Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC OT Z STOCKINGS NON CUSTOM $375

Facility

$390.15

Service Code	HCPCS A6549
Hospital Charge Code	98300126
Hospital Revenue Code	270
Min. Negotiated Rate	$153.33
Max. Negotiated Rate	$365.03
Rate for Payer: Aetna Commercial	$331.63
Rate for Payer: Aetna Medicare	$195.07
Rate for Payer: Aetna New Business (MI Preferred)	$253.60
Rate for Payer: BCBS Complete	$156.06
Rate for Payer: BCBS Trust/PPO	$365.03
Rate for Payer: BCN Commercial	$365.03
Rate for Payer: Cash Price	$312.12
Rate for Payer: Cash Price	$312.12
Rate for Payer: Cofinity Advantage	$273.11
Rate for Payer: Cofinity Commercial	$335.53
Rate for Payer: Encore Health Key Benefits Commercial	$312.12
Rate for Payer: Healthscope Commercial	$351.13
Rate for Payer: MI Amish Medical Board Commercial	$312.12
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$331.63
Rate for Payer: Opus (Opus Packaging Group) HMA	$292.61
Rate for Payer: PHP Commercial	$331.63
Rate for Payer: Priority Health SBD	$245.79
Rate for Payer: UHC All Payor (Choice/PPO)	$253.60
Rate for Payer: UHC Core	$203.27
Rate for Payer: UHC Exchange	$153.33

HC OT Z STOCKINGS NON CUSTOM $375

Facility

$390.15

Service Code	HCPCS A6549
Hospital Charge Code	98300126
Hospital Revenue Code	270
Min. Negotiated Rate	$245.79
Max. Negotiated Rate	$351.13
Rate for Payer: Aetna Commercial	$331.63
Rate for Payer: Aetna New Business (MI Preferred)	$253.60
Rate for Payer: Cash Price	$312.12
Rate for Payer: Cofinity Advantage	$273.11
Rate for Payer: Cofinity Commercial	$335.53
Rate for Payer: Encore Health Key Benefits Commercial	$312.12
Rate for Payer: Healthscope Commercial	$351.13
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$331.63
Rate for Payer: Opus (Opus Packaging Group) HMA	$292.61
Rate for Payer: PHP Commercial	$331.63
Rate for Payer: Priority Health SBD	$245.79

HC OT Z STOCKINGS NON CUSTOM $40

Facility

$41.62

Service Code	HCPCS A6549
Hospital Charge Code	98300127
Hospital Revenue Code	270
Min. Negotiated Rate	$26.22
Max. Negotiated Rate	$37.46
Rate for Payer: Aetna Commercial	$35.38
Rate for Payer: Aetna New Business (MI Preferred)	$27.05
Rate for Payer: Cash Price	$33.30
Rate for Payer: Cofinity Advantage	$29.13
Rate for Payer: Cofinity Commercial	$35.79
Rate for Payer: Encore Health Key Benefits Commercial	$33.30
Rate for Payer: Healthscope Commercial	$37.46
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$35.38
Rate for Payer: Opus (Opus Packaging Group) HMA	$31.21
Rate for Payer: PHP Commercial	$35.38
Rate for Payer: Priority Health SBD	$26.22

HC OT Z STOCKINGS NON CUSTOM $40

Facility

$41.62

Service Code	HCPCS A6549
Hospital Charge Code	98300127
Hospital Revenue Code	270
Min. Negotiated Rate	$16.36
Max. Negotiated Rate	$365.03
Rate for Payer: Aetna Commercial	$35.38
Rate for Payer: Aetna Medicare	$20.81
Rate for Payer: Aetna New Business (MI Preferred)	$27.05
Rate for Payer: BCBS Complete	$16.65
Rate for Payer: BCBS Trust/PPO	$365.03
Rate for Payer: BCN Commercial	$365.03
Rate for Payer: Cash Price	$33.30
Rate for Payer: Cash Price	$33.30
Rate for Payer: Cofinity Advantage	$29.13
Rate for Payer: Cofinity Commercial	$35.79
Rate for Payer: Encore Health Key Benefits Commercial	$33.30
Rate for Payer: Healthscope Commercial	$37.46
Rate for Payer: MI Amish Medical Board Commercial	$33.30
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$35.38
Rate for Payer: Opus (Opus Packaging Group) HMA	$31.21
Rate for Payer: PHP Commercial	$35.38
Rate for Payer: Priority Health SBD	$26.22
Rate for Payer: UHC All Payor (Choice/PPO)	$27.05
Rate for Payer: UHC Core	$21.68
Rate for Payer: UHC Exchange	$16.36

HC OT Z STOCKINGS NON CUSTOM $400

Facility

$416.16

Service Code	HCPCS A6549
Hospital Charge Code	98300128
Hospital Revenue Code	270
Min. Negotiated Rate	$163.55
Max. Negotiated Rate	$374.54
Rate for Payer: Aetna Commercial	$353.74
Rate for Payer: Aetna Medicare	$208.08
Rate for Payer: Aetna New Business (MI Preferred)	$270.50
Rate for Payer: BCBS Complete	$166.46
Rate for Payer: BCBS Trust/PPO	$365.03
Rate for Payer: BCN Commercial	$365.03
Rate for Payer: Cash Price	$332.93
Rate for Payer: Cash Price	$332.93
Rate for Payer: Cofinity Advantage	$291.31
Rate for Payer: Cofinity Commercial	$357.90
Rate for Payer: Encore Health Key Benefits Commercial	$332.93
Rate for Payer: Healthscope Commercial	$374.54
Rate for Payer: MI Amish Medical Board Commercial	$332.93
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$353.74
Rate for Payer: Opus (Opus Packaging Group) HMA	$312.12
Rate for Payer: PHP Commercial	$353.74
Rate for Payer: Priority Health SBD	$262.18
Rate for Payer: UHC All Payor (Choice/PPO)	$270.50
Rate for Payer: UHC Core	$216.82
Rate for Payer: UHC Exchange	$163.55

HC OT Z STOCKINGS NON CUSTOM $400

Facility

$416.16

Service Code	HCPCS A6549
Hospital Charge Code	98300128
Hospital Revenue Code	270
Min. Negotiated Rate	$262.18
Max. Negotiated Rate	$374.54
Rate for Payer: Aetna Commercial	$353.74
Rate for Payer: Aetna New Business (MI Preferred)	$270.50
Rate for Payer: Cash Price	$332.93
Rate for Payer: Cofinity Advantage	$291.31
Rate for Payer: Cofinity Commercial	$357.90
Rate for Payer: Encore Health Key Benefits Commercial	$332.93
Rate for Payer: Healthscope Commercial	$374.54
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$353.74
Rate for Payer: Opus (Opus Packaging Group) HMA	$312.12
Rate for Payer: PHP Commercial	$353.74
Rate for Payer: Priority Health SBD	$262.18

HC OT Z STOCKINGS NON CUSTOM $425

Facility

$442.17

Service Code	HCPCS A6549
Hospital Charge Code	98300129
Hospital Revenue Code	270
Min. Negotiated Rate	$278.57
Max. Negotiated Rate	$397.95
Rate for Payer: Aetna Commercial	$375.84
Rate for Payer: Aetna New Business (MI Preferred)	$287.41
Rate for Payer: Cash Price	$353.74
Rate for Payer: Cofinity Advantage	$309.52
Rate for Payer: Cofinity Commercial	$380.27
Rate for Payer: Encore Health Key Benefits Commercial	$353.74
Rate for Payer: Healthscope Commercial	$397.95
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$375.84
Rate for Payer: Opus (Opus Packaging Group) HMA	$331.63
Rate for Payer: PHP Commercial	$375.84
Rate for Payer: Priority Health SBD	$278.57

HC OT Z STOCKINGS NON CUSTOM $425

Facility

$442.17

Service Code	HCPCS A6549
Hospital Charge Code	98300129
Hospital Revenue Code	270
Min. Negotiated Rate	$173.77
Max. Negotiated Rate	$397.95
Rate for Payer: Cofinity Advantage	$309.52
Rate for Payer: Aetna Commercial	$375.84
Rate for Payer: Aetna Medicare	$221.09
Rate for Payer: Aetna New Business (MI Preferred)	$287.41
Rate for Payer: BCBS Complete	$176.87
Rate for Payer: BCBS Trust/PPO	$365.03
Rate for Payer: BCN Commercial	$365.03
Rate for Payer: Cash Price	$353.74
Rate for Payer: Cash Price	$353.74
Rate for Payer: Cofinity Commercial	$380.27
Rate for Payer: Encore Health Key Benefits Commercial	$353.74
Rate for Payer: Healthscope Commercial	$397.95
Rate for Payer: MI Amish Medical Board Commercial	$353.74
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$375.84
Rate for Payer: Opus (Opus Packaging Group) HMA	$331.63
Rate for Payer: PHP Commercial	$375.84
Rate for Payer: Priority Health SBD	$278.57
Rate for Payer: UHC All Payor (Choice/PPO)	$287.41
Rate for Payer: UHC Core	$230.37
Rate for Payer: UHC Exchange	$173.77

HC OT Z STOCKINGS NON CUSTOM $450

Facility

$468.18

Service Code	HCPCS A6549
Hospital Charge Code	98300130
Hospital Revenue Code	270
Min. Negotiated Rate	$183.99
Max. Negotiated Rate	$421.36
Rate for Payer: Aetna Commercial	$397.95
Rate for Payer: Aetna Medicare	$234.09
Rate for Payer: Aetna New Business (MI Preferred)	$304.32
Rate for Payer: BCBS Complete	$187.27
Rate for Payer: BCBS Trust/PPO	$365.03
Rate for Payer: BCN Commercial	$365.03
Rate for Payer: Cash Price	$374.54
Rate for Payer: Cash Price	$374.54
Rate for Payer: Cofinity Advantage	$327.73
Rate for Payer: Cofinity Commercial	$402.63
Rate for Payer: Encore Health Key Benefits Commercial	$374.54
Rate for Payer: Healthscope Commercial	$421.36
Rate for Payer: MI Amish Medical Board Commercial	$374.54
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$397.95
Rate for Payer: Opus (Opus Packaging Group) HMA	$351.13
Rate for Payer: PHP Commercial	$397.95
Rate for Payer: Priority Health SBD	$294.95
Rate for Payer: UHC All Payor (Choice/PPO)	$304.32
Rate for Payer: UHC Core	$243.92
Rate for Payer: UHC Exchange	$183.99

HC OT Z STOCKINGS NON CUSTOM $450

Facility

$468.18

Service Code	HCPCS A6549
Hospital Charge Code	98300130
Hospital Revenue Code	270
Min. Negotiated Rate	$294.95
Max. Negotiated Rate	$421.36
Rate for Payer: Aetna Commercial	$397.95
Rate for Payer: Aetna New Business (MI Preferred)	$304.32
Rate for Payer: Cash Price	$374.54
Rate for Payer: Cofinity Advantage	$327.73
Rate for Payer: Cofinity Commercial	$402.63
Rate for Payer: Encore Health Key Benefits Commercial	$374.54
Rate for Payer: Healthscope Commercial	$421.36
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$397.95
Rate for Payer: Opus (Opus Packaging Group) HMA	$351.13
Rate for Payer: PHP Commercial	$397.95
Rate for Payer: Priority Health SBD	$294.95

HC OT Z STOCKINGS NON CUSTOM $50

Facility

$52.02

Service Code	HCPCS A6549
Hospital Charge Code	98300131
Hospital Revenue Code	270
Min. Negotiated Rate	$20.44
Max. Negotiated Rate	$365.03
Rate for Payer: Aetna Commercial	$44.22
Rate for Payer: Aetna Medicare	$26.01
Rate for Payer: Aetna New Business (MI Preferred)	$33.81
Rate for Payer: BCBS Complete	$20.81
Rate for Payer: BCBS Trust/PPO	$365.03
Rate for Payer: BCN Commercial	$365.03
Rate for Payer: Cash Price	$41.62
Rate for Payer: Cash Price	$41.62
Rate for Payer: Cofinity Advantage	$36.41
Rate for Payer: Cofinity Commercial	$44.74
Rate for Payer: Encore Health Key Benefits Commercial	$41.62
Rate for Payer: Healthscope Commercial	$46.82
Rate for Payer: MI Amish Medical Board Commercial	$41.62
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$44.22
Rate for Payer: Opus (Opus Packaging Group) HMA	$39.02
Rate for Payer: PHP Commercial	$44.22
Rate for Payer: Priority Health SBD	$32.77
Rate for Payer: UHC All Payor (Choice/PPO)	$33.81
Rate for Payer: UHC Core	$27.10
Rate for Payer: UHC Exchange	$20.44

HC OT Z STOCKINGS NON CUSTOM $50

Facility

$52.02

Service Code	HCPCS A6549
Hospital Charge Code	98300131
Hospital Revenue Code	270
Min. Negotiated Rate	$32.77
Max. Negotiated Rate	$46.82
Rate for Payer: Aetna Commercial	$44.22
Rate for Payer: Aetna New Business (MI Preferred)	$33.81
Rate for Payer: Cash Price	$41.62
Rate for Payer: Cofinity Advantage	$36.41
Rate for Payer: Cofinity Commercial	$44.74
Rate for Payer: Encore Health Key Benefits Commercial	$41.62
Rate for Payer: Healthscope Commercial	$46.82
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$44.22
Rate for Payer: Opus (Opus Packaging Group) HMA	$39.02
Rate for Payer: PHP Commercial	$44.22
Rate for Payer: Priority Health SBD	$32.77

HC OT Z STOCKINGS NON CUSTOM $60

Facility

$62.42

Service Code	HCPCS A6549
Hospital Charge Code	98300132
Hospital Revenue Code	270
Min. Negotiated Rate	$39.32
Max. Negotiated Rate	$56.18
Rate for Payer: Aetna Commercial	$53.06
Rate for Payer: Aetna New Business (MI Preferred)	$40.57
Rate for Payer: Cash Price	$49.94
Rate for Payer: Cofinity Advantage	$43.69
Rate for Payer: Cofinity Commercial	$53.68
Rate for Payer: Encore Health Key Benefits Commercial	$49.94
Rate for Payer: Healthscope Commercial	$56.18
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$53.06
Rate for Payer: Opus (Opus Packaging Group) HMA	$46.81
Rate for Payer: PHP Commercial	$53.06
Rate for Payer: Priority Health SBD	$39.32

HC OT Z STOCKINGS NON CUSTOM $60

Facility

$62.42

Service Code	HCPCS A6549
Hospital Charge Code	98300132
Hospital Revenue Code	270
Min. Negotiated Rate	$24.53
Max. Negotiated Rate	$365.03
Rate for Payer: Aetna Commercial	$53.06
Rate for Payer: Aetna Medicare	$31.21
Rate for Payer: Aetna New Business (MI Preferred)	$40.57
Rate for Payer: BCBS Complete	$24.97
Rate for Payer: BCBS Trust/PPO	$365.03
Rate for Payer: BCN Commercial	$365.03
Rate for Payer: Cash Price	$49.94
Rate for Payer: Cash Price	$49.94
Rate for Payer: Cofinity Advantage	$43.69
Rate for Payer: Cofinity Commercial	$53.68
Rate for Payer: Encore Health Key Benefits Commercial	$49.94
Rate for Payer: Healthscope Commercial	$56.18
Rate for Payer: MI Amish Medical Board Commercial	$49.94
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$53.06
Rate for Payer: Opus (Opus Packaging Group) HMA	$46.81
Rate for Payer: PHP Commercial	$53.06
Rate for Payer: Priority Health SBD	$39.32
Rate for Payer: UHC All Payor (Choice/PPO)	$40.57
Rate for Payer: UHC Core	$32.52
Rate for Payer: UHC Exchange	$24.53

HC OT Z STOCKINGS NON CUSTOM $70

Facility

$72.83

Service Code	HCPCS A6549
Hospital Charge Code	98300133
Hospital Revenue Code	270
Min. Negotiated Rate	$28.62
Max. Negotiated Rate	$365.03
Rate for Payer: Aetna Commercial	$61.91
Rate for Payer: Aetna Medicare	$36.41
Rate for Payer: Aetna New Business (MI Preferred)	$47.34
Rate for Payer: BCBS Complete	$29.13
Rate for Payer: BCBS Trust/PPO	$365.03
Rate for Payer: BCN Commercial	$365.03
Rate for Payer: Cash Price	$58.26
Rate for Payer: Cash Price	$58.26
Rate for Payer: Cofinity Advantage	$50.98
Rate for Payer: Cofinity Commercial	$62.63
Rate for Payer: Encore Health Key Benefits Commercial	$58.26
Rate for Payer: Healthscope Commercial	$65.55
Rate for Payer: MI Amish Medical Board Commercial	$58.26
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$61.91
Rate for Payer: Opus (Opus Packaging Group) HMA	$54.62
Rate for Payer: PHP Commercial	$61.91
Rate for Payer: Priority Health SBD	$45.88
Rate for Payer: UHC All Payor (Choice/PPO)	$47.34
Rate for Payer: UHC Core	$37.94
Rate for Payer: UHC Exchange	$28.62

HC OT Z STOCKINGS NON CUSTOM $70

Facility

$72.83

Service Code	HCPCS A6549
Hospital Charge Code	98300133
Hospital Revenue Code	270
Min. Negotiated Rate	$45.88
Max. Negotiated Rate	$65.55
Rate for Payer: Aetna Commercial	$61.91
Rate for Payer: Aetna New Business (MI Preferred)	$47.34
Rate for Payer: Cash Price	$58.26
Rate for Payer: Cofinity Advantage	$50.98
Rate for Payer: Cofinity Commercial	$62.63
Rate for Payer: Encore Health Key Benefits Commercial	$58.26
Rate for Payer: Healthscope Commercial	$65.55
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$61.91
Rate for Payer: Opus (Opus Packaging Group) HMA	$54.62
Rate for Payer: PHP Commercial	$61.91
Rate for Payer: Priority Health SBD	$45.88

HC OT Z STOCKINGS NON CUSTOM $80

Facility

$83.23

Service Code	HCPCS A6549
Hospital Charge Code	98300134
Hospital Revenue Code	270
Min. Negotiated Rate	$52.43
Max. Negotiated Rate	$74.91
Rate for Payer: Aetna Commercial	$70.75
Rate for Payer: Aetna New Business (MI Preferred)	$54.10
Rate for Payer: Cash Price	$66.58
Rate for Payer: Cofinity Advantage	$58.26
Rate for Payer: Cofinity Commercial	$71.58
Rate for Payer: Encore Health Key Benefits Commercial	$66.58
Rate for Payer: Healthscope Commercial	$74.91
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$70.75
Rate for Payer: Opus (Opus Packaging Group) HMA	$62.42
Rate for Payer: PHP Commercial	$70.75
Rate for Payer: Priority Health SBD	$52.43

HC OT Z STOCKINGS NON CUSTOM $80

Facility

$83.23

Service Code	HCPCS A6549
Hospital Charge Code	98300134
Hospital Revenue Code	270
Min. Negotiated Rate	$32.71
Max. Negotiated Rate	$365.03
Rate for Payer: Aetna Commercial	$70.75
Rate for Payer: Aetna Medicare	$41.62
Rate for Payer: Aetna New Business (MI Preferred)	$54.10
Rate for Payer: BCBS Complete	$33.29
Rate for Payer: BCBS Trust/PPO	$365.03
Rate for Payer: BCN Commercial	$365.03
Rate for Payer: Cash Price	$66.58
Rate for Payer: Cash Price	$66.58
Rate for Payer: Cofinity Advantage	$58.26
Rate for Payer: Cofinity Commercial	$71.58
Rate for Payer: Encore Health Key Benefits Commercial	$66.58
Rate for Payer: Healthscope Commercial	$74.91
Rate for Payer: MI Amish Medical Board Commercial	$66.58
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$70.75
Rate for Payer: Opus (Opus Packaging Group) HMA	$62.42
Rate for Payer: PHP Commercial	$70.75
Rate for Payer: Priority Health SBD	$52.43
Rate for Payer: UHC All Payor (Choice/PPO)	$54.10
Rate for Payer: UHC Core	$43.36
Rate for Payer: UHC Exchange	$32.71

HC OT Z STOCKINGS NON CUSTOM $90

Facility

$93.64

Service Code	HCPCS A6549
Hospital Charge Code	98300135
Hospital Revenue Code	270
Min. Negotiated Rate	$36.80
Max. Negotiated Rate	$365.03
Rate for Payer: Aetna Commercial	$79.59
Rate for Payer: Aetna Medicare	$46.82
Rate for Payer: Aetna New Business (MI Preferred)	$60.87
Rate for Payer: BCBS Complete	$37.46
Rate for Payer: BCBS Trust/PPO	$365.03
Rate for Payer: BCN Commercial	$365.03
Rate for Payer: Cash Price	$74.91
Rate for Payer: Cash Price	$74.91
Rate for Payer: Cofinity Advantage	$65.55
Rate for Payer: Cofinity Commercial	$80.53
Rate for Payer: Encore Health Key Benefits Commercial	$74.91
Rate for Payer: Healthscope Commercial	$84.28
Rate for Payer: MI Amish Medical Board Commercial	$74.91
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$79.59
Rate for Payer: Opus (Opus Packaging Group) HMA	$70.23
Rate for Payer: PHP Commercial	$79.59
Rate for Payer: Priority Health SBD	$58.99
Rate for Payer: UHC All Payor (Choice/PPO)	$60.87
Rate for Payer: UHC Core	$48.79
Rate for Payer: UHC Exchange	$36.80

HC OT Z STOCKINGS NON CUSTOM $90

Facility

$93.64

Service Code	HCPCS A6549
Hospital Charge Code	98300135
Hospital Revenue Code	270
Min. Negotiated Rate	$58.99
Max. Negotiated Rate	$84.28
Rate for Payer: Aetna Commercial	$79.59
Rate for Payer: Aetna New Business (MI Preferred)	$60.87
Rate for Payer: Cash Price	$74.91
Rate for Payer: Cofinity Advantage	$65.55
Rate for Payer: Cofinity Commercial	$80.53
Rate for Payer: Encore Health Key Benefits Commercial	$74.91
Rate for Payer: Healthscope Commercial	$84.28
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$79.59
Rate for Payer: Opus (Opus Packaging Group) HMA	$70.23
Rate for Payer: PHP Commercial	$79.59
Rate for Payer: Priority Health SBD	$58.99

HC OVA & PARASITES

Facility

$89.58

Service Code	CPT 87177
Hospital Charge Code	30600096
Hospital Revenue Code	306
Min. Negotiated Rate	$56.44
Max. Negotiated Rate	$80.62
Rate for Payer: Aetna Commercial	$76.14
Rate for Payer: Aetna New Business (MI Preferred)	$58.23
Rate for Payer: Cash Price	$71.66
Rate for Payer: Cofinity Advantage	$62.71
Rate for Payer: Cofinity Commercial	$77.04
Rate for Payer: Encore Health Key Benefits Commercial	$71.66
Rate for Payer: Healthscope Commercial	$80.62
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$76.14
Rate for Payer: Opus (Opus Packaging Group) HMA	$67.19
Rate for Payer: PHP Commercial	$76.14
Rate for Payer: Priority Health SBD	$56.44

HC OVA & PARASITES

Facility

$89.58

Service Code	CPT 87177
Hospital Charge Code	30600096
Hospital Revenue Code	306
Min. Negotiated Rate	$4.65
Max. Negotiated Rate	$80.62
Rate for Payer: Aetna Commercial	$76.14
Rate for Payer: Aetna Medicare	$9.26
Rate for Payer: Aetna New Business (MI Preferred)	$58.23
Rate for Payer: Allen County Amish Medical Aid Commercial	$11.12
Rate for Payer: Amish Plain Church Group Commercial	$11.12
Rate for Payer: BCBS Complete	$4.89
Rate for Payer: BCBS MAPPO	$8.90
Rate for Payer: BCBS Trust/PPO	$9.50
Rate for Payer: BCN Commercial	$9.50
Rate for Payer: BCN Medicare Advantage	$8.90
Rate for Payer: Cash Price	$71.66
Rate for Payer: Cash Price	$71.66
Rate for Payer: Cofinity Advantage	$62.71
Rate for Payer: Cofinity Commercial	$77.04
Rate for Payer: Encore Health Key Benefits Commercial	$71.66
Rate for Payer: Health Alliance Plan Medicare Advantage	$8.90
Rate for Payer: Healthscope Commercial	$80.62
Rate for Payer: Mclaren Medicaid	$4.65
Rate for Payer: Mclaren Medicare	$8.90
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$9.35
Rate for Payer: Meridian Medicaid	$9.35
Rate for Payer: MI Amish Medical Board Commercial	$10.23
Rate for Payer: Molina Medicare/Medicaid	$9.79
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$76.14
Rate for Payer: Nomi Health Commercial	$13.35
Rate for Payer: Opus (Opus Packaging Group) HMA	$67.19
Rate for Payer: PACE Medicare	$8.46
Rate for Payer: PACE SWMI	$8.90
Rate for Payer: PHP Commercial	$76.14
Rate for Payer: PHP Medicare Advantage	$8.90
Rate for Payer: Priority Health Choice Medicaid	$4.65
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$8.90
Rate for Payer: Priority Health Medicare	$8.90
Rate for Payer: Priority Health SBD	$56.44
Rate for Payer: Priority Health Tiered Network	$7.12
Rate for Payer: Railroad Medicare Medicare	$8.90
Rate for Payer: UHC All Payor (Choice/PPO)	$13.35
Rate for Payer: UHC Core	$13.35
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$8.90
Rate for Payer: UHC Exchange	$13.35
Rate for Payer: UHC Medicaid	$4.65
Rate for Payer: UHCCP Medicaid	$4.65
Rate for Payer: VA VA	$8.90

HC OVA & PARASITES SPECIAL STAIN

Facility

$67.63

Service Code	CPT 87209
Hospital Charge Code	30600190
Hospital Revenue Code	306
Min. Negotiated Rate	$9.40
Max. Negotiated Rate	$60.87
Rate for Payer: Aetna Commercial	$57.49
Rate for Payer: Aetna Medicare	$18.70
Rate for Payer: Aetna New Business (MI Preferred)	$43.96
Rate for Payer: Allen County Amish Medical Aid Commercial	$22.48
Rate for Payer: Amish Plain Church Group Commercial	$22.48
Rate for Payer: BCBS Complete	$9.87
Rate for Payer: BCBS MAPPO	$17.98
Rate for Payer: BCBS Trust/PPO	$19.18
Rate for Payer: BCN Commercial	$19.18
Rate for Payer: BCN Medicare Advantage	$17.98
Rate for Payer: Cash Price	$54.10
Rate for Payer: Cash Price	$54.10
Rate for Payer: Cofinity Advantage	$47.34
Rate for Payer: Cofinity Commercial	$58.16
Rate for Payer: Encore Health Key Benefits Commercial	$54.10
Rate for Payer: Health Alliance Plan Medicare Advantage	$17.98
Rate for Payer: Healthscope Commercial	$60.87
Rate for Payer: Mclaren Medicaid	$9.40
Rate for Payer: Mclaren Medicare	$17.98
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$18.88
Rate for Payer: Meridian Medicaid	$18.88
Rate for Payer: MI Amish Medical Board Commercial	$20.68
Rate for Payer: Molina Medicare/Medicaid	$19.78
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$57.49
Rate for Payer: Nomi Health Commercial	$26.97
Rate for Payer: Opus (Opus Packaging Group) HMA	$50.72
Rate for Payer: PACE Medicare	$17.08
Rate for Payer: PACE SWMI	$17.98
Rate for Payer: PHP Commercial	$57.49
Rate for Payer: PHP Medicare Advantage	$17.98
Rate for Payer: Priority Health Choice Medicaid	$9.40
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$17.98
Rate for Payer: Priority Health Medicare	$17.98
Rate for Payer: Priority Health SBD	$42.61
Rate for Payer: Priority Health Tiered Network	$14.38
Rate for Payer: Railroad Medicare Medicare	$17.98
Rate for Payer: UHC All Payor (Choice/PPO)	$26.97
Rate for Payer: UHC Core	$26.97
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$17.98
Rate for Payer: UHC Exchange	$26.97
Rate for Payer: UHC Medicaid	$9.40
Rate for Payer: UHCCP Medicaid	$9.40
Rate for Payer: VA VA	$17.98

HC OVA & PARASITES SPECIAL STAIN

Facility

$67.63

Service Code	CPT 87209
Hospital Charge Code	30600190
Hospital Revenue Code	306
Min. Negotiated Rate	$42.61
Max. Negotiated Rate	$60.87
Rate for Payer: Aetna Commercial	$57.49
Rate for Payer: Aetna New Business (MI Preferred)	$43.96
Rate for Payer: Cash Price	$54.10
Rate for Payer: Cofinity Advantage	$47.34
Rate for Payer: Cofinity Commercial	$58.16
Rate for Payer: Encore Health Key Benefits Commercial	$54.10
Rate for Payer: Healthscope Commercial	$60.87
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$57.49
Rate for Payer: Opus (Opus Packaging Group) HMA	$50.72
Rate for Payer: PHP Commercial	$57.49
Rate for Payer: Priority Health SBD	$42.61

HC OXALATE URINE

Facility

$46.70

Service Code	CPT 83945
Hospital Charge Code	30100381
Hospital Revenue Code	301
Min. Negotiated Rate	$29.42
Max. Negotiated Rate	$42.03
Rate for Payer: Aetna Commercial	$39.70
Rate for Payer: Aetna New Business (MI Preferred)	$30.36
Rate for Payer: Cash Price	$37.36
Rate for Payer: Cofinity Advantage	$32.69
Rate for Payer: Cofinity Commercial	$40.16
Rate for Payer: Encore Health Key Benefits Commercial	$37.36
Rate for Payer: Healthscope Commercial	$42.03
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$39.70
Rate for Payer: Opus (Opus Packaging Group) HMA	$35.02
Rate for Payer: PHP Commercial	$39.70
Rate for Payer: Priority Health SBD	$29.42

Know your out-of-pocket cost for care.

All Charges