ASR Physicians Care Network: disclosed hospital rates

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Based on the published hospital price files, ASR Physicians Care Network appears in disclosed negotiated rates across 2 hospitals and 11524 services. This is public hospital price transparency data, not a guaranteed estimate of your bill.

Actual patient responsibility may vary based on your insurance plan, deductible, coinsurance, network status, diagnosis, setting, bundled services, clinical circumstances, and hospital billing practices.

11,524 prices shown.

Service	Hospital	Code	List price	Cash price	Negotiated range	Allowed (median)
.Clostridium difficile PCR Inpatient	Kalkaska Memorial Health Center	87493 CPT	$237	$201	$175 – $852	—
.Cortisol Pre Injection Inpatient	Kalkaska Memorial Health Center	82533 CPT	$109	$92.65	$80.66 – $852	—
.Cortisol Pre Injection Outpatient	Paul Oliver Memorial Hospital	82533 CPT	$133	$113	$11.49 – $126	—
.Cortisol Stimulation 30 Minutes Inpatient	Kalkaska Memorial Health Center	82533 CPT	$109	$92.65	$80.66 – $852	—
.Cortisol Stimulation 60 Minutes Inpatient	Kalkaska Memorial Health Center	82533 CPT	$109	$92.65	$80.66 – $852	—
.Cortisol Stimulation 60 Minutes Outpatient	Paul Oliver Memorial Hospital	82533 CPT	$133	$113	$11.49 – $126	—
.Glucose 2 Hour Inpatient	Kalkaska Memorial Health Center	82951 CPT	$56.00	$47.60	$41.44 – $852	—
.Glucose 2 Hour- Gestational Inpatient	Kalkaska Memorial Health Center	82951 CPT	$56.00	$47.60	$41.44 – $852	—
.Glucose 2 Hour- Gestational Outpatient	Paul Oliver Memorial Hospital	82951 CPT	$101	$85.85	$9.07 – $95.95	—
.Glucose 3 Hour Inpatient	Kalkaska Memorial Health Center	82952 CPT	$27.00	$22.95	$19.98 – $852	—
.Glucose 3 Hour- Gestational Inpatient	Kalkaska Memorial Health Center	82952 CPT	$27.00	$22.95	$19.98 – $852	—
.Quantiferon NIL Inpatient	Kalkaska Memorial Health Center	86480 CPT	$249	$212	$184 – $852	—
1 - Patient Antigen Type Bill Quantity Inpatient	Kalkaska Memorial Health Center	86905 CPT	$343	$292	$254 – $852	—
1 Misc ISOVUE 300 per cc Total admin & discard Inpatient	Kalkaska Memorial Health Center	Q9967 HCPCS	$0.25	$0.22	$0.19 – $852	—
1 Misc OMNI 300 per cc, admin & discard Inpatient	Kalkaska Memorial Health Center	Q9967 HCPCS	$0.25	$0.22	$0.19 – $852	—
1 Misc OMNI 300 per cc, admin & discard Outpatient	Paul Oliver Memorial Hospital	Q9967 HCPCS	$0.25	$0.22	$0.08 – $0.24	—
1 Misc OMNI 300/350 per cc total admin&disc Inpatient	Kalkaska Memorial Health Center	Q9967 HCPCS	$0.25	$0.22	$0.19 – $852	—
1 Misc OMNI 350 per cc, admin & discard Inpatient	Kalkaska Memorial Health Center	Q9967 HCPCS	$0.25	$0.22	$0.19 – $852	—
1 Misc Pulse Oximeter Inpatient	Kalkaska Memorial Health Center	94760 CPT	$6.00	$5.10	$4.44 – $852	—
1 Misc Pulse Oximeter Outpatient	Paul Oliver Memorial Hospital	94760 CPT	$12.00	$10.20	$2.63 – $11.40	—
1 Misc VISIPAQUE per cc Total admin & discard Inpatient	Kalkaska Memorial Health Center	Q9967 HCPCS	$0.25	$0.22	$0.19 – $852	—
1,25 Dihydroxy Vitamin D Inpatient	Kalkaska Memorial Health Center	82652 CPT	$180	$153	$133 – $852	—
1,25-Dihydroxyvitamin D, Serum Inpatient	Kalkaska Memorial Health Center	82652 CPT	$21.40	$18.19	$15.84 – $852	—
1,25-Dihydroxyvitamin D, Serum Outpatient	Paul Oliver Memorial Hospital	82652 CPT	$21.40	$18.19	$6.63 – $27.14	—
1,3-Beta-D-Glucan (Fungitell), Serum Inpatient	Kalkaska Memorial Health Center	87449 CPT	$100	$85.00	$74.00 – $852	—