Bronson South Haven Hospital

All Charges

Charge

Type

Setting

Price

HC NEG PRES VF DRSG MED

Facility

$436.37

Hospital Charge Code	27200228
Hospital Revenue Code	272
Min. Negotiated Rate	$305.46
Max. Negotiated Rate	$436.37
Rate for Payer: Aetna Commercial	$392.73
Rate for Payer: ASR ASR	$423.28
Rate for Payer: BCBS Trust/PPO	$338.32
Rate for Payer: BCN Commercial	$338.32
Rate for Payer: Cash Price	$349.10
Rate for Payer: Cofinity Commercial	$410.19
Rate for Payer: Encore Health Key Benefits Commercial	$349.10
Rate for Payer: Healthscope Commercial	$436.37
Rate for Payer: Healthscope Whirlpool	$423.28
Rate for Payer: Mclaren Commercial	$392.73
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$370.91
Rate for Payer: Priority Health Cigna Priority Health	$305.46
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$384.01

HC NEG PRES VF DRSG MED

Facility

$436.37

Hospital Charge Code	27200228
Hospital Revenue Code	272
Min. Negotiated Rate	$174.55
Max. Negotiated Rate	$436.37
Rate for Payer: Aetna Commercial	$392.73
Rate for Payer: ASR ASR	$423.28
Rate for Payer: BCBS Complete	$174.55
Rate for Payer: BCBS Trust/PPO	$338.32
Rate for Payer: BCN Commercial	$338.32
Rate for Payer: Cash Price	$349.10
Rate for Payer: Cofinity Commercial	$410.19
Rate for Payer: Encore Health Key Benefits Commercial	$349.10
Rate for Payer: Healthscope Commercial	$436.37
Rate for Payer: Healthscope Whirlpool	$423.28
Rate for Payer: Mclaren Commercial	$392.73
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$370.91
Rate for Payer: Priority Health Cigna Priority Health	$305.46
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$397.10
Rate for Payer: Priority Health Narrow Network	$309.82
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$384.01

HC NEG PRES VF DRSG SMA

Facility

$371.86

Hospital Charge Code	27200227
Hospital Revenue Code	272
Min. Negotiated Rate	$148.74
Max. Negotiated Rate	$371.86
Rate for Payer: Aetna Commercial	$334.67
Rate for Payer: ASR ASR	$360.70
Rate for Payer: BCBS Complete	$148.74
Rate for Payer: BCBS Trust/PPO	$288.30
Rate for Payer: BCN Commercial	$288.30
Rate for Payer: Cash Price	$297.49
Rate for Payer: Cofinity Commercial	$349.55
Rate for Payer: Encore Health Key Benefits Commercial	$297.49
Rate for Payer: Healthscope Commercial	$371.86
Rate for Payer: Healthscope Whirlpool	$360.70
Rate for Payer: Mclaren Commercial	$334.67
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$316.08
Rate for Payer: Priority Health Cigna Priority Health	$260.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$338.39
Rate for Payer: Priority Health Narrow Network	$264.02
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$327.24

HC NEG PRES VF DRSG SMA

Facility

$371.86

Hospital Charge Code	27200227
Hospital Revenue Code	272
Min. Negotiated Rate	$260.30
Max. Negotiated Rate	$371.86
Rate for Payer: Aetna Commercial	$334.67
Rate for Payer: ASR ASR	$360.70
Rate for Payer: BCBS Trust/PPO	$288.30
Rate for Payer: BCN Commercial	$288.30
Rate for Payer: Cash Price	$297.49
Rate for Payer: Cofinity Commercial	$349.55
Rate for Payer: Encore Health Key Benefits Commercial	$297.49
Rate for Payer: Healthscope Commercial	$371.86
Rate for Payer: Healthscope Whirlpool	$360.70
Rate for Payer: Mclaren Commercial	$334.67
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$316.08
Rate for Payer: Priority Health Cigna Priority Health	$260.30
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$327.24

HC NEG PRES VF DUO TRAC PAD

Facility

$284.59

Hospital Charge Code	27200231
Hospital Revenue Code	272
Min. Negotiated Rate	$113.84
Max. Negotiated Rate	$284.59
Rate for Payer: Aetna Commercial	$256.13
Rate for Payer: ASR ASR	$276.05
Rate for Payer: BCBS Complete	$113.84
Rate for Payer: BCBS Trust/PPO	$220.64
Rate for Payer: BCN Commercial	$220.64
Rate for Payer: Cash Price	$227.67
Rate for Payer: Cofinity Commercial	$267.51
Rate for Payer: Encore Health Key Benefits Commercial	$227.67
Rate for Payer: Healthscope Commercial	$284.59
Rate for Payer: Healthscope Whirlpool	$276.05
Rate for Payer: Mclaren Commercial	$256.13
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$241.90
Rate for Payer: Priority Health Cigna Priority Health	$199.21
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$258.98
Rate for Payer: Priority Health Narrow Network	$202.06
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$250.44

HC NEG PRES VF DUO TRAC PAD

Facility

$284.59

Hospital Charge Code	27200231
Hospital Revenue Code	272
Min. Negotiated Rate	$199.21
Max. Negotiated Rate	$284.59
Rate for Payer: Aetna Commercial	$256.13
Rate for Payer: ASR ASR	$276.05
Rate for Payer: BCBS Trust/PPO	$220.64
Rate for Payer: BCN Commercial	$220.64
Rate for Payer: Cash Price	$227.67
Rate for Payer: Cofinity Commercial	$267.51
Rate for Payer: Encore Health Key Benefits Commercial	$227.67
Rate for Payer: Healthscope Commercial	$284.59
Rate for Payer: Healthscope Whirlpool	$276.05
Rate for Payer: Mclaren Commercial	$256.13
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$241.90
Rate for Payer: Priority Health Cigna Priority Health	$199.21
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$250.44

HC NEG PRES WHT FOAM DRSG

Facility

$176.57

Hospital Charge Code	27200158
Hospital Revenue Code	272
Min. Negotiated Rate	$123.60
Max. Negotiated Rate	$176.57
Rate for Payer: Aetna Commercial	$158.91
Rate for Payer: ASR ASR	$171.27
Rate for Payer: BCBS Trust/PPO	$136.89
Rate for Payer: BCN Commercial	$136.89
Rate for Payer: Cash Price	$141.26
Rate for Payer: Cofinity Commercial	$165.98
Rate for Payer: Encore Health Key Benefits Commercial	$141.26
Rate for Payer: Healthscope Commercial	$176.57
Rate for Payer: Healthscope Whirlpool	$171.27
Rate for Payer: Mclaren Commercial	$158.91
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$150.08
Rate for Payer: Priority Health Cigna Priority Health	$123.60
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$155.38

HC NEG PRES WHT FOAM DRSG

Facility

$176.57

Hospital Charge Code	27200158
Hospital Revenue Code	272
Min. Negotiated Rate	$70.63
Max. Negotiated Rate	$176.57
Rate for Payer: Aetna Commercial	$158.91
Rate for Payer: ASR ASR	$171.27
Rate for Payer: BCBS Complete	$70.63
Rate for Payer: BCBS Trust/PPO	$136.89
Rate for Payer: BCN Commercial	$136.89
Rate for Payer: Cash Price	$141.26
Rate for Payer: Cofinity Commercial	$165.98
Rate for Payer: Encore Health Key Benefits Commercial	$141.26
Rate for Payer: Healthscope Commercial	$176.57
Rate for Payer: Healthscope Whirlpool	$171.27
Rate for Payer: Mclaren Commercial	$158.91
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$150.08
Rate for Payer: Priority Health Cigna Priority Health	$123.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$160.68
Rate for Payer: Priority Health Narrow Network	$125.36
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$155.38

HC NEG PRES WND THRPY DSG EXLGE

Facility

$373.77

Hospital Charge Code	27200137
Hospital Revenue Code	272
Min. Negotiated Rate	$261.64
Max. Negotiated Rate	$373.77
Rate for Payer: Aetna Commercial	$336.39
Rate for Payer: ASR ASR	$362.56
Rate for Payer: BCBS Trust/PPO	$289.78
Rate for Payer: BCN Commercial	$289.78
Rate for Payer: Cash Price	$299.02
Rate for Payer: Cofinity Commercial	$351.34
Rate for Payer: Encore Health Key Benefits Commercial	$299.02
Rate for Payer: Healthscope Commercial	$373.77
Rate for Payer: Healthscope Whirlpool	$362.56
Rate for Payer: Mclaren Commercial	$336.39
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$317.70
Rate for Payer: Priority Health Cigna Priority Health	$261.64
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$328.92

HC NEG PRES WND THRPY DSG EXLGE

Facility

$373.77

Hospital Charge Code	27200137
Hospital Revenue Code	272
Min. Negotiated Rate	$149.51
Max. Negotiated Rate	$373.77
Rate for Payer: Aetna Commercial	$336.39
Rate for Payer: ASR ASR	$362.56
Rate for Payer: BCBS Complete	$149.51
Rate for Payer: BCBS Trust/PPO	$289.78
Rate for Payer: BCN Commercial	$289.78
Rate for Payer: Cash Price	$299.02
Rate for Payer: Cofinity Commercial	$351.34
Rate for Payer: Encore Health Key Benefits Commercial	$299.02
Rate for Payer: Healthscope Commercial	$373.77
Rate for Payer: Healthscope Whirlpool	$362.56
Rate for Payer: Mclaren Commercial	$336.39
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$317.70
Rate for Payer: Priority Health Cigna Priority Health	$261.64
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$340.13
Rate for Payer: Priority Health Narrow Network	$265.38
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$328.92

HC NEG PRES WND THRPY DSG SET LAR

Facility

$198.58

Hospital Charge Code	27200138
Hospital Revenue Code	272
Min. Negotiated Rate	$139.01
Max. Negotiated Rate	$198.58
Rate for Payer: Aetna Commercial	$178.72
Rate for Payer: ASR ASR	$192.62
Rate for Payer: BCBS Trust/PPO	$153.96
Rate for Payer: BCN Commercial	$153.96
Rate for Payer: Cash Price	$158.86
Rate for Payer: Cofinity Commercial	$186.67
Rate for Payer: Encore Health Key Benefits Commercial	$158.86
Rate for Payer: Healthscope Commercial	$198.58
Rate for Payer: Healthscope Whirlpool	$192.62
Rate for Payer: Mclaren Commercial	$178.72
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$168.79
Rate for Payer: Priority Health Cigna Priority Health	$139.01
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$174.75

HC NEG PRES WND THRPY DSG SET LAR

Facility

$198.58

Hospital Charge Code	27200138
Hospital Revenue Code	272
Min. Negotiated Rate	$79.43
Max. Negotiated Rate	$198.58
Rate for Payer: Aetna Commercial	$178.72
Rate for Payer: ASR ASR	$192.62
Rate for Payer: BCBS Complete	$79.43
Rate for Payer: BCBS Trust/PPO	$153.96
Rate for Payer: BCN Commercial	$153.96
Rate for Payer: Cash Price	$158.86
Rate for Payer: Cofinity Commercial	$186.67
Rate for Payer: Encore Health Key Benefits Commercial	$158.86
Rate for Payer: Healthscope Commercial	$198.58
Rate for Payer: Healthscope Whirlpool	$192.62
Rate for Payer: Mclaren Commercial	$178.72
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$168.79
Rate for Payer: Priority Health Cigna Priority Health	$139.01
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$180.71
Rate for Payer: Priority Health Narrow Network	$140.99
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$174.75

HC NEG PRES WND THRPY DSG SET MED

Facility

$143.06

Hospital Charge Code	27200139
Hospital Revenue Code	272
Min. Negotiated Rate	$57.22
Max. Negotiated Rate	$143.06
Rate for Payer: Aetna Commercial	$128.75
Rate for Payer: ASR ASR	$138.77
Rate for Payer: BCBS Complete	$57.22
Rate for Payer: BCBS Trust/PPO	$110.91
Rate for Payer: BCN Commercial	$110.91
Rate for Payer: Cash Price	$114.45
Rate for Payer: Cofinity Commercial	$134.48
Rate for Payer: Encore Health Key Benefits Commercial	$114.45
Rate for Payer: Healthscope Commercial	$143.06
Rate for Payer: Healthscope Whirlpool	$138.77
Rate for Payer: Mclaren Commercial	$128.75
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$121.60
Rate for Payer: Priority Health Cigna Priority Health	$100.14
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$130.18
Rate for Payer: Priority Health Narrow Network	$101.57
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$125.89

HC NEG PRES WND THRPY DSG SET MED

Facility

$143.06

Hospital Charge Code	27200139
Hospital Revenue Code	272
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$143.06
Rate for Payer: Aetna Commercial	$128.75
Rate for Payer: ASR ASR	$138.77
Rate for Payer: BCBS Trust/PPO	$110.91
Rate for Payer: BCN Commercial	$110.91
Rate for Payer: Cash Price	$114.45
Rate for Payer: Cofinity Commercial	$134.48
Rate for Payer: Encore Health Key Benefits Commercial	$114.45
Rate for Payer: Healthscope Commercial	$143.06
Rate for Payer: Healthscope Whirlpool	$138.77
Rate for Payer: Mclaren Commercial	$128.75
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$121.60
Rate for Payer: Priority Health Cigna Priority Health	$100.14
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$125.89

HC NEG PRES WND THRPY DSG SET SIL

Facility

$267.14

Hospital Charge Code	27200140
Hospital Revenue Code	272
Min. Negotiated Rate	$106.86
Max. Negotiated Rate	$267.14
Rate for Payer: Aetna Commercial	$240.43
Rate for Payer: ASR ASR	$259.13
Rate for Payer: BCBS Complete	$106.86
Rate for Payer: BCBS Trust/PPO	$207.11
Rate for Payer: BCN Commercial	$207.11
Rate for Payer: Cash Price	$213.71
Rate for Payer: Cofinity Commercial	$251.11
Rate for Payer: Encore Health Key Benefits Commercial	$213.71
Rate for Payer: Healthscope Commercial	$267.14
Rate for Payer: Healthscope Whirlpool	$259.13
Rate for Payer: Mclaren Commercial	$240.43
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$227.07
Rate for Payer: Priority Health Cigna Priority Health	$187.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$243.10
Rate for Payer: Priority Health Narrow Network	$189.67
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$235.08

HC NEG PRES WND THRPY DSG SET SIL

Facility

$267.14

Hospital Charge Code	27200140
Hospital Revenue Code	272
Min. Negotiated Rate	$187.00
Max. Negotiated Rate	$267.14
Rate for Payer: Aetna Commercial	$240.43
Rate for Payer: ASR ASR	$259.13
Rate for Payer: BCBS Trust/PPO	$207.11
Rate for Payer: BCN Commercial	$207.11
Rate for Payer: Cash Price	$213.71
Rate for Payer: Cofinity Commercial	$251.11
Rate for Payer: Encore Health Key Benefits Commercial	$213.71
Rate for Payer: Healthscope Commercial	$267.14
Rate for Payer: Healthscope Whirlpool	$259.13
Rate for Payer: Mclaren Commercial	$240.43
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$227.07
Rate for Payer: Priority Health Cigna Priority Health	$187.00
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$235.08

HC NEG PRES WND THRPY DSG SET SMA

Facility

$113.72

Hospital Charge Code	27200141
Hospital Revenue Code	272
Min. Negotiated Rate	$79.60
Max. Negotiated Rate	$113.72
Rate for Payer: Aetna Commercial	$102.35
Rate for Payer: ASR ASR	$110.31
Rate for Payer: BCBS Trust/PPO	$88.17
Rate for Payer: BCN Commercial	$88.17
Rate for Payer: Cash Price	$90.98
Rate for Payer: Cofinity Commercial	$106.90
Rate for Payer: Encore Health Key Benefits Commercial	$90.98
Rate for Payer: Healthscope Commercial	$113.72
Rate for Payer: Healthscope Whirlpool	$110.31
Rate for Payer: Mclaren Commercial	$102.35
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$96.66
Rate for Payer: Priority Health Cigna Priority Health	$79.60
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$100.07

HC NEG PRES WND THRPY DSG SET SMA

Facility

$113.72

Hospital Charge Code	27200141
Hospital Revenue Code	272
Min. Negotiated Rate	$45.49
Max. Negotiated Rate	$113.72
Rate for Payer: Aetna Commercial	$102.35
Rate for Payer: ASR ASR	$110.31
Rate for Payer: BCBS Complete	$45.49
Rate for Payer: BCBS Trust/PPO	$88.17
Rate for Payer: BCN Commercial	$88.17
Rate for Payer: Cash Price	$90.98
Rate for Payer: Cofinity Commercial	$106.90
Rate for Payer: Encore Health Key Benefits Commercial	$90.98
Rate for Payer: Healthscope Commercial	$113.72
Rate for Payer: Healthscope Whirlpool	$110.31
Rate for Payer: Mclaren Commercial	$102.35
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$96.66
Rate for Payer: Priority Health Cigna Priority Health	$79.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$103.49
Rate for Payer: Priority Health Narrow Network	$80.74
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$100.07

HC NEG PRES WOUND TX SET MED

Facility

$78.42

Hospital Charge Code	27200127
Hospital Revenue Code	272
Min. Negotiated Rate	$31.37
Max. Negotiated Rate	$78.42
Rate for Payer: Aetna Commercial	$70.58
Rate for Payer: ASR ASR	$76.07
Rate for Payer: BCBS Complete	$31.37
Rate for Payer: BCBS Trust/PPO	$60.80
Rate for Payer: BCN Commercial	$60.80
Rate for Payer: Cash Price	$62.74
Rate for Payer: Cofinity Commercial	$73.71
Rate for Payer: Encore Health Key Benefits Commercial	$62.74
Rate for Payer: Healthscope Commercial	$78.42
Rate for Payer: Healthscope Whirlpool	$76.07
Rate for Payer: Mclaren Commercial	$70.58
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$66.66
Rate for Payer: Priority Health Cigna Priority Health	$54.89
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$71.36
Rate for Payer: Priority Health Narrow Network	$55.68
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$69.01

HC NEG PRES WOUND TX SET MED

Facility

$78.42

Hospital Charge Code	27200127
Hospital Revenue Code	272
Min. Negotiated Rate	$54.89
Max. Negotiated Rate	$78.42
Rate for Payer: Aetna Commercial	$70.58
Rate for Payer: ASR ASR	$76.07
Rate for Payer: BCBS Trust/PPO	$60.80
Rate for Payer: BCN Commercial	$60.80
Rate for Payer: Cash Price	$62.74
Rate for Payer: Cofinity Commercial	$73.71
Rate for Payer: Encore Health Key Benefits Commercial	$62.74
Rate for Payer: Healthscope Commercial	$78.42
Rate for Payer: Healthscope Whirlpool	$76.07
Rate for Payer: Mclaren Commercial	$70.58
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$66.66
Rate for Payer: Priority Health Cigna Priority Health	$54.89
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$69.01

HC NEG PRES WOUND TX SET SMALL

Facility

$113.72

Hospital Charge Code	27200128
Hospital Revenue Code	272
Min. Negotiated Rate	$45.49
Max. Negotiated Rate	$113.72
Rate for Payer: Aetna Commercial	$102.35
Rate for Payer: ASR ASR	$110.31
Rate for Payer: BCBS Complete	$45.49
Rate for Payer: BCBS Trust/PPO	$88.17
Rate for Payer: BCN Commercial	$88.17
Rate for Payer: Cash Price	$90.98
Rate for Payer: Cofinity Commercial	$106.90
Rate for Payer: Encore Health Key Benefits Commercial	$90.98
Rate for Payer: Healthscope Commercial	$113.72
Rate for Payer: Healthscope Whirlpool	$110.31
Rate for Payer: Mclaren Commercial	$102.35
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$96.66
Rate for Payer: Priority Health Cigna Priority Health	$79.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$103.49
Rate for Payer: Priority Health Narrow Network	$80.74
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$100.07

HC NEG PRES WOUND TX SET SMALL

Facility

$113.72

Hospital Charge Code	27200128
Hospital Revenue Code	272
Min. Negotiated Rate	$79.60
Max. Negotiated Rate	$113.72
Rate for Payer: Aetna Commercial	$102.35
Rate for Payer: ASR ASR	$110.31
Rate for Payer: BCBS Trust/PPO	$88.17
Rate for Payer: BCN Commercial	$88.17
Rate for Payer: Cash Price	$90.98
Rate for Payer: Cofinity Commercial	$106.90
Rate for Payer: Encore Health Key Benefits Commercial	$90.98
Rate for Payer: Healthscope Commercial	$113.72
Rate for Payer: Healthscope Whirlpool	$110.31
Rate for Payer: Mclaren Commercial	$102.35
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$96.66
Rate for Payer: Priority Health Cigna Priority Health	$79.60
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$100.07

HC NEG PRES Y CONNECTOR

Facility

$7.71

Hospital Charge Code	27000174
Hospital Revenue Code	270
Min. Negotiated Rate	$5.40
Max. Negotiated Rate	$7.71
Rate for Payer: Aetna Commercial	$6.94
Rate for Payer: ASR ASR	$7.48
Rate for Payer: BCBS Trust/PPO	$5.98
Rate for Payer: BCN Commercial	$5.98
Rate for Payer: Cash Price	$6.17
Rate for Payer: Cofinity Commercial	$7.25
Rate for Payer: Encore Health Key Benefits Commercial	$6.17
Rate for Payer: Healthscope Commercial	$7.71
Rate for Payer: Healthscope Whirlpool	$7.48
Rate for Payer: Mclaren Commercial	$6.94
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$6.55
Rate for Payer: Priority Health Cigna Priority Health	$5.40
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$6.78

HC NEG PRES Y CONNECTOR

Facility

$7.71

Hospital Charge Code	27000174
Hospital Revenue Code	270
Min. Negotiated Rate	$3.08
Max. Negotiated Rate	$7.71
Rate for Payer: Aetna Commercial	$6.94
Rate for Payer: ASR ASR	$7.48
Rate for Payer: BCBS Complete	$3.08
Rate for Payer: BCBS Trust/PPO	$5.98
Rate for Payer: BCN Commercial	$5.98
Rate for Payer: Cash Price	$6.17
Rate for Payer: Cofinity Commercial	$7.25
Rate for Payer: Encore Health Key Benefits Commercial	$6.17
Rate for Payer: Healthscope Commercial	$7.71
Rate for Payer: Healthscope Whirlpool	$7.48
Rate for Payer: Mclaren Commercial	$6.94
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$6.55
Rate for Payer: Priority Health Cigna Priority Health	$5.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$7.02
Rate for Payer: Priority Health Narrow Network	$5.47
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$6.78

HC NEISSERIA GONORRHOEAE AMP DNA

Facility

$66.30

Service Code	CPT 87591
Hospital Charge Code	30600163
Hospital Revenue Code	306
Min. Negotiated Rate	$46.41
Max. Negotiated Rate	$66.30
Rate for Payer: Aetna Commercial	$59.67
Rate for Payer: ASR ASR	$64.31
Rate for Payer: BCBS Trust/PPO	$51.40
Rate for Payer: BCN Commercial	$51.40
Rate for Payer: Cash Price	$53.04
Rate for Payer: Cofinity Commercial	$62.32
Rate for Payer: Encore Health Key Benefits Commercial	$53.04
Rate for Payer: Healthscope Commercial	$66.30
Rate for Payer: Healthscope Whirlpool	$64.31
Rate for Payer: Mclaren Commercial	$59.67
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$56.36
Rate for Payer: Priority Health Cigna Priority Health	$46.41
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$58.34

Know your out-of-pocket cost for care.

All Charges