Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PR ARTHRODESIS WRIST LIMITED W/O BONE GRAFT

Professional

Both

$2,781.00

Service Code	HCPCS 25820
Min. Negotiated Rate	$421.53
Max. Negotiated Rate	$1,946.70
Rate for Payer: Aetna Commercial	$857.48
Rate for Payer: BCBS Complete	$442.61
Rate for Payer: BCBS Trust/PPO	$1,840.07
Rate for Payer: Cash Price	$2,224.80
Rate for Payer: Cash Price	$2,224.80
Rate for Payer: Mclaren Medicaid	$421.53
Rate for Payer: Meridian Medicaid	$442.61
Rate for Payer: Priority Health Choice Medicaid	$421.53
Rate for Payer: Priority Health Cigna Priority Health	$1,946.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,005.47
Rate for Payer: Priority Health Narrow Network	$1,005.47
Rate for Payer: Priority Health SBD	$1,005.47

PR ARTHRODESIS WRIST W/ILIAC/OTHER AUTOGRAFT

Professional

Both

$3,345.00

Service Code	HCPCS 25810
Min. Negotiated Rate	$561.04
Max. Negotiated Rate	$2,341.50
Rate for Payer: Aetna Commercial	$1,152.99
Rate for Payer: BCBS Complete	$589.09
Rate for Payer: BCBS Trust/PPO	$1,598.11
Rate for Payer: Cash Price	$2,676.00
Rate for Payer: Cash Price	$2,676.00
Rate for Payer: Mclaren Medicaid	$561.04
Rate for Payer: Meridian Medicaid	$589.09
Rate for Payer: Priority Health Choice Medicaid	$561.04
Rate for Payer: Priority Health Cigna Priority Health	$2,341.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,333.81
Rate for Payer: Priority Health Narrow Network	$1,333.81
Rate for Payer: Priority Health SBD	$1,333.81

PR ARTHRODESIS WRIST W/SLIDING GRAFT

Professional

Both

$2,917.00

Service Code	HCPCS 25805
Min. Negotiated Rate	$548.48
Max. Negotiated Rate	$2,041.90
Rate for Payer: Aetna Commercial	$1,131.59
Rate for Payer: BCBS Complete	$575.90
Rate for Payer: BCBS Trust/PPO	$1,451.24
Rate for Payer: Cash Price	$2,333.60
Rate for Payer: Cash Price	$2,333.60
Rate for Payer: Mclaren Medicaid	$548.48
Rate for Payer: Meridian Medicaid	$575.90
Rate for Payer: Priority Health Choice Medicaid	$548.48
Rate for Payer: Priority Health Cigna Priority Health	$2,041.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,304.20
Rate for Payer: Priority Health Narrow Network	$1,304.20
Rate for Payer: Priority Health SBD	$1,304.20

PR ARTHRO, LOOSE BODY + CHONDRO

Facility

$222.00

Service Code	HCPCS G0289
Hospital Charge Code	G0289
Min. Negotiated Rate	$139.86
Max. Negotiated Rate	$199.80
Rate for Payer: Aetna Commercial	$188.70
Rate for Payer: Aetna New Business (MI Preferred)	$144.30
Rate for Payer: Cash Price	$177.60
Rate for Payer: Cofinity Commercial	$155.40
Rate for Payer: Cofinity Commercial	$190.92
Rate for Payer: Healthscope Commercial	$199.80
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$188.70
Rate for Payer: PHP Commercial	$188.70
Rate for Payer: Priority Health Cigna Priority Health	$155.40
Rate for Payer: Priority Health SBD	$139.86

PR ARTHRO, LOOSE BODY + CHONDRO

Professional

Both

$222.00

Service Code	HCPCS G0289
Hospital Charge Code	G0289
Min. Negotiated Rate	$85.90
Max. Negotiated Rate	$561.05
Rate for Payer: Aetna Commercial	$85.90
Rate for Payer: BCBS Complete	$88.80
Rate for Payer: BCBS Trust/PPO	$561.05
Rate for Payer: Cash Price	$177.60
Rate for Payer: Cash Price	$177.60
Rate for Payer: Priority Health Cigna Priority Health	$155.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$129.19
Rate for Payer: Priority Health Narrow Network	$129.19
Rate for Payer: Priority Health SBD	$129.19

PR ARTHRO, LOOSE BODY + CHONDRO

Professional

Both

$222.00

Service Code	HCPCS G0289
Min. Negotiated Rate	$85.90
Max. Negotiated Rate	$561.05
Rate for Payer: Aetna Commercial	$85.90
Rate for Payer: BCBS Complete	$88.80
Rate for Payer: BCBS Trust/PPO	$561.05
Rate for Payer: Cash Price	$177.60
Rate for Payer: Cash Price	$177.60
Rate for Payer: Priority Health Cigna Priority Health	$155.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$129.19
Rate for Payer: Priority Health Narrow Network	$129.19
Rate for Payer: Priority Health SBD	$129.19

PR ARTHRO, LOOSE BODY + CHONDRO

Facility

$222.00

Service Code	HCPCS G0289
Hospital Charge Code	G0289
Min. Negotiated Rate	$83.17
Max. Negotiated Rate	$199.80
Rate for Payer: Aetna Commercial	$188.70
Rate for Payer: Aetna New Business (MI Preferred)	$144.30
Rate for Payer: BCBS Complete	$88.80
Rate for Payer: BCBS Trust/PPO	$178.15
Rate for Payer: Cash Price	$177.60
Rate for Payer: Cash Price	$177.60
Rate for Payer: Cofinity Commercial	$190.92
Rate for Payer: Cofinity Commercial	$155.40
Rate for Payer: Healthscope Commercial	$199.80
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$188.70
Rate for Payer: PHP Commercial	$188.70
Rate for Payer: Priority Health Cigna Priority Health	$155.40
Rate for Payer: Priority Health SBD	$139.86
Rate for Payer: UHC All Payor (Choice/PPO)	$91.49
Rate for Payer: UHC Exchange	$83.17

PR ARTHROPLASTY ANKLE

Professional

Both

$2,650.00

Service Code	HCPCS 27700
Min. Negotiated Rate	$461.15
Max. Negotiated Rate	$1,855.00
Rate for Payer: Aetna Commercial	$810.77
Rate for Payer: BCBS Complete	$484.21
Rate for Payer: BCBS Trust/PPO	$1,228.83
Rate for Payer: Cash Price	$2,120.00
Rate for Payer: Cash Price	$2,120.00
Rate for Payer: Mclaren Medicaid	$461.15
Rate for Payer: Meridian Medicaid	$484.21
Rate for Payer: Priority Health Choice Medicaid	$461.15
Rate for Payer: Priority Health Cigna Priority Health	$1,855.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$935.51
Rate for Payer: Priority Health Narrow Network	$935.51
Rate for Payer: Priority Health SBD	$935.51

PR ARTHROPLASTY ANKLE REVISION TOTAL ANKLE

Professional

Both

$2,004.00

Service Code	HCPCS 27703
Min. Negotiated Rate	$712.91
Max. Negotiated Rate	$2,923.61
Rate for Payer: Aetna Commercial	$1,490.55
Rate for Payer: BCBS Complete	$748.56
Rate for Payer: BCBS Trust/PPO	$2,923.61
Rate for Payer: Cash Price	$1,603.20
Rate for Payer: Cash Price	$1,603.20
Rate for Payer: Mclaren Medicaid	$712.91
Rate for Payer: Meridian Medicaid	$748.56
Rate for Payer: Priority Health Choice Medicaid	$712.91
Rate for Payer: Priority Health Cigna Priority Health	$1,402.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,698.94
Rate for Payer: Priority Health Narrow Network	$1,698.94
Rate for Payer: Priority Health SBD	$1,698.94

PR ARTHROPLASTY ANKLE W/IMPLANT

Professional

Both

$1,937.74

Service Code	HCPCS 27702
Min. Negotiated Rate	$618.55
Max. Negotiated Rate	$2,899.77
Rate for Payer: Aetna Commercial	$1,287.42
Rate for Payer: BCBS Complete	$649.48
Rate for Payer: BCBS Trust/PPO	$2,899.77
Rate for Payer: Cash Price	$1,550.19
Rate for Payer: Cash Price	$1,550.19
Rate for Payer: Mclaren Medicaid	$618.55
Rate for Payer: Meridian Medicaid	$649.48
Rate for Payer: Priority Health Choice Medicaid	$618.55
Rate for Payer: Priority Health Cigna Priority Health	$1,356.42
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,470.67
Rate for Payer: Priority Health Narrow Network	$1,470.67
Rate for Payer: Priority Health SBD	$1,470.67

PR ARTHROPLASTY FEM CONDYLES/TIBIAL PLATEAU KNEE

Professional

Both

$1,524.00

Service Code	HCPCS 27442
Min. Negotiated Rate	$560.62
Max. Negotiated Rate	$1,338.41
Rate for Payer: Aetna Commercial	$1,163.41
Rate for Payer: BCBS Complete	$588.65
Rate for Payer: BCBS Trust/PPO	$640.30
Rate for Payer: Cash Price	$1,219.20
Rate for Payer: Cash Price	$1,219.20
Rate for Payer: Mclaren Medicaid	$560.62
Rate for Payer: Meridian Medicaid	$588.65
Rate for Payer: Priority Health Choice Medicaid	$560.62
Rate for Payer: Priority Health Cigna Priority Health	$1,066.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,338.41
Rate for Payer: Priority Health Narrow Network	$1,338.41
Rate for Payer: Priority Health SBD	$1,338.41

PR ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER

Facility

$4,485.00

Service Code	CPT 23472
Hospital Charge Code	23472
Min. Negotiated Rate	$2,825.55
Max. Negotiated Rate	$4,036.50
Rate for Payer: Aetna Commercial	$3,812.25
Rate for Payer: Aetna New Business (MI Preferred)	$2,915.25
Rate for Payer: Cash Price	$3,588.00
Rate for Payer: Cofinity Commercial	$3,139.50
Rate for Payer: Cofinity Commercial	$3,857.10
Rate for Payer: Healthscope Commercial	$4,036.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3,812.25
Rate for Payer: PHP Commercial	$3,812.25
Rate for Payer: Priority Health Cigna Priority Health	$3,139.50
Rate for Payer: Priority Health SBD	$2,825.55

PR ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER

Professional

Both

$4,485.00

Service Code	HCPCS 23472
Min. Negotiated Rate	$197.82
Max. Negotiated Rate	$3,139.50
Rate for Payer: Aetna Commercial	$1,937.50
Rate for Payer: BCBS Complete	$971.31
Rate for Payer: BCBS Trust/PPO	$197.82
Rate for Payer: Cash Price	$3,588.00
Rate for Payer: Cash Price	$3,588.00
Rate for Payer: Mclaren Medicaid	$925.06
Rate for Payer: Meridian Medicaid	$971.31
Rate for Payer: Priority Health Choice Medicaid	$925.06
Rate for Payer: Priority Health Cigna Priority Health	$3,139.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,205.50
Rate for Payer: Priority Health Narrow Network	$2,205.50
Rate for Payer: Priority Health SBD	$2,205.50

PR ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER

Professional

Both

$4,485.00

Service Code	HCPCS 23472
Hospital Charge Code	23472
Min. Negotiated Rate	$197.82
Max. Negotiated Rate	$3,139.50
Rate for Payer: Aetna Commercial	$1,937.50
Rate for Payer: BCBS Complete	$971.31
Rate for Payer: BCBS Trust/PPO	$197.82
Rate for Payer: Cash Price	$3,588.00
Rate for Payer: Cash Price	$3,588.00
Rate for Payer: Mclaren Medicaid	$925.06
Rate for Payer: Meridian Medicaid	$971.31
Rate for Payer: Priority Health Choice Medicaid	$925.06
Rate for Payer: Priority Health Cigna Priority Health	$3,139.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,205.50
Rate for Payer: Priority Health Narrow Network	$2,205.50
Rate for Payer: Priority Health SBD	$2,205.50

PR ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER

Facility

$4,485.00

Service Code	CPT 23472
Hospital Charge Code	23472
Min. Negotiated Rate	$1,422.08
Max. Negotiated Rate	$20,727.79
Rate for Payer: Aetna Commercial	$3,812.25
Rate for Payer: Aetna Medicare	$17,245.52
Rate for Payer: Aetna New Business (MI Preferred)	$2,915.25
Rate for Payer: Allen County Amish Medical Aid Commercial	$20,727.79
Rate for Payer: Amish Plain Church Group Commercial	$20,727.79
Rate for Payer: BCBS Complete	$9,524.83
Rate for Payer: BCBS MAPPO	$16,582.23
Rate for Payer: BCBS Trust/PPO	$10,332.17
Rate for Payer: BCN Medicare Advantage	$16,582.23
Rate for Payer: Cash Price	$3,588.00
Rate for Payer: Cash Price	$3,588.00
Rate for Payer: Cofinity Commercial	$3,139.50
Rate for Payer: Cofinity Commercial	$3,857.10
Rate for Payer: Health Alliance Plan Medicare Advantage	$16,582.23
Rate for Payer: Healthscope Commercial	$4,036.50
Rate for Payer: Mclaren Medicaid	$9,070.48
Rate for Payer: Mclaren Medicare	$16,582.23
Rate for Payer: Meridian Medicaid	$9,524.83
Rate for Payer: Meridian Wellcare - Medicare Advantage	$17,411.34
Rate for Payer: MI Amish Medical Board Commercial	$19,069.56
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3,812.25
Rate for Payer: PACE Medicare	$15,753.12
Rate for Payer: PACE SWMI	$16,582.23
Rate for Payer: PHP Commercial	$3,812.25
Rate for Payer: PHP Medicare Advantage	$16,582.23
Rate for Payer: Priority Health Choice Medicaid	$9,070.48
Rate for Payer: Priority Health Cigna Priority Health	$3,139.50
Rate for Payer: Priority Health Medicare	$16,582.23
Rate for Payer: Priority Health SBD	$2,825.55
Rate for Payer: Railroad Medicare Medicare	$16,582.23
Rate for Payer: UHC All Payor (Choice/PPO)	$1,564.29
Rate for Payer: UHC Dual Complete DSNP	$16,582.23
Rate for Payer: UHC Exchange	$1,422.08
Rate for Payer: UHC Medicare Advantage	$17,079.70
Rate for Payer: VA VA	$16,582.23

PR ARTHROPLASTY GLENOHUMRL JT HEMIARTHROPLASTY

Professional

Both

$3,398.00

Service Code	HCPCS 23470
Min. Negotiated Rate	$171.92
Max. Negotiated Rate	$2,378.60
Rate for Payer: Aetna Commercial	$1,604.69
Rate for Payer: BCBS Complete	$807.38
Rate for Payer: BCBS Trust/PPO	$171.92
Rate for Payer: Cash Price	$2,718.40
Rate for Payer: Cash Price	$2,718.40
Rate for Payer: Mclaren Medicaid	$768.93
Rate for Payer: Meridian Medicaid	$807.38
Rate for Payer: Priority Health Choice Medicaid	$768.93
Rate for Payer: Priority Health Cigna Priority Health	$2,378.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,830.69
Rate for Payer: Priority Health Narrow Network	$1,830.69
Rate for Payer: Priority Health SBD	$1,830.69

PR ARTHROPLASTY INTERPHALANGEAL JOINT EACH

Professional

Both

$1,657.00

Service Code	HCPCS 26535
Min. Negotiated Rate	$286.70
Max. Negotiated Rate	$1,159.90
Rate for Payer: Aetna Commercial	$580.99
Rate for Payer: BCBS Complete	$301.04
Rate for Payer: BCBS Trust/PPO	$943.54
Rate for Payer: Cash Price	$1,325.60
Rate for Payer: Cash Price	$1,325.60
Rate for Payer: Mclaren Medicaid	$286.70
Rate for Payer: Meridian Medicaid	$301.04
Rate for Payer: Priority Health Choice Medicaid	$286.70
Rate for Payer: Priority Health Cigna Priority Health	$1,159.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$679.16
Rate for Payer: Priority Health Narrow Network	$679.16
Rate for Payer: Priority Health SBD	$679.16

PR ARTHROPLASTY INTERPHALANGEAL JT W/PROSTHETIC EA

Professional

Both

$2,432.00

Service Code	HCPCS 26536
Min. Negotiated Rate	$331.24
Max. Negotiated Rate	$1,702.40
Rate for Payer: Aetna Commercial	$992.54
Rate for Payer: BCBS Complete	$509.70
Rate for Payer: BCBS Trust/PPO	$331.24
Rate for Payer: Cash Price	$1,945.60
Rate for Payer: Cash Price	$1,945.60
Rate for Payer: Mclaren Medicaid	$485.43
Rate for Payer: Meridian Medicaid	$509.70
Rate for Payer: Priority Health Choice Medicaid	$485.43
Rate for Payer: Priority Health Cigna Priority Health	$1,702.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,165.81
Rate for Payer: Priority Health Narrow Network	$1,165.81
Rate for Payer: Priority Health SBD	$1,165.81

PR ARTHROPLASTY KNEE TIBIAL PLATEAU

Professional

Both

$1,742.00

Service Code	HCPCS 27440
Min. Negotiated Rate	$516.10
Max. Negotiated Rate	$1,732.82
Rate for Payer: Aetna Commercial	$1,065.93
Rate for Payer: BCBS Complete	$541.90
Rate for Payer: BCBS Trust/PPO	$1,732.82
Rate for Payer: Cash Price	$1,393.60
Rate for Payer: Cash Price	$1,393.60
Rate for Payer: Mclaren Medicaid	$516.10
Rate for Payer: Meridian Medicaid	$541.90
Rate for Payer: Priority Health Choice Medicaid	$516.10
Rate for Payer: Priority Health Cigna Priority Health	$1,219.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,227.09
Rate for Payer: Priority Health Narrow Network	$1,227.09
Rate for Payer: Priority Health SBD	$1,227.09

PR ARTHROPLASTY METACARPOPHALANGEAL JOINT EACH

Professional

Both

$1,771.00

Service Code	HCPCS 26530
Min. Negotiated Rate	$353.79
Max. Negotiated Rate	$1,277.96
Rate for Payer: Aetna Commercial	$718.60
Rate for Payer: BCBS Complete	$371.48
Rate for Payer: BCBS Trust/PPO	$1,277.96
Rate for Payer: Cash Price	$1,416.80
Rate for Payer: Cash Price	$1,416.80
Rate for Payer: Mclaren Medicaid	$353.79
Rate for Payer: Meridian Medicaid	$371.48
Rate for Payer: Priority Health Choice Medicaid	$353.79
Rate for Payer: Priority Health Cigna Priority Health	$1,239.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$835.42
Rate for Payer: Priority Health Narrow Network	$835.42
Rate for Payer: Priority Health SBD	$835.42

PR ARTHROPLASTY PATELLA W/O PROSTHESIS

Professional

Both

$1,153.00

Service Code	HCPCS 27437
Min. Negotiated Rate	$429.41
Max. Negotiated Rate	$1,630.86
Rate for Payer: Aetna Commercial	$882.46
Rate for Payer: BCBS Complete	$450.88
Rate for Payer: BCBS Trust/PPO	$1,630.86
Rate for Payer: Cash Price	$922.40
Rate for Payer: Cash Price	$922.40
Rate for Payer: Mclaren Medicaid	$429.41
Rate for Payer: Meridian Medicaid	$450.88
Rate for Payer: Priority Health Choice Medicaid	$429.41
Rate for Payer: Priority Health Cigna Priority Health	$807.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,019.26
Rate for Payer: Priority Health Narrow Network	$1,019.26
Rate for Payer: Priority Health SBD	$1,019.26

PR ARTHROPLASTY PATELLA W/PROSTHESIS

Professional

Both

$2,289.00

Service Code	HCPCS 27438
Min. Negotiated Rate	$543.15
Max. Negotiated Rate	$1,651.99
Rate for Payer: Aetna Commercial	$1,122.35
Rate for Payer: BCBS Complete	$570.31
Rate for Payer: BCBS Trust/PPO	$1,651.99
Rate for Payer: Cash Price	$1,831.20
Rate for Payer: Cash Price	$1,831.20
Rate for Payer: Mclaren Medicaid	$543.15
Rate for Payer: Meridian Medicaid	$570.31
Rate for Payer: Priority Health Choice Medicaid	$543.15
Rate for Payer: Priority Health Cigna Priority Health	$1,602.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,290.93
Rate for Payer: Priority Health Narrow Network	$1,290.93
Rate for Payer: Priority Health SBD	$1,290.93

PR ARTHROPLASTY RADIAL HEAD

Professional

Both

$1,635.00

Service Code	HCPCS 24365
Min. Negotiated Rate	$258.95
Max. Negotiated Rate	$1,144.50
Rate for Payer: Aetna Commercial	$857.03
Rate for Payer: BCBS Complete	$437.24
Rate for Payer: BCBS Trust/PPO	$258.95
Rate for Payer: Cash Price	$1,308.00
Rate for Payer: Cash Price	$1,308.00
Rate for Payer: Mclaren Medicaid	$416.42
Rate for Payer: Meridian Medicaid	$437.24
Rate for Payer: Priority Health Choice Medicaid	$416.42
Rate for Payer: Priority Health Cigna Priority Health	$1,144.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$989.14
Rate for Payer: Priority Health Narrow Network	$989.14
Rate for Payer: Priority Health SBD	$989.14

PR ARTHROPLASTY RADIAL HEAD W/IMPLANT

Professional

Both

$2,465.00

Service Code	HCPCS 24366
Min. Negotiated Rate	$304.79
Max. Negotiated Rate	$1,725.50
Rate for Payer: Aetna Commercial	$909.61
Rate for Payer: BCBS Complete	$462.96
Rate for Payer: BCBS Trust/PPO	$304.79
Rate for Payer: Cash Price	$1,972.00
Rate for Payer: Cash Price	$1,972.00
Rate for Payer: Mclaren Medicaid	$440.91
Rate for Payer: Meridian Medicaid	$462.96
Rate for Payer: Priority Health Choice Medicaid	$440.91
Rate for Payer: Priority Health Cigna Priority Health	$1,725.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,048.36
Rate for Payer: Priority Health Narrow Network	$1,048.36
Rate for Payer: Priority Health SBD	$1,048.36

PR ARTHROPLASTY W/PROSTHETIC REPLACEMENT TRAPEZIUM

Professional

Both

$1,259.00

Service Code	HCPCS 25445
Min. Negotiated Rate	$467.11
Max. Negotiated Rate	$1,111.68
Rate for Payer: Aetna Commercial	$960.91
Rate for Payer: BCBS Complete	$490.47
Rate for Payer: BCBS Trust/PPO	$864.30
Rate for Payer: Cash Price	$1,007.20
Rate for Payer: Cash Price	$1,007.20
Rate for Payer: Mclaren Medicaid	$467.11
Rate for Payer: Meridian Medicaid	$490.47
Rate for Payer: Priority Health Choice Medicaid	$467.11
Rate for Payer: Priority Health Cigna Priority Health	$881.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,111.68
Rate for Payer: Priority Health Narrow Network	$1,111.68
Rate for Payer: Priority Health SBD	$1,111.68

Know your out-of-pocket cost for care.

All Charges