Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC SELECTIVE EACH INTRACRANIAL UNI

Facility

$4,967.05

Service Code	CPT 36228
Hospital Charge Code	36100386
Hospital Revenue Code	361
Min. Negotiated Rate	$1,986.82
Max. Negotiated Rate	$4,470.35
Rate for Payer: Aetna Commercial	$4,221.99
Rate for Payer: Aetna Medicare	$2,483.53
Rate for Payer: Aetna New Business (MI Preferred)	$3,228.58
Rate for Payer: BCBS Complete	$1,986.82
Rate for Payer: Cash Price	$3,973.64
Rate for Payer: Cofinity Commercial	$3,476.93
Rate for Payer: Cofinity Commercial	$4,271.66
Rate for Payer: Cofinity Medicare Advantage	$3,476.93
Rate for Payer: Encore Health Key Benefits Commercial	$3,973.64
Rate for Payer: Healthscope Commercial	$4,470.35
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4,221.99
Rate for Payer: PHP Commercial	$4,221.99
Rate for Payer: Priority Health Cigna Priority Health	$3,228.58
Rate for Payer: Priority Health SBD	$3,129.24

HC SELECTIVE EACH INTRACRANIAL UNI

Facility

$4,967.05

Service Code	CPT 36228
Hospital Charge Code	36100386
Hospital Revenue Code	361
Min. Negotiated Rate	$3,129.24
Max. Negotiated Rate	$4,470.35
Rate for Payer: Aetna Commercial	$4,221.99
Rate for Payer: Aetna New Business (MI Preferred)	$3,228.58
Rate for Payer: Cash Price	$3,973.64
Rate for Payer: Cofinity Commercial	$3,476.93
Rate for Payer: Cofinity Commercial	$4,271.66
Rate for Payer: Cofinity Medicare Advantage	$3,476.93
Rate for Payer: Encore Health Key Benefits Commercial	$3,973.64
Rate for Payer: Healthscope Commercial	$4,470.35
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4,221.99
Rate for Payer: PHP Commercial	$4,221.99
Rate for Payer: Priority Health Cigna Priority Health	$3,228.58
Rate for Payer: Priority Health SBD	$3,129.24

HC SELECTIVE EXTERNAL CAROTID UNI

Facility

$5,746.30

Service Code	CPT 36227
Hospital Charge Code	36100382
Hospital Revenue Code	361
Min. Negotiated Rate	$3,620.17
Max. Negotiated Rate	$5,171.67
Rate for Payer: Aetna Commercial	$4,884.35
Rate for Payer: Aetna New Business (MI Preferred)	$3,735.09
Rate for Payer: Cash Price	$4,597.04
Rate for Payer: Cofinity Commercial	$4,022.41
Rate for Payer: Cofinity Commercial	$4,941.82
Rate for Payer: Cofinity Medicare Advantage	$4,022.41
Rate for Payer: Encore Health Key Benefits Commercial	$4,597.04
Rate for Payer: Healthscope Commercial	$5,171.67
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4,884.35
Rate for Payer: PHP Commercial	$4,884.35
Rate for Payer: Priority Health Cigna Priority Health	$3,735.09
Rate for Payer: Priority Health SBD	$3,620.17

HC SELECTIVE EXTERNAL CAROTID UNI

Facility

$5,746.30

Service Code	CPT 36227
Hospital Charge Code	36100382
Hospital Revenue Code	361
Min. Negotiated Rate	$2,298.52
Max. Negotiated Rate	$5,171.67
Rate for Payer: Aetna Commercial	$4,884.35
Rate for Payer: Aetna Medicare	$2,873.15
Rate for Payer: Aetna New Business (MI Preferred)	$3,735.09
Rate for Payer: BCBS Complete	$2,298.52
Rate for Payer: Cash Price	$4,597.04
Rate for Payer: Cofinity Commercial	$4,022.41
Rate for Payer: Cofinity Commercial	$4,941.82
Rate for Payer: Cofinity Medicare Advantage	$4,022.41
Rate for Payer: Encore Health Key Benefits Commercial	$4,597.04
Rate for Payer: Healthscope Commercial	$5,171.67
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4,884.35
Rate for Payer: PHP Commercial	$4,884.35
Rate for Payer: Priority Health Cigna Priority Health	$3,735.09
Rate for Payer: Priority Health SBD	$3,620.17

HC SELECTIVE EXTRACRANIAL ARTERY UNI

Facility

$9,547.08

Service Code	CPT 36222
Hospital Charge Code	36100377
Hospital Revenue Code	361
Min. Negotiated Rate	$6,014.66
Max. Negotiated Rate	$8,592.37
Rate for Payer: Aetna Commercial	$8,115.02
Rate for Payer: Aetna New Business (MI Preferred)	$6,205.60
Rate for Payer: Cash Price	$7,637.66
Rate for Payer: Cofinity Commercial	$6,682.96
Rate for Payer: Cofinity Commercial	$8,210.49
Rate for Payer: Cofinity Medicare Advantage	$6,682.96
Rate for Payer: Encore Health Key Benefits Commercial	$7,637.66
Rate for Payer: Healthscope Commercial	$8,592.37
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$8,115.02
Rate for Payer: PHP Commercial	$8,115.02
Rate for Payer: Priority Health Cigna Priority Health	$6,205.60
Rate for Payer: Priority Health SBD	$6,014.66

HC SELECTIVE EXTRACRANIAL ARTERY UNI

Facility

$9,547.08

Service Code	CPT 36222
Hospital Charge Code	36100377
Hospital Revenue Code	361
Min. Negotiated Rate	$1,645.35
Max. Negotiated Rate	$8,640.87
Rate for Payer: Aetna Commercial	$8,115.02
Rate for Payer: Aetna Medicare	$3,192.48
Rate for Payer: Aetna New Business (MI Preferred)	$6,205.60
Rate for Payer: Allen County Amish Medical Aid Commercial	$3,837.11
Rate for Payer: Amish Plain Church Group Commercial	$3,837.11
Rate for Payer: BCBS Complete	$1,727.62
Rate for Payer: BCBS MAPPO	$3,069.69
Rate for Payer: BCN Medicare Advantage	$3,069.69
Rate for Payer: Cash Price	$7,637.66
Rate for Payer: Cash Price	$7,637.66
Rate for Payer: Cofinity Commercial	$8,210.49
Rate for Payer: Cofinity Commercial	$6,682.96
Rate for Payer: Cofinity Medicare Advantage	$6,682.96
Rate for Payer: Encore Health Key Benefits Commercial	$7,637.66
Rate for Payer: Health Alliance Plan Medicare Advantage	$3,069.69
Rate for Payer: Healthscope Commercial	$8,592.37
Rate for Payer: Mclaren Medicaid	$1,645.35
Rate for Payer: Mclaren Medicare	$3,069.69
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$3,223.17
Rate for Payer: Meridian Medicaid	$1,727.62
Rate for Payer: MI Amish Medical Board Commercial	$3,530.14
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$8,115.02
Rate for Payer: PACE Medicare	$2,916.21
Rate for Payer: PACE SWMI	$3,069.69
Rate for Payer: PHP Commercial	$8,115.02
Rate for Payer: PHP Medicare Advantage	$3,069.69
Rate for Payer: Priority Health Choice Medicaid	$1,645.35
Rate for Payer: Priority Health Cigna Priority Health	$6,205.60
Rate for Payer: Priority Health Medicare	$3,069.69
Rate for Payer: Priority Health SBD	$6,014.66
Rate for Payer: Railroad Medicare Medicare	$3,069.69
Rate for Payer: UHC All Payor (Choice/PPO)	$8,640.87
Rate for Payer: UHC Dual Complete DSNP	$3,069.69
Rate for Payer: UHC Medicare Advantage	$3,069.69
Rate for Payer: UHCCP Medicaid	$1,728.24
Rate for Payer: VA VA	$3,069.69

HC SELECTIVE EXTRA/INTRACRANIAL ARTERY UNI

Facility

$10,966.23

Service Code	CPT 36223
Hospital Charge Code	36100378
Hospital Revenue Code	361
Min. Negotiated Rate	$6,908.72
Max. Negotiated Rate	$9,869.61
Rate for Payer: Aetna Commercial	$9,321.30
Rate for Payer: Aetna New Business (MI Preferred)	$7,128.05
Rate for Payer: Cash Price	$8,772.98
Rate for Payer: Cofinity Commercial	$7,676.36
Rate for Payer: Cofinity Commercial	$9,430.96
Rate for Payer: Cofinity Medicare Advantage	$7,676.36
Rate for Payer: Encore Health Key Benefits Commercial	$8,772.98
Rate for Payer: Healthscope Commercial	$9,869.61
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$9,321.30
Rate for Payer: PHP Commercial	$9,321.30
Rate for Payer: Priority Health Cigna Priority Health	$7,128.05
Rate for Payer: Priority Health SBD	$6,908.72

HC SELECTIVE EXTRA/INTRACRANIAL ARTERY UNI

Facility

$10,966.23

Service Code	CPT 36223
Hospital Charge Code	36100378
Hospital Revenue Code	361
Min. Negotiated Rate	$2,825.83
Max. Negotiated Rate	$14,840.35
Rate for Payer: Aetna Commercial	$9,321.30
Rate for Payer: Aetna Medicare	$5,482.95
Rate for Payer: Aetna New Business (MI Preferred)	$7,128.05
Rate for Payer: Allen County Amish Medical Aid Commercial	$6,590.09
Rate for Payer: Amish Plain Church Group Commercial	$6,590.09
Rate for Payer: BCBS Complete	$2,967.12
Rate for Payer: BCBS MAPPO	$5,272.07
Rate for Payer: BCN Medicare Advantage	$5,272.07
Rate for Payer: Cash Price	$8,772.98
Rate for Payer: Cash Price	$8,772.98
Rate for Payer: Cofinity Commercial	$9,430.96
Rate for Payer: Cofinity Commercial	$7,676.36
Rate for Payer: Cofinity Medicare Advantage	$7,676.36
Rate for Payer: Encore Health Key Benefits Commercial	$8,772.98
Rate for Payer: Health Alliance Plan Medicare Advantage	$5,272.07
Rate for Payer: Healthscope Commercial	$9,869.61
Rate for Payer: Mclaren Medicaid	$2,825.83
Rate for Payer: Mclaren Medicare	$5,272.07
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$5,535.67
Rate for Payer: Meridian Medicaid	$2,967.12
Rate for Payer: MI Amish Medical Board Commercial	$6,062.88
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$9,321.30
Rate for Payer: PACE Medicare	$5,008.47
Rate for Payer: PACE SWMI	$5,272.07
Rate for Payer: PHP Commercial	$9,321.30
Rate for Payer: PHP Medicare Advantage	$5,272.07
Rate for Payer: Priority Health Choice Medicaid	$2,825.83
Rate for Payer: Priority Health Cigna Priority Health	$7,128.05
Rate for Payer: Priority Health Medicare	$5,272.07
Rate for Payer: Priority Health SBD	$6,908.72
Rate for Payer: Railroad Medicare Medicare	$5,272.07
Rate for Payer: UHC All Payor (Choice/PPO)	$14,840.35
Rate for Payer: UHC Dual Complete DSNP	$5,272.07
Rate for Payer: UHC Medicare Advantage	$5,272.07
Rate for Payer: UHCCP Medicaid	$2,968.18
Rate for Payer: VA VA	$5,272.07

HC SELECTIVE INTRACRANIAL ART UNI

Facility

$12,901.46

Service Code	CPT 36224
Hospital Charge Code	36100385
Hospital Revenue Code	361
Min. Negotiated Rate	$8,127.92
Max. Negotiated Rate	$11,611.31
Rate for Payer: Aetna Commercial	$10,966.24
Rate for Payer: Aetna New Business (MI Preferred)	$8,385.95
Rate for Payer: Cash Price	$10,321.17
Rate for Payer: Cofinity Commercial	$11,095.26
Rate for Payer: Cofinity Commercial	$9,031.02
Rate for Payer: Cofinity Medicare Advantage	$9,031.02
Rate for Payer: Encore Health Key Benefits Commercial	$10,321.17
Rate for Payer: Healthscope Commercial	$11,611.31
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$10,966.24
Rate for Payer: PHP Commercial	$10,966.24
Rate for Payer: Priority Health Cigna Priority Health	$8,385.95
Rate for Payer: Priority Health SBD	$8,127.92

HC SELECTIVE INTRACRANIAL ART UNI

Facility

$12,901.46

Service Code	CPT 36224
Hospital Charge Code	36100385
Hospital Revenue Code	361
Min. Negotiated Rate	$2,825.83
Max. Negotiated Rate	$14,840.35
Rate for Payer: Aetna Commercial	$10,966.24
Rate for Payer: Aetna Medicare	$5,482.95
Rate for Payer: Aetna New Business (MI Preferred)	$8,385.95
Rate for Payer: Allen County Amish Medical Aid Commercial	$6,590.09
Rate for Payer: Amish Plain Church Group Commercial	$6,590.09
Rate for Payer: BCBS Complete	$2,967.12
Rate for Payer: BCBS MAPPO	$5,272.07
Rate for Payer: BCN Medicare Advantage	$5,272.07
Rate for Payer: Cash Price	$10,321.17
Rate for Payer: Cash Price	$10,321.17
Rate for Payer: Cofinity Commercial	$9,031.02
Rate for Payer: Cofinity Commercial	$11,095.26
Rate for Payer: Cofinity Medicare Advantage	$9,031.02
Rate for Payer: Encore Health Key Benefits Commercial	$10,321.17
Rate for Payer: Health Alliance Plan Medicare Advantage	$5,272.07
Rate for Payer: Healthscope Commercial	$11,611.31
Rate for Payer: Mclaren Medicaid	$2,825.83
Rate for Payer: Mclaren Medicare	$5,272.07
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$5,535.67
Rate for Payer: Meridian Medicaid	$2,967.12
Rate for Payer: MI Amish Medical Board Commercial	$6,062.88
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$10,966.24
Rate for Payer: PACE Medicare	$5,008.47
Rate for Payer: PACE SWMI	$5,272.07
Rate for Payer: PHP Commercial	$10,966.24
Rate for Payer: PHP Medicare Advantage	$5,272.07
Rate for Payer: Priority Health Choice Medicaid	$2,825.83
Rate for Payer: Priority Health Cigna Priority Health	$8,385.95
Rate for Payer: Priority Health Medicare	$5,272.07
Rate for Payer: Priority Health SBD	$8,127.92
Rate for Payer: Railroad Medicare Medicare	$5,272.07
Rate for Payer: UHC All Payor (Choice/PPO)	$14,840.35
Rate for Payer: UHC Dual Complete DSNP	$5,272.07
Rate for Payer: UHC Medicare Advantage	$5,272.07
Rate for Payer: UHCCP Medicaid	$2,968.18
Rate for Payer: VA VA	$5,272.07

HC SELECTIVE VERTEBRAL ARTERY UNI

Facility

$12,901.46

Service Code	CPT 36226
Hospital Charge Code	36100381
Hospital Revenue Code	361
Min. Negotiated Rate	$8,127.92
Max. Negotiated Rate	$11,611.31
Rate for Payer: Aetna Commercial	$10,966.24
Rate for Payer: Aetna New Business (MI Preferred)	$8,385.95
Rate for Payer: Cash Price	$10,321.17
Rate for Payer: Cofinity Commercial	$11,095.26
Rate for Payer: Cofinity Commercial	$9,031.02
Rate for Payer: Cofinity Medicare Advantage	$9,031.02
Rate for Payer: Encore Health Key Benefits Commercial	$10,321.17
Rate for Payer: Healthscope Commercial	$11,611.31
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$10,966.24
Rate for Payer: PHP Commercial	$10,966.24
Rate for Payer: Priority Health Cigna Priority Health	$8,385.95
Rate for Payer: Priority Health SBD	$8,127.92

HC SELECTIVE VERTEBRAL ARTERY UNI

Facility

$12,901.46

Service Code	CPT 36226
Hospital Charge Code	36100381
Hospital Revenue Code	361
Min. Negotiated Rate	$2,825.83
Max. Negotiated Rate	$14,840.35
Rate for Payer: Aetna Commercial	$10,966.24
Rate for Payer: Aetna Medicare	$5,482.95
Rate for Payer: Aetna New Business (MI Preferred)	$8,385.95
Rate for Payer: Allen County Amish Medical Aid Commercial	$6,590.09
Rate for Payer: Amish Plain Church Group Commercial	$6,590.09
Rate for Payer: BCBS Complete	$2,967.12
Rate for Payer: BCBS MAPPO	$5,272.07
Rate for Payer: BCN Medicare Advantage	$5,272.07
Rate for Payer: Cash Price	$10,321.17
Rate for Payer: Cash Price	$10,321.17
Rate for Payer: Cofinity Commercial	$9,031.02
Rate for Payer: Cofinity Commercial	$11,095.26
Rate for Payer: Cofinity Medicare Advantage	$9,031.02
Rate for Payer: Encore Health Key Benefits Commercial	$10,321.17
Rate for Payer: Health Alliance Plan Medicare Advantage	$5,272.07
Rate for Payer: Healthscope Commercial	$11,611.31
Rate for Payer: Mclaren Medicaid	$2,825.83
Rate for Payer: Mclaren Medicare	$5,272.07
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$5,535.67
Rate for Payer: Meridian Medicaid	$2,967.12
Rate for Payer: MI Amish Medical Board Commercial	$6,062.88
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$10,966.24
Rate for Payer: PACE Medicare	$5,008.47
Rate for Payer: PACE SWMI	$5,272.07
Rate for Payer: PHP Commercial	$10,966.24
Rate for Payer: PHP Medicare Advantage	$5,272.07
Rate for Payer: Priority Health Choice Medicaid	$2,825.83
Rate for Payer: Priority Health Cigna Priority Health	$8,385.95
Rate for Payer: Priority Health Medicare	$5,272.07
Rate for Payer: Priority Health SBD	$8,127.92
Rate for Payer: Railroad Medicare Medicare	$5,272.07
Rate for Payer: UHC All Payor (Choice/PPO)	$14,840.35
Rate for Payer: UHC Dual Complete DSNP	$5,272.07
Rate for Payer: UHC Medicare Advantage	$5,272.07
Rate for Payer: UHCCP Medicaid	$2,968.18
Rate for Payer: VA VA	$5,272.07

HC SELECT SPECIALTY CATHETER INSERTION

Facility

$1,686.32

Hospital Charge Code	36100565
Hospital Revenue Code	361
Min. Negotiated Rate	$1,062.38
Max. Negotiated Rate	$1,517.69
Rate for Payer: Aetna Commercial	$1,433.37
Rate for Payer: Aetna New Business (MI Preferred)	$1,096.11
Rate for Payer: Cash Price	$1,349.06
Rate for Payer: Cofinity Commercial	$1,180.42
Rate for Payer: Cofinity Commercial	$1,450.24
Rate for Payer: Cofinity Medicare Advantage	$1,180.42
Rate for Payer: Encore Health Key Benefits Commercial	$1,349.06
Rate for Payer: Healthscope Commercial	$1,517.69
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,433.37
Rate for Payer: PHP Commercial	$1,433.37
Rate for Payer: Priority Health Cigna Priority Health	$1,096.11
Rate for Payer: Priority Health SBD	$1,062.38

HC SELECT SPECIALTY CATHETER INSERTION

Facility

$1,686.32

Hospital Charge Code	36100565
Hospital Revenue Code	361
Min. Negotiated Rate	$674.53
Max. Negotiated Rate	$1,517.69
Rate for Payer: Aetna Commercial	$1,433.37
Rate for Payer: Aetna Medicare	$843.16
Rate for Payer: Aetna New Business (MI Preferred)	$1,096.11
Rate for Payer: BCBS Complete	$674.53
Rate for Payer: Cash Price	$1,349.06
Rate for Payer: Cofinity Commercial	$1,180.42
Rate for Payer: Cofinity Commercial	$1,450.24
Rate for Payer: Cofinity Medicare Advantage	$1,180.42
Rate for Payer: Encore Health Key Benefits Commercial	$1,349.06
Rate for Payer: Healthscope Commercial	$1,517.69
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,433.37
Rate for Payer: PHP Commercial	$1,433.37
Rate for Payer: Priority Health Cigna Priority Health	$1,096.11
Rate for Payer: Priority Health SBD	$1,062.38

HC SELENIUM LEVEL

Facility

$52.02

Service Code	CPT 84255
Hospital Charge Code	30100420
Hospital Revenue Code	301
Min. Negotiated Rate	$32.77
Max. Negotiated Rate	$46.82
Rate for Payer: Aetna Commercial	$44.22
Rate for Payer: Aetna New Business (MI Preferred)	$33.81
Rate for Payer: Cash Price	$41.62
Rate for Payer: Cofinity Commercial	$36.41
Rate for Payer: Cofinity Commercial	$44.74
Rate for Payer: Cofinity Medicare Advantage	$36.41
Rate for Payer: Encore Health Key Benefits Commercial	$41.62
Rate for Payer: Healthscope Commercial	$46.82
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$44.22
Rate for Payer: PHP Commercial	$44.22
Rate for Payer: Priority Health Cigna Priority Health	$33.81
Rate for Payer: Priority Health SBD	$32.77

HC SELENIUM LEVEL

Facility

$52.02

Service Code	CPT 84255
Hospital Charge Code	30100420
Hospital Revenue Code	301
Min. Negotiated Rate	$13.68
Max. Negotiated Rate	$71.86
Rate for Payer: Aetna Commercial	$44.22
Rate for Payer: Aetna Medicare	$26.55
Rate for Payer: Aetna New Business (MI Preferred)	$33.81
Rate for Payer: Allen County Amish Medical Aid Commercial	$31.91
Rate for Payer: Amish Plain Church Group Commercial	$31.91
Rate for Payer: BCBS Complete	$14.37
Rate for Payer: BCBS MAPPO	$25.53
Rate for Payer: BCN Medicare Advantage	$25.53
Rate for Payer: Cash Price	$41.62
Rate for Payer: Cash Price	$41.62
Rate for Payer: Cofinity Commercial	$44.74
Rate for Payer: Cofinity Commercial	$36.41
Rate for Payer: Cofinity Medicare Advantage	$36.41
Rate for Payer: Encore Health Key Benefits Commercial	$41.62
Rate for Payer: Health Alliance Plan Medicare Advantage	$25.53
Rate for Payer: Healthscope Commercial	$46.82
Rate for Payer: Mclaren Medicaid	$13.68
Rate for Payer: Mclaren Medicare	$25.53
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$26.81
Rate for Payer: Meridian Medicaid	$14.37
Rate for Payer: MI Amish Medical Board Commercial	$29.36
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$44.22
Rate for Payer: PACE Medicare	$24.25
Rate for Payer: PACE SWMI	$25.53
Rate for Payer: PHP Commercial	$44.22
Rate for Payer: PHP Medicare Advantage	$25.53
Rate for Payer: Priority Health Choice Medicaid	$13.68
Rate for Payer: Priority Health Cigna Priority Health	$33.81
Rate for Payer: Priority Health Medicare	$25.53
Rate for Payer: Priority Health SBD	$32.77
Rate for Payer: Railroad Medicare Medicare	$25.53
Rate for Payer: UHC All Payor (Choice/PPO)	$71.86
Rate for Payer: UHC Dual Complete DSNP	$25.53
Rate for Payer: UHC Medicare Advantage	$25.53
Rate for Payer: UHCCP Medicaid	$14.37
Rate for Payer: VA VA	$25.53

HC SELF-ADMINISTRABLE DRUG

Facility

$0.52

Hospital Charge Code	63700003
Hospital Revenue Code	637
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$0.47
Rate for Payer: Aetna Commercial	$0.44
Rate for Payer: Aetna New Business (MI Preferred)	$0.34
Rate for Payer: Cash Price	$0.42
Rate for Payer: Cofinity Commercial	$0.36
Rate for Payer: Cofinity Commercial	$0.45
Rate for Payer: Cofinity Medicare Advantage	$0.36
Rate for Payer: Encore Health Key Benefits Commercial	$0.42
Rate for Payer: Healthscope Commercial	$0.47
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$0.44
Rate for Payer: PHP Commercial	$0.44
Rate for Payer: Priority Health Cigna Priority Health	$0.34
Rate for Payer: Priority Health SBD	$0.33

HC SELF-ADMINISTRABLE DRUG

Facility

$0.52

Hospital Charge Code	63700003
Hospital Revenue Code	637
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$0.47
Rate for Payer: Aetna Commercial	$0.44
Rate for Payer: Aetna Medicare	$0.26
Rate for Payer: Aetna New Business (MI Preferred)	$0.34
Rate for Payer: BCBS Complete	$0.21
Rate for Payer: Cash Price	$0.42
Rate for Payer: Cofinity Commercial	$0.36
Rate for Payer: Cofinity Commercial	$0.45
Rate for Payer: Cofinity Medicare Advantage	$0.36
Rate for Payer: Encore Health Key Benefits Commercial	$0.42
Rate for Payer: Healthscope Commercial	$0.47
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$0.44
Rate for Payer: PHP Commercial	$0.44
Rate for Payer: Priority Health Cigna Priority Health	$0.34
Rate for Payer: Priority Health SBD	$0.33

HC SELF-MGMT EDUC & TRAIN 1 PT PER 30 MIN

Facility

$47.94

Service Code	CPT 98960
Hospital Charge Code	94200039
Hospital Revenue Code	942
Min. Negotiated Rate	$19.18
Max. Negotiated Rate	$43.15
Rate for Payer: Aetna Commercial	$40.75
Rate for Payer: Aetna Medicare	$23.97
Rate for Payer: Aetna New Business (MI Preferred)	$31.16
Rate for Payer: BCBS Complete	$19.18
Rate for Payer: Cash Price	$38.35
Rate for Payer: Cofinity Commercial	$33.56
Rate for Payer: Cofinity Commercial	$41.23
Rate for Payer: Cofinity Medicare Advantage	$33.56
Rate for Payer: Encore Health Key Benefits Commercial	$38.35
Rate for Payer: Healthscope Commercial	$43.15
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$40.75
Rate for Payer: PHP Commercial	$40.75
Rate for Payer: Priority Health Cigna Priority Health	$31.16
Rate for Payer: Priority Health SBD	$30.20
Rate for Payer: UHC Core	$35.48
Rate for Payer: UHC Exchange	$35.48

HC SELF-MGMT EDUC & TRAIN 1 PT PER 30 MIN

Facility

$47.94

Service Code	CPT 98960
Hospital Charge Code	94200039
Hospital Revenue Code	942
Min. Negotiated Rate	$30.20
Max. Negotiated Rate	$43.15
Rate for Payer: Aetna Commercial	$40.75
Rate for Payer: Aetna New Business (MI Preferred)	$31.16
Rate for Payer: Cash Price	$38.35
Rate for Payer: Cofinity Commercial	$33.56
Rate for Payer: Cofinity Commercial	$41.23
Rate for Payer: Cofinity Medicare Advantage	$33.56
Rate for Payer: Encore Health Key Benefits Commercial	$38.35
Rate for Payer: Healthscope Commercial	$43.15
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$40.75
Rate for Payer: PHP Commercial	$40.75
Rate for Payer: Priority Health Cigna Priority Health	$31.16
Rate for Payer: Priority Health SBD	$30.20

HC SEMEN EXAM FERTILITY

Facility

$115.26

Service Code	CPT 89320
Hospital Charge Code	30000006
Hospital Revenue Code	300
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$103.73
Rate for Payer: Aetna Commercial	$97.97
Rate for Payer: Aetna Medicare	$12.80
Rate for Payer: Aetna New Business (MI Preferred)	$74.92
Rate for Payer: Allen County Amish Medical Aid Commercial	$15.39
Rate for Payer: Amish Plain Church Group Commercial	$15.39
Rate for Payer: BCBS Complete	$6.93
Rate for Payer: BCBS MAPPO	$12.31
Rate for Payer: BCN Medicare Advantage	$12.31
Rate for Payer: Cash Price	$92.21
Rate for Payer: Cash Price	$92.21
Rate for Payer: Cofinity Commercial	$99.12
Rate for Payer: Cofinity Commercial	$80.68
Rate for Payer: Cofinity Medicare Advantage	$80.68
Rate for Payer: Encore Health Key Benefits Commercial	$92.21
Rate for Payer: Health Alliance Plan Medicare Advantage	$12.31
Rate for Payer: Healthscope Commercial	$103.73
Rate for Payer: Mclaren Medicaid	$6.60
Rate for Payer: Mclaren Medicare	$12.31
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$12.93
Rate for Payer: Meridian Medicaid	$6.93
Rate for Payer: MI Amish Medical Board Commercial	$14.16
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$97.97
Rate for Payer: PACE Medicare	$11.69
Rate for Payer: PACE SWMI	$12.31
Rate for Payer: PHP Commercial	$97.97
Rate for Payer: PHP Medicare Advantage	$12.31
Rate for Payer: Priority Health Choice Medicaid	$6.60
Rate for Payer: Priority Health Cigna Priority Health	$74.92
Rate for Payer: Priority Health Medicare	$12.31
Rate for Payer: Priority Health SBD	$72.61
Rate for Payer: Railroad Medicare Medicare	$12.31
Rate for Payer: UHC All Payor (Choice/PPO)	$34.65
Rate for Payer: UHC Dual Complete DSNP	$12.31
Rate for Payer: UHC Medicare Advantage	$12.31
Rate for Payer: UHCCP Medicaid	$6.93
Rate for Payer: VA VA	$12.31

HC SEMEN EXAM FERTILITY

Facility

$115.26

Service Code	CPT 89320
Hospital Charge Code	30000006
Hospital Revenue Code	300
Min. Negotiated Rate	$72.61
Max. Negotiated Rate	$103.73
Rate for Payer: Aetna Commercial	$97.97
Rate for Payer: Aetna New Business (MI Preferred)	$74.92
Rate for Payer: Cash Price	$92.21
Rate for Payer: Cofinity Commercial	$80.68
Rate for Payer: Cofinity Commercial	$99.12
Rate for Payer: Cofinity Medicare Advantage	$80.68
Rate for Payer: Encore Health Key Benefits Commercial	$92.21
Rate for Payer: Healthscope Commercial	$103.73
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$97.97
Rate for Payer: PHP Commercial	$97.97
Rate for Payer: Priority Health Cigna Priority Health	$74.92
Rate for Payer: Priority Health SBD	$72.61

HC SEMEN EXAM VASECTOMY

Facility

$76.91

Service Code	CPT 89321
Hospital Charge Code	30000007
Hospital Revenue Code	300
Min. Negotiated Rate	$48.45
Max. Negotiated Rate	$69.22
Rate for Payer: Aetna Commercial	$65.37
Rate for Payer: Aetna New Business (MI Preferred)	$49.99
Rate for Payer: Cash Price	$61.53
Rate for Payer: Cofinity Commercial	$53.84
Rate for Payer: Cofinity Commercial	$66.14
Rate for Payer: Cofinity Medicare Advantage	$53.84
Rate for Payer: Encore Health Key Benefits Commercial	$61.53
Rate for Payer: Healthscope Commercial	$69.22
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$65.37
Rate for Payer: PHP Commercial	$65.37
Rate for Payer: Priority Health Cigna Priority Health	$49.99
Rate for Payer: Priority Health SBD	$48.45

HC SEMEN EXAM VASECTOMY

Facility

$76.91

Service Code	CPT 89321
Hospital Charge Code	30000007
Hospital Revenue Code	300
Min. Negotiated Rate	$6.46
Max. Negotiated Rate	$69.22
Rate for Payer: Aetna Commercial	$65.37
Rate for Payer: Aetna Medicare	$12.53
Rate for Payer: Aetna New Business (MI Preferred)	$49.99
Rate for Payer: Allen County Amish Medical Aid Commercial	$15.06
Rate for Payer: Amish Plain Church Group Commercial	$15.06
Rate for Payer: BCBS Complete	$6.78
Rate for Payer: BCBS MAPPO	$12.05
Rate for Payer: BCN Medicare Advantage	$12.05
Rate for Payer: Cash Price	$61.53
Rate for Payer: Cash Price	$61.53
Rate for Payer: Cofinity Commercial	$66.14
Rate for Payer: Cofinity Commercial	$53.84
Rate for Payer: Cofinity Medicare Advantage	$53.84
Rate for Payer: Encore Health Key Benefits Commercial	$61.53
Rate for Payer: Health Alliance Plan Medicare Advantage	$12.05
Rate for Payer: Healthscope Commercial	$69.22
Rate for Payer: Mclaren Medicaid	$6.46
Rate for Payer: Mclaren Medicare	$12.05
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$12.65
Rate for Payer: Meridian Medicaid	$6.78
Rate for Payer: MI Amish Medical Board Commercial	$13.86
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$65.37
Rate for Payer: PACE Medicare	$11.45
Rate for Payer: PACE SWMI	$12.05
Rate for Payer: PHP Commercial	$65.37
Rate for Payer: PHP Medicare Advantage	$12.05
Rate for Payer: Priority Health Choice Medicaid	$6.46
Rate for Payer: Priority Health Cigna Priority Health	$49.99
Rate for Payer: Priority Health Medicare	$12.05
Rate for Payer: Priority Health SBD	$48.45
Rate for Payer: Railroad Medicare Medicare	$12.05
Rate for Payer: UHC All Payor (Choice/PPO)	$33.92
Rate for Payer: UHC Dual Complete DSNP	$12.05
Rate for Payer: UHC Medicare Advantage	$12.05
Rate for Payer: UHCCP Medicaid	$6.78
Rate for Payer: VA VA	$12.05

HC SENSOR CDI 550 ART SHUNT

Facility

$382.50

Hospital Charge Code	27000655
Hospital Revenue Code	270
Min. Negotiated Rate	$153.00
Max. Negotiated Rate	$344.25
Rate for Payer: Aetna Commercial	$325.12
Rate for Payer: Aetna Medicare	$191.25
Rate for Payer: Aetna New Business (MI Preferred)	$248.62
Rate for Payer: BCBS Complete	$153.00
Rate for Payer: Cash Price	$306.00
Rate for Payer: Cofinity Commercial	$267.75
Rate for Payer: Cofinity Commercial	$328.95
Rate for Payer: Cofinity Medicare Advantage	$267.75
Rate for Payer: Encore Health Key Benefits Commercial	$306.00
Rate for Payer: Healthscope Commercial	$344.25
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$325.12
Rate for Payer: PHP Commercial	$325.12
Rate for Payer: Priority Health Cigna Priority Health	$248.62
Rate for Payer: Priority Health SBD	$240.97

Know your out-of-pocket cost for care.

All Charges