Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC LOCALIZATION DEVICE LEVEL 1

Facility

$146.88

Service Code	HCPCS A4648
Hospital Charge Code	27800350
Hospital Revenue Code	278
Min. Negotiated Rate	$58.75
Max. Negotiated Rate	$132.19
Rate for Payer: Aetna Commercial	$124.85
Rate for Payer: Aetna Medicare	$73.44
Rate for Payer: Aetna New Business (MI Preferred)	$95.47
Rate for Payer: BCBS Complete	$58.75
Rate for Payer: Cash Price	$117.50
Rate for Payer: Cofinity Commercial	$102.82
Rate for Payer: Cofinity Commercial	$126.32
Rate for Payer: Cofinity Medicare Advantage	$102.82
Rate for Payer: Encore Health Key Benefits Commercial	$117.50
Rate for Payer: Healthscope Commercial	$132.19
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$124.85
Rate for Payer: PHP Commercial	$124.85
Rate for Payer: Priority Health Cigna Priority Health	$95.47
Rate for Payer: Priority Health SBD	$92.53

HC LOCALIZATION DEVICE LEVEL 1

Facility

$146.88

Service Code	HCPCS A4648
Hospital Charge Code	27800350
Hospital Revenue Code	278
Min. Negotiated Rate	$92.53
Max. Negotiated Rate	$132.19
Rate for Payer: Aetna Commercial	$124.85
Rate for Payer: Aetna New Business (MI Preferred)	$95.47
Rate for Payer: Cash Price	$117.50
Rate for Payer: Cofinity Commercial	$102.82
Rate for Payer: Cofinity Commercial	$126.32
Rate for Payer: Cofinity Medicare Advantage	$102.82
Rate for Payer: Encore Health Key Benefits Commercial	$117.50
Rate for Payer: Healthscope Commercial	$132.19
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$124.85
Rate for Payer: PHP Commercial	$124.85
Rate for Payer: Priority Health Cigna Priority Health	$95.47
Rate for Payer: Priority Health SBD	$92.53

HC LOC INFIL W/CS 15 MIN

Facility

$144.37

Hospital Charge Code	37000007
Hospital Revenue Code	370
Min. Negotiated Rate	$90.95
Max. Negotiated Rate	$129.93
Rate for Payer: Aetna Commercial	$122.71
Rate for Payer: Aetna New Business (MI Preferred)	$93.84
Rate for Payer: Cash Price	$115.50
Rate for Payer: Cofinity Commercial	$101.06
Rate for Payer: Cofinity Commercial	$124.16
Rate for Payer: Cofinity Medicare Advantage	$101.06
Rate for Payer: Encore Health Key Benefits Commercial	$115.50
Rate for Payer: Healthscope Commercial	$129.93
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$122.71
Rate for Payer: PHP Commercial	$122.71
Rate for Payer: Priority Health Cigna Priority Health	$93.84
Rate for Payer: Priority Health SBD	$90.95

HC LOC INFIL W/CS 15 MIN

Facility

$144.37

Hospital Charge Code	37000007
Hospital Revenue Code	370
Min. Negotiated Rate	$57.75
Max. Negotiated Rate	$129.93
Rate for Payer: Aetna Commercial	$122.71
Rate for Payer: Aetna Medicare	$72.19
Rate for Payer: Aetna New Business (MI Preferred)	$93.84
Rate for Payer: BCBS Complete	$57.75
Rate for Payer: Cash Price	$115.50
Rate for Payer: Cofinity Commercial	$101.06
Rate for Payer: Cofinity Commercial	$124.16
Rate for Payer: Cofinity Medicare Advantage	$101.06
Rate for Payer: Encore Health Key Benefits Commercial	$115.50
Rate for Payer: Healthscope Commercial	$129.93
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$122.71
Rate for Payer: PHP Commercial	$122.71
Rate for Payer: Priority Health Cigna Priority Health	$93.84
Rate for Payer: Priority Health SBD	$90.95

HC LOC INFIL W/CS 30 MIN

Facility

$721.58

Hospital Charge Code	37000008
Hospital Revenue Code	370
Min. Negotiated Rate	$288.63
Max. Negotiated Rate	$649.42
Rate for Payer: Aetna Commercial	$613.34
Rate for Payer: Aetna Medicare	$360.79
Rate for Payer: Aetna New Business (MI Preferred)	$469.03
Rate for Payer: BCBS Complete	$288.63
Rate for Payer: Cash Price	$577.26
Rate for Payer: Cofinity Commercial	$505.11
Rate for Payer: Cofinity Commercial	$620.56
Rate for Payer: Cofinity Medicare Advantage	$505.11
Rate for Payer: Encore Health Key Benefits Commercial	$577.26
Rate for Payer: Healthscope Commercial	$649.42
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$613.34
Rate for Payer: PHP Commercial	$613.34
Rate for Payer: Priority Health Cigna Priority Health	$469.03
Rate for Payer: Priority Health SBD	$454.60

HC LOC INFIL W/CS 30 MIN

Facility

$721.58

Hospital Charge Code	37000008
Hospital Revenue Code	370
Min. Negotiated Rate	$454.60
Max. Negotiated Rate	$649.42
Rate for Payer: Aetna Commercial	$613.34
Rate for Payer: Aetna New Business (MI Preferred)	$469.03
Rate for Payer: Cash Price	$577.26
Rate for Payer: Cofinity Commercial	$505.11
Rate for Payer: Cofinity Commercial	$620.56
Rate for Payer: Cofinity Medicare Advantage	$505.11
Rate for Payer: Encore Health Key Benefits Commercial	$577.26
Rate for Payer: Healthscope Commercial	$649.42
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$613.34
Rate for Payer: PHP Commercial	$613.34
Rate for Payer: Priority Health Cigna Priority Health	$469.03
Rate for Payer: Priority Health SBD	$454.60

HC LOCM 100-199 MG/ML IODINE/ML1

Facility

$3.75

Service Code	HCPCS Q9965
Hospital Charge Code	25500002
Hospital Revenue Code	255
Min. Negotiated Rate	$2.36
Max. Negotiated Rate	$3.38
Rate for Payer: Aetna Commercial	$3.19
Rate for Payer: Aetna New Business (MI Preferred)	$2.44
Rate for Payer: Cash Price	$3.00
Rate for Payer: Cofinity Commercial	$2.62
Rate for Payer: Cofinity Commercial	$3.23
Rate for Payer: Cofinity Medicare Advantage	$2.62
Rate for Payer: Encore Health Key Benefits Commercial	$3.00
Rate for Payer: Healthscope Commercial	$3.38
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3.19
Rate for Payer: PHP Commercial	$3.19
Rate for Payer: Priority Health Cigna Priority Health	$2.44
Rate for Payer: Priority Health SBD	$2.36

HC LOCM 100-199 MG/ML IODINE/ML1

Facility

$3.75

Service Code	HCPCS Q9965
Hospital Charge Code	25500002
Hospital Revenue Code	255
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$3.38
Rate for Payer: Aetna Commercial	$3.19
Rate for Payer: Aetna Medicare	$1.88
Rate for Payer: Aetna New Business (MI Preferred)	$2.44
Rate for Payer: BCBS Complete	$1.50
Rate for Payer: Cash Price	$3.00
Rate for Payer: Cofinity Commercial	$2.62
Rate for Payer: Cofinity Commercial	$3.23
Rate for Payer: Cofinity Medicare Advantage	$2.62
Rate for Payer: Encore Health Key Benefits Commercial	$3.00
Rate for Payer: Healthscope Commercial	$3.38
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3.19
Rate for Payer: PHP Commercial	$3.19
Rate for Payer: Priority Health Cigna Priority Health	$2.44
Rate for Payer: Priority Health SBD	$2.36

HC LOOP AV 3/8 INCH OR 1/2 INCH

Facility

$216.04

Hospital Charge Code	27000444
Hospital Revenue Code	270
Min. Negotiated Rate	$136.11
Max. Negotiated Rate	$194.44
Rate for Payer: Aetna Commercial	$183.63
Rate for Payer: Aetna New Business (MI Preferred)	$140.43
Rate for Payer: Cash Price	$172.83
Rate for Payer: Cofinity Commercial	$151.23
Rate for Payer: Cofinity Commercial	$185.79
Rate for Payer: Cofinity Medicare Advantage	$151.23
Rate for Payer: Encore Health Key Benefits Commercial	$172.83
Rate for Payer: Healthscope Commercial	$194.44
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$183.63
Rate for Payer: PHP Commercial	$183.63
Rate for Payer: Priority Health Cigna Priority Health	$140.43
Rate for Payer: Priority Health SBD	$136.11

HC LOOP AV 3/8 INCH OR 1/2 INCH

Facility

$216.04

Hospital Charge Code	27000444
Hospital Revenue Code	270
Min. Negotiated Rate	$86.42
Max. Negotiated Rate	$194.44
Rate for Payer: Aetna Commercial	$183.63
Rate for Payer: Aetna Medicare	$108.02
Rate for Payer: Aetna New Business (MI Preferred)	$140.43
Rate for Payer: BCBS Complete	$86.42
Rate for Payer: Cash Price	$172.83
Rate for Payer: Cofinity Commercial	$151.23
Rate for Payer: Cofinity Commercial	$185.79
Rate for Payer: Cofinity Medicare Advantage	$151.23
Rate for Payer: Encore Health Key Benefits Commercial	$172.83
Rate for Payer: Healthscope Commercial	$194.44
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$183.63
Rate for Payer: PHP Commercial	$183.63
Rate for Payer: Priority Health Cigna Priority Health	$140.43
Rate for Payer: Priority Health SBD	$136.11

HC LOW-LEVEL LASER THERAPY

Facility

$91.80

Service Code	CPT 0552T
Hospital Charge Code	43000024
Hospital Revenue Code	420
Min. Negotiated Rate	$36.72
Max. Negotiated Rate	$135.00
Rate for Payer: Aetna Commercial	$78.03
Rate for Payer: Aetna Medicare	$45.90
Rate for Payer: Aetna New Business (MI Preferred)	$59.67
Rate for Payer: BCBS Complete	$36.72
Rate for Payer: Cash Price	$73.44
Rate for Payer: Cash Price	$73.44
Rate for Payer: Cofinity Commercial	$78.95
Rate for Payer: Cofinity Commercial	$64.26
Rate for Payer: Cofinity Medicare Advantage	$64.26
Rate for Payer: Encore Health Key Benefits Commercial	$73.44
Rate for Payer: Healthscope Commercial	$82.62
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$78.03
Rate for Payer: Nomi Health Commercial	$135.00
Rate for Payer: PHP Commercial	$78.03
Rate for Payer: Priority Health Cigna Priority Health	$59.67
Rate for Payer: Priority Health SBD	$57.83
Rate for Payer: UHC Core	$67.93
Rate for Payer: UHC Exchange	$67.93

HC LOW-LEVEL LASER THERAPY

Facility

$91.80

Service Code	CPT 0552T
Hospital Charge Code	43000024
Hospital Revenue Code	420
Min. Negotiated Rate	$57.83
Max. Negotiated Rate	$82.62
Rate for Payer: Aetna Commercial	$78.03
Rate for Payer: Aetna New Business (MI Preferred)	$59.67
Rate for Payer: Cash Price	$73.44
Rate for Payer: Cofinity Commercial	$64.26
Rate for Payer: Cofinity Commercial	$78.95
Rate for Payer: Cofinity Medicare Advantage	$64.26
Rate for Payer: Encore Health Key Benefits Commercial	$73.44
Rate for Payer: Healthscope Commercial	$82.62
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$78.03
Rate for Payer: PHP Commercial	$78.03
Rate for Payer: Priority Health Cigna Priority Health	$59.67
Rate for Payer: Priority Health SBD	$57.83

HC LP (A) CHOLESTEROL LMPP

Facility

$23.93

Service Code	CPT 83700
Hospital Charge Code	30100636
Hospital Revenue Code	301
Min. Negotiated Rate	$15.08
Max. Negotiated Rate	$21.54
Rate for Payer: Aetna Commercial	$20.34
Rate for Payer: Aetna New Business (MI Preferred)	$15.55
Rate for Payer: Cash Price	$19.14
Rate for Payer: Cofinity Commercial	$16.75
Rate for Payer: Cofinity Commercial	$20.58
Rate for Payer: Cofinity Medicare Advantage	$16.75
Rate for Payer: Encore Health Key Benefits Commercial	$19.14
Rate for Payer: Healthscope Commercial	$21.54
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$20.34
Rate for Payer: PHP Commercial	$20.34
Rate for Payer: Priority Health Cigna Priority Health	$15.55
Rate for Payer: Priority Health SBD	$15.08

HC LP (A) CHOLESTEROL LMPP

Facility

$23.93

Service Code	CPT 83700
Hospital Charge Code	30100636
Hospital Revenue Code	301
Min. Negotiated Rate	$6.04
Max. Negotiated Rate	$31.70
Rate for Payer: Aetna Commercial	$20.34
Rate for Payer: Aetna Medicare	$11.71
Rate for Payer: Aetna New Business (MI Preferred)	$15.55
Rate for Payer: Allen County Amish Medical Aid Commercial	$14.07
Rate for Payer: Amish Plain Church Group Commercial	$14.07
Rate for Payer: BCBS Complete	$6.34
Rate for Payer: BCBS MAPPO	$11.26
Rate for Payer: BCN Medicare Advantage	$11.26
Rate for Payer: Cash Price	$19.14
Rate for Payer: Cash Price	$19.14
Rate for Payer: Cofinity Commercial	$20.58
Rate for Payer: Cofinity Commercial	$16.75
Rate for Payer: Cofinity Medicare Advantage	$16.75
Rate for Payer: Encore Health Key Benefits Commercial	$19.14
Rate for Payer: Health Alliance Plan Medicare Advantage	$11.26
Rate for Payer: Healthscope Commercial	$21.54
Rate for Payer: Mclaren Medicaid	$6.04
Rate for Payer: Mclaren Medicare	$11.26
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$11.82
Rate for Payer: Meridian Medicaid	$6.34
Rate for Payer: MI Amish Medical Board Commercial	$12.95
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$20.34
Rate for Payer: PACE Medicare	$10.70
Rate for Payer: PACE SWMI	$11.26
Rate for Payer: PHP Commercial	$20.34
Rate for Payer: PHP Medicare Advantage	$11.26
Rate for Payer: Priority Health Choice Medicaid	$6.04
Rate for Payer: Priority Health Cigna Priority Health	$15.55
Rate for Payer: Priority Health Medicare	$11.26
Rate for Payer: Priority Health SBD	$15.08
Rate for Payer: Railroad Medicare Medicare	$11.26
Rate for Payer: UHC All Payor (Choice/PPO)	$31.70
Rate for Payer: UHC Dual Complete DSNP	$11.26
Rate for Payer: UHC Medicare Advantage	$11.26
Rate for Payer: UHCCP Medicaid	$6.34
Rate for Payer: VA VA	$11.26

HC LTC ROOM AND BOARD

Facility

$377.40

Hospital Charge Code	11000003
Hospital Revenue Code	110
Min. Negotiated Rate	$237.76
Max. Negotiated Rate	$339.66
Rate for Payer: Aetna Commercial	$320.79
Rate for Payer: Aetna New Business (MI Preferred)	$245.31
Rate for Payer: Cash Price	$301.92
Rate for Payer: Cofinity Commercial	$264.18
Rate for Payer: Cofinity Commercial	$324.56
Rate for Payer: Cofinity Medicare Advantage	$264.18
Rate for Payer: Encore Health Key Benefits Commercial	$301.92
Rate for Payer: Healthscope Commercial	$339.66
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$320.79
Rate for Payer: PHP Commercial	$320.79
Rate for Payer: Priority Health Cigna Priority Health	$245.31
Rate for Payer: Priority Health SBD	$237.76

HC LT/RT/C'S/CABG'S W INTERVENTION

Facility

$12,357.92

Service Code	CPT 93461
Hospital Charge Code	48100051
Hospital Revenue Code	481
Min. Negotiated Rate	$1,681.38
Max. Negotiated Rate	$11,122.13
Rate for Payer: Aetna Commercial	$10,504.23
Rate for Payer: Aetna Medicare	$3,262.38
Rate for Payer: Aetna New Business (MI Preferred)	$8,032.65
Rate for Payer: Allen County Amish Medical Aid Commercial	$3,921.12
Rate for Payer: Amish Plain Church Group Commercial	$3,921.12
Rate for Payer: BCBS Complete	$1,765.45
Rate for Payer: BCBS MAPPO	$3,136.90
Rate for Payer: BCN Medicare Advantage	$3,136.90
Rate for Payer: Cash Price	$9,886.34
Rate for Payer: Cash Price	$9,886.34
Rate for Payer: Cofinity Commercial	$8,650.54
Rate for Payer: Cofinity Commercial	$10,627.81
Rate for Payer: Cofinity Medicare Advantage	$8,650.54
Rate for Payer: Encore Health Key Benefits Commercial	$9,886.34
Rate for Payer: Health Alliance Plan Medicare Advantage	$3,136.90
Rate for Payer: Healthscope Commercial	$11,122.13
Rate for Payer: Mclaren Medicaid	$1,681.38
Rate for Payer: Mclaren Medicare	$3,136.90
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$3,293.74
Rate for Payer: Meridian Medicaid	$1,765.45
Rate for Payer: MI Amish Medical Board Commercial	$3,607.43
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$10,504.23
Rate for Payer: PACE Medicare	$2,980.05
Rate for Payer: PACE SWMI	$3,136.90
Rate for Payer: PHP Commercial	$10,504.23
Rate for Payer: PHP Medicare Advantage	$3,136.90
Rate for Payer: Priority Health Choice Medicaid	$1,681.38
Rate for Payer: Priority Health Cigna Priority Health	$8,032.65
Rate for Payer: Priority Health Medicare	$3,136.90
Rate for Payer: Priority Health SBD	$7,785.49
Rate for Payer: Railroad Medicare Medicare	$3,136.90
Rate for Payer: UHC All Payor (Choice/PPO)	$8,830.06
Rate for Payer: UHC Dual Complete DSNP	$3,136.90
Rate for Payer: UHC Medicare Advantage	$3,136.90
Rate for Payer: UHCCP Medicaid	$1,766.07
Rate for Payer: VA VA	$3,136.90

HC LT/RT/C'S/CABG'S W INTERVENTION

Facility

$12,357.92

Service Code	CPT 93461
Hospital Charge Code	48100051
Hospital Revenue Code	481
Min. Negotiated Rate	$7,785.49
Max. Negotiated Rate	$11,122.13
Rate for Payer: Aetna Commercial	$10,504.23
Rate for Payer: Aetna New Business (MI Preferred)	$8,032.65
Rate for Payer: Cash Price	$9,886.34
Rate for Payer: Cofinity Commercial	$10,627.81
Rate for Payer: Cofinity Commercial	$8,650.54
Rate for Payer: Cofinity Medicare Advantage	$8,650.54
Rate for Payer: Encore Health Key Benefits Commercial	$9,886.34
Rate for Payer: Healthscope Commercial	$11,122.13
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$10,504.23
Rate for Payer: PHP Commercial	$10,504.23
Rate for Payer: Priority Health Cigna Priority Health	$8,032.65
Rate for Payer: Priority Health SBD	$7,785.49

HC LUMASON PER ML

Facility

$79.50

Service Code	HCPCS Q9950
Hospital Charge Code	63600066
Hospital Revenue Code	636
Min. Negotiated Rate	$31.80
Max. Negotiated Rate	$71.55
Rate for Payer: Aetna Commercial	$67.58
Rate for Payer: Aetna Medicare	$39.75
Rate for Payer: Aetna New Business (MI Preferred)	$51.67
Rate for Payer: BCBS Complete	$31.80
Rate for Payer: Cash Price	$63.60
Rate for Payer: Cofinity Commercial	$55.65
Rate for Payer: Cofinity Commercial	$68.37
Rate for Payer: Cofinity Medicare Advantage	$55.65
Rate for Payer: Encore Health Key Benefits Commercial	$63.60
Rate for Payer: Healthscope Commercial	$71.55
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$67.58
Rate for Payer: PHP Commercial	$67.58
Rate for Payer: Priority Health Cigna Priority Health	$51.67
Rate for Payer: Priority Health SBD	$50.09

HC LUMASON PER ML

Facility

$79.50

Service Code	HCPCS Q9950
Hospital Charge Code	63600066
Hospital Revenue Code	636
Min. Negotiated Rate	$50.09
Max. Negotiated Rate	$71.55
Rate for Payer: Aetna Commercial	$67.58
Rate for Payer: Aetna New Business (MI Preferred)	$51.67
Rate for Payer: Cash Price	$63.60
Rate for Payer: Cofinity Commercial	$55.65
Rate for Payer: Cofinity Commercial	$68.37
Rate for Payer: Cofinity Medicare Advantage	$55.65
Rate for Payer: Encore Health Key Benefits Commercial	$63.60
Rate for Payer: Healthscope Commercial	$71.55
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$67.58
Rate for Payer: PHP Commercial	$67.58
Rate for Payer: Priority Health Cigna Priority Health	$51.67
Rate for Payer: Priority Health SBD	$50.09

HC LUMBAR PUNCTURE

Facility

$748.54

Hospital Charge Code	45000046
Hospital Revenue Code	450
Min. Negotiated Rate	$299.42
Max. Negotiated Rate	$673.69
Rate for Payer: Aetna Commercial	$636.26
Rate for Payer: Aetna Medicare	$374.27
Rate for Payer: Aetna New Business (MI Preferred)	$486.55
Rate for Payer: BCBS Complete	$299.42
Rate for Payer: Cash Price	$598.83
Rate for Payer: Cofinity Commercial	$523.98
Rate for Payer: Cofinity Commercial	$643.74
Rate for Payer: Cofinity Medicare Advantage	$523.98
Rate for Payer: Encore Health Key Benefits Commercial	$598.83
Rate for Payer: Healthscope Commercial	$673.69
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$636.26
Rate for Payer: PHP Commercial	$636.26
Rate for Payer: Priority Health Cigna Priority Health	$486.55
Rate for Payer: Priority Health SBD	$471.58

HC LUMBAR PUNCTURE

Facility

$748.54

Hospital Charge Code	45000046
Hospital Revenue Code	450
Min. Negotiated Rate	$471.58
Max. Negotiated Rate	$673.69
Rate for Payer: Aetna Commercial	$636.26
Rate for Payer: Aetna New Business (MI Preferred)	$486.55
Rate for Payer: Cash Price	$598.83
Rate for Payer: Cofinity Commercial	$523.98
Rate for Payer: Cofinity Commercial	$643.74
Rate for Payer: Cofinity Medicare Advantage	$523.98
Rate for Payer: Encore Health Key Benefits Commercial	$598.83
Rate for Payer: Healthscope Commercial	$673.69
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$636.26
Rate for Payer: PHP Commercial	$636.26
Rate for Payer: Priority Health Cigna Priority Health	$486.55
Rate for Payer: Priority Health SBD	$471.58

HC LUMBAR PUNCTURE DIAGNOSTIC

Facility

$916.38

Service Code	CPT 62270
Hospital Charge Code	36100278
Hospital Revenue Code	761
Min. Negotiated Rate	$362.01
Max. Negotiated Rate	$1,901.18
Rate for Payer: Aetna Commercial	$778.92
Rate for Payer: Aetna Medicare	$702.42
Rate for Payer: Aetna New Business (MI Preferred)	$595.65
Rate for Payer: Allen County Amish Medical Aid Commercial	$844.25
Rate for Payer: Amish Plain Church Group Commercial	$844.25
Rate for Payer: BCBS Complete	$380.12
Rate for Payer: BCBS MAPPO	$675.40
Rate for Payer: BCN Medicare Advantage	$675.40
Rate for Payer: Cash Price	$733.10
Rate for Payer: Cash Price	$733.10
Rate for Payer: Cofinity Commercial	$788.09
Rate for Payer: Cofinity Commercial	$641.47
Rate for Payer: Cofinity Medicare Advantage	$641.47
Rate for Payer: Encore Health Key Benefits Commercial	$733.10
Rate for Payer: Health Alliance Plan Medicare Advantage	$675.40
Rate for Payer: Healthscope Commercial	$824.74
Rate for Payer: Mclaren Medicaid	$362.01
Rate for Payer: Mclaren Medicare	$675.40
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$709.17
Rate for Payer: Meridian Medicaid	$380.12
Rate for Payer: MI Amish Medical Board Commercial	$776.71
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$778.92
Rate for Payer: PACE Medicare	$641.63
Rate for Payer: PACE SWMI	$675.40
Rate for Payer: PHP Commercial	$778.92
Rate for Payer: PHP Medicare Advantage	$675.40
Rate for Payer: Priority Health Choice Medicaid	$362.01
Rate for Payer: Priority Health Cigna Priority Health	$595.65
Rate for Payer: Priority Health Medicare	$675.40
Rate for Payer: Priority Health SBD	$577.32
Rate for Payer: Railroad Medicare Medicare	$675.40
Rate for Payer: UHC All Payor (Choice/PPO)	$1,901.18
Rate for Payer: UHC Dual Complete DSNP	$675.40
Rate for Payer: UHC Medicare Advantage	$675.40
Rate for Payer: UHCCP Medicaid	$380.25
Rate for Payer: VA VA	$675.40

HC LUMBAR PUNCTURE DIAGNOSTIC

Facility

$916.38

Service Code	CPT 62270
Hospital Charge Code	36100278
Hospital Revenue Code	761
Min. Negotiated Rate	$577.32
Max. Negotiated Rate	$824.74
Rate for Payer: Aetna Commercial	$778.92
Rate for Payer: Aetna New Business (MI Preferred)	$595.65
Rate for Payer: Cash Price	$733.10
Rate for Payer: Cofinity Commercial	$641.47
Rate for Payer: Cofinity Commercial	$788.09
Rate for Payer: Cofinity Medicare Advantage	$641.47
Rate for Payer: Encore Health Key Benefits Commercial	$733.10
Rate for Payer: Healthscope Commercial	$824.74
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$778.92
Rate for Payer: PHP Commercial	$778.92
Rate for Payer: Priority Health Cigna Priority Health	$595.65
Rate for Payer: Priority Health SBD	$577.32

HC LUMBAR PUNCTURE THERAPEUTIC

Facility

$771.00

Service Code	CPT 62272
Hospital Charge Code	36100279
Hospital Revenue Code	761
Min. Negotiated Rate	$485.73
Max. Negotiated Rate	$693.90
Rate for Payer: Aetna Commercial	$655.35
Rate for Payer: Aetna New Business (MI Preferred)	$501.15
Rate for Payer: Cash Price	$616.80
Rate for Payer: Cofinity Commercial	$539.70
Rate for Payer: Cofinity Commercial	$663.06
Rate for Payer: Cofinity Medicare Advantage	$539.70
Rate for Payer: Encore Health Key Benefits Commercial	$616.80
Rate for Payer: Healthscope Commercial	$693.90
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$655.35
Rate for Payer: PHP Commercial	$655.35
Rate for Payer: Priority Health Cigna Priority Health	$501.15
Rate for Payer: Priority Health SBD	$485.73

HC LUMBAR PUNCTURE THERAPEUTIC

Facility

$771.00

Service Code	CPT 62272
Hospital Charge Code	36100279
Hospital Revenue Code	761
Min. Negotiated Rate	$362.01
Max. Negotiated Rate	$1,901.18
Rate for Payer: Aetna Commercial	$655.35
Rate for Payer: Aetna Medicare	$702.42
Rate for Payer: Aetna New Business (MI Preferred)	$501.15
Rate for Payer: Allen County Amish Medical Aid Commercial	$844.25
Rate for Payer: Amish Plain Church Group Commercial	$844.25
Rate for Payer: BCBS Complete	$380.12
Rate for Payer: BCBS MAPPO	$675.40
Rate for Payer: BCN Medicare Advantage	$675.40
Rate for Payer: Cash Price	$616.80
Rate for Payer: Cash Price	$616.80
Rate for Payer: Cofinity Commercial	$663.06
Rate for Payer: Cofinity Commercial	$539.70
Rate for Payer: Cofinity Medicare Advantage	$539.70
Rate for Payer: Encore Health Key Benefits Commercial	$616.80
Rate for Payer: Health Alliance Plan Medicare Advantage	$675.40
Rate for Payer: Healthscope Commercial	$693.90
Rate for Payer: Mclaren Medicaid	$362.01
Rate for Payer: Mclaren Medicare	$675.40
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$709.17
Rate for Payer: Meridian Medicaid	$380.12
Rate for Payer: MI Amish Medical Board Commercial	$776.71
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$655.35
Rate for Payer: PACE Medicare	$641.63
Rate for Payer: PACE SWMI	$675.40
Rate for Payer: PHP Commercial	$655.35
Rate for Payer: PHP Medicare Advantage	$675.40
Rate for Payer: Priority Health Choice Medicaid	$362.01
Rate for Payer: Priority Health Cigna Priority Health	$501.15
Rate for Payer: Priority Health Medicare	$675.40
Rate for Payer: Priority Health SBD	$485.73
Rate for Payer: Railroad Medicare Medicare	$675.40
Rate for Payer: UHC All Payor (Choice/PPO)	$1,901.18
Rate for Payer: UHC Dual Complete DSNP	$675.40
Rate for Payer: UHC Medicare Advantage	$675.40
Rate for Payer: UHCCP Medicaid	$380.25
Rate for Payer: VA VA	$675.40

Know your out-of-pocket cost for care.

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