Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC RBC LEUKO REDUCED IRRAD

Facility

$1,257.09

Service Code	HCPCS P9040
Hospital Charge Code	39000072
Hospital Revenue Code	390
Min. Negotiated Rate	$791.97
Max. Negotiated Rate	$1,131.38
Rate for Payer: Aetna Commercial	$1,068.53
Rate for Payer: Aetna New Business (MI Preferred)	$817.11
Rate for Payer: Cash Price	$1,005.67
Rate for Payer: Cofinity Commercial	$1,081.10
Rate for Payer: Cofinity Commercial	$879.96
Rate for Payer: Cofinity Medicare Advantage	$879.96
Rate for Payer: Encore Health Key Benefits Commercial	$1,005.67
Rate for Payer: Healthscope Commercial	$1,131.38
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,068.53
Rate for Payer: PHP Commercial	$1,068.53
Rate for Payer: Priority Health Cigna Priority Health	$817.11
Rate for Payer: Priority Health SBD	$791.97

HC RBC LEUKO REDUCED IRRAD

Facility

$1,257.09

Service Code	HCPCS P9040
Hospital Charge Code	39000072
Hospital Revenue Code	390
Min. Negotiated Rate	$133.72
Max. Negotiated Rate	$1,131.38
Rate for Payer: Aetna Commercial	$1,068.53
Rate for Payer: Aetna Medicare	$259.46
Rate for Payer: Aetna New Business (MI Preferred)	$817.11
Rate for Payer: Allen County Amish Medical Aid Commercial	$311.85
Rate for Payer: Amish Plain Church Group Commercial	$311.85
Rate for Payer: BCBS Complete	$140.41
Rate for Payer: BCBS MAPPO	$249.48
Rate for Payer: BCN Medicare Advantage	$249.48
Rate for Payer: Cash Price	$1,005.67
Rate for Payer: Cash Price	$1,005.67
Rate for Payer: Cofinity Commercial	$879.96
Rate for Payer: Cofinity Commercial	$1,081.10
Rate for Payer: Cofinity Medicare Advantage	$879.96
Rate for Payer: Encore Health Key Benefits Commercial	$1,005.67
Rate for Payer: Health Alliance Plan Medicare Advantage	$249.48
Rate for Payer: Healthscope Commercial	$1,131.38
Rate for Payer: Mclaren Medicaid	$133.72
Rate for Payer: Mclaren Medicare	$249.48
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$261.95
Rate for Payer: Meridian Medicaid	$140.41
Rate for Payer: MI Amish Medical Board Commercial	$286.90
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,068.53
Rate for Payer: PACE Medicare	$237.01
Rate for Payer: PACE SWMI	$249.48
Rate for Payer: PHP Commercial	$1,068.53
Rate for Payer: PHP Medicare Advantage	$249.48
Rate for Payer: Priority Health Choice Medicaid	$133.72
Rate for Payer: Priority Health Cigna Priority Health	$817.11
Rate for Payer: Priority Health Medicare	$249.48
Rate for Payer: Priority Health SBD	$791.97
Rate for Payer: Railroad Medicare Medicare	$249.48
Rate for Payer: UHC All Payor (Choice/PPO)	$702.26
Rate for Payer: UHC Core	$930.25
Rate for Payer: UHC Dual Complete DSNP	$249.48
Rate for Payer: UHC Exchange	$930.25
Rate for Payer: UHC Medicare Advantage	$249.48
Rate for Payer: UHCCP Medicaid	$140.46
Rate for Payer: VA VA	$249.48

HC RECEPTOR ASSAY OTHER ENDOCRINE

Facility

$203.97

Service Code	CPT 84235
Hospital Charge Code	30100418
Hospital Revenue Code	301
Min. Negotiated Rate	$128.50
Max. Negotiated Rate	$183.57
Rate for Payer: Aetna Commercial	$173.37
Rate for Payer: Aetna New Business (MI Preferred)	$132.58
Rate for Payer: Cash Price	$163.18
Rate for Payer: Cofinity Commercial	$142.78
Rate for Payer: Cofinity Commercial	$175.41
Rate for Payer: Cofinity Medicare Advantage	$142.78
Rate for Payer: Encore Health Key Benefits Commercial	$163.18
Rate for Payer: Healthscope Commercial	$183.57
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$173.37
Rate for Payer: PHP Commercial	$173.37
Rate for Payer: Priority Health Cigna Priority Health	$132.58
Rate for Payer: Priority Health SBD	$128.50

HC RECEPTOR ASSAY OTHER ENDOCRINE

Facility

$203.97

Service Code	CPT 84235
Hospital Charge Code	30100418
Hospital Revenue Code	301
Min. Negotiated Rate	$38.18
Max. Negotiated Rate	$200.51
Rate for Payer: Aetna Commercial	$173.37
Rate for Payer: Aetna Medicare	$74.08
Rate for Payer: Aetna New Business (MI Preferred)	$132.58
Rate for Payer: Allen County Amish Medical Aid Commercial	$89.04
Rate for Payer: Amish Plain Church Group Commercial	$89.04
Rate for Payer: BCBS Complete	$40.09
Rate for Payer: BCBS MAPPO	$71.23
Rate for Payer: BCN Medicare Advantage	$71.23
Rate for Payer: Cash Price	$163.18
Rate for Payer: Cash Price	$163.18
Rate for Payer: Cofinity Commercial	$175.41
Rate for Payer: Cofinity Commercial	$142.78
Rate for Payer: Cofinity Medicare Advantage	$142.78
Rate for Payer: Encore Health Key Benefits Commercial	$163.18
Rate for Payer: Health Alliance Plan Medicare Advantage	$71.23
Rate for Payer: Healthscope Commercial	$183.57
Rate for Payer: Mclaren Medicaid	$38.18
Rate for Payer: Mclaren Medicare	$71.23
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$74.79
Rate for Payer: Meridian Medicaid	$40.09
Rate for Payer: MI Amish Medical Board Commercial	$81.91
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$173.37
Rate for Payer: PACE Medicare	$67.67
Rate for Payer: PACE SWMI	$71.23
Rate for Payer: PHP Commercial	$173.37
Rate for Payer: PHP Medicare Advantage	$71.23
Rate for Payer: Priority Health Choice Medicaid	$38.18
Rate for Payer: Priority Health Cigna Priority Health	$132.58
Rate for Payer: Priority Health Medicare	$71.23
Rate for Payer: Priority Health SBD	$128.50
Rate for Payer: Railroad Medicare Medicare	$71.23
Rate for Payer: UHC All Payor (Choice/PPO)	$200.51
Rate for Payer: UHC Dual Complete DSNP	$71.23
Rate for Payer: UHC Medicare Advantage	$71.23
Rate for Payer: UHCCP Medicaid	$40.10
Rate for Payer: VA VA	$71.23

HC RECOVERY 1 ADD'L 15 MIN

Facility

$157.01

Hospital Charge Code	71000020
Hospital Revenue Code	710
Min. Negotiated Rate	$98.92
Max. Negotiated Rate	$141.31
Rate for Payer: Aetna Commercial	$133.46
Rate for Payer: Aetna New Business (MI Preferred)	$102.06
Rate for Payer: Cash Price	$125.61
Rate for Payer: Cofinity Commercial	$109.91
Rate for Payer: Cofinity Commercial	$135.03
Rate for Payer: Cofinity Medicare Advantage	$109.91
Rate for Payer: Encore Health Key Benefits Commercial	$125.61
Rate for Payer: Healthscope Commercial	$141.31
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$133.46
Rate for Payer: PHP Commercial	$133.46
Rate for Payer: Priority Health Cigna Priority Health	$102.06
Rate for Payer: Priority Health SBD	$98.92

HC RECOVERY 1 ADD'L 15 MIN

Facility

$157.01

Hospital Charge Code	71000020
Hospital Revenue Code	710
Min. Negotiated Rate	$62.80
Max. Negotiated Rate	$141.31
Rate for Payer: Aetna Commercial	$133.46
Rate for Payer: Aetna Medicare	$78.50
Rate for Payer: Aetna New Business (MI Preferred)	$102.06
Rate for Payer: BCBS Complete	$62.80
Rate for Payer: Cash Price	$125.61
Rate for Payer: Cofinity Commercial	$109.91
Rate for Payer: Cofinity Commercial	$135.03
Rate for Payer: Cofinity Medicare Advantage	$109.91
Rate for Payer: Encore Health Key Benefits Commercial	$125.61
Rate for Payer: Healthscope Commercial	$141.31
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$133.46
Rate for Payer: PHP Commercial	$133.46
Rate for Payer: Priority Health Cigna Priority Health	$102.06
Rate for Payer: Priority Health SBD	$98.92

HC RECOVERY 1 INIT 30 MIN

Facility

$370.68

Hospital Charge Code	71000021
Hospital Revenue Code	710
Min. Negotiated Rate	$233.53
Max. Negotiated Rate	$333.61
Rate for Payer: Aetna Commercial	$315.08
Rate for Payer: Aetna New Business (MI Preferred)	$240.94
Rate for Payer: Cash Price	$296.54
Rate for Payer: Cofinity Commercial	$259.48
Rate for Payer: Cofinity Commercial	$318.78
Rate for Payer: Cofinity Medicare Advantage	$259.48
Rate for Payer: Encore Health Key Benefits Commercial	$296.54
Rate for Payer: Healthscope Commercial	$333.61
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$315.08
Rate for Payer: PHP Commercial	$315.08
Rate for Payer: Priority Health Cigna Priority Health	$240.94
Rate for Payer: Priority Health SBD	$233.53

HC RECOVERY 1 INIT 30 MIN

Facility

$370.68

Hospital Charge Code	71000021
Hospital Revenue Code	710
Min. Negotiated Rate	$148.27
Max. Negotiated Rate	$333.61
Rate for Payer: Aetna Commercial	$315.08
Rate for Payer: Aetna Medicare	$185.34
Rate for Payer: Aetna New Business (MI Preferred)	$240.94
Rate for Payer: BCBS Complete	$148.27
Rate for Payer: Cash Price	$296.54
Rate for Payer: Cofinity Commercial	$259.48
Rate for Payer: Cofinity Commercial	$318.78
Rate for Payer: Cofinity Medicare Advantage	$259.48
Rate for Payer: Encore Health Key Benefits Commercial	$296.54
Rate for Payer: Healthscope Commercial	$333.61
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$315.08
Rate for Payer: PHP Commercial	$315.08
Rate for Payer: Priority Health Cigna Priority Health	$240.94
Rate for Payer: Priority Health SBD	$233.53

HC RECOVERY 2 ADD'L 15 MIN

Facility

$183.83

Hospital Charge Code	71000022
Hospital Revenue Code	710
Min. Negotiated Rate	$73.53
Max. Negotiated Rate	$165.45
Rate for Payer: Aetna Commercial	$156.26
Rate for Payer: Aetna Medicare	$91.92
Rate for Payer: Aetna New Business (MI Preferred)	$119.49
Rate for Payer: BCBS Complete	$73.53
Rate for Payer: Cash Price	$147.06
Rate for Payer: Cofinity Commercial	$128.68
Rate for Payer: Cofinity Commercial	$158.09
Rate for Payer: Cofinity Medicare Advantage	$128.68
Rate for Payer: Encore Health Key Benefits Commercial	$147.06
Rate for Payer: Healthscope Commercial	$165.45
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$156.26
Rate for Payer: PHP Commercial	$156.26
Rate for Payer: Priority Health Cigna Priority Health	$119.49
Rate for Payer: Priority Health SBD	$115.81

HC RECOVERY 2 ADD'L 15 MIN

Facility

$183.83

Hospital Charge Code	71000022
Hospital Revenue Code	710
Min. Negotiated Rate	$115.81
Max. Negotiated Rate	$165.45
Rate for Payer: Aetna Commercial	$156.26
Rate for Payer: Aetna New Business (MI Preferred)	$119.49
Rate for Payer: Cash Price	$147.06
Rate for Payer: Cofinity Commercial	$128.68
Rate for Payer: Cofinity Commercial	$158.09
Rate for Payer: Cofinity Medicare Advantage	$128.68
Rate for Payer: Encore Health Key Benefits Commercial	$147.06
Rate for Payer: Healthscope Commercial	$165.45
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$156.26
Rate for Payer: PHP Commercial	$156.26
Rate for Payer: Priority Health Cigna Priority Health	$119.49
Rate for Payer: Priority Health SBD	$115.81

HC RECOVERY 2 INIT 30 MIN

Facility

$331.57

Hospital Charge Code	71000023
Hospital Revenue Code	710
Min. Negotiated Rate	$208.89
Max. Negotiated Rate	$298.41
Rate for Payer: Aetna Commercial	$281.83
Rate for Payer: Aetna New Business (MI Preferred)	$215.52
Rate for Payer: Cash Price	$265.26
Rate for Payer: Cofinity Commercial	$232.10
Rate for Payer: Cofinity Commercial	$285.15
Rate for Payer: Cofinity Medicare Advantage	$232.10
Rate for Payer: Encore Health Key Benefits Commercial	$265.26
Rate for Payer: Healthscope Commercial	$298.41
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$281.83
Rate for Payer: PHP Commercial	$281.83
Rate for Payer: Priority Health Cigna Priority Health	$215.52
Rate for Payer: Priority Health SBD	$208.89

HC RECOVERY 2 INIT 30 MIN

Facility

$331.57

Hospital Charge Code	71000023
Hospital Revenue Code	710
Min. Negotiated Rate	$132.63
Max. Negotiated Rate	$298.41
Rate for Payer: Aetna Commercial	$281.83
Rate for Payer: Aetna Medicare	$165.78
Rate for Payer: Aetna New Business (MI Preferred)	$215.52
Rate for Payer: BCBS Complete	$132.63
Rate for Payer: Cash Price	$265.26
Rate for Payer: Cofinity Commercial	$232.10
Rate for Payer: Cofinity Commercial	$285.15
Rate for Payer: Cofinity Medicare Advantage	$232.10
Rate for Payer: Encore Health Key Benefits Commercial	$265.26
Rate for Payer: Healthscope Commercial	$298.41
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$281.83
Rate for Payer: PHP Commercial	$281.83
Rate for Payer: Priority Health Cigna Priority Health	$215.52
Rate for Payer: Priority Health SBD	$208.89

HC RECOVERY 3 ADD'L 15 MIN

Facility

$102.17

Hospital Charge Code	71000024
Hospital Revenue Code	710
Min. Negotiated Rate	$40.87
Max. Negotiated Rate	$91.95
Rate for Payer: Aetna Commercial	$86.84
Rate for Payer: Aetna Medicare	$51.09
Rate for Payer: Aetna New Business (MI Preferred)	$66.41
Rate for Payer: BCBS Complete	$40.87
Rate for Payer: Cash Price	$81.74
Rate for Payer: Cofinity Commercial	$71.52
Rate for Payer: Cofinity Commercial	$87.87
Rate for Payer: Cofinity Medicare Advantage	$71.52
Rate for Payer: Encore Health Key Benefits Commercial	$81.74
Rate for Payer: Healthscope Commercial	$91.95
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$86.84
Rate for Payer: PHP Commercial	$86.84
Rate for Payer: Priority Health Cigna Priority Health	$66.41
Rate for Payer: Priority Health SBD	$64.37

HC RECOVERY 3 ADD'L 15 MIN

Facility

$102.17

Hospital Charge Code	71000024
Hospital Revenue Code	710
Min. Negotiated Rate	$64.37
Max. Negotiated Rate	$91.95
Rate for Payer: Aetna Commercial	$86.84
Rate for Payer: Aetna New Business (MI Preferred)	$66.41
Rate for Payer: Cash Price	$81.74
Rate for Payer: Cofinity Commercial	$71.52
Rate for Payer: Cofinity Commercial	$87.87
Rate for Payer: Cofinity Medicare Advantage	$71.52
Rate for Payer: Encore Health Key Benefits Commercial	$81.74
Rate for Payer: Healthscope Commercial	$91.95
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$86.84
Rate for Payer: PHP Commercial	$86.84
Rate for Payer: Priority Health Cigna Priority Health	$66.41
Rate for Payer: Priority Health SBD	$64.37

HC RECOVERY 3 INIT 30 MIN

Facility

$206.43

Hospital Charge Code	71000025
Hospital Revenue Code	710
Min. Negotiated Rate	$130.05
Max. Negotiated Rate	$185.79
Rate for Payer: Aetna Commercial	$175.47
Rate for Payer: Aetna New Business (MI Preferred)	$134.18
Rate for Payer: Cash Price	$165.14
Rate for Payer: Cofinity Commercial	$144.50
Rate for Payer: Cofinity Commercial	$177.53
Rate for Payer: Cofinity Medicare Advantage	$144.50
Rate for Payer: Encore Health Key Benefits Commercial	$165.14
Rate for Payer: Healthscope Commercial	$185.79
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$175.47
Rate for Payer: PHP Commercial	$175.47
Rate for Payer: Priority Health Cigna Priority Health	$134.18
Rate for Payer: Priority Health SBD	$130.05

HC RECOVERY 3 INIT 30 MIN

Facility

$206.43

Hospital Charge Code	71000025
Hospital Revenue Code	710
Min. Negotiated Rate	$82.57
Max. Negotiated Rate	$185.79
Rate for Payer: Aetna Commercial	$175.47
Rate for Payer: Aetna Medicare	$103.22
Rate for Payer: Aetna New Business (MI Preferred)	$134.18
Rate for Payer: BCBS Complete	$82.57
Rate for Payer: Cash Price	$165.14
Rate for Payer: Cofinity Commercial	$144.50
Rate for Payer: Cofinity Commercial	$177.53
Rate for Payer: Cofinity Medicare Advantage	$144.50
Rate for Payer: Encore Health Key Benefits Commercial	$165.14
Rate for Payer: Healthscope Commercial	$185.79
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$175.47
Rate for Payer: PHP Commercial	$175.47
Rate for Payer: Priority Health Cigna Priority Health	$134.18
Rate for Payer: Priority Health SBD	$130.05

HC RECOVERY PHASE 1 COMPLEX BASE CHARGE

Facility

$116.00

Hospital Charge Code	71000039
Hospital Revenue Code	710
Min. Negotiated Rate	$73.08
Max. Negotiated Rate	$104.40
Rate for Payer: Aetna Commercial	$98.60
Rate for Payer: Aetna New Business (MI Preferred)	$75.40
Rate for Payer: Cash Price	$92.80
Rate for Payer: Cofinity Commercial	$81.20
Rate for Payer: Cofinity Commercial	$99.76
Rate for Payer: Cofinity Medicare Advantage	$81.20
Rate for Payer: Encore Health Key Benefits Commercial	$92.80
Rate for Payer: Healthscope Commercial	$104.40
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$98.60
Rate for Payer: PHP Commercial	$98.60
Rate for Payer: Priority Health Cigna Priority Health	$75.40
Rate for Payer: Priority Health SBD	$73.08

HC RECOVERY PHASE 1 COMPLEX BASE CHARGE

Facility

$116.00

Hospital Charge Code	71000039
Hospital Revenue Code	710
Min. Negotiated Rate	$46.40
Max. Negotiated Rate	$104.40
Rate for Payer: Aetna Commercial	$98.60
Rate for Payer: Aetna Medicare	$58.00
Rate for Payer: Aetna New Business (MI Preferred)	$75.40
Rate for Payer: BCBS Complete	$46.40
Rate for Payer: Cash Price	$92.80
Rate for Payer: Cofinity Commercial	$81.20
Rate for Payer: Cofinity Commercial	$99.76
Rate for Payer: Cofinity Medicare Advantage	$81.20
Rate for Payer: Encore Health Key Benefits Commercial	$92.80
Rate for Payer: Healthscope Commercial	$104.40
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$98.60
Rate for Payer: PHP Commercial	$98.60
Rate for Payer: Priority Health Cigna Priority Health	$75.40
Rate for Payer: Priority Health SBD	$73.08

HC RECOVERY PHASE 1 COMPLEX EA MIN CHARGE

Facility

$15.00

Hospital Charge Code	71000034
Hospital Revenue Code	710
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$13.50
Rate for Payer: Aetna Commercial	$12.75
Rate for Payer: Aetna Medicare	$7.50
Rate for Payer: Aetna New Business (MI Preferred)	$9.75
Rate for Payer: BCBS Complete	$6.00
Rate for Payer: Cash Price	$12.00
Rate for Payer: Cofinity Commercial	$10.50
Rate for Payer: Cofinity Commercial	$12.90
Rate for Payer: Cofinity Medicare Advantage	$10.50
Rate for Payer: Encore Health Key Benefits Commercial	$12.00
Rate for Payer: Healthscope Commercial	$13.50
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$12.75
Rate for Payer: PHP Commercial	$12.75
Rate for Payer: Priority Health Cigna Priority Health	$9.75
Rate for Payer: Priority Health SBD	$9.45

HC RECOVERY PHASE 1 COMPLEX EA MIN CHARGE

Facility

$15.00

Hospital Charge Code	71000034
Hospital Revenue Code	710
Min. Negotiated Rate	$9.45
Max. Negotiated Rate	$13.50
Rate for Payer: Aetna Commercial	$12.75
Rate for Payer: Aetna New Business (MI Preferred)	$9.75
Rate for Payer: Cash Price	$12.00
Rate for Payer: Cofinity Commercial	$10.50
Rate for Payer: Cofinity Commercial	$12.90
Rate for Payer: Cofinity Medicare Advantage	$10.50
Rate for Payer: Encore Health Key Benefits Commercial	$12.00
Rate for Payer: Healthscope Commercial	$13.50
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$12.75
Rate for Payer: PHP Commercial	$12.75
Rate for Payer: Priority Health Cigna Priority Health	$9.75
Rate for Payer: Priority Health SBD	$9.45

HC RECOVERY PHASE 1 STANDARD BASE CHARGE

Facility

$97.00

Hospital Charge Code	71000035
Hospital Revenue Code	710
Min. Negotiated Rate	$61.11
Max. Negotiated Rate	$87.30
Rate for Payer: Aetna Commercial	$82.45
Rate for Payer: Aetna New Business (MI Preferred)	$63.05
Rate for Payer: Cash Price	$77.60
Rate for Payer: Cofinity Commercial	$67.90
Rate for Payer: Cofinity Commercial	$83.42
Rate for Payer: Cofinity Medicare Advantage	$67.90
Rate for Payer: Encore Health Key Benefits Commercial	$77.60
Rate for Payer: Healthscope Commercial	$87.30
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$82.45
Rate for Payer: PHP Commercial	$82.45
Rate for Payer: Priority Health Cigna Priority Health	$63.05
Rate for Payer: Priority Health SBD	$61.11

HC RECOVERY PHASE 1 STANDARD BASE CHARGE

Facility

$97.00

Hospital Charge Code	71000035
Hospital Revenue Code	710
Min. Negotiated Rate	$38.80
Max. Negotiated Rate	$87.30
Rate for Payer: Aetna Commercial	$82.45
Rate for Payer: Aetna Medicare	$48.50
Rate for Payer: Aetna New Business (MI Preferred)	$63.05
Rate for Payer: BCBS Complete	$38.80
Rate for Payer: Cash Price	$77.60
Rate for Payer: Cofinity Commercial	$67.90
Rate for Payer: Cofinity Commercial	$83.42
Rate for Payer: Cofinity Medicare Advantage	$67.90
Rate for Payer: Encore Health Key Benefits Commercial	$77.60
Rate for Payer: Healthscope Commercial	$87.30
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$82.45
Rate for Payer: PHP Commercial	$82.45
Rate for Payer: Priority Health Cigna Priority Health	$63.05
Rate for Payer: Priority Health SBD	$61.11

HC RECOVERY PHASE 1 STANDARD EA MIN CHARGE

Facility

$12.00

Hospital Charge Code	71000036
Hospital Revenue Code	710
Min. Negotiated Rate	$7.56
Max. Negotiated Rate	$10.80
Rate for Payer: Aetna Commercial	$10.20
Rate for Payer: Aetna New Business (MI Preferred)	$7.80
Rate for Payer: Cash Price	$9.60
Rate for Payer: Cofinity Commercial	$10.32
Rate for Payer: Cofinity Commercial	$8.40
Rate for Payer: Cofinity Medicare Advantage	$8.40
Rate for Payer: Encore Health Key Benefits Commercial	$9.60
Rate for Payer: Healthscope Commercial	$10.80
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$10.20
Rate for Payer: PHP Commercial	$10.20
Rate for Payer: Priority Health Cigna Priority Health	$7.80
Rate for Payer: Priority Health SBD	$7.56

HC RECOVERY PHASE 1 STANDARD EA MIN CHARGE

Facility

$12.00

Hospital Charge Code	71000036
Hospital Revenue Code	710
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$10.80
Rate for Payer: Aetna Commercial	$10.20
Rate for Payer: Aetna Medicare	$6.00
Rate for Payer: Aetna New Business (MI Preferred)	$7.80
Rate for Payer: BCBS Complete	$4.80
Rate for Payer: Cash Price	$9.60
Rate for Payer: Cofinity Commercial	$10.32
Rate for Payer: Cofinity Commercial	$8.40
Rate for Payer: Cofinity Medicare Advantage	$8.40
Rate for Payer: Encore Health Key Benefits Commercial	$9.60
Rate for Payer: Healthscope Commercial	$10.80
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$10.20
Rate for Payer: PHP Commercial	$10.20
Rate for Payer: Priority Health Cigna Priority Health	$7.80
Rate for Payer: Priority Health SBD	$7.56

HC RECOVERY PHASE 2 EA MIN CHARGE

Facility

$9.00

Hospital Charge Code	71000037
Hospital Revenue Code	710
Min. Negotiated Rate	$5.67
Max. Negotiated Rate	$8.10
Rate for Payer: Aetna Commercial	$7.65
Rate for Payer: Aetna New Business (MI Preferred)	$5.85
Rate for Payer: Cash Price	$7.20
Rate for Payer: Cofinity Commercial	$6.30
Rate for Payer: Cofinity Commercial	$7.74
Rate for Payer: Cofinity Medicare Advantage	$6.30
Rate for Payer: Encore Health Key Benefits Commercial	$7.20
Rate for Payer: Healthscope Commercial	$8.10
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$7.65
Rate for Payer: PHP Commercial	$7.65
Rate for Payer: Priority Health Cigna Priority Health	$5.85
Rate for Payer: Priority Health SBD	$5.67

Know your out-of-pocket cost for care.

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