Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC INFUSION CATHETER LVL 1

Facility

$160.65

Service Code	HCPCS C1751
Hospital Charge Code	27200278
Hospital Revenue Code	272
Min. Negotiated Rate	$64.26
Max. Negotiated Rate	$144.58
Rate for Payer: Aetna Commercial	$136.55
Rate for Payer: Aetna Medicare	$80.32
Rate for Payer: Aetna New Business (MI Preferred)	$104.42
Rate for Payer: BCBS Complete	$64.26
Rate for Payer: Cash Price	$128.52
Rate for Payer: Cofinity Commercial	$112.46
Rate for Payer: Cofinity Commercial	$138.16
Rate for Payer: Cofinity Medicare Advantage	$112.46
Rate for Payer: Encore Health Key Benefits Commercial	$128.52
Rate for Payer: Healthscope Commercial	$144.58
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$136.55
Rate for Payer: PHP Commercial	$136.55
Rate for Payer: Priority Health Cigna Priority Health	$104.42
Rate for Payer: Priority Health SBD	$101.21

HC INFUSION CATHETER LVL 1

Facility

$160.65

Service Code	HCPCS C1751
Hospital Charge Code	27200278
Hospital Revenue Code	272
Min. Negotiated Rate	$101.21
Max. Negotiated Rate	$144.58
Rate for Payer: Aetna Commercial	$136.55
Rate for Payer: Aetna New Business (MI Preferred)	$104.42
Rate for Payer: Cash Price	$128.52
Rate for Payer: Cofinity Commercial	$112.46
Rate for Payer: Cofinity Commercial	$138.16
Rate for Payer: Cofinity Medicare Advantage	$112.46
Rate for Payer: Encore Health Key Benefits Commercial	$128.52
Rate for Payer: Healthscope Commercial	$144.58
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$136.55
Rate for Payer: PHP Commercial	$136.55
Rate for Payer: Priority Health Cigna Priority Health	$104.42
Rate for Payer: Priority Health SBD	$101.21

HC INFUSION CATHETER LVL 2

Facility

$241.86

Service Code	HCPCS C1751
Hospital Charge Code	27200005
Hospital Revenue Code	272
Min. Negotiated Rate	$152.37
Max. Negotiated Rate	$217.67
Rate for Payer: Aetna Commercial	$205.58
Rate for Payer: Aetna New Business (MI Preferred)	$157.21
Rate for Payer: Cash Price	$193.49
Rate for Payer: Cofinity Commercial	$169.30
Rate for Payer: Cofinity Commercial	$208.00
Rate for Payer: Cofinity Medicare Advantage	$169.30
Rate for Payer: Encore Health Key Benefits Commercial	$193.49
Rate for Payer: Healthscope Commercial	$217.67
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$205.58
Rate for Payer: PHP Commercial	$205.58
Rate for Payer: Priority Health Cigna Priority Health	$157.21
Rate for Payer: Priority Health SBD	$152.37

HC INFUSION CATHETER LVL 2

Facility

$241.86

Service Code	HCPCS C1751
Hospital Charge Code	27200005
Hospital Revenue Code	272
Min. Negotiated Rate	$96.74
Max. Negotiated Rate	$217.67
Rate for Payer: Aetna Commercial	$205.58
Rate for Payer: Aetna Medicare	$120.93
Rate for Payer: Aetna New Business (MI Preferred)	$157.21
Rate for Payer: BCBS Complete	$96.74
Rate for Payer: Cash Price	$193.49
Rate for Payer: Cofinity Commercial	$169.30
Rate for Payer: Cofinity Commercial	$208.00
Rate for Payer: Cofinity Medicare Advantage	$169.30
Rate for Payer: Encore Health Key Benefits Commercial	$193.49
Rate for Payer: Healthscope Commercial	$217.67
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$205.58
Rate for Payer: PHP Commercial	$205.58
Rate for Payer: Priority Health Cigna Priority Health	$157.21
Rate for Payer: Priority Health SBD	$152.37

HC INFUSION CATHETER LVL 3

Facility

$396.90

Service Code	HCPCS C1751
Hospital Charge Code	27200265
Hospital Revenue Code	272
Min. Negotiated Rate	$158.76
Max. Negotiated Rate	$357.21
Rate for Payer: Aetna Commercial	$337.36
Rate for Payer: Aetna Medicare	$198.45
Rate for Payer: Aetna New Business (MI Preferred)	$257.98
Rate for Payer: BCBS Complete	$158.76
Rate for Payer: Cash Price	$317.52
Rate for Payer: Cofinity Commercial	$277.83
Rate for Payer: Cofinity Commercial	$341.33
Rate for Payer: Cofinity Medicare Advantage	$277.83
Rate for Payer: Encore Health Key Benefits Commercial	$317.52
Rate for Payer: Healthscope Commercial	$357.21
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$337.36
Rate for Payer: PHP Commercial	$337.36
Rate for Payer: Priority Health Cigna Priority Health	$257.98
Rate for Payer: Priority Health SBD	$250.05

HC INFUSION CATHETER LVL 3

Facility

$396.90

Service Code	HCPCS C1751
Hospital Charge Code	27200265
Hospital Revenue Code	272
Min. Negotiated Rate	$250.05
Max. Negotiated Rate	$357.21
Rate for Payer: Aetna Commercial	$337.36
Rate for Payer: Aetna New Business (MI Preferred)	$257.98
Rate for Payer: Cash Price	$317.52
Rate for Payer: Cofinity Commercial	$341.33
Rate for Payer: Cofinity Commercial	$277.83
Rate for Payer: Cofinity Medicare Advantage	$277.83
Rate for Payer: Encore Health Key Benefits Commercial	$317.52
Rate for Payer: Healthscope Commercial	$357.21
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$337.36
Rate for Payer: PHP Commercial	$337.36
Rate for Payer: Priority Health Cigna Priority Health	$257.98
Rate for Payer: Priority Health SBD	$250.05

HC INFUSION CATHETER LVL 6

Facility

$676.12

Service Code	HCPCS C1751
Hospital Charge Code	27200280
Hospital Revenue Code	272
Min. Negotiated Rate	$425.96
Max. Negotiated Rate	$608.51
Rate for Payer: Aetna Commercial	$574.70
Rate for Payer: Aetna New Business (MI Preferred)	$439.48
Rate for Payer: Cash Price	$540.90
Rate for Payer: Cofinity Commercial	$473.28
Rate for Payer: Cofinity Commercial	$581.46
Rate for Payer: Cofinity Medicare Advantage	$473.28
Rate for Payer: Encore Health Key Benefits Commercial	$540.90
Rate for Payer: Healthscope Commercial	$608.51
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$574.70
Rate for Payer: PHP Commercial	$574.70
Rate for Payer: Priority Health Cigna Priority Health	$439.48
Rate for Payer: Priority Health SBD	$425.96

HC INFUSION CATHETER LVL 6

Facility

$676.12

Service Code	HCPCS C1751
Hospital Charge Code	27200280
Hospital Revenue Code	272
Min. Negotiated Rate	$270.45
Max. Negotiated Rate	$608.51
Rate for Payer: Aetna Commercial	$574.70
Rate for Payer: Aetna Medicare	$338.06
Rate for Payer: Aetna New Business (MI Preferred)	$439.48
Rate for Payer: BCBS Complete	$270.45
Rate for Payer: Cash Price	$540.90
Rate for Payer: Cofinity Commercial	$473.28
Rate for Payer: Cofinity Commercial	$581.46
Rate for Payer: Cofinity Medicare Advantage	$473.28
Rate for Payer: Encore Health Key Benefits Commercial	$540.90
Rate for Payer: Healthscope Commercial	$608.51
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$574.70
Rate for Payer: PHP Commercial	$574.70
Rate for Payer: Priority Health Cigna Priority Health	$439.48
Rate for Payer: Priority Health SBD	$425.96

HC INFUSION CATHETER LVL 7

Facility

$755.19

Service Code	HCPCS C1751
Hospital Charge Code	27200003
Hospital Revenue Code	272
Min. Negotiated Rate	$475.77
Max. Negotiated Rate	$679.67
Rate for Payer: Aetna Commercial	$641.91
Rate for Payer: Aetna New Business (MI Preferred)	$490.87
Rate for Payer: Cash Price	$604.15
Rate for Payer: Cofinity Commercial	$528.63
Rate for Payer: Cofinity Commercial	$649.46
Rate for Payer: Cofinity Medicare Advantage	$528.63
Rate for Payer: Encore Health Key Benefits Commercial	$604.15
Rate for Payer: Healthscope Commercial	$679.67
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$641.91
Rate for Payer: PHP Commercial	$641.91
Rate for Payer: Priority Health Cigna Priority Health	$490.87
Rate for Payer: Priority Health SBD	$475.77

HC INFUSION CATHETER LVL 7

Facility

$755.19

Service Code	HCPCS C1751
Hospital Charge Code	27200003
Hospital Revenue Code	272
Min. Negotiated Rate	$302.08
Max. Negotiated Rate	$679.67
Rate for Payer: Aetna Commercial	$641.91
Rate for Payer: Aetna Medicare	$377.60
Rate for Payer: Aetna New Business (MI Preferred)	$490.87
Rate for Payer: BCBS Complete	$302.08
Rate for Payer: Cash Price	$604.15
Rate for Payer: Cofinity Commercial	$528.63
Rate for Payer: Cofinity Commercial	$649.46
Rate for Payer: Cofinity Medicare Advantage	$528.63
Rate for Payer: Encore Health Key Benefits Commercial	$604.15
Rate for Payer: Healthscope Commercial	$679.67
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$641.91
Rate for Payer: PHP Commercial	$641.91
Rate for Payer: Priority Health Cigna Priority Health	$490.87
Rate for Payer: Priority Health SBD	$475.77

HC INFUSION CATHETER LVL 9

Facility

$922.26

Service Code	HCPCS C1751
Hospital Charge Code	27200170
Hospital Revenue Code	272
Min. Negotiated Rate	$368.90
Max. Negotiated Rate	$830.03
Rate for Payer: Aetna Commercial	$783.92
Rate for Payer: Aetna Medicare	$461.13
Rate for Payer: Aetna New Business (MI Preferred)	$599.47
Rate for Payer: BCBS Complete	$368.90
Rate for Payer: Cash Price	$737.81
Rate for Payer: Cofinity Commercial	$645.58
Rate for Payer: Cofinity Commercial	$793.14
Rate for Payer: Cofinity Medicare Advantage	$645.58
Rate for Payer: Encore Health Key Benefits Commercial	$737.81
Rate for Payer: Healthscope Commercial	$830.03
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$783.92
Rate for Payer: PHP Commercial	$783.92
Rate for Payer: Priority Health Cigna Priority Health	$599.47
Rate for Payer: Priority Health SBD	$581.02

HC INFUSION CATHETER LVL 9

Facility

$922.26

Service Code	HCPCS C1751
Hospital Charge Code	27200170
Hospital Revenue Code	272
Min. Negotiated Rate	$581.02
Max. Negotiated Rate	$830.03
Rate for Payer: Aetna Commercial	$783.92
Rate for Payer: Aetna New Business (MI Preferred)	$599.47
Rate for Payer: Cash Price	$737.81
Rate for Payer: Cofinity Commercial	$645.58
Rate for Payer: Cofinity Commercial	$793.14
Rate for Payer: Cofinity Medicare Advantage	$645.58
Rate for Payer: Encore Health Key Benefits Commercial	$737.81
Rate for Payer: Healthscope Commercial	$830.03
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$783.92
Rate for Payer: PHP Commercial	$783.92
Rate for Payer: Priority Health Cigna Priority Health	$599.47
Rate for Payer: Priority Health SBD	$581.02

HC INFUSION CATH LVL 10

Facility

$1,026.84

Service Code	HCPCS C1751
Hospital Charge Code	27200310
Hospital Revenue Code	272
Min. Negotiated Rate	$410.74
Max. Negotiated Rate	$924.16
Rate for Payer: Aetna Commercial	$872.81
Rate for Payer: Aetna Medicare	$513.42
Rate for Payer: Aetna New Business (MI Preferred)	$667.45
Rate for Payer: BCBS Complete	$410.74
Rate for Payer: Cash Price	$821.47
Rate for Payer: Cofinity Commercial	$718.79
Rate for Payer: Cofinity Commercial	$883.08
Rate for Payer: Cofinity Medicare Advantage	$718.79
Rate for Payer: Encore Health Key Benefits Commercial	$821.47
Rate for Payer: Healthscope Commercial	$924.16
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$872.81
Rate for Payer: PHP Commercial	$872.81
Rate for Payer: Priority Health Cigna Priority Health	$667.45
Rate for Payer: Priority Health SBD	$646.91

HC INFUSION CATH LVL 10

Facility

$1,026.84

Service Code	HCPCS C1751
Hospital Charge Code	27200310
Hospital Revenue Code	272
Min. Negotiated Rate	$646.91
Max. Negotiated Rate	$924.16
Rate for Payer: Aetna Commercial	$872.81
Rate for Payer: Aetna New Business (MI Preferred)	$667.45
Rate for Payer: Cash Price	$821.47
Rate for Payer: Cofinity Commercial	$718.79
Rate for Payer: Cofinity Commercial	$883.08
Rate for Payer: Cofinity Medicare Advantage	$718.79
Rate for Payer: Encore Health Key Benefits Commercial	$821.47
Rate for Payer: Healthscope Commercial	$924.16
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$872.81
Rate for Payer: PHP Commercial	$872.81
Rate for Payer: Priority Health Cigna Priority Health	$667.45
Rate for Payer: Priority Health SBD	$646.91

HC INFUSION CATH LVL 11

Facility

$1,143.29

Service Code	HCPCS C1751
Hospital Charge Code	27200311
Hospital Revenue Code	272
Min. Negotiated Rate	$720.27
Max. Negotiated Rate	$1,028.96
Rate for Payer: Aetna Commercial	$971.80
Rate for Payer: Aetna New Business (MI Preferred)	$743.14
Rate for Payer: Cash Price	$914.63
Rate for Payer: Cofinity Commercial	$800.30
Rate for Payer: Cofinity Commercial	$983.23
Rate for Payer: Cofinity Medicare Advantage	$800.30
Rate for Payer: Encore Health Key Benefits Commercial	$914.63
Rate for Payer: Healthscope Commercial	$1,028.96
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$971.80
Rate for Payer: PHP Commercial	$971.80
Rate for Payer: Priority Health Cigna Priority Health	$743.14
Rate for Payer: Priority Health SBD	$720.27

HC INFUSION CATH LVL 11

Facility

$1,143.29

Service Code	HCPCS C1751
Hospital Charge Code	27200311
Hospital Revenue Code	272
Min. Negotiated Rate	$457.32
Max. Negotiated Rate	$1,028.96
Rate for Payer: Aetna Commercial	$971.80
Rate for Payer: Aetna Medicare	$571.64
Rate for Payer: Aetna New Business (MI Preferred)	$743.14
Rate for Payer: BCBS Complete	$457.32
Rate for Payer: Cash Price	$914.63
Rate for Payer: Cofinity Commercial	$800.30
Rate for Payer: Cofinity Commercial	$983.23
Rate for Payer: Cofinity Medicare Advantage	$800.30
Rate for Payer: Encore Health Key Benefits Commercial	$914.63
Rate for Payer: Healthscope Commercial	$1,028.96
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$971.80
Rate for Payer: PHP Commercial	$971.80
Rate for Payer: Priority Health Cigna Priority Health	$743.14
Rate for Payer: Priority Health SBD	$720.27

HC INFUSION CATH LVL 12

Facility

$1,272.93

Service Code	HCPCS C1751
Hospital Charge Code	27200312
Hospital Revenue Code	272
Min. Negotiated Rate	$509.17
Max. Negotiated Rate	$1,145.64
Rate for Payer: Aetna Commercial	$1,081.99
Rate for Payer: Aetna Medicare	$636.46
Rate for Payer: Aetna New Business (MI Preferred)	$827.40
Rate for Payer: BCBS Complete	$509.17
Rate for Payer: Cash Price	$1,018.34
Rate for Payer: Cofinity Commercial	$1,094.72
Rate for Payer: Cofinity Commercial	$891.05
Rate for Payer: Cofinity Medicare Advantage	$891.05
Rate for Payer: Encore Health Key Benefits Commercial	$1,018.34
Rate for Payer: Healthscope Commercial	$1,145.64
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,081.99
Rate for Payer: PHP Commercial	$1,081.99
Rate for Payer: Priority Health Cigna Priority Health	$827.40
Rate for Payer: Priority Health SBD	$801.95

HC INFUSION CATH LVL 12

Facility

$1,272.93

Service Code	HCPCS C1751
Hospital Charge Code	27200312
Hospital Revenue Code	272
Min. Negotiated Rate	$801.95
Max. Negotiated Rate	$1,145.64
Rate for Payer: Aetna Commercial	$1,081.99
Rate for Payer: Aetna New Business (MI Preferred)	$827.40
Rate for Payer: Cash Price	$1,018.34
Rate for Payer: Cofinity Commercial	$1,094.72
Rate for Payer: Cofinity Commercial	$891.05
Rate for Payer: Cofinity Medicare Advantage	$891.05
Rate for Payer: Encore Health Key Benefits Commercial	$1,018.34
Rate for Payer: Healthscope Commercial	$1,145.64
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,081.99
Rate for Payer: PHP Commercial	$1,081.99
Rate for Payer: Priority Health Cigna Priority Health	$827.40
Rate for Payer: Priority Health SBD	$801.95

HC INFUSION CATH LVL 13

Facility

$1,380.06

Service Code	HCPCS C1751
Hospital Charge Code	27200313
Hospital Revenue Code	272
Min. Negotiated Rate	$552.02
Max. Negotiated Rate	$1,242.05
Rate for Payer: Aetna Commercial	$1,173.05
Rate for Payer: Aetna Medicare	$690.03
Rate for Payer: Aetna New Business (MI Preferred)	$897.04
Rate for Payer: BCBS Complete	$552.02
Rate for Payer: Cash Price	$1,104.05
Rate for Payer: Cofinity Commercial	$1,186.85
Rate for Payer: Cofinity Commercial	$966.04
Rate for Payer: Cofinity Medicare Advantage	$966.04
Rate for Payer: Encore Health Key Benefits Commercial	$1,104.05
Rate for Payer: Healthscope Commercial	$1,242.05
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,173.05
Rate for Payer: PHP Commercial	$1,173.05
Rate for Payer: Priority Health Cigna Priority Health	$897.04
Rate for Payer: Priority Health SBD	$869.44

HC INFUSION CATH LVL 13

Facility

$1,380.06

Service Code	HCPCS C1751
Hospital Charge Code	27200313
Hospital Revenue Code	272
Min. Negotiated Rate	$869.44
Max. Negotiated Rate	$1,242.05
Rate for Payer: Aetna Commercial	$1,173.05
Rate for Payer: Aetna New Business (MI Preferred)	$897.04
Rate for Payer: Cash Price	$1,104.05
Rate for Payer: Cofinity Commercial	$1,186.85
Rate for Payer: Cofinity Commercial	$966.04
Rate for Payer: Cofinity Medicare Advantage	$966.04
Rate for Payer: Encore Health Key Benefits Commercial	$1,104.05
Rate for Payer: Healthscope Commercial	$1,242.05
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,173.05
Rate for Payer: PHP Commercial	$1,173.05
Rate for Payer: Priority Health Cigna Priority Health	$897.04
Rate for Payer: Priority Health SBD	$869.44

HC INFUSION CATH LVL 14

Facility

$1,475.84

Service Code	HCPCS C1751
Hospital Charge Code	27200267
Hospital Revenue Code	272
Min. Negotiated Rate	$929.78
Max. Negotiated Rate	$1,328.26
Rate for Payer: Aetna Commercial	$1,254.46
Rate for Payer: Aetna New Business (MI Preferred)	$959.30
Rate for Payer: Cash Price	$1,180.67
Rate for Payer: Cofinity Commercial	$1,033.09
Rate for Payer: Cofinity Commercial	$1,269.22
Rate for Payer: Cofinity Medicare Advantage	$1,033.09
Rate for Payer: Encore Health Key Benefits Commercial	$1,180.67
Rate for Payer: Healthscope Commercial	$1,328.26
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,254.46
Rate for Payer: PHP Commercial	$1,254.46
Rate for Payer: Priority Health Cigna Priority Health	$959.30
Rate for Payer: Priority Health SBD	$929.78

HC INFUSION CATH LVL 14

Facility

$1,475.84

Service Code	HCPCS C1751
Hospital Charge Code	27200267
Hospital Revenue Code	272
Min. Negotiated Rate	$590.34
Max. Negotiated Rate	$1,328.26
Rate for Payer: Aetna Commercial	$1,254.46
Rate for Payer: Aetna Medicare	$737.92
Rate for Payer: Aetna New Business (MI Preferred)	$959.30
Rate for Payer: BCBS Complete	$590.34
Rate for Payer: Cash Price	$1,180.67
Rate for Payer: Cofinity Commercial	$1,033.09
Rate for Payer: Cofinity Commercial	$1,269.22
Rate for Payer: Cofinity Medicare Advantage	$1,033.09
Rate for Payer: Encore Health Key Benefits Commercial	$1,180.67
Rate for Payer: Healthscope Commercial	$1,328.26
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,254.46
Rate for Payer: PHP Commercial	$1,254.46
Rate for Payer: Priority Health Cigna Priority Health	$959.30
Rate for Payer: Priority Health SBD	$929.78

HC INFUSION CATH LVL 4

Facility

$459.00

Service Code	HCPCS C1751
Hospital Charge Code	27200093
Hospital Revenue Code	272
Min. Negotiated Rate	$183.60
Max. Negotiated Rate	$413.10
Rate for Payer: Aetna Commercial	$390.15
Rate for Payer: Aetna Medicare	$229.50
Rate for Payer: Aetna New Business (MI Preferred)	$298.35
Rate for Payer: BCBS Complete	$183.60
Rate for Payer: Cash Price	$367.20
Rate for Payer: Cofinity Commercial	$321.30
Rate for Payer: Cofinity Commercial	$394.74
Rate for Payer: Cofinity Medicare Advantage	$321.30
Rate for Payer: Encore Health Key Benefits Commercial	$367.20
Rate for Payer: Healthscope Commercial	$413.10
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$390.15
Rate for Payer: PHP Commercial	$390.15
Rate for Payer: Priority Health Cigna Priority Health	$298.35
Rate for Payer: Priority Health SBD	$289.17

HC INFUSION CATH LVL 4

Facility

$459.00

Service Code	HCPCS C1751
Hospital Charge Code	27200093
Hospital Revenue Code	272
Min. Negotiated Rate	$289.17
Max. Negotiated Rate	$413.10
Rate for Payer: Aetna Commercial	$390.15
Rate for Payer: Aetna New Business (MI Preferred)	$298.35
Rate for Payer: Cash Price	$367.20
Rate for Payer: Cofinity Commercial	$321.30
Rate for Payer: Cofinity Commercial	$394.74
Rate for Payer: Cofinity Medicare Advantage	$321.30
Rate for Payer: Encore Health Key Benefits Commercial	$367.20
Rate for Payer: Healthscope Commercial	$413.10
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$390.15
Rate for Payer: PHP Commercial	$390.15
Rate for Payer: Priority Health Cigna Priority Health	$298.35
Rate for Payer: Priority Health SBD	$289.17

HC INFUSION CATH LVL 5

Facility

$595.35

Service Code	CPT C1751
Hospital Charge Code	27200296
Hospital Revenue Code	272
Min. Negotiated Rate	$375.07
Max. Negotiated Rate	$535.82
Rate for Payer: Aetna Commercial	$506.05
Rate for Payer: Aetna New Business (MI Preferred)	$386.98
Rate for Payer: Cash Price	$476.28
Rate for Payer: Cofinity Commercial	$416.74
Rate for Payer: Cofinity Commercial	$512.00
Rate for Payer: Cofinity Medicare Advantage	$416.74
Rate for Payer: Encore Health Key Benefits Commercial	$476.28
Rate for Payer: Healthscope Commercial	$535.82
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$506.05
Rate for Payer: PHP Commercial	$506.05
Rate for Payer: Priority Health Cigna Priority Health	$386.98
Rate for Payer: Priority Health SBD	$375.07

Know your out-of-pocket cost for care.

All Charges