Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC HEMO CMS SUPP/SERV

Facility

$75.00

Service Code	CPT 99211
Hospital Charge Code	51500004
Hospital Revenue Code	515
Min. Negotiated Rate	$47.25
Max. Negotiated Rate	$67.50
Rate for Payer: Aetna Commercial	$63.75
Rate for Payer: Aetna New Business (MI Preferred)	$48.75
Rate for Payer: Cash Price	$60.00
Rate for Payer: Cofinity Commercial	$52.50
Rate for Payer: Cofinity Commercial	$64.50
Rate for Payer: Cofinity Medicare Advantage	$52.50
Rate for Payer: Encore Health Key Benefits Commercial	$60.00
Rate for Payer: Healthscope Commercial	$67.50
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$63.75
Rate for Payer: PHP Commercial	$63.75
Rate for Payer: Priority Health Cigna Priority Health	$48.75
Rate for Payer: Priority Health SBD	$47.25

HC HEMO CMS SUPP/SERV

Facility

$75.00

Service Code	CPT 99211
Hospital Charge Code	51500004
Hospital Revenue Code	515
Min. Negotiated Rate	$9.21
Max. Negotiated Rate	$67.50
Rate for Payer: Aetna Commercial	$63.75
Rate for Payer: Aetna Medicare	$37.50
Rate for Payer: Aetna New Business (MI Preferred)	$48.75
Rate for Payer: BCBS Complete	$30.00
Rate for Payer: BCBS Trust/PPO	$49.38
Rate for Payer: BCCCP Commercial	$21.87
Rate for Payer: BCN Commercial	$49.38
Rate for Payer: Cash Price	$60.00
Rate for Payer: Cash Price	$60.00
Rate for Payer: Cofinity Commercial	$52.50
Rate for Payer: Cofinity Commercial	$64.50
Rate for Payer: Cofinity Medicare Advantage	$52.50
Rate for Payer: Encore Health Key Benefits Commercial	$60.00
Rate for Payer: Healthscope Commercial	$67.50
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$63.75
Rate for Payer: PHP Commercial	$63.75
Rate for Payer: Priority Health Cigna Priority Health	$48.75
Rate for Payer: Priority Health SBD	$47.25
Rate for Payer: UHC All Payor (Choice/PPO)	$9.21

HC HEMOCONCENTRATOR

Facility

$233.23

Hospital Charge Code	27006703
Hospital Revenue Code	270
Min. Negotiated Rate	$93.29
Max. Negotiated Rate	$209.91
Rate for Payer: Aetna Commercial	$198.25
Rate for Payer: Aetna Medicare	$116.62
Rate for Payer: Aetna New Business (MI Preferred)	$151.60
Rate for Payer: BCBS Complete	$93.29
Rate for Payer: Cash Price	$186.58
Rate for Payer: Cofinity Commercial	$163.26
Rate for Payer: Cofinity Commercial	$200.58
Rate for Payer: Cofinity Medicare Advantage	$163.26
Rate for Payer: Encore Health Key Benefits Commercial	$186.58
Rate for Payer: Healthscope Commercial	$209.91
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$198.25
Rate for Payer: PHP Commercial	$198.25
Rate for Payer: Priority Health Cigna Priority Health	$151.60
Rate for Payer: Priority Health SBD	$146.93

HC HEMOCONCENTRATOR

Facility

$233.23

Hospital Charge Code	27006703
Hospital Revenue Code	270
Min. Negotiated Rate	$146.93
Max. Negotiated Rate	$209.91
Rate for Payer: Aetna Commercial	$198.25
Rate for Payer: Aetna New Business (MI Preferred)	$151.60
Rate for Payer: Cash Price	$186.58
Rate for Payer: Cofinity Commercial	$163.26
Rate for Payer: Cofinity Commercial	$200.58
Rate for Payer: Cofinity Medicare Advantage	$163.26
Rate for Payer: Encore Health Key Benefits Commercial	$186.58
Rate for Payer: Healthscope Commercial	$209.91
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$198.25
Rate for Payer: PHP Commercial	$198.25
Rate for Payer: Priority Health Cigna Priority Health	$151.60
Rate for Payer: Priority Health SBD	$146.93

HC HEMOCONCENTRATOR DHF

Facility

$257.04

Hospital Charge Code	27000658
Hospital Revenue Code	270
Min. Negotiated Rate	$102.82
Max. Negotiated Rate	$231.34
Rate for Payer: Aetna Commercial	$218.48
Rate for Payer: Aetna Medicare	$128.52
Rate for Payer: Aetna New Business (MI Preferred)	$167.08
Rate for Payer: BCBS Complete	$102.82
Rate for Payer: Cash Price	$205.63
Rate for Payer: Cofinity Commercial	$179.93
Rate for Payer: Cofinity Commercial	$221.05
Rate for Payer: Cofinity Medicare Advantage	$179.93
Rate for Payer: Encore Health Key Benefits Commercial	$205.63
Rate for Payer: Healthscope Commercial	$231.34
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$218.48
Rate for Payer: PHP Commercial	$218.48
Rate for Payer: Priority Health Cigna Priority Health	$167.08
Rate for Payer: Priority Health SBD	$161.94

HC HEMOCONCENTRATOR DHF

Facility

$257.04

Hospital Charge Code	27000658
Hospital Revenue Code	270
Min. Negotiated Rate	$161.94
Max. Negotiated Rate	$231.34
Rate for Payer: Aetna Commercial	$218.48
Rate for Payer: Aetna New Business (MI Preferred)	$167.08
Rate for Payer: Cash Price	$205.63
Rate for Payer: Cofinity Commercial	$179.93
Rate for Payer: Cofinity Commercial	$221.05
Rate for Payer: Cofinity Medicare Advantage	$179.93
Rate for Payer: Encore Health Key Benefits Commercial	$205.63
Rate for Payer: Healthscope Commercial	$231.34
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$218.48
Rate for Payer: PHP Commercial	$218.48
Rate for Payer: Priority Health Cigna Priority Health	$167.08
Rate for Payer: Priority Health SBD	$161.94

HC HEMOCONCENTRATOR LONG

Facility

$214.20

Hospital Charge Code	27000103
Hospital Revenue Code	270
Min. Negotiated Rate	$85.68
Max. Negotiated Rate	$192.78
Rate for Payer: Aetna Commercial	$182.07
Rate for Payer: Aetna Medicare	$107.10
Rate for Payer: Aetna New Business (MI Preferred)	$139.23
Rate for Payer: BCBS Complete	$85.68
Rate for Payer: Cash Price	$171.36
Rate for Payer: Cofinity Commercial	$149.94
Rate for Payer: Cofinity Commercial	$184.21
Rate for Payer: Cofinity Medicare Advantage	$149.94
Rate for Payer: Encore Health Key Benefits Commercial	$171.36
Rate for Payer: Healthscope Commercial	$192.78
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$182.07
Rate for Payer: PHP Commercial	$182.07
Rate for Payer: Priority Health Cigna Priority Health	$139.23
Rate for Payer: Priority Health SBD	$134.95

HC HEMOCONCENTRATOR LONG

Facility

$214.20

Hospital Charge Code	27000103
Hospital Revenue Code	270
Min. Negotiated Rate	$134.95
Max. Negotiated Rate	$192.78
Rate for Payer: Aetna Commercial	$182.07
Rate for Payer: Aetna New Business (MI Preferred)	$139.23
Rate for Payer: Cash Price	$171.36
Rate for Payer: Cofinity Commercial	$149.94
Rate for Payer: Cofinity Commercial	$184.21
Rate for Payer: Cofinity Medicare Advantage	$149.94
Rate for Payer: Encore Health Key Benefits Commercial	$171.36
Rate for Payer: Healthscope Commercial	$192.78
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$182.07
Rate for Payer: PHP Commercial	$182.07
Rate for Payer: Priority Health Cigna Priority Health	$139.23
Rate for Payer: Priority Health SBD	$134.95

HC HEMODIALYSIS NON-URGENT

Facility

$969.00

Hospital Charge Code	88100003
Hospital Revenue Code	881
Min. Negotiated Rate	$610.47
Max. Negotiated Rate	$872.10
Rate for Payer: Aetna Commercial	$823.65
Rate for Payer: Aetna New Business (MI Preferred)	$629.85
Rate for Payer: Cash Price	$775.20
Rate for Payer: Cofinity Commercial	$678.30
Rate for Payer: Cofinity Commercial	$833.34
Rate for Payer: Cofinity Medicare Advantage	$678.30
Rate for Payer: Encore Health Key Benefits Commercial	$775.20
Rate for Payer: Healthscope Commercial	$872.10
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$823.65
Rate for Payer: PHP Commercial	$823.65
Rate for Payer: Priority Health Cigna Priority Health	$629.85
Rate for Payer: Priority Health SBD	$610.47

HC HEMODIALYSIS NON-URGENT

Facility

$969.00

Hospital Charge Code	88100003
Hospital Revenue Code	881
Min. Negotiated Rate	$387.60
Max. Negotiated Rate	$872.10
Rate for Payer: Aetna Commercial	$823.65
Rate for Payer: Aetna Medicare	$484.50
Rate for Payer: Aetna New Business (MI Preferred)	$629.85
Rate for Payer: BCBS Complete	$387.60
Rate for Payer: Cash Price	$775.20
Rate for Payer: Cofinity Commercial	$678.30
Rate for Payer: Cofinity Commercial	$833.34
Rate for Payer: Cofinity Medicare Advantage	$678.30
Rate for Payer: Encore Health Key Benefits Commercial	$775.20
Rate for Payer: Healthscope Commercial	$872.10
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$823.65
Rate for Payer: PHP Commercial	$823.65
Rate for Payer: Priority Health Cigna Priority Health	$629.85
Rate for Payer: Priority Health SBD	$610.47

HC HEMOFILTRATION MONITORING HOUR

Facility

$408.67

Hospital Charge Code	27000114
Hospital Revenue Code	270
Min. Negotiated Rate	$257.46
Max. Negotiated Rate	$367.80
Rate for Payer: Aetna Commercial	$347.37
Rate for Payer: Aetna New Business (MI Preferred)	$265.64
Rate for Payer: Cash Price	$326.94
Rate for Payer: Cofinity Commercial	$286.07
Rate for Payer: Cofinity Commercial	$351.46
Rate for Payer: Cofinity Medicare Advantage	$286.07
Rate for Payer: Encore Health Key Benefits Commercial	$326.94
Rate for Payer: Healthscope Commercial	$367.80
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$347.37
Rate for Payer: PHP Commercial	$347.37
Rate for Payer: Priority Health Cigna Priority Health	$265.64
Rate for Payer: Priority Health SBD	$257.46

HC HEMOFILTRATION MONITORING HOUR

Facility

$408.67

Hospital Charge Code	27000114
Hospital Revenue Code	270
Min. Negotiated Rate	$163.47
Max. Negotiated Rate	$367.80
Rate for Payer: Aetna Commercial	$347.37
Rate for Payer: Aetna Medicare	$204.34
Rate for Payer: Aetna New Business (MI Preferred)	$265.64
Rate for Payer: BCBS Complete	$163.47
Rate for Payer: Cash Price	$326.94
Rate for Payer: Cofinity Commercial	$286.07
Rate for Payer: Cofinity Commercial	$351.46
Rate for Payer: Cofinity Medicare Advantage	$286.07
Rate for Payer: Encore Health Key Benefits Commercial	$326.94
Rate for Payer: Healthscope Commercial	$367.80
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$347.37
Rate for Payer: PHP Commercial	$347.37
Rate for Payer: Priority Health Cigna Priority Health	$265.64
Rate for Payer: Priority Health SBD	$257.46

HC HEMOGLOBIN

Facility

$31.62

Service Code	CPT 85018
Hospital Charge Code	30500006
Hospital Revenue Code	305
Min. Negotiated Rate	$1.27
Max. Negotiated Rate	$28.46
Rate for Payer: Aetna Commercial	$26.88
Rate for Payer: Aetna Medicare	$2.46
Rate for Payer: Aetna New Business (MI Preferred)	$20.55
Rate for Payer: Allen County Amish Medical Aid Commercial	$2.96
Rate for Payer: Amish Plain Church Group Commercial	$2.96
Rate for Payer: BCBS Complete	$1.33
Rate for Payer: BCBS MAPPO	$2.37
Rate for Payer: BCBS Trust/PPO	$2.10
Rate for Payer: BCN Commercial	$2.10
Rate for Payer: BCN Medicare Advantage	$2.37
Rate for Payer: Cash Price	$25.30
Rate for Payer: Cash Price	$25.30
Rate for Payer: Cofinity Commercial	$27.19
Rate for Payer: Cofinity Commercial	$22.13
Rate for Payer: Cofinity Medicare Advantage	$22.13
Rate for Payer: Encore Health Key Benefits Commercial	$25.30
Rate for Payer: Health Alliance Plan Medicare Advantage	$2.37
Rate for Payer: Healthscope Commercial	$28.46
Rate for Payer: Mclaren Medicaid	$1.27
Rate for Payer: Mclaren Medicare	$2.37
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$2.49
Rate for Payer: Meridian Medicaid	$1.33
Rate for Payer: MI Amish Medical Board Commercial	$2.73
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$26.88
Rate for Payer: Nomi Health Commercial	$3.56
Rate for Payer: PACE Medicare	$2.25
Rate for Payer: PACE SWMI	$2.37
Rate for Payer: PHP Commercial	$26.88
Rate for Payer: PHP Medicare Advantage	$2.37
Rate for Payer: Priority Health Choice Medicaid	$1.27
Rate for Payer: Priority Health Cigna Priority Health	$20.55
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2.44
Rate for Payer: Priority Health Medicare	$2.37
Rate for Payer: Priority Health Narrow Network	$1.95
Rate for Payer: Priority Health SBD	$19.92
Rate for Payer: Railroad Medicare Medicare	$2.37
Rate for Payer: UHC All Payor (Choice/PPO)	$2.84
Rate for Payer: UHC Dual Complete DSNP	$2.37
Rate for Payer: UHC Medicare Advantage	$2.37
Rate for Payer: UHCCP Medicaid	$1.33
Rate for Payer: VA VA	$2.37

HC HEMOGLOBIN

Facility

$31.62

Service Code	CPT 85018
Hospital Charge Code	30500006
Hospital Revenue Code	305
Min. Negotiated Rate	$19.92
Max. Negotiated Rate	$28.46
Rate for Payer: Aetna Commercial	$26.88
Rate for Payer: Aetna New Business (MI Preferred)	$20.55
Rate for Payer: Cash Price	$25.30
Rate for Payer: Cofinity Commercial	$22.13
Rate for Payer: Cofinity Commercial	$27.19
Rate for Payer: Cofinity Medicare Advantage	$22.13
Rate for Payer: Encore Health Key Benefits Commercial	$25.30
Rate for Payer: Healthscope Commercial	$28.46
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$26.88
Rate for Payer: PHP Commercial	$26.88
Rate for Payer: Priority Health Cigna Priority Health	$20.55
Rate for Payer: Priority Health SBD	$19.92

HC HEMOGLOBIN A2 AND F

Facility

$27.48

Service Code	CPT 83021
Hospital Charge Code	30100624
Hospital Revenue Code	301
Min. Negotiated Rate	$17.31
Max. Negotiated Rate	$24.73
Rate for Payer: Aetna Commercial	$23.36
Rate for Payer: Aetna New Business (MI Preferred)	$17.86
Rate for Payer: Cash Price	$21.98
Rate for Payer: Cofinity Commercial	$19.24
Rate for Payer: Cofinity Commercial	$23.63
Rate for Payer: Cofinity Medicare Advantage	$19.24
Rate for Payer: Encore Health Key Benefits Commercial	$21.98
Rate for Payer: Healthscope Commercial	$24.73
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$23.36
Rate for Payer: PHP Commercial	$23.36
Rate for Payer: Priority Health Cigna Priority Health	$17.86
Rate for Payer: Priority Health SBD	$17.31

HC HEMOGLOBIN A2 AND F

Facility

$27.48

Service Code	CPT 83021
Hospital Charge Code	30100624
Hospital Revenue Code	301
Min. Negotiated Rate	$9.68
Max. Negotiated Rate	$27.09
Rate for Payer: Aetna Commercial	$23.36
Rate for Payer: Aetna Medicare	$18.78
Rate for Payer: Aetna New Business (MI Preferred)	$17.86
Rate for Payer: Allen County Amish Medical Aid Commercial	$22.58
Rate for Payer: Amish Plain Church Group Commercial	$22.58
Rate for Payer: BCBS Complete	$10.16
Rate for Payer: BCBS MAPPO	$18.06
Rate for Payer: BCBS Trust/PPO	$15.99
Rate for Payer: BCN Commercial	$15.99
Rate for Payer: BCN Medicare Advantage	$18.06
Rate for Payer: Cash Price	$21.98
Rate for Payer: Cash Price	$21.98
Rate for Payer: Cofinity Commercial	$23.63
Rate for Payer: Cofinity Commercial	$19.24
Rate for Payer: Cofinity Medicare Advantage	$19.24
Rate for Payer: Encore Health Key Benefits Commercial	$21.98
Rate for Payer: Health Alliance Plan Medicare Advantage	$18.06
Rate for Payer: Healthscope Commercial	$24.73
Rate for Payer: Mclaren Medicaid	$9.68
Rate for Payer: Mclaren Medicare	$18.06
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$18.96
Rate for Payer: Meridian Medicaid	$10.16
Rate for Payer: MI Amish Medical Board Commercial	$20.77
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$23.36
Rate for Payer: Nomi Health Commercial	$27.09
Rate for Payer: PACE Medicare	$17.16
Rate for Payer: PACE SWMI	$18.06
Rate for Payer: PHP Commercial	$23.36
Rate for Payer: PHP Medicare Advantage	$18.06
Rate for Payer: Priority Health Choice Medicaid	$9.68
Rate for Payer: Priority Health Cigna Priority Health	$17.86
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$18.06
Rate for Payer: Priority Health Medicare	$18.06
Rate for Payer: Priority Health Narrow Network	$14.45
Rate for Payer: Priority Health SBD	$17.31
Rate for Payer: Railroad Medicare Medicare	$18.06
Rate for Payer: UHC All Payor (Choice/PPO)	$21.67
Rate for Payer: UHC Dual Complete DSNP	$18.06
Rate for Payer: UHC Medicare Advantage	$18.06
Rate for Payer: UHCCP Medicaid	$10.17
Rate for Payer: VA VA	$18.06

HC HEMOGLOBIN ELECTROPHORESIS

Facility

$97.10

Service Code	CPT 83020
Hospital Charge Code	30100235
Hospital Revenue Code	301
Min. Negotiated Rate	$6.90
Max. Negotiated Rate	$87.39
Rate for Payer: Aetna Commercial	$82.54
Rate for Payer: Aetna Medicare	$13.38
Rate for Payer: Aetna New Business (MI Preferred)	$63.12
Rate for Payer: Allen County Amish Medical Aid Commercial	$16.09
Rate for Payer: Amish Plain Church Group Commercial	$16.09
Rate for Payer: BCBS Complete	$7.24
Rate for Payer: BCBS MAPPO	$12.87
Rate for Payer: BCBS Trust/PPO	$8.53
Rate for Payer: BCN Commercial	$8.53
Rate for Payer: BCN Medicare Advantage	$12.87
Rate for Payer: Cash Price	$77.68
Rate for Payer: Cash Price	$77.68
Rate for Payer: Cofinity Commercial	$83.51
Rate for Payer: Cofinity Commercial	$67.97
Rate for Payer: Cofinity Medicare Advantage	$67.97
Rate for Payer: Encore Health Key Benefits Commercial	$77.68
Rate for Payer: Health Alliance Plan Medicare Advantage	$12.87
Rate for Payer: Healthscope Commercial	$87.39
Rate for Payer: Mclaren Medicaid	$6.90
Rate for Payer: Mclaren Medicare	$12.87
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$13.51
Rate for Payer: Meridian Medicaid	$7.24
Rate for Payer: MI Amish Medical Board Commercial	$14.80
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$82.54
Rate for Payer: Nomi Health Commercial	$19.30
Rate for Payer: PACE Medicare	$12.23
Rate for Payer: PACE SWMI	$12.87
Rate for Payer: PHP Commercial	$82.54
Rate for Payer: PHP Medicare Advantage	$12.87
Rate for Payer: Priority Health Choice Medicaid	$6.90
Rate for Payer: Priority Health Cigna Priority Health	$63.12
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$13.25
Rate for Payer: Priority Health Medicare	$12.87
Rate for Payer: Priority Health Narrow Network	$10.60
Rate for Payer: Priority Health SBD	$61.17
Rate for Payer: Railroad Medicare Medicare	$12.87
Rate for Payer: UHC All Payor (Choice/PPO)	$15.44
Rate for Payer: UHC Dual Complete DSNP	$12.87
Rate for Payer: UHC Medicare Advantage	$12.87
Rate for Payer: UHCCP Medicaid	$7.25
Rate for Payer: VA VA	$12.87

HC HEMOGLOBIN ELECTROPHORESIS

Facility

$97.10

Service Code	CPT 83020
Hospital Charge Code	30100235
Hospital Revenue Code	301
Min. Negotiated Rate	$61.17
Max. Negotiated Rate	$87.39
Rate for Payer: Aetna Commercial	$82.54
Rate for Payer: Aetna New Business (MI Preferred)	$63.12
Rate for Payer: Cash Price	$77.68
Rate for Payer: Cofinity Commercial	$67.97
Rate for Payer: Cofinity Commercial	$83.51
Rate for Payer: Cofinity Medicare Advantage	$67.97
Rate for Payer: Encore Health Key Benefits Commercial	$77.68
Rate for Payer: Healthscope Commercial	$87.39
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$82.54
Rate for Payer: PHP Commercial	$82.54
Rate for Payer: Priority Health Cigna Priority Health	$63.12
Rate for Payer: Priority Health SBD	$61.17

HC HEMOGLOBIN ELECTROPHORESIS, B

Facility

$38.49

Service Code	CPT 83020
Hospital Charge Code	30100623
Hospital Revenue Code	301
Min. Negotiated Rate	$24.25
Max. Negotiated Rate	$34.64
Rate for Payer: Aetna Commercial	$32.72
Rate for Payer: Aetna New Business (MI Preferred)	$25.02
Rate for Payer: Cash Price	$30.79
Rate for Payer: Cofinity Commercial	$26.94
Rate for Payer: Cofinity Commercial	$33.10
Rate for Payer: Cofinity Medicare Advantage	$26.94
Rate for Payer: Encore Health Key Benefits Commercial	$30.79
Rate for Payer: Healthscope Commercial	$34.64
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$32.72
Rate for Payer: PHP Commercial	$32.72
Rate for Payer: Priority Health Cigna Priority Health	$25.02
Rate for Payer: Priority Health SBD	$24.25

HC HEMOGLOBIN ELECTROPHORESIS, B

Facility

$38.49

Service Code	CPT 83020
Hospital Charge Code	30100623
Hospital Revenue Code	301
Min. Negotiated Rate	$6.90
Max. Negotiated Rate	$34.64
Rate for Payer: Aetna Commercial	$32.72
Rate for Payer: Aetna Medicare	$13.38
Rate for Payer: Aetna New Business (MI Preferred)	$25.02
Rate for Payer: Allen County Amish Medical Aid Commercial	$16.09
Rate for Payer: Amish Plain Church Group Commercial	$16.09
Rate for Payer: BCBS Complete	$7.24
Rate for Payer: BCBS MAPPO	$12.87
Rate for Payer: BCBS Trust/PPO	$8.53
Rate for Payer: BCN Commercial	$8.53
Rate for Payer: BCN Medicare Advantage	$12.87
Rate for Payer: Cash Price	$30.79
Rate for Payer: Cash Price	$30.79
Rate for Payer: Cofinity Commercial	$33.10
Rate for Payer: Cofinity Commercial	$26.94
Rate for Payer: Cofinity Medicare Advantage	$26.94
Rate for Payer: Encore Health Key Benefits Commercial	$30.79
Rate for Payer: Health Alliance Plan Medicare Advantage	$12.87
Rate for Payer: Healthscope Commercial	$34.64
Rate for Payer: Mclaren Medicaid	$6.90
Rate for Payer: Mclaren Medicare	$12.87
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$13.51
Rate for Payer: Meridian Medicaid	$7.24
Rate for Payer: MI Amish Medical Board Commercial	$14.80
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$32.72
Rate for Payer: Nomi Health Commercial	$19.30
Rate for Payer: PACE Medicare	$12.23
Rate for Payer: PACE SWMI	$12.87
Rate for Payer: PHP Commercial	$32.72
Rate for Payer: PHP Medicare Advantage	$12.87
Rate for Payer: Priority Health Choice Medicaid	$6.90
Rate for Payer: Priority Health Cigna Priority Health	$25.02
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$13.25
Rate for Payer: Priority Health Medicare	$12.87
Rate for Payer: Priority Health Narrow Network	$10.60
Rate for Payer: Priority Health SBD	$24.25
Rate for Payer: Railroad Medicare Medicare	$12.87
Rate for Payer: UHC All Payor (Choice/PPO)	$15.44
Rate for Payer: UHC Dual Complete DSNP	$12.87
Rate for Payer: UHC Medicare Advantage	$12.87
Rate for Payer: UHCCP Medicaid	$7.25
Rate for Payer: VA VA	$12.87

HC HEMOGLOBIN ELECTROPHORESIS CMP

Facility

$97.10

Service Code	CPT 83020
Hospital Charge Code	30100236
Hospital Revenue Code	301
Min. Negotiated Rate	$61.17
Max. Negotiated Rate	$87.39
Rate for Payer: Aetna Commercial	$82.54
Rate for Payer: Aetna New Business (MI Preferred)	$63.12
Rate for Payer: Cash Price	$77.68
Rate for Payer: Cofinity Commercial	$67.97
Rate for Payer: Cofinity Commercial	$83.51
Rate for Payer: Cofinity Medicare Advantage	$67.97
Rate for Payer: Encore Health Key Benefits Commercial	$77.68
Rate for Payer: Healthscope Commercial	$87.39
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$82.54
Rate for Payer: PHP Commercial	$82.54
Rate for Payer: Priority Health Cigna Priority Health	$63.12
Rate for Payer: Priority Health SBD	$61.17

HC HEMOGLOBIN ELECTROPHORESIS CMP

Facility

$97.10

Service Code	CPT 83020
Hospital Charge Code	30100236
Hospital Revenue Code	301
Min. Negotiated Rate	$6.90
Max. Negotiated Rate	$87.39
Rate for Payer: Aetna Commercial	$82.54
Rate for Payer: Aetna Medicare	$13.38
Rate for Payer: Aetna New Business (MI Preferred)	$63.12
Rate for Payer: Allen County Amish Medical Aid Commercial	$16.09
Rate for Payer: Amish Plain Church Group Commercial	$16.09
Rate for Payer: BCBS Complete	$7.24
Rate for Payer: BCBS MAPPO	$12.87
Rate for Payer: BCBS Trust/PPO	$8.53
Rate for Payer: BCN Commercial	$8.53
Rate for Payer: BCN Medicare Advantage	$12.87
Rate for Payer: Cash Price	$77.68
Rate for Payer: Cash Price	$77.68
Rate for Payer: Cofinity Commercial	$83.51
Rate for Payer: Cofinity Commercial	$67.97
Rate for Payer: Cofinity Medicare Advantage	$67.97
Rate for Payer: Encore Health Key Benefits Commercial	$77.68
Rate for Payer: Health Alliance Plan Medicare Advantage	$12.87
Rate for Payer: Healthscope Commercial	$87.39
Rate for Payer: Mclaren Medicaid	$6.90
Rate for Payer: Mclaren Medicare	$12.87
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$13.51
Rate for Payer: Meridian Medicaid	$7.24
Rate for Payer: MI Amish Medical Board Commercial	$14.80
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$82.54
Rate for Payer: Nomi Health Commercial	$19.30
Rate for Payer: PACE Medicare	$12.23
Rate for Payer: PACE SWMI	$12.87
Rate for Payer: PHP Commercial	$82.54
Rate for Payer: PHP Medicare Advantage	$12.87
Rate for Payer: Priority Health Choice Medicaid	$6.90
Rate for Payer: Priority Health Cigna Priority Health	$63.12
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$13.25
Rate for Payer: Priority Health Medicare	$12.87
Rate for Payer: Priority Health Narrow Network	$10.60
Rate for Payer: Priority Health SBD	$61.17
Rate for Payer: Railroad Medicare Medicare	$12.87
Rate for Payer: UHC All Payor (Choice/PPO)	$15.44
Rate for Payer: UHC Dual Complete DSNP	$12.87
Rate for Payer: UHC Medicare Advantage	$12.87
Rate for Payer: UHCCP Medicaid	$7.25
Rate for Payer: VA VA	$12.87

HC HEM/ONC CMS COMP

Facility

$300.00

Service Code	CPT 99215
Hospital Charge Code	51500006
Hospital Revenue Code	515
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$270.00
Rate for Payer: Aetna Commercial	$255.00
Rate for Payer: Aetna Medicare	$150.00
Rate for Payer: Aetna New Business (MI Preferred)	$195.00
Rate for Payer: BCBS Complete	$120.00
Rate for Payer: BCBS Trust/PPO	$208.46
Rate for Payer: BCN Commercial	$208.46
Rate for Payer: Cash Price	$240.00
Rate for Payer: Cash Price	$240.00
Rate for Payer: Cofinity Commercial	$258.00
Rate for Payer: Cofinity Commercial	$210.00
Rate for Payer: Cofinity Medicare Advantage	$210.00
Rate for Payer: Encore Health Key Benefits Commercial	$240.00
Rate for Payer: Healthscope Commercial	$270.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$255.00
Rate for Payer: PHP Commercial	$255.00
Rate for Payer: Priority Health Cigna Priority Health	$195.00
Rate for Payer: Priority Health SBD	$189.00
Rate for Payer: UHC All Payor (Choice/PPO)	$151.82

HC HEM/ONC CMS COMP

Facility

$300.00

Service Code	CPT 99215
Hospital Charge Code	51500006
Hospital Revenue Code	515
Min. Negotiated Rate	$189.00
Max. Negotiated Rate	$270.00
Rate for Payer: Aetna Commercial	$255.00
Rate for Payer: Aetna New Business (MI Preferred)	$195.00
Rate for Payer: Cash Price	$240.00
Rate for Payer: Cofinity Commercial	$210.00
Rate for Payer: Cofinity Commercial	$258.00
Rate for Payer: Cofinity Medicare Advantage	$210.00
Rate for Payer: Encore Health Key Benefits Commercial	$240.00
Rate for Payer: Healthscope Commercial	$270.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$255.00
Rate for Payer: PHP Commercial	$255.00
Rate for Payer: Priority Health Cigna Priority Health	$195.00
Rate for Payer: Priority Health SBD	$189.00

HC HEM/ONC CMS F/U

Facility

$125.00

Service Code	CPT 99213
Hospital Charge Code	51500007
Hospital Revenue Code	515
Min. Negotiated Rate	$50.00
Max. Negotiated Rate	$119.52
Rate for Payer: Aetna Commercial	$106.25
Rate for Payer: Aetna Medicare	$62.50
Rate for Payer: Aetna New Business (MI Preferred)	$81.25
Rate for Payer: BCBS Complete	$50.00
Rate for Payer: BCBS Trust/PPO	$119.52
Rate for Payer: BCCCP Commercial	$87.68
Rate for Payer: BCN Commercial	$119.52
Rate for Payer: Cash Price	$100.00
Rate for Payer: Cash Price	$100.00
Rate for Payer: Cofinity Commercial	$107.50
Rate for Payer: Cofinity Commercial	$87.50
Rate for Payer: Cofinity Medicare Advantage	$87.50
Rate for Payer: Encore Health Key Benefits Commercial	$100.00
Rate for Payer: Healthscope Commercial	$112.50
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$106.25
Rate for Payer: PHP Commercial	$106.25
Rate for Payer: Priority Health Cigna Priority Health	$81.25
Rate for Payer: Priority Health SBD	$78.75
Rate for Payer: UHC All Payor (Choice/PPO)	$69.42

Know your out-of-pocket cost for care.

All Charges