Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

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	$323.05
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: 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	$354.77
Rate for Payer: Aetna New Business (MI Preferred)	$461.21
Rate for Payer: BCBS Complete	$283.82
Rate for Payer: Cash Price	$567.64
Rate for Payer: Cofinity Commercial	$496.69
Rate for Payer: Cofinity Commercial	$610.21
Rate for Payer: Cofinity Medicare Advantage	$496.69
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	$496.69
Rate for Payer: Cofinity Commercial	$610.21
Rate for Payer: Cofinity Medicare Advantage	$496.69
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	$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: 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	$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 2X3 PER SQ CM

Facility

$495.92

Service Code	HCPCS Q4186
Hospital Charge Code	63600131
Hospital Revenue Code	636
Min. Negotiated Rate	$312.43
Max. Negotiated Rate	$446.33
Rate for Payer: Aetna Commercial	$421.53
Rate for Payer: Aetna New Business (MI Preferred)	$322.35
Rate for Payer: Cash Price	$396.74
Rate for Payer: Cofinity Commercial	$347.14
Rate for Payer: Cofinity Commercial	$426.49
Rate for Payer: Cofinity Medicare Advantage	$347.14
Rate for Payer: Encore Health Key Benefits Commercial	$396.74
Rate for Payer: Healthscope Commercial	$446.33
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$421.53
Rate for Payer: PHP Commercial	$421.53
Rate for Payer: Priority Health Cigna Priority Health	$322.35
Rate for Payer: Priority Health SBD	$312.43

HC EPIFIX 2X3 PER SQ CM

Facility

$495.92

Service Code	HCPCS Q4186
Hospital Charge Code	63600131
Hospital Revenue Code	636
Min. Negotiated Rate	$198.37
Max. Negotiated Rate	$446.33
Rate for Payer: Aetna Commercial	$421.53
Rate for Payer: Aetna Medicare	$247.96
Rate for Payer: Aetna New Business (MI Preferred)	$322.35
Rate for Payer: BCBS Complete	$198.37
Rate for Payer: Cash Price	$396.74
Rate for Payer: Cofinity Commercial	$347.14
Rate for Payer: Cofinity Commercial	$426.49
Rate for Payer: Cofinity Medicare Advantage	$347.14
Rate for Payer: Encore Health Key Benefits Commercial	$396.74
Rate for Payer: Healthscope Commercial	$446.33
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$421.53
Rate for Payer: PHP Commercial	$421.53
Rate for Payer: Priority Health Cigna Priority Health	$322.35
Rate for Payer: Priority Health SBD	$312.43

HC EPIFIX 2X4 PER SQ CM

Facility

$438.93

Service Code	HCPCS Q4186
Hospital Charge Code	63600132
Hospital Revenue Code	636
Min. Negotiated Rate	$175.57
Max. Negotiated Rate	$395.04
Rate for Payer: Aetna Commercial	$373.09
Rate for Payer: Aetna Medicare	$219.47
Rate for Payer: Aetna New Business (MI Preferred)	$285.30
Rate for Payer: BCBS Complete	$175.57
Rate for Payer: Cash Price	$351.14
Rate for Payer: Cofinity Commercial	$307.25
Rate for Payer: Cofinity Commercial	$377.48
Rate for Payer: Cofinity Medicare Advantage	$307.25
Rate for Payer: Encore Health Key Benefits Commercial	$351.14
Rate for Payer: Healthscope Commercial	$395.04
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$373.09
Rate for Payer: PHP Commercial	$373.09
Rate for Payer: Priority Health Cigna Priority Health	$285.30
Rate for Payer: Priority Health SBD	$276.53

HC EPIFIX 2X4 PER SQ CM

Facility

$438.93

Service Code	HCPCS Q4186
Hospital Charge Code	63600132
Hospital Revenue Code	636
Min. Negotiated Rate	$276.53
Max. Negotiated Rate	$395.04
Rate for Payer: Aetna Commercial	$373.09
Rate for Payer: Aetna New Business (MI Preferred)	$285.30
Rate for Payer: Cash Price	$351.14
Rate for Payer: Cofinity Commercial	$307.25
Rate for Payer: Cofinity Commercial	$377.48
Rate for Payer: Cofinity Medicare Advantage	$307.25
Rate for Payer: Encore Health Key Benefits Commercial	$351.14
Rate for Payer: Healthscope Commercial	$395.04
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$373.09
Rate for Payer: PHP Commercial	$373.09
Rate for Payer: Priority Health Cigna Priority Health	$285.30
Rate for Payer: Priority Health SBD	$276.53

HC EPIFIX 3X4 PER SQ CM

Facility

$412.52

Service Code	HCPCS Q4186
Hospital Charge Code	63600133
Hospital Revenue Code	636
Min. Negotiated Rate	$259.89
Max. Negotiated Rate	$371.27
Rate for Payer: Aetna Commercial	$350.64
Rate for Payer: Aetna New Business (MI Preferred)	$268.14
Rate for Payer: Cash Price	$330.02
Rate for Payer: Cofinity Commercial	$288.76
Rate for Payer: Cofinity Commercial	$354.77
Rate for Payer: Cofinity Medicare Advantage	$288.76
Rate for Payer: Encore Health Key Benefits Commercial	$330.02
Rate for Payer: Healthscope Commercial	$371.27
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$350.64
Rate for Payer: PHP Commercial	$350.64
Rate for Payer: Priority Health Cigna Priority Health	$268.14
Rate for Payer: Priority Health SBD	$259.89

HC EPIFIX 3X4 PER SQ CM

Facility

$412.52

Service Code	HCPCS Q4186
Hospital Charge Code	63600133
Hospital Revenue Code	636
Min. Negotiated Rate	$165.01
Max. Negotiated Rate	$371.27
Rate for Payer: Aetna Commercial	$350.64
Rate for Payer: Aetna Medicare	$206.26
Rate for Payer: Aetna New Business (MI Preferred)	$268.14
Rate for Payer: BCBS Complete	$165.01
Rate for Payer: Cash Price	$330.02
Rate for Payer: Cofinity Commercial	$288.76
Rate for Payer: Cofinity Commercial	$354.77
Rate for Payer: Cofinity Medicare Advantage	$288.76
Rate for Payer: Encore Health Key Benefits Commercial	$330.02
Rate for Payer: Healthscope Commercial	$371.27
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$350.64
Rate for Payer: PHP Commercial	$350.64
Rate for Payer: Priority Health Cigna Priority Health	$268.14
Rate for Payer: Priority Health SBD	$259.89

HC EPIFIX 4 X 4.5 PER SQ CM

Facility

$211.79

Service Code	HCPCS Q4186
Hospital Charge Code	63600227
Hospital Revenue Code	636
Min. Negotiated Rate	$133.43
Max. Negotiated Rate	$190.61
Rate for Payer: Aetna Commercial	$180.02
Rate for Payer: Aetna New Business (MI Preferred)	$137.66
Rate for Payer: Cash Price	$169.43
Rate for Payer: Cofinity Commercial	$148.25
Rate for Payer: Cofinity Commercial	$182.14
Rate for Payer: Cofinity Medicare Advantage	$148.25
Rate for Payer: Encore Health Key Benefits Commercial	$169.43
Rate for Payer: Healthscope Commercial	$190.61
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$180.02
Rate for Payer: PHP Commercial	$180.02
Rate for Payer: Priority Health Cigna Priority Health	$137.66
Rate for Payer: Priority Health SBD	$133.43

HC EPIFIX 4 X 4.5 PER SQ CM

Facility

$211.79

Service Code	HCPCS Q4186
Hospital Charge Code	63600227
Hospital Revenue Code	636
Min. Negotiated Rate	$84.72
Max. Negotiated Rate	$190.61
Rate for Payer: Aetna Commercial	$180.02
Rate for Payer: Aetna Medicare	$105.89
Rate for Payer: Aetna New Business (MI Preferred)	$137.66
Rate for Payer: BCBS Complete	$84.72
Rate for Payer: Cash Price	$169.43
Rate for Payer: Cofinity Commercial	$148.25
Rate for Payer: Cofinity Commercial	$182.14
Rate for Payer: Cofinity Medicare Advantage	$148.25
Rate for Payer: Encore Health Key Benefits Commercial	$169.43
Rate for Payer: Healthscope Commercial	$190.61
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$180.02
Rate for Payer: PHP Commercial	$180.02
Rate for Payer: Priority Health Cigna Priority Health	$137.66
Rate for Payer: Priority Health SBD	$133.43

HC EPIFIX 4X4 PER SQ CM

Facility

$396.79

Service Code	HCPCS Q4186
Hospital Charge Code	63600134
Hospital Revenue Code	636
Min. Negotiated Rate	$158.72
Max. Negotiated Rate	$357.11
Rate for Payer: Aetna Commercial	$337.27
Rate for Payer: Aetna Medicare	$198.40
Rate for Payer: Aetna New Business (MI Preferred)	$257.91
Rate for Payer: BCBS Complete	$158.72
Rate for Payer: Cash Price	$317.43
Rate for Payer: Cofinity Commercial	$277.75
Rate for Payer: Cofinity Commercial	$341.24
Rate for Payer: Cofinity Medicare Advantage	$277.75
Rate for Payer: Encore Health Key Benefits Commercial	$317.43
Rate for Payer: Healthscope Commercial	$357.11
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$337.27
Rate for Payer: PHP Commercial	$337.27
Rate for Payer: Priority Health Cigna Priority Health	$257.91
Rate for Payer: Priority Health SBD	$249.98

HC EPIFIX 4X4 PER SQ CM

Facility

$396.79

Service Code	HCPCS Q4186
Hospital Charge Code	63600134
Hospital Revenue Code	636
Min. Negotiated Rate	$249.98
Max. Negotiated Rate	$357.11
Rate for Payer: Aetna Commercial	$337.27
Rate for Payer: Aetna New Business (MI Preferred)	$257.91
Rate for Payer: Cash Price	$317.43
Rate for Payer: Cofinity Commercial	$277.75
Rate for Payer: Cofinity Commercial	$341.24
Rate for Payer: Cofinity Medicare Advantage	$277.75
Rate for Payer: Encore Health Key Benefits Commercial	$317.43
Rate for Payer: Healthscope Commercial	$357.11
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$337.27
Rate for Payer: PHP Commercial	$337.27
Rate for Payer: Priority Health Cigna Priority Health	$257.91
Rate for Payer: Priority Health SBD	$249.98

HC EPIFIX 5X6 PER SQ CM

Facility

$297.61

Service Code	HCPCS Q4186
Hospital Charge Code	63600188
Hospital Revenue Code	636
Min. Negotiated Rate	$187.49
Max. Negotiated Rate	$267.85
Rate for Payer: Aetna Commercial	$252.97
Rate for Payer: Aetna New Business (MI Preferred)	$193.45
Rate for Payer: Cash Price	$238.09
Rate for Payer: Cofinity Commercial	$208.33
Rate for Payer: Cofinity Commercial	$255.94
Rate for Payer: Cofinity Medicare Advantage	$208.33
Rate for Payer: Encore Health Key Benefits Commercial	$238.09
Rate for Payer: Healthscope Commercial	$267.85
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$252.97
Rate for Payer: PHP Commercial	$252.97
Rate for Payer: Priority Health Cigna Priority Health	$193.45
Rate for Payer: Priority Health SBD	$187.49

HC EPIFIX 5X6 PER SQ CM

Facility

$297.61

Service Code	HCPCS Q4186
Hospital Charge Code	63600188
Hospital Revenue Code	636
Min. Negotiated Rate	$119.04
Max. Negotiated Rate	$267.85
Rate for Payer: Aetna Commercial	$252.97
Rate for Payer: Aetna Medicare	$148.81
Rate for Payer: Aetna New Business (MI Preferred)	$193.45
Rate for Payer: BCBS Complete	$119.04
Rate for Payer: Cash Price	$238.09
Rate for Payer: Cofinity Commercial	$208.33
Rate for Payer: Cofinity Commercial	$255.94
Rate for Payer: Cofinity Medicare Advantage	$208.33
Rate for Payer: Encore Health Key Benefits Commercial	$238.09
Rate for Payer: Healthscope Commercial	$267.85
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$252.97
Rate for Payer: PHP Commercial	$252.97
Rate for Payer: Priority Health Cigna Priority Health	$193.45
Rate for Payer: Priority Health SBD	$187.49

HC EPIPEN EPINEPHRINE INJECTION .3MG

Facility

$416.16

Service Code	CPT J3490
Hospital Charge Code	63600228
Hospital Revenue Code	636
Min. Negotiated Rate	$166.46
Max. Negotiated Rate	$374.54
Rate for Payer: Aetna Commercial	$353.74
Rate for Payer: Aetna Medicare	$208.08
Rate for Payer: Aetna New Business (MI Preferred)	$270.50
Rate for Payer: BCBS Complete	$166.46
Rate for Payer: Cash Price	$332.93
Rate for Payer: Cofinity Commercial	$291.31
Rate for Payer: Cofinity Commercial	$357.90
Rate for Payer: Cofinity Medicare Advantage	$291.31
Rate for Payer: Encore Health Key Benefits Commercial	$332.93
Rate for Payer: Healthscope Commercial	$374.54
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$353.74
Rate for Payer: PHP Commercial	$353.74
Rate for Payer: Priority Health Cigna Priority Health	$270.50
Rate for Payer: Priority Health SBD	$262.18

HC EPIPEN EPINEPHRINE INJECTION .3MG

Facility

$416.16

Service Code	CPT J3490
Hospital Charge Code	63600228
Hospital Revenue Code	636
Min. Negotiated Rate	$262.18
Max. Negotiated Rate	$374.54
Rate for Payer: Aetna Commercial	$353.74
Rate for Payer: Aetna New Business (MI Preferred)	$270.50
Rate for Payer: Cash Price	$332.93
Rate for Payer: Cofinity Commercial	$291.31
Rate for Payer: Cofinity Commercial	$357.90
Rate for Payer: Cofinity Medicare Advantage	$291.31
Rate for Payer: Encore Health Key Benefits Commercial	$332.93
Rate for Payer: Healthscope Commercial	$374.54
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$353.74
Rate for Payer: PHP Commercial	$353.74
Rate for Payer: Priority Health Cigna Priority Health	$270.50
Rate for Payer: Priority Health SBD	$262.18

HC EP LOWER EXTREMITY SOMATOSENSO

Facility

$935.10

Service Code	CPT 95926
Hospital Charge Code	92200015
Hospital Revenue Code	922
Min. Negotiated Rate	$162.78
Max. Negotiated Rate	$854.89
Rate for Payer: Aetna Commercial	$794.84
Rate for Payer: Aetna Medicare	$315.85
Rate for Payer: Aetna New Business (MI Preferred)	$607.82
Rate for Payer: Allen County Amish Medical Aid Commercial	$379.62
Rate for Payer: Amish Plain Church Group Commercial	$379.62
Rate for Payer: BCBS Complete	$170.92
Rate for Payer: BCBS MAPPO	$303.70
Rate for Payer: BCN Medicare Advantage	$303.70
Rate for Payer: Cash Price	$748.08
Rate for Payer: Cash Price	$748.08
Rate for Payer: Cofinity Commercial	$804.19
Rate for Payer: Cofinity Commercial	$654.57
Rate for Payer: Cofinity Medicare Advantage	$654.57
Rate for Payer: Encore Health Key Benefits Commercial	$748.08
Rate for Payer: Health Alliance Plan Medicare Advantage	$303.70
Rate for Payer: Healthscope Commercial	$841.59
Rate for Payer: Mclaren Medicaid	$162.78
Rate for Payer: Mclaren Medicare	$303.70
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$318.88
Rate for Payer: Meridian Medicaid	$170.92
Rate for Payer: MI Amish Medical Board Commercial	$349.25
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$794.84
Rate for Payer: PACE Medicare	$288.51
Rate for Payer: PACE SWMI	$303.70
Rate for Payer: PHP Commercial	$794.84
Rate for Payer: PHP Medicare Advantage	$303.70
Rate for Payer: Priority Health Choice Medicaid	$162.78
Rate for Payer: Priority Health Cigna Priority Health	$607.82
Rate for Payer: Priority Health Medicare	$303.70
Rate for Payer: Priority Health SBD	$589.11
Rate for Payer: Railroad Medicare Medicare	$303.70
Rate for Payer: UHC All Payor (Choice/PPO)	$854.89
Rate for Payer: UHC Core	$691.97
Rate for Payer: UHC Dual Complete DSNP	$303.70
Rate for Payer: UHC Exchange	$691.97
Rate for Payer: UHC Medicare Advantage	$303.70
Rate for Payer: UHCCP Medicaid	$170.98
Rate for Payer: VA VA	$303.70

HC EP LOWER EXTREMITY SOMATOSENSO

Facility

$935.10

Service Code	CPT 95926
Hospital Charge Code	92200015
Hospital Revenue Code	922
Min. Negotiated Rate	$589.11
Max. Negotiated Rate	$841.59
Rate for Payer: Aetna Commercial	$794.84
Rate for Payer: Aetna New Business (MI Preferred)	$607.82
Rate for Payer: Cash Price	$748.08
Rate for Payer: Cofinity Commercial	$654.57
Rate for Payer: Cofinity Commercial	$804.19
Rate for Payer: Cofinity Medicare Advantage	$654.57
Rate for Payer: Encore Health Key Benefits Commercial	$748.08
Rate for Payer: Healthscope Commercial	$841.59
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$794.84
Rate for Payer: PHP Commercial	$794.84
Rate for Payer: Priority Health Cigna Priority Health	$607.82
Rate for Payer: Priority Health SBD	$589.11

Know your out-of-pocket cost for care.

All Charges