Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC ENDO DILATATION

Facility

$1,330.39

Hospital Charge Code	36000115
Hospital Revenue Code	360
Min. Negotiated Rate	$532.16
Max. Negotiated Rate	$1,197.35
Rate for Payer: Aetna Commercial	$1,130.83
Rate for Payer: Aetna Medicare	$665.20
Rate for Payer: Aetna New Business (MI Preferred)	$864.75
Rate for Payer: BCBS Complete	$532.16
Rate for Payer: Cash Price	$1,064.31
Rate for Payer: Cofinity Commercial	$1,144.14
Rate for Payer: Cofinity Commercial	$931.27
Rate for Payer: Cofinity Medicare Advantage	$931.27
Rate for Payer: Encore Health Key Benefits Commercial	$1,064.31
Rate for Payer: Healthscope Commercial	$1,197.35
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,130.83
Rate for Payer: PHP Commercial	$1,130.83
Rate for Payer: Priority Health Cigna Priority Health	$864.75
Rate for Payer: Priority Health SBD	$838.15

HC ENDO DILATATION

Facility

$1,330.39

Hospital Charge Code	36000115
Hospital Revenue Code	360
Min. Negotiated Rate	$838.15
Max. Negotiated Rate	$1,197.35
Rate for Payer: Aetna Commercial	$1,130.83
Rate for Payer: Aetna New Business (MI Preferred)	$864.75
Rate for Payer: Cash Price	$1,064.31
Rate for Payer: Cofinity Commercial	$1,144.14
Rate for Payer: Cofinity Commercial	$931.27
Rate for Payer: Cofinity Medicare Advantage	$931.27
Rate for Payer: Encore Health Key Benefits Commercial	$1,064.31
Rate for Payer: Healthscope Commercial	$1,197.35
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,130.83
Rate for Payer: PHP Commercial	$1,130.83
Rate for Payer: Priority Health Cigna Priority Health	$864.75
Rate for Payer: Priority Health SBD	$838.15

HC ENDO FINE NEEDLE ASP/BIOPSY

Facility

$1,074.53

Hospital Charge Code	36000103
Hospital Revenue Code	360
Min. Negotiated Rate	$429.81
Max. Negotiated Rate	$967.08
Rate for Payer: Aetna Commercial	$913.35
Rate for Payer: Aetna Medicare	$537.26
Rate for Payer: Aetna New Business (MI Preferred)	$698.44
Rate for Payer: BCBS Complete	$429.81
Rate for Payer: Cash Price	$859.62
Rate for Payer: Cofinity Commercial	$752.17
Rate for Payer: Cofinity Commercial	$924.10
Rate for Payer: Cofinity Medicare Advantage	$752.17
Rate for Payer: Encore Health Key Benefits Commercial	$859.62
Rate for Payer: Healthscope Commercial	$967.08
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$913.35
Rate for Payer: PHP Commercial	$913.35
Rate for Payer: Priority Health Cigna Priority Health	$698.44
Rate for Payer: Priority Health SBD	$676.95

HC ENDO FINE NEEDLE ASP/BIOPSY

Facility

$1,074.53

Hospital Charge Code	36000103
Hospital Revenue Code	360
Min. Negotiated Rate	$676.95
Max. Negotiated Rate	$967.08
Rate for Payer: Aetna Commercial	$913.35
Rate for Payer: Aetna New Business (MI Preferred)	$698.44
Rate for Payer: Cash Price	$859.62
Rate for Payer: Cofinity Commercial	$752.17
Rate for Payer: Cofinity Commercial	$924.10
Rate for Payer: Cofinity Medicare Advantage	$752.17
Rate for Payer: Encore Health Key Benefits Commercial	$859.62
Rate for Payer: Healthscope Commercial	$967.08
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$913.35
Rate for Payer: PHP Commercial	$913.35
Rate for Payer: Priority Health Cigna Priority Health	$698.44
Rate for Payer: Priority Health SBD	$676.95

HC ENDOFORM 2X2

Facility

$39.02

Hospital Charge Code	27000459
Hospital Revenue Code	270
Min. Negotiated Rate	$24.58
Max. Negotiated Rate	$35.12
Rate for Payer: Aetna Commercial	$33.17
Rate for Payer: Aetna New Business (MI Preferred)	$25.36
Rate for Payer: Cash Price	$31.22
Rate for Payer: Cofinity Commercial	$27.31
Rate for Payer: Cofinity Commercial	$33.56
Rate for Payer: Cofinity Medicare Advantage	$27.31
Rate for Payer: Encore Health Key Benefits Commercial	$31.22
Rate for Payer: Healthscope Commercial	$35.12
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$33.17
Rate for Payer: PHP Commercial	$33.17
Rate for Payer: Priority Health Cigna Priority Health	$25.36
Rate for Payer: Priority Health SBD	$24.58

HC ENDOFORM 2X2

Facility

$39.02

Hospital Charge Code	27000459
Hospital Revenue Code	270
Min. Negotiated Rate	$15.61
Max. Negotiated Rate	$35.12
Rate for Payer: Aetna Commercial	$33.17
Rate for Payer: Aetna Medicare	$19.51
Rate for Payer: Aetna New Business (MI Preferred)	$25.36
Rate for Payer: BCBS Complete	$15.61
Rate for Payer: Cash Price	$31.22
Rate for Payer: Cofinity Commercial	$27.31
Rate for Payer: Cofinity Commercial	$33.56
Rate for Payer: Cofinity Medicare Advantage	$27.31
Rate for Payer: Encore Health Key Benefits Commercial	$31.22
Rate for Payer: Healthscope Commercial	$35.12
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$33.17
Rate for Payer: PHP Commercial	$33.17
Rate for Payer: Priority Health Cigna Priority Health	$25.36
Rate for Payer: Priority Health SBD	$24.58

HC ENDOFORM 4X4

Facility

$135.72

Hospital Charge Code	27000460
Hospital Revenue Code	270
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: Cofinity Medicare Advantage	$95.00
Rate for Payer: Encore Health Key Benefits Commercial	$108.58
Rate for Payer: Healthscope Commercial	$122.15
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$115.36
Rate for Payer: PHP Commercial	$115.36
Rate for Payer: Priority Health Cigna Priority Health	$88.22
Rate for Payer: Priority Health SBD	$85.50

HC ENDOFORM 4X4

Facility

$135.72

Hospital Charge Code	27000460
Hospital Revenue Code	270
Min. Negotiated Rate	$54.29
Max. Negotiated Rate	$122.15
Rate for Payer: Aetna Commercial	$115.36
Rate for Payer: Aetna Medicare	$67.86
Rate for Payer: Aetna New Business (MI Preferred)	$88.22
Rate for Payer: BCBS Complete	$54.29
Rate for Payer: Cash Price	$108.58
Rate for Payer: Cofinity Commercial	$116.72
Rate for Payer: Cofinity Commercial	$95.00
Rate for Payer: Cofinity Medicare Advantage	$95.00
Rate for Payer: Encore Health Key Benefits Commercial	$108.58
Rate for Payer: Healthscope Commercial	$122.15
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$115.36
Rate for Payer: PHP Commercial	$115.36
Rate for Payer: Priority Health Cigna Priority Health	$88.22
Rate for Payer: Priority Health SBD	$85.50

HC ENDO HEMOSTASIS

Facility

$125.46

Hospital Charge Code	36000116
Hospital Revenue Code	360
Min. Negotiated Rate	$50.18
Max. Negotiated Rate	$112.91
Rate for Payer: Aetna Commercial	$106.64
Rate for Payer: Aetna Medicare	$62.73
Rate for Payer: Aetna New Business (MI Preferred)	$81.55
Rate for Payer: BCBS Complete	$50.18
Rate for Payer: Cash Price	$100.37
Rate for Payer: Cofinity Commercial	$107.90
Rate for Payer: Cofinity Commercial	$87.82
Rate for Payer: Cofinity Medicare Advantage	$87.82
Rate for Payer: Encore Health Key Benefits Commercial	$100.37
Rate for Payer: Healthscope Commercial	$112.91
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$106.64
Rate for Payer: PHP Commercial	$106.64
Rate for Payer: Priority Health Cigna Priority Health	$81.55
Rate for Payer: Priority Health SBD	$79.04

HC ENDO HEMOSTASIS

Facility

$125.46

Hospital Charge Code	36000116
Hospital Revenue Code	360
Min. Negotiated Rate	$79.04
Max. Negotiated Rate	$112.91
Rate for Payer: Aetna Commercial	$106.64
Rate for Payer: Aetna New Business (MI Preferred)	$81.55
Rate for Payer: Cash Price	$100.37
Rate for Payer: Cofinity Commercial	$107.90
Rate for Payer: Cofinity Commercial	$87.82
Rate for Payer: Cofinity Medicare Advantage	$87.82
Rate for Payer: Encore Health Key Benefits Commercial	$100.37
Rate for Payer: Healthscope Commercial	$112.91
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$106.64
Rate for Payer: PHP Commercial	$106.64
Rate for Payer: Priority Health Cigna Priority Health	$81.55
Rate for Payer: Priority Health SBD	$79.04

HC ENDOLUMINAL BIOPSY OF BILIARY TREE

Facility

$662.41

Service Code	CPT 47543
Hospital Charge Code	36100500
Hospital Revenue Code	361
Min. Negotiated Rate	$148.72
Max. Negotiated Rate	$2,176.56
Rate for Payer: Aetna Commercial	$563.05
Rate for Payer: Aetna Medicare	$331.20
Rate for Payer: Aetna New Business (MI Preferred)	$430.57
Rate for Payer: BCBS Complete	$264.96
Rate for Payer: BCBS Trust/PPO	$2,176.56
Rate for Payer: BCN Commercial	$2,176.56
Rate for Payer: Cash Price	$529.93
Rate for Payer: Cash Price	$529.93
Rate for Payer: Cash Price	$529.93
Rate for Payer: Cofinity Commercial	$463.69
Rate for Payer: Cofinity Commercial	$569.67
Rate for Payer: Cofinity Medicare Advantage	$463.69
Rate for Payer: Encore Health Key Benefits Commercial	$529.93
Rate for Payer: Healthscope Commercial	$596.17
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$563.05
Rate for Payer: PHP Commercial	$563.05
Rate for Payer: Priority Health Cigna Priority Health	$430.57
Rate for Payer: Priority Health SBD	$417.32
Rate for Payer: UHC All Payor (Choice/PPO)	$148.72
Rate for Payer: UHC Core	$878.00
Rate for Payer: UHC Exchange	$940.00

HC ENDOLUMINAL BIOPSY OF BILIARY TREE

Facility

$662.41

Service Code	CPT 47543
Hospital Charge Code	36100500
Hospital Revenue Code	361
Min. Negotiated Rate	$417.32
Max. Negotiated Rate	$596.17
Rate for Payer: Aetna Commercial	$563.05
Rate for Payer: Aetna New Business (MI Preferred)	$430.57
Rate for Payer: Cash Price	$529.93
Rate for Payer: Cofinity Commercial	$463.69
Rate for Payer: Cofinity Commercial	$569.67
Rate for Payer: Cofinity Medicare Advantage	$463.69
Rate for Payer: Encore Health Key Benefits Commercial	$529.93
Rate for Payer: Healthscope Commercial	$596.17
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$563.05
Rate for Payer: PHP Commercial	$563.05
Rate for Payer: Priority Health Cigna Priority Health	$430.57
Rate for Payer: Priority Health SBD	$417.32

HC ENDOLUMINAL BX URTR &/RNL PELVIS NONENDOSCOPIC

Facility

$5,097.96

Service Code	CPT 50606
Hospital Charge Code	36100615
Hospital Revenue Code	361
Min. Negotiated Rate	$147.03
Max. Negotiated Rate	$4,588.16
Rate for Payer: Aetna Commercial	$4,333.27
Rate for Payer: Aetna Medicare	$2,548.98
Rate for Payer: Aetna New Business (MI Preferred)	$3,313.67
Rate for Payer: BCBS Complete	$2,039.18
Rate for Payer: BCBS Trust/PPO	$2,656.55
Rate for Payer: BCN Commercial	$2,656.55
Rate for Payer: Cash Price	$4,078.37
Rate for Payer: Cash Price	$4,078.37
Rate for Payer: Cash Price	$4,078.37
Rate for Payer: Cofinity Commercial	$3,568.57
Rate for Payer: Cofinity Commercial	$4,384.25
Rate for Payer: Cofinity Medicare Advantage	$3,568.57
Rate for Payer: Encore Health Key Benefits Commercial	$4,078.37
Rate for Payer: Healthscope Commercial	$4,588.16
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4,333.27
Rate for Payer: PHP Commercial	$4,333.27
Rate for Payer: Priority Health Cigna Priority Health	$3,313.67
Rate for Payer: Priority Health SBD	$3,211.71
Rate for Payer: UHC All Payor (Choice/PPO)	$147.03
Rate for Payer: UHC Core	$878.00
Rate for Payer: UHC Exchange	$940.00

HC ENDOLUMINAL BX URTR &/RNL PELVIS NONENDOSCOPIC

Facility

$5,097.96

Service Code	CPT 50606
Hospital Charge Code	36100615
Hospital Revenue Code	361
Min. Negotiated Rate	$3,211.71
Max. Negotiated Rate	$4,588.16
Rate for Payer: Aetna Commercial	$4,333.27
Rate for Payer: Aetna New Business (MI Preferred)	$3,313.67
Rate for Payer: Cash Price	$4,078.37
Rate for Payer: Cofinity Commercial	$3,568.57
Rate for Payer: Cofinity Commercial	$4,384.25
Rate for Payer: Cofinity Medicare Advantage	$3,568.57
Rate for Payer: Encore Health Key Benefits Commercial	$4,078.37
Rate for Payer: Healthscope Commercial	$4,588.16
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4,333.27
Rate for Payer: PHP Commercial	$4,333.27
Rate for Payer: Priority Health Cigna Priority Health	$3,313.67
Rate for Payer: Priority Health SBD	$3,211.71

HC ENDOMETR ABLATE THERMAL

Facility

$13,353.53

Service Code	CPT 58353
Hospital Charge Code	76100336
Hospital Revenue Code	761
Min. Negotiated Rate	$245.90
Max. Negotiated Rate	$15,201.47
Rate for Payer: Aetna Commercial	$11,350.50
Rate for Payer: Aetna Medicare	$5,030.10
Rate for Payer: Aetna New Business (MI Preferred)	$8,679.79
Rate for Payer: Allen County Amish Medical Aid Commercial	$6,045.79
Rate for Payer: Amish Plain Church Group Commercial	$6,045.79
Rate for Payer: BCBS Complete	$2,722.06
Rate for Payer: BCBS MAPPO	$4,836.63
Rate for Payer: BCBS Trust/PPO	$2,069.95
Rate for Payer: BCN Commercial	$2,069.95
Rate for Payer: BCN Medicare Advantage	$4,836.63
Rate for Payer: Cash Price	$10,682.82
Rate for Payer: Cash Price	$10,682.82
Rate for Payer: Cash Price	$10,682.82
Rate for Payer: Cofinity Commercial	$9,347.47
Rate for Payer: Cofinity Commercial	$11,484.04
Rate for Payer: Cofinity Medicare Advantage	$9,347.47
Rate for Payer: Encore Health Key Benefits Commercial	$10,682.82
Rate for Payer: Health Alliance Plan Medicare Advantage	$4,836.63
Rate for Payer: Healthscope Commercial	$12,018.18
Rate for Payer: Mclaren Medicaid	$2,592.43
Rate for Payer: Mclaren Medicare	$4,836.63
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$5,078.46
Rate for Payer: Meridian Medicaid	$2,722.06
Rate for Payer: MI Amish Medical Board Commercial	$5,562.12
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$11,350.50
Rate for Payer: Nomi Health Commercial	$10,156.92
Rate for Payer: PACE Medicare	$4,594.80
Rate for Payer: PACE SWMI	$4,836.63
Rate for Payer: PHP Commercial	$11,350.50
Rate for Payer: PHP Medicare Advantage	$4,836.63
Rate for Payer: Priority Health Choice Medicaid	$2,592.43
Rate for Payer: Priority Health Cigna Priority Health	$8,679.79
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$15,201.47
Rate for Payer: Priority Health Medicare	$4,836.63
Rate for Payer: Priority Health Narrow Network	$12,161.18
Rate for Payer: Priority Health SBD	$8,412.72
Rate for Payer: Railroad Medicare Medicare	$4,836.63
Rate for Payer: UHC All Payor (Choice/PPO)	$245.90
Rate for Payer: UHC Core	$5,427.00
Rate for Payer: UHC Dual Complete DSNP	$4,836.63
Rate for Payer: UHC Medicare Advantage	$4,836.63
Rate for Payer: UHCCP Medicaid	$2,723.02
Rate for Payer: VA VA	$4,836.63

HC ENDOMETR ABLATE THERMAL

Facility

$13,353.53

Service Code	CPT 58353
Hospital Charge Code	76100336
Hospital Revenue Code	761
Min. Negotiated Rate	$8,412.72
Max. Negotiated Rate	$12,018.18
Rate for Payer: Aetna Commercial	$11,350.50
Rate for Payer: Aetna New Business (MI Preferred)	$8,679.79
Rate for Payer: Cash Price	$10,682.82
Rate for Payer: Cofinity Commercial	$11,484.04
Rate for Payer: Cofinity Commercial	$9,347.47
Rate for Payer: Cofinity Medicare Advantage	$9,347.47
Rate for Payer: Encore Health Key Benefits Commercial	$10,682.82
Rate for Payer: Healthscope Commercial	$12,018.18
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$11,350.50
Rate for Payer: PHP Commercial	$11,350.50
Rate for Payer: Priority Health Cigna Priority Health	$8,679.79
Rate for Payer: Priority Health SBD	$8,412.72

HC ENDOMETR BX CONJUNCT W/COLP

Facility

$723.08

Service Code	CPT 58110
Hospital Charge Code	76100335
Hospital Revenue Code	761
Min. Negotiated Rate	$43.08
Max. Negotiated Rate	$878.00
Rate for Payer: Aetna Commercial	$614.62
Rate for Payer: Aetna Medicare	$361.54
Rate for Payer: Aetna New Business (MI Preferred)	$470.00
Rate for Payer: BCBS Complete	$289.23
Rate for Payer: BCBS Trust/PPO	$98.61
Rate for Payer: BCN Commercial	$98.61
Rate for Payer: Cash Price	$578.46
Rate for Payer: Cash Price	$578.46
Rate for Payer: Cash Price	$578.46
Rate for Payer: Cofinity Commercial	$506.16
Rate for Payer: Cofinity Commercial	$621.85
Rate for Payer: Cofinity Medicare Advantage	$506.16
Rate for Payer: Encore Health Key Benefits Commercial	$578.46
Rate for Payer: Healthscope Commercial	$650.77
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$614.62
Rate for Payer: PHP Commercial	$614.62
Rate for Payer: Priority Health Cigna Priority Health	$470.00
Rate for Payer: Priority Health SBD	$455.54
Rate for Payer: UHC All Payor (Choice/PPO)	$43.08
Rate for Payer: UHC Core	$878.00

HC ENDOMETR BX CONJUNCT W/COLP

Facility

$723.08

Service Code	CPT 58110
Hospital Charge Code	76100335
Hospital Revenue Code	761
Min. Negotiated Rate	$455.54
Max. Negotiated Rate	$650.77
Rate for Payer: Aetna Commercial	$614.62
Rate for Payer: Aetna New Business (MI Preferred)	$470.00
Rate for Payer: Cash Price	$578.46
Rate for Payer: Cofinity Commercial	$506.16
Rate for Payer: Cofinity Commercial	$621.85
Rate for Payer: Cofinity Medicare Advantage	$506.16
Rate for Payer: Encore Health Key Benefits Commercial	$578.46
Rate for Payer: Healthscope Commercial	$650.77
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$614.62
Rate for Payer: PHP Commercial	$614.62
Rate for Payer: Priority Health Cigna Priority Health	$470.00
Rate for Payer: Priority Health SBD	$455.54

HC ENDOMETRIAL SAMPLING

Facility

$219.52

Service Code	CPT 58100
Hospital Charge Code	76100141
Hospital Revenue Code	761
Min. Negotiated Rate	$138.30
Max. Negotiated Rate	$197.57
Rate for Payer: Aetna Commercial	$186.59
Rate for Payer: Aetna New Business (MI Preferred)	$142.69
Rate for Payer: Cash Price	$175.62
Rate for Payer: Cofinity Commercial	$153.66
Rate for Payer: Cofinity Commercial	$188.79
Rate for Payer: Cofinity Medicare Advantage	$153.66
Rate for Payer: Encore Health Key Benefits Commercial	$175.62
Rate for Payer: Healthscope Commercial	$197.57
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$186.59
Rate for Payer: PHP Commercial	$186.59
Rate for Payer: Priority Health Cigna Priority Health	$142.69
Rate for Payer: Priority Health SBD	$138.30

HC ENDOMETRIAL SAMPLING

Facility

$219.52

Service Code	CPT 58100
Hospital Charge Code	76100141
Hospital Revenue Code	761
Min. Negotiated Rate	$67.78
Max. Negotiated Rate	$878.00
Rate for Payer: Aetna Commercial	$186.59
Rate for Payer: Aetna Medicare	$204.98
Rate for Payer: Aetna New Business (MI Preferred)	$142.69
Rate for Payer: Allen County Amish Medical Aid Commercial	$246.38
Rate for Payer: Amish Plain Church Group Commercial	$246.38
Rate for Payer: BCBS Complete	$110.93
Rate for Payer: BCBS MAPPO	$197.10
Rate for Payer: BCBS Trust/PPO	$75.89
Rate for Payer: BCCCP Commercial	$97.15
Rate for Payer: BCN Commercial	$75.89
Rate for Payer: BCN Medicare Advantage	$197.10
Rate for Payer: Cash Price	$175.62
Rate for Payer: Cash Price	$175.62
Rate for Payer: Cash Price	$175.62
Rate for Payer: Cofinity Commercial	$188.79
Rate for Payer: Cofinity Commercial	$153.66
Rate for Payer: Cofinity Medicare Advantage	$153.66
Rate for Payer: Encore Health Key Benefits Commercial	$175.62
Rate for Payer: Health Alliance Plan Medicare Advantage	$197.10
Rate for Payer: Healthscope Commercial	$197.57
Rate for Payer: Mclaren Medicaid	$105.65
Rate for Payer: Mclaren Medicare	$197.10
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$206.96
Rate for Payer: Meridian Medicaid	$110.93
Rate for Payer: MI Amish Medical Board Commercial	$226.66
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$186.59
Rate for Payer: Nomi Health Commercial	$413.91
Rate for Payer: PACE Medicare	$187.24
Rate for Payer: PACE SWMI	$197.10
Rate for Payer: PHP Commercial	$186.59
Rate for Payer: PHP Medicare Advantage	$197.10
Rate for Payer: Priority Health Choice Medicaid	$105.65
Rate for Payer: Priority Health Cigna Priority Health	$142.69
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$619.50
Rate for Payer: Priority Health Medicare	$197.10
Rate for Payer: Priority Health Narrow Network	$495.60
Rate for Payer: Priority Health SBD	$138.30
Rate for Payer: Railroad Medicare Medicare	$197.10
Rate for Payer: UHC All Payor (Choice/PPO)	$67.78
Rate for Payer: UHC Core	$878.00
Rate for Payer: UHC Dual Complete DSNP	$197.10
Rate for Payer: UHC Medicare Advantage	$197.10
Rate for Payer: UHCCP Medicaid	$110.97
Rate for Payer: VA VA	$197.10

HC ENDOMYOCARDIAL BIOPSY

Facility

$2,865.80

Service Code	CPT 93505
Hospital Charge Code	48100025
Hospital Revenue Code	481
Min. Negotiated Rate	$1,805.45
Max. Negotiated Rate	$2,579.22
Rate for Payer: Aetna Commercial	$2,435.93
Rate for Payer: Aetna New Business (MI Preferred)	$1,862.77
Rate for Payer: Cash Price	$2,292.64
Rate for Payer: Cofinity Commercial	$2,006.06
Rate for Payer: Cofinity Commercial	$2,464.59
Rate for Payer: Cofinity Medicare Advantage	$2,006.06
Rate for Payer: Encore Health Key Benefits Commercial	$2,292.64
Rate for Payer: Healthscope Commercial	$2,579.22
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2,435.93
Rate for Payer: PHP Commercial	$2,435.93
Rate for Payer: Priority Health Cigna Priority Health	$1,862.77
Rate for Payer: Priority Health SBD	$1,805.45

HC ENDOMYOCARDIAL BIOPSY

Facility

$2,865.80

Service Code	CPT 93505
Hospital Charge Code	48100025
Hospital Revenue Code	481
Min. Negotiated Rate	$648.04
Max. Negotiated Rate	$9,692.51
Rate for Payer: Aetna Commercial	$2,435.93
Rate for Payer: Aetna Medicare	$3,207.21
Rate for Payer: Aetna New Business (MI Preferred)	$1,862.77
Rate for Payer: Allen County Amish Medical Aid Commercial	$3,854.82
Rate for Payer: Amish Plain Church Group Commercial	$3,854.82
Rate for Payer: BCBS Complete	$1,735.60
Rate for Payer: BCBS MAPPO	$3,083.86
Rate for Payer: BCBS Trust/PPO	$1,844.32
Rate for Payer: BCN Commercial	$1,844.32
Rate for Payer: BCN Medicare Advantage	$3,083.86
Rate for Payer: Cash Price	$2,292.64
Rate for Payer: Cash Price	$2,292.64
Rate for Payer: Cash Price	$2,292.64
Rate for Payer: Cofinity Commercial	$2,006.06
Rate for Payer: Cofinity Commercial	$2,464.59
Rate for Payer: Cofinity Medicare Advantage	$2,006.06
Rate for Payer: Encore Health Key Benefits Commercial	$2,292.64
Rate for Payer: Health Alliance Plan Medicare Advantage	$3,083.86
Rate for Payer: Healthscope Commercial	$2,579.22
Rate for Payer: Mclaren Medicaid	$1,652.95
Rate for Payer: Mclaren Medicare	$3,083.86
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$3,238.05
Rate for Payer: Meridian Medicaid	$1,735.60
Rate for Payer: MI Amish Medical Board Commercial	$3,546.44
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2,435.93
Rate for Payer: Nomi Health Commercial	$6,476.11
Rate for Payer: PACE Medicare	$2,929.67
Rate for Payer: PACE SWMI	$3,083.86
Rate for Payer: PHP Commercial	$2,435.93
Rate for Payer: PHP Medicare Advantage	$3,083.86
Rate for Payer: Priority Health Choice Medicaid	$1,652.95
Rate for Payer: Priority Health Cigna Priority Health	$1,862.77
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$9,692.51
Rate for Payer: Priority Health Medicare	$3,083.86
Rate for Payer: Priority Health Narrow Network	$7,754.01
Rate for Payer: Priority Health SBD	$1,805.45
Rate for Payer: Railroad Medicare Medicare	$3,083.86
Rate for Payer: UHC All Payor (Choice/PPO)	$648.04
Rate for Payer: UHC Core	$5,427.00
Rate for Payer: UHC Dual Complete DSNP	$3,083.86
Rate for Payer: UHC Exchange	$5,811.00
Rate for Payer: UHC Medicare Advantage	$3,083.86
Rate for Payer: UHCCP Medicaid	$1,736.21
Rate for Payer: VA VA	$3,083.86

HC ENDOMYSIAL IGA ANTIBODY.

Facility

$80.11

Service Code	CPT 86255
Hospital Charge Code	30200426
Hospital Revenue Code	302
Min. Negotiated Rate	$50.47
Max. Negotiated Rate	$72.10
Rate for Payer: Aetna Commercial	$68.09
Rate for Payer: Aetna New Business (MI Preferred)	$52.07
Rate for Payer: Cash Price	$64.09
Rate for Payer: Cofinity Commercial	$56.08
Rate for Payer: Cofinity Commercial	$68.89
Rate for Payer: Cofinity Medicare Advantage	$56.08
Rate for Payer: Encore Health Key Benefits Commercial	$64.09
Rate for Payer: Healthscope Commercial	$72.10
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$68.09
Rate for Payer: PHP Commercial	$68.09
Rate for Payer: Priority Health Cigna Priority Health	$52.07
Rate for Payer: Priority Health SBD	$50.47

HC ENDOMYSIAL IGA ANTIBODY.

Facility

$80.11

Service Code	CPT 86255
Hospital Charge Code	30200426
Hospital Revenue Code	302
Min. Negotiated Rate	$6.46
Max. Negotiated Rate	$72.10
Rate for Payer: Aetna Commercial	$68.09
Rate for Payer: Aetna Medicare	$12.53
Rate for Payer: Aetna New Business (MI Preferred)	$52.07
Rate for Payer: Allen County Amish Medical Aid Commercial	$15.06
Rate for Payer: Amish Plain Church Group Commercial	$15.06
Rate for Payer: BCBS Complete	$6.78
Rate for Payer: BCBS MAPPO	$12.05
Rate for Payer: BCBS Trust/PPO	$8.00
Rate for Payer: BCN Commercial	$8.00
Rate for Payer: BCN Medicare Advantage	$12.05
Rate for Payer: Cash Price	$64.09
Rate for Payer: Cash Price	$64.09
Rate for Payer: Cofinity Commercial	$68.89
Rate for Payer: Cofinity Commercial	$56.08
Rate for Payer: Cofinity Medicare Advantage	$56.08
Rate for Payer: Encore Health Key Benefits Commercial	$64.09
Rate for Payer: Health Alliance Plan Medicare Advantage	$12.05
Rate for Payer: Healthscope Commercial	$72.10
Rate for Payer: Mclaren Medicaid	$6.46
Rate for Payer: Mclaren Medicare	$12.05
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$12.65
Rate for Payer: Meridian Medicaid	$6.78
Rate for Payer: MI Amish Medical Board Commercial	$13.86
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$68.09
Rate for Payer: Nomi Health Commercial	$18.08
Rate for Payer: PACE Medicare	$11.45
Rate for Payer: PACE SWMI	$12.05
Rate for Payer: PHP Commercial	$68.09
Rate for Payer: PHP Medicare Advantage	$12.05
Rate for Payer: Priority Health Choice Medicaid	$6.46
Rate for Payer: Priority Health Cigna Priority Health	$52.07
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$12.40
Rate for Payer: Priority Health Medicare	$12.05
Rate for Payer: Priority Health Narrow Network	$9.92
Rate for Payer: Priority Health SBD	$50.47
Rate for Payer: Railroad Medicare Medicare	$12.05
Rate for Payer: UHC All Payor (Choice/PPO)	$14.46
Rate for Payer: UHC Dual Complete DSNP	$12.05
Rate for Payer: UHC Medicare Advantage	$12.05
Rate for Payer: UHCCP Medicaid	$6.78
Rate for Payer: VA VA	$12.05

HC ENDOMYSIAL IGA TITER.

Facility

$160.04

Service Code	CPT 86231
Hospital Charge Code	30200494
Hospital Revenue Code	302
Min. Negotiated Rate	$100.83
Max. Negotiated Rate	$144.04
Rate for Payer: Aetna Commercial	$136.03
Rate for Payer: Aetna New Business (MI Preferred)	$104.03
Rate for Payer: Cash Price	$128.03
Rate for Payer: Cofinity Commercial	$112.03
Rate for Payer: Cofinity Commercial	$137.63
Rate for Payer: Cofinity Medicare Advantage	$112.03
Rate for Payer: Encore Health Key Benefits Commercial	$128.03
Rate for Payer: Healthscope Commercial	$144.04
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$136.03
Rate for Payer: PHP Commercial	$136.03
Rate for Payer: Priority Health Cigna Priority Health	$104.03
Rate for Payer: Priority Health SBD	$100.83

Know your out-of-pocket cost for care.

All Charges