Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC ST JUDE CRT LEAD

Facility

$5,712.00

Service Code	HCPCS C1900
Hospital Charge Code	27800026
Hospital Revenue Code	278
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$5,140.80
Rate for Payer: Aetna Commercial	$4,855.20
Rate for Payer: Aetna New Business (MI Preferred)	$3,712.80
Rate for Payer: BCBS Complete	$2,284.80
Rate for Payer: BCBS Trust/PPO	$0.03
Rate for Payer: Cash Price	$4,569.60
Rate for Payer: Cash Price	$4,569.60
Rate for Payer: Cofinity Commercial	$3,998.40
Rate for Payer: Cofinity Commercial	$4,912.32
Rate for Payer: Healthscope Commercial	$5,140.80
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$4,855.20
Rate for Payer: PHP Commercial	$4,855.20
Rate for Payer: Priority Health Cigna Priority Health	$3,998.40
Rate for Payer: Priority Health SBD	$3,598.56

HC ST JUDE CRT LEAD

Facility

$5,712.00

Service Code	HCPCS C1900
Hospital Charge Code	27800026
Hospital Revenue Code	278
Min. Negotiated Rate	$3,598.56
Max. Negotiated Rate	$5,140.80
Rate for Payer: Aetna Commercial	$4,855.20
Rate for Payer: Aetna New Business (MI Preferred)	$3,712.80
Rate for Payer: Cash Price	$4,569.60
Rate for Payer: Cofinity Commercial	$4,912.32
Rate for Payer: Cofinity Commercial	$3,998.40
Rate for Payer: Healthscope Commercial	$5,140.80
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$4,855.20
Rate for Payer: PHP Commercial	$4,855.20
Rate for Payer: Priority Health Cigna Priority Health	$3,998.40
Rate for Payer: Priority Health SBD	$3,598.56

HC ST JUDE DUAL PACEMAKER

Facility

$9,180.00

Service Code	HCPCS C1785
Hospital Charge Code	27500010
Hospital Revenue Code	275
Min. Negotiated Rate	$3,672.00
Max. Negotiated Rate	$8,262.00
Rate for Payer: Aetna Commercial	$7,803.00
Rate for Payer: Aetna New Business (MI Preferred)	$5,967.00
Rate for Payer: BCBS Complete	$3,672.00
Rate for Payer: Cash Price	$7,344.00
Rate for Payer: Cofinity Commercial	$6,426.00
Rate for Payer: Cofinity Commercial	$7,894.80
Rate for Payer: Healthscope Commercial	$8,262.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$7,803.00
Rate for Payer: PHP Commercial	$7,803.00
Rate for Payer: Priority Health Cigna Priority Health	$6,426.00
Rate for Payer: Priority Health SBD	$5,783.40

HC ST JUDE DUAL PACEMAKER

Facility

$9,180.00

Service Code	HCPCS C1785
Hospital Charge Code	27500010
Hospital Revenue Code	275
Min. Negotiated Rate	$5,783.40
Max. Negotiated Rate	$8,262.00
Rate for Payer: Aetna Commercial	$7,803.00
Rate for Payer: Aetna New Business (MI Preferred)	$5,967.00
Rate for Payer: Cash Price	$7,344.00
Rate for Payer: Cofinity Commercial	$6,426.00
Rate for Payer: Cofinity Commercial	$7,894.80
Rate for Payer: Healthscope Commercial	$8,262.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$7,803.00
Rate for Payer: PHP Commercial	$7,803.00
Rate for Payer: Priority Health Cigna Priority Health	$6,426.00
Rate for Payer: Priority Health SBD	$5,783.40

HC ST JUDE ICD DUAL

Facility

$20,808.00

Service Code	HCPCS C1721
Hospital Charge Code	27800027
Hospital Revenue Code	278
Min. Negotiated Rate	$8,323.20
Max. Negotiated Rate	$18,727.20
Rate for Payer: Aetna Commercial	$17,686.80
Rate for Payer: Aetna New Business (MI Preferred)	$13,525.20
Rate for Payer: BCBS Complete	$8,323.20
Rate for Payer: Cash Price	$16,646.40
Rate for Payer: Cofinity Commercial	$14,565.60
Rate for Payer: Cofinity Commercial	$17,894.88
Rate for Payer: Healthscope Commercial	$18,727.20
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$17,686.80
Rate for Payer: PHP Commercial	$17,686.80
Rate for Payer: Priority Health Cigna Priority Health	$14,565.60
Rate for Payer: Priority Health SBD	$13,109.04

HC ST JUDE ICD DUAL

Facility

$20,808.00

Service Code	HCPCS C1721
Hospital Charge Code	27800027
Hospital Revenue Code	278
Min. Negotiated Rate	$13,109.04
Max. Negotiated Rate	$18,727.20
Rate for Payer: Aetna Commercial	$17,686.80
Rate for Payer: Aetna New Business (MI Preferred)	$13,525.20
Rate for Payer: Cash Price	$16,646.40
Rate for Payer: Cofinity Commercial	$14,565.60
Rate for Payer: Cofinity Commercial	$17,894.88
Rate for Payer: Healthscope Commercial	$18,727.20
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$17,686.80
Rate for Payer: PHP Commercial	$17,686.80
Rate for Payer: Priority Health Cigna Priority Health	$14,565.60
Rate for Payer: Priority Health SBD	$13,109.04

HC ST JUDE ICD SINGLE

Facility

$13,790.40

Service Code	HCPCS C1722
Hospital Charge Code	27800028
Hospital Revenue Code	278
Min. Negotiated Rate	$5,516.16
Max. Negotiated Rate	$12,411.36
Rate for Payer: Aetna Commercial	$11,721.84
Rate for Payer: Aetna New Business (MI Preferred)	$8,963.76
Rate for Payer: BCBS Complete	$5,516.16
Rate for Payer: Cash Price	$11,032.32
Rate for Payer: Cofinity Commercial	$11,859.74
Rate for Payer: Cofinity Commercial	$9,653.28
Rate for Payer: Healthscope Commercial	$12,411.36
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$11,721.84
Rate for Payer: PHP Commercial	$11,721.84
Rate for Payer: Priority Health Cigna Priority Health	$9,653.28
Rate for Payer: Priority Health SBD	$8,687.95

HC ST JUDE ICD SINGLE

Facility

$13,790.40

Service Code	HCPCS C1722
Hospital Charge Code	27800028
Hospital Revenue Code	278
Min. Negotiated Rate	$8,687.95
Max. Negotiated Rate	$12,411.36
Rate for Payer: Aetna Commercial	$11,721.84
Rate for Payer: Aetna New Business (MI Preferred)	$8,963.76
Rate for Payer: Cash Price	$11,032.32
Rate for Payer: Cofinity Commercial	$11,859.74
Rate for Payer: Cofinity Commercial	$9,653.28
Rate for Payer: Healthscope Commercial	$12,411.36
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$11,721.84
Rate for Payer: PHP Commercial	$11,721.84
Rate for Payer: Priority Health Cigna Priority Health	$9,653.28
Rate for Payer: Priority Health SBD	$8,687.95

HC ST JUDE SINGLE PACEMAKER

Facility

$7,038.00

Service Code	HCPCS C1786
Hospital Charge Code	27500011
Hospital Revenue Code	275
Min. Negotiated Rate	$2,815.20
Max. Negotiated Rate	$6,334.20
Rate for Payer: Aetna Commercial	$5,982.30
Rate for Payer: Aetna New Business (MI Preferred)	$4,574.70
Rate for Payer: BCBS Complete	$2,815.20
Rate for Payer: Cash Price	$5,630.40
Rate for Payer: Cofinity Commercial	$4,926.60
Rate for Payer: Cofinity Commercial	$6,052.68
Rate for Payer: Healthscope Commercial	$6,334.20
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$5,982.30
Rate for Payer: PHP Commercial	$5,982.30
Rate for Payer: Priority Health Cigna Priority Health	$4,926.60
Rate for Payer: Priority Health SBD	$4,433.94

HC ST JUDE SINGLE PACEMAKER

Facility

$7,038.00

Service Code	HCPCS C1786
Hospital Charge Code	27500011
Hospital Revenue Code	275
Min. Negotiated Rate	$4,433.94
Max. Negotiated Rate	$6,334.20
Rate for Payer: Aetna Commercial	$5,982.30
Rate for Payer: Aetna New Business (MI Preferred)	$4,574.70
Rate for Payer: Cash Price	$5,630.40
Rate for Payer: Cofinity Commercial	$4,926.60
Rate for Payer: Cofinity Commercial	$6,052.68
Rate for Payer: Healthscope Commercial	$6,334.20
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$5,982.30
Rate for Payer: PHP Commercial	$5,982.30
Rate for Payer: Priority Health Cigna Priority Health	$4,926.60
Rate for Payer: Priority Health SBD	$4,433.94

HC ST JUDE TACHY (ICD) LEAD

Facility

$8,004.63

Service Code	HCPCS C1895
Hospital Charge Code	27800029
Hospital Revenue Code	278
Min. Negotiated Rate	$5,042.92
Max. Negotiated Rate	$7,204.17
Rate for Payer: Aetna Commercial	$6,803.94
Rate for Payer: Aetna New Business (MI Preferred)	$5,203.01
Rate for Payer: Cash Price	$6,403.70
Rate for Payer: Cofinity Commercial	$5,603.24
Rate for Payer: Cofinity Commercial	$6,883.98
Rate for Payer: Healthscope Commercial	$7,204.17
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$6,803.94
Rate for Payer: PHP Commercial	$6,803.94
Rate for Payer: Priority Health Cigna Priority Health	$5,603.24
Rate for Payer: Priority Health SBD	$5,042.92

HC ST JUDE TACHY (ICD) LEAD

Facility

$8,004.63

Service Code	HCPCS C1895
Hospital Charge Code	27800029
Hospital Revenue Code	278
Min. Negotiated Rate	$3,201.85
Max. Negotiated Rate	$7,204.17
Rate for Payer: Aetna Commercial	$6,803.94
Rate for Payer: Aetna New Business (MI Preferred)	$5,203.01
Rate for Payer: BCBS Complete	$3,201.85
Rate for Payer: Cash Price	$6,403.70
Rate for Payer: Cofinity Commercial	$5,603.24
Rate for Payer: Cofinity Commercial	$6,883.98
Rate for Payer: Healthscope Commercial	$7,204.17
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$6,803.94
Rate for Payer: PHP Commercial	$6,803.94
Rate for Payer: Priority Health Cigna Priority Health	$5,603.24
Rate for Payer: Priority Health SBD	$5,042.92

HC STOOL CULTURE

Facility

$39.17

Service Code	CPT 87045
Hospital Charge Code	30600073
Hospital Revenue Code	306
Min. Negotiated Rate	$24.68
Max. Negotiated Rate	$35.25
Rate for Payer: Aetna Commercial	$33.29
Rate for Payer: Aetna New Business (MI Preferred)	$25.46
Rate for Payer: Cash Price	$31.34
Rate for Payer: Cofinity Commercial	$27.42
Rate for Payer: Cofinity Commercial	$33.69
Rate for Payer: Healthscope Commercial	$35.25
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$33.29
Rate for Payer: PHP Commercial	$33.29
Rate for Payer: Priority Health Cigna Priority Health	$27.42
Rate for Payer: Priority Health SBD	$24.68

HC STOOL CULTURE

Facility

$39.17

Service Code	CPT 87045
Hospital Charge Code	30600073
Hospital Revenue Code	306
Min. Negotiated Rate	$5.16
Max. Negotiated Rate	$35.25
Rate for Payer: Aetna Commercial	$33.29
Rate for Payer: Aetna Medicare	$9.82
Rate for Payer: Aetna New Business (MI Preferred)	$25.46
Rate for Payer: Allen County Amish Medical Aid Commercial	$11.80
Rate for Payer: Amish Plain Church Group Commercial	$11.80
Rate for Payer: BCBS Complete	$5.42
Rate for Payer: BCBS MAPPO	$9.44
Rate for Payer: BCBS Trust/PPO	$7.39
Rate for Payer: BCN Medicare Advantage	$9.44
Rate for Payer: Cash Price	$31.34
Rate for Payer: Cash Price	$31.34
Rate for Payer: Cofinity Commercial	$33.69
Rate for Payer: Cofinity Commercial	$27.42
Rate for Payer: Health Alliance Plan Medicare Advantage	$9.44
Rate for Payer: Healthscope Commercial	$35.25
Rate for Payer: Mclaren Medicaid	$5.16
Rate for Payer: Mclaren Medicare	$9.44
Rate for Payer: Meridian Medicaid	$5.42
Rate for Payer: Meridian Wellcare - Medicare Advantage	$9.91
Rate for Payer: MI Amish Medical Board Commercial	$10.86
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$33.29
Rate for Payer: PACE Medicare	$8.97
Rate for Payer: PACE SWMI	$9.44
Rate for Payer: PHP Commercial	$33.29
Rate for Payer: PHP Medicare Advantage	$9.44
Rate for Payer: Priority Health Choice Medicaid	$5.16
Rate for Payer: Priority Health Cigna Priority Health	$27.42
Rate for Payer: Priority Health Medicare	$9.44
Rate for Payer: Priority Health SBD	$24.68
Rate for Payer: Railroad Medicare Medicare	$9.44
Rate for Payer: UHC All Payor (Choice/PPO)	$11.33
Rate for Payer: UHC Core	$16.03
Rate for Payer: UHC Dual Complete DSNP	$9.44
Rate for Payer: UHC Exchange	$9.44
Rate for Payer: UHC Medicare Advantage	$9.72
Rate for Payer: VA VA	$9.44

HC STOOL CULTURE CMPT

Facility

$39.17

Service Code	CPT 87046
Hospital Charge Code	30600074
Hospital Revenue Code	306
Min. Negotiated Rate	$5.16
Max. Negotiated Rate	$35.25
Rate for Payer: Aetna Commercial	$33.29
Rate for Payer: Aetna Medicare	$9.82
Rate for Payer: Aetna New Business (MI Preferred)	$25.46
Rate for Payer: Allen County Amish Medical Aid Commercial	$11.80
Rate for Payer: Amish Plain Church Group Commercial	$11.80
Rate for Payer: BCBS Complete	$5.42
Rate for Payer: BCBS MAPPO	$9.44
Rate for Payer: BCBS Trust/PPO	$7.39
Rate for Payer: BCN Medicare Advantage	$9.44
Rate for Payer: Cash Price	$31.34
Rate for Payer: Cash Price	$31.34
Rate for Payer: Cofinity Commercial	$27.42
Rate for Payer: Cofinity Commercial	$33.69
Rate for Payer: Health Alliance Plan Medicare Advantage	$9.44
Rate for Payer: Healthscope Commercial	$35.25
Rate for Payer: Mclaren Medicaid	$5.16
Rate for Payer: Mclaren Medicare	$9.44
Rate for Payer: Meridian Medicaid	$5.42
Rate for Payer: Meridian Wellcare - Medicare Advantage	$9.91
Rate for Payer: MI Amish Medical Board Commercial	$10.86
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$33.29
Rate for Payer: PACE Medicare	$8.97
Rate for Payer: PACE SWMI	$9.44
Rate for Payer: PHP Commercial	$33.29
Rate for Payer: PHP Medicare Advantage	$9.44
Rate for Payer: Priority Health Choice Medicaid	$5.16
Rate for Payer: Priority Health Cigna Priority Health	$27.42
Rate for Payer: Priority Health Medicare	$9.44
Rate for Payer: Priority Health SBD	$24.68
Rate for Payer: Railroad Medicare Medicare	$9.44
Rate for Payer: UHC All Payor (Choice/PPO)	$11.33
Rate for Payer: UHC Core	$16.03
Rate for Payer: UHC Dual Complete DSNP	$9.44
Rate for Payer: UHC Exchange	$9.44
Rate for Payer: UHC Medicare Advantage	$9.72
Rate for Payer: VA VA	$9.44

HC STOOL CULTURE CMPT

Facility

$39.17

Service Code	CPT 87046
Hospital Charge Code	30600074
Hospital Revenue Code	306
Min. Negotiated Rate	$24.68
Max. Negotiated Rate	$35.25
Rate for Payer: Aetna Commercial	$33.29
Rate for Payer: Aetna New Business (MI Preferred)	$25.46
Rate for Payer: Cash Price	$31.34
Rate for Payer: Cofinity Commercial	$27.42
Rate for Payer: Cofinity Commercial	$33.69
Rate for Payer: Healthscope Commercial	$35.25
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$33.29
Rate for Payer: PHP Commercial	$33.29
Rate for Payer: Priority Health Cigna Priority Health	$27.42
Rate for Payer: Priority Health SBD	$24.68

HC STOOL CULTURE CMPT2

Facility

$13.06

Service Code	CPT 87015
Hospital Charge Code	30600069
Hospital Revenue Code	306
Min. Negotiated Rate	$8.23
Max. Negotiated Rate	$11.75
Rate for Payer: Aetna Commercial	$11.10
Rate for Payer: Aetna New Business (MI Preferred)	$8.49
Rate for Payer: Cash Price	$10.45
Rate for Payer: Cofinity Commercial	$11.23
Rate for Payer: Cofinity Commercial	$9.14
Rate for Payer: Healthscope Commercial	$11.75
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$11.10
Rate for Payer: PHP Commercial	$11.10
Rate for Payer: Priority Health Cigna Priority Health	$9.14
Rate for Payer: Priority Health SBD	$8.23

HC STOOL CULTURE CMPT2

Facility

$13.06

Service Code	CPT 87015
Hospital Charge Code	30600069
Hospital Revenue Code	306
Min. Negotiated Rate	$3.65
Max. Negotiated Rate	$11.75
Rate for Payer: Aetna Commercial	$11.10
Rate for Payer: Aetna Medicare	$6.95
Rate for Payer: Aetna New Business (MI Preferred)	$8.49
Rate for Payer: Allen County Amish Medical Aid Commercial	$8.35
Rate for Payer: Amish Plain Church Group Commercial	$8.35
Rate for Payer: BCBS Complete	$3.84
Rate for Payer: BCBS MAPPO	$6.68
Rate for Payer: BCBS Trust/PPO	$5.23
Rate for Payer: BCN Medicare Advantage	$6.68
Rate for Payer: Cash Price	$10.45
Rate for Payer: Cash Price	$10.45
Rate for Payer: Cofinity Commercial	$9.14
Rate for Payer: Cofinity Commercial	$11.23
Rate for Payer: Health Alliance Plan Medicare Advantage	$6.68
Rate for Payer: Healthscope Commercial	$11.75
Rate for Payer: Mclaren Medicaid	$3.65
Rate for Payer: Mclaren Medicare	$6.68
Rate for Payer: Meridian Medicaid	$3.84
Rate for Payer: Meridian Wellcare - Medicare Advantage	$7.01
Rate for Payer: MI Amish Medical Board Commercial	$7.68
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$11.10
Rate for Payer: PACE Medicare	$6.35
Rate for Payer: PACE SWMI	$6.68
Rate for Payer: PHP Commercial	$11.10
Rate for Payer: PHP Medicare Advantage	$6.68
Rate for Payer: Priority Health Choice Medicaid	$3.65
Rate for Payer: Priority Health Cigna Priority Health	$9.14
Rate for Payer: Priority Health Medicare	$6.68
Rate for Payer: Priority Health SBD	$8.23
Rate for Payer: Railroad Medicare Medicare	$6.68
Rate for Payer: UHC All Payor (Choice/PPO)	$8.02
Rate for Payer: UHC Core	$11.35
Rate for Payer: UHC Dual Complete DSNP	$6.68
Rate for Payer: UHC Exchange	$6.68
Rate for Payer: UHC Medicare Advantage	$6.88
Rate for Payer: VA VA	$6.68

HC STOOL CULTURE CMPT 3

Facility

$41.72

Service Code	CPT 87899
Hospital Charge Code	30600177
Hospital Revenue Code	306
Min. Negotiated Rate	$8.79
Max. Negotiated Rate	$37.55
Rate for Payer: Aetna Commercial	$35.46
Rate for Payer: Aetna Medicare	$16.71
Rate for Payer: Aetna New Business (MI Preferred)	$27.12
Rate for Payer: Allen County Amish Medical Aid Commercial	$20.09
Rate for Payer: Amish Plain Church Group Commercial	$20.09
Rate for Payer: BCBS Complete	$9.23
Rate for Payer: BCBS MAPPO	$16.07
Rate for Payer: BCBS Trust/PPO	$12.58
Rate for Payer: BCN Medicare Advantage	$16.07
Rate for Payer: Cash Price	$33.38
Rate for Payer: Cash Price	$33.38
Rate for Payer: Cofinity Commercial	$35.88
Rate for Payer: Cofinity Commercial	$29.20
Rate for Payer: Health Alliance Plan Medicare Advantage	$16.07
Rate for Payer: Healthscope Commercial	$37.55
Rate for Payer: Mclaren Medicaid	$8.79
Rate for Payer: Mclaren Medicare	$16.07
Rate for Payer: Meridian Medicaid	$9.23
Rate for Payer: Meridian Wellcare - Medicare Advantage	$16.87
Rate for Payer: MI Amish Medical Board Commercial	$18.48
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$35.46
Rate for Payer: PACE Medicare	$15.27
Rate for Payer: PACE SWMI	$16.07
Rate for Payer: PHP Commercial	$35.46
Rate for Payer: PHP Medicare Advantage	$16.07
Rate for Payer: Priority Health Choice Medicaid	$8.79
Rate for Payer: Priority Health Cigna Priority Health	$29.20
Rate for Payer: Priority Health Medicare	$16.07
Rate for Payer: Priority Health SBD	$26.28
Rate for Payer: Railroad Medicare Medicare	$16.07
Rate for Payer: UHC All Payor (Choice/PPO)	$19.28
Rate for Payer: UHC Core	$20.39
Rate for Payer: UHC Dual Complete DSNP	$16.07
Rate for Payer: UHC Exchange	$16.07
Rate for Payer: UHC Medicare Advantage	$16.55
Rate for Payer: VA VA	$16.07

HC STOOL CULTURE CMPT 3

Facility

$41.72

Service Code	CPT 87899
Hospital Charge Code	30600177
Hospital Revenue Code	306
Min. Negotiated Rate	$26.28
Max. Negotiated Rate	$37.55
Rate for Payer: Aetna Commercial	$35.46
Rate for Payer: Aetna New Business (MI Preferred)	$27.12
Rate for Payer: Cash Price	$33.38
Rate for Payer: Cofinity Commercial	$29.20
Rate for Payer: Cofinity Commercial	$35.88
Rate for Payer: Healthscope Commercial	$37.55
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$35.46
Rate for Payer: PHP Commercial	$35.46
Rate for Payer: Priority Health Cigna Priority Health	$29.20
Rate for Payer: Priority Health SBD	$26.28

HC STRAPPING ANKLE AND OR FOOT

Facility

$131.88

Service Code	CPT 29540
Hospital Charge Code	42000005
Hospital Revenue Code	420
Min. Negotiated Rate	$16.70
Max. Negotiated Rate	$175.25
Rate for Payer: Aetna Commercial	$112.10
Rate for Payer: Aetna Medicare	$145.81
Rate for Payer: Aetna New Business (MI Preferred)	$85.72
Rate for Payer: Allen County Amish Medical Aid Commercial	$175.25
Rate for Payer: Amish Plain Church Group Commercial	$175.25
Rate for Payer: BCBS Complete	$80.53
Rate for Payer: BCBS MAPPO	$140.20
Rate for Payer: BCBS Trust/PPO	$91.11
Rate for Payer: BCN Medicare Advantage	$140.20
Rate for Payer: Cash Price	$105.50
Rate for Payer: Cash Price	$105.50
Rate for Payer: Cofinity Commercial	$92.32
Rate for Payer: Cofinity Commercial	$113.42
Rate for Payer: Health Alliance Plan Medicare Advantage	$140.20
Rate for Payer: Healthscope Commercial	$118.69
Rate for Payer: Mclaren Medicaid	$76.69
Rate for Payer: Mclaren Medicare	$140.20
Rate for Payer: Meridian Medicaid	$80.53
Rate for Payer: Meridian Wellcare - Medicare Advantage	$147.21
Rate for Payer: MI Amish Medical Board Commercial	$161.23
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$112.10
Rate for Payer: PACE Medicare	$133.19
Rate for Payer: PACE SWMI	$140.20
Rate for Payer: PHP Commercial	$112.10
Rate for Payer: PHP Medicare Advantage	$140.20
Rate for Payer: Priority Health Choice Medicaid	$76.69
Rate for Payer: Priority Health Cigna Priority Health	$92.32
Rate for Payer: Priority Health Medicare	$140.20
Rate for Payer: Priority Health SBD	$83.08
Rate for Payer: Railroad Medicare Medicare	$140.20
Rate for Payer: UHC All Payor (Choice/PPO)	$18.37
Rate for Payer: UHC Dual Complete DSNP	$140.20
Rate for Payer: UHC Exchange	$16.70
Rate for Payer: UHC Medicare Advantage	$144.41
Rate for Payer: VA VA	$140.20

HC STRAPPING ANKLE AND OR FOOT

Facility

$131.88

Service Code	CPT 29540
Hospital Charge Code	42000005
Hospital Revenue Code	420
Min. Negotiated Rate	$83.08
Max. Negotiated Rate	$118.69
Rate for Payer: Aetna Commercial	$112.10
Rate for Payer: Aetna New Business (MI Preferred)	$85.72
Rate for Payer: Cash Price	$105.50
Rate for Payer: Cofinity Commercial	$92.32
Rate for Payer: Cofinity Commercial	$113.42
Rate for Payer: Healthscope Commercial	$118.69
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$112.10
Rate for Payer: PHP Commercial	$112.10
Rate for Payer: Priority Health Cigna Priority Health	$92.32
Rate for Payer: Priority Health SBD	$83.08

HC STRAPPING CASTING UNLISTED

Facility

$227.67

Service Code	CPT 29799
Hospital Charge Code	42000053
Hospital Revenue Code	420
Min. Negotiated Rate	$65.15
Max. Negotiated Rate	$204.90
Rate for Payer: Aetna Commercial	$193.52
Rate for Payer: Aetna Medicare	$145.81
Rate for Payer: Aetna New Business (MI Preferred)	$147.99
Rate for Payer: Allen County Amish Medical Aid Commercial	$175.25
Rate for Payer: Amish Plain Church Group Commercial	$175.25
Rate for Payer: BCBS Complete	$80.53
Rate for Payer: BCBS MAPPO	$140.20
Rate for Payer: BCBS Trust/PPO	$65.15
Rate for Payer: BCN Medicare Advantage	$140.20
Rate for Payer: Cash Price	$182.14
Rate for Payer: Cash Price	$182.14
Rate for Payer: Cofinity Commercial	$195.80
Rate for Payer: Cofinity Commercial	$159.37
Rate for Payer: Health Alliance Plan Medicare Advantage	$140.20
Rate for Payer: Healthscope Commercial	$204.90
Rate for Payer: Mclaren Medicaid	$76.69
Rate for Payer: Mclaren Medicare	$140.20
Rate for Payer: Meridian Medicaid	$80.53
Rate for Payer: Meridian Wellcare - Medicare Advantage	$147.21
Rate for Payer: MI Amish Medical Board Commercial	$161.23
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$193.52
Rate for Payer: PACE Medicare	$133.19
Rate for Payer: PACE SWMI	$140.20
Rate for Payer: PHP Commercial	$193.52
Rate for Payer: PHP Medicare Advantage	$140.20
Rate for Payer: Priority Health Choice Medicaid	$76.69
Rate for Payer: Priority Health Cigna Priority Health	$159.37
Rate for Payer: Priority Health Medicare	$140.20
Rate for Payer: Priority Health SBD	$143.43
Rate for Payer: Railroad Medicare Medicare	$140.20
Rate for Payer: UHC Dual Complete DSNP	$140.20
Rate for Payer: UHC Medicare Advantage	$144.41
Rate for Payer: VA VA	$140.20

HC STRAPPING CASTING UNLISTED

Facility

$227.67

Service Code	CPT 29799
Hospital Charge Code	42000053
Hospital Revenue Code	420
Min. Negotiated Rate	$143.43
Max. Negotiated Rate	$204.90
Rate for Payer: Aetna Commercial	$193.52
Rate for Payer: Aetna New Business (MI Preferred)	$147.99
Rate for Payer: Cash Price	$182.14
Rate for Payer: Cofinity Commercial	$159.37
Rate for Payer: Cofinity Commercial	$195.80
Rate for Payer: Healthscope Commercial	$204.90
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$193.52
Rate for Payer: PHP Commercial	$193.52
Rate for Payer: Priority Health Cigna Priority Health	$159.37
Rate for Payer: Priority Health SBD	$143.43

HC STRAPPING CHEST KINESIOTAPING

Facility

$119.28

Service Code	CPT 29200
Hospital Charge Code	42000052
Hospital Revenue Code	420
Min. Negotiated Rate	$11.65
Max. Negotiated Rate	$175.25
Rate for Payer: Aetna Commercial	$101.39
Rate for Payer: Aetna Medicare	$145.81
Rate for Payer: Aetna New Business (MI Preferred)	$77.53
Rate for Payer: Allen County Amish Medical Aid Commercial	$175.25
Rate for Payer: Amish Plain Church Group Commercial	$175.25
Rate for Payer: BCBS Complete	$80.53
Rate for Payer: BCBS MAPPO	$140.20
Rate for Payer: BCBS Trust/PPO	$11.65
Rate for Payer: BCN Medicare Advantage	$140.20
Rate for Payer: Cash Price	$95.42
Rate for Payer: Cash Price	$95.42
Rate for Payer: Cofinity Commercial	$102.58
Rate for Payer: Cofinity Commercial	$83.50
Rate for Payer: Health Alliance Plan Medicare Advantage	$140.20
Rate for Payer: Healthscope Commercial	$107.35
Rate for Payer: Mclaren Medicaid	$76.69
Rate for Payer: Mclaren Medicare	$140.20
Rate for Payer: Meridian Medicaid	$80.53
Rate for Payer: Meridian Wellcare - Medicare Advantage	$147.21
Rate for Payer: MI Amish Medical Board Commercial	$161.23
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$101.39
Rate for Payer: PACE Medicare	$133.19
Rate for Payer: PACE SWMI	$140.20
Rate for Payer: PHP Commercial	$101.39
Rate for Payer: PHP Medicare Advantage	$140.20
Rate for Payer: Priority Health Choice Medicaid	$76.69
Rate for Payer: Priority Health Cigna Priority Health	$83.50
Rate for Payer: Priority Health Medicare	$140.20
Rate for Payer: Priority Health SBD	$75.15
Rate for Payer: Railroad Medicare Medicare	$140.20
Rate for Payer: UHC All Payor (Choice/PPO)	$19.45
Rate for Payer: UHC Dual Complete DSNP	$140.20
Rate for Payer: UHC Exchange	$17.68
Rate for Payer: UHC Medicare Advantage	$144.41
Rate for Payer: VA VA	$140.20

Know your out-of-pocket cost for care.

All Charges