Commercial	$3,174.26
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2,997.92
Rate for Payer: PHP Commercial	$2,997.92
Rate for Payer: Priority Health Cigna Priority Health	$2,292.52
Rate for Payer: Priority Health SBD	$2,221.98

HC CRYOABLATION NEEDLE/PROBE

Facility

$3,526.96

Service Code	HCPCS C2618
Hospital Charge Code	27200244
Hospital Revenue Code	272
Min. Negotiated Rate	$1,410.78
Max. Negotiated Rate	$3,174.26
Rate for Payer: Aetna Commercial	$2,997.92
Rate for Payer: Aetna Medicare	$1,763.48
Rate for Payer: Aetna New Business (MI Preferred)	$2,292.52
Rate for Payer: BCBS Complete	$1,410.78
Rate for Payer: Cash Price	$2,821.57
Rate for Payer: Cofinity Commercial	$2,468.87
Rate for Payer: Cofinity Commercial	$3,033.19
Rate for Payer: Cofinity Medicare Advantage	$2,468.87
Rate for Payer: Encore Health Key Benefits Commercial	$2,821.57
Rate for Payer: Healthscope Commercial	$3,174.26
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2,997.92
Rate for Payer: PHP Commercial	$2,997.92
Rate for Payer: Priority Health Cigna Priority Health	$2,292.52
Rate for Payer: Priority Health SBD	$2,221.98

HC CRYOABLATION STANDBY

Facility

$8,180.24

Hospital Charge Code	27200283
Hospital Revenue Code	272
Min. Negotiated Rate	$3,272.10
Max. Negotiated Rate	$7,362.22
Rate for Payer: Aetna Commercial	$6,953.20
Rate for Payer: Aetna Medicare	$4,090.12
Rate for Payer: Aetna New Business (MI Preferred)	$5,317.16
Rate for Payer: BCBS Complete	$3,272.10
Rate for Payer: Cash Price	$6,544.19
Rate for Payer: Cofinity Commercial	$5,726.17
Rate for Payer: Cofinity Commercial	$7,035.01
Rate for Payer: Cofinity Medicare Advantage	$5,726.17
Rate for Payer: Encore Health Key Benefits Commercial	$6,544.19
Rate for Payer: Healthscope Commercial	$7,362.22
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$6,953.20
Rate for Payer: PHP Commercial	$6,953.20
Rate for Payer: Priority Health Cigna Priority Health	$5,317.16
Rate for Payer: Priority Health SBD	$5,153.55

HC CRYOABLATION STANDBY

Facility

$8,180.24

Hospital Charge Code	27200283
Hospital Revenue Code	272
Min. Negotiated Rate	$5,153.55
Max. Negotiated Rate	$7,362.22
Rate for Payer: Aetna Commercial	$6,953.20
Rate for Payer: Aetna New Business (MI Preferred)	$5,317.16
Rate for Payer: Cash Price	$6,544.19
Rate for Payer: Cofinity Commercial	$5,726.17
Rate for Payer: Cofinity Commercial	$7,035.01
Rate for Payer: Cofinity Medicare Advantage	$5,726.17
Rate for Payer: Encore Health Key Benefits Commercial	$6,544.19
Rate for Payer: Healthscope Commercial	$7,362.22
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$6,953.20
Rate for Payer: PHP Commercial	$6,953.20
Rate for Payer: Priority Health Cigna Priority Health	$5,317.16
Rate for Payer: Priority Health SBD	$5,153.55

HC CRYOABLATION SUPPLIES

Facility

$12,272.17

Service Code	HCPCS C2618
Hospital Charge Code	27200284
Hospital Revenue Code	272
Min. Negotiated Rate	$7,731.47
Max. Negotiated Rate	$11,044.95
Rate for Payer: Aetna Commercial	$10,431.34
Rate for Payer: Aetna New Business (MI Preferred)	$7,976.91
Rate for Payer: Cash Price	$9,817.74
Rate for Payer: Cofinity Commercial	$10,554.07
Rate for Payer: Cofinity Commercial	$8,590.52
Rate for Payer: Cofinity Medicare Advantage	$8,590.52
Rate for Payer: Encore Health Key Benefits Commercial	$9,817.74
Rate for Payer: Healthscope Commercial	$11,044.95
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$10,431.34
Rate for Payer: PHP Commercial	$10,431.34
Rate for Payer: Priority Health Cigna Priority Health	$7,976.91
Rate for Payer: Priority Health SBD	$7,731.47

HC CRYOABLATION SUPPLIES

Facility

$12,272.17

Service Code	HCPCS C2618
Hospital Charge Code	27200284
Hospital Revenue Code	272
Min. Negotiated Rate	$4,908.87
Max. Negotiated Rate	$11,044.95
Rate for Payer: Aetna Commercial	$10,431.34
Rate for Payer: Aetna Medicare	$6,136.08
Rate for Payer: Aetna New Business (MI Preferred)	$7,976.91
Rate for Payer: BCBS Complete	$4,908.87
Rate for Payer: Cash Price	$9,817.74
Rate for Payer: Cofinity Commercial	$10,554.07
Rate for Payer: Cofinity Commercial	$8,590.52
Rate for Payer: Cofinity Medicare Advantage	$8,590.52
Rate for Payer: Encore Health Key Benefits Commercial	$9,817.74
Rate for Payer: Healthscope Commercial	$11,044.95
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$10,431.34
Rate for Payer: PHP Commercial	$10,431.34
Rate for Payer: Priority Health Cigna Priority Health	$7,976.91
Rate for Payer: Priority Health SBD	$7,731.47

HC CRYOGLOBULINS

Facility

$19.77

Service Code	CPT 82595
Hospital Charge Code	30100184
Hospital Revenue Code	301
Min. Negotiated Rate	$12.46
Max. Negotiated Rate	$17.79
Rate for Payer: Aetna Commercial	$16.80
Rate for Payer: Aetna New Business (MI Preferred)	$12.85
Rate for Payer: Cash Price	$15.82
Rate for Payer: Cofinity Commercial	$13.84
Rate for Payer: Cofinity Commercial	$17.00
Rate for Payer: Cofinity Medicare Advantage	$13.84
Rate for Payer: Encore Health Key Benefits Commercial	$15.82
Rate for Payer: Healthscope Commercial	$17.79
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$16.80
Rate for Payer: PHP Commercial	$16.80
Rate for Payer: Priority Health Cigna Priority Health	$12.85
Rate for Payer: Priority Health SBD	$12.46

Know your out-of-pocket cost for care.

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