Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PROPRANOLOL 40 MG TABLET

Facility

$225.15

Service Code	NDC 00115166101
Hospital Charge Code	6658
Hospital Revenue Code	637
Min. Negotiated Rate	$141.84
Max. Negotiated Rate	$202.63
Rate for Payer: Aetna Commercial	$191.38
Rate for Payer: Aetna New Business (MI Preferred)	$146.35
Rate for Payer: Cash Price	$180.12
Rate for Payer: Cofinity Commercial	$157.60
Rate for Payer: Cofinity Commercial	$193.63
Rate for Payer: Cofinity Medicare Advantage	$157.60
Rate for Payer: Encore Health Key Benefits Commercial	$180.12
Rate for Payer: Healthscope Commercial	$202.63
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$191.38
Rate for Payer: PHP Commercial	$191.38
Rate for Payer: Priority Health Cigna Priority Health	$146.35
Rate for Payer: Priority Health SBD	$141.84

PROPRANOLOL 40 MG TABLET

Facility

$51.70

Service Code	NDC 23155011201
Hospital Charge Code	6658
Hospital Revenue Code	637
Min. Negotiated Rate	$20.68
Max. Negotiated Rate	$46.53
Rate for Payer: Aetna Commercial	$43.95
Rate for Payer: Aetna Medicare	$25.85
Rate for Payer: Aetna New Business (MI Preferred)	$33.60
Rate for Payer: BCBS Complete	$20.68
Rate for Payer: Cash Price	$41.36
Rate for Payer: Cofinity Commercial	$36.19
Rate for Payer: Cofinity Commercial	$44.46
Rate for Payer: Cofinity Medicare Advantage	$36.19
Rate for Payer: Encore Health Key Benefits Commercial	$41.36
Rate for Payer: Healthscope Commercial	$46.53
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$43.95
Rate for Payer: PHP Commercial	$43.95
Rate for Payer: Priority Health Cigna Priority Health	$33.60
Rate for Payer: Priority Health SBD	$32.57

PROPRANOLOL 40 MG TABLET

Facility

$121.20

Service Code	NDC 50268070215
Hospital Charge Code	6658
Hospital Revenue Code	637
Min. Negotiated Rate	$48.48
Max. Negotiated Rate	$109.08
Rate for Payer: Aetna Commercial	$103.02
Rate for Payer: Aetna Medicare	$60.60
Rate for Payer: Aetna New Business (MI Preferred)	$78.78
Rate for Payer: BCBS Complete	$48.48
Rate for Payer: Cash Price	$96.96
Rate for Payer: Cofinity Commercial	$104.23
Rate for Payer: Cofinity Commercial	$84.84
Rate for Payer: Cofinity Medicare Advantage	$84.84
Rate for Payer: Encore Health Key Benefits Commercial	$96.96
Rate for Payer: Healthscope Commercial	$109.08
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$103.02
Rate for Payer: PHP Commercial	$103.02
Rate for Payer: Priority Health Cigna Priority Health	$78.78
Rate for Payer: Priority Health SBD	$76.36

PROPRANOLOL 40 MG TABLET

Facility

$121.20

Service Code	NDC 50268070215
Hospital Charge Code	6658
Hospital Revenue Code	637
Min. Negotiated Rate	$76.36
Max. Negotiated Rate	$109.08
Rate for Payer: Aetna Commercial	$103.02
Rate for Payer: Aetna New Business (MI Preferred)	$78.78
Rate for Payer: Cash Price	$96.96
Rate for Payer: Cofinity Commercial	$104.23
Rate for Payer: Cofinity Commercial	$84.84
Rate for Payer: Cofinity Medicare Advantage	$84.84
Rate for Payer: Encore Health Key Benefits Commercial	$96.96
Rate for Payer: Healthscope Commercial	$109.08
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$103.02
Rate for Payer: PHP Commercial	$103.02
Rate for Payer: Priority Health Cigna Priority Health	$78.78
Rate for Payer: Priority Health SBD	$76.36

PROPRANOLOL 40 MG TABLET

Facility

$2.43

Service Code	NDC 50268070211
Hospital Charge Code	6658
Hospital Revenue Code	637
Min. Negotiated Rate	$0.97
Max. Negotiated Rate	$2.19
Rate for Payer: Aetna Commercial	$2.07
Rate for Payer: Aetna Medicare	$1.22
Rate for Payer: Aetna New Business (MI Preferred)	$1.58
Rate for Payer: BCBS Complete	$0.97
Rate for Payer: Cash Price	$1.94
Rate for Payer: Cofinity Commercial	$1.70
Rate for Payer: Cofinity Commercial	$2.09
Rate for Payer: Cofinity Medicare Advantage	$1.70
Rate for Payer: Encore Health Key Benefits Commercial	$1.94
Rate for Payer: Healthscope Commercial	$2.19
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2.07
Rate for Payer: PHP Commercial	$2.07
Rate for Payer: Priority Health Cigna Priority Health	$1.58
Rate for Payer: Priority Health SBD	$1.53

PROPRANOLOL ER 60 MG CAPSULE,24 HR,EXTENDED RELEASE

Facility

$876.48

Service Code	NDC 60687021501
Hospital Charge Code	38224
Hospital Revenue Code	637
Min. Negotiated Rate	$552.18
Max. Negotiated Rate	$788.83
Rate for Payer: Aetna Commercial	$745.01
Rate for Payer: Aetna New Business (MI Preferred)	$569.71
Rate for Payer: Cash Price	$701.18
Rate for Payer: Cofinity Commercial	$613.54
Rate for Payer: Cofinity Commercial	$753.77
Rate for Payer: Cofinity Medicare Advantage	$613.54
Rate for Payer: Encore Health Key Benefits Commercial	$701.18
Rate for Payer: Healthscope Commercial	$788.83
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$745.01
Rate for Payer: PHP Commercial	$745.01
Rate for Payer: Priority Health Cigna Priority Health	$569.71
Rate for Payer: Priority Health SBD	$552.18

PROPRANOLOL ER 60 MG CAPSULE,24 HR,EXTENDED RELEASE

Facility

$8.77

Service Code	NDC 60687021511
Hospital Charge Code	38224
Hospital Revenue Code	637
Min. Negotiated Rate	$3.51
Max. Negotiated Rate	$7.89
Rate for Payer: Aetna Commercial	$7.45
Rate for Payer: Aetna Medicare	$4.38
Rate for Payer: Aetna New Business (MI Preferred)	$5.70
Rate for Payer: BCBS Complete	$3.51
Rate for Payer: Cash Price	$7.02
Rate for Payer: Cofinity Commercial	$6.14
Rate for Payer: Cofinity Commercial	$7.54
Rate for Payer: Cofinity Medicare Advantage	$6.14
Rate for Payer: Encore Health Key Benefits Commercial	$7.02
Rate for Payer: Healthscope Commercial	$7.89
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$7.45
Rate for Payer: PHP Commercial	$7.45
Rate for Payer: Priority Health Cigna Priority Health	$5.70
Rate for Payer: Priority Health SBD	$5.53

PROPRANOLOL ER 60 MG CAPSULE,24 HR,EXTENDED RELEASE

Facility

$243.84

Service Code	NDC 51991081701
Hospital Charge Code	38224
Hospital Revenue Code	637
Min. Negotiated Rate	$153.62
Max. Negotiated Rate	$219.46
Rate for Payer: Aetna Commercial	$207.26
Rate for Payer: Aetna New Business (MI Preferred)	$158.50
Rate for Payer: Cash Price	$195.07
Rate for Payer: Cofinity Commercial	$170.69
Rate for Payer: Cofinity Commercial	$209.70
Rate for Payer: Cofinity Medicare Advantage	$170.69
Rate for Payer: Encore Health Key Benefits Commercial	$195.07
Rate for Payer: Healthscope Commercial	$219.46
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$207.26
Rate for Payer: PHP Commercial	$207.26
Rate for Payer: Priority Health Cigna Priority Health	$158.50
Rate for Payer: Priority Health SBD	$153.62

PROPRANOLOL ER 60 MG CAPSULE,24 HR,EXTENDED RELEASE

Facility

$876.48

Service Code	NDC 60687021501
Hospital Charge Code	38224
Hospital Revenue Code	637
Min. Negotiated Rate	$350.59
Max. Negotiated Rate	$788.83
Rate for Payer: Aetna Commercial	$745.01
Rate for Payer: Aetna Medicare	$438.24
Rate for Payer: Aetna New Business (MI Preferred)	$569.71
Rate for Payer: BCBS Complete	$350.59
Rate for Payer: Cash Price	$701.18
Rate for Payer: Cofinity Commercial	$613.54
Rate for Payer: Cofinity Commercial	$753.77
Rate for Payer: Cofinity Medicare Advantage	$613.54
Rate for Payer: Encore Health Key Benefits Commercial	$701.18
Rate for Payer: Healthscope Commercial	$788.83
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$745.01
Rate for Payer: PHP Commercial	$745.01
Rate for Payer: Priority Health Cigna Priority Health	$569.71
Rate for Payer: Priority Health SBD	$552.18

PROPRANOLOL ER 60 MG CAPSULE,24 HR,EXTENDED RELEASE

Facility

$8.77

Service Code	NDC 60687021511
Hospital Charge Code	38224
Hospital Revenue Code	637
Min. Negotiated Rate	$5.53
Max. Negotiated Rate	$7.89
Rate for Payer: Aetna Commercial	$7.45
Rate for Payer: Aetna New Business (MI Preferred)	$5.70
Rate for Payer: Cash Price	$7.02
Rate for Payer: Cofinity Commercial	$6.14
Rate for Payer: Cofinity Commercial	$7.54
Rate for Payer: Cofinity Medicare Advantage	$6.14
Rate for Payer: Encore Health Key Benefits Commercial	$7.02
Rate for Payer: Healthscope Commercial	$7.89
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$7.45
Rate for Payer: PHP Commercial	$7.45
Rate for Payer: Priority Health Cigna Priority Health	$5.70
Rate for Payer: Priority Health SBD	$5.53

PROPRANOLOL ER 60 MG CAPSULE,24 HR,EXTENDED RELEASE

Facility

$243.84

Service Code	NDC 51991081701
Hospital Charge Code	38224
Hospital Revenue Code	637
Min. Negotiated Rate	$97.54
Max. Negotiated Rate	$219.46
Rate for Payer: Aetna Commercial	$207.26
Rate for Payer: Aetna Medicare	$121.92
Rate for Payer: Aetna New Business (MI Preferred)	$158.50
Rate for Payer: BCBS Complete	$97.54
Rate for Payer: Cash Price	$195.07
Rate for Payer: Cofinity Commercial	$170.69
Rate for Payer: Cofinity Commercial	$209.70
Rate for Payer: Cofinity Medicare Advantage	$170.69
Rate for Payer: Encore Health Key Benefits Commercial	$195.07
Rate for Payer: Healthscope Commercial	$219.46
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$207.26
Rate for Payer: PHP Commercial	$207.26
Rate for Payer: Priority Health Cigna Priority Health	$158.50
Rate for Payer: Priority Health SBD	$153.62

PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE

Facility

$441.75

Service Code	NDC 62559053101
Hospital Charge Code	38225
Hospital Revenue Code	637
Min. Negotiated Rate	$278.30
Max. Negotiated Rate	$397.57
Rate for Payer: Aetna Commercial	$375.49
Rate for Payer: Aetna New Business (MI Preferred)	$287.14
Rate for Payer: Cash Price	$353.40
Rate for Payer: Cofinity Commercial	$309.23
Rate for Payer: Cofinity Commercial	$379.90
Rate for Payer: Cofinity Medicare Advantage	$309.23
Rate for Payer: Encore Health Key Benefits Commercial	$353.40
Rate for Payer: Healthscope Commercial	$397.57
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$375.49
Rate for Payer: PHP Commercial	$375.49
Rate for Payer: Priority Health Cigna Priority Health	$287.14
Rate for Payer: Priority Health SBD	$278.30

PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE

Facility

$789.21

Service Code	NDC 60687022601
Hospital Charge Code	38225
Hospital Revenue Code	637
Min. Negotiated Rate	$497.20
Max. Negotiated Rate	$710.29
Rate for Payer: Aetna Commercial	$670.83
Rate for Payer: Aetna New Business (MI Preferred)	$512.99
Rate for Payer: Cash Price	$631.37
Rate for Payer: Cofinity Commercial	$552.45
Rate for Payer: Cofinity Commercial	$678.72
Rate for Payer: Cofinity Medicare Advantage	$552.45
Rate for Payer: Encore Health Key Benefits Commercial	$631.37
Rate for Payer: Healthscope Commercial	$710.29
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$670.83
Rate for Payer: PHP Commercial	$670.83
Rate for Payer: Priority Health Cigna Priority Health	$512.99
Rate for Payer: Priority Health SBD	$497.20

PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE

Facility

$195.70

Service Code	NDC 00527411737
Hospital Charge Code	38225
Hospital Revenue Code	637
Min. Negotiated Rate	$123.29
Max. Negotiated Rate	$176.13
Rate for Payer: Aetna Commercial	$166.34
Rate for Payer: Aetna New Business (MI Preferred)	$127.20
Rate for Payer: Cash Price	$156.56
Rate for Payer: Cofinity Commercial	$136.99
Rate for Payer: Cofinity Commercial	$168.30
Rate for Payer: Cofinity Medicare Advantage	$136.99
Rate for Payer: Encore Health Key Benefits Commercial	$156.56
Rate for Payer: Healthscope Commercial	$176.13
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$166.34
Rate for Payer: PHP Commercial	$166.34
Rate for Payer: Priority Health Cigna Priority Health	$127.20
Rate for Payer: Priority Health SBD	$123.29

PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE

Facility

$195.70

Service Code	NDC 00527411737
Hospital Charge Code	38225
Hospital Revenue Code	637
Min. Negotiated Rate	$78.28
Max. Negotiated Rate	$176.13
Rate for Payer: Aetna Commercial	$166.34
Rate for Payer: Aetna Medicare	$97.85
Rate for Payer: Aetna New Business (MI Preferred)	$127.20
Rate for Payer: BCBS Complete	$78.28
Rate for Payer: Cash Price	$156.56
Rate for Payer: Cofinity Commercial	$136.99
Rate for Payer: Cofinity Commercial	$168.30
Rate for Payer: Cofinity Medicare Advantage	$136.99
Rate for Payer: Encore Health Key Benefits Commercial	$156.56
Rate for Payer: Healthscope Commercial	$176.13
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$166.34
Rate for Payer: PHP Commercial	$166.34
Rate for Payer: Priority Health Cigna Priority Health	$127.20
Rate for Payer: Priority Health SBD	$123.29

PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE

Facility

$7.90

Service Code	NDC 60687022611
Hospital Charge Code	38225
Hospital Revenue Code	637
Min. Negotiated Rate	$3.16
Max. Negotiated Rate	$7.11
Rate for Payer: Aetna Commercial	$6.71
Rate for Payer: Aetna Medicare	$3.95
Rate for Payer: Aetna New Business (MI Preferred)	$5.13
Rate for Payer: BCBS Complete	$3.16
Rate for Payer: Cash Price	$6.32
Rate for Payer: Cofinity Commercial	$5.53
Rate for Payer: Cofinity Commercial	$6.79
Rate for Payer: Cofinity Medicare Advantage	$5.53
Rate for Payer: Encore Health Key Benefits Commercial	$6.32
Rate for Payer: Healthscope Commercial	$7.11
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$6.71
Rate for Payer: PHP Commercial	$6.71
Rate for Payer: Priority Health Cigna Priority Health	$5.13
Rate for Payer: Priority Health SBD	$4.98

PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE

Facility

$7.90

Service Code	NDC 60687022611
Hospital Charge Code	38225
Hospital Revenue Code	637
Min. Negotiated Rate	$4.98
Max. Negotiated Rate	$7.11
Rate for Payer: Aetna Commercial	$6.71
Rate for Payer: Aetna New Business (MI Preferred)	$5.13
Rate for Payer: Cash Price	$6.32
Rate for Payer: Cofinity Commercial	$5.53
Rate for Payer: Cofinity Commercial	$6.79
Rate for Payer: Cofinity Medicare Advantage	$5.53
Rate for Payer: Encore Health Key Benefits Commercial	$6.32
Rate for Payer: Healthscope Commercial	$7.11
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$6.71
Rate for Payer: PHP Commercial	$6.71
Rate for Payer: Priority Health Cigna Priority Health	$5.13
Rate for Payer: Priority Health SBD	$4.98

PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE

Facility

$789.21

Service Code	NDC 60687022601
Hospital Charge Code	38225
Hospital Revenue Code	637
Min. Negotiated Rate	$315.68
Max. Negotiated Rate	$710.29
Rate for Payer: Aetna Commercial	$670.83
Rate for Payer: Aetna Medicare	$394.61
Rate for Payer: Aetna New Business (MI Preferred)	$512.99
Rate for Payer: BCBS Complete	$315.68
Rate for Payer: Cash Price	$631.37
Rate for Payer: Cofinity Commercial	$552.45
Rate for Payer: Cofinity Commercial	$678.72
Rate for Payer: Cofinity Medicare Advantage	$552.45
Rate for Payer: Encore Health Key Benefits Commercial	$631.37
Rate for Payer: Healthscope Commercial	$710.29
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$670.83
Rate for Payer: PHP Commercial	$670.83
Rate for Payer: Priority Health Cigna Priority Health	$512.99
Rate for Payer: Priority Health SBD	$497.20

PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE

Facility

$441.75

Service Code	NDC 62559053101
Hospital Charge Code	38225
Hospital Revenue Code	637
Min. Negotiated Rate	$176.70
Max. Negotiated Rate	$397.57
Rate for Payer: Aetna Commercial	$375.49
Rate for Payer: Aetna Medicare	$220.88
Rate for Payer: Aetna New Business (MI Preferred)	$287.14
Rate for Payer: BCBS Complete	$176.70
Rate for Payer: Cash Price	$353.40
Rate for Payer: Cofinity Commercial	$309.23
Rate for Payer: Cofinity Commercial	$379.90
Rate for Payer: Cofinity Medicare Advantage	$309.23
Rate for Payer: Encore Health Key Benefits Commercial	$353.40
Rate for Payer: Healthscope Commercial	$397.57
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$375.49
Rate for Payer: PHP Commercial	$375.49
Rate for Payer: Priority Health Cigna Priority Health	$287.14
Rate for Payer: Priority Health SBD	$278.30

PR OPTKINETIC NYSTAG BIDIR/FOVEAL/PERIPH STIM W/REC

Professional

Both

$33.00

Service Code	HCPCS 92544
Min. Negotiated Rate	$13.20
Max. Negotiated Rate	$31.19
Rate for Payer: Aetna Commercial	$22.59
Rate for Payer: Aetna Medicare	$17.53
Rate for Payer: Aetna New Business (MI Preferred)	$24.28
Rate for Payer: Aetna New Business (MI Preferred)	$22.59
Rate for Payer: BCBS Complete	$13.20
Rate for Payer: BCBS MAPPO	$16.86
Rate for Payer: BCN Medicare Advantage	$16.86
Rate for Payer: Cash Price	$26.40
Rate for Payer: Cash Price	$26.40
Rate for Payer: Cofinity Commercial	$24.28
Rate for Payer: Cofinity Commercial	$22.59
Rate for Payer: Health Alliance Plan Medicare Advantage	$16.86
Rate for Payer: Healthscope Commercial	$26.98
Rate for Payer: Healthscope Commercial	$31.19
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$17.70
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$21.45
Rate for Payer: Nomi Health Commercial	$20.23
Rate for Payer: PACE SWMI	$16.86
Rate for Payer: PHP Medicare Advantage	$16.86
Rate for Payer: Priority Health Cigna Priority Health	$21.45
Rate for Payer: Priority Health Medicare	$16.86
Rate for Payer: UHC Dual Complete DSNP	$16.86
Rate for Payer: UHC Medicare Advantage	$16.86

PR OPTX ACROMCLAV DISLC ACUTE/CHRONIC W/FASCIAL GRF

Professional

Both

$3,471.00

Service Code	HCPCS 23552
Min. Negotiated Rate	$623.93
Max. Negotiated Rate	$2,256.15
Rate for Payer: Aetna Commercial	$836.07
Rate for Payer: Aetna Medicare	$648.89
Rate for Payer: Aetna New Business (MI Preferred)	$898.46
Rate for Payer: Aetna New Business (MI Preferred)	$836.07
Rate for Payer: BCBS Complete	$1,388.40
Rate for Payer: BCBS MAPPO	$623.93
Rate for Payer: BCN Medicare Advantage	$623.93
Rate for Payer: Cash Price	$2,776.80
Rate for Payer: Cash Price	$2,776.80
Rate for Payer: Cofinity Commercial	$898.46
Rate for Payer: Cofinity Commercial	$836.07
Rate for Payer: Health Alliance Plan Medicare Advantage	$623.93
Rate for Payer: Healthscope Commercial	$998.29
Rate for Payer: Healthscope Commercial	$1,154.27
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$655.13
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2,256.15
Rate for Payer: Nomi Health Commercial	$748.72
Rate for Payer: PACE SWMI	$623.93
Rate for Payer: PHP Medicare Advantage	$623.93
Rate for Payer: Priority Health Cigna Priority Health	$2,256.15
Rate for Payer: Priority Health Medicare	$623.93
Rate for Payer: UHC Dual Complete DSNP	$623.93
Rate for Payer: UHC Medicare Advantage	$623.93

PR OPTX ACTBLR FX INVG ANT&POST 2 COLUMNS FX W/INT

Professional

Both

$3,890.00

Service Code	HCPCS 27228
Min. Negotiated Rate	$1,556.00
Max. Negotiated Rate	$3,342.76
Rate for Payer: Aetna Commercial	$2,421.25
Rate for Payer: Aetna Medicare	$1,879.18
Rate for Payer: Aetna New Business (MI Preferred)	$2,601.94
Rate for Payer: Aetna New Business (MI Preferred)	$2,421.25
Rate for Payer: BCBS Complete	$1,556.00
Rate for Payer: BCBS MAPPO	$1,806.90
Rate for Payer: BCN Medicare Advantage	$1,806.90
Rate for Payer: Cash Price	$3,112.00
Rate for Payer: Cash Price	$3,112.00
Rate for Payer: Cofinity Commercial	$2,601.94
Rate for Payer: Cofinity Commercial	$2,421.25
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,806.90
Rate for Payer: Healthscope Commercial	$2,891.04
Rate for Payer: Healthscope Commercial	$3,342.76
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$1,897.24
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2,528.50
Rate for Payer: Nomi Health Commercial	$2,168.28
Rate for Payer: PACE SWMI	$1,806.90
Rate for Payer: PHP Medicare Advantage	$1,806.90
Rate for Payer: Priority Health Cigna Priority Health	$2,528.50
Rate for Payer: Priority Health Medicare	$1,806.90
Rate for Payer: UHC Dual Complete DSNP	$1,806.90
Rate for Payer: UHC Medicare Advantage	$1,806.90

PR OPTX ACTBLR FX INVG ANT/PST 1 COLUMN/FX W/INT

Professional

Both

$4,665.00

Service Code	HCPCS 27227
Min. Negotiated Rate	$1,590.05
Max. Negotiated Rate	$3,032.25
Rate for Payer: Aetna Commercial	$2,130.67
Rate for Payer: Aetna Medicare	$1,653.65
Rate for Payer: Aetna New Business (MI Preferred)	$2,289.67
Rate for Payer: Aetna New Business (MI Preferred)	$2,130.67
Rate for Payer: BCBS Complete	$1,866.00
Rate for Payer: BCBS MAPPO	$1,590.05
Rate for Payer: BCN Medicare Advantage	$1,590.05
Rate for Payer: Cash Price	$3,732.00
Rate for Payer: Cash Price	$3,732.00
Rate for Payer: Cofinity Commercial	$2,289.67
Rate for Payer: Cofinity Commercial	$2,130.67
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,590.05
Rate for Payer: Healthscope Commercial	$2,941.59
Rate for Payer: Healthscope Commercial	$2,544.08
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$1,669.55
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3,032.25
Rate for Payer: Nomi Health Commercial	$1,908.06
Rate for Payer: PACE SWMI	$1,590.05
Rate for Payer: PHP Medicare Advantage	$1,590.05
Rate for Payer: Priority Health Cigna Priority Health	$3,032.25
Rate for Payer: Priority Health Medicare	$1,590.05
Rate for Payer: UHC Dual Complete DSNP	$1,590.05
Rate for Payer: UHC Medicare Advantage	$1,590.05

PR OPTX ANKLE DISLOCATION W/O REPAIR/INTERNAL FIXJ

Professional

Both

$3,005.00

Service Code	HCPCS 27846
Min. Negotiated Rate	$697.73
Max. Negotiated Rate	$1,953.25
Rate for Payer: Aetna Commercial	$934.96
Rate for Payer: Aetna Medicare	$725.64
Rate for Payer: Aetna New Business (MI Preferred)	$934.96
Rate for Payer: Aetna New Business (MI Preferred)	$1,004.73
Rate for Payer: BCBS Complete	$1,202.00
Rate for Payer: BCBS MAPPO	$697.73
Rate for Payer: BCN Medicare Advantage	$697.73
Rate for Payer: Cash Price	$2,404.00
Rate for Payer: Cash Price	$2,404.00
Rate for Payer: Cofinity Commercial	$934.96
Rate for Payer: Cofinity Commercial	$1,004.73
Rate for Payer: Health Alliance Plan Medicare Advantage	$697.73
Rate for Payer: Healthscope Commercial	$1,116.37
Rate for Payer: Healthscope Commercial	$1,290.80
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$732.62
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,953.25
Rate for Payer: Nomi Health Commercial	$837.28
Rate for Payer: PACE SWMI	$697.73
Rate for Payer: PHP Medicare Advantage	$697.73
Rate for Payer: Priority Health Cigna Priority Health	$1,953.25
Rate for Payer: Priority Health Medicare	$697.73
Rate for Payer: UHC Dual Complete DSNP	$697.73
Rate for Payer: UHC Medicare Advantage	$697.73

PR OPTX ANKLE DISLOCATION W/REPAIR/INT/XTRNL FIXJ

Professional

Both

$3,247.00

Service Code	HCPCS 27848
Min. Negotiated Rate	$766.60
Max. Negotiated Rate	$2,110.55
Rate for Payer: Aetna Commercial	$1,027.24
Rate for Payer: Aetna Medicare	$797.26
Rate for Payer: Aetna New Business (MI Preferred)	$1,103.90
Rate for Payer: Aetna New Business (MI Preferred)	$1,027.24
Rate for Payer: BCBS Complete	$1,298.80
Rate for Payer: BCBS MAPPO	$766.60
Rate for Payer: BCN Medicare Advantage	$766.60
Rate for Payer: Cash Price	$2,597.60
Rate for Payer: Cash Price	$2,597.60
Rate for Payer: Cofinity Commercial	$1,103.90
Rate for Payer: Cofinity Commercial	$1,027.24
Rate for Payer: Health Alliance Plan Medicare Advantage	$766.60
Rate for Payer: Healthscope Commercial	$1,226.56
Rate for Payer: Healthscope Commercial	$1,418.21
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$804.93
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2,110.55
Rate for Payer: Nomi Health Commercial	$919.92
Rate for Payer: PACE SWMI	$766.60
Rate for Payer: PHP Medicare Advantage	$766.60
Rate for Payer: Priority Health Cigna Priority Health	$2,110.55
Rate for Payer: Priority Health Medicare	$766.60
Rate for Payer: UHC Dual Complete DSNP	$766.60
Rate for Payer: UHC Medicare Advantage	$766.60

Know your out-of-pocket cost for care.

All Charges