Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC Y SET ANTE/RETRO

Facility

$41.25

Hospital Charge Code	27000661
Hospital Revenue Code	270
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$37.12
Rate for Payer: Aetna Commercial	$35.06
Rate for Payer: Aetna New Business (MI Preferred)	$26.81
Rate for Payer: BCBS Complete	$16.50
Rate for Payer: Cash Price	$33.00
Rate for Payer: Cofinity Commercial	$28.88
Rate for Payer: Cofinity Commercial	$35.48
Rate for Payer: Healthscope Commercial	$37.12
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$35.06
Rate for Payer: PHP Commercial	$35.06
Rate for Payer: Priority Health Cigna Priority Health	$28.88
Rate for Payer: Priority Health SBD	$25.99

HC Y SET ANTE/RETRO

Facility

$41.25

Hospital Charge Code	27000661
Hospital Revenue Code	270
Min. Negotiated Rate	$25.99
Max. Negotiated Rate	$37.12
Rate for Payer: Aetna Commercial	$35.06
Rate for Payer: Aetna New Business (MI Preferred)	$26.81
Rate for Payer: Cash Price	$33.00
Rate for Payer: Cofinity Commercial	$28.88
Rate for Payer: Cofinity Commercial	$35.48
Rate for Payer: Healthscope Commercial	$37.12
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$35.06
Rate for Payer: PHP Commercial	$35.06
Rate for Payer: Priority Health Cigna Priority Health	$28.88
Rate for Payer: Priority Health SBD	$25.99

HC YTTRIUM 90 MICROSPHERES

Facility

$49,783.83

Service Code	HCPCS C2616
Hospital Charge Code	27800106
Hospital Revenue Code	278
Min. Negotiated Rate	$8,774.57
Max. Negotiated Rate	$52,803.55
Rate for Payer: Aetna Commercial	$42,316.26
Rate for Payer: Aetna Medicare	$16,682.92
Rate for Payer: Aetna New Business (MI Preferred)	$32,359.49
Rate for Payer: Allen County Amish Medical Aid Commercial	$20,051.59
Rate for Payer: Amish Plain Church Group Commercial	$20,051.59
Rate for Payer: BCBS Complete	$9,214.11
Rate for Payer: BCBS MAPPO	$16,041.27
Rate for Payer: BCN Medicare Advantage	$16,041.27
Rate for Payer: Cash Price	$39,827.06
Rate for Payer: Cash Price	$39,827.06
Rate for Payer: Cofinity Commercial	$42,814.09
Rate for Payer: Cofinity Commercial	$34,848.68
Rate for Payer: Health Alliance Plan Medicare Advantage	$16,041.27
Rate for Payer: Healthscope Commercial	$44,805.45
Rate for Payer: Mclaren Medicaid	$8,774.57
Rate for Payer: Mclaren Medicare	$16,041.27
Rate for Payer: Meridian Medicaid	$9,214.11
Rate for Payer: Meridian Wellcare - Medicare Advantage	$16,843.33
Rate for Payer: MI Amish Medical Board Commercial	$18,447.46
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$42,316.26
Rate for Payer: PACE Medicare	$15,239.21
Rate for Payer: PACE SWMI	$16,041.27
Rate for Payer: PHP Commercial	$42,316.26
Rate for Payer: PHP Medicare Advantage	$16,041.27
Rate for Payer: Priority Health Choice Medicaid	$8,774.57
Rate for Payer: Priority Health Cigna Priority Health	$34,848.68
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$52,803.55
Rate for Payer: Priority Health Medicare	$16,041.27
Rate for Payer: Priority Health Narrow Network	$42,242.84
Rate for Payer: Priority Health SBD	$31,363.81
Rate for Payer: Railroad Medicare Medicare	$16,041.27
Rate for Payer: UHC All Payor (Choice/PPO)	$44,974.91
Rate for Payer: UHC Dual Complete DSNP	$16,041.27
Rate for Payer: UHC Exchange	$30,656.47
Rate for Payer: UHC Medicare Advantage	$16,522.51
Rate for Payer: VA VA	$16,041.27

HC YTTRIUM 90 MICROSPHERES

Facility

$49,783.83

Service Code	HCPCS C2616
Hospital Charge Code	27800106
Hospital Revenue Code	278
Min. Negotiated Rate	$31,363.81
Max. Negotiated Rate	$44,805.45
Rate for Payer: Aetna Commercial	$42,316.26
Rate for Payer: Aetna New Business (MI Preferred)	$32,359.49
Rate for Payer: Cash Price	$39,827.06
Rate for Payer: Cofinity Commercial	$34,848.68
Rate for Payer: Cofinity Commercial	$42,814.09
Rate for Payer: Healthscope Commercial	$44,805.45
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$42,316.26
Rate for Payer: PHP Commercial	$42,316.26
Rate for Payer: Priority Health Cigna Priority Health	$34,848.68
Rate for Payer: Priority Health SBD	$31,363.81

HC Y VENOUS BICAVAL

Facility

$41.00

Hospital Charge Code	27000279
Hospital Revenue Code	270
Min. Negotiated Rate	$25.83
Max. Negotiated Rate	$36.90
Rate for Payer: Aetna Commercial	$34.85
Rate for Payer: Aetna New Business (MI Preferred)	$26.65
Rate for Payer: Cash Price	$32.80
Rate for Payer: Cofinity Commercial	$28.70
Rate for Payer: Cofinity Commercial	$35.26
Rate for Payer: Healthscope Commercial	$36.90
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$34.85
Rate for Payer: PHP Commercial	$34.85
Rate for Payer: Priority Health Cigna Priority Health	$28.70
Rate for Payer: Priority Health SBD	$25.83

HC Y VENOUS BICAVAL

Facility

$41.00

Hospital Charge Code	27000279
Hospital Revenue Code	270
Min. Negotiated Rate	$16.40
Max. Negotiated Rate	$36.90
Rate for Payer: Aetna Commercial	$34.85
Rate for Payer: Aetna New Business (MI Preferred)	$26.65
Rate for Payer: BCBS Complete	$16.40
Rate for Payer: Cash Price	$32.80
Rate for Payer: Cofinity Commercial	$28.70
Rate for Payer: Cofinity Commercial	$35.26
Rate for Payer: Healthscope Commercial	$36.90
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$34.85
Rate for Payer: PHP Commercial	$34.85
Rate for Payer: Priority Health Cigna Priority Health	$28.70
Rate for Payer: Priority Health SBD	$25.83

HC Z ACCESS DEVICE

Facility

$200.84

Service Code	HCPCS C1894
Hospital Charge Code	27200082
Hospital Revenue Code	272
Min. Negotiated Rate	$126.53
Max. Negotiated Rate	$180.76
Rate for Payer: Aetna Commercial	$170.71
Rate for Payer: Aetna New Business (MI Preferred)	$130.55
Rate for Payer: Cash Price	$160.67
Rate for Payer: Cofinity Commercial	$140.59
Rate for Payer: Cofinity Commercial	$172.72
Rate for Payer: Healthscope Commercial	$180.76
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$170.71
Rate for Payer: PHP Commercial	$170.71
Rate for Payer: Priority Health Cigna Priority Health	$140.59
Rate for Payer: Priority Health SBD	$126.53

HC Z ACCESS DEVICE

Facility

$200.84

Service Code	HCPCS C1894
Hospital Charge Code	27200082
Hospital Revenue Code	272
Min. Negotiated Rate	$80.34
Max. Negotiated Rate	$180.76
Rate for Payer: Aetna Commercial	$170.71
Rate for Payer: Aetna New Business (MI Preferred)	$130.55
Rate for Payer: BCBS Complete	$80.34
Rate for Payer: Cash Price	$160.67
Rate for Payer: Cofinity Commercial	$140.59
Rate for Payer: Cofinity Commercial	$172.72
Rate for Payer: Healthscope Commercial	$180.76
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$170.71
Rate for Payer: PHP Commercial	$170.71
Rate for Payer: Priority Health Cigna Priority Health	$140.59
Rate for Payer: Priority Health SBD	$126.53

HC Z ACCULINK CAROTID STENT

Facility

$6,779.33

Service Code	HCPCS C1876
Hospital Charge Code	27800036
Hospital Revenue Code	278
Min. Negotiated Rate	$4,270.98
Max. Negotiated Rate	$6,101.40
Rate for Payer: Aetna Commercial	$5,762.43
Rate for Payer: Aetna New Business (MI Preferred)	$4,406.56
Rate for Payer: Cash Price	$5,423.46
Rate for Payer: Cofinity Commercial	$4,745.53
Rate for Payer: Cofinity Commercial	$5,830.22
Rate for Payer: Healthscope Commercial	$6,101.40
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$5,762.43
Rate for Payer: PHP Commercial	$5,762.43
Rate for Payer: Priority Health Cigna Priority Health	$4,745.53
Rate for Payer: Priority Health SBD	$4,270.98

HC Z ACCULINK CAROTID STENT

Facility

$6,779.33

Service Code	HCPCS C1876
Hospital Charge Code	27800036
Hospital Revenue Code	278
Min. Negotiated Rate	$2,711.73
Max. Negotiated Rate	$6,101.40
Rate for Payer: Aetna Commercial	$5,762.43
Rate for Payer: Aetna New Business (MI Preferred)	$4,406.56
Rate for Payer: BCBS Complete	$2,711.73
Rate for Payer: Cash Price	$5,423.46
Rate for Payer: Cofinity Commercial	$4,745.53
Rate for Payer: Cofinity Commercial	$5,830.22
Rate for Payer: Healthscope Commercial	$6,101.40
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$5,762.43
Rate for Payer: PHP Commercial	$5,762.43
Rate for Payer: Priority Health Cigna Priority Health	$4,745.53
Rate for Payer: Priority Health SBD	$4,270.98

HC Z ACCUNET PROTECTIVE SYSTEM

Facility

$6,241.28

Service Code	HCPCS C1884
Hospital Charge Code	27800037
Hospital Revenue Code	278
Min. Negotiated Rate	$3,932.01
Max. Negotiated Rate	$5,617.15
Rate for Payer: Aetna Commercial	$5,305.09
Rate for Payer: Aetna New Business (MI Preferred)	$4,056.83
Rate for Payer: Cash Price	$4,993.02
Rate for Payer: Cofinity Commercial	$4,368.90
Rate for Payer: Cofinity Commercial	$5,367.50
Rate for Payer: Healthscope Commercial	$5,617.15
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$5,305.09
Rate for Payer: PHP Commercial	$5,305.09
Rate for Payer: Priority Health Cigna Priority Health	$4,368.90
Rate for Payer: Priority Health SBD	$3,932.01

HC Z ACCUNET PROTECTIVE SYSTEM

Facility

$6,241.28

Service Code	HCPCS C1884
Hospital Charge Code	27800037
Hospital Revenue Code	278
Min. Negotiated Rate	$2,496.51
Max. Negotiated Rate	$5,617.15
Rate for Payer: Aetna Commercial	$5,305.09
Rate for Payer: Aetna New Business (MI Preferred)	$4,056.83
Rate for Payer: BCBS Complete	$2,496.51
Rate for Payer: Cash Price	$4,993.02
Rate for Payer: Cofinity Commercial	$4,368.90
Rate for Payer: Cofinity Commercial	$5,367.50
Rate for Payer: Healthscope Commercial	$5,617.15
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$5,305.09
Rate for Payer: PHP Commercial	$5,305.09
Rate for Payer: Priority Health Cigna Priority Health	$4,368.90
Rate for Payer: Priority Health SBD	$3,932.01

HC Z ARTHROCENTESIS SMALL JOINT BIL

Facility

$429.05

Service Code	CPT 20600
Hospital Charge Code	36100023
Hospital Revenue Code	761
Min. Negotiated Rate	$270.30
Max. Negotiated Rate	$386.14
Rate for Payer: Aetna Commercial	$364.69
Rate for Payer: Aetna New Business (MI Preferred)	$278.88
Rate for Payer: Cash Price	$343.24
Rate for Payer: Cofinity Commercial	$300.34
Rate for Payer: Cofinity Commercial	$368.98
Rate for Payer: Healthscope Commercial	$386.14
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$364.69
Rate for Payer: PHP Commercial	$364.69
Rate for Payer: Priority Health Cigna Priority Health	$300.34
Rate for Payer: Priority Health SBD	$270.30

HC Z ARTHROCENTESIS SMALL JOINT BIL

Facility

$429.05

Service Code	CPT 20600
Hospital Charge Code	36100023
Hospital Revenue Code	761
Min. Negotiated Rate	$35.04
Max. Negotiated Rate	$813.49
Rate for Payer: Aetna Commercial	$364.69
Rate for Payer: Aetna Medicare	$274.08
Rate for Payer: Aetna New Business (MI Preferred)	$278.88
Rate for Payer: Allen County Amish Medical Aid Commercial	$329.42
Rate for Payer: Amish Plain Church Group Commercial	$329.42
Rate for Payer: BCBS Complete	$151.38
Rate for Payer: BCBS MAPPO	$263.54
Rate for Payer: BCBS Trust/PPO	$169.96
Rate for Payer: BCN Medicare Advantage	$263.54
Rate for Payer: Cash Price	$343.24
Rate for Payer: Cash Price	$343.24
Rate for Payer: Cofinity Commercial	$300.34
Rate for Payer: Cofinity Commercial	$368.98
Rate for Payer: Health Alliance Plan Medicare Advantage	$263.54
Rate for Payer: Healthscope Commercial	$386.14
Rate for Payer: Mclaren Medicaid	$144.16
Rate for Payer: Mclaren Medicare	$263.54
Rate for Payer: Meridian Medicaid	$151.38
Rate for Payer: Meridian Wellcare - Medicare Advantage	$276.72
Rate for Payer: MI Amish Medical Board Commercial	$303.07
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$364.69
Rate for Payer: PACE Medicare	$250.36
Rate for Payer: PACE SWMI	$263.54
Rate for Payer: PHP Commercial	$364.69
Rate for Payer: PHP Medicare Advantage	$263.54
Rate for Payer: Priority Health Choice Medicaid	$144.16
Rate for Payer: Priority Health Cigna Priority Health	$300.34
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$813.49
Rate for Payer: Priority Health Medicare	$263.54
Rate for Payer: Priority Health Narrow Network	$650.79
Rate for Payer: Priority Health SBD	$270.30
Rate for Payer: Railroad Medicare Medicare	$263.54
Rate for Payer: UHC All Payor (Choice/PPO)	$38.54
Rate for Payer: UHC Dual Complete DSNP	$263.54
Rate for Payer: UHC Exchange	$35.04
Rate for Payer: UHC Medicare Advantage	$271.45
Rate for Payer: VA VA	$263.54

HC ZB002 CX ID GI PANEL 12-25 TARGETS

Facility

$679.12

Service Code	CPT 87507
Hospital Charge Code	30600280
Hospital Revenue Code	306
Min. Negotiated Rate	$427.85
Max. Negotiated Rate	$611.21
Rate for Payer: Aetna Commercial	$577.25
Rate for Payer: Aetna New Business (MI Preferred)	$441.43
Rate for Payer: Cash Price	$543.30
Rate for Payer: Cofinity Commercial	$475.38
Rate for Payer: Cofinity Commercial	$584.04
Rate for Payer: Healthscope Commercial	$611.21
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$577.25
Rate for Payer: PHP Commercial	$577.25
Rate for Payer: Priority Health Cigna Priority Health	$475.38
Rate for Payer: Priority Health SBD	$427.85

HC ZB002 CX ID GI PANEL 12-25 TARGETS

Facility

$679.12

Service Code	CPT 87507
Hospital Charge Code	30600280
Hospital Revenue Code	306
Min. Negotiated Rate	$227.98
Max. Negotiated Rate	$680.62
Rate for Payer: Aetna Commercial	$577.25
Rate for Payer: Aetna Medicare	$433.45
Rate for Payer: Aetna New Business (MI Preferred)	$441.43
Rate for Payer: Allen County Amish Medical Aid Commercial	$520.98
Rate for Payer: Amish Plain Church Group Commercial	$520.98
Rate for Payer: BCBS Complete	$239.40
Rate for Payer: BCBS MAPPO	$416.78
Rate for Payer: BCBS Trust/PPO	$326.38
Rate for Payer: BCN Medicare Advantage	$416.78
Rate for Payer: Cash Price	$543.30
Rate for Payer: Cash Price	$543.30
Rate for Payer: Cofinity Commercial	$584.04
Rate for Payer: Cofinity Commercial	$475.38
Rate for Payer: Health Alliance Plan Medicare Advantage	$416.78
Rate for Payer: Healthscope Commercial	$611.21
Rate for Payer: Mclaren Medicaid	$227.98
Rate for Payer: Mclaren Medicare	$416.78
Rate for Payer: Meridian Medicaid	$239.40
Rate for Payer: Meridian Wellcare - Medicare Advantage	$437.62
Rate for Payer: MI Amish Medical Board Commercial	$479.30
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$577.25
Rate for Payer: PACE Medicare	$395.94
Rate for Payer: PACE SWMI	$416.78
Rate for Payer: PHP Commercial	$577.25
Rate for Payer: PHP Medicare Advantage	$416.78
Rate for Payer: Priority Health Choice Medicaid	$227.98
Rate for Payer: Priority Health Cigna Priority Health	$475.38
Rate for Payer: Priority Health Medicare	$416.78
Rate for Payer: Priority Health SBD	$427.85
Rate for Payer: Railroad Medicare Medicare	$416.78
Rate for Payer: UHC All Payor (Choice/PPO)	$500.14
Rate for Payer: UHC Core	$680.62
Rate for Payer: UHC Dual Complete DSNP	$416.78
Rate for Payer: UHC Exchange	$416.78
Rate for Payer: UHC Medicare Advantage	$429.28
Rate for Payer: VA VA	$416.78

HC ZB5CG RESPIRATORY VIRAL PANEL 12-25 TARGETS

Facility

$610.48

Service Code	CPT 87633
Hospital Charge Code	30600205
Hospital Revenue Code	306
Min. Negotiated Rate	$227.98
Max. Negotiated Rate	$687.49
Rate for Payer: Aetna Commercial	$518.91
Rate for Payer: Aetna Medicare	$433.45
Rate for Payer: Aetna New Business (MI Preferred)	$396.81
Rate for Payer: Allen County Amish Medical Aid Commercial	$520.98
Rate for Payer: Amish Plain Church Group Commercial	$520.98
Rate for Payer: BCBS Complete	$239.40
Rate for Payer: BCBS MAPPO	$416.78
Rate for Payer: BCBS Trust/PPO	$326.38
Rate for Payer: BCN Medicare Advantage	$416.78
Rate for Payer: Cash Price	$488.38
Rate for Payer: Cash Price	$488.38
Rate for Payer: Cofinity Commercial	$525.01
Rate for Payer: Cofinity Commercial	$427.34
Rate for Payer: Health Alliance Plan Medicare Advantage	$416.78
Rate for Payer: Healthscope Commercial	$549.43
Rate for Payer: Mclaren Medicaid	$227.98
Rate for Payer: Mclaren Medicare	$416.78
Rate for Payer: Meridian Medicaid	$239.40
Rate for Payer: Meridian Wellcare - Medicare Advantage	$437.62
Rate for Payer: MI Amish Medical Board Commercial	$479.30
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$518.91
Rate for Payer: PACE Medicare	$395.94
Rate for Payer: PACE SWMI	$416.78
Rate for Payer: PHP Commercial	$518.91
Rate for Payer: PHP Medicare Advantage	$416.78
Rate for Payer: Priority Health Choice Medicaid	$227.98
Rate for Payer: Priority Health Cigna Priority Health	$427.34
Rate for Payer: Priority Health Medicare	$416.78
Rate for Payer: Priority Health SBD	$384.60
Rate for Payer: Railroad Medicare Medicare	$416.78
Rate for Payer: UHC All Payor (Choice/PPO)	$500.14
Rate for Payer: UHC Core	$687.49
Rate for Payer: UHC Dual Complete DSNP	$416.78
Rate for Payer: UHC Exchange	$416.78
Rate for Payer: UHC Medicare Advantage	$429.28
Rate for Payer: VA VA	$416.78

HC ZB5CG RESPIRATORY VIRAL PANEL 12-25 TARGETS

Facility

$610.48

Service Code	CPT 87633
Hospital Charge Code	30600205
Hospital Revenue Code	306
Min. Negotiated Rate	$384.60
Max. Negotiated Rate	$549.43
Rate for Payer: Aetna Commercial	$518.91
Rate for Payer: Aetna New Business (MI Preferred)	$396.81
Rate for Payer: Cash Price	$488.38
Rate for Payer: Cofinity Commercial	$427.34
Rate for Payer: Cofinity Commercial	$525.01
Rate for Payer: Healthscope Commercial	$549.43
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$518.91
Rate for Payer: PHP Commercial	$518.91
Rate for Payer: Priority Health Cigna Priority Health	$427.34
Rate for Payer: Priority Health SBD	$384.60

HC ZB774 FACTOR II (2) & FACTOR V LEIDEN MUTATION

Facility

$108.12

Service Code	CPT 81240
Hospital Charge Code	30100514
Hospital Revenue Code	301
Min. Negotiated Rate	$35.93
Max. Negotiated Rate	$97.31
Rate for Payer: Aetna Commercial	$91.90
Rate for Payer: Aetna Medicare	$68.32
Rate for Payer: Aetna New Business (MI Preferred)	$70.28
Rate for Payer: Allen County Amish Medical Aid Commercial	$82.11
Rate for Payer: Amish Plain Church Group Commercial	$82.11
Rate for Payer: BCBS Complete	$37.73
Rate for Payer: BCBS MAPPO	$65.69
Rate for Payer: BCBS Trust/PPO	$51.44
Rate for Payer: BCN Medicare Advantage	$65.69
Rate for Payer: Cash Price	$86.50
Rate for Payer: Cash Price	$86.50
Rate for Payer: Cofinity Commercial	$92.98
Rate for Payer: Cofinity Commercial	$75.68
Rate for Payer: Health Alliance Plan Medicare Advantage	$65.69
Rate for Payer: Healthscope Commercial	$97.31
Rate for Payer: Mclaren Medicaid	$35.93
Rate for Payer: Mclaren Medicare	$65.69
Rate for Payer: Meridian Medicaid	$37.73
Rate for Payer: Meridian Wellcare - Medicare Advantage	$68.97
Rate for Payer: MI Amish Medical Board Commercial	$75.54
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$91.90
Rate for Payer: PACE Medicare	$62.41
Rate for Payer: PACE SWMI	$65.69
Rate for Payer: PHP Commercial	$91.90
Rate for Payer: PHP Medicare Advantage	$65.69
Rate for Payer: Priority Health Choice Medicaid	$35.93
Rate for Payer: Priority Health Cigna Priority Health	$75.68
Rate for Payer: Priority Health Medicare	$65.69
Rate for Payer: Priority Health SBD	$68.12
Rate for Payer: Railroad Medicare Medicare	$65.69
Rate for Payer: UHC All Payor (Choice/PPO)	$78.83
Rate for Payer: UHC Core	$80.56
Rate for Payer: UHC Dual Complete DSNP	$65.69
Rate for Payer: UHC Exchange	$65.69
Rate for Payer: UHC Medicare Advantage	$67.66
Rate for Payer: VA VA	$65.69

HC ZB774 FACTOR II (2) & FACTOR V LEIDEN MUTATION

Facility

$108.12

Service Code	CPT 81240
Hospital Charge Code	30100514
Hospital Revenue Code	301
Min. Negotiated Rate	$68.12
Max. Negotiated Rate	$97.31
Rate for Payer: Aetna Commercial	$91.90
Rate for Payer: Aetna New Business (MI Preferred)	$70.28
Rate for Payer: Cash Price	$86.50
Rate for Payer: Cofinity Commercial	$75.68
Rate for Payer: Cofinity Commercial	$92.98
Rate for Payer: Healthscope Commercial	$97.31
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$91.90
Rate for Payer: PHP Commercial	$91.90
Rate for Payer: Priority Health Cigna Priority Health	$75.68
Rate for Payer: Priority Health SBD	$68.12

HC ZB774 FACTOR II (2) & FACTOR V LEIDEN MUTATION CMPT

Facility

$116.60

Service Code	CPT 81241
Hospital Charge Code	30100515
Hospital Revenue Code	301
Min. Negotiated Rate	$73.46
Max. Negotiated Rate	$104.94
Rate for Payer: Aetna Commercial	$99.11
Rate for Payer: Aetna New Business (MI Preferred)	$75.79
Rate for Payer: Cash Price	$93.28
Rate for Payer: Cofinity Commercial	$100.28
Rate for Payer: Cofinity Commercial	$81.62
Rate for Payer: Healthscope Commercial	$104.94
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$99.11
Rate for Payer: PHP Commercial	$99.11
Rate for Payer: Priority Health Cigna Priority Health	$81.62
Rate for Payer: Priority Health SBD	$73.46

HC ZB774 FACTOR II (2) & FACTOR V LEIDEN MUTATION CMPT

Facility

$116.60

Service Code	CPT 81241
Hospital Charge Code	30100515
Hospital Revenue Code	301
Min. Negotiated Rate	$40.13
Max. Negotiated Rate	$104.94
Rate for Payer: Aetna Commercial	$99.11
Rate for Payer: Aetna Medicare	$76.30
Rate for Payer: Aetna New Business (MI Preferred)	$75.79
Rate for Payer: Allen County Amish Medical Aid Commercial	$91.71
Rate for Payer: Amish Plain Church Group Commercial	$91.71
Rate for Payer: BCBS Complete	$42.14
Rate for Payer: BCBS MAPPO	$73.37
Rate for Payer: BCBS Trust/PPO	$57.46
Rate for Payer: BCN Medicare Advantage	$73.37
Rate for Payer: Cash Price	$93.28
Rate for Payer: Cash Price	$93.28
Rate for Payer: Cofinity Commercial	$100.28
Rate for Payer: Cofinity Commercial	$81.62
Rate for Payer: Health Alliance Plan Medicare Advantage	$73.37
Rate for Payer: Healthscope Commercial	$104.94
Rate for Payer: Mclaren Medicaid	$40.13
Rate for Payer: Mclaren Medicare	$73.37
Rate for Payer: Meridian Medicaid	$42.14
Rate for Payer: Meridian Wellcare - Medicare Advantage	$77.04
Rate for Payer: MI Amish Medical Board Commercial	$84.38
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$99.11
Rate for Payer: PACE Medicare	$69.70
Rate for Payer: PACE SWMI	$73.37
Rate for Payer: PHP Commercial	$99.11
Rate for Payer: PHP Medicare Advantage	$73.37
Rate for Payer: Priority Health Choice Medicaid	$40.13
Rate for Payer: Priority Health Cigna Priority Health	$81.62
Rate for Payer: Priority Health Medicare	$73.37
Rate for Payer: Priority Health SBD	$73.46
Rate for Payer: Railroad Medicare Medicare	$73.37
Rate for Payer: UHC All Payor (Choice/PPO)	$88.04
Rate for Payer: UHC Core	$100.04
Rate for Payer: UHC Dual Complete DSNP	$73.37
Rate for Payer: UHC Exchange	$73.37
Rate for Payer: UHC Medicare Advantage	$75.57
Rate for Payer: VA VA	$73.37

HC Z BALLOON CATHETER

Facility

$1,522.88

Service Code	HCPCS C1725
Hospital Charge Code	27200083
Hospital Revenue Code	272
Min. Negotiated Rate	$959.41
Max. Negotiated Rate	$1,370.59
Rate for Payer: Aetna Commercial	$1,294.45
Rate for Payer: Aetna New Business (MI Preferred)	$989.87
Rate for Payer: Cash Price	$1,218.30
Rate for Payer: Cofinity Commercial	$1,066.02
Rate for Payer: Cofinity Commercial	$1,309.68
Rate for Payer: Healthscope Commercial	$1,370.59
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,294.45
Rate for Payer: PHP Commercial	$1,294.45
Rate for Payer: Priority Health Cigna Priority Health	$1,066.02
Rate for Payer: Priority Health SBD	$959.41

HC Z BALLOON CATHETER

Facility

$1,522.88

Service Code	HCPCS C1725
Hospital Charge Code	27200083
Hospital Revenue Code	272
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$1,370.59
Rate for Payer: Aetna Commercial	$1,294.45
Rate for Payer: Aetna New Business (MI Preferred)	$989.87
Rate for Payer: BCBS Complete	$609.15
Rate for Payer: BCBS Trust/PPO	$0.03
Rate for Payer: Cash Price	$1,218.30
Rate for Payer: Cash Price	$1,218.30
Rate for Payer: Cofinity Commercial	$1,066.02
Rate for Payer: Cofinity Commercial	$1,309.68
Rate for Payer: Healthscope Commercial	$1,370.59
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,294.45
Rate for Payer: PHP Commercial	$1,294.45
Rate for Payer: Priority Health Cigna Priority Health	$1,066.02
Rate for Payer: Priority Health SBD	$959.41

HC Z CORDIS BALLOON STENT

Facility

$5,380.54

Service Code	HCPCS C1876
Hospital Charge Code	27800038
Hospital Revenue Code	278
Min. Negotiated Rate	$3,389.74
Max. Negotiated Rate	$4,842.49
Rate for Payer: Aetna Commercial	$4,573.46
Rate for Payer: Aetna New Business (MI Preferred)	$3,497.35
Rate for Payer: Cash Price	$4,304.43
Rate for Payer: Cofinity Commercial	$3,766.38
Rate for Payer: Cofinity Commercial	$4,627.26
Rate for Payer: Healthscope Commercial	$4,842.49
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$4,573.46
Rate for Payer: PHP Commercial	$4,573.46
Rate for Payer: Priority Health Cigna Priority Health	$3,766.38
Rate for Payer: Priority Health SBD	$3,389.74

Know your out-of-pocket cost for care.

All Charges