Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC PICC INTRODUCER

Facility

$98.32

Hospital Charge Code	27200147
Hospital Revenue Code	272
Min. Negotiated Rate	$61.94
Max. Negotiated Rate	$88.49
Rate for Payer: Aetna Commercial	$83.57
Rate for Payer: Aetna New Business (MI Preferred)	$63.91
Rate for Payer: Cash Price	$78.66
Rate for Payer: Cofinity Commercial	$68.82
Rate for Payer: Cofinity Commercial	$84.56
Rate for Payer: Cofinity Medicare Advantage	$68.82
Rate for Payer: Encore Health Key Benefits Commercial	$78.66
Rate for Payer: Healthscope Commercial	$88.49
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$83.57
Rate for Payer: PHP Commercial	$83.57
Rate for Payer: Priority Health Cigna Priority Health	$63.91
Rate for Payer: Priority Health SBD	$61.94

HC PICC INTRODUCER

Facility

$98.32

Hospital Charge Code	27200147
Hospital Revenue Code	272
Min. Negotiated Rate	$39.33
Max. Negotiated Rate	$88.49
Rate for Payer: Aetna Commercial	$83.57
Rate for Payer: Aetna Medicare	$49.16
Rate for Payer: Aetna New Business (MI Preferred)	$63.91
Rate for Payer: BCBS Complete	$39.33
Rate for Payer: Cash Price	$78.66
Rate for Payer: Cofinity Commercial	$68.82
Rate for Payer: Cofinity Commercial	$84.56
Rate for Payer: Cofinity Medicare Advantage	$68.82
Rate for Payer: Encore Health Key Benefits Commercial	$78.66
Rate for Payer: Healthscope Commercial	$88.49
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$83.57
Rate for Payer: PHP Commercial	$83.57
Rate for Payer: Priority Health Cigna Priority Health	$63.91
Rate for Payer: Priority Health SBD	$61.94

HC PICU 30" NITROUS OXIDE SED RECOVERY

Facility

$112.59

Hospital Charge Code	37000019
Hospital Revenue Code	370
Min. Negotiated Rate	$70.93
Max. Negotiated Rate	$101.33
Rate for Payer: Aetna Commercial	$95.70
Rate for Payer: Aetna New Business (MI Preferred)	$73.18
Rate for Payer: Cash Price	$90.07
Rate for Payer: Cofinity Commercial	$78.81
Rate for Payer: Cofinity Commercial	$96.83
Rate for Payer: Cofinity Medicare Advantage	$78.81
Rate for Payer: Encore Health Key Benefits Commercial	$90.07
Rate for Payer: Healthscope Commercial	$101.33
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$95.70
Rate for Payer: PHP Commercial	$95.70
Rate for Payer: Priority Health Cigna Priority Health	$73.18
Rate for Payer: Priority Health SBD	$70.93

HC PICU 30" NITROUS OXIDE SED RECOVERY

Facility

$112.59

Hospital Charge Code	37000019
Hospital Revenue Code	370
Min. Negotiated Rate	$45.04
Max. Negotiated Rate	$101.33
Rate for Payer: Aetna Commercial	$95.70
Rate for Payer: Aetna Medicare	$56.30
Rate for Payer: Aetna New Business (MI Preferred)	$73.18
Rate for Payer: BCBS Complete	$45.04
Rate for Payer: Cash Price	$90.07
Rate for Payer: Cofinity Commercial	$78.81
Rate for Payer: Cofinity Commercial	$96.83
Rate for Payer: Cofinity Medicare Advantage	$78.81
Rate for Payer: Encore Health Key Benefits Commercial	$90.07
Rate for Payer: Healthscope Commercial	$101.33
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$95.70
Rate for Payer: PHP Commercial	$95.70
Rate for Payer: Priority Health Cigna Priority Health	$73.18
Rate for Payer: Priority Health SBD	$70.93

HC PICU OBSERVATION PER HOUR

Facility

$200.94

Service Code	HCPCS G0378
Hospital Charge Code	76200017
Hospital Revenue Code	762
Min. Negotiated Rate	$126.59
Max. Negotiated Rate	$180.85
Rate for Payer: Aetna Commercial	$170.80
Rate for Payer: Aetna New Business (MI Preferred)	$130.61
Rate for Payer: Cash Price	$160.75
Rate for Payer: Cofinity Commercial	$140.66
Rate for Payer: Cofinity Commercial	$172.81
Rate for Payer: Cofinity Medicare Advantage	$140.66
Rate for Payer: Encore Health Key Benefits Commercial	$160.75
Rate for Payer: Healthscope Commercial	$180.85
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$170.80
Rate for Payer: PHP Commercial	$170.80
Rate for Payer: Priority Health Cigna Priority Health	$130.61
Rate for Payer: Priority Health SBD	$126.59

HC PICU OBSERVATION PER HOUR

Facility

$200.94

Service Code	HCPCS G0378
Hospital Charge Code	76200017
Hospital Revenue Code	762
Min. Negotiated Rate	$80.38
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$170.80
Rate for Payer: Aetna Medicare	$100.47
Rate for Payer: Aetna New Business (MI Preferred)	$130.61
Rate for Payer: BCBS Complete	$80.38
Rate for Payer: Cash Price	$160.75
Rate for Payer: Cash Price	$160.75
Rate for Payer: Cofinity Commercial	$140.66
Rate for Payer: Cofinity Commercial	$172.81
Rate for Payer: Cofinity Medicare Advantage	$140.66
Rate for Payer: Encore Health Key Benefits Commercial	$160.75
Rate for Payer: Healthscope Commercial	$180.85
Rate for Payer: Meridian Medicaid	$1,000.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$170.80
Rate for Payer: PHP Commercial	$170.80
Rate for Payer: Priority Health Cigna Priority Health	$130.61
Rate for Payer: Priority Health SBD	$126.59
Rate for Payer: UHC Core	$148.70
Rate for Payer: UHC Exchange	$148.70

HC PICU OR PED CRITICAL CARE R&B

Facility

$7,801.90

Hospital Charge Code	20300001
Hospital Revenue Code	203
Min. Negotiated Rate	$4,915.20
Max. Negotiated Rate	$7,021.71
Rate for Payer: Aetna Commercial	$6,631.61
Rate for Payer: Aetna New Business (MI Preferred)	$5,071.23
Rate for Payer: Cash Price	$6,241.52
Rate for Payer: Cofinity Commercial	$5,461.33
Rate for Payer: Cofinity Commercial	$6,709.63
Rate for Payer: Cofinity Medicare Advantage	$5,461.33
Rate for Payer: Encore Health Key Benefits Commercial	$6,241.52
Rate for Payer: Healthscope Commercial	$7,021.71
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$6,631.61
Rate for Payer: PHP Commercial	$6,631.61
Rate for Payer: Priority Health Cigna Priority Health	$5,071.23
Rate for Payer: Priority Health SBD	$4,915.20

HC PICU OR PED INTERMEDIATE CARE R&B

Facility

$6,510.25

Hospital Charge Code	20600002
Hospital Revenue Code	206
Min. Negotiated Rate	$4,101.46
Max. Negotiated Rate	$5,859.23
Rate for Payer: Aetna Commercial	$5,533.71
Rate for Payer: Aetna New Business (MI Preferred)	$4,231.66
Rate for Payer: Cash Price	$5,208.20
Rate for Payer: Cofinity Commercial	$4,557.18
Rate for Payer: Cofinity Commercial	$5,598.81
Rate for Payer: Cofinity Medicare Advantage	$4,557.18
Rate for Payer: Encore Health Key Benefits Commercial	$5,208.20
Rate for Payer: Healthscope Commercial	$5,859.23
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$5,533.71
Rate for Payer: PHP Commercial	$5,533.71
Rate for Payer: Priority Health Cigna Priority Health	$4,231.66
Rate for Payer: Priority Health SBD	$4,101.46

HC PICU/PEDS 30" SEDATION RECOVERY

Facility

$315.06

Hospital Charge Code	71000009
Hospital Revenue Code	710
Min. Negotiated Rate	$126.02
Max. Negotiated Rate	$283.55
Rate for Payer: Aetna Commercial	$267.80
Rate for Payer: Aetna Medicare	$157.53
Rate for Payer: Aetna New Business (MI Preferred)	$204.79
Rate for Payer: BCBS Complete	$126.02
Rate for Payer: Cash Price	$252.05
Rate for Payer: Cofinity Commercial	$220.54
Rate for Payer: Cofinity Commercial	$270.95
Rate for Payer: Cofinity Medicare Advantage	$220.54
Rate for Payer: Encore Health Key Benefits Commercial	$252.05
Rate for Payer: Healthscope Commercial	$283.55
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$267.80
Rate for Payer: PHP Commercial	$267.80
Rate for Payer: Priority Health Cigna Priority Health	$204.79
Rate for Payer: Priority Health SBD	$198.49

HC PICU/PEDS 30" SEDATION RECOVERY

Facility

$315.06

Hospital Charge Code	71000009
Hospital Revenue Code	710
Min. Negotiated Rate	$198.49
Max. Negotiated Rate	$283.55
Rate for Payer: Aetna Commercial	$267.80
Rate for Payer: Aetna New Business (MI Preferred)	$204.79
Rate for Payer: Cash Price	$252.05
Rate for Payer: Cofinity Commercial	$220.54
Rate for Payer: Cofinity Commercial	$270.95
Rate for Payer: Cofinity Medicare Advantage	$220.54
Rate for Payer: Encore Health Key Benefits Commercial	$252.05
Rate for Payer: Healthscope Commercial	$283.55
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$267.80
Rate for Payer: PHP Commercial	$267.80
Rate for Payer: Priority Health Cigna Priority Health	$204.79
Rate for Payer: Priority Health SBD	$198.49

HC PIFLUFOLASTAT PER MILLICURIE

Facility

$1,560.60

Service Code	CPT A9595
Hospital Charge Code	34300369
Hospital Revenue Code	343
Min. Negotiated Rate	$983.18
Max. Negotiated Rate	$1,404.54
Rate for Payer: Aetna Commercial	$1,326.51
Rate for Payer: Aetna New Business (MI Preferred)	$1,014.39
Rate for Payer: Cash Price	$1,248.48
Rate for Payer: Cofinity Commercial	$1,092.42
Rate for Payer: Cofinity Commercial	$1,342.12
Rate for Payer: Cofinity Medicare Advantage	$1,092.42
Rate for Payer: Encore Health Key Benefits Commercial	$1,248.48
Rate for Payer: Healthscope Commercial	$1,404.54
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,326.51
Rate for Payer: PHP Commercial	$1,326.51
Rate for Payer: Priority Health Cigna Priority Health	$1,014.39
Rate for Payer: Priority Health SBD	$983.18

HC PIFLUFOLASTAT PER MILLICURIE

Facility

$1,560.60

Service Code	CPT A9595
Hospital Charge Code	34300369
Hospital Revenue Code	343
Min. Negotiated Rate	$178.19
Max. Negotiated Rate	$1,404.54
Rate for Payer: Aetna Commercial	$1,326.51
Rate for Payer: Aetna Medicare	$345.74
Rate for Payer: Aetna New Business (MI Preferred)	$1,014.39
Rate for Payer: Allen County Amish Medical Aid Commercial	$415.55
Rate for Payer: Amish Plain Church Group Commercial	$415.55
Rate for Payer: BCBS Complete	$187.10
Rate for Payer: BCBS MAPPO	$332.44
Rate for Payer: BCN Medicare Advantage	$332.44
Rate for Payer: Cash Price	$1,248.48
Rate for Payer: Cash Price	$1,248.48
Rate for Payer: Cofinity Commercial	$1,092.42
Rate for Payer: Cofinity Commercial	$1,342.12
Rate for Payer: Cofinity Medicare Advantage	$1,092.42
Rate for Payer: Encore Health Key Benefits Commercial	$1,248.48
Rate for Payer: Health Alliance Plan Medicare Advantage	$332.44
Rate for Payer: Healthscope Commercial	$1,404.54
Rate for Payer: Mclaren Medicaid	$178.19
Rate for Payer: Mclaren Medicare	$332.44
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$349.06
Rate for Payer: Meridian Medicaid	$187.10
Rate for Payer: MI Amish Medical Board Commercial	$382.31
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,326.51
Rate for Payer: PACE Medicare	$315.82
Rate for Payer: PACE SWMI	$332.44
Rate for Payer: PHP Commercial	$1,326.51
Rate for Payer: PHP Medicare Advantage	$332.44
Rate for Payer: Priority Health Choice Medicaid	$178.19
Rate for Payer: Priority Health Cigna Priority Health	$1,014.39
Rate for Payer: Priority Health Medicare	$332.44
Rate for Payer: Priority Health SBD	$983.18
Rate for Payer: Railroad Medicare Medicare	$332.44
Rate for Payer: UHC All Payor (Choice/PPO)	$935.79
Rate for Payer: UHC Dual Complete DSNP	$332.44
Rate for Payer: UHC Medicare Advantage	$332.44
Rate for Payer: UHCCP Medicaid	$187.16
Rate for Payer: VA VA	$332.44

HC PIGWEED IGE

Facility

$25.39

Service Code	CPT 86003
Hospital Charge Code	30200098
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 PIGWEED IGE

Facility

$25.39

Service Code	CPT 86003
Hospital Charge Code	30200098
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 PI LINKED ANTIGEN

Facility

$170.78

Service Code	CPT 88184
Hospital Charge Code	31000004
Hospital Revenue Code	310
Min. Negotiated Rate	$107.59
Max. Negotiated Rate	$987.55
Rate for Payer: Aetna Commercial	$145.16
Rate for Payer: Aetna Medicare	$364.86
Rate for Payer: Aetna New Business (MI Preferred)	$111.01
Rate for Payer: Allen County Amish Medical Aid Commercial	$438.54
Rate for Payer: Amish Plain Church Group Commercial	$438.54
Rate for Payer: BCBS Complete	$197.45
Rate for Payer: BCBS MAPPO	$350.83
Rate for Payer: BCN Medicare Advantage	$350.83
Rate for Payer: Cash Price	$136.62
Rate for Payer: Cash Price	$136.62
Rate for Payer: Cofinity Commercial	$146.87
Rate for Payer: Cofinity Commercial	$119.55
Rate for Payer: Cofinity Medicare Advantage	$119.55
Rate for Payer: Encore Health Key Benefits Commercial	$136.62
Rate for Payer: Health Alliance Plan Medicare Advantage	$350.83
Rate for Payer: Healthscope Commercial	$153.70
Rate for Payer: Mclaren Medicaid	$188.04
Rate for Payer: Mclaren Medicare	$350.83
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$368.37
Rate for Payer: Meridian Medicaid	$197.45
Rate for Payer: MI Amish Medical Board Commercial	$403.45
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$145.16
Rate for Payer: PACE Medicare	$333.29
Rate for Payer: PACE SWMI	$350.83
Rate for Payer: PHP Commercial	$145.16
Rate for Payer: PHP Medicare Advantage	$350.83
Rate for Payer: Priority Health Choice Medicaid	$188.04
Rate for Payer: Priority Health Cigna Priority Health	$111.01
Rate for Payer: Priority Health Medicare	$350.83
Rate for Payer: Priority Health SBD	$107.59
Rate for Payer: Railroad Medicare Medicare	$350.83
Rate for Payer: UHC All Payor (Choice/PPO)	$987.55
Rate for Payer: UHC Dual Complete DSNP	$350.83
Rate for Payer: UHC Medicare Advantage	$350.83
Rate for Payer: UHCCP Medicaid	$197.52
Rate for Payer: VA VA	$350.83

HC PI LINKED ANTIGEN

Facility

$170.78

Service Code	CPT 88184
Hospital Charge Code	31000004
Hospital Revenue Code	310
Min. Negotiated Rate	$107.59
Max. Negotiated Rate	$153.70
Rate for Payer: Aetna Commercial	$145.16
Rate for Payer: Aetna New Business (MI Preferred)	$111.01
Rate for Payer: Cash Price	$136.62
Rate for Payer: Cofinity Commercial	$119.55
Rate for Payer: Cofinity Commercial	$146.87
Rate for Payer: Cofinity Medicare Advantage	$119.55
Rate for Payer: Encore Health Key Benefits Commercial	$136.62
Rate for Payer: Healthscope Commercial	$153.70
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$145.16
Rate for Payer: PHP Commercial	$145.16
Rate for Payer: Priority Health Cigna Priority Health	$111.01
Rate for Payer: Priority Health SBD	$107.59

HC PI LINKED ANTIGEN CMPT

Facility

$170.78

Service Code	CPT 88184
Hospital Charge Code	31000005
Hospital Revenue Code	310
Min. Negotiated Rate	$107.59
Max. Negotiated Rate	$153.70
Rate for Payer: Aetna Commercial	$145.16
Rate for Payer: Aetna New Business (MI Preferred)	$111.01
Rate for Payer: Cash Price	$136.62
Rate for Payer: Cofinity Commercial	$119.55
Rate for Payer: Cofinity Commercial	$146.87
Rate for Payer: Cofinity Medicare Advantage	$119.55
Rate for Payer: Encore Health Key Benefits Commercial	$136.62
Rate for Payer: Healthscope Commercial	$153.70
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$145.16
Rate for Payer: PHP Commercial	$145.16
Rate for Payer: Priority Health Cigna Priority Health	$111.01
Rate for Payer: Priority Health SBD	$107.59

HC PI LINKED ANTIGEN CMPT

Facility

$170.78

Service Code	CPT 88184
Hospital Charge Code	31000005
Hospital Revenue Code	310
Min. Negotiated Rate	$107.59
Max. Negotiated Rate	$987.55
Rate for Payer: Aetna Commercial	$145.16
Rate for Payer: Aetna Medicare	$364.86
Rate for Payer: Aetna New Business (MI Preferred)	$111.01
Rate for Payer: Allen County Amish Medical Aid Commercial	$438.54
Rate for Payer: Amish Plain Church Group Commercial	$438.54
Rate for Payer: BCBS Complete	$197.45
Rate for Payer: BCBS MAPPO	$350.83
Rate for Payer: BCN Medicare Advantage	$350.83
Rate for Payer: Cash Price	$136.62
Rate for Payer: Cash Price	$136.62
Rate for Payer: Cofinity Commercial	$146.87
Rate for Payer: Cofinity Commercial	$119.55
Rate for Payer: Cofinity Medicare Advantage	$119.55
Rate for Payer: Encore Health Key Benefits Commercial	$136.62
Rate for Payer: Health Alliance Plan Medicare Advantage	$350.83
Rate for Payer: Healthscope Commercial	$153.70
Rate for Payer: Mclaren Medicaid	$188.04
Rate for Payer: Mclaren Medicare	$350.83
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$368.37
Rate for Payer: Meridian Medicaid	$197.45
Rate for Payer: MI Amish Medical Board Commercial	$403.45
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$145.16
Rate for Payer: PACE Medicare	$333.29
Rate for Payer: PACE SWMI	$350.83
Rate for Payer: PHP Commercial	$145.16
Rate for Payer: PHP Medicare Advantage	$350.83
Rate for Payer: Priority Health Choice Medicaid	$188.04
Rate for Payer: Priority Health Cigna Priority Health	$111.01
Rate for Payer: Priority Health Medicare	$350.83
Rate for Payer: Priority Health SBD	$107.59
Rate for Payer: Railroad Medicare Medicare	$350.83
Rate for Payer: UHC All Payor (Choice/PPO)	$987.55
Rate for Payer: UHC Dual Complete DSNP	$350.83
Rate for Payer: UHC Medicare Advantage	$350.83
Rate for Payer: UHCCP Medicaid	$197.52
Rate for Payer: VA VA	$350.83

HC PI LINKED ANTIGEN CMPT2

Facility

$61.85

Service Code	CPT 88185
Hospital Charge Code	31000011
Hospital Revenue Code	310
Min. Negotiated Rate	$24.74
Max. Negotiated Rate	$55.66
Rate for Payer: Aetna Commercial	$52.57
Rate for Payer: Aetna Medicare	$30.93
Rate for Payer: Aetna New Business (MI Preferred)	$40.20
Rate for Payer: BCBS Complete	$24.74
Rate for Payer: Cash Price	$49.48
Rate for Payer: Cofinity Commercial	$43.30
Rate for Payer: Cofinity Commercial	$53.19
Rate for Payer: Cofinity Medicare Advantage	$43.30
Rate for Payer: Encore Health Key Benefits Commercial	$49.48
Rate for Payer: Healthscope Commercial	$55.66
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$52.57
Rate for Payer: PHP Commercial	$52.57
Rate for Payer: Priority Health Cigna Priority Health	$40.20
Rate for Payer: Priority Health SBD	$38.97

HC PI LINKED ANTIGEN CMPT2

Facility

$61.85

Service Code	CPT 88185
Hospital Charge Code	31000011
Hospital Revenue Code	310
Min. Negotiated Rate	$38.97
Max. Negotiated Rate	$55.66
Rate for Payer: Aetna Commercial	$52.57
Rate for Payer: Aetna New Business (MI Preferred)	$40.20
Rate for Payer: Cash Price	$49.48
Rate for Payer: Cofinity Commercial	$43.30
Rate for Payer: Cofinity Commercial	$53.19
Rate for Payer: Cofinity Medicare Advantage	$43.30
Rate for Payer: Encore Health Key Benefits Commercial	$49.48
Rate for Payer: Healthscope Commercial	$55.66
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$52.57
Rate for Payer: PHP Commercial	$52.57
Rate for Payer: Priority Health Cigna Priority Health	$40.20
Rate for Payer: Priority Health SBD	$38.97

HC PINWORM EXAM

Facility

$55.49

Service Code	CPT 87172
Hospital Charge Code	30600094
Hospital Revenue Code	306
Min. Negotiated Rate	$34.96
Max. Negotiated Rate	$49.94
Rate for Payer: Aetna Commercial	$47.17
Rate for Payer: Aetna New Business (MI Preferred)	$36.07
Rate for Payer: Cash Price	$44.39
Rate for Payer: Cofinity Commercial	$38.84
Rate for Payer: Cofinity Commercial	$47.72
Rate for Payer: Cofinity Medicare Advantage	$38.84
Rate for Payer: Encore Health Key Benefits Commercial	$44.39
Rate for Payer: Healthscope Commercial	$49.94
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$47.17
Rate for Payer: PHP Commercial	$47.17
Rate for Payer: Priority Health Cigna Priority Health	$36.07
Rate for Payer: Priority Health SBD	$34.96

HC PINWORM EXAM

Facility

$55.49

Service Code	CPT 87172
Hospital Charge Code	30600094
Hospital Revenue Code	306
Min. Negotiated Rate	$2.29
Max. Negotiated Rate	$49.94
Rate for Payer: Aetna Commercial	$47.17
Rate for Payer: Aetna Medicare	$4.44
Rate for Payer: Aetna New Business (MI Preferred)	$36.07
Rate for Payer: Allen County Amish Medical Aid Commercial	$5.34
Rate for Payer: Amish Plain Church Group Commercial	$5.34
Rate for Payer: BCBS Complete	$2.40
Rate for Payer: BCBS MAPPO	$4.27
Rate for Payer: BCN Medicare Advantage	$4.27
Rate for Payer: Cash Price	$44.39
Rate for Payer: Cash Price	$44.39
Rate for Payer: Cofinity Commercial	$47.72
Rate for Payer: Cofinity Commercial	$38.84
Rate for Payer: Cofinity Medicare Advantage	$38.84
Rate for Payer: Encore Health Key Benefits Commercial	$44.39
Rate for Payer: Health Alliance Plan Medicare Advantage	$4.27
Rate for Payer: Healthscope Commercial	$49.94
Rate for Payer: Mclaren Medicaid	$2.29
Rate for Payer: Mclaren Medicare	$4.27
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$4.48
Rate for Payer: Meridian Medicaid	$2.40
Rate for Payer: MI Amish Medical Board Commercial	$4.91
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$47.17
Rate for Payer: PACE Medicare	$4.06
Rate for Payer: PACE SWMI	$4.27
Rate for Payer: PHP Commercial	$47.17
Rate for Payer: PHP Medicare Advantage	$4.27
Rate for Payer: Priority Health Choice Medicaid	$2.29
Rate for Payer: Priority Health Cigna Priority Health	$36.07
Rate for Payer: Priority Health Medicare	$4.27
Rate for Payer: Priority Health SBD	$34.96
Rate for Payer: Railroad Medicare Medicare	$4.27
Rate for Payer: UHC All Payor (Choice/PPO)	$12.02
Rate for Payer: UHC Dual Complete DSNP	$4.27
Rate for Payer: UHC Medicare Advantage	$4.27
Rate for Payer: UHCCP Medicaid	$2.40
Rate for Payer: VA VA	$4.27

HC PIONEER RE-ENTRY CATHETER

Facility

$9,316.79

Service Code	HCPCS C1753
Hospital Charge Code	27200063
Hospital Revenue Code	272
Min. Negotiated Rate	$5,869.58
Max. Negotiated Rate	$8,385.11
Rate for Payer: Aetna Commercial	$7,919.27
Rate for Payer: Aetna New Business (MI Preferred)	$6,055.91
Rate for Payer: Cash Price	$7,453.43
Rate for Payer: Cofinity Commercial	$6,521.75
Rate for Payer: Cofinity Commercial	$8,012.44
Rate for Payer: Cofinity Medicare Advantage	$6,521.75
Rate for Payer: Encore Health Key Benefits Commercial	$7,453.43
Rate for Payer: Healthscope Commercial	$8,385.11
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$7,919.27
Rate for Payer: PHP Commercial	$7,919.27
Rate for Payer: Priority Health Cigna Priority Health	$6,055.91
Rate for Payer: Priority Health SBD	$5,869.58

HC PIONEER RE-ENTRY CATHETER

Facility

$9,316.79

Service Code	HCPCS C1753
Hospital Charge Code	27200063
Hospital Revenue Code	272
Min. Negotiated Rate	$3,726.72
Max. Negotiated Rate	$8,385.11
Rate for Payer: Aetna Commercial	$7,919.27
Rate for Payer: Aetna Medicare	$4,658.40
Rate for Payer: Aetna New Business (MI Preferred)	$6,055.91
Rate for Payer: BCBS Complete	$3,726.72
Rate for Payer: Cash Price	$7,453.43
Rate for Payer: Cofinity Commercial	$6,521.75
Rate for Payer: Cofinity Commercial	$8,012.44
Rate for Payer: Cofinity Medicare Advantage	$6,521.75
Rate for Payer: Encore Health Key Benefits Commercial	$7,453.43
Rate for Payer: Healthscope Commercial	$8,385.11
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$7,919.27
Rate for Payer: PHP Commercial	$7,919.27
Rate for Payer: Priority Health Cigna Priority Health	$6,055.91
Rate for Payer: Priority Health SBD	$5,869.58

HC PIPELINE EMBOLIZATION DEVICE

Facility

$19,571.39

Hospital Charge Code	27800081
Hospital Revenue Code	278
Min. Negotiated Rate	$7,828.56
Max. Negotiated Rate	$17,614.25
Rate for Payer: Aetna Commercial	$16,635.68
Rate for Payer: Aetna Medicare	$9,785.69
Rate for Payer: Aetna New Business (MI Preferred)	$12,721.40
Rate for Payer: BCBS Complete	$7,828.56
Rate for Payer: Cash Price	$15,657.11
Rate for Payer: Cofinity Commercial	$13,699.97
Rate for Payer: Cofinity Commercial	$16,831.40
Rate for Payer: Cofinity Medicare Advantage	$13,699.97
Rate for Payer: Encore Health Key Benefits Commercial	$15,657.11
Rate for Payer: Healthscope Commercial	$17,614.25
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$16,635.68
Rate for Payer: PHP Commercial	$16,635.68
Rate for Payer: Priority Health Cigna Priority Health	$12,721.40
Rate for Payer: Priority Health SBD	$12,329.98

Know your out-of-pocket cost for care.

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