Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PROVENTIL HFA 90 MCG/ACTUATION AEROSOL COMMON CANISTER INHALER

Facility

$102.90

Service Code	NDC 66993001968
Hospital Charge Code	300058
Hospital Revenue Code	637
Min. Negotiated Rate	$41.16
Max. Negotiated Rate	$92.61
Rate for Payer: Aetna Commercial	$87.47
Rate for Payer: Aetna Medicare	$51.45
Rate for Payer: Aetna New Business (MI Preferred)	$66.89
Rate for Payer: BCBS Complete	$41.16
Rate for Payer: Cash Price	$82.32
Rate for Payer: Cofinity Commercial	$72.03
Rate for Payer: Cofinity Commercial	$88.49
Rate for Payer: Cofinity Medicare Advantage	$72.03
Rate for Payer: Encore Health Key Benefits Commercial	$82.32
Rate for Payer: Healthscope Commercial	$92.61
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$87.47
Rate for Payer: PHP Commercial	$87.47
Rate for Payer: Priority Health Cigna Priority Health	$66.89
Rate for Payer: Priority Health SBD	$64.83

PROVENTIL HFA 90 MCG/ACTUATION AEROSOL COMMON CANISTER INHALER

Facility

$50.40

Service Code	NDC 69097014260
Hospital Charge Code	300058
Hospital Revenue Code	637
Min. Negotiated Rate	$20.16
Max. Negotiated Rate	$45.36
Rate for Payer: Aetna Commercial	$42.84
Rate for Payer: Aetna Medicare	$25.20
Rate for Payer: Aetna New Business (MI Preferred)	$32.76
Rate for Payer: BCBS Complete	$20.16
Rate for Payer: Cash Price	$40.32
Rate for Payer: Cofinity Commercial	$35.28
Rate for Payer: Cofinity Commercial	$43.34
Rate for Payer: Cofinity Medicare Advantage	$35.28
Rate for Payer: Encore Health Key Benefits Commercial	$40.32
Rate for Payer: Healthscope Commercial	$45.36
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$42.84
Rate for Payer: PHP Commercial	$42.84
Rate for Payer: Priority Health Cigna Priority Health	$32.76
Rate for Payer: Priority Health SBD	$31.75

PROVENTIL HFA 90 MCG/ACTUATION AEROSOL COMMON CANISTER INHALER

Facility

$149.10

Service Code	NDC 00085113204
Hospital Charge Code	300058
Hospital Revenue Code	637
Min. Negotiated Rate	$93.93
Max. Negotiated Rate	$134.19
Rate for Payer: Aetna Commercial	$126.73
Rate for Payer: Aetna New Business (MI Preferred)	$96.92
Rate for Payer: Cash Price	$119.28
Rate for Payer: Cofinity Commercial	$104.37
Rate for Payer: Cofinity Commercial	$128.23
Rate for Payer: Cofinity Medicare Advantage	$104.37
Rate for Payer: Encore Health Key Benefits Commercial	$119.28
Rate for Payer: Healthscope Commercial	$134.19
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$126.73
Rate for Payer: PHP Commercial	$126.73
Rate for Payer: Priority Health Cigna Priority Health	$96.92
Rate for Payer: Priority Health SBD	$93.93

PROVENTIL HFA 90 MCG/ACTUATION AEROSOL COMMON CANISTER INHALER

Facility

$114.80

Service Code	NDC 00254100752
Hospital Charge Code	300058
Hospital Revenue Code	637
Min. Negotiated Rate	$72.32
Max. Negotiated Rate	$103.32
Rate for Payer: Aetna Commercial	$97.58
Rate for Payer: Aetna New Business (MI Preferred)	$74.62
Rate for Payer: Cash Price	$91.84
Rate for Payer: Cofinity Commercial	$80.36
Rate for Payer: Cofinity Commercial	$98.73
Rate for Payer: Cofinity Medicare Advantage	$80.36
Rate for Payer: Encore Health Key Benefits Commercial	$91.84
Rate for Payer: Healthscope Commercial	$103.32
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$97.58
Rate for Payer: PHP Commercial	$97.58
Rate for Payer: Priority Health Cigna Priority Health	$74.62
Rate for Payer: Priority Health SBD	$72.32

PROVENTIL HFA 90 MCG/ACTUATION AEROSOL COMMON CANISTER INHALER

Facility

$50.40

Service Code	NDC 69097014260
Hospital Charge Code	300058
Hospital Revenue Code	637
Min. Negotiated Rate	$31.75
Max. Negotiated Rate	$45.36
Rate for Payer: Aetna Commercial	$42.84
Rate for Payer: Aetna New Business (MI Preferred)	$32.76
Rate for Payer: Cash Price	$40.32
Rate for Payer: Cofinity Commercial	$35.28
Rate for Payer: Cofinity Commercial	$43.34
Rate for Payer: Cofinity Medicare Advantage	$35.28
Rate for Payer: Encore Health Key Benefits Commercial	$40.32
Rate for Payer: Healthscope Commercial	$45.36
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$42.84
Rate for Payer: PHP Commercial	$42.84
Rate for Payer: Priority Health Cigna Priority Health	$32.76
Rate for Payer: Priority Health SBD	$31.75

PROVENTIL HFA 90 MCG/ACTUATION AEROSOL COMMON CANISTER INHALER

Facility

$149.10

Service Code	NDC 00085113204
Hospital Charge Code	300058
Hospital Revenue Code	637
Min. Negotiated Rate	$59.64
Max. Negotiated Rate	$134.19
Rate for Payer: Aetna Commercial	$126.73
Rate for Payer: Aetna Medicare	$74.55
Rate for Payer: Aetna New Business (MI Preferred)	$96.92
Rate for Payer: BCBS Complete	$59.64
Rate for Payer: Cash Price	$119.28
Rate for Payer: Cofinity Commercial	$104.37
Rate for Payer: Cofinity Commercial	$128.23
Rate for Payer: Cofinity Medicare Advantage	$104.37
Rate for Payer: Encore Health Key Benefits Commercial	$119.28
Rate for Payer: Healthscope Commercial	$134.19
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$126.73
Rate for Payer: PHP Commercial	$126.73
Rate for Payer: Priority Health Cigna Priority Health	$96.92
Rate for Payer: Priority Health SBD	$93.93

PROVENTIL HFA 90 MCG/ACTUATION AEROSOL COMMON CANISTER INHALER

Facility

$116.90

Service Code	NDC 00781729685
Hospital Charge Code	300058
Hospital Revenue Code	637
Min. Negotiated Rate	$73.65
Max. Negotiated Rate	$105.21
Rate for Payer: Aetna Commercial	$99.36
Rate for Payer: Aetna New Business (MI Preferred)	$75.98
Rate for Payer: Cash Price	$93.52
Rate for Payer: Cofinity Commercial	$100.53
Rate for Payer: Cofinity Commercial	$81.83
Rate for Payer: Cofinity Medicare Advantage	$81.83
Rate for Payer: Encore Health Key Benefits Commercial	$93.52
Rate for Payer: Healthscope Commercial	$105.21
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$99.36
Rate for Payer: PHP Commercial	$99.36
Rate for Payer: Priority Health Cigna Priority Health	$75.98
Rate for Payer: Priority Health SBD	$73.65

PROVENTIL HFA 90 MCG/ACTUATION AEROSOL INHALER

Facility

$50.40

Service Code	NDC 69097014260
Hospital Charge Code	17934
Hospital Revenue Code	637
Min. Negotiated Rate	$31.75
Max. Negotiated Rate	$45.36
Rate for Payer: Aetna Commercial	$42.84
Rate for Payer: Aetna New Business (MI Preferred)	$32.76
Rate for Payer: Cash Price	$40.32
Rate for Payer: Cofinity Commercial	$35.28
Rate for Payer: Cofinity Commercial	$43.34
Rate for Payer: Cofinity Medicare Advantage	$35.28
Rate for Payer: Encore Health Key Benefits Commercial	$40.32
Rate for Payer: Healthscope Commercial	$45.36
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$42.84
Rate for Payer: PHP Commercial	$42.84
Rate for Payer: Priority Health Cigna Priority Health	$32.76
Rate for Payer: Priority Health SBD	$31.75

PROVENTIL HFA 90 MCG/ACTUATION AEROSOL INHALER

Facility

$114.80

Service Code	NDC 00254100752
Hospital Charge Code	17934
Hospital Revenue Code	637
Min. Negotiated Rate	$45.92
Max. Negotiated Rate	$103.32
Rate for Payer: Aetna Commercial	$97.58
Rate for Payer: Aetna Medicare	$57.40
Rate for Payer: Aetna New Business (MI Preferred)	$74.62
Rate for Payer: BCBS Complete	$45.92
Rate for Payer: Cash Price	$91.84
Rate for Payer: Cofinity Commercial	$80.36
Rate for Payer: Cofinity Commercial	$98.73
Rate for Payer: Cofinity Medicare Advantage	$80.36
Rate for Payer: Encore Health Key Benefits Commercial	$91.84
Rate for Payer: Healthscope Commercial	$103.32
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$97.58
Rate for Payer: PHP Commercial	$97.58
Rate for Payer: Priority Health Cigna Priority Health	$74.62
Rate for Payer: Priority Health SBD	$72.32

PROVENTIL HFA 90 MCG/ACTUATION AEROSOL INHALER

Facility

$50.40

Service Code	NDC 69097014260
Hospital Charge Code	17934
Hospital Revenue Code	637
Min. Negotiated Rate	$20.16
Max. Negotiated Rate	$45.36
Rate for Payer: Aetna Commercial	$42.84
Rate for Payer: Aetna Medicare	$25.20
Rate for Payer: Aetna New Business (MI Preferred)	$32.76
Rate for Payer: BCBS Complete	$20.16
Rate for Payer: Cash Price	$40.32
Rate for Payer: Cofinity Commercial	$35.28
Rate for Payer: Cofinity Commercial	$43.34
Rate for Payer: Cofinity Medicare Advantage	$35.28
Rate for Payer: Encore Health Key Benefits Commercial	$40.32
Rate for Payer: Healthscope Commercial	$45.36
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$42.84
Rate for Payer: PHP Commercial	$42.84
Rate for Payer: Priority Health Cigna Priority Health	$32.76
Rate for Payer: Priority Health SBD	$31.75

PROVENTIL HFA 90 MCG/ACTUATION AEROSOL INHALER

Facility

$149.10

Service Code	NDC 00085113204
Hospital Charge Code	17934
Hospital Revenue Code	637
Min. Negotiated Rate	$59.64
Max. Negotiated Rate	$134.19
Rate for Payer: Aetna Commercial	$126.73
Rate for Payer: Aetna Medicare	$74.55
Rate for Payer: Aetna New Business (MI Preferred)	$96.92
Rate for Payer: BCBS Complete	$59.64
Rate for Payer: Cash Price	$119.28
Rate for Payer: Cofinity Commercial	$104.37
Rate for Payer: Cofinity Commercial	$128.23
Rate for Payer: Cofinity Medicare Advantage	$104.37
Rate for Payer: Encore Health Key Benefits Commercial	$119.28
Rate for Payer: Healthscope Commercial	$134.19
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$126.73
Rate for Payer: PHP Commercial	$126.73
Rate for Payer: Priority Health Cigna Priority Health	$96.92
Rate for Payer: Priority Health SBD	$93.93

PROVENTIL HFA 90 MCG/ACTUATION AEROSOL INHALER

Facility

$149.10

Service Code	NDC 00085113204
Hospital Charge Code	17934
Hospital Revenue Code	637
Min. Negotiated Rate	$93.93
Max. Negotiated Rate	$134.19
Rate for Payer: Aetna Commercial	$126.73
Rate for Payer: Aetna New Business (MI Preferred)	$96.92
Rate for Payer: Cash Price	$119.28
Rate for Payer: Cofinity Commercial	$104.37
Rate for Payer: Cofinity Commercial	$128.23
Rate for Payer: Cofinity Medicare Advantage	$104.37
Rate for Payer: Encore Health Key Benefits Commercial	$119.28
Rate for Payer: Healthscope Commercial	$134.19
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$126.73
Rate for Payer: PHP Commercial	$126.73
Rate for Payer: Priority Health Cigna Priority Health	$96.92
Rate for Payer: Priority Health SBD	$93.93

PROVENTIL HFA 90 MCG/ACTUATION AEROSOL INHALER

Facility

$114.80

Service Code	NDC 00254100752
Hospital Charge Code	17934
Hospital Revenue Code	637
Min. Negotiated Rate	$72.32
Max. Negotiated Rate	$103.32
Rate for Payer: Aetna Commercial	$97.58
Rate for Payer: Aetna New Business (MI Preferred)	$74.62
Rate for Payer: Cash Price	$91.84
Rate for Payer: Cofinity Commercial	$80.36
Rate for Payer: Cofinity Commercial	$98.73
Rate for Payer: Cofinity Medicare Advantage	$80.36
Rate for Payer: Encore Health Key Benefits Commercial	$91.84
Rate for Payer: Healthscope Commercial	$103.32
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$97.58
Rate for Payer: PHP Commercial	$97.58
Rate for Payer: Priority Health Cigna Priority Health	$74.62
Rate for Payer: Priority Health SBD	$72.32

PR OVINE, UP TO 999 USP UNITS

Professional

Both

$2.00

Service Code	HCPCS J3471
Min. Negotiated Rate	$0.50
Max. Negotiated Rate	$1.30
Rate for Payer: Aetna Commercial	$0.67
Rate for Payer: Aetna Medicare	$0.52
Rate for Payer: Aetna New Business (MI Preferred)	$0.72
Rate for Payer: Aetna New Business (MI Preferred)	$0.67
Rate for Payer: BCBS Complete	$0.80
Rate for Payer: BCBS MAPPO	$0.50
Rate for Payer: BCN Medicare Advantage	$0.50
Rate for Payer: Cash Price	$1.60
Rate for Payer: Cash Price	$1.60
Rate for Payer: Cofinity Commercial	$0.72
Rate for Payer: Cofinity Commercial	$0.67
Rate for Payer: Health Alliance Plan Medicare Advantage	$0.50
Rate for Payer: Healthscope Commercial	$0.80
Rate for Payer: Healthscope Commercial	$0.93
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$0.53
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1.30
Rate for Payer: Nomi Health Commercial	$0.60
Rate for Payer: PACE SWMI	$0.50
Rate for Payer: PHP Medicare Advantage	$0.50
Rate for Payer: Priority Health Cigna Priority Health	$1.30
Rate for Payer: Priority Health Medicare	$0.50
Rate for Payer: UHC Dual Complete DSNP	$0.50
Rate for Payer: UHC Medicare Advantage	$0.50

PR PACKING STRIPS, NON-IMPREG

Professional

Both

$6.00

Service Code	HCPCS A6407
Min. Negotiated Rate	$2.40
Max. Negotiated Rate	$4.83
Rate for Payer: Aetna Commercial	$3.50
Rate for Payer: Aetna Medicare	$2.71
Rate for Payer: Aetna New Business (MI Preferred)	$3.76
Rate for Payer: Aetna New Business (MI Preferred)	$3.50
Rate for Payer: BCBS Complete	$2.40
Rate for Payer: BCBS MAPPO	$2.61
Rate for Payer: BCN Medicare Advantage	$2.61
Rate for Payer: Cash Price	$4.80
Rate for Payer: Cash Price	$4.80
Rate for Payer: Cofinity Commercial	$3.76
Rate for Payer: Cofinity Commercial	$3.50
Rate for Payer: Health Alliance Plan Medicare Advantage	$2.61
Rate for Payer: Healthscope Commercial	$4.83
Rate for Payer: Healthscope Commercial	$4.18
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$2.74
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3.90
Rate for Payer: Nomi Health Commercial	$3.13
Rate for Payer: PACE SWMI	$2.61
Rate for Payer: PHP Medicare Advantage	$2.61
Rate for Payer: Priority Health Cigna Priority Health	$3.90
Rate for Payer: Priority Health Medicare	$2.61
Rate for Payer: UHC Dual Complete DSNP	$2.61
Rate for Payer: UHC Medicare Advantage	$2.61

PR PALATOPHARYNGOPLASTY

Professional

Both

$2,472.00

Service Code	HCPCS 42145
Min. Negotiated Rate	$652.82
Max. Negotiated Rate	$1,606.80
Rate for Payer: Aetna Commercial	$874.78
Rate for Payer: Aetna Medicare	$678.93
Rate for Payer: Aetna New Business (MI Preferred)	$940.06
Rate for Payer: Aetna New Business (MI Preferred)	$874.78
Rate for Payer: BCBS Complete	$988.80
Rate for Payer: BCBS MAPPO	$652.82
Rate for Payer: BCN Medicare Advantage	$652.82
Rate for Payer: Cash Price	$1,977.60
Rate for Payer: Cash Price	$1,977.60
Rate for Payer: Cofinity Commercial	$940.06
Rate for Payer: Cofinity Commercial	$874.78
Rate for Payer: Health Alliance Plan Medicare Advantage	$652.82
Rate for Payer: Healthscope Commercial	$1,044.51
Rate for Payer: Healthscope Commercial	$1,207.72
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$685.46
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,606.80
Rate for Payer: Nomi Health Commercial	$783.38
Rate for Payer: PACE SWMI	$652.82
Rate for Payer: PHP Medicare Advantage	$652.82
Rate for Payer: Priority Health Cigna Priority Health	$1,606.80
Rate for Payer: Priority Health Medicare	$652.82
Rate for Payer: UHC Dual Complete DSNP	$652.82
Rate for Payer: UHC Medicare Advantage	$652.82

PR PANCREATECTOMY W/TRNSPLJ PANCREAS/ISLET CELLS

Professional

Both

$7,598.00

Service Code	HCPCS 48160
Min. Negotiated Rate	$3,039.20
Max. Negotiated Rate	$4,938.70
Rate for Payer: Aetna Medicare	$3,799.00
Rate for Payer: BCBS Complete	$3,039.20
Rate for Payer: Cash Price	$6,078.40
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4,938.70
Rate for Payer: Priority Health Cigna Priority Health	$4,938.70

PR PANCREATICOJEJUNOSTOMY SIDE-TO-SIDE ANAST

Professional

Both

$3,447.00

Service Code	HCPCS 48548
Min. Negotiated Rate	$1,378.80
Max. Negotiated Rate	$3,004.90
Rate for Payer: Aetna Commercial	$2,176.52
Rate for Payer: Aetna Medicare	$1,689.24
Rate for Payer: Aetna New Business (MI Preferred)	$2,176.52
Rate for Payer: Aetna New Business (MI Preferred)	$2,338.95
Rate for Payer: BCBS Complete	$1,378.80
Rate for Payer: BCBS MAPPO	$1,624.27
Rate for Payer: BCN Medicare Advantage	$1,624.27
Rate for Payer: Cash Price	$2,757.60
Rate for Payer: Cash Price	$2,757.60
Rate for Payer: Cofinity Commercial	$2,338.95
Rate for Payer: Cofinity Commercial	$2,176.52
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,624.27
Rate for Payer: Healthscope Commercial	$3,004.90
Rate for Payer: Healthscope Commercial	$2,598.83
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$1,705.48
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2,240.55
Rate for Payer: Nomi Health Commercial	$1,949.12
Rate for Payer: PACE SWMI	$1,624.27
Rate for Payer: PHP Medicare Advantage	$1,624.27
Rate for Payer: Priority Health Cigna Priority Health	$2,240.55
Rate for Payer: Priority Health Medicare	$1,624.27
Rate for Payer: UHC Dual Complete DSNP	$1,624.27
Rate for Payer: UHC Medicare Advantage	$1,624.27

PR PANCREATORRHAPHY INJURY

Professional

Both

$3,272.00

Service Code	HCPCS 48545
Min. Negotiated Rate	$1,308.80
Max. Negotiated Rate	$2,423.17
Rate for Payer: Aetna Commercial	$1,755.16
Rate for Payer: Aetna Medicare	$1,362.21
Rate for Payer: Aetna New Business (MI Preferred)	$1,755.16
Rate for Payer: Aetna New Business (MI Preferred)	$1,886.14
Rate for Payer: BCBS Complete	$1,308.80
Rate for Payer: BCBS MAPPO	$1,309.82
Rate for Payer: BCN Medicare Advantage	$1,309.82
Rate for Payer: Cash Price	$2,617.60
Rate for Payer: Cash Price	$2,617.60
Rate for Payer: Cofinity Commercial	$1,755.16
Rate for Payer: Cofinity Commercial	$1,886.14
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,309.82
Rate for Payer: Healthscope Commercial	$2,095.71
Rate for Payer: Healthscope Commercial	$2,423.17
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$1,375.31
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2,126.80
Rate for Payer: Nomi Health Commercial	$1,571.78
Rate for Payer: PACE SWMI	$1,309.82
Rate for Payer: PHP Medicare Advantage	$1,309.82
Rate for Payer: Priority Health Cigna Priority Health	$2,126.80
Rate for Payer: Priority Health Medicare	$1,309.82
Rate for Payer: UHC Dual Complete DSNP	$1,309.82
Rate for Payer: UHC Medicare Advantage	$1,309.82

PR PARATHYRDEC/EXPL PARATHYR MEDSTNL STERNAL/TTHRC

Professional

Both

$2,535.00

Service Code	HCPCS 60505
Min. Negotiated Rate	$1,014.00
Max. Negotiated Rate	$2,466.14
Rate for Payer: Aetna Commercial	$1,786.29
Rate for Payer: Aetna Medicare	$1,386.37
Rate for Payer: Aetna New Business (MI Preferred)	$1,919.59
Rate for Payer: Aetna New Business (MI Preferred)	$1,786.29
Rate for Payer: BCBS Complete	$1,014.00
Rate for Payer: BCBS MAPPO	$1,333.05
Rate for Payer: BCN Medicare Advantage	$1,333.05
Rate for Payer: Cash Price	$2,028.00
Rate for Payer: Cash Price	$2,028.00
Rate for Payer: Cofinity Commercial	$1,919.59
Rate for Payer: Cofinity Commercial	$1,786.29
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,333.05
Rate for Payer: Healthscope Commercial	$2,466.14
Rate for Payer: Healthscope Commercial	$2,132.88
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$1,399.70
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,647.75
Rate for Payer: Nomi Health Commercial	$1,599.66
Rate for Payer: PACE SWMI	$1,333.05
Rate for Payer: PHP Medicare Advantage	$1,333.05
Rate for Payer: Priority Health Cigna Priority Health	$1,647.75
Rate for Payer: Priority Health Medicare	$1,333.05
Rate for Payer: UHC Dual Complete DSNP	$1,333.05
Rate for Payer: UHC Medicare Advantage	$1,333.05

PR PARATHYROID AUTOTRANSPLANTATION ADD-ON

Professional

Both

$485.00

Service Code	HCPCS 60512
Min. Negotiated Rate	$194.00
Max. Negotiated Rate	$429.57
Rate for Payer: Aetna Commercial	$311.15
Rate for Payer: Aetna Medicare	$241.49
Rate for Payer: Aetna New Business (MI Preferred)	$334.37
Rate for Payer: Aetna New Business (MI Preferred)	$311.15
Rate for Payer: BCBS Complete	$194.00
Rate for Payer: BCBS MAPPO	$232.20
Rate for Payer: BCN Medicare Advantage	$232.20
Rate for Payer: Cash Price	$388.00
Rate for Payer: Cash Price	$388.00
Rate for Payer: Cofinity Commercial	$334.37
Rate for Payer: Cofinity Commercial	$311.15
Rate for Payer: Health Alliance Plan Medicare Advantage	$232.20
Rate for Payer: Healthscope Commercial	$371.52
Rate for Payer: Healthscope Commercial	$429.57
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$243.81
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$315.25
Rate for Payer: Nomi Health Commercial	$278.64
Rate for Payer: PACE SWMI	$232.20
Rate for Payer: PHP Medicare Advantage	$232.20
Rate for Payer: Priority Health Cigna Priority Health	$315.25
Rate for Payer: Priority Health Medicare	$232.20
Rate for Payer: UHC Dual Complete DSNP	$232.20
Rate for Payer: UHC Medicare Advantage	$232.20

PR PARATHYROIDECTOMY/EXPLORATION PARATHYROIDS

Professional

Both

$3,507.00

Service Code	HCPCS 60500
Min. Negotiated Rate	$937.84
Max. Negotiated Rate	$2,279.55
Rate for Payer: Aetna Commercial	$1,256.71
Rate for Payer: Aetna Medicare	$975.35
Rate for Payer: Aetna New Business (MI Preferred)	$1,350.49
Rate for Payer: Aetna New Business (MI Preferred)	$1,256.71
Rate for Payer: BCBS Complete	$1,402.80
Rate for Payer: BCBS MAPPO	$937.84
Rate for Payer: BCN Medicare Advantage	$937.84
Rate for Payer: Cash Price	$2,805.60
Rate for Payer: Cash Price	$2,805.60
Rate for Payer: Cofinity Commercial	$1,350.49
Rate for Payer: Cofinity Commercial	$1,256.71
Rate for Payer: Health Alliance Plan Medicare Advantage	$937.84
Rate for Payer: Healthscope Commercial	$1,735.00
Rate for Payer: Healthscope Commercial	$1,500.54
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$984.73
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2,279.55
Rate for Payer: Nomi Health Commercial	$1,125.41
Rate for Payer: PACE SWMI	$937.84
Rate for Payer: PHP Medicare Advantage	$937.84
Rate for Payer: Priority Health Cigna Priority Health	$2,279.55
Rate for Payer: Priority Health Medicare	$937.84
Rate for Payer: UHC Dual Complete DSNP	$937.84
Rate for Payer: UHC Medicare Advantage	$937.84

PR PARATHYROIDECTOMY/EXPLOR PARATHYROIDS RE-EXPLOR

Professional

Both

$3,879.00

Service Code	HCPCS 60502
Min. Negotiated Rate	$1,262.30
Max. Negotiated Rate	$2,521.35
Rate for Payer: Aetna Commercial	$1,691.48
Rate for Payer: Aetna Medicare	$1,312.79
Rate for Payer: Aetna New Business (MI Preferred)	$1,817.71
Rate for Payer: Aetna New Business (MI Preferred)	$1,691.48
Rate for Payer: BCBS Complete	$1,551.60
Rate for Payer: BCBS MAPPO	$1,262.30
Rate for Payer: BCN Medicare Advantage	$1,262.30
Rate for Payer: Cash Price	$3,103.20
Rate for Payer: Cash Price	$3,103.20
Rate for Payer: Cofinity Commercial	$1,817.71
Rate for Payer: Cofinity Commercial	$1,691.48
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,262.30
Rate for Payer: Healthscope Commercial	$2,019.68
Rate for Payer: Healthscope Commercial	$2,335.26
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$1,325.41
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2,521.35
Rate for Payer: Nomi Health Commercial	$1,514.76
Rate for Payer: PACE SWMI	$1,262.30
Rate for Payer: PHP Medicare Advantage	$1,262.30
Rate for Payer: Priority Health Cigna Priority Health	$2,521.35
Rate for Payer: Priority Health Medicare	$1,262.30
Rate for Payer: UHC Dual Complete DSNP	$1,262.30
Rate for Payer: UHC Medicare Advantage	$1,262.30

PR PARAVAGINAL DEFECT REPAIR VAGINAL APPROACH

Professional

Both

$1,930.00

Service Code	HCPCS 57285
Min. Negotiated Rate	$663.43
Max. Negotiated Rate	$1,254.50
Rate for Payer: Aetna Commercial	$889.00
Rate for Payer: Aetna Medicare	$689.97
Rate for Payer: Aetna New Business (MI Preferred)	$955.34
Rate for Payer: Aetna New Business (MI Preferred)	$889.00
Rate for Payer: BCBS Complete	$772.00
Rate for Payer: BCBS MAPPO	$663.43
Rate for Payer: BCN Medicare Advantage	$663.43
Rate for Payer: Cash Price	$1,544.00
Rate for Payer: Cash Price	$1,544.00
Rate for Payer: Cofinity Commercial	$955.34
Rate for Payer: Cofinity Commercial	$889.00
Rate for Payer: Health Alliance Plan Medicare Advantage	$663.43
Rate for Payer: Healthscope Commercial	$1,227.35
Rate for Payer: Healthscope Commercial	$1,061.49
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$696.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,254.50
Rate for Payer: Nomi Health Commercial	$796.12
Rate for Payer: PACE SWMI	$663.43
Rate for Payer: PHP Medicare Advantage	$663.43
Rate for Payer: Priority Health Cigna Priority Health	$1,254.50
Rate for Payer: Priority Health Medicare	$663.43
Rate for Payer: UHC Dual Complete DSNP	$663.43
Rate for Payer: UHC Medicare Advantage	$663.43

PR PARING/CUTTING BENIGN HYPERKERATOTIC LESION 1

Professional

Both

$115.00

Service Code	HCPCS 11055
Min. Negotiated Rate	$14.82
Max. Negotiated Rate	$74.75
Rate for Payer: Aetna Commercial	$19.86
Rate for Payer: Aetna Medicare	$15.41
Rate for Payer: Aetna New Business (MI Preferred)	$21.34
Rate for Payer: Aetna New Business (MI Preferred)	$19.86
Rate for Payer: BCBS Complete	$46.00
Rate for Payer: BCBS MAPPO	$14.82
Rate for Payer: BCN Medicare Advantage	$14.82
Rate for Payer: Cash Price	$92.00
Rate for Payer: Cash Price	$92.00
Rate for Payer: Cofinity Commercial	$21.34
Rate for Payer: Cofinity Commercial	$19.86
Rate for Payer: Health Alliance Plan Medicare Advantage	$14.82
Rate for Payer: Healthscope Commercial	$23.71
Rate for Payer: Healthscope Commercial	$27.42
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$15.56
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$74.75
Rate for Payer: Nomi Health Commercial	$17.78
Rate for Payer: PACE SWMI	$14.82
Rate for Payer: PHP Medicare Advantage	$14.82
Rate for Payer: Priority Health Cigna Priority Health	$74.75
Rate for Payer: Priority Health Medicare	$14.82
Rate for Payer: UHC Dual Complete DSNP	$14.82
Rate for Payer: UHC Medicare Advantage	$14.82

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