Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC FETUS SINGLE OR FIRST GESTATION

Facility

$312.12

Service Code	CPT 74712
Hospital Charge Code	61000083
Hospital Revenue Code	610
Min. Negotiated Rate	$196.64
Max. Negotiated Rate	$280.91
Rate for Payer: Aetna Commercial	$265.30
Rate for Payer: Aetna New Business (MI Preferred)	$202.88
Rate for Payer: Cash Price	$249.70
Rate for Payer: Cofinity Commercial	$218.48
Rate for Payer: Cofinity Commercial	$268.42
Rate for Payer: Cofinity Medicare Advantage	$218.48
Rate for Payer: Encore Health Key Benefits Commercial	$249.70
Rate for Payer: Healthscope Commercial	$280.91
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$265.30
Rate for Payer: PHP Commercial	$265.30
Rate for Payer: Priority Health Cigna Priority Health	$202.88
Rate for Payer: Priority Health SBD	$196.64

HC FETUS SINGLE OR FIRST GESTATION

Facility

$312.12

Service Code	CPT 74712
Hospital Charge Code	61000083
Hospital Revenue Code	610
Min. Negotiated Rate	$126.36
Max. Negotiated Rate	$663.58
Rate for Payer: Aetna Commercial	$265.30
Rate for Payer: Aetna Medicare	$245.17
Rate for Payer: Aetna New Business (MI Preferred)	$202.88
Rate for Payer: Allen County Amish Medical Aid Commercial	$294.68
Rate for Payer: Amish Plain Church Group Commercial	$294.68
Rate for Payer: BCBS Complete	$132.67
Rate for Payer: BCBS MAPPO	$235.74
Rate for Payer: BCN Medicare Advantage	$235.74
Rate for Payer: Cash Price	$249.70
Rate for Payer: Cash Price	$249.70
Rate for Payer: Cofinity Commercial	$268.42
Rate for Payer: Cofinity Commercial	$218.48
Rate for Payer: Cofinity Medicare Advantage	$218.48
Rate for Payer: Encore Health Key Benefits Commercial	$249.70
Rate for Payer: Health Alliance Plan Medicare Advantage	$235.74
Rate for Payer: Healthscope Commercial	$280.91
Rate for Payer: Mclaren Medicaid	$126.36
Rate for Payer: Mclaren Medicare	$235.74
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$247.53
Rate for Payer: Meridian Medicaid	$132.67
Rate for Payer: MI Amish Medical Board Commercial	$271.10
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$265.30
Rate for Payer: PACE Medicare	$223.95
Rate for Payer: PACE SWMI	$235.74
Rate for Payer: PHP Commercial	$265.30
Rate for Payer: PHP Medicare Advantage	$235.74
Rate for Payer: Priority Health Choice Medicaid	$126.36
Rate for Payer: Priority Health Cigna Priority Health	$202.88
Rate for Payer: Priority Health Medicare	$235.74
Rate for Payer: Priority Health SBD	$196.64
Rate for Payer: Railroad Medicare Medicare	$235.74
Rate for Payer: UHC All Payor (Choice/PPO)	$663.58
Rate for Payer: UHC Core	$230.97
Rate for Payer: UHC Dual Complete DSNP	$235.74
Rate for Payer: UHC Exchange	$230.97
Rate for Payer: UHC Medicare Advantage	$235.74
Rate for Payer: UHCCP Medicaid	$132.72
Rate for Payer: VA VA	$235.74

HC FFR DEVICE

Facility

$2,096.50

Service Code	HCPCS C1769
Hospital Charge Code	27200242
Hospital Revenue Code	272
Min. Negotiated Rate	$838.60
Max. Negotiated Rate	$1,886.85
Rate for Payer: Aetna Commercial	$1,782.03
Rate for Payer: Aetna Medicare	$1,048.25
Rate for Payer: Aetna New Business (MI Preferred)	$1,362.72
Rate for Payer: BCBS Complete	$838.60
Rate for Payer: Cash Price	$1,677.20
Rate for Payer: Cofinity Commercial	$1,467.55
Rate for Payer: Cofinity Commercial	$1,802.99
Rate for Payer: Cofinity Medicare Advantage	$1,467.55
Rate for Payer: Encore Health Key Benefits Commercial	$1,677.20
Rate for Payer: Healthscope Commercial	$1,886.85
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,782.03
Rate for Payer: PHP Commercial	$1,782.03
Rate for Payer: Priority Health Cigna Priority Health	$1,362.72
Rate for Payer: Priority Health SBD	$1,320.80

HC FFR DEVICE

Facility

$2,096.50

Service Code	HCPCS C1769
Hospital Charge Code	27200242
Hospital Revenue Code	272
Min. Negotiated Rate	$1,320.80
Max. Negotiated Rate	$1,886.85
Rate for Payer: Aetna Commercial	$1,782.03
Rate for Payer: Aetna New Business (MI Preferred)	$1,362.72
Rate for Payer: Cash Price	$1,677.20
Rate for Payer: Cofinity Commercial	$1,467.55
Rate for Payer: Cofinity Commercial	$1,802.99
Rate for Payer: Cofinity Medicare Advantage	$1,467.55
Rate for Payer: Encore Health Key Benefits Commercial	$1,677.20
Rate for Payer: Healthscope Commercial	$1,886.85
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,782.03
Rate for Payer: PHP Commercial	$1,782.03
Rate for Payer: Priority Health Cigna Priority Health	$1,362.72
Rate for Payer: Priority Health SBD	$1,320.80

HC FFR MEASUREMENT

Facility

$3,878.57

Service Code	CPT 93571
Hospital Charge Code	48100027
Hospital Revenue Code	481
Min. Negotiated Rate	$2,443.50
Max. Negotiated Rate	$3,490.71
Rate for Payer: Aetna Commercial	$3,296.78
Rate for Payer: Aetna New Business (MI Preferred)	$2,521.07
Rate for Payer: Cash Price	$3,102.86
Rate for Payer: Cofinity Commercial	$2,715.00
Rate for Payer: Cofinity Commercial	$3,335.57
Rate for Payer: Cofinity Medicare Advantage	$2,715.00
Rate for Payer: Encore Health Key Benefits Commercial	$3,102.86
Rate for Payer: Healthscope Commercial	$3,490.71
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3,296.78
Rate for Payer: PHP Commercial	$3,296.78
Rate for Payer: Priority Health Cigna Priority Health	$2,521.07
Rate for Payer: Priority Health SBD	$2,443.50

HC FFR MEASUREMENT

Facility

$3,878.57

Service Code	CPT 93571
Hospital Charge Code	48100027
Hospital Revenue Code	481
Min. Negotiated Rate	$1,551.43
Max. Negotiated Rate	$3,490.71
Rate for Payer: Aetna Commercial	$3,296.78
Rate for Payer: Aetna Medicare	$1,939.29
Rate for Payer: Aetna New Business (MI Preferred)	$2,521.07
Rate for Payer: BCBS Complete	$1,551.43
Rate for Payer: Cash Price	$3,102.86
Rate for Payer: Cofinity Commercial	$2,715.00
Rate for Payer: Cofinity Commercial	$3,335.57
Rate for Payer: Cofinity Medicare Advantage	$2,715.00
Rate for Payer: Encore Health Key Benefits Commercial	$3,102.86
Rate for Payer: Healthscope Commercial	$3,490.71
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3,296.78
Rate for Payer: PHP Commercial	$3,296.78
Rate for Payer: Priority Health Cigna Priority Health	$2,521.07
Rate for Payer: Priority Health SBD	$2,443.50

HC FFR MEASUREMENT ADD VESS

Facility

$840.56

Service Code	CPT 93572
Hospital Charge Code	48100028
Hospital Revenue Code	481
Min. Negotiated Rate	$336.22
Max. Negotiated Rate	$756.50
Rate for Payer: Aetna Commercial	$714.48
Rate for Payer: Aetna Medicare	$420.28
Rate for Payer: Aetna New Business (MI Preferred)	$546.36
Rate for Payer: BCBS Complete	$336.22
Rate for Payer: Cash Price	$672.45
Rate for Payer: Cofinity Commercial	$588.39
Rate for Payer: Cofinity Commercial	$722.88
Rate for Payer: Cofinity Medicare Advantage	$588.39
Rate for Payer: Encore Health Key Benefits Commercial	$672.45
Rate for Payer: Healthscope Commercial	$756.50
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$714.48
Rate for Payer: PHP Commercial	$714.48
Rate for Payer: Priority Health Cigna Priority Health	$546.36
Rate for Payer: Priority Health SBD	$529.55

HC FFR MEASUREMENT ADD VESS

Facility

$840.56

Service Code	CPT 93572
Hospital Charge Code	48100028
Hospital Revenue Code	481
Min. Negotiated Rate	$529.55
Max. Negotiated Rate	$756.50
Rate for Payer: Aetna Commercial	$714.48
Rate for Payer: Aetna New Business (MI Preferred)	$546.36
Rate for Payer: Cash Price	$672.45
Rate for Payer: Cofinity Commercial	$588.39
Rate for Payer: Cofinity Commercial	$722.88
Rate for Payer: Cofinity Medicare Advantage	$588.39
Rate for Payer: Encore Health Key Benefits Commercial	$672.45
Rate for Payer: Healthscope Commercial	$756.50
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$714.48
Rate for Payer: PHP Commercial	$714.48
Rate for Payer: Priority Health Cigna Priority Health	$546.36
Rate for Payer: Priority Health SBD	$529.55

HC FIBEROPTIC IABP KIT

Facility

$2,676.43

Hospital Charge Code	27200301
Hospital Revenue Code	272
Min. Negotiated Rate	$1,070.57
Max. Negotiated Rate	$2,408.79
Rate for Payer: Aetna Commercial	$2,274.97
Rate for Payer: Aetna Medicare	$1,338.21
Rate for Payer: Aetna New Business (MI Preferred)	$1,739.68
Rate for Payer: BCBS Complete	$1,070.57
Rate for Payer: Cash Price	$2,141.14
Rate for Payer: Cofinity Commercial	$1,873.50
Rate for Payer: Cofinity Commercial	$2,301.73
Rate for Payer: Cofinity Medicare Advantage	$1,873.50
Rate for Payer: Encore Health Key Benefits Commercial	$2,141.14
Rate for Payer: Healthscope Commercial	$2,408.79
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2,274.97
Rate for Payer: PHP Commercial	$2,274.97
Rate for Payer: Priority Health Cigna Priority Health	$1,739.68
Rate for Payer: Priority Health SBD	$1,686.15

HC FIBEROPTIC IABP KIT

Facility

$2,676.43

Hospital Charge Code	27200301
Hospital Revenue Code	272
Min. Negotiated Rate	$1,686.15
Max. Negotiated Rate	$2,408.79
Rate for Payer: Aetna Commercial	$2,274.97
Rate for Payer: Aetna New Business (MI Preferred)	$1,739.68
Rate for Payer: Cash Price	$2,141.14
Rate for Payer: Cofinity Commercial	$1,873.50
Rate for Payer: Cofinity Commercial	$2,301.73
Rate for Payer: Cofinity Medicare Advantage	$1,873.50
Rate for Payer: Encore Health Key Benefits Commercial	$2,141.14
Rate for Payer: Healthscope Commercial	$2,408.79
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2,274.97
Rate for Payer: PHP Commercial	$2,274.97
Rate for Payer: Priority Health Cigna Priority Health	$1,739.68
Rate for Payer: Priority Health SBD	$1,686.15

HC FIBRINOGEN

Facility

$76.91

Service Code	CPT 85384
Hospital Charge Code	30500045
Hospital Revenue Code	305
Min. Negotiated Rate	$48.45
Max. Negotiated Rate	$69.22
Rate for Payer: Aetna Commercial	$65.37
Rate for Payer: Aetna New Business (MI Preferred)	$49.99
Rate for Payer: Cash Price	$61.53
Rate for Payer: Cofinity Commercial	$53.84
Rate for Payer: Cofinity Commercial	$66.14
Rate for Payer: Cofinity Medicare Advantage	$53.84
Rate for Payer: Encore Health Key Benefits Commercial	$61.53
Rate for Payer: Healthscope Commercial	$69.22
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$65.37
Rate for Payer: PHP Commercial	$65.37
Rate for Payer: Priority Health Cigna Priority Health	$49.99
Rate for Payer: Priority Health SBD	$48.45

HC FIBRINOGEN

Facility

$76.91

Service Code	CPT 85384
Hospital Charge Code	30500045
Hospital Revenue Code	305
Min. Negotiated Rate	$5.21
Max. Negotiated Rate	$69.22
Rate for Payer: Aetna Commercial	$65.37
Rate for Payer: Aetna Medicare	$10.11
Rate for Payer: Aetna New Business (MI Preferred)	$49.99
Rate for Payer: Allen County Amish Medical Aid Commercial	$12.15
Rate for Payer: Amish Plain Church Group Commercial	$12.15
Rate for Payer: BCBS Complete	$5.47
Rate for Payer: BCBS MAPPO	$9.72
Rate for Payer: BCN Medicare Advantage	$9.72
Rate for Payer: Cash Price	$61.53
Rate for Payer: Cash Price	$61.53
Rate for Payer: Cofinity Commercial	$66.14
Rate for Payer: Cofinity Commercial	$53.84
Rate for Payer: Cofinity Medicare Advantage	$53.84
Rate for Payer: Encore Health Key Benefits Commercial	$61.53
Rate for Payer: Health Alliance Plan Medicare Advantage	$9.72
Rate for Payer: Healthscope Commercial	$69.22
Rate for Payer: Mclaren Medicaid	$5.21
Rate for Payer: Mclaren Medicare	$9.72
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$10.21
Rate for Payer: Meridian Medicaid	$5.47
Rate for Payer: MI Amish Medical Board Commercial	$11.18
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$65.37
Rate for Payer: PACE Medicare	$9.23
Rate for Payer: PACE SWMI	$9.72
Rate for Payer: PHP Commercial	$65.37
Rate for Payer: PHP Medicare Advantage	$9.72
Rate for Payer: Priority Health Choice Medicaid	$5.21
Rate for Payer: Priority Health Cigna Priority Health	$49.99
Rate for Payer: Priority Health Medicare	$9.72
Rate for Payer: Priority Health SBD	$48.45
Rate for Payer: Railroad Medicare Medicare	$9.72
Rate for Payer: UHC All Payor (Choice/PPO)	$27.36
Rate for Payer: UHC Dual Complete DSNP	$9.72
Rate for Payer: UHC Medicare Advantage	$9.72
Rate for Payer: UHCCP Medicaid	$5.47
Rate for Payer: VA VA	$9.72

HC FIBROTEST-ACTITEST, S

Facility

$290.70

Service Code	CPT 81596
Hospital Charge Code	30000155
Hospital Revenue Code	300
Min. Negotiated Rate	$38.69
Max. Negotiated Rate	$261.63
Rate for Payer: Aetna Commercial	$247.09
Rate for Payer: Aetna Medicare	$75.08
Rate for Payer: Aetna New Business (MI Preferred)	$188.96
Rate for Payer: Allen County Amish Medical Aid Commercial	$90.24
Rate for Payer: Amish Plain Church Group Commercial	$90.24
Rate for Payer: BCBS Complete	$40.63
Rate for Payer: BCBS MAPPO	$72.19
Rate for Payer: BCN Medicare Advantage	$72.19
Rate for Payer: Cash Price	$232.56
Rate for Payer: Cash Price	$232.56
Rate for Payer: Cofinity Commercial	$250.00
Rate for Payer: Cofinity Commercial	$203.49
Rate for Payer: Cofinity Medicare Advantage	$203.49
Rate for Payer: Encore Health Key Benefits Commercial	$232.56
Rate for Payer: Health Alliance Plan Medicare Advantage	$72.19
Rate for Payer: Healthscope Commercial	$261.63
Rate for Payer: Mclaren Medicaid	$38.69
Rate for Payer: Mclaren Medicare	$72.19
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$75.80
Rate for Payer: Meridian Medicaid	$40.63
Rate for Payer: MI Amish Medical Board Commercial	$83.02
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$247.09
Rate for Payer: PACE Medicare	$68.58
Rate for Payer: PACE SWMI	$72.19
Rate for Payer: PHP Commercial	$247.09
Rate for Payer: PHP Medicare Advantage	$72.19
Rate for Payer: Priority Health Choice Medicaid	$38.69
Rate for Payer: Priority Health Cigna Priority Health	$188.96
Rate for Payer: Priority Health Medicare	$72.19
Rate for Payer: Priority Health SBD	$183.14
Rate for Payer: Railroad Medicare Medicare	$72.19
Rate for Payer: UHC All Payor (Choice/PPO)	$203.21
Rate for Payer: UHC Dual Complete DSNP	$72.19
Rate for Payer: UHC Medicare Advantage	$72.19
Rate for Payer: UHCCP Medicaid	$40.64
Rate for Payer: VA VA	$72.19

HC FIBROTEST-ACTITEST, S

Facility

$290.70

Service Code	CPT 81596
Hospital Charge Code	30000155
Hospital Revenue Code	300
Min. Negotiated Rate	$183.14
Max. Negotiated Rate	$261.63
Rate for Payer: Aetna Commercial	$247.09
Rate for Payer: Aetna New Business (MI Preferred)	$188.96
Rate for Payer: Cash Price	$232.56
Rate for Payer: Cofinity Commercial	$203.49
Rate for Payer: Cofinity Commercial	$250.00
Rate for Payer: Cofinity Medicare Advantage	$203.49
Rate for Payer: Encore Health Key Benefits Commercial	$232.56
Rate for Payer: Healthscope Commercial	$261.63
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$247.09
Rate for Payer: PHP Commercial	$247.09
Rate for Payer: Priority Health Cigna Priority Health	$188.96
Rate for Payer: Priority Health SBD	$183.14

HC FILSHIE CLIP

Facility

$335.82

Hospital Charge Code	27000076
Hospital Revenue Code	270
Min. Negotiated Rate	$134.33
Max. Negotiated Rate	$302.24
Rate for Payer: Aetna Commercial	$285.45
Rate for Payer: Aetna Medicare	$167.91
Rate for Payer: Aetna New Business (MI Preferred)	$218.28
Rate for Payer: BCBS Complete	$134.33
Rate for Payer: Cash Price	$268.66
Rate for Payer: Cofinity Commercial	$235.07
Rate for Payer: Cofinity Commercial	$288.81
Rate for Payer: Cofinity Medicare Advantage	$235.07
Rate for Payer: Encore Health Key Benefits Commercial	$268.66
Rate for Payer: Healthscope Commercial	$302.24
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$285.45
Rate for Payer: PHP Commercial	$285.45
Rate for Payer: Priority Health Cigna Priority Health	$218.28
Rate for Payer: Priority Health SBD	$211.57

HC FILSHIE CLIP

Facility

$335.82

Hospital Charge Code	27000076
Hospital Revenue Code	270
Min. Negotiated Rate	$211.57
Max. Negotiated Rate	$302.24
Rate for Payer: Aetna Commercial	$285.45
Rate for Payer: Aetna New Business (MI Preferred)	$218.28
Rate for Payer: Cash Price	$268.66
Rate for Payer: Cofinity Commercial	$235.07
Rate for Payer: Cofinity Commercial	$288.81
Rate for Payer: Cofinity Medicare Advantage	$235.07
Rate for Payer: Encore Health Key Benefits Commercial	$268.66
Rate for Payer: Healthscope Commercial	$302.24
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$285.45
Rate for Payer: PHP Commercial	$285.45
Rate for Payer: Priority Health Cigna Priority Health	$218.28
Rate for Payer: Priority Health SBD	$211.57

HC FILTER ATS LIPIGUARD

Facility

$58.14

Hospital Charge Code	27000121
Hospital Revenue Code	270
Min. Negotiated Rate	$23.26
Max. Negotiated Rate	$52.33
Rate for Payer: Aetna Commercial	$49.42
Rate for Payer: Aetna Medicare	$29.07
Rate for Payer: Aetna New Business (MI Preferred)	$37.79
Rate for Payer: BCBS Complete	$23.26
Rate for Payer: Cash Price	$46.51
Rate for Payer: Cofinity Commercial	$40.70
Rate for Payer: Cofinity Commercial	$50.00
Rate for Payer: Cofinity Medicare Advantage	$40.70
Rate for Payer: Encore Health Key Benefits Commercial	$46.51
Rate for Payer: Healthscope Commercial	$52.33
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$49.42
Rate for Payer: PHP Commercial	$49.42
Rate for Payer: Priority Health Cigna Priority Health	$37.79
Rate for Payer: Priority Health SBD	$36.63

HC FILTER ATS LIPIGUARD

Facility

$58.14

Hospital Charge Code	27000121
Hospital Revenue Code	270
Min. Negotiated Rate	$36.63
Max. Negotiated Rate	$52.33
Rate for Payer: Aetna Commercial	$49.42
Rate for Payer: Aetna New Business (MI Preferred)	$37.79
Rate for Payer: Cash Price	$46.51
Rate for Payer: Cofinity Commercial	$40.70
Rate for Payer: Cofinity Commercial	$50.00
Rate for Payer: Cofinity Medicare Advantage	$40.70
Rate for Payer: Encore Health Key Benefits Commercial	$46.51
Rate for Payer: Healthscope Commercial	$52.33
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$49.42
Rate for Payer: PHP Commercial	$49.42
Rate for Payer: Priority Health Cigna Priority Health	$37.79
Rate for Payer: Priority Health SBD	$36.63

HC FILTERWIRE

Facility

$3,814.45

Service Code	HCPCS C1884
Hospital Charge Code	27800011
Hospital Revenue Code	278
Min. Negotiated Rate	$2,403.10
Max. Negotiated Rate	$3,433.01
Rate for Payer: Aetna Commercial	$3,242.28
Rate for Payer: Aetna New Business (MI Preferred)	$2,479.39
Rate for Payer: Cash Price	$3,051.56
Rate for Payer: Cofinity Commercial	$2,670.11
Rate for Payer: Cofinity Commercial	$3,280.43
Rate for Payer: Cofinity Medicare Advantage	$2,670.11
Rate for Payer: Encore Health Key Benefits Commercial	$3,051.56
Rate for Payer: Healthscope Commercial	$3,433.01
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3,242.28
Rate for Payer: PHP Commercial	$3,242.28
Rate for Payer: Priority Health Cigna Priority Health	$2,479.39
Rate for Payer: Priority Health SBD	$2,403.10

HC FILTERWIRE

Facility

$3,814.45

Service Code	HCPCS C1884
Hospital Charge Code	27800011
Hospital Revenue Code	278
Min. Negotiated Rate	$1,525.78
Max. Negotiated Rate	$3,433.01
Rate for Payer: Aetna Commercial	$3,242.28
Rate for Payer: Aetna Medicare	$1,907.22
Rate for Payer: Aetna New Business (MI Preferred)	$2,479.39
Rate for Payer: BCBS Complete	$1,525.78
Rate for Payer: Cash Price	$3,051.56
Rate for Payer: Cofinity Commercial	$2,670.11
Rate for Payer: Cofinity Commercial	$3,280.43
Rate for Payer: Cofinity Medicare Advantage	$2,670.11
Rate for Payer: Encore Health Key Benefits Commercial	$3,051.56
Rate for Payer: Healthscope Commercial	$3,433.01
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3,242.28
Rate for Payer: PHP Commercial	$3,242.28
Rate for Payer: Priority Health Cigna Priority Health	$2,479.39
Rate for Payer: Priority Health SBD	$2,403.10

HC FINGER SPLINT, STATIC, SUPPLY

Facility

$20.81

Hospital Charge Code	27000646
Hospital Revenue Code	270
Min. Negotiated Rate	$8.32
Max. Negotiated Rate	$18.73
Rate for Payer: Aetna Commercial	$17.69
Rate for Payer: Aetna Medicare	$10.40
Rate for Payer: Aetna New Business (MI Preferred)	$13.53
Rate for Payer: BCBS Complete	$8.32
Rate for Payer: Cash Price	$16.65
Rate for Payer: Cofinity Commercial	$14.57
Rate for Payer: Cofinity Commercial	$17.90
Rate for Payer: Cofinity Medicare Advantage	$14.57
Rate for Payer: Encore Health Key Benefits Commercial	$16.65
Rate for Payer: Healthscope Commercial	$18.73
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$17.69
Rate for Payer: PHP Commercial	$17.69
Rate for Payer: Priority Health Cigna Priority Health	$13.53
Rate for Payer: Priority Health SBD	$13.11

HC FINGER SPLINT, STATIC, SUPPLY

Facility

$20.81

Hospital Charge Code	27000646
Hospital Revenue Code	270
Min. Negotiated Rate	$13.11
Max. Negotiated Rate	$18.73
Rate for Payer: Aetna Commercial	$17.69
Rate for Payer: Aetna New Business (MI Preferred)	$13.53
Rate for Payer: Cash Price	$16.65
Rate for Payer: Cofinity Commercial	$14.57
Rate for Payer: Cofinity Commercial	$17.90
Rate for Payer: Cofinity Medicare Advantage	$14.57
Rate for Payer: Encore Health Key Benefits Commercial	$16.65
Rate for Payer: Healthscope Commercial	$18.73
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$17.69
Rate for Payer: PHP Commercial	$17.69
Rate for Payer: Priority Health Cigna Priority Health	$13.53
Rate for Payer: Priority Health SBD	$13.11

HC FISH PRENATAL ANEUPLOIDY

Facility

$168.54

Service Code	CPT 88275
Hospital Charge Code	31000034
Hospital Revenue Code	310
Min. Negotiated Rate	$106.18
Max. Negotiated Rate	$151.69
Rate for Payer: Aetna Commercial	$143.26
Rate for Payer: Aetna New Business (MI Preferred)	$109.55
Rate for Payer: Cash Price	$134.83
Rate for Payer: Cofinity Commercial	$117.98
Rate for Payer: Cofinity Commercial	$144.94
Rate for Payer: Cofinity Medicare Advantage	$117.98
Rate for Payer: Encore Health Key Benefits Commercial	$134.83
Rate for Payer: Healthscope Commercial	$151.69
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$143.26
Rate for Payer: PHP Commercial	$143.26
Rate for Payer: Priority Health Cigna Priority Health	$109.55
Rate for Payer: Priority Health SBD	$106.18

HC FISH PRENATAL ANEUPLOIDY

Facility

$168.54

Service Code	CPT 88275
Hospital Charge Code	31000034
Hospital Revenue Code	310
Min. Negotiated Rate	$27.44
Max. Negotiated Rate	$151.69
Rate for Payer: Aetna Commercial	$143.26
Rate for Payer: Aetna Medicare	$53.24
Rate for Payer: Aetna New Business (MI Preferred)	$109.55
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	$28.81
Rate for Payer: BCBS MAPPO	$51.19
Rate for Payer: BCN Medicare Advantage	$51.19
Rate for Payer: Cash Price	$134.83
Rate for Payer: Cash Price	$134.83
Rate for Payer: Cofinity Commercial	$144.94
Rate for Payer: Cofinity Commercial	$117.98
Rate for Payer: Cofinity Medicare Advantage	$117.98
Rate for Payer: Encore Health Key Benefits Commercial	$134.83
Rate for Payer: Health Alliance Plan Medicare Advantage	$51.19
Rate for Payer: Healthscope Commercial	$151.69
Rate for Payer: Mclaren Medicaid	$27.44
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	$28.81
Rate for Payer: MI Amish Medical Board Commercial	$58.87
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$143.26
Rate for Payer: PACE Medicare	$48.63
Rate for Payer: PACE SWMI	$51.19
Rate for Payer: PHP Commercial	$143.26
Rate for Payer: PHP Medicare Advantage	$51.19
Rate for Payer: Priority Health Choice Medicaid	$27.44
Rate for Payer: Priority Health Cigna Priority Health	$109.55
Rate for Payer: Priority Health Medicare	$51.19
Rate for Payer: Priority Health SBD	$106.18
Rate for Payer: Railroad Medicare Medicare	$51.19
Rate for Payer: UHC All Payor (Choice/PPO)	$144.09
Rate for Payer: UHC Dual Complete DSNP	$51.19
Rate for Payer: UHC Medicare Advantage	$51.19
Rate for Payer: UHCCP Medicaid	$28.82
Rate for Payer: VA VA	$51.19

HC FISH PROBES

Facility

$77.87

Service Code	CPT 88275
Hospital Charge Code	31000067
Hospital Revenue Code	310
Min. Negotiated Rate	$27.44
Max. Negotiated Rate	$144.09
Rate for Payer: Aetna Commercial	$66.19
Rate for Payer: Aetna Medicare	$53.24
Rate for Payer: Aetna New Business (MI Preferred)	$50.62
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	$28.81
Rate for Payer: BCBS MAPPO	$51.19
Rate for Payer: BCN Medicare Advantage	$51.19
Rate for Payer: Cash Price	$62.30
Rate for Payer: Cash Price	$62.30
Rate for Payer: Cofinity Commercial	$66.97
Rate for Payer: Cofinity Commercial	$54.51
Rate for Payer: Cofinity Medicare Advantage	$54.51
Rate for Payer: Encore Health Key Benefits Commercial	$62.30
Rate for Payer: Health Alliance Plan Medicare Advantage	$51.19
Rate for Payer: Healthscope Commercial	$70.08
Rate for Payer: Mclaren Medicaid	$27.44
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	$28.81
Rate for Payer: MI Amish Medical Board Commercial	$58.87
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$66.19
Rate for Payer: PACE Medicare	$48.63
Rate for Payer: PACE SWMI	$51.19
Rate for Payer: PHP Commercial	$66.19
Rate for Payer: PHP Medicare Advantage	$51.19
Rate for Payer: Priority Health Choice Medicaid	$27.44
Rate for Payer: Priority Health Cigna Priority Health	$50.62
Rate for Payer: Priority Health Medicare	$51.19
Rate for Payer: Priority Health SBD	$49.06
Rate for Payer: Railroad Medicare Medicare	$51.19
Rate for Payer: UHC All Payor (Choice/PPO)	$144.09
Rate for Payer: UHC Dual Complete DSNP	$51.19
Rate for Payer: UHC Medicare Advantage	$51.19
Rate for Payer: UHCCP Medicaid	$28.82
Rate for Payer: VA VA	$51.19

Know your out-of-pocket cost for care.

All Charges