Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC OASIS WD MATRIX PER SQ CM

Facility

$31.92

Service Code	HCPCS Q4102
Hospital Charge Code	63600050
Hospital Revenue Code	636
Min. Negotiated Rate	$12.77
Max. Negotiated Rate	$28.73
Rate for Payer: Aetna Commercial	$27.13
Rate for Payer: Aetna Medicare	$15.96
Rate for Payer: Aetna New Business (MI Preferred)	$20.75
Rate for Payer: BCBS Complete	$12.77
Rate for Payer: Cash Price	$25.54
Rate for Payer: Cofinity Commercial	$22.34
Rate for Payer: Cofinity Commercial	$27.45
Rate for Payer: Cofinity Medicare Advantage	$22.34
Rate for Payer: Encore Health Key Benefits Commercial	$25.54
Rate for Payer: Healthscope Commercial	$28.73
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$27.13
Rate for Payer: PHP Commercial	$27.13
Rate for Payer: Priority Health Cigna Priority Health	$20.75
Rate for Payer: Priority Health SBD	$20.11

HC OASIS WD MATRIX PER SQ CM

Facility

$31.92

Service Code	HCPCS Q4102
Hospital Charge Code	63600050
Hospital Revenue Code	636
Min. Negotiated Rate	$20.11
Max. Negotiated Rate	$28.73
Rate for Payer: Aetna Commercial	$27.13
Rate for Payer: Aetna New Business (MI Preferred)	$20.75
Rate for Payer: Cash Price	$25.54
Rate for Payer: Cofinity Commercial	$22.34
Rate for Payer: Cofinity Commercial	$27.45
Rate for Payer: Cofinity Medicare Advantage	$22.34
Rate for Payer: Encore Health Key Benefits Commercial	$25.54
Rate for Payer: Healthscope Commercial	$28.73
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$27.13
Rate for Payer: PHP Commercial	$27.13
Rate for Payer: Priority Health Cigna Priority Health	$20.75
Rate for Payer: Priority Health SBD	$20.11

HC OAT IGE

Facility

$25.39

Service Code	CPT 86003
Hospital Charge Code	30200051
Hospital Revenue Code	302
Min. Negotiated Rate	$16.00
Max. Negotiated Rate	$22.85
Rate for Payer: Aetna Commercial	$21.58
Rate for Payer: Aetna New Business (MI Preferred)	$16.50
Rate for Payer: Cash Price	$20.31
Rate for Payer: Cofinity Commercial	$17.77
Rate for Payer: Cofinity Commercial	$21.84
Rate for Payer: Cofinity Medicare Advantage	$17.77
Rate for Payer: Encore Health Key Benefits Commercial	$20.31
Rate for Payer: Healthscope Commercial	$22.85
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$21.58
Rate for Payer: PHP Commercial	$21.58
Rate for Payer: Priority Health Cigna Priority Health	$16.50
Rate for Payer: Priority Health SBD	$16.00

HC OAT IGE

Facility

$25.39

Service Code	CPT 86003
Hospital Charge Code	30200051
Hospital Revenue Code	302
Min. Negotiated Rate	$2.80
Max. Negotiated Rate	$22.85
Rate for Payer: Aetna Commercial	$21.58
Rate for Payer: Aetna Medicare	$5.43
Rate for Payer: Aetna New Business (MI Preferred)	$16.50
Rate for Payer: Allen County Amish Medical Aid Commercial	$6.53
Rate for Payer: Amish Plain Church Group Commercial	$6.53
Rate for Payer: BCBS Complete	$2.94
Rate for Payer: BCBS MAPPO	$5.22
Rate for Payer: BCN Medicare Advantage	$5.22
Rate for Payer: Cash Price	$20.31
Rate for Payer: Cash Price	$20.31
Rate for Payer: Cofinity Commercial	$21.84
Rate for Payer: Cofinity Commercial	$17.77
Rate for Payer: Cofinity Medicare Advantage	$17.77
Rate for Payer: Encore Health Key Benefits Commercial	$20.31
Rate for Payer: Health Alliance Plan Medicare Advantage	$5.22
Rate for Payer: Healthscope Commercial	$22.85
Rate for Payer: Mclaren Medicaid	$2.80
Rate for Payer: Mclaren Medicare	$5.22
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$5.48
Rate for Payer: Meridian Medicaid	$2.94
Rate for Payer: MI Amish Medical Board Commercial	$6.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$21.58
Rate for Payer: PACE Medicare	$4.96
Rate for Payer: PACE SWMI	$5.22
Rate for Payer: PHP Commercial	$21.58
Rate for Payer: PHP Medicare Advantage	$5.22
Rate for Payer: Priority Health Choice Medicaid	$2.80
Rate for Payer: Priority Health Cigna Priority Health	$16.50
Rate for Payer: Priority Health Medicare	$5.22
Rate for Payer: Priority Health SBD	$16.00
Rate for Payer: Railroad Medicare Medicare	$5.22
Rate for Payer: UHC All Payor (Choice/PPO)	$14.69
Rate for Payer: UHC Dual Complete DSNP	$5.22
Rate for Payer: UHC Medicare Advantage	$5.22
Rate for Payer: UHCCP Medicaid	$2.94
Rate for Payer: VA VA	$5.22

HC OB ANTEPARTUM R&B

Facility

$3,634.61

Hospital Charge Code	20000003
Hospital Revenue Code	110
Min. Negotiated Rate	$2,289.80
Max. Negotiated Rate	$3,271.15
Rate for Payer: Aetna Commercial	$3,089.42
Rate for Payer: Aetna New Business (MI Preferred)	$2,362.50
Rate for Payer: Cash Price	$2,907.69
Rate for Payer: Cofinity Commercial	$2,544.23
Rate for Payer: Cofinity Commercial	$3,125.76
Rate for Payer: Cofinity Medicare Advantage	$2,544.23
Rate for Payer: Encore Health Key Benefits Commercial	$2,907.69
Rate for Payer: Healthscope Commercial	$3,271.15
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3,089.42
Rate for Payer: PHP Commercial	$3,089.42
Rate for Payer: Priority Health Cigna Priority Health	$2,362.50
Rate for Payer: Priority Health SBD	$2,289.80

HC OB DELIVERY R&B

Facility

$1,810.72

Hospital Charge Code	11200001
Hospital Revenue Code	112
Min. Negotiated Rate	$1,140.75
Max. Negotiated Rate	$1,629.65
Rate for Payer: Aetna Commercial	$1,539.11
Rate for Payer: Aetna New Business (MI Preferred)	$1,176.97
Rate for Payer: Cash Price	$1,448.58
Rate for Payer: Cofinity Commercial	$1,267.50
Rate for Payer: Cofinity Commercial	$1,557.22
Rate for Payer: Cofinity Medicare Advantage	$1,267.50
Rate for Payer: Encore Health Key Benefits Commercial	$1,448.58
Rate for Payer: Healthscope Commercial	$1,629.65
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,539.11
Rate for Payer: PHP Commercial	$1,539.11
Rate for Payer: Priority Health Cigna Priority Health	$1,176.97
Rate for Payer: Priority Health SBD	$1,140.75

HC OB HIGH RISK R&B

Facility

$3,983.98

Hospital Charge Code	20000004
Hospital Revenue Code	110
Min. Negotiated Rate	$2,509.91
Max. Negotiated Rate	$3,585.58
Rate for Payer: Aetna Commercial	$3,386.38
Rate for Payer: Aetna New Business (MI Preferred)	$2,589.59
Rate for Payer: Cash Price	$3,187.18
Rate for Payer: Cofinity Commercial	$2,788.79
Rate for Payer: Cofinity Commercial	$3,426.22
Rate for Payer: Cofinity Medicare Advantage	$2,788.79
Rate for Payer: Encore Health Key Benefits Commercial	$3,187.18
Rate for Payer: Healthscope Commercial	$3,585.58
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3,386.38
Rate for Payer: PHP Commercial	$3,386.38
Rate for Payer: Priority Health Cigna Priority Health	$2,589.59
Rate for Payer: Priority Health SBD	$2,509.91

HC OB MED OBSERVATION PER HOUR

Facility

$145.08

Service Code	HCPCS G0378
Hospital Charge Code	76200012
Hospital Revenue Code	762
Min. Negotiated Rate	$58.03
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$123.32
Rate for Payer: Aetna Medicare	$72.54
Rate for Payer: Aetna New Business (MI Preferred)	$94.30
Rate for Payer: BCBS Complete	$58.03
Rate for Payer: Cash Price	$116.06
Rate for Payer: Cash Price	$116.06
Rate for Payer: Cofinity Commercial	$101.56
Rate for Payer: Cofinity Commercial	$124.77
Rate for Payer: Cofinity Medicare Advantage	$101.56
Rate for Payer: Encore Health Key Benefits Commercial	$116.06
Rate for Payer: Healthscope Commercial	$130.57
Rate for Payer: Meridian Medicaid	$1,000.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$123.32
Rate for Payer: PHP Commercial	$123.32
Rate for Payer: Priority Health Cigna Priority Health	$94.30
Rate for Payer: Priority Health SBD	$91.40
Rate for Payer: UHC Core	$107.36
Rate for Payer: UHC Exchange	$107.36

HC OB MED OBSERVATION PER HOUR

Facility

$145.08

Service Code	HCPCS G0378
Hospital Charge Code	76200012
Hospital Revenue Code	762
Min. Negotiated Rate	$91.40
Max. Negotiated Rate	$130.57
Rate for Payer: Aetna Commercial	$123.32
Rate for Payer: Aetna New Business (MI Preferred)	$94.30
Rate for Payer: Cash Price	$116.06
Rate for Payer: Cofinity Commercial	$101.56
Rate for Payer: Cofinity Commercial	$124.77
Rate for Payer: Cofinity Medicare Advantage	$101.56
Rate for Payer: Encore Health Key Benefits Commercial	$116.06
Rate for Payer: Healthscope Commercial	$130.57
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$123.32
Rate for Payer: PHP Commercial	$123.32
Rate for Payer: Priority Health Cigna Priority Health	$94.30
Rate for Payer: Priority Health SBD	$91.40

HC OB POSTPARTUM R&B

Facility

$2,560.29

Hospital Charge Code	11200002
Hospital Revenue Code	112
Min. Negotiated Rate	$1,612.98
Max. Negotiated Rate	$2,304.26
Rate for Payer: Aetna Commercial	$2,176.25
Rate for Payer: Aetna New Business (MI Preferred)	$1,664.19
Rate for Payer: Cash Price	$2,048.23
Rate for Payer: Cofinity Commercial	$1,792.20
Rate for Payer: Cofinity Commercial	$2,201.85
Rate for Payer: Cofinity Medicare Advantage	$1,792.20
Rate for Payer: Encore Health Key Benefits Commercial	$2,048.23
Rate for Payer: Healthscope Commercial	$2,304.26
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2,176.25
Rate for Payer: PHP Commercial	$2,176.25
Rate for Payer: Priority Health Cigna Priority Health	$1,664.19
Rate for Payer: Priority Health SBD	$1,612.98

HC OBSERVATION OVERFLOW PER HOUR

Facility

$137.02

Hospital Charge Code	76900005
Hospital Revenue Code	769
Min. Negotiated Rate	$54.81
Max. Negotiated Rate	$123.32
Rate for Payer: Aetna Commercial	$116.47
Rate for Payer: Aetna Medicare	$68.51
Rate for Payer: Aetna New Business (MI Preferred)	$89.06
Rate for Payer: BCBS Complete	$54.81
Rate for Payer: Cash Price	$109.62
Rate for Payer: Cofinity Commercial	$117.84
Rate for Payer: Cofinity Commercial	$95.91
Rate for Payer: Cofinity Medicare Advantage	$95.91
Rate for Payer: Encore Health Key Benefits Commercial	$109.62
Rate for Payer: Healthscope Commercial	$123.32
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$116.47
Rate for Payer: PHP Commercial	$116.47
Rate for Payer: Priority Health Cigna Priority Health	$89.06
Rate for Payer: Priority Health SBD	$86.32

HC OBSERVATION OVERFLOW PER HOUR

Facility

$137.02

Hospital Charge Code	76900005
Hospital Revenue Code	769
Min. Negotiated Rate	$86.32
Max. Negotiated Rate	$123.32
Rate for Payer: Aetna Commercial	$116.47
Rate for Payer: Aetna New Business (MI Preferred)	$89.06
Rate for Payer: Cash Price	$109.62
Rate for Payer: Cofinity Commercial	$117.84
Rate for Payer: Cofinity Commercial	$95.91
Rate for Payer: Cofinity Medicare Advantage	$95.91
Rate for Payer: Encore Health Key Benefits Commercial	$109.62
Rate for Payer: Healthscope Commercial	$123.32
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$116.47
Rate for Payer: PHP Commercial	$116.47
Rate for Payer: Priority Health Cigna Priority Health	$89.06
Rate for Payer: Priority Health SBD	$86.32

HC OBSERVATION PER HOUR

Facility

$145.08

Service Code	HCPCS G0378
Hospital Charge Code	76200023
Hospital Revenue Code	762
Min. Negotiated Rate	$91.40
Max. Negotiated Rate	$130.57
Rate for Payer: Aetna Commercial	$123.32
Rate for Payer: Aetna New Business (MI Preferred)	$94.30
Rate for Payer: Cash Price	$116.06
Rate for Payer: Cofinity Commercial	$101.56
Rate for Payer: Cofinity Commercial	$124.77
Rate for Payer: Cofinity Medicare Advantage	$101.56
Rate for Payer: Encore Health Key Benefits Commercial	$116.06
Rate for Payer: Healthscope Commercial	$130.57
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$123.32
Rate for Payer: PHP Commercial	$123.32
Rate for Payer: Priority Health Cigna Priority Health	$94.30
Rate for Payer: Priority Health SBD	$91.40

HC OBSERVATION PER HOUR

Facility

$145.08

Service Code	HCPCS G0378
Hospital Charge Code	76200023
Hospital Revenue Code	762
Min. Negotiated Rate	$58.03
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$123.32
Rate for Payer: Aetna Medicare	$72.54
Rate for Payer: Aetna New Business (MI Preferred)	$94.30
Rate for Payer: BCBS Complete	$58.03
Rate for Payer: Cash Price	$116.06
Rate for Payer: Cash Price	$116.06
Rate for Payer: Cofinity Commercial	$101.56
Rate for Payer: Cofinity Commercial	$124.77
Rate for Payer: Cofinity Medicare Advantage	$101.56
Rate for Payer: Encore Health Key Benefits Commercial	$116.06
Rate for Payer: Healthscope Commercial	$130.57
Rate for Payer: Meridian Medicaid	$1,000.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$123.32
Rate for Payer: PHP Commercial	$123.32
Rate for Payer: Priority Health Cigna Priority Health	$94.30
Rate for Payer: Priority Health SBD	$91.40
Rate for Payer: UHC Core	$107.36
Rate for Payer: UHC Exchange	$107.36

HC OBS OVERFLOW PER HR

Facility

$137.02

Hospital Charge Code	76900002
Hospital Revenue Code	769
Min. Negotiated Rate	$86.32
Max. Negotiated Rate	$123.32
Rate for Payer: Aetna Commercial	$116.47
Rate for Payer: Aetna New Business (MI Preferred)	$89.06
Rate for Payer: Cash Price	$109.62
Rate for Payer: Cofinity Commercial	$117.84
Rate for Payer: Cofinity Commercial	$95.91
Rate for Payer: Cofinity Medicare Advantage	$95.91
Rate for Payer: Encore Health Key Benefits Commercial	$109.62
Rate for Payer: Healthscope Commercial	$123.32
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$116.47
Rate for Payer: PHP Commercial	$116.47
Rate for Payer: Priority Health Cigna Priority Health	$89.06
Rate for Payer: Priority Health SBD	$86.32

HC OBS OVERFLOW PER HR

Facility

$137.02

Hospital Charge Code	76900002
Hospital Revenue Code	769
Min. Negotiated Rate	$54.81
Max. Negotiated Rate	$123.32
Rate for Payer: Aetna Commercial	$116.47
Rate for Payer: Aetna Medicare	$68.51
Rate for Payer: Aetna New Business (MI Preferred)	$89.06
Rate for Payer: BCBS Complete	$54.81
Rate for Payer: Cash Price	$109.62
Rate for Payer: Cofinity Commercial	$117.84
Rate for Payer: Cofinity Commercial	$95.91
Rate for Payer: Cofinity Medicare Advantage	$95.91
Rate for Payer: Encore Health Key Benefits Commercial	$109.62
Rate for Payer: Healthscope Commercial	$123.32
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$116.47
Rate for Payer: PHP Commercial	$116.47
Rate for Payer: Priority Health Cigna Priority Health	$89.06
Rate for Payer: Priority Health SBD	$86.32

HC OB SURGERY ADDL 15 MIN

Facility

$274.02

Hospital Charge Code	36000104
Hospital Revenue Code	360
Min. Negotiated Rate	$172.63
Max. Negotiated Rate	$246.62
Rate for Payer: Aetna Commercial	$232.92
Rate for Payer: Aetna New Business (MI Preferred)	$178.11
Rate for Payer: Cash Price	$219.22
Rate for Payer: Cofinity Commercial	$191.81
Rate for Payer: Cofinity Commercial	$235.66
Rate for Payer: Cofinity Medicare Advantage	$191.81
Rate for Payer: Encore Health Key Benefits Commercial	$219.22
Rate for Payer: Healthscope Commercial	$246.62
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$232.92
Rate for Payer: PHP Commercial	$232.92
Rate for Payer: Priority Health Cigna Priority Health	$178.11
Rate for Payer: Priority Health SBD	$172.63

HC OB SURGERY ADDL 15 MIN

Facility

$274.02

Hospital Charge Code	36000104
Hospital Revenue Code	360
Min. Negotiated Rate	$109.61
Max. Negotiated Rate	$246.62
Rate for Payer: Aetna Commercial	$232.92
Rate for Payer: Aetna Medicare	$137.01
Rate for Payer: Aetna New Business (MI Preferred)	$178.11
Rate for Payer: BCBS Complete	$109.61
Rate for Payer: Cash Price	$219.22
Rate for Payer: Cofinity Commercial	$191.81
Rate for Payer: Cofinity Commercial	$235.66
Rate for Payer: Cofinity Medicare Advantage	$191.81
Rate for Payer: Encore Health Key Benefits Commercial	$219.22
Rate for Payer: Healthscope Commercial	$246.62
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$232.92
Rate for Payer: PHP Commercial	$232.92
Rate for Payer: Priority Health Cigna Priority Health	$178.11
Rate for Payer: Priority Health SBD	$172.63

HC OB SURGERY INITIAL 30 MIN

Facility

$1,453.56

Hospital Charge Code	36000077
Hospital Revenue Code	360
Min. Negotiated Rate	$581.42
Max. Negotiated Rate	$1,308.20
Rate for Payer: Aetna Commercial	$1,235.53
Rate for Payer: Aetna Medicare	$726.78
Rate for Payer: Aetna New Business (MI Preferred)	$944.81
Rate for Payer: BCBS Complete	$581.42
Rate for Payer: Cash Price	$1,162.85
Rate for Payer: Cofinity Commercial	$1,017.49
Rate for Payer: Cofinity Commercial	$1,250.06
Rate for Payer: Cofinity Medicare Advantage	$1,017.49
Rate for Payer: Encore Health Key Benefits Commercial	$1,162.85
Rate for Payer: Healthscope Commercial	$1,308.20
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,235.53
Rate for Payer: PHP Commercial	$1,235.53
Rate for Payer: Priority Health Cigna Priority Health	$944.81
Rate for Payer: Priority Health SBD	$915.74

HC OB SURGERY INITIAL 30 MIN

Facility

$1,453.56

Hospital Charge Code	36000077
Hospital Revenue Code	360
Min. Negotiated Rate	$915.74
Max. Negotiated Rate	$1,308.20
Rate for Payer: Aetna Commercial	$1,235.53
Rate for Payer: Aetna New Business (MI Preferred)	$944.81
Rate for Payer: Cash Price	$1,162.85
Rate for Payer: Cofinity Commercial	$1,017.49
Rate for Payer: Cofinity Commercial	$1,250.06
Rate for Payer: Cofinity Medicare Advantage	$1,017.49
Rate for Payer: Encore Health Key Benefits Commercial	$1,162.85
Rate for Payer: Healthscope Commercial	$1,308.20
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,235.53
Rate for Payer: PHP Commercial	$1,235.53
Rate for Payer: Priority Health Cigna Priority Health	$944.81
Rate for Payer: Priority Health SBD	$915.74

HC OB VAC DEL KIT DISP (OB)

Facility

$257.77

Hospital Charge Code	27000127
Hospital Revenue Code	272
Min. Negotiated Rate	$103.11
Max. Negotiated Rate	$231.99
Rate for Payer: Aetna Commercial	$219.10
Rate for Payer: Aetna Medicare	$128.88
Rate for Payer: Aetna New Business (MI Preferred)	$167.55
Rate for Payer: BCBS Complete	$103.11
Rate for Payer: Cash Price	$206.22
Rate for Payer: Cofinity Commercial	$180.44
Rate for Payer: Cofinity Commercial	$221.68
Rate for Payer: Cofinity Medicare Advantage	$180.44
Rate for Payer: Encore Health Key Benefits Commercial	$206.22
Rate for Payer: Healthscope Commercial	$231.99
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$219.10
Rate for Payer: PHP Commercial	$219.10
Rate for Payer: Priority Health Cigna Priority Health	$167.55
Rate for Payer: Priority Health SBD	$162.40

HC OB VAC DEL KIT DISP (OB)

Facility

$257.77

Hospital Charge Code	27000127
Hospital Revenue Code	272
Min. Negotiated Rate	$162.40
Max. Negotiated Rate	$231.99
Rate for Payer: Aetna Commercial	$219.10
Rate for Payer: Aetna New Business (MI Preferred)	$167.55
Rate for Payer: Cash Price	$206.22
Rate for Payer: Cofinity Commercial	$180.44
Rate for Payer: Cofinity Commercial	$221.68
Rate for Payer: Cofinity Medicare Advantage	$180.44
Rate for Payer: Encore Health Key Benefits Commercial	$206.22
Rate for Payer: Healthscope Commercial	$231.99
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$219.10
Rate for Payer: PHP Commercial	$219.10
Rate for Payer: Priority Health Cigna Priority Health	$167.55
Rate for Payer: Priority Health SBD	$162.40

HC OCCLUSION CATH

Facility

$4,754.63

Service Code	HCPCS C2628
Hospital Charge Code	27200344
Hospital Revenue Code	272
Min. Negotiated Rate	$1,901.85
Max. Negotiated Rate	$4,279.17
Rate for Payer: Aetna Commercial	$4,041.44
Rate for Payer: Aetna Medicare	$2,377.32
Rate for Payer: Aetna New Business (MI Preferred)	$3,090.51
Rate for Payer: BCBS Complete	$1,901.85
Rate for Payer: Cash Price	$3,803.70
Rate for Payer: Cofinity Commercial	$3,328.24
Rate for Payer: Cofinity Commercial	$4,088.98
Rate for Payer: Cofinity Medicare Advantage	$3,328.24
Rate for Payer: Encore Health Key Benefits Commercial	$3,803.70
Rate for Payer: Healthscope Commercial	$4,279.17
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4,041.44
Rate for Payer: PHP Commercial	$4,041.44
Rate for Payer: Priority Health Cigna Priority Health	$3,090.51
Rate for Payer: Priority Health SBD	$2,995.42

HC OCCLUSION CATH

Facility

$4,754.63

Service Code	HCPCS C2628
Hospital Charge Code	27200344
Hospital Revenue Code	272
Min. Negotiated Rate	$2,995.42
Max. Negotiated Rate	$4,279.17
Rate for Payer: Aetna Commercial	$4,041.44
Rate for Payer: Aetna New Business (MI Preferred)	$3,090.51
Rate for Payer: Cash Price	$3,803.70
Rate for Payer: Cofinity Commercial	$3,328.24
Rate for Payer: Cofinity Commercial	$4,088.98
Rate for Payer: Cofinity Medicare Advantage	$3,328.24
Rate for Payer: Encore Health Key Benefits Commercial	$3,803.70
Rate for Payer: Healthscope Commercial	$4,279.17
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4,041.44
Rate for Payer: PHP Commercial	$4,041.44
Rate for Payer: Priority Health Cigna Priority Health	$3,090.51
Rate for Payer: Priority Health SBD	$2,995.42

HC OCCULT BLOOD OTHER SOURCES

Facility

$30.70

Service Code	CPT 82271
Hospital Charge Code	30100122
Hospital Revenue Code	301
Min. Negotiated Rate	$2.85
Max. Negotiated Rate	$27.63
Rate for Payer: Aetna Commercial	$26.09
Rate for Payer: Aetna Medicare	$5.53
Rate for Payer: Aetna New Business (MI Preferred)	$19.95
Rate for Payer: Allen County Amish Medical Aid Commercial	$6.65
Rate for Payer: Amish Plain Church Group Commercial	$6.65
Rate for Payer: BCBS Complete	$2.99
Rate for Payer: BCBS MAPPO	$5.32
Rate for Payer: BCN Medicare Advantage	$5.32
Rate for Payer: Cash Price	$24.56
Rate for Payer: Cash Price	$24.56
Rate for Payer: Cofinity Commercial	$26.40
Rate for Payer: Cofinity Commercial	$21.49
Rate for Payer: Cofinity Medicare Advantage	$21.49
Rate for Payer: Encore Health Key Benefits Commercial	$24.56
Rate for Payer: Health Alliance Plan Medicare Advantage	$5.32
Rate for Payer: Healthscope Commercial	$27.63
Rate for Payer: Mclaren Medicaid	$2.85
Rate for Payer: Mclaren Medicare	$5.32
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$5.59
Rate for Payer: Meridian Medicaid	$2.99
Rate for Payer: MI Amish Medical Board Commercial	$6.12
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$26.09
Rate for Payer: PACE Medicare	$5.05
Rate for Payer: PACE SWMI	$5.32
Rate for Payer: PHP Commercial	$26.09
Rate for Payer: PHP Medicare Advantage	$5.32
Rate for Payer: Priority Health Choice Medicaid	$2.85
Rate for Payer: Priority Health Cigna Priority Health	$19.95
Rate for Payer: Priority Health Medicare	$5.32
Rate for Payer: Priority Health SBD	$19.34
Rate for Payer: Railroad Medicare Medicare	$5.32
Rate for Payer: UHC All Payor (Choice/PPO)	$14.98
Rate for Payer: UHC Dual Complete DSNP	$5.32
Rate for Payer: UHC Medicare Advantage	$5.32
Rate for Payer: UHCCP Medicaid	$3.00
Rate for Payer: VA VA	$5.32

Know your out-of-pocket cost for care.

All Charges