Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC KETONES (ACETONE)

Facility

$36.10

Service Code	CPT 82009
Hospital Charge Code	30100067
Hospital Revenue Code	301
Min. Negotiated Rate	$22.74
Max. Negotiated Rate	$32.49
Rate for Payer: Aetna Commercial	$30.68
Rate for Payer: Aetna New Business (MI Preferred)	$23.46
Rate for Payer: Cash Price	$28.88
Rate for Payer: Cofinity Commercial	$31.05
Rate for Payer: Cofinity Commercial	$25.27
Rate for Payer: Healthscope Commercial	$32.49
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$30.68
Rate for Payer: PHP Commercial	$30.68
Rate for Payer: Priority Health Cigna Priority Health	$25.27
Rate for Payer: Priority Health SBD	$22.74

HC KIDNEY ENDOSCOPY

Facility

$5,852.76

Service Code	CPT 50551
Hospital Charge Code	76100307
Hospital Revenue Code	761
Min. Negotiated Rate	$283.56
Max. Negotiated Rate	$13,737.10
Rate for Payer: Aetna Commercial	$4,974.85
Rate for Payer: Aetna Medicare	$4,788.26
Rate for Payer: Aetna New Business (MI Preferred)	$3,804.29
Rate for Payer: Allen County Amish Medical Aid Commercial	$5,755.12
Rate for Payer: Amish Plain Church Group Commercial	$5,755.12
Rate for Payer: BCBS Complete	$2,644.60
Rate for Payer: BCBS MAPPO	$4,604.10
Rate for Payer: BCBS Trust/PPO	$1,510.65
Rate for Payer: BCN Medicare Advantage	$4,604.10
Rate for Payer: Cash Price	$4,682.21
Rate for Payer: Cash Price	$4,682.21
Rate for Payer: Cofinity Commercial	$5,033.37
Rate for Payer: Cofinity Commercial	$4,096.93
Rate for Payer: Health Alliance Plan Medicare Advantage	$4,604.10
Rate for Payer: Healthscope Commercial	$5,267.48
Rate for Payer: Mclaren Medicaid	$2,518.44
Rate for Payer: Mclaren Medicare	$4,604.10
Rate for Payer: Meridian Medicaid	$2,644.60
Rate for Payer: Meridian Wellcare - Medicare Advantage	$4,834.30
Rate for Payer: MI Amish Medical Board Commercial	$5,294.72
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$4,974.85
Rate for Payer: PACE Medicare	$4,373.90
Rate for Payer: PACE SWMI	$4,604.10
Rate for Payer: PHP Commercial	$4,974.85
Rate for Payer: PHP Medicare Advantage	$4,604.10
Rate for Payer: Priority Health Choice Medicaid	$2,518.44
Rate for Payer: Priority Health Cigna Priority Health	$4,096.93
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$13,737.10
Rate for Payer: Priority Health Medicare	$4,604.10
Rate for Payer: Priority Health Narrow Network	$10,989.68
Rate for Payer: Priority Health SBD	$3,687.24
Rate for Payer: Railroad Medicare Medicare	$4,604.10
Rate for Payer: UHC All Payor (Choice/PPO)	$311.92
Rate for Payer: UHC Dual Complete DSNP	$4,604.10
Rate for Payer: UHC Exchange	$283.56
Rate for Payer: UHC Medicare Advantage	$4,742.22
Rate for Payer: VA VA	$4,604.10

HC KIDNEY ENDOSCOPY

Facility

$5,852.76

Service Code	CPT 50551
Hospital Charge Code	76100307
Hospital Revenue Code	761
Min. Negotiated Rate	$3,687.24
Max. Negotiated Rate	$5,267.48
Rate for Payer: Aetna Commercial	$4,974.85
Rate for Payer: Aetna New Business (MI Preferred)	$3,804.29
Rate for Payer: Cash Price	$4,682.21
Rate for Payer: Cofinity Commercial	$4,096.93
Rate for Payer: Cofinity Commercial	$5,033.37
Rate for Payer: Healthscope Commercial	$5,267.48
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$4,974.85
Rate for Payer: PHP Commercial	$4,974.85
Rate for Payer: Priority Health Cigna Priority Health	$4,096.93
Rate for Payer: Priority Health SBD	$3,687.24

HC KINEVAC 5 MCG IV

Facility

$135.72

Service Code	HCPCS J2805
Hospital Charge Code	63600014
Hospital Revenue Code	636
Min. Negotiated Rate	$54.29
Max. Negotiated Rate	$394.04
Rate for Payer: Aetna Commercial	$115.36
Rate for Payer: Aetna New Business (MI Preferred)	$88.22
Rate for Payer: BCBS Complete	$54.29
Rate for Payer: BCBS Trust/PPO	$394.04
Rate for Payer: Cash Price	$108.58
Rate for Payer: Cash Price	$108.58
Rate for Payer: Cofinity Commercial	$116.72
Rate for Payer: Cofinity Commercial	$95.00
Rate for Payer: Healthscope Commercial	$122.15
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$115.36
Rate for Payer: PHP Commercial	$115.36
Rate for Payer: Priority Health Cigna Priority Health	$95.00
Rate for Payer: Priority Health SBD	$85.50

HC KINEVAC 5 MCG IV

Facility

$135.72

Service Code	HCPCS J2805
Hospital Charge Code	63600014
Hospital Revenue Code	636
Min. Negotiated Rate	$85.50
Max. Negotiated Rate	$122.15
Rate for Payer: Aetna Commercial	$115.36
Rate for Payer: Aetna New Business (MI Preferred)	$88.22
Rate for Payer: Cash Price	$108.58
Rate for Payer: Cofinity Commercial	$116.72
Rate for Payer: Cofinity Commercial	$95.00
Rate for Payer: Healthscope Commercial	$122.15
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$115.36
Rate for Payer: PHP Commercial	$115.36
Rate for Payer: Priority Health Cigna Priority Health	$95.00
Rate for Payer: Priority Health SBD	$85.50

HC KIT ATS

Facility

$150.00

Hospital Charge Code	27000666
Hospital Revenue Code	270
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$135.00
Rate for Payer: Aetna Commercial	$127.50
Rate for Payer: Aetna New Business (MI Preferred)	$97.50
Rate for Payer: BCBS Complete	$60.00
Rate for Payer: Cash Price	$120.00
Rate for Payer: Cofinity Commercial	$105.00
Rate for Payer: Cofinity Commercial	$129.00
Rate for Payer: Healthscope Commercial	$135.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$127.50
Rate for Payer: PHP Commercial	$127.50
Rate for Payer: Priority Health Cigna Priority Health	$105.00
Rate for Payer: Priority Health SBD	$94.50

HC KIT ATS

Facility

$150.00

Hospital Charge Code	27000666
Hospital Revenue Code	270
Min. Negotiated Rate	$94.50
Max. Negotiated Rate	$135.00
Rate for Payer: Aetna Commercial	$127.50
Rate for Payer: Aetna New Business (MI Preferred)	$97.50
Rate for Payer: Cash Price	$120.00
Rate for Payer: Cofinity Commercial	$105.00
Rate for Payer: Cofinity Commercial	$129.00
Rate for Payer: Healthscope Commercial	$135.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$127.50
Rate for Payer: PHP Commercial	$127.50
Rate for Payer: Priority Health Cigna Priority Health	$105.00
Rate for Payer: Priority Health SBD	$94.50

HC KIT DILATOR VASC

Facility

$525.00

Hospital Charge Code	27000101
Hospital Revenue Code	270
Min. Negotiated Rate	$210.00
Max. Negotiated Rate	$472.50
Rate for Payer: Aetna Commercial	$446.25
Rate for Payer: Aetna New Business (MI Preferred)	$341.25
Rate for Payer: BCBS Complete	$210.00
Rate for Payer: Cash Price	$420.00
Rate for Payer: Cofinity Commercial	$367.50
Rate for Payer: Cofinity Commercial	$451.50
Rate for Payer: Healthscope Commercial	$472.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$446.25
Rate for Payer: PHP Commercial	$446.25
Rate for Payer: Priority Health Cigna Priority Health	$367.50
Rate for Payer: Priority Health SBD	$330.75

HC KIT DILATOR VASC

Facility

$525.00

Hospital Charge Code	27000101
Hospital Revenue Code	270
Min. Negotiated Rate	$330.75
Max. Negotiated Rate	$472.50
Rate for Payer: Aetna Commercial	$446.25
Rate for Payer: Aetna New Business (MI Preferred)	$341.25
Rate for Payer: Cash Price	$420.00
Rate for Payer: Cofinity Commercial	$367.50
Rate for Payer: Cofinity Commercial	$451.50
Rate for Payer: Healthscope Commercial	$472.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$446.25
Rate for Payer: PHP Commercial	$446.25
Rate for Payer: Priority Health Cigna Priority Health	$367.50
Rate for Payer: Priority Health SBD	$330.75

HC KLEIHAUER-BETKE STAIN

Facility

$120.80

Service Code	CPT 85460
Hospital Charge Code	30500046
Hospital Revenue Code	305
Min. Negotiated Rate	$4.23
Max. Negotiated Rate	$108.72
Rate for Payer: Aetna Commercial	$102.68
Rate for Payer: Aetna Medicare	$8.04
Rate for Payer: Aetna New Business (MI Preferred)	$78.52
Rate for Payer: Allen County Amish Medical Aid Commercial	$9.66
Rate for Payer: Amish Plain Church Group Commercial	$9.66
Rate for Payer: BCBS Complete	$4.44
Rate for Payer: BCBS MAPPO	$7.73
Rate for Payer: BCBS Trust/PPO	$6.06
Rate for Payer: BCN Medicare Advantage	$7.73
Rate for Payer: Cash Price	$96.64
Rate for Payer: Cash Price	$96.64
Rate for Payer: Cofinity Commercial	$84.56
Rate for Payer: Cofinity Commercial	$103.89
Rate for Payer: Health Alliance Plan Medicare Advantage	$7.73
Rate for Payer: Healthscope Commercial	$108.72
Rate for Payer: Mclaren Medicaid	$4.23
Rate for Payer: Mclaren Medicare	$7.73
Rate for Payer: Meridian Medicaid	$4.44
Rate for Payer: Meridian Wellcare - Medicare Advantage	$8.12
Rate for Payer: MI Amish Medical Board Commercial	$8.89
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$102.68
Rate for Payer: PACE Medicare	$7.34
Rate for Payer: PACE SWMI	$7.73
Rate for Payer: PHP Commercial	$102.68
Rate for Payer: PHP Medicare Advantage	$7.73
Rate for Payer: Priority Health Choice Medicaid	$4.23
Rate for Payer: Priority Health Cigna Priority Health	$84.56
Rate for Payer: Priority Health Medicare	$7.73
Rate for Payer: Priority Health SBD	$76.10
Rate for Payer: Railroad Medicare Medicare	$7.73
Rate for Payer: UHC All Payor (Choice/PPO)	$9.28
Rate for Payer: UHC Core	$13.16
Rate for Payer: UHC Dual Complete DSNP	$7.73
Rate for Payer: UHC Exchange	$7.73
Rate for Payer: UHC Medicare Advantage	$7.96
Rate for Payer: VA VA	$7.73

HC KLEIHAUER-BETKE STAIN

Facility

$120.80

Service Code	CPT 85460
Hospital Charge Code	30500046
Hospital Revenue Code	305
Min. Negotiated Rate	$76.10
Max. Negotiated Rate	$108.72
Rate for Payer: Aetna Commercial	$102.68
Rate for Payer: Aetna New Business (MI Preferred)	$78.52
Rate for Payer: Cash Price	$96.64
Rate for Payer: Cofinity Commercial	$103.89
Rate for Payer: Cofinity Commercial	$84.56
Rate for Payer: Healthscope Commercial	$108.72
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$102.68
Rate for Payer: PHP Commercial	$102.68
Rate for Payer: Priority Health Cigna Priority Health	$84.56
Rate for Payer: Priority Health SBD	$76.10

HC KOH PREPARATION

Facility

$23.46

Service Code	CPT 87220
Hospital Charge Code	30600111
Hospital Revenue Code	306
Min. Negotiated Rate	$2.34
Max. Negotiated Rate	$21.11
Rate for Payer: Aetna Commercial	$19.94
Rate for Payer: Aetna Medicare	$4.44
Rate for Payer: Aetna New Business (MI Preferred)	$15.25
Rate for Payer: Allen County Amish Medical Aid Commercial	$5.34
Rate for Payer: Amish Plain Church Group Commercial	$5.34
Rate for Payer: BCBS Complete	$2.45
Rate for Payer: BCBS MAPPO	$4.27
Rate for Payer: BCBS Trust/PPO	$3.34
Rate for Payer: BCN Medicare Advantage	$4.27
Rate for Payer: Cash Price	$18.77
Rate for Payer: Cash Price	$18.77
Rate for Payer: Cofinity Commercial	$16.42
Rate for Payer: Cofinity Commercial	$20.18
Rate for Payer: Health Alliance Plan Medicare Advantage	$4.27
Rate for Payer: Healthscope Commercial	$21.11
Rate for Payer: Mclaren Medicaid	$2.34
Rate for Payer: Mclaren Medicare	$4.27
Rate for Payer: Meridian Medicaid	$2.45
Rate for Payer: Meridian Wellcare - Medicare Advantage	$4.48
Rate for Payer: MI Amish Medical Board Commercial	$4.91
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$19.94
Rate for Payer: PACE Medicare	$4.06
Rate for Payer: PACE SWMI	$4.27
Rate for Payer: PHP Commercial	$19.94
Rate for Payer: PHP Medicare Advantage	$4.27
Rate for Payer: Priority Health Choice Medicaid	$2.34
Rate for Payer: Priority Health Cigna Priority Health	$16.42
Rate for Payer: Priority Health Medicare	$4.27
Rate for Payer: Priority Health SBD	$14.78
Rate for Payer: Railroad Medicare Medicare	$4.27
Rate for Payer: UHC All Payor (Choice/PPO)	$5.12
Rate for Payer: UHC Core	$7.26
Rate for Payer: UHC Dual Complete DSNP	$4.27
Rate for Payer: UHC Exchange	$4.27
Rate for Payer: UHC Medicare Advantage	$4.40
Rate for Payer: VA VA	$4.27

HC KOH PREPARATION

Facility

$23.46

Service Code	CPT 87220
Hospital Charge Code	30600111
Hospital Revenue Code	306
Min. Negotiated Rate	$14.78
Max. Negotiated Rate	$21.11
Rate for Payer: Aetna Commercial	$19.94
Rate for Payer: Aetna New Business (MI Preferred)	$15.25
Rate for Payer: Cash Price	$18.77
Rate for Payer: Cofinity Commercial	$16.42
Rate for Payer: Cofinity Commercial	$20.18
Rate for Payer: Healthscope Commercial	$21.11
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$19.94
Rate for Payer: PHP Commercial	$19.94
Rate for Payer: Priority Health Cigna Priority Health	$16.42
Rate for Payer: Priority Health SBD	$14.78

HC KYLEENA 19.5MG

Facility

$2,878.85

Service Code	CPT J7296
Hospital Charge Code	63600165
Hospital Revenue Code	636
Min. Negotiated Rate	$1,813.68
Max. Negotiated Rate	$2,590.96
Rate for Payer: Aetna Commercial	$2,447.02
Rate for Payer: Aetna New Business (MI Preferred)	$1,871.25
Rate for Payer: Cash Price	$2,303.08
Rate for Payer: Cofinity Commercial	$2,015.20
Rate for Payer: Cofinity Commercial	$2,475.81
Rate for Payer: Healthscope Commercial	$2,590.96
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,447.02
Rate for Payer: PHP Commercial	$2,447.02
Rate for Payer: Priority Health Cigna Priority Health	$2,015.20
Rate for Payer: Priority Health SBD	$1,813.68

HC KYLEENA 19.5MG

Facility

$2,878.85

Service Code	CPT J7296
Hospital Charge Code	63600165
Hospital Revenue Code	636
Min. Negotiated Rate	$1,151.54
Max. Negotiated Rate	$3,249.85
Rate for Payer: Aetna Commercial	$2,447.02
Rate for Payer: Aetna New Business (MI Preferred)	$1,871.25
Rate for Payer: BCBS Complete	$1,151.54
Rate for Payer: BCBS Trust/PPO	$3,249.85
Rate for Payer: Cash Price	$2,303.08
Rate for Payer: Cash Price	$2,303.08
Rate for Payer: Cofinity Commercial	$2,015.20
Rate for Payer: Cofinity Commercial	$2,475.81
Rate for Payer: Healthscope Commercial	$2,590.96
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,447.02
Rate for Payer: PHP Commercial	$2,447.02
Rate for Payer: Priority Health Cigna Priority Health	$2,015.20
Rate for Payer: Priority Health SBD	$1,813.68

HC LAAC IMPLANT

Facility

$18,207.00

Hospital Charge Code	27800117
Hospital Revenue Code	278
Min. Negotiated Rate	$7,282.80
Max. Negotiated Rate	$16,386.30
Rate for Payer: Aetna Commercial	$15,475.95
Rate for Payer: Aetna New Business (MI Preferred)	$11,834.55
Rate for Payer: BCBS Complete	$7,282.80
Rate for Payer: Cash Price	$14,565.60
Rate for Payer: Cofinity Commercial	$12,744.90
Rate for Payer: Cofinity Commercial	$15,658.02
Rate for Payer: Healthscope Commercial	$16,386.30
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$15,475.95
Rate for Payer: PHP Commercial	$15,475.95
Rate for Payer: Priority Health Cigna Priority Health	$12,744.90
Rate for Payer: Priority Health SBD	$11,470.41

HC LAAC IMPLANT

Facility

$18,207.00

Hospital Charge Code	27800117
Hospital Revenue Code	278
Min. Negotiated Rate	$11,470.41
Max. Negotiated Rate	$16,386.30
Rate for Payer: Aetna Commercial	$15,475.95
Rate for Payer: Aetna New Business (MI Preferred)	$11,834.55
Rate for Payer: Cash Price	$14,565.60
Rate for Payer: Cofinity Commercial	$12,744.90
Rate for Payer: Cofinity Commercial	$15,658.02
Rate for Payer: Healthscope Commercial	$16,386.30
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$15,475.95
Rate for Payer: PHP Commercial	$15,475.95
Rate for Payer: Priority Health Cigna Priority Health	$12,744.90
Rate for Payer: Priority Health SBD	$11,470.41

HC LABOR CAT (1) 0-2HRS

Facility

$1,500.99

Hospital Charge Code	72000001
Hospital Revenue Code	720
Min. Negotiated Rate	$600.40
Max. Negotiated Rate	$1,350.89
Rate for Payer: Aetna Commercial	$1,275.84
Rate for Payer: Aetna New Business (MI Preferred)	$975.64
Rate for Payer: BCBS Complete	$600.40
Rate for Payer: Cash Price	$1,200.79
Rate for Payer: Cofinity Commercial	$1,050.69
Rate for Payer: Cofinity Commercial	$1,290.85
Rate for Payer: Healthscope Commercial	$1,350.89
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,275.84
Rate for Payer: PHP Commercial	$1,275.84
Rate for Payer: Priority Health Cigna Priority Health	$1,050.69
Rate for Payer: Priority Health SBD	$945.62
Rate for Payer: UHC Core	$1,110.73

HC LABOR CAT (1) 0-2HRS

Facility

$1,500.99

Hospital Charge Code	72000001
Hospital Revenue Code	720
Min. Negotiated Rate	$945.62
Max. Negotiated Rate	$1,350.89
Rate for Payer: Aetna Commercial	$1,275.84
Rate for Payer: Aetna New Business (MI Preferred)	$975.64
Rate for Payer: Cash Price	$1,200.79
Rate for Payer: Cofinity Commercial	$1,050.69
Rate for Payer: Cofinity Commercial	$1,290.85
Rate for Payer: Healthscope Commercial	$1,350.89
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,275.84
Rate for Payer: PHP Commercial	$1,275.84
Rate for Payer: Priority Health Cigna Priority Health	$1,050.69
Rate for Payer: Priority Health SBD	$945.62

HC LABOR CAT (2) 2-5HRS

Facility

$2,001.38

Hospital Charge Code	72000002
Hospital Revenue Code	720
Min. Negotiated Rate	$800.55
Max. Negotiated Rate	$1,801.24
Rate for Payer: Aetna Commercial	$1,701.17
Rate for Payer: Aetna New Business (MI Preferred)	$1,300.90
Rate for Payer: BCBS Complete	$800.55
Rate for Payer: Cash Price	$1,601.10
Rate for Payer: Cofinity Commercial	$1,400.97
Rate for Payer: Cofinity Commercial	$1,721.19
Rate for Payer: Healthscope Commercial	$1,801.24
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,701.17
Rate for Payer: PHP Commercial	$1,701.17
Rate for Payer: Priority Health Cigna Priority Health	$1,400.97
Rate for Payer: Priority Health SBD	$1,260.87
Rate for Payer: UHC Core	$1,481.02

HC LABOR CAT (2) 2-5HRS

Facility

$2,001.38

Hospital Charge Code	72000002
Hospital Revenue Code	720
Min. Negotiated Rate	$1,260.87
Max. Negotiated Rate	$1,801.24
Rate for Payer: Aetna Commercial	$1,701.17
Rate for Payer: Aetna New Business (MI Preferred)	$1,300.90
Rate for Payer: Cash Price	$1,601.10
Rate for Payer: Cofinity Commercial	$1,400.97
Rate for Payer: Cofinity Commercial	$1,721.19
Rate for Payer: Healthscope Commercial	$1,801.24
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,701.17
Rate for Payer: PHP Commercial	$1,701.17
Rate for Payer: Priority Health Cigna Priority Health	$1,400.97
Rate for Payer: Priority Health SBD	$1,260.87

HC LABOR CAT (3) 5-8HRS

Facility

$2,501.62

Hospital Charge Code	72000003
Hospital Revenue Code	720
Min. Negotiated Rate	$1,000.65
Max. Negotiated Rate	$2,251.46
Rate for Payer: Aetna Commercial	$2,126.38
Rate for Payer: Aetna New Business (MI Preferred)	$1,626.05
Rate for Payer: BCBS Complete	$1,000.65
Rate for Payer: Cash Price	$2,001.30
Rate for Payer: Cofinity Commercial	$1,751.13
Rate for Payer: Cofinity Commercial	$2,151.39
Rate for Payer: Healthscope Commercial	$2,251.46
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,126.38
Rate for Payer: PHP Commercial	$2,126.38
Rate for Payer: Priority Health Cigna Priority Health	$1,751.13
Rate for Payer: Priority Health SBD	$1,576.02
Rate for Payer: UHC Core	$1,851.20

HC LABOR CAT (3) 5-8HRS

Facility

$2,501.62

Hospital Charge Code	72000003
Hospital Revenue Code	720
Min. Negotiated Rate	$1,576.02
Max. Negotiated Rate	$2,251.46
Rate for Payer: Aetna Commercial	$2,126.38
Rate for Payer: Aetna New Business (MI Preferred)	$1,626.05
Rate for Payer: Cash Price	$2,001.30
Rate for Payer: Cofinity Commercial	$1,751.13
Rate for Payer: Cofinity Commercial	$2,151.39
Rate for Payer: Healthscope Commercial	$2,251.46
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,126.38
Rate for Payer: PHP Commercial	$2,126.38
Rate for Payer: Priority Health Cigna Priority Health	$1,751.13
Rate for Payer: Priority Health SBD	$1,576.02

HC LABOR CAT (4) 8-12HRS

Facility

$3,001.99

Hospital Charge Code	72000004
Hospital Revenue Code	720
Min. Negotiated Rate	$1,891.25
Max. Negotiated Rate	$2,701.79
Rate for Payer: Aetna Commercial	$2,551.69
Rate for Payer: Aetna New Business (MI Preferred)	$1,951.29
Rate for Payer: Cash Price	$2,401.59
Rate for Payer: Cofinity Commercial	$2,101.39
Rate for Payer: Cofinity Commercial	$2,581.71
Rate for Payer: Healthscope Commercial	$2,701.79
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,551.69
Rate for Payer: PHP Commercial	$2,551.69
Rate for Payer: Priority Health Cigna Priority Health	$2,101.39
Rate for Payer: Priority Health SBD	$1,891.25

HC LABOR CAT (4) 8-12HRS

Facility

$3,001.99

Hospital Charge Code	72000004
Hospital Revenue Code	720
Min. Negotiated Rate	$1,200.80
Max. Negotiated Rate	$2,701.79
Rate for Payer: Aetna Commercial	$2,551.69
Rate for Payer: Aetna New Business (MI Preferred)	$1,951.29
Rate for Payer: BCBS Complete	$1,200.80
Rate for Payer: Cash Price	$2,401.59
Rate for Payer: Cofinity Commercial	$2,101.39
Rate for Payer: Cofinity Commercial	$2,581.71
Rate for Payer: Healthscope Commercial	$2,701.79
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,551.69
Rate for Payer: PHP Commercial	$2,551.69
Rate for Payer: Priority Health Cigna Priority Health	$2,101.39
Rate for Payer: Priority Health SBD	$1,891.25
Rate for Payer: UHC Core	$2,221.47

Know your out-of-pocket cost for care.

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