Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PR BURR HOLE/TREPHINE W/BX BRAIN/INTRACRNIAL LESION

Professional

Both

$4,523.00

Service Code	HCPCS 61140
Min. Negotiated Rate	$829.00
Max. Negotiated Rate	$3,166.10
Rate for Payer: Aetna Commercial	$1,640.54
Rate for Payer: BCBS Complete	$870.45
Rate for Payer: BCBS Trust/PPO	$1,274.79
Rate for Payer: Cash Price	$3,618.40
Rate for Payer: Cash Price	$3,618.40
Rate for Payer: Mclaren Medicaid	$829.00
Rate for Payer: Meridian Medicaid	$870.45
Rate for Payer: Priority Health Choice Medicaid	$829.00
Rate for Payer: Priority Health Cigna Priority Health	$3,166.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,175.44
Rate for Payer: Priority Health Narrow Network	$2,175.44
Rate for Payer: Priority Health SBD	$2,175.44

PR BURR HOLE/TREPHINE W/DRG BRAIN ABSCESS/CYST

Professional

Both

$4,040.00

Service Code	HCPCS 61150
Min. Negotiated Rate	$614.94
Max. Negotiated Rate	$2,828.00
Rate for Payer: Aetna Commercial	$1,745.51
Rate for Payer: BCBS Complete	$922.11
Rate for Payer: BCBS Trust/PPO	$614.94
Rate for Payer: Cash Price	$3,232.00
Rate for Payer: Cash Price	$3,232.00
Rate for Payer: Mclaren Medicaid	$878.20
Rate for Payer: Meridian Medicaid	$922.11
Rate for Payer: Priority Health Choice Medicaid	$878.20
Rate for Payer: Priority Health Cigna Priority Health	$2,828.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,312.45
Rate for Payer: Priority Health Narrow Network	$2,312.45
Rate for Payer: Priority Health SBD	$2,312.45

PR BURR HOLE VENTRICULAR PUNCTURE

Professional

Both

$1,834.00

Service Code	HCPCS 61120
Min. Negotiated Rate	$490.54
Max. Negotiated Rate	$1,670.48
Rate for Payer: Aetna Commercial	$965.51
Rate for Payer: BCBS Complete	$515.07
Rate for Payer: BCBS Trust/PPO	$1,670.48
Rate for Payer: Cash Price	$1,467.20
Rate for Payer: Cash Price	$1,467.20
Rate for Payer: Mclaren Medicaid	$490.54
Rate for Payer: Meridian Medicaid	$515.07
Rate for Payer: Priority Health Choice Medicaid	$490.54
Rate for Payer: Priority Health Cigna Priority Health	$1,283.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,288.72
Rate for Payer: Priority Health Narrow Network	$1,288.72
Rate for Payer: Priority Health SBD	$1,288.72

PR BURR HOLE W/ASPIR HEMATOMA/CYST INTRACEREBRAL

Professional

Both

$3,613.00

Service Code	HCPCS 61156
Min. Negotiated Rate	$284.75
Max. Negotiated Rate	$2,529.10
Rate for Payer: Aetna Commercial	$1,606.58
Rate for Payer: BCBS Complete	$846.52
Rate for Payer: BCBS Trust/PPO	$284.75
Rate for Payer: Cash Price	$2,890.40
Rate for Payer: Cash Price	$2,890.40
Rate for Payer: Mclaren Medicaid	$806.21
Rate for Payer: Meridian Medicaid	$846.52
Rate for Payer: Priority Health Choice Medicaid	$806.21
Rate for Payer: Priority Health Cigna Priority Health	$2,529.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,109.19
Rate for Payer: Priority Health Narrow Network	$2,109.19
Rate for Payer: Priority Health SBD	$2,109.19

PR BURR HOLE W/EVAC&/DRG HEMATOMA XDRL/SDRL

Professional

Both

$4,106.00

Service Code	HCPCS 61154
Min. Negotiated Rate	$757.05
Max. Negotiated Rate	$2,874.20
Rate for Payer: Aetna Commercial	$1,645.02
Rate for Payer: BCBS Complete	$874.69
Rate for Payer: BCBS Trust/PPO	$757.05
Rate for Payer: Cash Price	$3,284.80
Rate for Payer: Cash Price	$3,284.80
Rate for Payer: Mclaren Medicaid	$833.04
Rate for Payer: Meridian Medicaid	$874.69
Rate for Payer: Priority Health Choice Medicaid	$833.04
Rate for Payer: Priority Health Cigna Priority Health	$2,874.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,189.59
Rate for Payer: Priority Health Narrow Network	$2,189.59
Rate for Payer: Priority Health SBD	$2,189.59

PR BUTORPHANOL TARTRATE 1 MG

Professional

Both

$7.00

Service Code	HCPCS J0595
Min. Negotiated Rate	$0.72
Max. Negotiated Rate	$4.90
Rate for Payer: Aetna Commercial	$2.88
Rate for Payer: BCBS Complete	$2.80
Rate for Payer: BCBS Trust/PPO	$0.72
Rate for Payer: Cash Price	$5.60
Rate for Payer: Cash Price	$5.60
Rate for Payer: Priority Health Cigna Priority Health	$4.90

PR BX ABDL/RETROPERITONEAL MASS PRQ NEEDLE

Professional

Both

$333.00

Service Code	HCPCS 49180
Min. Negotiated Rate	$51.55
Max. Negotiated Rate	$553.66
Rate for Payer: Aetna Commercial	$112.01
Rate for Payer: BCBS Complete	$54.13
Rate for Payer: BCBS Trust/PPO	$553.66
Rate for Payer: Cash Price	$266.40
Rate for Payer: Cash Price	$266.40
Rate for Payer: Mclaren Medicaid	$51.55
Rate for Payer: Meridian Medicaid	$54.13
Rate for Payer: Priority Health Choice Medicaid	$51.55
Rate for Payer: Priority Health Cigna Priority Health	$233.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$144.05
Rate for Payer: Priority Health Narrow Network	$144.05
Rate for Payer: Priority Health SBD	$144.05

PR BX ANORECTAL WALL ANAL APPROACH

Professional

Both

$754.00

Service Code	HCPCS 45100
Min. Negotiated Rate	$195.53
Max. Negotiated Rate	$534.64
Rate for Payer: Aetna Commercial	$399.52
Rate for Payer: BCBS Complete	$205.31
Rate for Payer: BCBS Trust/PPO	$534.64
Rate for Payer: Cash Price	$603.20
Rate for Payer: Cash Price	$603.20
Rate for Payer: Mclaren Medicaid	$195.53
Rate for Payer: Meridian Medicaid	$205.31
Rate for Payer: Priority Health Choice Medicaid	$195.53
Rate for Payer: Priority Health Cigna Priority Health	$527.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$533.89
Rate for Payer: Priority Health Narrow Network	$533.89
Rate for Payer: Priority Health SBD	$533.89

PR BX BREAST NEEDLE CORE W/O IMAGING GUIDANCE SPX

Facility

$293.00

Service Code	CPT 19100
Hospital Charge Code	19100
Min. Negotiated Rate	$184.59
Max. Negotiated Rate	$263.70
Rate for Payer: Aetna Commercial	$249.05
Rate for Payer: Aetna New Business (MI Preferred)	$190.45
Rate for Payer: Cash Price	$234.40
Rate for Payer: Cofinity Commercial	$205.10
Rate for Payer: Cofinity Commercial	$251.98
Rate for Payer: Healthscope Commercial	$263.70
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$249.05
Rate for Payer: PHP Commercial	$249.05
Rate for Payer: Priority Health Cigna Priority Health	$205.10
Rate for Payer: Priority Health SBD	$184.59

PR BX BREAST NEEDLE CORE W/O IMAGING GUIDANCE SPX

Professional

Both

$293.00

Service Code	HCPCS 19100
Min. Negotiated Rate	$43.88
Max. Negotiated Rate	$456.13
Rate for Payer: Aetna Commercial	$76.80
Rate for Payer: BCBS Complete	$46.07
Rate for Payer: BCBS Trust/PPO	$456.13
Rate for Payer: Cash Price	$234.40
Rate for Payer: Cash Price	$234.40
Rate for Payer: Mclaren Medicaid	$43.88
Rate for Payer: Meridian Medicaid	$46.07
Rate for Payer: Priority Health Choice Medicaid	$43.88
Rate for Payer: Priority Health Cigna Priority Health	$205.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$84.26
Rate for Payer: Priority Health Narrow Network	$84.26
Rate for Payer: Priority Health SBD	$84.26

PR BX BREAST NEEDLE CORE W/O IMAGING GUIDANCE SPX

Professional

Both

$293.00

Service Code	HCPCS 19100
Hospital Charge Code	19100
Min. Negotiated Rate	$43.88
Max. Negotiated Rate	$456.13
Rate for Payer: Aetna Commercial	$76.80
Rate for Payer: BCBS Complete	$46.07
Rate for Payer: BCBS Trust/PPO	$456.13
Rate for Payer: Cash Price	$234.40
Rate for Payer: Cash Price	$234.40
Rate for Payer: Mclaren Medicaid	$43.88
Rate for Payer: Meridian Medicaid	$46.07
Rate for Payer: Priority Health Choice Medicaid	$43.88
Rate for Payer: Priority Health Cigna Priority Health	$205.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$84.26
Rate for Payer: Priority Health Narrow Network	$84.26
Rate for Payer: Priority Health SBD	$84.26

PR BX BREAST NEEDLE CORE W/O IMAGING GUIDANCE SPX

Facility

$293.00

Service Code	CPT 19100
Hospital Charge Code	19100
Min. Negotiated Rate	$67.45
Max. Negotiated Rate	$4,496.47
Rate for Payer: Aetna Commercial	$249.05
Rate for Payer: Aetna Medicare	$1,500.31
Rate for Payer: Aetna New Business (MI Preferred)	$190.45
Rate for Payer: Allen County Amish Medical Aid Commercial	$1,803.26
Rate for Payer: Amish Plain Church Group Commercial	$1,803.26
Rate for Payer: BCBS Complete	$828.64
Rate for Payer: BCBS MAPPO	$1,442.61
Rate for Payer: BCBS Trust/PPO	$380.82
Rate for Payer: BCCCP Commercial	$159.85
Rate for Payer: BCN Medicare Advantage	$1,442.61
Rate for Payer: Cash Price	$234.40
Rate for Payer: Cash Price	$234.40
Rate for Payer: Cofinity Commercial	$251.98
Rate for Payer: Cofinity Commercial	$205.10
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,442.61
Rate for Payer: Healthscope Commercial	$263.70
Rate for Payer: Mclaren Medicaid	$789.11
Rate for Payer: Mclaren Medicare	$1,442.61
Rate for Payer: Meridian Medicaid	$828.64
Rate for Payer: Meridian Wellcare - Medicare Advantage	$1,514.74
Rate for Payer: MI Amish Medical Board Commercial	$1,659.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$249.05
Rate for Payer: PACE Medicare	$1,370.48
Rate for Payer: PACE SWMI	$1,442.61
Rate for Payer: PHP Commercial	$249.05
Rate for Payer: PHP Medicare Advantage	$1,442.61
Rate for Payer: Priority Health Choice Medicaid	$789.11
Rate for Payer: Priority Health Cigna Priority Health	$205.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$4,496.47
Rate for Payer: Priority Health Medicare	$1,442.61
Rate for Payer: Priority Health Narrow Network	$3,597.18
Rate for Payer: Priority Health SBD	$184.59
Rate for Payer: Railroad Medicare Medicare	$1,442.61
Rate for Payer: UHC All Payor (Choice/PPO)	$74.20
Rate for Payer: UHC Dual Complete DSNP	$1,442.61
Rate for Payer: UHC Exchange	$67.45
Rate for Payer: UHC Medicare Advantage	$1,485.89
Rate for Payer: VA VA	$1,442.61

PR BX BREAST W/DEVICE 1ST LESION STEREOTACTIC GUID

Professional

Both

$758.00

Service Code	HCPCS 19081
Min. Negotiated Rate	$102.03
Max. Negotiated Rate	$1,836.42
Rate for Payer: Aetna Commercial	$179.91
Rate for Payer: BCBS Complete	$107.13
Rate for Payer: BCBS Trust/PPO	$1,836.42
Rate for Payer: Cash Price	$606.40
Rate for Payer: Cash Price	$606.40
Rate for Payer: Mclaren Medicaid	$102.03
Rate for Payer: Meridian Medicaid	$107.13
Rate for Payer: Priority Health Choice Medicaid	$102.03
Rate for Payer: Priority Health Cigna Priority Health	$530.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$198.13
Rate for Payer: Priority Health Narrow Network	$198.13
Rate for Payer: Priority Health SBD	$198.13

PR BX BREAST W/DEVICE 1ST LESION ULTRASOUND GUID

Professional

Both

$432.00

Service Code	HCPCS 19083
Min. Negotiated Rate	$96.49
Max. Negotiated Rate	$456.13
Rate for Payer: Aetna Commercial	$170.17
Rate for Payer: BCBS Complete	$101.31
Rate for Payer: BCBS Trust/PPO	$456.13
Rate for Payer: Cash Price	$345.60
Rate for Payer: Cash Price	$345.60
Rate for Payer: Mclaren Medicaid	$96.49
Rate for Payer: Meridian Medicaid	$101.31
Rate for Payer: Priority Health Choice Medicaid	$96.49
Rate for Payer: Priority Health Cigna Priority Health	$302.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$186.20
Rate for Payer: Priority Health Narrow Network	$186.20
Rate for Payer: Priority Health SBD	$186.20

PR BX BREAST W/DEVICE ADDL LESION ULTRASOUND GUID

Professional

Both

$777.00

Service Code	HCPCS 19084
Min. Negotiated Rate	$48.14
Max. Negotiated Rate	$543.90
Rate for Payer: Aetna Commercial	$84.71
Rate for Payer: BCBS Complete	$50.55
Rate for Payer: BCBS Trust/PPO	$145.43
Rate for Payer: Cash Price	$621.60
Rate for Payer: Cash Price	$621.60
Rate for Payer: Mclaren Medicaid	$48.14
Rate for Payer: Meridian Medicaid	$50.55
Rate for Payer: Priority Health Choice Medicaid	$48.14
Rate for Payer: Priority Health Cigna Priority Health	$543.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$94.13
Rate for Payer: Priority Health Narrow Network	$94.13
Rate for Payer: Priority Health SBD	$94.13

PR BX/EXC LYMPH NODE NEEDLE SUPERFICIAL

Professional

Both

$224.00

Service Code	HCPCS 38505
Min. Negotiated Rate	$53.89
Max. Negotiated Rate	$656.16
Rate for Payer: Aetna Commercial	$85.02
Rate for Payer: BCBS Complete	$56.58
Rate for Payer: BCBS Trust/PPO	$656.16
Rate for Payer: Cash Price	$179.20
Rate for Payer: Cash Price	$179.20
Rate for Payer: Mclaren Medicaid	$53.89
Rate for Payer: Meridian Medicaid	$56.58
Rate for Payer: Priority Health Choice Medicaid	$53.89
Rate for Payer: Priority Health Cigna Priority Health	$156.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$183.98
Rate for Payer: Priority Health Narrow Network	$183.98
Rate for Payer: Priority Health SBD	$183.98

PR BX/EXC LYMPH NODE OPEN DEEP AXILLARY NODE

Facility

$1,546.00

Service Code	CPT 38525
Hospital Charge Code	38525
Hospital Revenue Code	960
Min. Negotiated Rate	$973.98
Max. Negotiated Rate	$1,391.40
Rate for Payer: Aetna Commercial	$1,314.10
Rate for Payer: Aetna New Business (MI Preferred)	$1,004.90
Rate for Payer: Cash Price	$1,236.80
Rate for Payer: Cofinity Commercial	$1,082.20
Rate for Payer: Cofinity Commercial	$1,329.56
Rate for Payer: Healthscope Commercial	$1,391.40
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,314.10
Rate for Payer: PHP Commercial	$1,314.10
Rate for Payer: Priority Health Cigna Priority Health	$1,082.20
Rate for Payer: Priority Health SBD	$973.98

PR BX/EXC LYMPH NODE OPEN DEEP AXILLARY NODE

Professional

Both

$1,546.00

Service Code	HCPCS 38525
Min. Negotiated Rate	$284.14
Max. Negotiated Rate	$1,082.20
Rate for Payer: Aetna Commercial	$545.65
Rate for Payer: BCBS Complete	$298.35
Rate for Payer: BCBS Trust/PPO	$486.04
Rate for Payer: Cash Price	$1,236.80
Rate for Payer: Cash Price	$1,236.80
Rate for Payer: Mclaren Medicaid	$284.14
Rate for Payer: Meridian Medicaid	$298.35
Rate for Payer: Priority Health Choice Medicaid	$284.14
Rate for Payer: Priority Health Cigna Priority Health	$1,082.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$957.58
Rate for Payer: Priority Health Narrow Network	$957.58
Rate for Payer: Priority Health SBD	$957.58

PR BX/EXC LYMPH NODE OPEN DEEP AXILLARY NODE

Facility

$1,546.00

Service Code	CPT 38525
Hospital Charge Code	38525
Hospital Revenue Code	960
Min. Negotiated Rate	$436.81
Max. Negotiated Rate	$4,239.58
Rate for Payer: Aetna Commercial	$1,314.10
Rate for Payer: Aetna Medicare	$3,527.33
Rate for Payer: Aetna New Business (MI Preferred)	$1,004.90
Rate for Payer: Allen County Amish Medical Aid Commercial	$4,239.58
Rate for Payer: Amish Plain Church Group Commercial	$4,239.58
Rate for Payer: BCBS Complete	$1,948.17
Rate for Payer: BCBS MAPPO	$3,391.66
Rate for Payer: BCBS Trust/PPO	$1,818.13
Rate for Payer: BCN Medicare Advantage	$3,391.66
Rate for Payer: Cash Price	$1,236.80
Rate for Payer: Cash Price	$1,236.80
Rate for Payer: Cofinity Commercial	$1,329.56
Rate for Payer: Cofinity Commercial	$1,082.20
Rate for Payer: Health Alliance Plan Medicare Advantage	$3,391.66
Rate for Payer: Healthscope Commercial	$1,391.40
Rate for Payer: Mclaren Medicaid	$1,855.24
Rate for Payer: Mclaren Medicare	$3,391.66
Rate for Payer: Meridian Medicaid	$1,948.17
Rate for Payer: Meridian Wellcare - Medicare Advantage	$3,561.24
Rate for Payer: MI Amish Medical Board Commercial	$3,900.41
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,314.10
Rate for Payer: PACE Medicare	$3,222.08
Rate for Payer: PACE SWMI	$3,391.66
Rate for Payer: PHP Commercial	$1,314.10
Rate for Payer: PHP Medicare Advantage	$3,391.66
Rate for Payer: Priority Health Choice Medicaid	$1,855.24
Rate for Payer: Priority Health Cigna Priority Health	$1,082.20
Rate for Payer: Priority Health Medicare	$3,391.66
Rate for Payer: Priority Health SBD	$973.98
Rate for Payer: Railroad Medicare Medicare	$3,391.66
Rate for Payer: UHC All Payor (Choice/PPO)	$480.49
Rate for Payer: UHC Dual Complete DSNP	$3,391.66
Rate for Payer: UHC Exchange	$436.81
Rate for Payer: UHC Medicare Advantage	$3,493.41
Rate for Payer: VA VA	$3,391.66

PR BX/EXC LYMPH NODE OPEN DEEP AXILLARY NODE

Professional

Both

$1,546.00

Service Code	HCPCS 38525
Hospital Charge Code	38525
Min. Negotiated Rate	$284.14
Max. Negotiated Rate	$1,082.20
Rate for Payer: Aetna Commercial	$545.65
Rate for Payer: BCBS Complete	$298.35
Rate for Payer: BCBS Trust/PPO	$486.04
Rate for Payer: Cash Price	$1,236.80
Rate for Payer: Cash Price	$1,236.80
Rate for Payer: Mclaren Medicaid	$284.14
Rate for Payer: Meridian Medicaid	$298.35
Rate for Payer: Priority Health Choice Medicaid	$284.14
Rate for Payer: Priority Health Cigna Priority Health	$1,082.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$957.58
Rate for Payer: Priority Health Narrow Network	$957.58
Rate for Payer: Priority Health SBD	$957.58

PR BX/EXC LYMPH NODE OPEN DEEP CERVICAL NODE

Professional

Both

$1,546.00

Service Code	HCPCS 38510
Hospital Charge Code	38510
Min. Negotiated Rate	$267.95
Max. Negotiated Rate	$1,082.20
Rate for Payer: Aetna Commercial	$517.41
Rate for Payer: BCBS Complete	$281.35
Rate for Payer: BCBS Trust/PPO	$559.47
Rate for Payer: Cash Price	$1,236.80
Rate for Payer: Cash Price	$1,236.80
Rate for Payer: Mclaren Medicaid	$267.95
Rate for Payer: Meridian Medicaid	$281.35
Rate for Payer: Priority Health Choice Medicaid	$267.95
Rate for Payer: Priority Health Cigna Priority Health	$1,082.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$908.33
Rate for Payer: Priority Health Narrow Network	$908.33
Rate for Payer: Priority Health SBD	$908.33

PR BX/EXC LYMPH NODE OPEN DEEP CERVICAL NODE

Facility

$1,546.00

Service Code	CPT 38510
Hospital Charge Code	38510
Hospital Revenue Code	960
Min. Negotiated Rate	$411.92
Max. Negotiated Rate	$4,239.58
Rate for Payer: Aetna Commercial	$1,314.10
Rate for Payer: Aetna Medicare	$3,527.33
Rate for Payer: Aetna New Business (MI Preferred)	$1,004.90
Rate for Payer: Allen County Amish Medical Aid Commercial	$4,239.58
Rate for Payer: Amish Plain Church Group Commercial	$4,239.58
Rate for Payer: BCBS Complete	$1,948.17
Rate for Payer: BCBS MAPPO	$3,391.66
Rate for Payer: BCBS Trust/PPO	$2,263.46
Rate for Payer: BCN Medicare Advantage	$3,391.66
Rate for Payer: Cash Price	$1,236.80
Rate for Payer: Cash Price	$1,236.80
Rate for Payer: Cofinity Commercial	$1,082.20
Rate for Payer: Cofinity Commercial	$1,329.56
Rate for Payer: Health Alliance Plan Medicare Advantage	$3,391.66
Rate for Payer: Healthscope Commercial	$1,391.40
Rate for Payer: Mclaren Medicaid	$1,855.24
Rate for Payer: Mclaren Medicare	$3,391.66
Rate for Payer: Meridian Medicaid	$1,948.17
Rate for Payer: Meridian Wellcare - Medicare Advantage	$3,561.24
Rate for Payer: MI Amish Medical Board Commercial	$3,900.41
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,314.10
Rate for Payer: PACE Medicare	$3,222.08
Rate for Payer: PACE SWMI	$3,391.66
Rate for Payer: PHP Commercial	$1,314.10
Rate for Payer: PHP Medicare Advantage	$3,391.66
Rate for Payer: Priority Health Choice Medicaid	$1,855.24
Rate for Payer: Priority Health Cigna Priority Health	$1,082.20
Rate for Payer: Priority Health Medicare	$3,391.66
Rate for Payer: Priority Health SBD	$973.98
Rate for Payer: Railroad Medicare Medicare	$3,391.66
Rate for Payer: UHC All Payor (Choice/PPO)	$453.11
Rate for Payer: UHC Dual Complete DSNP	$3,391.66
Rate for Payer: UHC Exchange	$411.92
Rate for Payer: UHC Medicare Advantage	$3,493.41
Rate for Payer: VA VA	$3,391.66

PR BX/EXC LYMPH NODE OPEN DEEP CERVICAL NODE

Facility

$1,546.00

Service Code	CPT 38510
Hospital Charge Code	38510
Hospital Revenue Code	960
Min. Negotiated Rate	$973.98
Max. Negotiated Rate	$1,391.40
Rate for Payer: Aetna Commercial	$1,314.10
Rate for Payer: Aetna New Business (MI Preferred)	$1,004.90
Rate for Payer: Cash Price	$1,236.80
Rate for Payer: Cofinity Commercial	$1,082.20
Rate for Payer: Cofinity Commercial	$1,329.56
Rate for Payer: Healthscope Commercial	$1,391.40
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,314.10
Rate for Payer: PHP Commercial	$1,314.10
Rate for Payer: Priority Health Cigna Priority Health	$1,082.20
Rate for Payer: Priority Health SBD	$973.98

PR BX/EXC LYMPH NODE OPEN DEEP CERVICAL NODE

Professional

Both

$1,546.00

Service Code	HCPCS 38510
Min. Negotiated Rate	$267.95
Max. Negotiated Rate	$1,082.20
Rate for Payer: Aetna Commercial	$517.41
Rate for Payer: BCBS Complete	$281.35
Rate for Payer: BCBS Trust/PPO	$559.47
Rate for Payer: Cash Price	$1,236.80
Rate for Payer: Cash Price	$1,236.80
Rate for Payer: Mclaren Medicaid	$267.95
Rate for Payer: Meridian Medicaid	$281.35
Rate for Payer: Priority Health Choice Medicaid	$267.95
Rate for Payer: Priority Health Cigna Priority Health	$1,082.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$908.33
Rate for Payer: Priority Health Narrow Network	$908.33
Rate for Payer: Priority Health SBD	$908.33

PR BX/EXC LYMPH NODE OPEN INT MAMMARY NODE

Professional

Both

$1,668.00

Service Code	HCPCS 38530
Min. Negotiated Rate	$363.59
Max. Negotiated Rate	$1,223.40
Rate for Payer: Aetna Commercial	$697.32
Rate for Payer: BCBS Complete	$381.77
Rate for Payer: BCBS Trust/PPO	$427.39
Rate for Payer: Cash Price	$1,334.40
Rate for Payer: Cash Price	$1,334.40
Rate for Payer: Mclaren Medicaid	$363.59
Rate for Payer: Meridian Medicaid	$381.77
Rate for Payer: Priority Health Choice Medicaid	$363.59
Rate for Payer: Priority Health Cigna Priority Health	$1,167.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,223.40
Rate for Payer: Priority Health Narrow Network	$1,223.40
Rate for Payer: Priority Health SBD	$1,223.40

Know your out-of-pocket cost for care.

All Charges