Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC IOM EEG CAROTID ENDARTERECTOMY

Facility

$1,272.44

Service Code	CPT 95955
Hospital Charge Code	74000014
Hospital Revenue Code	740
Min. Negotiated Rate	$186.97
Max. Negotiated Rate	$1,145.20
Rate for Payer: Aetna Commercial	$1,081.57
Rate for Payer: Aetna New Business (MI Preferred)	$827.09
Rate for Payer: BCBS Complete	$508.98
Rate for Payer: BCBS Trust/PPO	$644.75
Rate for Payer: Cash Price	$1,017.95
Rate for Payer: Cash Price	$1,017.95
Rate for Payer: Cofinity Commercial	$1,094.30
Rate for Payer: Cofinity Commercial	$890.71
Rate for Payer: Healthscope Commercial	$1,145.20
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,081.57
Rate for Payer: PHP Commercial	$1,081.57
Rate for Payer: Priority Health Cigna Priority Health	$890.71
Rate for Payer: Priority Health SBD	$801.64
Rate for Payer: UHC All Payor (Choice/PPO)	$205.67
Rate for Payer: UHC Exchange	$186.97

HC IOM EEG CAROTID ENDARTERECTOMY

Facility

$1,272.44

Service Code	CPT 95955
Hospital Charge Code	74000014
Hospital Revenue Code	740
Min. Negotiated Rate	$801.64
Max. Negotiated Rate	$1,145.20
Rate for Payer: Aetna Commercial	$1,081.57
Rate for Payer: Aetna New Business (MI Preferred)	$827.09
Rate for Payer: Cash Price	$1,017.95
Rate for Payer: Cofinity Commercial	$1,094.30
Rate for Payer: Cofinity Commercial	$890.71
Rate for Payer: Healthscope Commercial	$1,145.20
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,081.57
Rate for Payer: PHP Commercial	$1,081.57
Rate for Payer: Priority Health Cigna Priority Health	$890.71
Rate for Payer: Priority Health SBD	$801.64

HC IOM INTRAOPERATIVE MONITOR/15 MINUTES

Facility

$183.40

Service Code	CPT 95940
Hospital Charge Code	74000017
Hospital Revenue Code	740
Min. Negotiated Rate	$31.11
Max. Negotiated Rate	$165.06
Rate for Payer: Aetna Commercial	$155.89
Rate for Payer: Aetna New Business (MI Preferred)	$119.21
Rate for Payer: BCBS Complete	$73.36
Rate for Payer: Cash Price	$146.72
Rate for Payer: Cash Price	$146.72
Rate for Payer: Cofinity Commercial	$157.72
Rate for Payer: Cofinity Commercial	$128.38
Rate for Payer: Healthscope Commercial	$165.06
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$155.89
Rate for Payer: PHP Commercial	$155.89
Rate for Payer: Priority Health Cigna Priority Health	$128.38
Rate for Payer: Priority Health SBD	$115.54
Rate for Payer: UHC All Payor (Choice/PPO)	$34.22
Rate for Payer: UHC Exchange	$31.11

HC IOM INTRAOPERATIVE MONITOR/15 MINUTES

Facility

$183.40

Service Code	CPT 95940
Hospital Charge Code	74000017
Hospital Revenue Code	740
Min. Negotiated Rate	$115.54
Max. Negotiated Rate	$165.06
Rate for Payer: Aetna Commercial	$155.89
Rate for Payer: Aetna New Business (MI Preferred)	$119.21
Rate for Payer: Cash Price	$146.72
Rate for Payer: Cofinity Commercial	$128.38
Rate for Payer: Cofinity Commercial	$157.72
Rate for Payer: Healthscope Commercial	$165.06
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$155.89
Rate for Payer: PHP Commercial	$155.89
Rate for Payer: Priority Health Cigna Priority Health	$128.38
Rate for Payer: Priority Health SBD	$115.54

HC IOM STD PRASS PROBE

Facility

$350.37

Hospital Charge Code	62200008
Hospital Revenue Code	270
Min. Negotiated Rate	$140.15
Max. Negotiated Rate	$315.33
Rate for Payer: Aetna Commercial	$297.81
Rate for Payer: Aetna New Business (MI Preferred)	$227.74
Rate for Payer: BCBS Complete	$140.15
Rate for Payer: Cash Price	$280.30
Rate for Payer: Cofinity Commercial	$245.26
Rate for Payer: Cofinity Commercial	$301.32
Rate for Payer: Healthscope Commercial	$315.33
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$297.81
Rate for Payer: PHP Commercial	$297.81
Rate for Payer: Priority Health Cigna Priority Health	$245.26
Rate for Payer: Priority Health SBD	$220.73

HC IOM STD PRASS PROBE

Facility

$350.37

Hospital Charge Code	62200008
Hospital Revenue Code	270
Min. Negotiated Rate	$220.73
Max. Negotiated Rate	$315.33
Rate for Payer: Aetna Commercial	$297.81
Rate for Payer: Aetna New Business (MI Preferred)	$227.74
Rate for Payer: Cash Price	$280.30
Rate for Payer: Cofinity Commercial	$245.26
Rate for Payer: Cofinity Commercial	$301.32
Rate for Payer: Healthscope Commercial	$315.33
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$297.81
Rate for Payer: PHP Commercial	$297.81
Rate for Payer: Priority Health Cigna Priority Health	$245.26
Rate for Payer: Priority Health SBD	$220.73

HC IOM SUBDERMAL RECORDING ELECTR

Facility

$15.06

Hospital Charge Code	62200009
Hospital Revenue Code	270
Min. Negotiated Rate	$9.49
Max. Negotiated Rate	$13.55
Rate for Payer: Aetna Commercial	$12.80
Rate for Payer: Aetna New Business (MI Preferred)	$9.79
Rate for Payer: Cash Price	$12.05
Rate for Payer: Cofinity Commercial	$10.54
Rate for Payer: Cofinity Commercial	$12.95
Rate for Payer: Healthscope Commercial	$13.55
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$12.80
Rate for Payer: PHP Commercial	$12.80
Rate for Payer: Priority Health Cigna Priority Health	$10.54
Rate for Payer: Priority Health SBD	$9.49

HC IOM SUBDERMAL RECORDING ELECTR

Facility

$15.06

Hospital Charge Code	62200009
Hospital Revenue Code	270
Min. Negotiated Rate	$6.02
Max. Negotiated Rate	$13.55
Rate for Payer: Aetna Commercial	$12.80
Rate for Payer: Aetna New Business (MI Preferred)	$9.79
Rate for Payer: BCBS Complete	$6.02
Rate for Payer: Cash Price	$12.05
Rate for Payer: Cofinity Commercial	$10.54
Rate for Payer: Cofinity Commercial	$12.95
Rate for Payer: Healthscope Commercial	$13.55
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$12.80
Rate for Payer: PHP Commercial	$12.80
Rate for Payer: Priority Health Cigna Priority Health	$10.54
Rate for Payer: Priority Health SBD	$9.49

HC IONIZED CALCIUM

Facility

$105.40

Service Code	CPT 82330
Hospital Charge Code	30100130
Hospital Revenue Code	301
Min. Negotiated Rate	$7.48
Max. Negotiated Rate	$94.86
Rate for Payer: Aetna Commercial	$89.59
Rate for Payer: Aetna Medicare	$14.23
Rate for Payer: Aetna New Business (MI Preferred)	$68.51
Rate for Payer: Allen County Amish Medical Aid Commercial	$17.10
Rate for Payer: Amish Plain Church Group Commercial	$17.10
Rate for Payer: BCBS Complete	$7.86
Rate for Payer: BCBS MAPPO	$13.68
Rate for Payer: BCBS Trust/PPO	$10.71
Rate for Payer: BCN Medicare Advantage	$13.68
Rate for Payer: Cash Price	$84.32
Rate for Payer: Cash Price	$84.32
Rate for Payer: Cofinity Commercial	$90.64
Rate for Payer: Cofinity Commercial	$73.78
Rate for Payer: Health Alliance Plan Medicare Advantage	$13.68
Rate for Payer: Healthscope Commercial	$94.86
Rate for Payer: Mclaren Medicaid	$7.48
Rate for Payer: Mclaren Medicare	$13.68
Rate for Payer: Meridian Medicaid	$7.86
Rate for Payer: Meridian Wellcare - Medicare Advantage	$14.36
Rate for Payer: MI Amish Medical Board Commercial	$15.73
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$89.59
Rate for Payer: PACE Medicare	$13.00
Rate for Payer: PACE SWMI	$13.68
Rate for Payer: PHP Commercial	$89.59
Rate for Payer: PHP Medicare Advantage	$13.68
Rate for Payer: Priority Health Choice Medicaid	$7.48
Rate for Payer: Priority Health Cigna Priority Health	$73.78
Rate for Payer: Priority Health Medicare	$13.68
Rate for Payer: Priority Health SBD	$66.40
Rate for Payer: Railroad Medicare Medicare	$13.68
Rate for Payer: UHC All Payor (Choice/PPO)	$16.42
Rate for Payer: UHC Core	$23.23
Rate for Payer: UHC Dual Complete DSNP	$13.68
Rate for Payer: UHC Exchange	$13.68
Rate for Payer: UHC Medicare Advantage	$14.09
Rate for Payer: VA VA	$13.68

HC IONIZED CALCIUM

Facility

$105.40

Service Code	CPT 82330
Hospital Charge Code	30100130
Hospital Revenue Code	301
Min. Negotiated Rate	$66.40
Max. Negotiated Rate	$94.86
Rate for Payer: Aetna Commercial	$89.59
Rate for Payer: Aetna New Business (MI Preferred)	$68.51
Rate for Payer: Cash Price	$84.32
Rate for Payer: Cofinity Commercial	$73.78
Rate for Payer: Cofinity Commercial	$90.64
Rate for Payer: Healthscope Commercial	$94.86
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$89.59
Rate for Payer: PHP Commercial	$89.59
Rate for Payer: Priority Health Cigna Priority Health	$73.78
Rate for Payer: Priority Health SBD	$66.40

HC IONTOPHORESIS EACH 15 MIN

Facility

$104.04

Service Code	CPT 97033
Hospital Charge Code	42000016
Hospital Revenue Code	420
Min. Negotiated Rate	$13.17
Max. Negotiated Rate	$93.64
Rate for Payer: Aetna Commercial	$88.43
Rate for Payer: Aetna New Business (MI Preferred)	$67.63
Rate for Payer: BCBS Complete	$41.62
Rate for Payer: BCBS Trust/PPO	$13.17
Rate for Payer: Cash Price	$83.23
Rate for Payer: Cash Price	$83.23
Rate for Payer: Cofinity Commercial	$72.83
Rate for Payer: Cofinity Commercial	$89.47
Rate for Payer: Healthscope Commercial	$93.64
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$88.43
Rate for Payer: PHP Commercial	$88.43
Rate for Payer: Priority Health Cigna Priority Health	$72.83
Rate for Payer: Priority Health SBD	$65.55
Rate for Payer: UHC All Payor (Choice/PPO)	$20.89
Rate for Payer: UHC Exchange	$18.99

HC IONTOPHORESIS EACH 15 MIN

Facility

$104.04

Service Code	CPT 97033
Hospital Charge Code	42000016
Hospital Revenue Code	420
Min. Negotiated Rate	$65.55
Max. Negotiated Rate	$93.64
Rate for Payer: Aetna Commercial	$88.43
Rate for Payer: Aetna New Business (MI Preferred)	$67.63
Rate for Payer: Cash Price	$83.23
Rate for Payer: Cofinity Commercial	$72.83
Rate for Payer: Cofinity Commercial	$89.47
Rate for Payer: Healthscope Commercial	$93.64
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$88.43
Rate for Payer: PHP Commercial	$88.43
Rate for Payer: Priority Health Cigna Priority Health	$72.83
Rate for Payer: Priority Health SBD	$65.55

HC IP 1:1 HEMODIALYSIS

Facility

$950.00

Hospital Charge Code	80100002
Hospital Revenue Code	801
Min. Negotiated Rate	$380.00
Max. Negotiated Rate	$855.00
Rate for Payer: Aetna Commercial	$807.50
Rate for Payer: Aetna New Business (MI Preferred)	$617.50
Rate for Payer: BCBS Complete	$380.00
Rate for Payer: Cash Price	$760.00
Rate for Payer: Cofinity Commercial	$665.00
Rate for Payer: Cofinity Commercial	$817.00
Rate for Payer: Healthscope Commercial	$855.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$807.50
Rate for Payer: PHP Commercial	$807.50
Rate for Payer: Priority Health Cigna Priority Health	$665.00
Rate for Payer: Priority Health SBD	$598.50

HC IP 1:1 HEMODIALYSIS

Facility

$950.00

Hospital Charge Code	80100002
Hospital Revenue Code	801
Min. Negotiated Rate	$598.50
Max. Negotiated Rate	$855.00
Rate for Payer: Aetna Commercial	$807.50
Rate for Payer: Aetna New Business (MI Preferred)	$617.50
Rate for Payer: Cash Price	$760.00
Rate for Payer: Cofinity Commercial	$817.00
Rate for Payer: Cofinity Commercial	$665.00
Rate for Payer: Healthscope Commercial	$855.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$807.50
Rate for Payer: PHP Commercial	$807.50
Rate for Payer: Priority Health Cigna Priority Health	$665.00
Rate for Payer: Priority Health SBD	$598.50

HC IP 2:1 HEMODIALYSIS

Facility

$969.00

Service Code	HCPCS G0257
Hospital Charge Code	80100001
Hospital Revenue Code	801
Min. Negotiated Rate	$340.12
Max. Negotiated Rate	$2,039.31
Rate for Payer: Aetna Commercial	$823.65
Rate for Payer: Aetna Medicare	$646.66
Rate for Payer: Aetna New Business (MI Preferred)	$629.85
Rate for Payer: Allen County Amish Medical Aid Commercial	$777.24
Rate for Payer: Amish Plain Church Group Commercial	$777.24
Rate for Payer: BCBS Complete	$357.16
Rate for Payer: BCBS MAPPO	$621.79
Rate for Payer: BCN Medicare Advantage	$621.79
Rate for Payer: Cash Price	$775.20
Rate for Payer: Cash Price	$775.20
Rate for Payer: Cofinity Commercial	$833.34
Rate for Payer: Cofinity Commercial	$678.30
Rate for Payer: Health Alliance Plan Medicare Advantage	$621.79
Rate for Payer: Healthscope Commercial	$872.10
Rate for Payer: Mclaren Medicaid	$340.12
Rate for Payer: Mclaren Medicare	$621.79
Rate for Payer: Meridian Medicaid	$357.16
Rate for Payer: Meridian Wellcare - Medicare Advantage	$652.88
Rate for Payer: MI Amish Medical Board Commercial	$715.06
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$823.65
Rate for Payer: PACE Medicare	$590.70
Rate for Payer: PACE SWMI	$621.79
Rate for Payer: PHP Commercial	$823.65
Rate for Payer: PHP Medicare Advantage	$621.79
Rate for Payer: Priority Health Choice Medicaid	$340.12
Rate for Payer: Priority Health Cigna Priority Health	$678.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,039.31
Rate for Payer: Priority Health Medicare	$621.79
Rate for Payer: Priority Health Narrow Network	$1,631.45
Rate for Payer: Priority Health SBD	$610.47
Rate for Payer: Railroad Medicare Medicare	$621.79
Rate for Payer: UHC Dual Complete DSNP	$621.79
Rate for Payer: UHC Medicare Advantage	$640.44
Rate for Payer: VA VA	$621.79

HC IP 2:1 HEMODIALYSIS

Facility

$969.00

Service Code	HCPCS G0257
Hospital Charge Code	80100001
Hospital Revenue Code	801
Min. Negotiated Rate	$610.47
Max. Negotiated Rate	$872.10
Rate for Payer: Aetna Commercial	$823.65
Rate for Payer: Aetna New Business (MI Preferred)	$629.85
Rate for Payer: Cash Price	$775.20
Rate for Payer: Cofinity Commercial	$678.30
Rate for Payer: Cofinity Commercial	$833.34
Rate for Payer: Healthscope Commercial	$872.10
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$823.65
Rate for Payer: PHP Commercial	$823.65
Rate for Payer: Priority Health Cigna Priority Health	$678.30
Rate for Payer: Priority Health SBD	$610.47

HC IPPB/IPV TREATMENT

Facility

$135.92

Service Code	CPT 94640
Hospital Charge Code	41000015
Hospital Revenue Code	410
Min. Negotiated Rate	$7.86
Max. Negotiated Rate	$237.22
Rate for Payer: Aetna Commercial	$115.53
Rate for Payer: Aetna Medicare	$197.37
Rate for Payer: Aetna New Business (MI Preferred)	$88.35
Rate for Payer: Allen County Amish Medical Aid Commercial	$237.22
Rate for Payer: Amish Plain Church Group Commercial	$237.22
Rate for Payer: BCBS Complete	$109.01
Rate for Payer: BCBS MAPPO	$189.78
Rate for Payer: BCBS Trust/PPO	$39.92
Rate for Payer: BCN Medicare Advantage	$189.78
Rate for Payer: Cash Price	$108.74
Rate for Payer: Cash Price	$108.74
Rate for Payer: Cofinity Commercial	$116.89
Rate for Payer: Cofinity Commercial	$95.14
Rate for Payer: Health Alliance Plan Medicare Advantage	$189.78
Rate for Payer: Healthscope Commercial	$122.33
Rate for Payer: Mclaren Medicaid	$103.81
Rate for Payer: Mclaren Medicare	$189.78
Rate for Payer: Meridian Medicaid	$109.01
Rate for Payer: Meridian Wellcare - Medicare Advantage	$199.27
Rate for Payer: MI Amish Medical Board Commercial	$218.25
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$115.53
Rate for Payer: PACE Medicare	$180.29
Rate for Payer: PACE SWMI	$189.78
Rate for Payer: PHP Commercial	$115.53
Rate for Payer: PHP Medicare Advantage	$189.78
Rate for Payer: Priority Health Choice Medicaid	$103.81
Rate for Payer: Priority Health Cigna Priority Health	$95.14
Rate for Payer: Priority Health Medicare	$189.78
Rate for Payer: Priority Health SBD	$85.63
Rate for Payer: Railroad Medicare Medicare	$189.78
Rate for Payer: UHC All Payor (Choice/PPO)	$8.65
Rate for Payer: UHC Dual Complete DSNP	$189.78
Rate for Payer: UHC Exchange	$7.86
Rate for Payer: UHC Medicare Advantage	$195.47
Rate for Payer: VA VA	$189.78

HC IPPB/IPV TREATMENT

Facility

$135.92

Service Code	CPT 94640
Hospital Charge Code	41000015
Hospital Revenue Code	410
Min. Negotiated Rate	$85.63
Max. Negotiated Rate	$122.33
Rate for Payer: Aetna Commercial	$115.53
Rate for Payer: Aetna New Business (MI Preferred)	$88.35
Rate for Payer: Cash Price	$108.74
Rate for Payer: Cofinity Commercial	$116.89
Rate for Payer: Cofinity Commercial	$95.14
Rate for Payer: Healthscope Commercial	$122.33
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$115.53
Rate for Payer: PHP Commercial	$115.53
Rate for Payer: Priority Health Cigna Priority Health	$95.14
Rate for Payer: Priority Health SBD	$85.63

HC IPRATROPIUM BROMIDE, INHALATION SOLUTION, UNIT DOSE/MILLIGRAM

Facility

$4.08

Service Code	CPT J7644
Hospital Charge Code	63600112
Hospital Revenue Code	636
Min. Negotiated Rate	$2.57
Max. Negotiated Rate	$3.67
Rate for Payer: Aetna Commercial	$3.47
Rate for Payer: Aetna New Business (MI Preferred)	$2.65
Rate for Payer: Cash Price	$3.26
Rate for Payer: Cofinity Commercial	$2.86
Rate for Payer: Cofinity Commercial	$3.51
Rate for Payer: Healthscope Commercial	$3.67
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3.47
Rate for Payer: PHP Commercial	$3.47
Rate for Payer: Priority Health Cigna Priority Health	$2.86
Rate for Payer: Priority Health SBD	$2.57

HC IPRATROPIUM BROMIDE, INHALATION SOLUTION, UNIT DOSE/MILLIGRAM

Facility

$4.08

Service Code	CPT J7644
Hospital Charge Code	63600112
Hospital Revenue Code	636
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$3.67
Rate for Payer: Aetna Commercial	$3.47
Rate for Payer: Aetna New Business (MI Preferred)	$2.65
Rate for Payer: BCBS Complete	$1.63
Rate for Payer: BCBS Trust/PPO	$0.27
Rate for Payer: Cash Price	$3.26
Rate for Payer: Cash Price	$3.26
Rate for Payer: Cofinity Commercial	$2.86
Rate for Payer: Cofinity Commercial	$3.51
Rate for Payer: Healthscope Commercial	$3.67
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3.47
Rate for Payer: PHP Commercial	$3.47
Rate for Payer: Priority Health Cigna Priority Health	$2.86
Rate for Payer: Priority Health SBD	$2.57

HC IR ABSCESS DRAIN CATH PLACE

Facility

$860.90

Service Code	CPT 75989
Hospital Charge Code	35000021
Hospital Revenue Code	350
Min. Negotiated Rate	$542.37
Max. Negotiated Rate	$774.81
Rate for Payer: Aetna Commercial	$731.76
Rate for Payer: Aetna New Business (MI Preferred)	$559.58
Rate for Payer: Cash Price	$688.72
Rate for Payer: Cofinity Commercial	$602.63
Rate for Payer: Cofinity Commercial	$740.37
Rate for Payer: Healthscope Commercial	$774.81
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$731.76
Rate for Payer: PHP Commercial	$731.76
Rate for Payer: Priority Health Cigna Priority Health	$602.63
Rate for Payer: Priority Health SBD	$542.37

HC IR ABSCESS DRAIN CATH PLACE

Facility

$860.90

Service Code	CPT 75989
Hospital Charge Code	35000021
Hospital Revenue Code	350
Min. Negotiated Rate	$95.97
Max. Negotiated Rate	$774.81
Rate for Payer: Aetna Commercial	$731.76
Rate for Payer: Aetna New Business (MI Preferred)	$559.58
Rate for Payer: BCBS Complete	$344.36
Rate for Payer: BCBS Trust/PPO	$95.97
Rate for Payer: Cash Price	$688.72
Rate for Payer: Cash Price	$688.72
Rate for Payer: Cofinity Commercial	$740.37
Rate for Payer: Cofinity Commercial	$602.63
Rate for Payer: Healthscope Commercial	$774.81
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$731.76
Rate for Payer: PHP Commercial	$731.76
Rate for Payer: Priority Health Cigna Priority Health	$602.63
Rate for Payer: Priority Health SBD	$542.37
Rate for Payer: UHC All Payor (Choice/PPO)	$120.31
Rate for Payer: UHC Exchange	$109.37

HC IR ABSCESS DRAIN TUBE CHECK

Facility

$381.09

Service Code	CPT 76080
Hospital Charge Code	32000236
Hospital Revenue Code	320
Min. Negotiated Rate	$58.47
Max. Negotiated Rate	$1,504.47
Rate for Payer: Aetna Commercial	$323.93
Rate for Payer: Aetna Medicare	$510.52
Rate for Payer: Aetna New Business (MI Preferred)	$247.71
Rate for Payer: Allen County Amish Medical Aid Commercial	$613.60
Rate for Payer: Amish Plain Church Group Commercial	$613.60
Rate for Payer: BCBS Complete	$281.96
Rate for Payer: BCBS MAPPO	$490.88
Rate for Payer: BCBS Trust/PPO	$58.47
Rate for Payer: BCN Medicare Advantage	$490.88
Rate for Payer: Cash Price	$304.87
Rate for Payer: Cash Price	$304.87
Rate for Payer: Cofinity Commercial	$327.74
Rate for Payer: Cofinity Commercial	$266.76
Rate for Payer: Health Alliance Plan Medicare Advantage	$490.88
Rate for Payer: Healthscope Commercial	$342.98
Rate for Payer: Mclaren Medicaid	$268.51
Rate for Payer: Mclaren Medicare	$490.88
Rate for Payer: Meridian Medicaid	$281.96
Rate for Payer: Meridian Wellcare - Medicare Advantage	$515.42
Rate for Payer: MI Amish Medical Board Commercial	$564.51
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$323.93
Rate for Payer: PACE Medicare	$466.34
Rate for Payer: PACE SWMI	$490.88
Rate for Payer: PHP Commercial	$323.93
Rate for Payer: PHP Medicare Advantage	$490.88
Rate for Payer: Priority Health Choice Medicaid	$268.51
Rate for Payer: Priority Health Cigna Priority Health	$266.76
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,504.47
Rate for Payer: Priority Health Medicare	$490.88
Rate for Payer: Priority Health Narrow Network	$1,203.58
Rate for Payer: Priority Health SBD	$240.09
Rate for Payer: Railroad Medicare Medicare	$490.88
Rate for Payer: UHC All Payor (Choice/PPO)	$64.47
Rate for Payer: UHC Dual Complete DSNP	$490.88
Rate for Payer: UHC Exchange	$58.61
Rate for Payer: UHC Medicare Advantage	$505.61
Rate for Payer: VA VA	$490.88

HC IR ABSCESS DRAIN TUBE CHECK

Facility

$381.09

Service Code	CPT 76080
Hospital Charge Code	32000236
Hospital Revenue Code	320
Min. Negotiated Rate	$240.09
Max. Negotiated Rate	$342.98
Rate for Payer: Aetna Commercial	$323.93
Rate for Payer: Aetna New Business (MI Preferred)	$247.71
Rate for Payer: Cash Price	$304.87
Rate for Payer: Cofinity Commercial	$266.76
Rate for Payer: Cofinity Commercial	$327.74
Rate for Payer: Healthscope Commercial	$342.98
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$323.93
Rate for Payer: PHP Commercial	$323.93
Rate for Payer: Priority Health Cigna Priority Health	$266.76
Rate for Payer: Priority Health SBD	$240.09

HC IR ANGIO FU EMBO THROMBOLYSIS

Facility

$1,683.20

Service Code	CPT 75898
Hospital Charge Code	32000212
Hospital Revenue Code	320
Min. Negotiated Rate	$1,060.42
Max. Negotiated Rate	$1,514.88
Rate for Payer: Aetna Commercial	$1,430.72
Rate for Payer: Aetna New Business (MI Preferred)	$1,094.08
Rate for Payer: Cash Price	$1,346.56
Rate for Payer: Cofinity Commercial	$1,178.24
Rate for Payer: Cofinity Commercial	$1,447.55
Rate for Payer: Healthscope Commercial	$1,514.88
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,430.72
Rate for Payer: PHP Commercial	$1,430.72
Rate for Payer: Priority Health Cigna Priority Health	$1,178.24
Rate for Payer: Priority Health SBD	$1,060.42

Know your out-of-pocket cost for care.

All Charges