Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC SUMP VENTRICULAR MEDTRONIC

Facility

$42.00

Hospital Charge Code	27000122
Hospital Revenue Code	270
Min. Negotiated Rate	$26.46
Max. Negotiated Rate	$37.80
Rate for Payer: Aetna Commercial	$35.70
Rate for Payer: Aetna New Business (MI Preferred)	$27.30
Rate for Payer: Cash Price	$33.60
Rate for Payer: Cofinity Commercial	$29.40
Rate for Payer: Cofinity Commercial	$36.12
Rate for Payer: Healthscope Commercial	$37.80
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$35.70
Rate for Payer: PHP Commercial	$35.70
Rate for Payer: Priority Health Cigna Priority Health	$29.40
Rate for Payer: Priority Health SBD	$26.46

HC SUPERVISION & HANDLING

Facility

$154.02

Service Code	CPT 77790
Hospital Charge Code	33300029
Hospital Revenue Code	333
Min. Negotiated Rate	$97.03
Max. Negotiated Rate	$138.62
Rate for Payer: Aetna Commercial	$130.92
Rate for Payer: Aetna Commercial	$142.80
Rate for Payer: Aetna New Business (MI Preferred)	$109.20
Rate for Payer: Aetna New Business (MI Preferred)	$100.11
Rate for Payer: Cash Price	$134.40
Rate for Payer: Cash Price	$123.22
Rate for Payer: Cofinity Commercial	$132.46
Rate for Payer: Cofinity Commercial	$117.60
Rate for Payer: Cofinity Commercial	$144.48
Rate for Payer: Cofinity Commercial	$107.81
Rate for Payer: Healthscope Commercial	$151.20
Rate for Payer: Healthscope Commercial	$138.62
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$130.92
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$142.80
Rate for Payer: PHP Commercial	$130.92
Rate for Payer: PHP Commercial	$142.80
Rate for Payer: Priority Health Cigna Priority Health	$117.60
Rate for Payer: Priority Health Cigna Priority Health	$107.81
Rate for Payer: Priority Health SBD	$97.03
Rate for Payer: Priority Health SBD	$105.84

HC SUPERVISION & HANDLING

Facility

$168.00

Service Code	CPT 77790
Hospital Charge Code	33300029
Hospital Revenue Code	333
Min. Negotiated Rate	$17.68
Max. Negotiated Rate	$151.20
Rate for Payer: Aetna Commercial	$142.80
Rate for Payer: Aetna Commercial	$130.92
Rate for Payer: Aetna New Business (MI Preferred)	$109.20
Rate for Payer: Aetna New Business (MI Preferred)	$100.11
Rate for Payer: BCBS Complete	$61.61
Rate for Payer: BCBS Complete	$67.20
Rate for Payer: BCBS Trust/PPO	$28.68
Rate for Payer: BCBS Trust/PPO	$28.68
Rate for Payer: Cash Price	$134.40
Rate for Payer: Cash Price	$123.22
Rate for Payer: Cash Price	$123.22
Rate for Payer: Cash Price	$134.40
Rate for Payer: Cofinity Commercial	$144.48
Rate for Payer: Cofinity Commercial	$132.46
Rate for Payer: Cofinity Commercial	$107.81
Rate for Payer: Cofinity Commercial	$117.60
Rate for Payer: Healthscope Commercial	$151.20
Rate for Payer: Healthscope Commercial	$138.62
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$142.80
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$130.92
Rate for Payer: PHP Commercial	$142.80
Rate for Payer: PHP Commercial	$130.92
Rate for Payer: Priority Health Cigna Priority Health	$117.60
Rate for Payer: Priority Health Cigna Priority Health	$107.81
Rate for Payer: Priority Health SBD	$105.84
Rate for Payer: Priority Health SBD	$97.03
Rate for Payer: UHC All Payor (Choice/PPO)	$19.45
Rate for Payer: UHC All Payor (Choice/PPO)	$19.45
Rate for Payer: UHC Exchange	$17.68
Rate for Payer: UHC Exchange	$17.68

HC SUPPLEMENTAL NEWBORN SCRN

Facility

$85.00

Service Code	CPT 83789
Hospital Charge Code	30100686
Hospital Revenue Code	301
Min. Negotiated Rate	$13.19
Max. Negotiated Rate	$76.50
Rate for Payer: Aetna Commercial	$72.25
Rate for Payer: Aetna Medicare	$25.07
Rate for Payer: Aetna New Business (MI Preferred)	$55.25
Rate for Payer: Allen County Amish Medical Aid Commercial	$30.14
Rate for Payer: Amish Plain Church Group Commercial	$30.14
Rate for Payer: BCBS Complete	$13.85
Rate for Payer: BCBS MAPPO	$24.11
Rate for Payer: BCBS Trust/PPO	$18.88
Rate for Payer: BCN Medicare Advantage	$24.11
Rate for Payer: Cash Price	$68.00
Rate for Payer: Cash Price	$68.00
Rate for Payer: Cofinity Commercial	$73.10
Rate for Payer: Cofinity Commercial	$59.50
Rate for Payer: Health Alliance Plan Medicare Advantage	$24.11
Rate for Payer: Healthscope Commercial	$76.50
Rate for Payer: Mclaren Medicaid	$13.19
Rate for Payer: Mclaren Medicare	$24.11
Rate for Payer: Meridian Medicaid	$13.85
Rate for Payer: Meridian Wellcare - Medicare Advantage	$25.32
Rate for Payer: MI Amish Medical Board Commercial	$27.73
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$72.25
Rate for Payer: PACE Medicare	$22.90
Rate for Payer: PACE SWMI	$24.11
Rate for Payer: PHP Commercial	$72.25
Rate for Payer: PHP Medicare Advantage	$24.11
Rate for Payer: Priority Health Choice Medicaid	$13.19
Rate for Payer: Priority Health Cigna Priority Health	$59.50
Rate for Payer: Priority Health Medicare	$24.11
Rate for Payer: Priority Health SBD	$53.55
Rate for Payer: Railroad Medicare Medicare	$24.11
Rate for Payer: UHC All Payor (Choice/PPO)	$28.93
Rate for Payer: UHC Core	$30.68
Rate for Payer: UHC Dual Complete DSNP	$24.11
Rate for Payer: UHC Exchange	$24.11
Rate for Payer: UHC Medicare Advantage	$24.83
Rate for Payer: VA VA	$24.11

HC SUPPLEMENTAL NEWBORN SCRN

Facility

$85.00

Service Code	CPT 83789
Hospital Charge Code	30100686
Hospital Revenue Code	301
Min. Negotiated Rate	$53.55
Max. Negotiated Rate	$76.50
Rate for Payer: Aetna Commercial	$72.25
Rate for Payer: Aetna New Business (MI Preferred)	$55.25
Rate for Payer: Cash Price	$68.00
Rate for Payer: Cofinity Commercial	$59.50
Rate for Payer: Cofinity Commercial	$73.10
Rate for Payer: Healthscope Commercial	$76.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$72.25
Rate for Payer: PHP Commercial	$72.25
Rate for Payer: Priority Health Cigna Priority Health	$59.50
Rate for Payer: Priority Health SBD	$53.55

HC SUPRAPUBIC CATHETER

Facility

$116.64

Service Code	HCPCS C2627
Hospital Charge Code	27200072
Hospital Revenue Code	272
Min. Negotiated Rate	$46.66
Max. Negotiated Rate	$104.98
Rate for Payer: Aetna Commercial	$99.14
Rate for Payer: Aetna New Business (MI Preferred)	$75.82
Rate for Payer: BCBS Complete	$46.66
Rate for Payer: Cash Price	$93.31
Rate for Payer: Cofinity Commercial	$100.31
Rate for Payer: Cofinity Commercial	$81.65
Rate for Payer: Healthscope Commercial	$104.98
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$99.14
Rate for Payer: PHP Commercial	$99.14
Rate for Payer: Priority Health Cigna Priority Health	$81.65
Rate for Payer: Priority Health SBD	$73.48

HC SUPRAPUBIC CATHETER

Facility

$116.64

Service Code	HCPCS C2627
Hospital Charge Code	27200072
Hospital Revenue Code	272
Min. Negotiated Rate	$73.48
Max. Negotiated Rate	$104.98
Rate for Payer: Aetna Commercial	$99.14
Rate for Payer: Aetna New Business (MI Preferred)	$75.82
Rate for Payer: Cash Price	$93.31
Rate for Payer: Cofinity Commercial	$100.31
Rate for Payer: Cofinity Commercial	$81.65
Rate for Payer: Healthscope Commercial	$104.98
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$99.14
Rate for Payer: PHP Commercial	$99.14
Rate for Payer: Priority Health Cigna Priority Health	$81.65
Rate for Payer: Priority Health SBD	$73.48

HC SURGERY FROZEN EA ADDL

Facility

$73.24

Service Code	CPT 88332
Hospital Charge Code	31000057
Hospital Revenue Code	310
Min. Negotiated Rate	$13.39
Max. Negotiated Rate	$65.92
Rate for Payer: Aetna Commercial	$62.25
Rate for Payer: Aetna New Business (MI Preferred)	$47.61
Rate for Payer: BCBS Complete	$29.30
Rate for Payer: BCBS Trust/PPO	$30.61
Rate for Payer: BCCCP Commercial	$55.41
Rate for Payer: Cash Price	$58.59
Rate for Payer: Cash Price	$58.59
Rate for Payer: Cofinity Commercial	$62.99
Rate for Payer: Cofinity Commercial	$51.27
Rate for Payer: Healthscope Commercial	$65.92
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$62.25
Rate for Payer: PHP Commercial	$62.25
Rate for Payer: Priority Health Cigna Priority Health	$51.27
Rate for Payer: Priority Health SBD	$46.14
Rate for Payer: UHC All Payor (Choice/PPO)	$58.71
Rate for Payer: UHC Core	$13.39
Rate for Payer: UHC Exchange	$53.37

HC SURGERY FROZEN EA ADDL

Facility

$73.24

Service Code	CPT 88332
Hospital Charge Code	31000057
Hospital Revenue Code	310
Min. Negotiated Rate	$46.14
Max. Negotiated Rate	$65.92
Rate for Payer: Aetna Commercial	$62.25
Rate for Payer: Aetna New Business (MI Preferred)	$47.61
Rate for Payer: Cash Price	$58.59
Rate for Payer: Cofinity Commercial	$62.99
Rate for Payer: Cofinity Commercial	$51.27
Rate for Payer: Healthscope Commercial	$65.92
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$62.25
Rate for Payer: PHP Commercial	$62.25
Rate for Payer: Priority Health Cigna Priority Health	$51.27
Rate for Payer: Priority Health SBD	$46.14

HC SURGICAL HAND

Facility

$690.61

Hospital Charge Code	45000053
Hospital Revenue Code	450
Min. Negotiated Rate	$435.08
Max. Negotiated Rate	$621.55
Rate for Payer: Aetna Commercial	$587.02
Rate for Payer: Aetna New Business (MI Preferred)	$448.90
Rate for Payer: Cash Price	$552.49
Rate for Payer: Cofinity Commercial	$483.43
Rate for Payer: Cofinity Commercial	$593.92
Rate for Payer: Healthscope Commercial	$621.55
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$587.02
Rate for Payer: PHP Commercial	$587.02
Rate for Payer: Priority Health Cigna Priority Health	$483.43
Rate for Payer: Priority Health SBD	$435.08

HC SURGICAL HAND

Facility

$690.61

Hospital Charge Code	45000053
Hospital Revenue Code	450
Min. Negotiated Rate	$276.24
Max. Negotiated Rate	$621.55
Rate for Payer: Aetna Commercial	$587.02
Rate for Payer: Aetna New Business (MI Preferred)	$448.90
Rate for Payer: BCBS Complete	$276.24
Rate for Payer: Cash Price	$552.49
Rate for Payer: Cofinity Commercial	$483.43
Rate for Payer: Cofinity Commercial	$593.92
Rate for Payer: Healthscope Commercial	$621.55
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$587.02
Rate for Payer: PHP Commercial	$587.02
Rate for Payer: Priority Health Cigna Priority Health	$483.43
Rate for Payer: Priority Health SBD	$435.08

HC SURG SUPPLY MISC

Facility

$84.74

Service Code	HCPCS A4649
Hospital Charge Code	62300132
Hospital Revenue Code	623
Min. Negotiated Rate	$33.90
Max. Negotiated Rate	$394.10
Rate for Payer: Aetna Commercial	$72.03
Rate for Payer: Aetna New Business (MI Preferred)	$55.08
Rate for Payer: BCBS Complete	$33.90
Rate for Payer: BCBS Trust/PPO	$394.10
Rate for Payer: Cash Price	$67.79
Rate for Payer: Cash Price	$67.79
Rate for Payer: Cofinity Commercial	$72.88
Rate for Payer: Cofinity Commercial	$59.32
Rate for Payer: Healthscope Commercial	$76.27
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$72.03
Rate for Payer: PHP Commercial	$72.03
Rate for Payer: Priority Health Cigna Priority Health	$59.32
Rate for Payer: Priority Health SBD	$53.39

HC SURG SUPPLY MISC

Facility

$84.74

Service Code	HCPCS A4649
Hospital Charge Code	62300132
Hospital Revenue Code	623
Min. Negotiated Rate	$53.39
Max. Negotiated Rate	$76.27
Rate for Payer: Aetna Commercial	$72.03
Rate for Payer: Aetna New Business (MI Preferred)	$55.08
Rate for Payer: Cash Price	$67.79
Rate for Payer: Cofinity Commercial	$72.88
Rate for Payer: Cofinity Commercial	$59.32
Rate for Payer: Healthscope Commercial	$76.27
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$72.03
Rate for Payer: PHP Commercial	$72.03
Rate for Payer: Priority Health Cigna Priority Health	$59.32
Rate for Payer: Priority Health SBD	$53.39

HC SUSCEPTIBILITY DISK

Facility

$57.50

Service Code	CPT 87184
Hospital Charge Code	30600098
Hospital Revenue Code	306
Min. Negotiated Rate	$4.09
Max. Negotiated Rate	$51.75
Rate for Payer: Aetna Commercial	$48.88
Rate for Payer: Aetna Medicare	$7.78
Rate for Payer: Aetna New Business (MI Preferred)	$37.38
Rate for Payer: Allen County Amish Medical Aid Commercial	$9.35
Rate for Payer: Amish Plain Church Group Commercial	$9.35
Rate for Payer: BCBS Complete	$4.30
Rate for Payer: BCBS MAPPO	$7.48
Rate for Payer: BCBS Trust/PPO	$5.86
Rate for Payer: BCN Medicare Advantage	$7.48
Rate for Payer: Cash Price	$46.00
Rate for Payer: Cash Price	$46.00
Rate for Payer: Cofinity Commercial	$49.45
Rate for Payer: Cofinity Commercial	$40.25
Rate for Payer: Health Alliance Plan Medicare Advantage	$7.48
Rate for Payer: Healthscope Commercial	$51.75
Rate for Payer: Mclaren Medicaid	$4.09
Rate for Payer: Mclaren Medicare	$7.48
Rate for Payer: Meridian Medicaid	$4.30
Rate for Payer: Meridian Wellcare - Medicare Advantage	$7.85
Rate for Payer: MI Amish Medical Board Commercial	$8.60
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$48.88
Rate for Payer: PACE Medicare	$7.11
Rate for Payer: PACE SWMI	$7.48
Rate for Payer: PHP Commercial	$48.88
Rate for Payer: PHP Medicare Advantage	$7.48
Rate for Payer: Priority Health Choice Medicaid	$4.09
Rate for Payer: Priority Health Cigna Priority Health	$40.25
Rate for Payer: Priority Health Medicare	$7.48
Rate for Payer: Priority Health SBD	$36.22
Rate for Payer: Railroad Medicare Medicare	$7.48
Rate for Payer: UHC All Payor (Choice/PPO)	$8.98
Rate for Payer: UHC Core	$11.74
Rate for Payer: UHC Dual Complete DSNP	$7.48
Rate for Payer: UHC Exchange	$7.48
Rate for Payer: UHC Medicare Advantage	$7.70
Rate for Payer: VA VA	$7.48

HC SUSCEPTIBILITY DISK

Facility

$57.50

Service Code	CPT 87184
Hospital Charge Code	30600098
Hospital Revenue Code	306
Min. Negotiated Rate	$36.22
Max. Negotiated Rate	$51.75
Rate for Payer: Aetna Commercial	$48.88
Rate for Payer: Aetna New Business (MI Preferred)	$37.38
Rate for Payer: Cash Price	$46.00
Rate for Payer: Cofinity Commercial	$40.25
Rate for Payer: Cofinity Commercial	$49.45
Rate for Payer: Healthscope Commercial	$51.75
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$48.88
Rate for Payer: PHP Commercial	$48.88
Rate for Payer: Priority Health Cigna Priority Health	$40.25
Rate for Payer: Priority Health SBD	$36.22

HC SUSCEPTIBILITY E TEST

Facility

$32.13

Service Code	CPT 87181
Hospital Charge Code	30600097
Hospital Revenue Code	306
Min. Negotiated Rate	$2.60
Max. Negotiated Rate	$28.92
Rate for Payer: Aetna Commercial	$27.31
Rate for Payer: Aetna Medicare	$4.94
Rate for Payer: Aetna New Business (MI Preferred)	$20.88
Rate for Payer: Allen County Amish Medical Aid Commercial	$5.94
Rate for Payer: Amish Plain Church Group Commercial	$5.94
Rate for Payer: BCBS Complete	$2.73
Rate for Payer: BCBS MAPPO	$4.75
Rate for Payer: BCBS Trust/PPO	$3.72
Rate for Payer: BCN Medicare Advantage	$4.75
Rate for Payer: Cash Price	$25.70
Rate for Payer: Cash Price	$25.70
Rate for Payer: Cofinity Commercial	$22.49
Rate for Payer: Cofinity Commercial	$27.63
Rate for Payer: Health Alliance Plan Medicare Advantage	$4.75
Rate for Payer: Healthscope Commercial	$28.92
Rate for Payer: Mclaren Medicaid	$2.60
Rate for Payer: Mclaren Medicare	$4.75
Rate for Payer: Meridian Medicaid	$2.73
Rate for Payer: Meridian Wellcare - Medicare Advantage	$4.99
Rate for Payer: MI Amish Medical Board Commercial	$5.46
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$27.31
Rate for Payer: PACE Medicare	$4.51
Rate for Payer: PACE SWMI	$4.75
Rate for Payer: PHP Commercial	$27.31
Rate for Payer: PHP Medicare Advantage	$4.75
Rate for Payer: Priority Health Choice Medicaid	$2.60
Rate for Payer: Priority Health Cigna Priority Health	$22.49
Rate for Payer: Priority Health Medicare	$4.75
Rate for Payer: Priority Health SBD	$20.24
Rate for Payer: Railroad Medicare Medicare	$4.75
Rate for Payer: UHC All Payor (Choice/PPO)	$5.70
Rate for Payer: UHC Core	$8.08
Rate for Payer: UHC Dual Complete DSNP	$4.75
Rate for Payer: UHC Exchange	$4.75
Rate for Payer: UHC Medicare Advantage	$4.89
Rate for Payer: VA VA	$4.75

HC SUSCEPTIBILITY E TEST

Facility

$32.13

Service Code	CPT 87181
Hospital Charge Code	30600097
Hospital Revenue Code	306
Min. Negotiated Rate	$20.24
Max. Negotiated Rate	$28.92
Rate for Payer: Aetna Commercial	$27.31
Rate for Payer: Aetna New Business (MI Preferred)	$20.88
Rate for Payer: Cash Price	$25.70
Rate for Payer: Cofinity Commercial	$22.49
Rate for Payer: Cofinity Commercial	$27.63
Rate for Payer: Healthscope Commercial	$28.92
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$27.31
Rate for Payer: PHP Commercial	$27.31
Rate for Payer: Priority Health Cigna Priority Health	$22.49
Rate for Payer: Priority Health SBD	$20.24

HC SUSCEPTIBILITY, MIC

Facility

$79.00

Service Code	CPT 87186
Hospital Charge Code	30600100
Hospital Revenue Code	306
Min. Negotiated Rate	$49.77
Max. Negotiated Rate	$71.10
Rate for Payer: Aetna Commercial	$67.15
Rate for Payer: Aetna New Business (MI Preferred)	$51.35
Rate for Payer: Cash Price	$63.20
Rate for Payer: Cofinity Commercial	$55.30
Rate for Payer: Cofinity Commercial	$67.94
Rate for Payer: Healthscope Commercial	$71.10
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$67.15
Rate for Payer: PHP Commercial	$67.15
Rate for Payer: Priority Health Cigna Priority Health	$55.30
Rate for Payer: Priority Health SBD	$49.77

HC SUSCEPTIBILITY, MIC

Facility

$79.00

Service Code	CPT 87186
Hospital Charge Code	30600100
Hospital Revenue Code	306
Min. Negotiated Rate	$4.73
Max. Negotiated Rate	$71.10
Rate for Payer: Aetna Commercial	$67.15
Rate for Payer: Aetna Medicare	$9.00
Rate for Payer: Aetna New Business (MI Preferred)	$51.35
Rate for Payer: Allen County Amish Medical Aid Commercial	$10.81
Rate for Payer: Amish Plain Church Group Commercial	$10.81
Rate for Payer: BCBS Complete	$4.97
Rate for Payer: BCBS MAPPO	$8.65
Rate for Payer: BCBS Trust/PPO	$6.78
Rate for Payer: BCN Medicare Advantage	$8.65
Rate for Payer: Cash Price	$63.20
Rate for Payer: Cash Price	$63.20
Rate for Payer: Cofinity Commercial	$67.94
Rate for Payer: Cofinity Commercial	$55.30
Rate for Payer: Health Alliance Plan Medicare Advantage	$8.65
Rate for Payer: Healthscope Commercial	$71.10
Rate for Payer: Mclaren Medicaid	$4.73
Rate for Payer: Mclaren Medicare	$8.65
Rate for Payer: Meridian Medicaid	$4.97
Rate for Payer: Meridian Wellcare - Medicare Advantage	$9.08
Rate for Payer: MI Amish Medical Board Commercial	$9.95
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$67.15
Rate for Payer: PACE Medicare	$8.22
Rate for Payer: PACE SWMI	$8.65
Rate for Payer: PHP Commercial	$67.15
Rate for Payer: PHP Medicare Advantage	$8.65
Rate for Payer: Priority Health Choice Medicaid	$4.73
Rate for Payer: Priority Health Cigna Priority Health	$55.30
Rate for Payer: Priority Health Medicare	$8.65
Rate for Payer: Priority Health SBD	$49.77
Rate for Payer: Railroad Medicare Medicare	$8.65
Rate for Payer: UHC All Payor (Choice/PPO)	$10.38
Rate for Payer: UHC Core	$14.70
Rate for Payer: UHC Dual Complete DSNP	$8.65
Rate for Payer: UHC Exchange	$8.65
Rate for Payer: UHC Medicare Advantage	$8.91
Rate for Payer: VA VA	$8.65

HC SUTURE REMOVAL UNDER ANESTHESIA

Facility

$768.07

Hospital Charge Code	36100544
Hospital Revenue Code	361
Min. Negotiated Rate	$483.88
Max. Negotiated Rate	$691.26
Rate for Payer: Aetna Commercial	$652.86
Rate for Payer: Aetna New Business (MI Preferred)	$499.25
Rate for Payer: Cash Price	$614.46
Rate for Payer: Cofinity Commercial	$537.65
Rate for Payer: Cofinity Commercial	$660.54
Rate for Payer: Healthscope Commercial	$691.26
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$652.86
Rate for Payer: PHP Commercial	$652.86
Rate for Payer: Priority Health Cigna Priority Health	$537.65
Rate for Payer: Priority Health SBD	$483.88

HC SUTURE REMOVAL UNDER ANESTHESIA

Facility

$768.07

Hospital Charge Code	36100544
Hospital Revenue Code	361
Min. Negotiated Rate	$307.23
Max. Negotiated Rate	$691.26
Rate for Payer: Aetna Commercial	$652.86
Rate for Payer: Aetna New Business (MI Preferred)	$499.25
Rate for Payer: BCBS Complete	$307.23
Rate for Payer: Cash Price	$614.46
Rate for Payer: Cofinity Commercial	$537.65
Rate for Payer: Cofinity Commercial	$660.54
Rate for Payer: Healthscope Commercial	$691.26
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$652.86
Rate for Payer: PHP Commercial	$652.86
Rate for Payer: Priority Health Cigna Priority Health	$537.65
Rate for Payer: Priority Health SBD	$483.88

HC SWALLOW EVALUATION

Facility

$326.81

Service Code	CPT 92610
Hospital Charge Code	44400004
Hospital Revenue Code	444
Min. Negotiated Rate	$68.76
Max. Negotiated Rate	$294.13
Rate for Payer: Aetna Commercial	$277.79
Rate for Payer: Aetna New Business (MI Preferred)	$212.43
Rate for Payer: BCBS Complete	$130.72
Rate for Payer: BCBS Trust/PPO	$84.62
Rate for Payer: Cash Price	$261.45
Rate for Payer: Cash Price	$261.45
Rate for Payer: Cofinity Commercial	$281.06
Rate for Payer: Cofinity Commercial	$228.77
Rate for Payer: Healthscope Commercial	$294.13
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$277.79
Rate for Payer: PHP Commercial	$277.79
Rate for Payer: Priority Health Cigna Priority Health	$228.77
Rate for Payer: Priority Health SBD	$205.89
Rate for Payer: UHC All Payor (Choice/PPO)	$75.64
Rate for Payer: UHC Exchange	$68.76

HC SWALLOW EVALUATION

Facility

$326.81

Service Code	CPT 92610
Hospital Charge Code	44400004
Hospital Revenue Code	444
Min. Negotiated Rate	$205.89
Max. Negotiated Rate	$294.13
Rate for Payer: Aetna Commercial	$277.79
Rate for Payer: Aetna New Business (MI Preferred)	$212.43
Rate for Payer: Cash Price	$261.45
Rate for Payer: Cofinity Commercial	$228.77
Rate for Payer: Cofinity Commercial	$281.06
Rate for Payer: Healthscope Commercial	$294.13
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$277.79
Rate for Payer: PHP Commercial	$277.79
Rate for Payer: Priority Health Cigna Priority Health	$228.77
Rate for Payer: Priority Health SBD	$205.89

HC SWALLOWING THERAPY

Facility

$214.20

Service Code	CPT 92526
Hospital Charge Code	43000020
Hospital Revenue Code	430
Min. Negotiated Rate	$83.17
Max. Negotiated Rate	$192.78
Rate for Payer: Aetna Commercial	$182.07
Rate for Payer: Aetna New Business (MI Preferred)	$139.23
Rate for Payer: BCBS Complete	$85.68
Rate for Payer: BCBS Trust/PPO	$84.62
Rate for Payer: Cash Price	$171.36
Rate for Payer: Cash Price	$171.36
Rate for Payer: Cofinity Commercial	$149.94
Rate for Payer: Cofinity Commercial	$184.21
Rate for Payer: Healthscope Commercial	$192.78
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$182.07
Rate for Payer: PHP Commercial	$182.07
Rate for Payer: Priority Health Cigna Priority Health	$149.94
Rate for Payer: Priority Health SBD	$134.95
Rate for Payer: UHC All Payor (Choice/PPO)	$91.49
Rate for Payer: UHC Exchange	$83.17

HC SWALLOWING THERAPY

Facility

$214.20

Service Code	CPT 92526
Hospital Charge Code	43000020
Hospital Revenue Code	430
Min. Negotiated Rate	$134.95
Max. Negotiated Rate	$192.78
Rate for Payer: Aetna Commercial	$182.07
Rate for Payer: Aetna New Business (MI Preferred)	$139.23
Rate for Payer: Cash Price	$171.36
Rate for Payer: Cofinity Commercial	$149.94
Rate for Payer: Cofinity Commercial	$184.21
Rate for Payer: Healthscope Commercial	$192.78
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$182.07
Rate for Payer: PHP Commercial	$182.07
Rate for Payer: Priority Health Cigna Priority Health	$149.94
Rate for Payer: Priority Health SBD	$134.95

Know your out-of-pocket cost for care.

All Charges