Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC ZINC LEVEL

Facility

$49.00

Service Code	CPT 84630
Hospital Charge Code	30100462
Hospital Revenue Code	301
Min. Negotiated Rate	$30.87
Max. Negotiated Rate	$44.10
Rate for Payer: Aetna Commercial	$41.65
Rate for Payer: Aetna New Business (MI Preferred)	$31.85
Rate for Payer: Cash Price	$39.20
Rate for Payer: Cofinity Commercial	$34.30
Rate for Payer: Cofinity Commercial	$42.14
Rate for Payer: Healthscope Commercial	$44.10
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$41.65
Rate for Payer: PHP Commercial	$41.65
Rate for Payer: Priority Health Cigna Priority Health	$34.30
Rate for Payer: Priority Health SBD	$30.87

HC ZINC LEVEL

Facility

$49.00

Service Code	CPT 84630
Hospital Charge Code	30100462
Hospital Revenue Code	301
Min. Negotiated Rate	$6.23
Max. Negotiated Rate	$44.10
Rate for Payer: Aetna Commercial	$41.65
Rate for Payer: Aetna Medicare	$11.85
Rate for Payer: Aetna New Business (MI Preferred)	$31.85
Rate for Payer: Allen County Amish Medical Aid Commercial	$14.24
Rate for Payer: Amish Plain Church Group Commercial	$14.24
Rate for Payer: BCBS Complete	$6.54
Rate for Payer: BCBS MAPPO	$11.39
Rate for Payer: BCBS Trust/PPO	$8.92
Rate for Payer: BCN Medicare Advantage	$11.39
Rate for Payer: Cash Price	$39.20
Rate for Payer: Cash Price	$39.20
Rate for Payer: Cofinity Commercial	$42.14
Rate for Payer: Cofinity Commercial	$34.30
Rate for Payer: Health Alliance Plan Medicare Advantage	$11.39
Rate for Payer: Healthscope Commercial	$44.10
Rate for Payer: Mclaren Medicaid	$6.23
Rate for Payer: Mclaren Medicare	$11.39
Rate for Payer: Meridian Medicaid	$6.54
Rate for Payer: Meridian Wellcare - Medicare Advantage	$11.96
Rate for Payer: MI Amish Medical Board Commercial	$13.10
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$41.65
Rate for Payer: PACE Medicare	$10.82
Rate for Payer: PACE SWMI	$11.39
Rate for Payer: PHP Commercial	$41.65
Rate for Payer: PHP Medicare Advantage	$11.39
Rate for Payer: Priority Health Choice Medicaid	$6.23
Rate for Payer: Priority Health Cigna Priority Health	$34.30
Rate for Payer: Priority Health Medicare	$11.39
Rate for Payer: Priority Health SBD	$30.87
Rate for Payer: Railroad Medicare Medicare	$11.39
Rate for Payer: UHC All Payor (Choice/PPO)	$13.67
Rate for Payer: UHC Core	$19.34
Rate for Payer: UHC Dual Complete DSNP	$11.39
Rate for Payer: UHC Exchange	$11.39
Rate for Payer: UHC Medicare Advantage	$11.73
Rate for Payer: VA VA	$11.39

HC ZINC URINE

Facility

$68.60

Service Code	CPT 84630
Hospital Charge Code	30100463
Hospital Revenue Code	301
Min. Negotiated Rate	$43.22
Max. Negotiated Rate	$61.74
Rate for Payer: Aetna Commercial	$58.31
Rate for Payer: Aetna New Business (MI Preferred)	$44.59
Rate for Payer: Cash Price	$54.88
Rate for Payer: Cofinity Commercial	$48.02
Rate for Payer: Cofinity Commercial	$59.00
Rate for Payer: Healthscope Commercial	$61.74
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$58.31
Rate for Payer: PHP Commercial	$58.31
Rate for Payer: Priority Health Cigna Priority Health	$48.02
Rate for Payer: Priority Health SBD	$43.22

HC ZINC URINE

Facility

$68.60

Service Code	CPT 84630
Hospital Charge Code	30100463
Hospital Revenue Code	301
Min. Negotiated Rate	$6.23
Max. Negotiated Rate	$61.74
Rate for Payer: Aetna Commercial	$58.31
Rate for Payer: Aetna Medicare	$11.85
Rate for Payer: Aetna New Business (MI Preferred)	$44.59
Rate for Payer: Allen County Amish Medical Aid Commercial	$14.24
Rate for Payer: Amish Plain Church Group Commercial	$14.24
Rate for Payer: BCBS Complete	$6.54
Rate for Payer: BCBS MAPPO	$11.39
Rate for Payer: BCBS Trust/PPO	$8.92
Rate for Payer: BCN Medicare Advantage	$11.39
Rate for Payer: Cash Price	$54.88
Rate for Payer: Cash Price	$54.88
Rate for Payer: Cofinity Commercial	$59.00
Rate for Payer: Cofinity Commercial	$48.02
Rate for Payer: Health Alliance Plan Medicare Advantage	$11.39
Rate for Payer: Healthscope Commercial	$61.74
Rate for Payer: Mclaren Medicaid	$6.23
Rate for Payer: Mclaren Medicare	$11.39
Rate for Payer: Meridian Medicaid	$6.54
Rate for Payer: Meridian Wellcare - Medicare Advantage	$11.96
Rate for Payer: MI Amish Medical Board Commercial	$13.10
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$58.31
Rate for Payer: PACE Medicare	$10.82
Rate for Payer: PACE SWMI	$11.39
Rate for Payer: PHP Commercial	$58.31
Rate for Payer: PHP Medicare Advantage	$11.39
Rate for Payer: Priority Health Choice Medicaid	$6.23
Rate for Payer: Priority Health Cigna Priority Health	$48.02
Rate for Payer: Priority Health Medicare	$11.39
Rate for Payer: Priority Health SBD	$43.22
Rate for Payer: Railroad Medicare Medicare	$11.39
Rate for Payer: UHC All Payor (Choice/PPO)	$13.67
Rate for Payer: UHC Core	$19.34
Rate for Payer: UHC Dual Complete DSNP	$11.39
Rate for Payer: UHC Exchange	$11.39
Rate for Payer: UHC Medicare Advantage	$11.73
Rate for Payer: VA VA	$11.39

HC Z INFUSION WIRE

Facility

$857.70

Hospital Charge Code	62100001
Hospital Revenue Code	621
Min. Negotiated Rate	$540.35
Max. Negotiated Rate	$771.93
Rate for Payer: Aetna Commercial	$729.04
Rate for Payer: Aetna New Business (MI Preferred)	$557.50
Rate for Payer: Cash Price	$686.16
Rate for Payer: Cofinity Commercial	$600.39
Rate for Payer: Cofinity Commercial	$737.62
Rate for Payer: Healthscope Commercial	$771.93
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$729.04
Rate for Payer: PHP Commercial	$729.04
Rate for Payer: Priority Health Cigna Priority Health	$600.39
Rate for Payer: Priority Health SBD	$540.35

HC Z INFUSION WIRE

Facility

$857.70

Hospital Charge Code	62100001
Hospital Revenue Code	621
Min. Negotiated Rate	$343.08
Max. Negotiated Rate	$771.93
Rate for Payer: Aetna Commercial	$729.04
Rate for Payer: Aetna New Business (MI Preferred)	$557.50
Rate for Payer: BCBS Complete	$343.08
Rate for Payer: Cash Price	$686.16
Rate for Payer: Cofinity Commercial	$600.39
Rate for Payer: Cofinity Commercial	$737.62
Rate for Payer: Healthscope Commercial	$771.93
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$729.04
Rate for Payer: PHP Commercial	$729.04
Rate for Payer: Priority Health Cigna Priority Health	$600.39
Rate for Payer: Priority Health SBD	$540.35

HC Z INTRACRANIAL STENT

Facility

$12,880.85

Hospital Charge Code	27800049
Hospital Revenue Code	278
Min. Negotiated Rate	$8,114.94
Max. Negotiated Rate	$11,592.76
Rate for Payer: Aetna Commercial	$10,948.72
Rate for Payer: Aetna New Business (MI Preferred)	$8,372.55
Rate for Payer: Cash Price	$10,304.68
Rate for Payer: Cofinity Commercial	$11,077.53
Rate for Payer: Cofinity Commercial	$9,016.60
Rate for Payer: Healthscope Commercial	$11,592.76
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$10,948.72
Rate for Payer: PHP Commercial	$10,948.72
Rate for Payer: Priority Health Cigna Priority Health	$9,016.60
Rate for Payer: Priority Health SBD	$8,114.94

HC Z INTRACRANIAL STENT

Facility

$12,880.85

Hospital Charge Code	27800049
Hospital Revenue Code	278
Min. Negotiated Rate	$5,152.34
Max. Negotiated Rate	$11,592.76
Rate for Payer: Aetna Commercial	$10,948.72
Rate for Payer: Aetna New Business (MI Preferred)	$8,372.55
Rate for Payer: BCBS Complete	$5,152.34
Rate for Payer: Cash Price	$10,304.68
Rate for Payer: Cofinity Commercial	$11,077.53
Rate for Payer: Cofinity Commercial	$9,016.60
Rate for Payer: Healthscope Commercial	$11,592.76
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$10,948.72
Rate for Payer: PHP Commercial	$10,948.72
Rate for Payer: Priority Health Cigna Priority Health	$9,016.60
Rate for Payer: Priority Health SBD	$8,114.94

HC Z INTRODUCER SHEATH

Facility

$322.79

Service Code	HCPCS C1894
Hospital Charge Code	27200090
Hospital Revenue Code	272
Min. Negotiated Rate	$129.12
Max. Negotiated Rate	$290.51
Rate for Payer: Aetna Commercial	$274.37
Rate for Payer: Aetna New Business (MI Preferred)	$209.81
Rate for Payer: BCBS Complete	$129.12
Rate for Payer: Cash Price	$258.23
Rate for Payer: Cofinity Commercial	$225.95
Rate for Payer: Cofinity Commercial	$277.60
Rate for Payer: Healthscope Commercial	$290.51
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$274.37
Rate for Payer: PHP Commercial	$274.37
Rate for Payer: Priority Health Cigna Priority Health	$225.95
Rate for Payer: Priority Health SBD	$203.36

HC Z INTRODUCER SHEATH

Facility

$322.79

Service Code	HCPCS C1894
Hospital Charge Code	27200090
Hospital Revenue Code	272
Min. Negotiated Rate	$203.36
Max. Negotiated Rate	$290.51
Rate for Payer: Aetna Commercial	$274.37
Rate for Payer: Aetna New Business (MI Preferred)	$209.81
Rate for Payer: Cash Price	$258.23
Rate for Payer: Cofinity Commercial	$225.95
Rate for Payer: Cofinity Commercial	$277.60
Rate for Payer: Healthscope Commercial	$290.51
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$274.37
Rate for Payer: PHP Commercial	$274.37
Rate for Payer: Priority Health Cigna Priority Health	$225.95
Rate for Payer: Priority Health SBD	$203.36

HC Z ITERPRET VISCERAL PTRA

Facility

$3,701.46

Hospital Charge Code	32000272
Hospital Revenue Code	320
Min. Negotiated Rate	$2,331.92
Max. Negotiated Rate	$3,331.31
Rate for Payer: Aetna Commercial	$3,146.24
Rate for Payer: Aetna New Business (MI Preferred)	$2,405.95
Rate for Payer: Cash Price	$2,961.17
Rate for Payer: Cofinity Commercial	$3,183.26
Rate for Payer: Cofinity Commercial	$2,591.02
Rate for Payer: Healthscope Commercial	$3,331.31
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3,146.24
Rate for Payer: PHP Commercial	$3,146.24
Rate for Payer: Priority Health Cigna Priority Health	$2,591.02
Rate for Payer: Priority Health SBD	$2,331.92

HC Z ITERPRET VISCERAL PTRA

Facility

$3,701.46

Hospital Charge Code	32000272
Hospital Revenue Code	320
Min. Negotiated Rate	$1,480.58
Max. Negotiated Rate	$3,331.31
Rate for Payer: Aetna Commercial	$3,146.24
Rate for Payer: Aetna New Business (MI Preferred)	$2,405.95
Rate for Payer: BCBS Complete	$1,480.58
Rate for Payer: Cash Price	$2,961.17
Rate for Payer: Cofinity Commercial	$2,591.02
Rate for Payer: Cofinity Commercial	$3,183.26
Rate for Payer: Healthscope Commercial	$3,331.31
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3,146.24
Rate for Payer: PHP Commercial	$3,146.24
Rate for Payer: Priority Health Cigna Priority Health	$2,591.02
Rate for Payer: Priority Health SBD	$2,331.92
Rate for Payer: UHC Core	$2,739.08

HC Z NEPHROSTOMY CATH

Facility

$760.56

Service Code	HCPCS C1729
Hospital Charge Code	27200092
Hospital Revenue Code	272
Min. Negotiated Rate	$479.15
Max. Negotiated Rate	$684.50
Rate for Payer: Aetna Commercial	$646.48
Rate for Payer: Aetna New Business (MI Preferred)	$494.36
Rate for Payer: Cash Price	$608.45
Rate for Payer: Cofinity Commercial	$532.39
Rate for Payer: Cofinity Commercial	$654.08
Rate for Payer: Healthscope Commercial	$684.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$646.48
Rate for Payer: PHP Commercial	$646.48
Rate for Payer: Priority Health Cigna Priority Health	$532.39
Rate for Payer: Priority Health SBD	$479.15

HC Z NEPHROSTOMY CATH

Facility

$760.56

Service Code	HCPCS C1729
Hospital Charge Code	27200092
Hospital Revenue Code	272
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$684.50
Rate for Payer: Aetna Commercial	$646.48
Rate for Payer: Aetna New Business (MI Preferred)	$494.36
Rate for Payer: BCBS Complete	$304.22
Rate for Payer: BCBS Trust/PPO	$0.03
Rate for Payer: Cash Price	$608.45
Rate for Payer: Cash Price	$608.45
Rate for Payer: Cofinity Commercial	$654.08
Rate for Payer: Cofinity Commercial	$532.39
Rate for Payer: Healthscope Commercial	$684.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$646.48
Rate for Payer: PHP Commercial	$646.48
Rate for Payer: Priority Health Cigna Priority Health	$532.39
Rate for Payer: Priority Health SBD	$479.15

HC ZONISAMIDE

Facility

$75.00

Service Code	CPT 80203
Hospital Charge Code	30100052
Hospital Revenue Code	301
Min. Negotiated Rate	$7.25
Max. Negotiated Rate	$67.50
Rate for Payer: Aetna Commercial	$63.75
Rate for Payer: Aetna Medicare	$13.78
Rate for Payer: Aetna New Business (MI Preferred)	$48.75
Rate for Payer: Allen County Amish Medical Aid Commercial	$16.56
Rate for Payer: Amish Plain Church Group Commercial	$16.56
Rate for Payer: BCBS Complete	$7.61
Rate for Payer: BCBS MAPPO	$13.25
Rate for Payer: BCBS Trust/PPO	$10.38
Rate for Payer: BCN Medicare Advantage	$13.25
Rate for Payer: Cash Price	$60.00
Rate for Payer: Cash Price	$60.00
Rate for Payer: Cofinity Commercial	$52.50
Rate for Payer: Cofinity Commercial	$64.50
Rate for Payer: Health Alliance Plan Medicare Advantage	$13.25
Rate for Payer: Healthscope Commercial	$67.50
Rate for Payer: Mclaren Medicaid	$7.25
Rate for Payer: Mclaren Medicare	$13.25
Rate for Payer: Meridian Medicaid	$7.61
Rate for Payer: Meridian Wellcare - Medicare Advantage	$13.91
Rate for Payer: MI Amish Medical Board Commercial	$15.24
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$63.75
Rate for Payer: PACE Medicare	$12.59
Rate for Payer: PACE SWMI	$13.25
Rate for Payer: PHP Commercial	$63.75
Rate for Payer: PHP Medicare Advantage	$13.25
Rate for Payer: Priority Health Choice Medicaid	$7.25
Rate for Payer: Priority Health Cigna Priority Health	$52.50
Rate for Payer: Priority Health Medicare	$13.25
Rate for Payer: Priority Health SBD	$47.25
Rate for Payer: Railroad Medicare Medicare	$13.25
Rate for Payer: UHC All Payor (Choice/PPO)	$15.90
Rate for Payer: UHC Core	$21.71
Rate for Payer: UHC Dual Complete DSNP	$13.25
Rate for Payer: UHC Exchange	$13.25
Rate for Payer: UHC Medicare Advantage	$13.65
Rate for Payer: VA VA	$13.25

HC ZONISAMIDE

Facility

$75.00

Service Code	CPT 80203
Hospital Charge Code	30100052
Hospital Revenue Code	301
Min. Negotiated Rate	$47.25
Max. Negotiated Rate	$67.50
Rate for Payer: Aetna Commercial	$63.75
Rate for Payer: Aetna New Business (MI Preferred)	$48.75
Rate for Payer: Cash Price	$60.00
Rate for Payer: Cofinity Commercial	$52.50
Rate for Payer: Cofinity Commercial	$64.50
Rate for Payer: Healthscope Commercial	$67.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$63.75
Rate for Payer: PHP Commercial	$63.75
Rate for Payer: Priority Health Cigna Priority Health	$52.50
Rate for Payer: Priority Health SBD	$47.25

HC ZOSTER VACCINE (HZV) RECOMB ADJ, IM

Facility

$171.36

Service Code	CPT 90750
Hospital Charge Code	63600123
Hospital Revenue Code	636
Min. Negotiated Rate	$107.96
Max. Negotiated Rate	$154.22
Rate for Payer: Aetna Commercial	$145.66
Rate for Payer: Aetna New Business (MI Preferred)	$111.38
Rate for Payer: Cash Price	$137.09
Rate for Payer: Cofinity Commercial	$119.95
Rate for Payer: Cofinity Commercial	$147.37
Rate for Payer: Healthscope Commercial	$154.22
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$145.66
Rate for Payer: PHP Commercial	$145.66
Rate for Payer: Priority Health Cigna Priority Health	$119.95
Rate for Payer: Priority Health SBD	$107.96

HC ZOSTER VACCINE (HZV) RECOMB ADJ, IM

Facility

$171.36

Service Code	CPT 90750
Hospital Charge Code	63600123
Hospital Revenue Code	636
Min. Negotiated Rate	$68.54
Max. Negotiated Rate	$509.25
Rate for Payer: Aetna Commercial	$145.66
Rate for Payer: Aetna New Business (MI Preferred)	$111.38
Rate for Payer: BCBS Complete	$68.54
Rate for Payer: BCBS Trust/PPO	$509.25
Rate for Payer: Cash Price	$137.09
Rate for Payer: Cash Price	$137.09
Rate for Payer: Cofinity Commercial	$147.37
Rate for Payer: Cofinity Commercial	$119.95
Rate for Payer: Healthscope Commercial	$154.22
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$145.66
Rate for Payer: PHP Commercial	$145.66
Rate for Payer: Priority Health Cigna Priority Health	$119.95
Rate for Payer: Priority Health SBD	$107.96

HC Z RETRIEVAL SNARE

Facility

$1,306.70

Service Code	HCPCS C1773
Hospital Charge Code	27200094
Hospital Revenue Code	272
Min. Negotiated Rate	$522.68
Max. Negotiated Rate	$1,176.03
Rate for Payer: Aetna Commercial	$1,110.70
Rate for Payer: Aetna New Business (MI Preferred)	$849.36
Rate for Payer: BCBS Complete	$522.68
Rate for Payer: Cash Price	$1,045.36
Rate for Payer: Cofinity Commercial	$1,123.76
Rate for Payer: Cofinity Commercial	$914.69
Rate for Payer: Healthscope Commercial	$1,176.03
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,110.70
Rate for Payer: PHP Commercial	$1,110.70
Rate for Payer: Priority Health Cigna Priority Health	$914.69
Rate for Payer: Priority Health SBD	$823.22

HC Z RETRIEVAL SNARE

Facility

$1,306.70

Service Code	HCPCS C1773
Hospital Charge Code	27200094
Hospital Revenue Code	272
Min. Negotiated Rate	$823.22
Max. Negotiated Rate	$1,176.03
Rate for Payer: Aetna Commercial	$1,110.70
Rate for Payer: Aetna New Business (MI Preferred)	$849.36
Rate for Payer: Cash Price	$1,045.36
Rate for Payer: Cofinity Commercial	$1,123.76
Rate for Payer: Cofinity Commercial	$914.69
Rate for Payer: Healthscope Commercial	$1,176.03
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,110.70
Rate for Payer: PHP Commercial	$1,110.70
Rate for Payer: Priority Health Cigna Priority Health	$914.69
Rate for Payer: Priority Health SBD	$823.22

HC Z STENT URETERAL

Facility

$1,189.08

Service Code	HCPCS C2625
Hospital Charge Code	27800041
Hospital Revenue Code	278
Min. Negotiated Rate	$749.12
Max. Negotiated Rate	$1,070.17
Rate for Payer: Aetna Commercial	$1,010.72
Rate for Payer: Aetna New Business (MI Preferred)	$772.90
Rate for Payer: Cash Price	$951.26
Rate for Payer: Cofinity Commercial	$1,022.61
Rate for Payer: Cofinity Commercial	$832.36
Rate for Payer: Healthscope Commercial	$1,070.17
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,010.72
Rate for Payer: PHP Commercial	$1,010.72
Rate for Payer: Priority Health Cigna Priority Health	$832.36
Rate for Payer: Priority Health SBD	$749.12

HC Z STENT URETERAL

Facility

$1,189.08

Service Code	HCPCS C2625
Hospital Charge Code	27800041
Hospital Revenue Code	278
Min. Negotiated Rate	$475.63
Max. Negotiated Rate	$1,070.17
Rate for Payer: Aetna Commercial	$1,010.72
Rate for Payer: Aetna New Business (MI Preferred)	$772.90
Rate for Payer: BCBS Complete	$475.63
Rate for Payer: Cash Price	$951.26
Rate for Payer: Cofinity Commercial	$1,022.61
Rate for Payer: Cofinity Commercial	$832.36
Rate for Payer: Healthscope Commercial	$1,070.17
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,010.72
Rate for Payer: PHP Commercial	$1,010.72
Rate for Payer: Priority Health Cigna Priority Health	$832.36
Rate for Payer: Priority Health SBD	$749.12

HC Z TUNNELED PLEURAL CATHETER

Facility

$1,722.49

Service Code	HCPCS C1729
Hospital Charge Code	27200097
Hospital Revenue Code	272
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$1,550.24
Rate for Payer: Aetna Commercial	$1,464.12
Rate for Payer: Aetna New Business (MI Preferred)	$1,119.62
Rate for Payer: BCBS Complete	$689.00
Rate for Payer: BCBS Trust/PPO	$0.03
Rate for Payer: Cash Price	$1,377.99
Rate for Payer: Cash Price	$1,377.99
Rate for Payer: Cofinity Commercial	$1,205.74
Rate for Payer: Cofinity Commercial	$1,481.34
Rate for Payer: Healthscope Commercial	$1,550.24
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,464.12
Rate for Payer: PHP Commercial	$1,464.12
Rate for Payer: Priority Health Cigna Priority Health	$1,205.74
Rate for Payer: Priority Health SBD	$1,085.17

HC Z TUNNELED PLEURAL CATHETER

Facility

$1,722.49

Service Code	HCPCS C1729
Hospital Charge Code	27200097
Hospital Revenue Code	272
Min. Negotiated Rate	$1,085.17
Max. Negotiated Rate	$1,550.24
Rate for Payer: Aetna Commercial	$1,464.12
Rate for Payer: Aetna New Business (MI Preferred)	$1,119.62
Rate for Payer: Cash Price	$1,377.99
Rate for Payer: Cofinity Commercial	$1,205.74
Rate for Payer: Cofinity Commercial	$1,481.34
Rate for Payer: Healthscope Commercial	$1,550.24
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,464.12
Rate for Payer: PHP Commercial	$1,464.12
Rate for Payer: Priority Health Cigna Priority Health	$1,205.74
Rate for Payer: Priority Health SBD	$1,085.17

HC Z VACUUM BIOPSY DEVICE

Facility

$633.62

Hospital Charge Code	27200129
Hospital Revenue Code	272
Min. Negotiated Rate	$399.18
Max. Negotiated Rate	$570.26
Rate for Payer: Aetna Commercial	$538.58
Rate for Payer: Aetna New Business (MI Preferred)	$411.85
Rate for Payer: Cash Price	$506.90
Rate for Payer: Cofinity Commercial	$443.53
Rate for Payer: Cofinity Commercial	$544.91
Rate for Payer: Healthscope Commercial	$570.26
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$538.58
Rate for Payer: PHP Commercial	$538.58
Rate for Payer: Priority Health Cigna Priority Health	$443.53
Rate for Payer: Priority Health SBD	$399.18

Know your out-of-pocket cost for care.

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