Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC EOVIST PER ML

Facility

$31.31

Service Code	HCPCS A9581
Hospital Charge Code	63600009
Hospital Revenue Code	636
Min. Negotiated Rate	$12.52
Max. Negotiated Rate	$28.18
Rate for Payer: Aetna Commercial	$26.61
Rate for Payer: Aetna Medicare	$15.66
Rate for Payer: Aetna New Business (MI Preferred)	$20.35
Rate for Payer: BCBS Complete	$12.52
Rate for Payer: BCBS Trust/PPO	$17.70
Rate for Payer: BCN Commercial	$17.70
Rate for Payer: Cash Price	$25.05
Rate for Payer: Cash Price	$25.05
Rate for Payer: Cofinity Commercial	$21.92
Rate for Payer: Cofinity Commercial	$26.93
Rate for Payer: Cofinity Medicare Advantage	$21.92
Rate for Payer: Encore Health Key Benefits Commercial	$25.05
Rate for Payer: Healthscope Commercial	$28.18
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$26.61
Rate for Payer: PHP Commercial	$26.61
Rate for Payer: Priority Health Cigna Priority Health	$20.35
Rate for Payer: Priority Health SBD	$19.73

HC EO W/O JOINTS CF

Facility

$275.71

Service Code	HCPCS L3702
Hospital Charge Code	27400050
Hospital Revenue Code	274
Min. Negotiated Rate	$173.70
Max. Negotiated Rate	$248.14
Rate for Payer: Aetna Commercial	$234.35
Rate for Payer: Aetna New Business (MI Preferred)	$179.21
Rate for Payer: Cash Price	$220.57
Rate for Payer: Cofinity Commercial	$193.00
Rate for Payer: Cofinity Commercial	$237.11
Rate for Payer: Cofinity Medicare Advantage	$193.00
Rate for Payer: Encore Health Key Benefits Commercial	$220.57
Rate for Payer: Healthscope Commercial	$248.14
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$234.35
Rate for Payer: PHP Commercial	$234.35
Rate for Payer: Priority Health Cigna Priority Health	$179.21
Rate for Payer: Priority Health SBD	$173.70

HC EO W/O JOINTS CF

Facility

$275.71

Service Code	HCPCS L3702
Hospital Charge Code	27400050
Hospital Revenue Code	274
Min. Negotiated Rate	$110.28
Max. Negotiated Rate	$857.31
Rate for Payer: Aetna Commercial	$234.35
Rate for Payer: Aetna Medicare	$137.86
Rate for Payer: Aetna New Business (MI Preferred)	$179.21
Rate for Payer: BCBS Complete	$110.28
Rate for Payer: BCBS Trust/PPO	$857.31
Rate for Payer: BCN Commercial	$857.31
Rate for Payer: Cash Price	$220.57
Rate for Payer: Cash Price	$220.57
Rate for Payer: Cofinity Commercial	$193.00
Rate for Payer: Cofinity Commercial	$237.11
Rate for Payer: Cofinity Medicare Advantage	$193.00
Rate for Payer: Encore Health Key Benefits Commercial	$220.57
Rate for Payer: Healthscope Commercial	$248.14
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$234.35
Rate for Payer: PHP Commercial	$234.35
Rate for Payer: Priority Health Cigna Priority Health	$179.21
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$316.64
Rate for Payer: Priority Health Narrow Network	$253.31
Rate for Payer: Priority Health SBD	$173.70

HC EP+ABL ARRHYTHMIA

Facility

$17,739.50

Service Code	CPT 93653
Hospital Charge Code	48100091
Hospital Revenue Code	481
Min. Negotiated Rate	$881.65
Max. Negotiated Rate	$75,545.59
Rate for Payer: Aetna Commercial	$15,078.58
Rate for Payer: Aetna Medicare	$24,997.71
Rate for Payer: Aetna New Business (MI Preferred)	$11,530.68
Rate for Payer: Allen County Amish Medical Aid Commercial	$30,045.32
Rate for Payer: Amish Plain Church Group Commercial	$30,045.32
Rate for Payer: BCBS Complete	$13,527.61
Rate for Payer: BCBS MAPPO	$24,036.26
Rate for Payer: BCBS Trust/PPO	$885.98
Rate for Payer: BCN Commercial	$885.98
Rate for Payer: BCN Medicare Advantage	$24,036.26
Rate for Payer: Cash Price	$14,191.60
Rate for Payer: Cash Price	$14,191.60
Rate for Payer: Cash Price	$14,191.60
Rate for Payer: Cofinity Commercial	$12,417.65
Rate for Payer: Cofinity Commercial	$15,255.97
Rate for Payer: Cofinity Medicare Advantage	$12,417.65
Rate for Payer: Encore Health Key Benefits Commercial	$14,191.60
Rate for Payer: Health Alliance Plan Medicare Advantage	$24,036.26
Rate for Payer: Healthscope Commercial	$15,965.55
Rate for Payer: Mclaren Medicaid	$12,883.44
Rate for Payer: Mclaren Medicare	$24,036.26
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$25,238.07
Rate for Payer: Meridian Medicaid	$13,527.61
Rate for Payer: MI Amish Medical Board Commercial	$27,641.70
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$15,078.58
Rate for Payer: Nomi Health Commercial	$50,476.15
Rate for Payer: PACE Medicare	$22,834.45
Rate for Payer: PACE SWMI	$24,036.26
Rate for Payer: PHP Commercial	$15,078.58
Rate for Payer: PHP Medicare Advantage	$24,036.26
Rate for Payer: Priority Health Choice Medicaid	$12,883.44
Rate for Payer: Priority Health Cigna Priority Health	$11,530.68
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$75,545.59
Rate for Payer: Priority Health Medicare	$24,036.26
Rate for Payer: Priority Health Narrow Network	$60,436.47
Rate for Payer: Priority Health SBD	$11,175.88
Rate for Payer: Railroad Medicare Medicare	$24,036.26
Rate for Payer: UHC All Payor (Choice/PPO)	$881.65
Rate for Payer: UHC Core	$10,600.00
Rate for Payer: UHC Dual Complete DSNP	$24,036.26
Rate for Payer: UHC Exchange	$11,353.00
Rate for Payer: UHC Medicare Advantage	$24,036.26
Rate for Payer: UHCCP Medicaid	$13,532.41
Rate for Payer: VA VA	$24,036.26

HC EP+ABL ARRHYTHMIA

Facility

$17,739.50

Service Code	CPT 93653
Hospital Charge Code	48100091
Hospital Revenue Code	481
Min. Negotiated Rate	$11,175.88
Max. Negotiated Rate	$15,965.55
Rate for Payer: Aetna Commercial	$15,078.58
Rate for Payer: Aetna New Business (MI Preferred)	$11,530.68
Rate for Payer: Cash Price	$14,191.60
Rate for Payer: Cofinity Commercial	$12,417.65
Rate for Payer: Cofinity Commercial	$15,255.97
Rate for Payer: Cofinity Medicare Advantage	$12,417.65
Rate for Payer: Encore Health Key Benefits Commercial	$14,191.60
Rate for Payer: Healthscope Commercial	$15,965.55
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$15,078.58
Rate for Payer: PHP Commercial	$15,078.58
Rate for Payer: Priority Health Cigna Priority Health	$11,530.68
Rate for Payer: Priority Health SBD	$11,175.88

HC EP+ABL VT

Facility

$17,739.50

Service Code	CPT 93654
Hospital Charge Code	48100092
Hospital Revenue Code	481
Min. Negotiated Rate	$1,062.26
Max. Negotiated Rate	$75,545.59
Rate for Payer: Aetna Commercial	$15,078.58
Rate for Payer: Aetna Medicare	$24,997.71
Rate for Payer: Aetna New Business (MI Preferred)	$11,530.68
Rate for Payer: Allen County Amish Medical Aid Commercial	$30,045.32
Rate for Payer: Amish Plain Church Group Commercial	$30,045.32
Rate for Payer: BCBS Complete	$13,527.61
Rate for Payer: BCBS MAPPO	$24,036.26
Rate for Payer: BCBS Trust/PPO	$1,063.17
Rate for Payer: BCN Commercial	$1,063.17
Rate for Payer: BCN Medicare Advantage	$24,036.26
Rate for Payer: Cash Price	$14,191.60
Rate for Payer: Cash Price	$14,191.60
Rate for Payer: Cash Price	$14,191.60
Rate for Payer: Cofinity Commercial	$12,417.65
Rate for Payer: Cofinity Commercial	$15,255.97
Rate for Payer: Cofinity Medicare Advantage	$12,417.65
Rate for Payer: Encore Health Key Benefits Commercial	$14,191.60
Rate for Payer: Health Alliance Plan Medicare Advantage	$24,036.26
Rate for Payer: Healthscope Commercial	$15,965.55
Rate for Payer: Mclaren Medicaid	$12,883.44
Rate for Payer: Mclaren Medicare	$24,036.26
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$25,238.07
Rate for Payer: Meridian Medicaid	$13,527.61
Rate for Payer: MI Amish Medical Board Commercial	$27,641.70
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$15,078.58
Rate for Payer: Nomi Health Commercial	$50,476.15
Rate for Payer: PACE Medicare	$22,834.45
Rate for Payer: PACE SWMI	$24,036.26
Rate for Payer: PHP Commercial	$15,078.58
Rate for Payer: PHP Medicare Advantage	$24,036.26
Rate for Payer: Priority Health Choice Medicaid	$12,883.44
Rate for Payer: Priority Health Cigna Priority Health	$11,530.68
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$75,545.59
Rate for Payer: Priority Health Medicare	$24,036.26
Rate for Payer: Priority Health Narrow Network	$60,436.47
Rate for Payer: Priority Health SBD	$11,175.88
Rate for Payer: Railroad Medicare Medicare	$24,036.26
Rate for Payer: UHC All Payor (Choice/PPO)	$1,062.26
Rate for Payer: UHC Core	$10,600.00
Rate for Payer: UHC Dual Complete DSNP	$24,036.26
Rate for Payer: UHC Exchange	$11,353.00
Rate for Payer: UHC Medicare Advantage	$24,036.26
Rate for Payer: UHCCP Medicaid	$13,532.41
Rate for Payer: VA VA	$24,036.26

HC EP+ABL VT

Facility

$17,739.50

Service Code	CPT 93654
Hospital Charge Code	48100092
Hospital Revenue Code	481
Min. Negotiated Rate	$11,175.88
Max. Negotiated Rate	$15,965.55
Rate for Payer: Aetna Commercial	$15,078.58
Rate for Payer: Aetna New Business (MI Preferred)	$11,530.68
Rate for Payer: Cash Price	$14,191.60
Rate for Payer: Cofinity Commercial	$12,417.65
Rate for Payer: Cofinity Commercial	$15,255.97
Rate for Payer: Cofinity Medicare Advantage	$12,417.65
Rate for Payer: Encore Health Key Benefits Commercial	$14,191.60
Rate for Payer: Healthscope Commercial	$15,965.55
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$15,078.58
Rate for Payer: PHP Commercial	$15,078.58
Rate for Payer: Priority Health Cigna Priority Health	$11,530.68
Rate for Payer: Priority Health SBD	$11,175.88

HC EP AFTER DRUGS

Facility

$7,423.93

Service Code	CPT 93623
Hospital Charge Code	48100039
Hospital Revenue Code	481
Min. Negotiated Rate	$4,677.08
Max. Negotiated Rate	$6,681.54
Rate for Payer: Aetna Commercial	$6,310.34
Rate for Payer: Aetna New Business (MI Preferred)	$4,825.55
Rate for Payer: Cash Price	$5,939.14
Rate for Payer: Cofinity Commercial	$5,196.75
Rate for Payer: Cofinity Commercial	$6,384.58
Rate for Payer: Cofinity Medicare Advantage	$5,196.75
Rate for Payer: Encore Health Key Benefits Commercial	$5,939.14
Rate for Payer: Healthscope Commercial	$6,681.54
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$6,310.34
Rate for Payer: PHP Commercial	$6,310.34
Rate for Payer: Priority Health Cigna Priority Health	$4,825.55
Rate for Payer: Priority Health SBD	$4,677.08

HC EP AFTER DRUGS

Facility

$7,423.93

Service Code	CPT 93623
Hospital Charge Code	48100039
Hospital Revenue Code	481
Min. Negotiated Rate	$878.00
Max. Negotiated Rate	$6,681.54
Rate for Payer: Aetna Commercial	$6,310.34
Rate for Payer: Aetna Medicare	$3,711.96
Rate for Payer: Aetna New Business (MI Preferred)	$4,825.55
Rate for Payer: BCBS Complete	$2,969.57
Rate for Payer: BCBS Trust/PPO	$4,565.36
Rate for Payer: BCN Commercial	$4,565.36
Rate for Payer: Cash Price	$5,939.14
Rate for Payer: Cash Price	$5,939.14
Rate for Payer: Cash Price	$5,939.14
Rate for Payer: Cofinity Commercial	$5,196.75
Rate for Payer: Cofinity Commercial	$6,384.58
Rate for Payer: Cofinity Medicare Advantage	$5,196.75
Rate for Payer: Encore Health Key Benefits Commercial	$5,939.14
Rate for Payer: Healthscope Commercial	$6,681.54
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$6,310.34
Rate for Payer: PHP Commercial	$6,310.34
Rate for Payer: Priority Health Cigna Priority Health	$4,825.55
Rate for Payer: Priority Health SBD	$4,677.08
Rate for Payer: UHC Core	$878.00
Rate for Payer: UHC Exchange	$940.00

HC EP EVAL OF SQ ICD

Facility

$3,342.81

Service Code	CPT 93644
Hospital Charge Code	48000027
Hospital Revenue Code	480
Min. Negotiated Rate	$2,105.97
Max. Negotiated Rate	$3,008.53
Rate for Payer: Aetna Commercial	$2,841.39
Rate for Payer: Aetna New Business (MI Preferred)	$2,172.83
Rate for Payer: Cash Price	$2,674.25
Rate for Payer: Cofinity Commercial	$2,339.97
Rate for Payer: Cofinity Commercial	$2,874.82
Rate for Payer: Cofinity Medicare Advantage	$2,339.97
Rate for Payer: Encore Health Key Benefits Commercial	$2,674.25
Rate for Payer: Healthscope Commercial	$3,008.53
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2,841.39
Rate for Payer: PHP Commercial	$2,841.39
Rate for Payer: Priority Health Cigna Priority Health	$2,172.83
Rate for Payer: Priority Health SBD	$2,105.97

HC EP EVAL OF SQ ICD

Facility

$3,342.81

Service Code	CPT 93644
Hospital Charge Code	48000027
Hospital Revenue Code	480
Min. Negotiated Rate	$197.40
Max. Negotiated Rate	$3,008.53
Rate for Payer: Aetna Commercial	$2,841.39
Rate for Payer: Aetna Medicare	$1,671.40
Rate for Payer: Aetna New Business (MI Preferred)	$2,172.83
Rate for Payer: BCBS Complete	$1,337.12
Rate for Payer: Cash Price	$2,674.25
Rate for Payer: Cash Price	$2,674.25
Rate for Payer: Cash Price	$2,674.25
Rate for Payer: Cofinity Commercial	$2,339.97
Rate for Payer: Cofinity Commercial	$2,874.82
Rate for Payer: Cofinity Medicare Advantage	$2,339.97
Rate for Payer: Encore Health Key Benefits Commercial	$2,674.25
Rate for Payer: Healthscope Commercial	$3,008.53
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2,841.39
Rate for Payer: PHP Commercial	$2,841.39
Rate for Payer: Priority Health Cigna Priority Health	$2,172.83
Rate for Payer: Priority Health SBD	$2,105.97
Rate for Payer: UHC All Payor (Choice/PPO)	$197.40
Rate for Payer: UHC Core	$878.00
Rate for Payer: UHC Exchange	$2,473.68

HC EP EVALUATION OF GEN/LEADS

Facility

$2,388.64

Service Code	CPT 93641
Hospital Charge Code	48100042
Hospital Revenue Code	481
Min. Negotiated Rate	$1,504.84
Max. Negotiated Rate	$2,149.78
Rate for Payer: Aetna Commercial	$2,030.34
Rate for Payer: Aetna New Business (MI Preferred)	$1,552.62
Rate for Payer: Cash Price	$1,910.91
Rate for Payer: Cofinity Commercial	$1,672.05
Rate for Payer: Cofinity Commercial	$2,054.23
Rate for Payer: Cofinity Medicare Advantage	$1,672.05
Rate for Payer: Encore Health Key Benefits Commercial	$1,910.91
Rate for Payer: Healthscope Commercial	$2,149.78
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2,030.34
Rate for Payer: PHP Commercial	$2,030.34
Rate for Payer: Priority Health Cigna Priority Health	$1,552.62
Rate for Payer: Priority Health SBD	$1,504.84

HC EP EVALUATION OF GEN/LEADS

Facility

$2,388.64

Service Code	CPT 93641
Hospital Charge Code	48100042
Hospital Revenue Code	481
Min. Negotiated Rate	$878.00
Max. Negotiated Rate	$2,149.78
Rate for Payer: Aetna Commercial	$2,030.34
Rate for Payer: Aetna Medicare	$1,194.32
Rate for Payer: Aetna New Business (MI Preferred)	$1,552.62
Rate for Payer: BCBS Complete	$955.46
Rate for Payer: BCBS Trust/PPO	$1,178.34
Rate for Payer: BCN Commercial	$1,178.34
Rate for Payer: Cash Price	$1,910.91
Rate for Payer: Cash Price	$1,910.91
Rate for Payer: Cash Price	$1,910.91
Rate for Payer: Cofinity Commercial	$1,672.05
Rate for Payer: Cofinity Commercial	$2,054.23
Rate for Payer: Cofinity Medicare Advantage	$1,672.05
Rate for Payer: Encore Health Key Benefits Commercial	$1,910.91
Rate for Payer: Healthscope Commercial	$2,149.78
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2,030.34
Rate for Payer: PHP Commercial	$2,030.34
Rate for Payer: Priority Health Cigna Priority Health	$1,552.62
Rate for Payer: Priority Health SBD	$1,504.84
Rate for Payer: UHC Core	$878.00
Rate for Payer: UHC Exchange	$940.00

HC EP EVALUATION OF LEADS

Facility

$2,189.46

Service Code	CPT 93640
Hospital Charge Code	48100041
Hospital Revenue Code	481
Min. Negotiated Rate	$875.78
Max. Negotiated Rate	$1,970.51
Rate for Payer: Aetna Commercial	$1,861.04
Rate for Payer: Aetna Medicare	$1,094.73
Rate for Payer: Aetna New Business (MI Preferred)	$1,423.15
Rate for Payer: BCBS Complete	$875.78
Rate for Payer: BCBS Trust/PPO	$1,137.00
Rate for Payer: BCN Commercial	$1,137.00
Rate for Payer: Cash Price	$1,751.57
Rate for Payer: Cash Price	$1,751.57
Rate for Payer: Cash Price	$1,751.57
Rate for Payer: Cofinity Commercial	$1,532.62
Rate for Payer: Cofinity Commercial	$1,882.94
Rate for Payer: Cofinity Medicare Advantage	$1,532.62
Rate for Payer: Encore Health Key Benefits Commercial	$1,751.57
Rate for Payer: Healthscope Commercial	$1,970.51
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,861.04
Rate for Payer: PHP Commercial	$1,861.04
Rate for Payer: Priority Health Cigna Priority Health	$1,423.15
Rate for Payer: Priority Health SBD	$1,379.36
Rate for Payer: UHC Core	$878.00
Rate for Payer: UHC Exchange	$940.00

HC EP EVALUATION OF LEADS

Facility

$2,189.46

Service Code	CPT 93640
Hospital Charge Code	48100041
Hospital Revenue Code	481
Min. Negotiated Rate	$1,379.36
Max. Negotiated Rate	$1,970.51
Rate for Payer: Aetna Commercial	$1,861.04
Rate for Payer: Aetna New Business (MI Preferred)	$1,423.15
Rate for Payer: Cash Price	$1,751.57
Rate for Payer: Cofinity Commercial	$1,532.62
Rate for Payer: Cofinity Commercial	$1,882.94
Rate for Payer: Cofinity Medicare Advantage	$1,532.62
Rate for Payer: Encore Health Key Benefits Commercial	$1,751.57
Rate for Payer: Healthscope Commercial	$1,970.51
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,861.04
Rate for Payer: PHP Commercial	$1,861.04
Rate for Payer: Priority Health Cigna Priority Health	$1,423.15
Rate for Payer: Priority Health SBD	$1,379.36

HC EPIDURAL/LOCAL FLAT

Facility

$675.00

Hospital Charge Code	37000023
Hospital Revenue Code	370
Min. Negotiated Rate	$270.00
Max. Negotiated Rate	$607.50
Rate for Payer: Aetna Commercial	$573.75
Rate for Payer: Aetna Medicare	$337.50
Rate for Payer: Aetna New Business (MI Preferred)	$438.75
Rate for Payer: BCBS Complete	$270.00
Rate for Payer: Cash Price	$540.00
Rate for Payer: Cofinity Commercial	$472.50
Rate for Payer: Cofinity Commercial	$580.50
Rate for Payer: Cofinity Medicare Advantage	$472.50
Rate for Payer: Encore Health Key Benefits Commercial	$540.00
Rate for Payer: Healthscope Commercial	$607.50
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$573.75
Rate for Payer: PHP Commercial	$573.75
Rate for Payer: Priority Health Cigna Priority Health	$438.75
Rate for Payer: Priority Health SBD	$425.25

HC EPIDURAL/LOCAL FLAT

Facility

$675.00

Hospital Charge Code	37000023
Hospital Revenue Code	370
Min. Negotiated Rate	$425.25
Max. Negotiated Rate	$607.50
Rate for Payer: Aetna Commercial	$573.75
Rate for Payer: Aetna New Business (MI Preferred)	$438.75
Rate for Payer: Cash Price	$540.00
Rate for Payer: Cofinity Commercial	$472.50
Rate for Payer: Cofinity Commercial	$580.50
Rate for Payer: Cofinity Medicare Advantage	$472.50
Rate for Payer: Encore Health Key Benefits Commercial	$540.00
Rate for Payer: Healthscope Commercial	$607.50
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$573.75
Rate for Payer: PHP Commercial	$573.75
Rate for Payer: Priority Health Cigna Priority Health	$438.75
Rate for Payer: Priority Health SBD	$425.25

HC EPIDURAL PREP (OB)

Facility

$646.09

Hospital Charge Code	37000003
Hospital Revenue Code	370
Min. Negotiated Rate	$258.44
Max. Negotiated Rate	$581.48
Rate for Payer: Aetna Commercial	$549.18
Rate for Payer: Aetna Medicare	$323.04
Rate for Payer: Aetna New Business (MI Preferred)	$419.96
Rate for Payer: BCBS Complete	$258.44
Rate for Payer: Cash Price	$516.87
Rate for Payer: Cofinity Commercial	$452.26
Rate for Payer: Cofinity Commercial	$555.64
Rate for Payer: Cofinity Medicare Advantage	$452.26
Rate for Payer: Encore Health Key Benefits Commercial	$516.87
Rate for Payer: Healthscope Commercial	$581.48
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$549.18
Rate for Payer: PHP Commercial	$549.18
Rate for Payer: Priority Health Cigna Priority Health	$419.96
Rate for Payer: Priority Health SBD	$407.04

HC EPIDURAL PREP (OB)

Facility

$646.09

Hospital Charge Code	37000003
Hospital Revenue Code	370
Min. Negotiated Rate	$407.04
Max. Negotiated Rate	$581.48
Rate for Payer: Aetna Commercial	$549.18
Rate for Payer: Aetna New Business (MI Preferred)	$419.96
Rate for Payer: Cash Price	$516.87
Rate for Payer: Cofinity Commercial	$452.26
Rate for Payer: Cofinity Commercial	$555.64
Rate for Payer: Cofinity Medicare Advantage	$452.26
Rate for Payer: Encore Health Key Benefits Commercial	$516.87
Rate for Payer: Healthscope Commercial	$581.48
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$549.18
Rate for Payer: PHP Commercial	$549.18
Rate for Payer: Priority Health Cigna Priority Health	$419.96
Rate for Payer: Priority Health SBD	$407.04

HC EPIFIX (14 MM DISC) PER SQ CM

Facility

$488.47

Service Code	HCPCS Q4186
Hospital Charge Code	63600135
Hospital Revenue Code	636
Min. Negotiated Rate	$195.39
Max. Negotiated Rate	$439.62
Rate for Payer: Aetna Commercial	$415.20
Rate for Payer: Aetna Medicare	$244.24
Rate for Payer: Aetna New Business (MI Preferred)	$317.51
Rate for Payer: BCBS Complete	$195.39
Rate for Payer: BCBS Trust/PPO	$289.76
Rate for Payer: BCN Commercial	$289.76
Rate for Payer: Cash Price	$390.78
Rate for Payer: Cash Price	$390.78
Rate for Payer: Cofinity Commercial	$341.93
Rate for Payer: Cofinity Commercial	$420.08
Rate for Payer: Cofinity Medicare Advantage	$341.93
Rate for Payer: Encore Health Key Benefits Commercial	$390.78
Rate for Payer: Healthscope Commercial	$439.62
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$415.20
Rate for Payer: PHP Commercial	$415.20
Rate for Payer: Priority Health Cigna Priority Health	$317.51
Rate for Payer: Priority Health SBD	$307.74

HC EPIFIX (14 MM DISC) PER SQ CM

Facility

$488.47

Service Code	HCPCS Q4186
Hospital Charge Code	63600135
Hospital Revenue Code	636
Min. Negotiated Rate	$307.74
Max. Negotiated Rate	$439.62
Rate for Payer: Aetna Commercial	$415.20
Rate for Payer: Aetna New Business (MI Preferred)	$317.51
Rate for Payer: Cash Price	$390.78
Rate for Payer: Cofinity Commercial	$341.93
Rate for Payer: Cofinity Commercial	$420.08
Rate for Payer: Cofinity Medicare Advantage	$341.93
Rate for Payer: Encore Health Key Benefits Commercial	$390.78
Rate for Payer: Healthscope Commercial	$439.62
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$415.20
Rate for Payer: PHP Commercial	$415.20
Rate for Payer: Priority Health Cigna Priority Health	$317.51
Rate for Payer: Priority Health SBD	$307.74

HC EPIFIX (18 MM DISC) PER SQ CM

Facility

$709.55

Service Code	HCPCS Q4186
Hospital Charge Code	63600136
Hospital Revenue Code	636
Min. Negotiated Rate	$283.82
Max. Negotiated Rate	$638.60
Rate for Payer: Aetna Commercial	$603.12
Rate for Payer: Aetna Medicare	$354.78
Rate for Payer: Aetna New Business (MI Preferred)	$461.21
Rate for Payer: BCBS Complete	$283.82
Rate for Payer: BCBS Trust/PPO	$289.76
Rate for Payer: BCN Commercial	$289.76
Rate for Payer: Cash Price	$567.64
Rate for Payer: Cash Price	$567.64
Rate for Payer: Cofinity Commercial	$496.68
Rate for Payer: Cofinity Commercial	$610.21
Rate for Payer: Cofinity Medicare Advantage	$496.68
Rate for Payer: Encore Health Key Benefits Commercial	$567.64
Rate for Payer: Healthscope Commercial	$638.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$603.12
Rate for Payer: PHP Commercial	$603.12
Rate for Payer: Priority Health Cigna Priority Health	$461.21
Rate for Payer: Priority Health SBD	$447.02

HC EPIFIX (18 MM DISC) PER SQ CM

Facility

$709.55

Service Code	HCPCS Q4186
Hospital Charge Code	63600136
Hospital Revenue Code	636
Min. Negotiated Rate	$447.02
Max. Negotiated Rate	$638.60
Rate for Payer: Aetna Commercial	$603.12
Rate for Payer: Aetna New Business (MI Preferred)	$461.21
Rate for Payer: Cash Price	$567.64
Rate for Payer: Cofinity Commercial	$496.68
Rate for Payer: Cofinity Commercial	$610.21
Rate for Payer: Cofinity Medicare Advantage	$496.68
Rate for Payer: Encore Health Key Benefits Commercial	$567.64
Rate for Payer: Healthscope Commercial	$638.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$603.12
Rate for Payer: PHP Commercial	$603.12
Rate for Payer: Priority Health Cigna Priority Health	$461.21
Rate for Payer: Priority Health SBD	$447.02

HC EPIFIX 2X2 PER SQ CM

Facility

$691.87

Service Code	HCPCS Q4186
Hospital Charge Code	63600130
Hospital Revenue Code	636
Min. Negotiated Rate	$435.88
Max. Negotiated Rate	$622.68
Rate for Payer: Aetna Commercial	$588.09
Rate for Payer: Aetna New Business (MI Preferred)	$449.72
Rate for Payer: Cash Price	$553.50
Rate for Payer: Cofinity Commercial	$484.31
Rate for Payer: Cofinity Commercial	$595.01
Rate for Payer: Cofinity Medicare Advantage	$484.31
Rate for Payer: Encore Health Key Benefits Commercial	$553.50
Rate for Payer: Healthscope Commercial	$622.68
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$588.09
Rate for Payer: PHP Commercial	$588.09
Rate for Payer: Priority Health Cigna Priority Health	$449.72
Rate for Payer: Priority Health SBD	$435.88

HC EPIFIX 2X2 PER SQ CM

Facility

$691.87

Service Code	HCPCS Q4186
Hospital Charge Code	63600130
Hospital Revenue Code	636
Min. Negotiated Rate	$276.75
Max. Negotiated Rate	$622.68
Rate for Payer: Aetna Commercial	$588.09
Rate for Payer: Aetna Medicare	$345.94
Rate for Payer: Aetna New Business (MI Preferred)	$449.72
Rate for Payer: BCBS Complete	$276.75
Rate for Payer: BCBS Trust/PPO	$289.76
Rate for Payer: BCN Commercial	$289.76
Rate for Payer: Cash Price	$553.50
Rate for Payer: Cash Price	$553.50
Rate for Payer: Cofinity Commercial	$484.31
Rate for Payer: Cofinity Commercial	$595.01
Rate for Payer: Cofinity Medicare Advantage	$484.31
Rate for Payer: Encore Health Key Benefits Commercial	$553.50
Rate for Payer: Healthscope Commercial	$622.68
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$588.09
Rate for Payer: PHP Commercial	$588.09
Rate for Payer: Priority Health Cigna Priority Health	$449.72
Rate for Payer: Priority Health SBD	$435.88

Know your out-of-pocket cost for care.

All Charges