Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC MAC/REGIONAL PER MINUTE

Facility

$14.00

Hospital Charge Code	37000025
Hospital Revenue Code	370
Min. Negotiated Rate	$5.60
Max. Negotiated Rate	$12.60
Rate for Payer: Aetna Commercial	$11.90
Rate for Payer: Aetna Medicare	$7.00
Rate for Payer: Aetna New Business (MI Preferred)	$9.10
Rate for Payer: BCBS Complete	$5.60
Rate for Payer: Cash Price	$11.20
Rate for Payer: Cofinity Commercial	$12.04
Rate for Payer: Cofinity Commercial	$9.80
Rate for Payer: Cofinity Medicare Advantage	$9.80
Rate for Payer: Encore Health Key Benefits Commercial	$11.20
Rate for Payer: Healthscope Commercial	$12.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$11.90
Rate for Payer: PHP Commercial	$11.90
Rate for Payer: Priority Health Cigna Priority Health	$9.10
Rate for Payer: Priority Health SBD	$8.82

HC MAC/REGIONAL PER MINUTE

Facility

$14.00

Hospital Charge Code	37000025
Hospital Revenue Code	370
Min. Negotiated Rate	$8.82
Max. Negotiated Rate	$12.60
Rate for Payer: Aetna Commercial	$11.90
Rate for Payer: Aetna New Business (MI Preferred)	$9.10
Rate for Payer: Cash Price	$11.20
Rate for Payer: Cofinity Commercial	$12.04
Rate for Payer: Cofinity Commercial	$9.80
Rate for Payer: Cofinity Medicare Advantage	$9.80
Rate for Payer: Encore Health Key Benefits Commercial	$11.20
Rate for Payer: Healthscope Commercial	$12.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$11.90
Rate for Payer: PHP Commercial	$11.90
Rate for Payer: Priority Health Cigna Priority Health	$9.10
Rate for Payer: Priority Health SBD	$8.82

HC MACROSCOPIC EXAM ARTHROPOD

Facility

$44.94

Service Code	CPT 87168
Hospital Charge Code	30600092
Hospital Revenue Code	306
Min. Negotiated Rate	$28.31
Max. Negotiated Rate	$40.45
Rate for Payer: Aetna Commercial	$38.20
Rate for Payer: Aetna New Business (MI Preferred)	$29.21
Rate for Payer: Cash Price	$35.95
Rate for Payer: Cofinity Commercial	$31.46
Rate for Payer: Cofinity Commercial	$38.65
Rate for Payer: Cofinity Medicare Advantage	$31.46
Rate for Payer: Encore Health Key Benefits Commercial	$35.95
Rate for Payer: Healthscope Commercial	$40.45
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$38.20
Rate for Payer: PHP Commercial	$38.20
Rate for Payer: Priority Health Cigna Priority Health	$29.21
Rate for Payer: Priority Health SBD	$28.31

HC MACROSCOPIC EXAM ARTHROPOD

Facility

$44.94

Service Code	CPT 87168
Hospital Charge Code	30600092
Hospital Revenue Code	306
Min. Negotiated Rate	$2.29
Max. Negotiated Rate	$40.45
Rate for Payer: Aetna Commercial	$38.20
Rate for Payer: Aetna Medicare	$4.44
Rate for Payer: Aetna New Business (MI Preferred)	$29.21
Rate for Payer: Allen County Amish Medical Aid Commercial	$5.34
Rate for Payer: Amish Plain Church Group Commercial	$5.34
Rate for Payer: BCBS Complete	$2.40
Rate for Payer: BCBS MAPPO	$4.27
Rate for Payer: BCN Medicare Advantage	$4.27
Rate for Payer: Cash Price	$35.95
Rate for Payer: Cash Price	$35.95
Rate for Payer: Cofinity Commercial	$38.65
Rate for Payer: Cofinity Commercial	$31.46
Rate for Payer: Cofinity Medicare Advantage	$31.46
Rate for Payer: Encore Health Key Benefits Commercial	$35.95
Rate for Payer: Health Alliance Plan Medicare Advantage	$4.27
Rate for Payer: Healthscope Commercial	$40.45
Rate for Payer: Mclaren Medicaid	$2.29
Rate for Payer: Mclaren Medicare	$4.27
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$4.48
Rate for Payer: Meridian Medicaid	$2.40
Rate for Payer: MI Amish Medical Board Commercial	$4.91
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$38.20
Rate for Payer: PACE Medicare	$4.06
Rate for Payer: PACE SWMI	$4.27
Rate for Payer: PHP Commercial	$38.20
Rate for Payer: PHP Medicare Advantage	$4.27
Rate for Payer: Priority Health Choice Medicaid	$2.29
Rate for Payer: Priority Health Cigna Priority Health	$29.21
Rate for Payer: Priority Health Medicare	$4.27
Rate for Payer: Priority Health SBD	$28.31
Rate for Payer: Railroad Medicare Medicare	$4.27
Rate for Payer: UHC All Payor (Choice/PPO)	$12.02
Rate for Payer: UHC Dual Complete DSNP	$4.27
Rate for Payer: UHC Medicare Advantage	$4.27
Rate for Payer: UHCCP Medicaid	$2.40
Rate for Payer: VA VA	$4.27

HC MACROSCOPIC EXAM PARASITE

Facility

$44.06

Service Code	CPT 87169
Hospital Charge Code	30600093
Hospital Revenue Code	306
Min. Negotiated Rate	$27.76
Max. Negotiated Rate	$39.65
Rate for Payer: Aetna Commercial	$37.45
Rate for Payer: Aetna New Business (MI Preferred)	$28.64
Rate for Payer: Cash Price	$35.25
Rate for Payer: Cofinity Commercial	$30.84
Rate for Payer: Cofinity Commercial	$37.89
Rate for Payer: Cofinity Medicare Advantage	$30.84
Rate for Payer: Encore Health Key Benefits Commercial	$35.25
Rate for Payer: Healthscope Commercial	$39.65
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$37.45
Rate for Payer: PHP Commercial	$37.45
Rate for Payer: Priority Health Cigna Priority Health	$28.64
Rate for Payer: Priority Health SBD	$27.76

HC MACROSCOPIC EXAM PARASITE

Facility

$44.06

Service Code	CPT 87169
Hospital Charge Code	30600093
Hospital Revenue Code	306
Min. Negotiated Rate	$2.31
Max. Negotiated Rate	$39.65
Rate for Payer: Aetna Commercial	$37.45
Rate for Payer: Aetna Medicare	$4.48
Rate for Payer: Aetna New Business (MI Preferred)	$28.64
Rate for Payer: Allen County Amish Medical Aid Commercial	$5.39
Rate for Payer: Amish Plain Church Group Commercial	$5.39
Rate for Payer: BCBS Complete	$2.43
Rate for Payer: BCBS MAPPO	$4.31
Rate for Payer: BCN Medicare Advantage	$4.31
Rate for Payer: Cash Price	$35.25
Rate for Payer: Cash Price	$35.25
Rate for Payer: Cofinity Commercial	$37.89
Rate for Payer: Cofinity Commercial	$30.84
Rate for Payer: Cofinity Medicare Advantage	$30.84
Rate for Payer: Encore Health Key Benefits Commercial	$35.25
Rate for Payer: Health Alliance Plan Medicare Advantage	$4.31
Rate for Payer: Healthscope Commercial	$39.65
Rate for Payer: Mclaren Medicaid	$2.31
Rate for Payer: Mclaren Medicare	$4.31
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$4.53
Rate for Payer: Meridian Medicaid	$2.43
Rate for Payer: MI Amish Medical Board Commercial	$4.96
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$37.45
Rate for Payer: PACE Medicare	$4.09
Rate for Payer: PACE SWMI	$4.31
Rate for Payer: PHP Commercial	$37.45
Rate for Payer: PHP Medicare Advantage	$4.31
Rate for Payer: Priority Health Choice Medicaid	$2.31
Rate for Payer: Priority Health Cigna Priority Health	$28.64
Rate for Payer: Priority Health Medicare	$4.31
Rate for Payer: Priority Health SBD	$27.76
Rate for Payer: Railroad Medicare Medicare	$4.31
Rate for Payer: UHC All Payor (Choice/PPO)	$12.13
Rate for Payer: UHC Dual Complete DSNP	$4.31
Rate for Payer: UHC Medicare Advantage	$4.31
Rate for Payer: UHCCP Medicaid	$2.43
Rate for Payer: VA VA	$4.31

HC MAG 3 TC 99M PER STUDY

Facility

$975.34

Service Code	HCPCS A9562
Hospital Charge Code	34300016
Hospital Revenue Code	343
Min. Negotiated Rate	$614.46
Max. Negotiated Rate	$877.81
Rate for Payer: Aetna Commercial	$829.04
Rate for Payer: Aetna New Business (MI Preferred)	$633.97
Rate for Payer: Cash Price	$780.27
Rate for Payer: Cofinity Commercial	$682.74
Rate for Payer: Cofinity Commercial	$838.79
Rate for Payer: Cofinity Medicare Advantage	$682.74
Rate for Payer: Encore Health Key Benefits Commercial	$780.27
Rate for Payer: Healthscope Commercial	$877.81
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$829.04
Rate for Payer: PHP Commercial	$829.04
Rate for Payer: Priority Health Cigna Priority Health	$633.97
Rate for Payer: Priority Health SBD	$614.46

HC MAG 3 TC 99M PER STUDY

Facility

$975.34

Service Code	HCPCS A9562
Hospital Charge Code	34300016
Hospital Revenue Code	343
Min. Negotiated Rate	$390.14
Max. Negotiated Rate	$877.81
Rate for Payer: Aetna Commercial	$829.04
Rate for Payer: Aetna Medicare	$487.67
Rate for Payer: Aetna New Business (MI Preferred)	$633.97
Rate for Payer: BCBS Complete	$390.14
Rate for Payer: Cash Price	$780.27
Rate for Payer: Cofinity Commercial	$682.74
Rate for Payer: Cofinity Commercial	$838.79
Rate for Payer: Cofinity Medicare Advantage	$682.74
Rate for Payer: Encore Health Key Benefits Commercial	$780.27
Rate for Payer: Healthscope Commercial	$877.81
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$829.04
Rate for Payer: PHP Commercial	$829.04
Rate for Payer: Priority Health Cigna Priority Health	$633.97
Rate for Payer: Priority Health SBD	$614.46

HC MAGGOT THERAPY

Facility

$1,092.42

Hospital Charge Code	27000634
Hospital Revenue Code	270
Min. Negotiated Rate	$688.22
Max. Negotiated Rate	$983.18
Rate for Payer: Aetna Commercial	$928.56
Rate for Payer: Aetna New Business (MI Preferred)	$710.07
Rate for Payer: Cash Price	$873.94
Rate for Payer: Cofinity Commercial	$764.69
Rate for Payer: Cofinity Commercial	$939.48
Rate for Payer: Cofinity Medicare Advantage	$764.69
Rate for Payer: Encore Health Key Benefits Commercial	$873.94
Rate for Payer: Healthscope Commercial	$983.18
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$928.56
Rate for Payer: PHP Commercial	$928.56
Rate for Payer: Priority Health Cigna Priority Health	$710.07
Rate for Payer: Priority Health SBD	$688.22

HC MAGGOT THERAPY

Facility

$1,092.42

Hospital Charge Code	27000634
Hospital Revenue Code	270
Min. Negotiated Rate	$436.97
Max. Negotiated Rate	$983.18
Rate for Payer: Aetna Commercial	$928.56
Rate for Payer: Aetna Medicare	$546.21
Rate for Payer: Aetna New Business (MI Preferred)	$710.07
Rate for Payer: BCBS Complete	$436.97
Rate for Payer: Cash Price	$873.94
Rate for Payer: Cofinity Commercial	$764.69
Rate for Payer: Cofinity Commercial	$939.48
Rate for Payer: Cofinity Medicare Advantage	$764.69
Rate for Payer: Encore Health Key Benefits Commercial	$873.94
Rate for Payer: Healthscope Commercial	$983.18
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$928.56
Rate for Payer: PHP Commercial	$928.56
Rate for Payer: Priority Health Cigna Priority Health	$710.07
Rate for Payer: Priority Health SBD	$688.22

HC MAGNESIUM LEVEL

Facility

$26.01

Service Code	CPT 83735
Hospital Charge Code	30100284
Hospital Revenue Code	301
Min. Negotiated Rate	$16.39
Max. Negotiated Rate	$23.41
Rate for Payer: Aetna Commercial	$22.11
Rate for Payer: Aetna New Business (MI Preferred)	$16.91
Rate for Payer: Cash Price	$20.81
Rate for Payer: Cofinity Commercial	$18.21
Rate for Payer: Cofinity Commercial	$22.37
Rate for Payer: Cofinity Medicare Advantage	$18.21
Rate for Payer: Encore Health Key Benefits Commercial	$20.81
Rate for Payer: Healthscope Commercial	$23.41
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$22.11
Rate for Payer: PHP Commercial	$22.11
Rate for Payer: Priority Health Cigna Priority Health	$16.91
Rate for Payer: Priority Health SBD	$16.39

HC MAGNESIUM LEVEL

Facility

$26.01

Service Code	CPT 83735
Hospital Charge Code	30100284
Hospital Revenue Code	301
Min. Negotiated Rate	$3.59
Max. Negotiated Rate	$23.41
Rate for Payer: Aetna Commercial	$22.11
Rate for Payer: Aetna Medicare	$6.97
Rate for Payer: Aetna New Business (MI Preferred)	$16.91
Rate for Payer: Allen County Amish Medical Aid Commercial	$8.38
Rate for Payer: Amish Plain Church Group Commercial	$8.38
Rate for Payer: BCBS Complete	$3.77
Rate for Payer: BCBS MAPPO	$6.70
Rate for Payer: BCN Medicare Advantage	$6.70
Rate for Payer: Cash Price	$20.81
Rate for Payer: Cash Price	$20.81
Rate for Payer: Cofinity Commercial	$22.37
Rate for Payer: Cofinity Commercial	$18.21
Rate for Payer: Cofinity Medicare Advantage	$18.21
Rate for Payer: Encore Health Key Benefits Commercial	$20.81
Rate for Payer: Health Alliance Plan Medicare Advantage	$6.70
Rate for Payer: Healthscope Commercial	$23.41
Rate for Payer: Mclaren Medicaid	$3.59
Rate for Payer: Mclaren Medicare	$6.70
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$7.04
Rate for Payer: Meridian Medicaid	$3.77
Rate for Payer: MI Amish Medical Board Commercial	$7.71
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$22.11
Rate for Payer: PACE Medicare	$6.37
Rate for Payer: PACE SWMI	$6.70
Rate for Payer: PHP Commercial	$22.11
Rate for Payer: PHP Medicare Advantage	$6.70
Rate for Payer: Priority Health Choice Medicaid	$3.59
Rate for Payer: Priority Health Cigna Priority Health	$16.91
Rate for Payer: Priority Health Medicare	$6.70
Rate for Payer: Priority Health SBD	$16.39
Rate for Payer: Railroad Medicare Medicare	$6.70
Rate for Payer: UHC All Payor (Choice/PPO)	$18.86
Rate for Payer: UHC Dual Complete DSNP	$6.70
Rate for Payer: UHC Medicare Advantage	$6.70
Rate for Payer: UHCCP Medicaid	$3.77
Rate for Payer: VA VA	$6.70

HC MAKENA 10 MG

Facility

$2.60

Service Code	HCPCS J1726
Hospital Charge Code	63600141
Hospital Revenue Code	636
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$2.34
Rate for Payer: Aetna Commercial	$2.21
Rate for Payer: Aetna New Business (MI Preferred)	$1.69
Rate for Payer: Cash Price	$2.08
Rate for Payer: Cofinity Commercial	$1.82
Rate for Payer: Cofinity Commercial	$2.24
Rate for Payer: Cofinity Medicare Advantage	$1.82
Rate for Payer: Encore Health Key Benefits Commercial	$2.08
Rate for Payer: Healthscope Commercial	$2.34
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2.21
Rate for Payer: PHP Commercial	$2.21
Rate for Payer: Priority Health Cigna Priority Health	$1.69
Rate for Payer: Priority Health SBD	$1.64

HC MAKENA 10 MG

Facility

$2.60

Service Code	HCPCS J1726
Hospital Charge Code	63600141
Hospital Revenue Code	636
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$2.34
Rate for Payer: Aetna Commercial	$2.21
Rate for Payer: Aetna Medicare	$1.30
Rate for Payer: Aetna New Business (MI Preferred)	$1.69
Rate for Payer: BCBS Complete	$1.04
Rate for Payer: Cash Price	$2.08
Rate for Payer: Cofinity Commercial	$1.82
Rate for Payer: Cofinity Commercial	$2.24
Rate for Payer: Cofinity Medicare Advantage	$1.82
Rate for Payer: Encore Health Key Benefits Commercial	$2.08
Rate for Payer: Healthscope Commercial	$2.34
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2.21
Rate for Payer: PHP Commercial	$2.21
Rate for Payer: Priority Health Cigna Priority Health	$1.69
Rate for Payer: Priority Health SBD	$1.64

HC MALARIA SMEAR

Facility

$76.91

Service Code	CPT 87207
Hospital Charge Code	30600106
Hospital Revenue Code	306
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$69.22
Rate for Payer: Aetna Commercial	$65.37
Rate for Payer: Aetna Medicare	$6.23
Rate for Payer: Aetna New Business (MI Preferred)	$49.99
Rate for Payer: Allen County Amish Medical Aid Commercial	$7.49
Rate for Payer: Amish Plain Church Group Commercial	$7.49
Rate for Payer: BCBS Complete	$3.37
Rate for Payer: BCBS MAPPO	$5.99
Rate for Payer: BCN Medicare Advantage	$5.99
Rate for Payer: Cash Price	$61.53
Rate for Payer: Cash Price	$61.53
Rate for Payer: Cofinity Commercial	$66.14
Rate for Payer: Cofinity Commercial	$53.84
Rate for Payer: Cofinity Medicare Advantage	$53.84
Rate for Payer: Encore Health Key Benefits Commercial	$61.53
Rate for Payer: Health Alliance Plan Medicare Advantage	$5.99
Rate for Payer: Healthscope Commercial	$69.22
Rate for Payer: Mclaren Medicaid	$3.21
Rate for Payer: Mclaren Medicare	$5.99
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$6.29
Rate for Payer: Meridian Medicaid	$3.37
Rate for Payer: MI Amish Medical Board Commercial	$6.89
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$65.37
Rate for Payer: PACE Medicare	$5.69
Rate for Payer: PACE SWMI	$5.99
Rate for Payer: PHP Commercial	$65.37
Rate for Payer: PHP Medicare Advantage	$5.99
Rate for Payer: Priority Health Choice Medicaid	$3.21
Rate for Payer: Priority Health Cigna Priority Health	$49.99
Rate for Payer: Priority Health Medicare	$5.99
Rate for Payer: Priority Health SBD	$48.45
Rate for Payer: Railroad Medicare Medicare	$5.99
Rate for Payer: UHC All Payor (Choice/PPO)	$16.86
Rate for Payer: UHC Dual Complete DSNP	$5.99
Rate for Payer: UHC Medicare Advantage	$5.99
Rate for Payer: UHCCP Medicaid	$3.37
Rate for Payer: VA VA	$5.99

HC MALARIA SMEAR

Facility

$76.91

Service Code	CPT 87207
Hospital Charge Code	30600106
Hospital Revenue Code	306
Min. Negotiated Rate	$48.45
Max. Negotiated Rate	$69.22
Rate for Payer: Aetna Commercial	$65.37
Rate for Payer: Aetna New Business (MI Preferred)	$49.99
Rate for Payer: Cash Price	$61.53
Rate for Payer: Cofinity Commercial	$53.84
Rate for Payer: Cofinity Commercial	$66.14
Rate for Payer: Cofinity Medicare Advantage	$53.84
Rate for Payer: Encore Health Key Benefits Commercial	$61.53
Rate for Payer: Healthscope Commercial	$69.22
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$65.37
Rate for Payer: PHP Commercial	$65.37
Rate for Payer: Priority Health Cigna Priority Health	$49.99
Rate for Payer: Priority Health SBD	$48.45

HC MALONEY/BOUGIE DILATATION

Facility

$1,330.39

Hospital Charge Code	36000074
Hospital Revenue Code	360
Min. Negotiated Rate	$838.15
Max. Negotiated Rate	$1,197.35
Rate for Payer: Aetna Commercial	$1,130.83
Rate for Payer: Aetna New Business (MI Preferred)	$864.75
Rate for Payer: Cash Price	$1,064.31
Rate for Payer: Cofinity Commercial	$1,144.14
Rate for Payer: Cofinity Commercial	$931.27
Rate for Payer: Cofinity Medicare Advantage	$931.27
Rate for Payer: Encore Health Key Benefits Commercial	$1,064.31
Rate for Payer: Healthscope Commercial	$1,197.35
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,130.83
Rate for Payer: PHP Commercial	$1,130.83
Rate for Payer: Priority Health Cigna Priority Health	$864.75
Rate for Payer: Priority Health SBD	$838.15

HC MALONEY/BOUGIE DILATATION

Facility

$1,330.39

Hospital Charge Code	36000074
Hospital Revenue Code	360
Min. Negotiated Rate	$532.16
Max. Negotiated Rate	$1,197.35
Rate for Payer: Aetna Commercial	$1,130.83
Rate for Payer: Aetna Medicare	$665.20
Rate for Payer: Aetna New Business (MI Preferred)	$864.75
Rate for Payer: BCBS Complete	$532.16
Rate for Payer: Cash Price	$1,064.31
Rate for Payer: Cofinity Commercial	$1,144.14
Rate for Payer: Cofinity Commercial	$931.27
Rate for Payer: Cofinity Medicare Advantage	$931.27
Rate for Payer: Encore Health Key Benefits Commercial	$1,064.31
Rate for Payer: Healthscope Commercial	$1,197.35
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,130.83
Rate for Payer: PHP Commercial	$1,130.83
Rate for Payer: Priority Health Cigna Priority Health	$864.75
Rate for Payer: Priority Health SBD	$838.15

HC MAMM BILAT DIAGNOSTIC W CAD

Facility

$430.14

Service Code	HCPCS 77066
Hospital Charge Code	40100004
Hospital Revenue Code	401
Min. Negotiated Rate	$270.99
Max. Negotiated Rate	$387.13
Rate for Payer: Aetna Commercial	$365.62
Rate for Payer: Aetna New Business (MI Preferred)	$279.59
Rate for Payer: Cash Price	$344.11
Rate for Payer: Cofinity Commercial	$301.10
Rate for Payer: Cofinity Commercial	$369.92
Rate for Payer: Cofinity Medicare Advantage	$301.10
Rate for Payer: Encore Health Key Benefits Commercial	$344.11
Rate for Payer: Healthscope Commercial	$387.13
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$365.62
Rate for Payer: PHP Commercial	$365.62
Rate for Payer: Priority Health Cigna Priority Health	$279.59
Rate for Payer: Priority Health SBD	$270.99

HC MAMM BILAT DIAGNOSTIC W CAD

Facility

$430.14

Service Code	HCPCS 77066
Hospital Charge Code	40100004
Hospital Revenue Code	401
Min. Negotiated Rate	$172.06
Max. Negotiated Rate	$387.13
Rate for Payer: Aetna Commercial	$365.62
Rate for Payer: Aetna Medicare	$215.07
Rate for Payer: Aetna New Business (MI Preferred)	$279.59
Rate for Payer: BCBS Complete	$172.06
Rate for Payer: Cash Price	$344.11
Rate for Payer: Cofinity Commercial	$301.10
Rate for Payer: Cofinity Commercial	$369.92
Rate for Payer: Cofinity Medicare Advantage	$301.10
Rate for Payer: Encore Health Key Benefits Commercial	$344.11
Rate for Payer: Healthscope Commercial	$387.13
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$365.62
Rate for Payer: PHP Commercial	$365.62
Rate for Payer: Priority Health Cigna Priority Health	$279.59
Rate for Payer: Priority Health SBD	$270.99
Rate for Payer: UHC Core	$318.30
Rate for Payer: UHC Exchange	$318.30

HC MAMM BILAT SCREEN WITH CAD

Facility

$424.41

Service Code	HCPCS 77067
Hospital Charge Code	40300006
Hospital Revenue Code	403
Min. Negotiated Rate	$267.38
Max. Negotiated Rate	$381.97
Rate for Payer: Aetna Commercial	$360.75
Rate for Payer: Aetna New Business (MI Preferred)	$275.87
Rate for Payer: Cash Price	$339.53
Rate for Payer: Cofinity Commercial	$297.09
Rate for Payer: Cofinity Commercial	$364.99
Rate for Payer: Cofinity Medicare Advantage	$297.09
Rate for Payer: Encore Health Key Benefits Commercial	$339.53
Rate for Payer: Healthscope Commercial	$381.97
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$360.75
Rate for Payer: PHP Commercial	$360.75
Rate for Payer: Priority Health Cigna Priority Health	$275.87
Rate for Payer: Priority Health SBD	$267.38

HC MAMM BILAT SCREEN WITH CAD

Facility

$424.41

Service Code	HCPCS 77067
Hospital Charge Code	40300006
Hospital Revenue Code	403
Min. Negotiated Rate	$169.76
Max. Negotiated Rate	$381.97
Rate for Payer: Aetna Commercial	$360.75
Rate for Payer: Aetna Medicare	$212.21
Rate for Payer: Aetna New Business (MI Preferred)	$275.87
Rate for Payer: BCBS Complete	$169.76
Rate for Payer: Cash Price	$339.53
Rate for Payer: Cofinity Commercial	$297.09
Rate for Payer: Cofinity Commercial	$364.99
Rate for Payer: Cofinity Medicare Advantage	$297.09
Rate for Payer: Encore Health Key Benefits Commercial	$339.53
Rate for Payer: Healthscope Commercial	$381.97
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$360.75
Rate for Payer: PHP Commercial	$360.75
Rate for Payer: Priority Health Cigna Priority Health	$275.87
Rate for Payer: Priority Health SBD	$267.38
Rate for Payer: UHC Core	$314.06
Rate for Payer: UHC Exchange	$314.06

HC MAMMO BREAST ASP CYST

Facility

$720.36

Service Code	CPT 19000
Hospital Charge Code	36100008
Hospital Revenue Code	361
Min. Negotiated Rate	$367.80
Max. Negotiated Rate	$1,931.58
Rate for Payer: Aetna Commercial	$612.31
Rate for Payer: Aetna Medicare	$713.65
Rate for Payer: Aetna New Business (MI Preferred)	$468.23
Rate for Payer: Allen County Amish Medical Aid Commercial	$857.75
Rate for Payer: Amish Plain Church Group Commercial	$857.75
Rate for Payer: BCBS Complete	$386.19
Rate for Payer: BCBS MAPPO	$686.20
Rate for Payer: BCN Medicare Advantage	$686.20
Rate for Payer: Cash Price	$576.29
Rate for Payer: Cash Price	$576.29
Rate for Payer: Cofinity Commercial	$619.51
Rate for Payer: Cofinity Commercial	$504.25
Rate for Payer: Cofinity Medicare Advantage	$504.25
Rate for Payer: Encore Health Key Benefits Commercial	$576.29
Rate for Payer: Health Alliance Plan Medicare Advantage	$686.20
Rate for Payer: Healthscope Commercial	$648.32
Rate for Payer: Mclaren Medicaid	$367.80
Rate for Payer: Mclaren Medicare	$686.20
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$720.51
Rate for Payer: Meridian Medicaid	$386.19
Rate for Payer: MI Amish Medical Board Commercial	$789.13
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$612.31
Rate for Payer: PACE Medicare	$651.89
Rate for Payer: PACE SWMI	$686.20
Rate for Payer: PHP Commercial	$612.31
Rate for Payer: PHP Medicare Advantage	$686.20
Rate for Payer: Priority Health Choice Medicaid	$367.80
Rate for Payer: Priority Health Cigna Priority Health	$468.23
Rate for Payer: Priority Health Medicare	$686.20
Rate for Payer: Priority Health SBD	$453.83
Rate for Payer: Railroad Medicare Medicare	$686.20
Rate for Payer: UHC All Payor (Choice/PPO)	$1,931.58
Rate for Payer: UHC Dual Complete DSNP	$686.20
Rate for Payer: UHC Medicare Advantage	$686.20
Rate for Payer: UHCCP Medicaid	$386.33
Rate for Payer: VA VA	$686.20

HC MAMMO BREAST ASP CYST

Facility

$720.36

Service Code	CPT 19000
Hospital Charge Code	36100008
Hospital Revenue Code	361
Min. Negotiated Rate	$453.83
Max. Negotiated Rate	$648.32
Rate for Payer: Aetna Commercial	$612.31
Rate for Payer: Aetna New Business (MI Preferred)	$468.23
Rate for Payer: Cash Price	$576.29
Rate for Payer: Cofinity Commercial	$504.25
Rate for Payer: Cofinity Commercial	$619.51
Rate for Payer: Cofinity Medicare Advantage	$504.25
Rate for Payer: Encore Health Key Benefits Commercial	$576.29
Rate for Payer: Healthscope Commercial	$648.32
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$612.31
Rate for Payer: PHP Commercial	$612.31
Rate for Payer: Priority Health Cigna Priority Health	$468.23
Rate for Payer: Priority Health SBD	$453.83

HC MAMMO BREAST ASP CYST ADD LESION

Facility

$396.58

Service Code	CPT 19001
Hospital Charge Code	36100009
Hospital Revenue Code	361
Min. Negotiated Rate	$158.63
Max. Negotiated Rate	$356.92
Rate for Payer: Aetna Commercial	$337.09
Rate for Payer: Aetna Medicare	$198.29
Rate for Payer: Aetna New Business (MI Preferred)	$257.78
Rate for Payer: BCBS Complete	$158.63
Rate for Payer: Cash Price	$317.26
Rate for Payer: Cofinity Commercial	$277.61
Rate for Payer: Cofinity Commercial	$341.06
Rate for Payer: Cofinity Medicare Advantage	$277.61
Rate for Payer: Encore Health Key Benefits Commercial	$317.26
Rate for Payer: Healthscope Commercial	$356.92
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$337.09
Rate for Payer: PHP Commercial	$337.09
Rate for Payer: Priority Health Cigna Priority Health	$257.78
Rate for Payer: Priority Health SBD	$249.85

Know your out-of-pocket cost for care.

All Charges