Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC FILSHIE CLIP

Facility

$342.54

Hospital Charge Code	27000076
Hospital Revenue Code	270
Min. Negotiated Rate	$215.80
Max. Negotiated Rate	$308.29
Rate for Payer: Aetna Commercial	$291.16
Rate for Payer: Aetna New Business (MI Preferred)	$222.65
Rate for Payer: Cash Price	$274.03
Rate for Payer: Cofinity Advantage	$239.78
Rate for Payer: Cofinity Commercial	$294.58
Rate for Payer: Encore Health Key Benefits Commercial	$274.03
Rate for Payer: Healthscope Commercial	$308.29
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$291.16
Rate for Payer: Opus (Opus Packaging Group) HMA	$256.90
Rate for Payer: PHP Commercial	$291.16
Rate for Payer: Priority Health SBD	$215.80

HC FILTER ATS LIPIGUARD

Facility

$59.30

Hospital Charge Code	27000121
Hospital Revenue Code	270
Min. Negotiated Rate	$23.30
Max. Negotiated Rate	$53.37
Rate for Payer: Aetna Commercial	$50.41
Rate for Payer: Aetna Medicare	$29.65
Rate for Payer: Aetna New Business (MI Preferred)	$38.55
Rate for Payer: BCBS Complete	$23.72
Rate for Payer: Cash Price	$47.44
Rate for Payer: Cofinity Advantage	$41.51
Rate for Payer: Cofinity Commercial	$51.00
Rate for Payer: Encore Health Key Benefits Commercial	$47.44
Rate for Payer: Healthscope Commercial	$53.37
Rate for Payer: MI Amish Medical Board Commercial	$47.44
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$50.41
Rate for Payer: Opus (Opus Packaging Group) HMA	$44.48
Rate for Payer: PHP Commercial	$50.41
Rate for Payer: Priority Health SBD	$37.36
Rate for Payer: UHC All Payor (Choice/PPO)	$38.55
Rate for Payer: UHC Core	$30.90
Rate for Payer: UHC Exchange	$23.30

HC FILTER ATS LIPIGUARD

Facility

$59.30

Hospital Charge Code	27000121
Hospital Revenue Code	270
Min. Negotiated Rate	$37.36
Max. Negotiated Rate	$53.37
Rate for Payer: Aetna Commercial	$50.41
Rate for Payer: Aetna New Business (MI Preferred)	$38.55
Rate for Payer: Cash Price	$47.44
Rate for Payer: Cofinity Advantage	$41.51
Rate for Payer: Cofinity Commercial	$51.00
Rate for Payer: Encore Health Key Benefits Commercial	$47.44
Rate for Payer: Healthscope Commercial	$53.37
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$50.41
Rate for Payer: Opus (Opus Packaging Group) HMA	$44.48
Rate for Payer: PHP Commercial	$50.41
Rate for Payer: Priority Health SBD	$37.36

HC FILTERWIRE

Facility

$3,890.74

Service Code	HCPCS C1884
Hospital Charge Code	27800011
Hospital Revenue Code	278
Min. Negotiated Rate	$1,529.06
Max. Negotiated Rate	$3,501.67
Rate for Payer: Aetna Commercial	$3,307.13
Rate for Payer: Aetna Medicare	$1,945.37
Rate for Payer: Aetna New Business (MI Preferred)	$2,528.98
Rate for Payer: BCBS Complete	$1,556.30
Rate for Payer: Cash Price	$3,112.59
Rate for Payer: Cofinity Advantage	$2,723.52
Rate for Payer: Cofinity Commercial	$3,346.04
Rate for Payer: Encore Health Key Benefits Commercial	$3,112.59
Rate for Payer: Healthscope Commercial	$3,501.67
Rate for Payer: MI Amish Medical Board Commercial	$3,112.59
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3,307.13
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,918.05
Rate for Payer: PHP Commercial	$3,307.13
Rate for Payer: Priority Health SBD	$2,451.17
Rate for Payer: UHC All Payor (Choice/PPO)	$2,528.98
Rate for Payer: UHC Core	$2,027.08
Rate for Payer: UHC Exchange	$1,529.06

HC FILTERWIRE

Facility

$3,890.74

Service Code	HCPCS C1884
Hospital Charge Code	27800011
Hospital Revenue Code	278
Min. Negotiated Rate	$2,451.17
Max. Negotiated Rate	$3,501.67
Rate for Payer: Aetna Commercial	$3,307.13
Rate for Payer: Aetna New Business (MI Preferred)	$2,528.98
Rate for Payer: Cash Price	$3,112.59
Rate for Payer: Cofinity Advantage	$2,723.52
Rate for Payer: Cofinity Commercial	$3,346.04
Rate for Payer: Encore Health Key Benefits Commercial	$3,112.59
Rate for Payer: Healthscope Commercial	$3,501.67
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3,307.13
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,918.05
Rate for Payer: PHP Commercial	$3,307.13
Rate for Payer: Priority Health SBD	$2,451.17

HC FINGER SPLINT, STATIC, SUPPLY

Facility

$21.23

Hospital Charge Code	27000646
Hospital Revenue Code	270
Min. Negotiated Rate	$8.34
Max. Negotiated Rate	$19.11
Rate for Payer: Aetna Commercial	$18.05
Rate for Payer: Aetna Medicare	$10.62
Rate for Payer: Aetna New Business (MI Preferred)	$13.80
Rate for Payer: BCBS Complete	$8.49
Rate for Payer: Cash Price	$16.98
Rate for Payer: Cofinity Advantage	$14.86
Rate for Payer: Cofinity Commercial	$18.26
Rate for Payer: Encore Health Key Benefits Commercial	$16.98
Rate for Payer: Healthscope Commercial	$19.11
Rate for Payer: MI Amish Medical Board Commercial	$16.98
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$18.05
Rate for Payer: Opus (Opus Packaging Group) HMA	$15.92
Rate for Payer: PHP Commercial	$18.05
Rate for Payer: Priority Health SBD	$13.37
Rate for Payer: UHC All Payor (Choice/PPO)	$13.80
Rate for Payer: UHC Core	$11.06
Rate for Payer: UHC Exchange	$8.34

HC FINGER SPLINT, STATIC, SUPPLY

Facility

$21.23

Hospital Charge Code	27000646
Hospital Revenue Code	270
Min. Negotiated Rate	$13.37
Max. Negotiated Rate	$19.11
Rate for Payer: Aetna Commercial	$18.05
Rate for Payer: Aetna New Business (MI Preferred)	$13.80
Rate for Payer: Cash Price	$16.98
Rate for Payer: Cofinity Advantage	$14.86
Rate for Payer: Cofinity Commercial	$18.26
Rate for Payer: Encore Health Key Benefits Commercial	$16.98
Rate for Payer: Healthscope Commercial	$19.11
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$18.05
Rate for Payer: Opus (Opus Packaging Group) HMA	$15.92
Rate for Payer: PHP Commercial	$18.05
Rate for Payer: Priority Health SBD	$13.37

HC FISH PRENATAL ANEUPLOIDY

Facility

$171.91

Service Code	CPT 88275
Hospital Charge Code	31000034
Hospital Revenue Code	310
Min. Negotiated Rate	$108.30
Max. Negotiated Rate	$154.72
Rate for Payer: Aetna Commercial	$146.12
Rate for Payer: Aetna New Business (MI Preferred)	$111.74
Rate for Payer: Cash Price	$137.53
Rate for Payer: Cofinity Advantage	$120.34
Rate for Payer: Cofinity Commercial	$147.84
Rate for Payer: Encore Health Key Benefits Commercial	$137.53
Rate for Payer: Healthscope Commercial	$154.72
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$146.12
Rate for Payer: Opus (Opus Packaging Group) HMA	$128.93
Rate for Payer: PHP Commercial	$146.12
Rate for Payer: Priority Health SBD	$108.30

HC FISH PRENATAL ANEUPLOIDY

Facility

$171.91

Service Code	CPT 88275
Hospital Charge Code	31000034
Hospital Revenue Code	310
Min. Negotiated Rate	$26.77
Max. Negotiated Rate	$154.72
Rate for Payer: Aetna Commercial	$146.12
Rate for Payer: Aetna Medicare	$53.24
Rate for Payer: Aetna New Business (MI Preferred)	$111.74
Rate for Payer: Allen County Amish Medical Aid Commercial	$63.99
Rate for Payer: Amish Plain Church Group Commercial	$63.99
Rate for Payer: BCBS Complete	$28.11
Rate for Payer: BCBS MAPPO	$51.19
Rate for Payer: BCBS Trust/PPO	$54.58
Rate for Payer: BCN Commercial	$54.58
Rate for Payer: BCN Medicare Advantage	$51.19
Rate for Payer: Cash Price	$137.53
Rate for Payer: Cash Price	$137.53
Rate for Payer: Cofinity Advantage	$120.34
Rate for Payer: Cofinity Commercial	$147.84
Rate for Payer: Encore Health Key Benefits Commercial	$137.53
Rate for Payer: Health Alliance Plan Medicare Advantage	$51.19
Rate for Payer: Healthscope Commercial	$154.72
Rate for Payer: Mclaren Medicaid	$26.77
Rate for Payer: Mclaren Medicare	$51.19
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$53.75
Rate for Payer: Meridian Medicaid	$53.75
Rate for Payer: MI Amish Medical Board Commercial	$58.87
Rate for Payer: Molina Medicare/Medicaid	$56.31
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$146.12
Rate for Payer: Nomi Health Commercial	$76.78
Rate for Payer: Opus (Opus Packaging Group) HMA	$128.93
Rate for Payer: PACE Medicare	$48.63
Rate for Payer: PACE SWMI	$51.19
Rate for Payer: PHP Commercial	$146.12
Rate for Payer: PHP Medicare Advantage	$51.19
Rate for Payer: Priority Health Choice Medicaid	$26.77
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$51.19
Rate for Payer: Priority Health Medicare	$51.19
Rate for Payer: Priority Health SBD	$108.30
Rate for Payer: Priority Health Tiered Network	$40.95
Rate for Payer: Railroad Medicare Medicare	$51.19
Rate for Payer: UHC All Payor (Choice/PPO)	$76.79
Rate for Payer: UHC Core	$76.79
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$51.19
Rate for Payer: UHC Exchange	$76.79
Rate for Payer: UHC Medicaid	$26.77
Rate for Payer: UHCCP Medicaid	$26.77
Rate for Payer: VA VA	$51.19

HC FISH PROBES

Facility

$79.43

Service Code	CPT 88275
Hospital Charge Code	31000067
Hospital Revenue Code	310
Min. Negotiated Rate	$50.04
Max. Negotiated Rate	$71.49
Rate for Payer: Aetna Commercial	$67.52
Rate for Payer: Aetna New Business (MI Preferred)	$51.63
Rate for Payer: Cash Price	$63.54
Rate for Payer: Cofinity Advantage	$55.60
Rate for Payer: Cofinity Commercial	$68.31
Rate for Payer: Encore Health Key Benefits Commercial	$63.54
Rate for Payer: Healthscope Commercial	$71.49
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$67.52
Rate for Payer: Opus (Opus Packaging Group) HMA	$59.57
Rate for Payer: PHP Commercial	$67.52
Rate for Payer: Priority Health SBD	$50.04

HC FISH PROBES

Facility

$79.43

Service Code	CPT 88275
Hospital Charge Code	31000067
Hospital Revenue Code	310
Min. Negotiated Rate	$26.77
Max. Negotiated Rate	$76.79
Rate for Payer: Aetna Commercial	$67.52
Rate for Payer: Aetna Medicare	$53.24
Rate for Payer: Aetna New Business (MI Preferred)	$51.63
Rate for Payer: Allen County Amish Medical Aid Commercial	$63.99
Rate for Payer: Amish Plain Church Group Commercial	$63.99
Rate for Payer: BCBS Complete	$28.11
Rate for Payer: BCBS MAPPO	$51.19
Rate for Payer: BCBS Trust/PPO	$54.58
Rate for Payer: BCN Commercial	$54.58
Rate for Payer: BCN Medicare Advantage	$51.19
Rate for Payer: Cash Price	$63.54
Rate for Payer: Cash Price	$63.54
Rate for Payer: Cofinity Advantage	$55.60
Rate for Payer: Cofinity Commercial	$68.31
Rate for Payer: Encore Health Key Benefits Commercial	$63.54
Rate for Payer: Health Alliance Plan Medicare Advantage	$51.19
Rate for Payer: Healthscope Commercial	$71.49
Rate for Payer: Mclaren Medicaid	$26.77
Rate for Payer: Mclaren Medicare	$51.19
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$53.75
Rate for Payer: Meridian Medicaid	$53.75
Rate for Payer: MI Amish Medical Board Commercial	$58.87
Rate for Payer: Molina Medicare/Medicaid	$56.31
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$67.52
Rate for Payer: Nomi Health Commercial	$76.78
Rate for Payer: Opus (Opus Packaging Group) HMA	$59.57
Rate for Payer: PACE Medicare	$48.63
Rate for Payer: PACE SWMI	$51.19
Rate for Payer: PHP Commercial	$67.52
Rate for Payer: PHP Medicare Advantage	$51.19
Rate for Payer: Priority Health Choice Medicaid	$26.77
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$51.19
Rate for Payer: Priority Health Medicare	$51.19
Rate for Payer: Priority Health SBD	$50.04
Rate for Payer: Priority Health Tiered Network	$40.95
Rate for Payer: Railroad Medicare Medicare	$51.19
Rate for Payer: UHC All Payor (Choice/PPO)	$76.79
Rate for Payer: UHC Core	$76.79
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$51.19
Rate for Payer: UHC Exchange	$76.79
Rate for Payer: UHC Medicaid	$26.77
Rate for Payer: UHCCP Medicaid	$26.77
Rate for Payer: VA VA	$51.19

HC FISTULA SHUNTOGRAM

Facility

$2,299.22

Hospital Charge Code	32000264
Hospital Revenue Code	360
Min. Negotiated Rate	$919.69
Max. Negotiated Rate	$2,069.30
Rate for Payer: Aetna Commercial	$1,954.34
Rate for Payer: Aetna Medicare	$1,149.61
Rate for Payer: Aetna New Business (MI Preferred)	$1,494.49
Rate for Payer: BCBS Complete	$919.69
Rate for Payer: Cash Price	$1,839.38
Rate for Payer: Cofinity Advantage	$1,609.45
Rate for Payer: Cofinity Commercial	$1,977.33
Rate for Payer: Encore Health Key Benefits Commercial	$1,839.38
Rate for Payer: Healthscope Commercial	$2,069.30
Rate for Payer: MI Amish Medical Board Commercial	$1,839.38
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,954.34
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,724.41
Rate for Payer: PHP Commercial	$1,954.34
Rate for Payer: Priority Health SBD	$1,448.51

HC FISTULA SHUNTOGRAM

Facility

$2,299.22

Hospital Charge Code	32000264
Hospital Revenue Code	360
Min. Negotiated Rate	$1,448.51
Max. Negotiated Rate	$2,069.30
Rate for Payer: Aetna Commercial	$1,954.34
Rate for Payer: Aetna New Business (MI Preferred)	$1,494.49
Rate for Payer: Cash Price	$1,839.38
Rate for Payer: Cofinity Advantage	$1,609.45
Rate for Payer: Cofinity Commercial	$1,977.33
Rate for Payer: Encore Health Key Benefits Commercial	$1,839.38
Rate for Payer: Healthscope Commercial	$2,069.30
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,954.34
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,724.41
Rate for Payer: PHP Commercial	$1,954.34
Rate for Payer: Priority Health SBD	$1,448.51

HC FIT INSERT INTRAVAG SUPPORT DEVICE

Facility

$264.14

Service Code	CPT 57150
Hospital Charge Code	76100203
Hospital Revenue Code	761
Min. Negotiated Rate	$166.41
Max. Negotiated Rate	$237.73
Rate for Payer: Aetna Commercial	$224.52
Rate for Payer: Aetna New Business (MI Preferred)	$171.69
Rate for Payer: Cash Price	$211.31
Rate for Payer: Cofinity Advantage	$184.90
Rate for Payer: Cofinity Commercial	$227.16
Rate for Payer: Encore Health Key Benefits Commercial	$211.31
Rate for Payer: Healthscope Commercial	$237.73
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$224.52
Rate for Payer: Opus (Opus Packaging Group) HMA	$198.10
Rate for Payer: PHP Commercial	$224.52
Rate for Payer: Priority Health SBD	$166.41

HC FIT INSERT INTRAVAG SUPPORT DEVICE

Facility

$264.14

Service Code	CPT 57150
Hospital Charge Code	76100203
Hospital Revenue Code	761
Min. Negotiated Rate	$30.74
Max. Negotiated Rate	$237.73
Rate for Payer: Cofinity Commercial	$227.16
Rate for Payer: Aetna Commercial	$224.52
Rate for Payer: Aetna Medicare	$61.13
Rate for Payer: Aetna New Business (MI Preferred)	$171.69
Rate for Payer: Allen County Amish Medical Aid Commercial	$73.47
Rate for Payer: Amish Plain Church Group Commercial	$73.47
Rate for Payer: BCBS Complete	$32.28
Rate for Payer: BCBS MAPPO	$58.78
Rate for Payer: BCBS Trust/PPO	$68.67
Rate for Payer: BCN Commercial	$68.67
Rate for Payer: BCN Medicare Advantage	$58.78
Rate for Payer: Cash Price	$211.31
Rate for Payer: Cash Price	$211.31
Rate for Payer: Cash Price	$211.31
Rate for Payer: Cofinity Advantage	$184.90
Rate for Payer: Encore Health Key Benefits Commercial	$211.31
Rate for Payer: Health Alliance Plan Medicare Advantage	$58.78
Rate for Payer: Healthscope Commercial	$237.73
Rate for Payer: Mclaren Medicaid	$30.74
Rate for Payer: Mclaren Medicare	$58.78
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$61.72
Rate for Payer: Meridian Medicaid	$61.72
Rate for Payer: MI Amish Medical Board Commercial	$67.60
Rate for Payer: Molina Medicare/Medicaid	$64.66
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$224.52
Rate for Payer: Nomi Health Commercial	$176.34
Rate for Payer: Opus (Opus Packaging Group) HMA	$198.10
Rate for Payer: PACE Medicare	$55.84
Rate for Payer: PACE SWMI	$58.78
Rate for Payer: PHP Commercial	$224.52
Rate for Payer: PHP Medicare Advantage	$58.78
Rate for Payer: Priority Health Choice Medicaid	$30.74
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$190.09
Rate for Payer: Priority Health Medicare	$58.78
Rate for Payer: Priority Health SBD	$166.41
Rate for Payer: Priority Health Tiered Network	$152.07
Rate for Payer: Railroad Medicare Medicare	$58.78
Rate for Payer: UHC All Payor (Choice/PPO)	$171.69
Rate for Payer: UHC Core	$137.62
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$58.78
Rate for Payer: UHC Exchange	$103.81
Rate for Payer: UHC Medicaid	$30.74
Rate for Payer: UHCCP Medicaid	$30.74
Rate for Payer: VA VA	$58.78

HC FIT & INSERT PESSARY/OTHER DEVICE

Facility

$535.45

Service Code	CPT 57160
Hospital Charge Code	76100357
Hospital Revenue Code	761
Min. Negotiated Rate	$105.35
Max. Negotiated Rate	$651.46
Rate for Payer: Aetna Commercial	$455.13
Rate for Payer: Aetna Medicare	$209.50
Rate for Payer: Aetna New Business (MI Preferred)	$348.04
Rate for Payer: Allen County Amish Medical Aid Commercial	$251.80
Rate for Payer: Amish Plain Church Group Commercial	$251.80
Rate for Payer: BCBS Complete	$110.63
Rate for Payer: BCBS MAPPO	$201.44
Rate for Payer: BCBS Trust/PPO	$146.87
Rate for Payer: BCN Commercial	$146.87
Rate for Payer: BCN Medicare Advantage	$201.44
Rate for Payer: Cash Price	$428.36
Rate for Payer: Cash Price	$428.36
Rate for Payer: Cash Price	$428.36
Rate for Payer: Cofinity Advantage	$374.81
Rate for Payer: Cofinity Commercial	$460.49
Rate for Payer: Encore Health Key Benefits Commercial	$428.36
Rate for Payer: Health Alliance Plan Medicare Advantage	$201.44
Rate for Payer: Healthscope Commercial	$481.90
Rate for Payer: Mclaren Medicaid	$105.35
Rate for Payer: Mclaren Medicare	$201.44
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$211.51
Rate for Payer: Meridian Medicaid	$211.51
Rate for Payer: MI Amish Medical Board Commercial	$231.66
Rate for Payer: Molina Medicare/Medicaid	$221.58
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$455.13
Rate for Payer: Nomi Health Commercial	$604.32
Rate for Payer: Opus (Opus Packaging Group) HMA	$401.59
Rate for Payer: PACE Medicare	$191.37
Rate for Payer: PACE SWMI	$201.44
Rate for Payer: PHP Commercial	$455.13
Rate for Payer: PHP Medicare Advantage	$201.44
Rate for Payer: Priority Health Choice Medicaid	$105.35
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$651.46
Rate for Payer: Priority Health Medicare	$201.44
Rate for Payer: Priority Health SBD	$337.33
Rate for Payer: Priority Health Tiered Network	$521.17
Rate for Payer: Railroad Medicare Medicare	$201.44
Rate for Payer: UHC All Payor (Choice/PPO)	$348.04
Rate for Payer: UHC Core	$278.97
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$201.44
Rate for Payer: UHC Exchange	$210.43
Rate for Payer: UHC Medicaid	$105.35
Rate for Payer: UHCCP Medicaid	$105.35
Rate for Payer: VA VA	$201.44

HC FIT & INSERT PESSARY/OTHER DEVICE

Facility

$535.45

Service Code	CPT 57160
Hospital Charge Code	76100357
Hospital Revenue Code	761
Min. Negotiated Rate	$337.33
Max. Negotiated Rate	$481.90
Rate for Payer: Aetna Commercial	$455.13
Rate for Payer: Aetna New Business (MI Preferred)	$348.04
Rate for Payer: Cash Price	$428.36
Rate for Payer: Cofinity Advantage	$374.81
Rate for Payer: Cofinity Commercial	$460.49
Rate for Payer: Encore Health Key Benefits Commercial	$428.36
Rate for Payer: Healthscope Commercial	$481.90
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$455.13
Rate for Payer: Opus (Opus Packaging Group) HMA	$401.59
Rate for Payer: PHP Commercial	$455.13
Rate for Payer: Priority Health SBD	$337.33

HC FLEXIBLE SIGMOIDOSCOPY

Facility

$1,813.46

Hospital Charge Code	36000044
Hospital Revenue Code	360
Min. Negotiated Rate	$725.38
Max. Negotiated Rate	$1,632.11
Rate for Payer: Aetna Commercial	$1,541.44
Rate for Payer: Aetna Medicare	$906.73
Rate for Payer: Aetna New Business (MI Preferred)	$1,178.75
Rate for Payer: BCBS Complete	$725.38
Rate for Payer: Cash Price	$1,450.77
Rate for Payer: Cofinity Advantage	$1,269.42
Rate for Payer: Cofinity Commercial	$1,559.58
Rate for Payer: Encore Health Key Benefits Commercial	$1,450.77
Rate for Payer: Healthscope Commercial	$1,632.11
Rate for Payer: MI Amish Medical Board Commercial	$1,450.77
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,541.44
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,360.10
Rate for Payer: PHP Commercial	$1,541.44
Rate for Payer: Priority Health SBD	$1,142.48

HC FLEXIBLE SIGMOIDOSCOPY

Facility

$1,813.46

Hospital Charge Code	36000044
Hospital Revenue Code	360
Min. Negotiated Rate	$1,142.48
Max. Negotiated Rate	$1,632.11
Rate for Payer: Aetna Commercial	$1,541.44
Rate for Payer: Aetna New Business (MI Preferred)	$1,178.75
Rate for Payer: Cash Price	$1,450.77
Rate for Payer: Cofinity Advantage	$1,269.42
Rate for Payer: Cofinity Commercial	$1,559.58
Rate for Payer: Encore Health Key Benefits Commercial	$1,450.77
Rate for Payer: Healthscope Commercial	$1,632.11
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,541.44
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,360.10
Rate for Payer: PHP Commercial	$1,541.44
Rate for Payer: Priority Health SBD	$1,142.48

HC FLEX SHEATH INTRO

Facility

$260.03

Service Code	HCPCS C1894
Hospital Charge Code	27200041
Hospital Revenue Code	272
Min. Negotiated Rate	$102.19
Max. Negotiated Rate	$234.03
Rate for Payer: Aetna Commercial	$221.03
Rate for Payer: Aetna Medicare	$130.01
Rate for Payer: Aetna New Business (MI Preferred)	$169.02
Rate for Payer: BCBS Complete	$104.01
Rate for Payer: Cash Price	$208.02
Rate for Payer: Cofinity Advantage	$182.02
Rate for Payer: Cofinity Commercial	$223.63
Rate for Payer: Encore Health Key Benefits Commercial	$208.02
Rate for Payer: Healthscope Commercial	$234.03
Rate for Payer: MI Amish Medical Board Commercial	$208.02
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$221.03
Rate for Payer: Opus (Opus Packaging Group) HMA	$195.02
Rate for Payer: PHP Commercial	$221.03
Rate for Payer: Priority Health SBD	$163.82
Rate for Payer: UHC All Payor (Choice/PPO)	$169.02
Rate for Payer: UHC Core	$135.48
Rate for Payer: UHC Exchange	$102.19

HC FLEX SHEATH INTRO

Facility

$260.03

Service Code	HCPCS C1894
Hospital Charge Code	27200041
Hospital Revenue Code	272
Min. Negotiated Rate	$163.82
Max. Negotiated Rate	$234.03
Rate for Payer: Aetna Commercial	$221.03
Rate for Payer: Aetna New Business (MI Preferred)	$169.02
Rate for Payer: Cash Price	$208.02
Rate for Payer: Cofinity Advantage	$182.02
Rate for Payer: Cofinity Commercial	$223.63
Rate for Payer: Encore Health Key Benefits Commercial	$208.02
Rate for Payer: Healthscope Commercial	$234.03
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$221.03
Rate for Payer: Opus (Opus Packaging Group) HMA	$195.02
Rate for Payer: PHP Commercial	$221.03
Rate for Payer: Priority Health SBD	$163.82

HC FLOSEAL HEMOSTATIC MATRIX

Facility

$760.43

Hospital Charge Code	27200123
Hospital Revenue Code	272
Min. Negotiated Rate	$479.07
Max. Negotiated Rate	$684.39
Rate for Payer: Aetna Commercial	$646.37
Rate for Payer: Aetna New Business (MI Preferred)	$494.28
Rate for Payer: Cash Price	$608.34
Rate for Payer: Cofinity Advantage	$532.30
Rate for Payer: Cofinity Commercial	$653.97
Rate for Payer: Encore Health Key Benefits Commercial	$608.34
Rate for Payer: Healthscope Commercial	$684.39
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$646.37
Rate for Payer: Opus (Opus Packaging Group) HMA	$570.32
Rate for Payer: PHP Commercial	$646.37
Rate for Payer: Priority Health SBD	$479.07

HC FLOSEAL HEMOSTATIC MATRIX

Facility

$760.43

Hospital Charge Code	27200123
Hospital Revenue Code	272
Min. Negotiated Rate	$298.85
Max. Negotiated Rate	$684.39
Rate for Payer: Aetna Commercial	$646.37
Rate for Payer: Aetna Medicare	$380.21
Rate for Payer: Aetna New Business (MI Preferred)	$494.28
Rate for Payer: BCBS Complete	$304.17
Rate for Payer: Cash Price	$608.34
Rate for Payer: Cofinity Advantage	$532.30
Rate for Payer: Cofinity Commercial	$653.97
Rate for Payer: Encore Health Key Benefits Commercial	$608.34
Rate for Payer: Healthscope Commercial	$684.39
Rate for Payer: MI Amish Medical Board Commercial	$608.34
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$646.37
Rate for Payer: Opus (Opus Packaging Group) HMA	$570.32
Rate for Payer: PHP Commercial	$646.37
Rate for Payer: Priority Health SBD	$479.07
Rate for Payer: UHC All Payor (Choice/PPO)	$494.28
Rate for Payer: UHC Core	$396.18
Rate for Payer: UHC Exchange	$298.85

HC FLOW CYTOMETRY, CELL SURFACE, ADDL

Facility

$64.85

Service Code	CPT 88185
Hospital Charge Code	31100041
Hospital Revenue Code	311
Min. Negotiated Rate	$40.86
Max. Negotiated Rate	$58.37
Rate for Payer: Aetna Commercial	$55.12
Rate for Payer: Aetna New Business (MI Preferred)	$42.15
Rate for Payer: Cash Price	$51.88
Rate for Payer: Cofinity Advantage	$45.40
Rate for Payer: Cofinity Commercial	$55.77
Rate for Payer: Encore Health Key Benefits Commercial	$51.88
Rate for Payer: Healthscope Commercial	$58.37
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$55.12
Rate for Payer: Opus (Opus Packaging Group) HMA	$48.64
Rate for Payer: PHP Commercial	$55.12
Rate for Payer: Priority Health SBD	$40.86

HC FLOW CYTOMETRY, CELL SURFACE, ADDL

Facility

$64.85

Service Code	CPT 88185
Hospital Charge Code	31100041
Hospital Revenue Code	311
Min. Negotiated Rate	$25.94
Max. Negotiated Rate	$58.37
Rate for Payer: Aetna Commercial	$55.12
Rate for Payer: Aetna Medicare	$32.42
Rate for Payer: Aetna New Business (MI Preferred)	$42.15
Rate for Payer: BCBS Complete	$25.94
Rate for Payer: BCBS Trust/PPO	$38.62
Rate for Payer: BCN Commercial	$38.62
Rate for Payer: Cash Price	$51.88
Rate for Payer: Cash Price	$51.88
Rate for Payer: Cofinity Advantage	$45.40
Rate for Payer: Cofinity Commercial	$55.77
Rate for Payer: Encore Health Key Benefits Commercial	$51.88
Rate for Payer: Healthscope Commercial	$58.37
Rate for Payer: MI Amish Medical Board Commercial	$51.88
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$55.12
Rate for Payer: Opus (Opus Packaging Group) HMA	$48.64
Rate for Payer: PHP Commercial	$55.12
Rate for Payer: Priority Health SBD	$40.86
Rate for Payer: UHC All Payor (Choice/PPO)	$33.00
Rate for Payer: UHC Core	$33.00
Rate for Payer: UHC Exchange	$33.00

Know your out-of-pocket cost for care.

All Charges