Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PR ARTHRP WRST W/WO INTERPOS W/WO XTRNL/INT FIXJ

Professional

Both

$3,612.00

Service Code	HCPCS 25332
Min. Negotiated Rate	$546.77
Max. Negotiated Rate	$2,528.40
Rate for Payer: Aetna Commercial	$1,126.09
Rate for Payer: BCBS Complete	$574.11
Rate for Payer: BCBS Trust/PPO	$547.85
Rate for Payer: Cash Price	$2,889.60
Rate for Payer: Cash Price	$2,889.60
Rate for Payer: Mclaren Medicaid	$546.77
Rate for Payer: Meridian Medicaid	$574.11
Rate for Payer: Priority Health Choice Medicaid	$546.77
Rate for Payer: Priority Health Cigna Priority Health	$2,528.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,300.12
Rate for Payer: Priority Health Narrow Network	$1,300.12
Rate for Payer: Priority Health SBD	$1,300.12

PR ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ

Facility

$3,998.00

Service Code	CPT 29888
Hospital Charge Code	29888
Min. Negotiated Rate	$963.33
Max. Negotiated Rate	$7,957.04
Rate for Payer: Aetna Commercial	$3,398.30
Rate for Payer: Aetna Medicare	$6,620.26
Rate for Payer: Aetna New Business (MI Preferred)	$2,598.70
Rate for Payer: Allen County Amish Medical Aid Commercial	$7,957.04
Rate for Payer: Amish Plain Church Group Commercial	$7,957.04
Rate for Payer: BCBS Complete	$3,656.42
Rate for Payer: BCBS MAPPO	$6,365.63
Rate for Payer: BCBS Trust/PPO	$3,827.06
Rate for Payer: BCN Medicare Advantage	$6,365.63
Rate for Payer: Cash Price	$3,198.40
Rate for Payer: Cash Price	$3,198.40
Rate for Payer: Cofinity Commercial	$3,438.28
Rate for Payer: Cofinity Commercial	$2,798.60
Rate for Payer: Health Alliance Plan Medicare Advantage	$6,365.63
Rate for Payer: Healthscope Commercial	$3,598.20
Rate for Payer: Mclaren Medicaid	$3,482.00
Rate for Payer: Mclaren Medicare	$6,365.63
Rate for Payer: Meridian Medicaid	$3,656.42
Rate for Payer: Meridian Wellcare - Medicare Advantage	$6,683.91
Rate for Payer: MI Amish Medical Board Commercial	$7,320.47
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3,398.30
Rate for Payer: PACE Medicare	$6,047.35
Rate for Payer: PACE SWMI	$6,365.63
Rate for Payer: PHP Commercial	$3,398.30
Rate for Payer: PHP Medicare Advantage	$6,365.63
Rate for Payer: Priority Health Choice Medicaid	$3,482.00
Rate for Payer: Priority Health Cigna Priority Health	$2,798.60
Rate for Payer: Priority Health Medicare	$6,365.63
Rate for Payer: Priority Health SBD	$2,518.74
Rate for Payer: Railroad Medicare Medicare	$6,365.63
Rate for Payer: UHC All Payor (Choice/PPO)	$1,059.66
Rate for Payer: UHC Dual Complete DSNP	$6,365.63
Rate for Payer: UHC Exchange	$963.33
Rate for Payer: UHC Medicare Advantage	$6,556.60
Rate for Payer: VA VA	$6,365.63

PR ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ

Facility

$3,998.00

Service Code	CPT 29888
Hospital Charge Code	29888
Min. Negotiated Rate	$2,518.74
Max. Negotiated Rate	$3,598.20
Rate for Payer: Aetna Commercial	$3,398.30
Rate for Payer: Aetna New Business (MI Preferred)	$2,598.70
Rate for Payer: Cash Price	$3,198.40
Rate for Payer: Cofinity Commercial	$2,798.60
Rate for Payer: Cofinity Commercial	$3,438.28
Rate for Payer: Healthscope Commercial	$3,598.20
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3,398.30
Rate for Payer: PHP Commercial	$3,398.30
Rate for Payer: Priority Health Cigna Priority Health	$2,798.60
Rate for Payer: Priority Health SBD	$2,518.74

PR ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ

Professional

Both

$3,998.00

Service Code	HCPCS 29888
Min. Negotiated Rate	$626.65
Max. Negotiated Rate	$2,798.60
Rate for Payer: Aetna Commercial	$1,306.22
Rate for Payer: BCBS Complete	$657.98
Rate for Payer: BCBS Trust/PPO	$1,043.92
Rate for Payer: Cash Price	$3,198.40
Rate for Payer: Cash Price	$3,198.40
Rate for Payer: Mclaren Medicaid	$626.65
Rate for Payer: Meridian Medicaid	$657.98
Rate for Payer: Priority Health Choice Medicaid	$626.65
Rate for Payer: Priority Health Cigna Priority Health	$2,798.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,493.14
Rate for Payer: Priority Health Narrow Network	$1,493.14
Rate for Payer: Priority Health SBD	$1,493.14

PR ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ

Professional

Both

$3,998.00

Service Code	HCPCS 29888
Hospital Charge Code	29888
Min. Negotiated Rate	$626.65
Max. Negotiated Rate	$2,798.60
Rate for Payer: Aetna Commercial	$1,306.22
Rate for Payer: BCBS Complete	$657.98
Rate for Payer: BCBS Trust/PPO	$1,043.92
Rate for Payer: Cash Price	$3,198.40
Rate for Payer: Cash Price	$3,198.40
Rate for Payer: Mclaren Medicaid	$626.65
Rate for Payer: Meridian Medicaid	$657.98
Rate for Payer: Priority Health Choice Medicaid	$626.65
Rate for Payer: Priority Health Cigna Priority Health	$2,798.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,493.14
Rate for Payer: Priority Health Narrow Network	$1,493.14
Rate for Payer: Priority Health SBD	$1,493.14

PR ARTHRS AIDED PST CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ

Professional

Both

$4,154.00

Service Code	HCPCS 29889
Min. Negotiated Rate	$788.95
Max. Negotiated Rate	$2,907.80
Rate for Payer: Aetna Commercial	$1,632.85
Rate for Payer: BCBS Complete	$828.40
Rate for Payer: BCBS Trust/PPO	$1,326.56
Rate for Payer: Cash Price	$3,323.20
Rate for Payer: Cash Price	$3,323.20
Rate for Payer: Mclaren Medicaid	$788.95
Rate for Payer: Meridian Medicaid	$828.40
Rate for Payer: Priority Health Choice Medicaid	$788.95
Rate for Payer: Priority Health Cigna Priority Health	$2,907.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,874.60
Rate for Payer: Priority Health Narrow Network	$1,874.60
Rate for Payer: Priority Health SBD	$1,874.60

PR ARTHRS AID RPR LES/TALAR DOME FX/TIBL PLAFOND FX

Professional

Both

$2,635.00

Service Code	HCPCS 29892
Min. Negotiated Rate	$413.43
Max. Negotiated Rate	$1,844.50
Rate for Payer: Aetna Commercial	$860.03
Rate for Payer: BCBS Complete	$434.10
Rate for Payer: BCBS Trust/PPO	$1,172.83
Rate for Payer: Cash Price	$2,108.00
Rate for Payer: Cash Price	$2,108.00
Rate for Payer: Mclaren Medicaid	$413.43
Rate for Payer: Meridian Medicaid	$434.10
Rate for Payer: Priority Health Choice Medicaid	$413.43
Rate for Payer: Priority Health Cigna Priority Health	$1,844.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$981.47
Rate for Payer: Priority Health Narrow Network	$981.47
Rate for Payer: Priority Health SBD	$981.47

PR ARTHRS AID TIBIAL FRACTURE PROXIMAL UNICONDYLAR

Professional

Both

$2,492.00

Service Code	HCPCS 29855
Min. Negotiated Rate	$503.96
Max. Negotiated Rate	$1,744.40
Rate for Payer: Aetna Commercial	$1,041.85
Rate for Payer: BCBS Complete	$529.16
Rate for Payer: BCBS Trust/PPO	$1,471.84
Rate for Payer: Cash Price	$1,993.60
Rate for Payer: Cash Price	$1,993.60
Rate for Payer: Mclaren Medicaid	$503.96
Rate for Payer: Meridian Medicaid	$529.16
Rate for Payer: Priority Health Choice Medicaid	$503.96
Rate for Payer: Priority Health Cigna Priority Health	$1,744.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,199.52
Rate for Payer: Priority Health Narrow Network	$1,199.52
Rate for Payer: Priority Health SBD	$1,199.52

PR ARTHRS AID TIBIAL FX PROX UNICONDYLAR BICONDYLAR

Professional

Both

$1,751.00

Service Code	HCPCS 29856
Min. Negotiated Rate	$639.21
Max. Negotiated Rate	$1,644.07
Rate for Payer: Aetna Commercial	$1,318.77
Rate for Payer: BCBS Complete	$671.17
Rate for Payer: BCBS Trust/PPO	$1,644.07
Rate for Payer: Cash Price	$1,400.80
Rate for Payer: Cash Price	$1,400.80
Rate for Payer: Mclaren Medicaid	$639.21
Rate for Payer: Meridian Medicaid	$671.17
Rate for Payer: Priority Health Choice Medicaid	$639.21
Rate for Payer: Priority Health Cigna Priority Health	$1,225.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,520.71
Rate for Payer: Priority Health Narrow Network	$1,520.71
Rate for Payer: Priority Health SBD	$1,520.71

PR ARTHRS ANKLE EXC OSTCHNDRL DFCT W/DRLG DFCT

Professional

Both

$2,380.00

Service Code	HCPCS 29891
Min. Negotiated Rate	$435.37
Max. Negotiated Rate	$1,666.00
Rate for Payer: Aetna Commercial	$892.98
Rate for Payer: BCBS Complete	$457.14
Rate for Payer: BCBS Trust/PPO	$1,590.71
Rate for Payer: Cash Price	$1,904.00
Rate for Payer: Cash Price	$1,904.00
Rate for Payer: Mclaren Medicaid	$435.37
Rate for Payer: Meridian Medicaid	$457.14
Rate for Payer: Priority Health Choice Medicaid	$435.37
Rate for Payer: Priority Health Cigna Priority Health	$1,666.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,026.91
Rate for Payer: Priority Health Narrow Network	$1,026.91
Rate for Payer: Priority Health SBD	$1,026.91

PR ARTHRS HIP DEBRIDEMENT/SHAVING ARTICULAR CRTLG

Professional

Both

$2,704.00

Service Code	HCPCS 29862
Min. Negotiated Rate	$526.75
Max. Negotiated Rate	$1,892.80
Rate for Payer: Aetna Commercial	$1,084.46
Rate for Payer: BCBS Complete	$553.09
Rate for Payer: BCBS Trust/PPO	$798.79
Rate for Payer: Cash Price	$2,163.20
Rate for Payer: Cash Price	$2,163.20
Rate for Payer: Mclaren Medicaid	$526.75
Rate for Payer: Meridian Medicaid	$553.09
Rate for Payer: Priority Health Choice Medicaid	$526.75
Rate for Payer: Priority Health Cigna Priority Health	$1,892.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,247.01
Rate for Payer: Priority Health Narrow Network	$1,247.01
Rate for Payer: Priority Health SBD	$1,247.01

PR ARTHRS KNEE ABRASION ARTHRP/MLT DRLG/MICROFX

Professional

Both

$2,475.00

Service Code	HCPCS 29879
Hospital Charge Code	29879
Min. Negotiated Rate	$428.56
Max. Negotiated Rate	$1,732.50
Rate for Payer: Aetna Commercial	$882.28
Rate for Payer: BCBS Complete	$449.99
Rate for Payer: BCBS Trust/PPO	$943.02
Rate for Payer: Cash Price	$1,980.00
Rate for Payer: Cash Price	$1,980.00
Rate for Payer: Mclaren Medicaid	$428.56
Rate for Payer: Meridian Medicaid	$449.99
Rate for Payer: Priority Health Choice Medicaid	$428.56
Rate for Payer: Priority Health Cigna Priority Health	$1,732.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,017.21
Rate for Payer: Priority Health Narrow Network	$1,017.21
Rate for Payer: Priority Health SBD	$1,017.21

PR ARTHRS KNEE ABRASION ARTHRP/MLT DRLG/MICROFX

Professional

Both

$2,475.00

Service Code	HCPCS 29879
Min. Negotiated Rate	$428.56
Max. Negotiated Rate	$1,732.50
Rate for Payer: Aetna Commercial	$882.28
Rate for Payer: BCBS Complete	$449.99
Rate for Payer: BCBS Trust/PPO	$943.02
Rate for Payer: Cash Price	$1,980.00
Rate for Payer: Cash Price	$1,980.00
Rate for Payer: Mclaren Medicaid	$428.56
Rate for Payer: Meridian Medicaid	$449.99
Rate for Payer: Priority Health Choice Medicaid	$428.56
Rate for Payer: Priority Health Cigna Priority Health	$1,732.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,017.21
Rate for Payer: Priority Health Narrow Network	$1,017.21
Rate for Payer: Priority Health SBD	$1,017.21

PR ARTHRS KNEE ABRASION ARTHRP/MLT DRLG/MICROFX

Facility

$2,475.00

Service Code	CPT 29879
Hospital Charge Code	29879
Min. Negotiated Rate	$1,559.25
Max. Negotiated Rate	$2,227.50
Rate for Payer: Aetna Commercial	$2,103.75
Rate for Payer: Aetna New Business (MI Preferred)	$1,608.75
Rate for Payer: Cash Price	$1,980.00
Rate for Payer: Cofinity Commercial	$2,128.50
Rate for Payer: Cofinity Commercial	$1,732.50
Rate for Payer: Healthscope Commercial	$2,227.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,103.75
Rate for Payer: PHP Commercial	$2,103.75
Rate for Payer: Priority Health Cigna Priority Health	$1,732.50
Rate for Payer: Priority Health SBD	$1,559.25

PR ARTHRS KNEE ABRASION ARTHRP/MLT DRLG/MICROFX

Facility

$2,475.00

Service Code	CPT 29879
Hospital Charge Code	29879
Min. Negotiated Rate	$658.81
Max. Negotiated Rate	$3,600.14
Rate for Payer: Aetna Commercial	$2,103.75
Rate for Payer: Aetna Medicare	$2,995.31
Rate for Payer: Aetna New Business (MI Preferred)	$1,608.75
Rate for Payer: Allen County Amish Medical Aid Commercial	$3,600.14
Rate for Payer: Amish Plain Church Group Commercial	$3,600.14
Rate for Payer: BCBS Complete	$1,654.34
Rate for Payer: BCBS MAPPO	$2,880.11
Rate for Payer: BCBS Trust/PPO	$1,234.36
Rate for Payer: BCN Medicare Advantage	$2,880.11
Rate for Payer: Cash Price	$1,980.00
Rate for Payer: Cash Price	$1,980.00
Rate for Payer: Cofinity Commercial	$2,128.50
Rate for Payer: Cofinity Commercial	$1,732.50
Rate for Payer: Health Alliance Plan Medicare Advantage	$2,880.11
Rate for Payer: Healthscope Commercial	$2,227.50
Rate for Payer: Mclaren Medicaid	$1,575.42
Rate for Payer: Mclaren Medicare	$2,880.11
Rate for Payer: Meridian Medicaid	$1,654.34
Rate for Payer: Meridian Wellcare - Medicare Advantage	$3,024.12
Rate for Payer: MI Amish Medical Board Commercial	$3,312.13
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,103.75
Rate for Payer: PACE Medicare	$2,736.10
Rate for Payer: PACE SWMI	$2,880.11
Rate for Payer: PHP Commercial	$2,103.75
Rate for Payer: PHP Medicare Advantage	$2,880.11
Rate for Payer: Priority Health Choice Medicaid	$1,575.42
Rate for Payer: Priority Health Cigna Priority Health	$1,732.50
Rate for Payer: Priority Health Medicare	$2,880.11
Rate for Payer: Priority Health SBD	$1,559.25
Rate for Payer: Railroad Medicare Medicare	$2,880.11
Rate for Payer: UHC All Payor (Choice/PPO)	$724.69
Rate for Payer: UHC Dual Complete DSNP	$2,880.11
Rate for Payer: UHC Exchange	$658.81
Rate for Payer: UHC Medicare Advantage	$2,966.51
Rate for Payer: VA VA	$2,880.11

PR ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG

Facility

$2,221.00

Service Code	CPT 29877
Hospital Charge Code	29877
Min. Negotiated Rate	$1,399.23
Max. Negotiated Rate	$1,998.90
Rate for Payer: Aetna Commercial	$1,887.85
Rate for Payer: Aetna New Business (MI Preferred)	$1,443.65
Rate for Payer: Cash Price	$1,776.80
Rate for Payer: Cofinity Commercial	$1,554.70
Rate for Payer: Cofinity Commercial	$1,910.06
Rate for Payer: Healthscope Commercial	$1,998.90
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,887.85
Rate for Payer: PHP Commercial	$1,887.85
Rate for Payer: Priority Health Cigna Priority Health	$1,554.70
Rate for Payer: Priority Health SBD	$1,399.23

PR ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG

Professional

Both

$2,221.00

Service Code	HCPCS 29877
Min. Negotiated Rate	$402.36
Max. Negotiated Rate	$1,554.70
Rate for Payer: Aetna Commercial	$828.30
Rate for Payer: BCBS Complete	$422.48
Rate for Payer: BCBS Trust/PPO	$1,138.49
Rate for Payer: Cash Price	$1,776.80
Rate for Payer: Cash Price	$1,776.80
Rate for Payer: Mclaren Medicaid	$402.36
Rate for Payer: Meridian Medicaid	$422.48
Rate for Payer: Priority Health Choice Medicaid	$402.36
Rate for Payer: Priority Health Cigna Priority Health	$1,554.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$955.94
Rate for Payer: Priority Health Narrow Network	$955.94
Rate for Payer: Priority Health SBD	$955.94

PR ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG

Facility

$2,221.00

Service Code	CPT 29877
Hospital Charge Code	29877
Min. Negotiated Rate	$618.54
Max. Negotiated Rate	$3,600.14
Rate for Payer: Aetna Commercial	$1,887.85
Rate for Payer: Aetna Medicare	$2,995.31
Rate for Payer: Aetna New Business (MI Preferred)	$1,443.65
Rate for Payer: Allen County Amish Medical Aid Commercial	$3,600.14
Rate for Payer: Amish Plain Church Group Commercial	$3,600.14
Rate for Payer: BCBS Complete	$1,654.34
Rate for Payer: BCBS MAPPO	$2,880.11
Rate for Payer: BCBS Trust/PPO	$1,696.54
Rate for Payer: BCN Medicare Advantage	$2,880.11
Rate for Payer: Cash Price	$1,776.80
Rate for Payer: Cash Price	$1,776.80
Rate for Payer: Cofinity Commercial	$1,910.06
Rate for Payer: Cofinity Commercial	$1,554.70
Rate for Payer: Health Alliance Plan Medicare Advantage	$2,880.11
Rate for Payer: Healthscope Commercial	$1,998.90
Rate for Payer: Mclaren Medicaid	$1,575.42
Rate for Payer: Mclaren Medicare	$2,880.11
Rate for Payer: Meridian Medicaid	$1,654.34
Rate for Payer: Meridian Wellcare - Medicare Advantage	$3,024.12
Rate for Payer: MI Amish Medical Board Commercial	$3,312.13
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,887.85
Rate for Payer: PACE Medicare	$2,736.10
Rate for Payer: PACE SWMI	$2,880.11
Rate for Payer: PHP Commercial	$1,887.85
Rate for Payer: PHP Medicare Advantage	$2,880.11
Rate for Payer: Priority Health Choice Medicaid	$1,575.42
Rate for Payer: Priority Health Cigna Priority Health	$1,554.70
Rate for Payer: Priority Health Medicare	$2,880.11
Rate for Payer: Priority Health SBD	$1,399.23
Rate for Payer: Railroad Medicare Medicare	$2,880.11
Rate for Payer: UHC All Payor (Choice/PPO)	$680.39
Rate for Payer: UHC Dual Complete DSNP	$2,880.11
Rate for Payer: UHC Exchange	$618.54
Rate for Payer: UHC Medicare Advantage	$2,966.51
Rate for Payer: VA VA	$2,880.11

PR ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG

Professional

Both

$2,221.00

Service Code	HCPCS 29877
Hospital Charge Code	29877
Min. Negotiated Rate	$402.36
Max. Negotiated Rate	$1,554.70
Rate for Payer: Aetna Commercial	$828.30
Rate for Payer: BCBS Complete	$422.48
Rate for Payer: BCBS Trust/PPO	$1,138.49
Rate for Payer: Cash Price	$1,776.80
Rate for Payer: Cash Price	$1,776.80
Rate for Payer: Mclaren Medicaid	$402.36
Rate for Payer: Meridian Medicaid	$422.48
Rate for Payer: Priority Health Choice Medicaid	$402.36
Rate for Payer: Priority Health Cigna Priority Health	$1,554.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$955.94
Rate for Payer: Priority Health Narrow Network	$955.94
Rate for Payer: Priority Health SBD	$955.94

PR ARTHRS KNEE DRILLING OSTEOCHOND DISSECANS LESION

Professional

Both

$2,348.00

Service Code	HCPCS 29886
Min. Negotiated Rate	$413.22
Max. Negotiated Rate	$1,643.60
Rate for Payer: Aetna Commercial	$848.21
Rate for Payer: BCBS Complete	$433.88
Rate for Payer: BCBS Trust/PPO	$436.38
Rate for Payer: Cash Price	$1,878.40
Rate for Payer: Cash Price	$1,878.40
Rate for Payer: Mclaren Medicaid	$413.22
Rate for Payer: Meridian Medicaid	$433.88
Rate for Payer: Priority Health Choice Medicaid	$413.22
Rate for Payer: Priority Health Cigna Priority Health	$1,643.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$980.44
Rate for Payer: Priority Health Narrow Network	$980.44
Rate for Payer: Priority Health SBD	$980.44

PR ARTHRS KNEE DRILL OSTEOCHONDRITIS DISSECANS GRFG

Professional

Both

$2,492.00

Service Code	HCPCS 29885
Min. Negotiated Rate	$489.90
Max. Negotiated Rate	$1,744.40
Rate for Payer: Aetna Commercial	$1,007.16
Rate for Payer: BCBS Complete	$514.40
Rate for Payer: BCBS Trust/PPO	$1,168.07
Rate for Payer: Cash Price	$1,993.60
Rate for Payer: Cash Price	$1,993.60
Rate for Payer: Mclaren Medicaid	$489.90
Rate for Payer: Meridian Medicaid	$514.40
Rate for Payer: Priority Health Choice Medicaid	$489.90
Rate for Payer: Priority Health Cigna Priority Health	$1,744.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,162.75
Rate for Payer: Priority Health Narrow Network	$1,162.75
Rate for Payer: Priority Health SBD	$1,162.75

PR ARTHRS KNEE DRLG OSTEOCHOND DISSECANS INT FIXJ

Professional

Both

$2,475.00

Service Code	HCPCS 29887
Min. Negotiated Rate	$488.20
Max. Negotiated Rate	$1,732.50
Rate for Payer: Aetna Commercial	$1,003.49
Rate for Payer: BCBS Complete	$512.61
Rate for Payer: BCBS Trust/PPO	$675.17
Rate for Payer: Cash Price	$1,980.00
Rate for Payer: Cash Price	$1,980.00
Rate for Payer: Mclaren Medicaid	$488.20
Rate for Payer: Meridian Medicaid	$512.61
Rate for Payer: Priority Health Choice Medicaid	$488.20
Rate for Payer: Priority Health Cigna Priority Health	$1,732.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,158.15
Rate for Payer: Priority Health Narrow Network	$1,158.15
Rate for Payer: Priority Health SBD	$1,158.15

PR ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHAVING

Facility

$2,538.00

Service Code	CPT 29880
Hospital Charge Code	29880
Min. Negotiated Rate	$560.58
Max. Negotiated Rate	$3,600.14
Rate for Payer: Aetna Commercial	$2,157.30
Rate for Payer: Aetna Medicare	$2,995.31
Rate for Payer: Aetna New Business (MI Preferred)	$1,649.70
Rate for Payer: Allen County Amish Medical Aid Commercial	$3,600.14
Rate for Payer: Amish Plain Church Group Commercial	$3,600.14
Rate for Payer: BCBS Complete	$1,654.34
Rate for Payer: BCBS MAPPO	$2,880.11
Rate for Payer: BCBS Trust/PPO	$1,918.94
Rate for Payer: BCN Medicare Advantage	$2,880.11
Rate for Payer: Cash Price	$2,030.40
Rate for Payer: Cash Price	$2,030.40
Rate for Payer: Cofinity Commercial	$1,776.60
Rate for Payer: Cofinity Commercial	$2,182.68
Rate for Payer: Health Alliance Plan Medicare Advantage	$2,880.11
Rate for Payer: Healthscope Commercial	$2,284.20
Rate for Payer: Mclaren Medicaid	$1,575.42
Rate for Payer: Mclaren Medicare	$2,880.11
Rate for Payer: Meridian Medicaid	$1,654.34
Rate for Payer: Meridian Wellcare - Medicare Advantage	$3,024.12
Rate for Payer: MI Amish Medical Board Commercial	$3,312.13
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,157.30
Rate for Payer: PACE Medicare	$2,736.10
Rate for Payer: PACE SWMI	$2,880.11
Rate for Payer: PHP Commercial	$2,157.30
Rate for Payer: PHP Medicare Advantage	$2,880.11
Rate for Payer: Priority Health Choice Medicaid	$1,575.42
Rate for Payer: Priority Health Cigna Priority Health	$1,776.60
Rate for Payer: Priority Health Medicare	$2,880.11
Rate for Payer: Priority Health SBD	$1,598.94
Rate for Payer: Railroad Medicare Medicare	$2,880.11
Rate for Payer: UHC All Payor (Choice/PPO)	$616.64
Rate for Payer: UHC Dual Complete DSNP	$2,880.11
Rate for Payer: UHC Exchange	$560.58
Rate for Payer: UHC Medicare Advantage	$2,966.51
Rate for Payer: VA VA	$2,880.11

PR ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHAVING

Facility

$2,538.00

Service Code	CPT 29880
Hospital Charge Code	29880
Min. Negotiated Rate	$1,598.94
Max. Negotiated Rate	$2,284.20
Rate for Payer: Aetna Commercial	$2,157.30
Rate for Payer: Aetna New Business (MI Preferred)	$1,649.70
Rate for Payer: Cash Price	$2,030.40
Rate for Payer: Cofinity Commercial	$1,776.60
Rate for Payer: Cofinity Commercial	$2,182.68
Rate for Payer: Healthscope Commercial	$2,284.20
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,157.30
Rate for Payer: PHP Commercial	$2,157.30
Rate for Payer: Priority Health Cigna Priority Health	$1,776.60
Rate for Payer: Priority Health SBD	$1,598.94

PR ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHAVING

Professional

Both

$2,538.00

Service Code	HCPCS 29880
Min. Negotiated Rate	$364.66
Max. Negotiated Rate	$1,776.60
Rate for Payer: Aetna Commercial	$749.27
Rate for Payer: BCBS Complete	$382.89
Rate for Payer: BCBS Trust/PPO	$1,079.85
Rate for Payer: Cash Price	$2,030.40
Rate for Payer: Cash Price	$2,030.40
Rate for Payer: Mclaren Medicaid	$364.66
Rate for Payer: Meridian Medicaid	$382.89
Rate for Payer: Priority Health Choice Medicaid	$364.66
Rate for Payer: Priority Health Cigna Priority Health	$1,776.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$866.07
Rate for Payer: Priority Health Narrow Network	$866.07
Rate for Payer: Priority Health SBD	$866.07

Know your out-of-pocket cost for care.

All Charges