Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PR COLOTOMY EXPLORATION/BIOPSY/FOREIGN BODY REMOVAL

Professional

Both

$2,816.00

Service Code	HCPCS 44025
Min. Negotiated Rate	$627.07
Max. Negotiated Rate	$2,143.84
Rate for Payer: Aetna Commercial	$1,320.54
Rate for Payer: BCBS Complete	$658.42
Rate for Payer: BCBS Trust/PPO	$2,143.84
Rate for Payer: Cash Price	$2,252.80
Rate for Payer: Cash Price	$2,252.80
Rate for Payer: Mclaren Medicaid	$627.07
Rate for Payer: Meridian Medicaid	$658.42
Rate for Payer: Priority Health Choice Medicaid	$627.07
Rate for Payer: Priority Health Cigna Priority Health	$1,971.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,718.05
Rate for Payer: Priority Health Narrow Network	$1,718.05
Rate for Payer: Priority Health SBD	$1,718.05

PR COLPOCENTESIS SEPARATE PROCEDURE

Professional

Both

$169.00

Service Code	HCPCS 57020
Min. Negotiated Rate	$50.48
Max. Negotiated Rate	$2,675.31
Rate for Payer: Aetna Commercial	$96.32
Rate for Payer: BCBS Complete	$53.00
Rate for Payer: BCBS Trust/PPO	$2,675.31
Rate for Payer: Cash Price	$135.20
Rate for Payer: Cash Price	$135.20
Rate for Payer: Mclaren Medicaid	$50.48
Rate for Payer: Meridian Medicaid	$53.00
Rate for Payer: Priority Health Choice Medicaid	$50.48
Rate for Payer: Priority Health Cigna Priority Health	$118.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$112.20
Rate for Payer: Priority Health Narrow Network	$112.20
Rate for Payer: Priority Health SBD	$112.20

PR COLPOCLEISIS LE FORT TYPE

Professional

Both

$2,584.00

Service Code	HCPCS 57120
Min. Negotiated Rate	$341.87
Max. Negotiated Rate	$1,901.88
Rate for Payer: Aetna Commercial	$629.10
Rate for Payer: BCBS Complete	$358.96
Rate for Payer: BCBS Trust/PPO	$1,901.88
Rate for Payer: Cash Price	$2,067.20
Rate for Payer: Cash Price	$2,067.20
Rate for Payer: Mclaren Medicaid	$341.87
Rate for Payer: Meridian Medicaid	$358.96
Rate for Payer: Priority Health Choice Medicaid	$341.87
Rate for Payer: Priority Health Cigna Priority Health	$1,808.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$755.59
Rate for Payer: Priority Health Narrow Network	$755.59
Rate for Payer: Priority Health SBD	$755.59

PR COLPOPERINEORRHAPHY SUTURE INJ VAGINA&/PERINEU

Professional

Both

$1,058.00

Service Code	HCPCS 57210
Min. Negotiated Rate	$253.90
Max. Negotiated Rate	$2,571.24
Rate for Payer: Aetna Commercial	$464.42
Rate for Payer: BCBS Complete	$266.60
Rate for Payer: BCBS Trust/PPO	$2,571.24
Rate for Payer: Cash Price	$846.40
Rate for Payer: Cash Price	$846.40
Rate for Payer: Mclaren Medicaid	$253.90
Rate for Payer: Meridian Medicaid	$266.60
Rate for Payer: Priority Health Choice Medicaid	$253.90
Rate for Payer: Priority Health Cigna Priority Health	$740.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$560.07
Rate for Payer: Priority Health Narrow Network	$560.07
Rate for Payer: Priority Health SBD	$560.07

PR COLPOPEXY ABDOMINAL APPROACH

Professional

Both

$2,062.00

Service Code	HCPCS 57280
Min. Negotiated Rate	$618.55
Max. Negotiated Rate	$2,847.01
Rate for Payer: Aetna Commercial	$1,153.81
Rate for Payer: BCBS Complete	$649.48
Rate for Payer: BCBS Trust/PPO	$2,847.01
Rate for Payer: Cash Price	$1,649.60
Rate for Payer: Cash Price	$1,649.60
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	$1,443.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,368.20
Rate for Payer: Priority Health Narrow Network	$1,368.20
Rate for Payer: Priority Health SBD	$1,368.20

PR COLPOPEXY VAGINAL EXTRAPERITONEAL APPROACH

Professional

Both

$2,086.00

Service Code	HCPCS 57282
Min. Negotiated Rate	$445.60
Max. Negotiated Rate	$2,780.44
Rate for Payer: Aetna Commercial	$827.22
Rate for Payer: BCBS Complete	$467.88
Rate for Payer: BCBS Trust/PPO	$2,780.44
Rate for Payer: Cash Price	$1,668.80
Rate for Payer: Cash Price	$1,668.80
Rate for Payer: Mclaren Medicaid	$445.60
Rate for Payer: Meridian Medicaid	$467.88
Rate for Payer: Priority Health Choice Medicaid	$445.60
Rate for Payer: Priority Health Cigna Priority Health	$1,460.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$985.67
Rate for Payer: Priority Health Narrow Network	$985.67
Rate for Payer: Priority Health SBD	$985.67

PR COLPOPEXY VAGINAL INTRAPERITONEAL APPROACH

Professional

Both

$1,141.00

Service Code	HCPCS 57283
Min. Negotiated Rate	$448.79
Max. Negotiated Rate	$3,053.05
Rate for Payer: Aetna Commercial	$832.81
Rate for Payer: BCBS Complete	$471.23
Rate for Payer: BCBS Trust/PPO	$3,053.05
Rate for Payer: Cash Price	$912.80
Rate for Payer: Cash Price	$912.80
Rate for Payer: Mclaren Medicaid	$448.79
Rate for Payer: Meridian Medicaid	$471.23
Rate for Payer: Priority Health Choice Medicaid	$448.79
Rate for Payer: Priority Health Cigna Priority Health	$798.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$994.19
Rate for Payer: Priority Health Narrow Network	$994.19
Rate for Payer: Priority Health SBD	$994.19

PR COLPORRHAPHY SUTURE INJURY VAGINA

Professional

Both

$858.00

Service Code	HCPCS 57200
Min. Negotiated Rate	$214.92
Max. Negotiated Rate	$2,224.14
Rate for Payer: Aetna Commercial	$387.33
Rate for Payer: BCBS Complete	$225.67
Rate for Payer: BCBS Trust/PPO	$2,224.14
Rate for Payer: Cash Price	$686.40
Rate for Payer: Cash Price	$686.40
Rate for Payer: Mclaren Medicaid	$214.92
Rate for Payer: Meridian Medicaid	$225.67
Rate for Payer: Priority Health Choice Medicaid	$214.92
Rate for Payer: Priority Health Cigna Priority Health	$600.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$472.47
Rate for Payer: Priority Health Narrow Network	$472.47
Rate for Payer: Priority Health SBD	$472.47

PR COLPOSCOPY CERVIX BX CERVIX & ENDOCRV CURRETAGE

Professional

Both

$354.00

Service Code	HCPCS 57454
Min. Negotiated Rate	$85.41
Max. Negotiated Rate	$247.80
Rate for Payer: Aetna Commercial	$159.65
Rate for Payer: BCBS Complete	$89.68
Rate for Payer: BCBS Trust/PPO	$246.72
Rate for Payer: Cash Price	$283.20
Rate for Payer: Cash Price	$283.20
Rate for Payer: Mclaren Medicaid	$85.41
Rate for Payer: Meridian Medicaid	$89.68
Rate for Payer: Priority Health Choice Medicaid	$85.41
Rate for Payer: Priority Health Cigna Priority Health	$247.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$187.47
Rate for Payer: Priority Health Narrow Network	$187.47
Rate for Payer: Priority Health SBD	$187.47

PR COLPOSCOPY CERVIX ENDOCERVICAL CURETTAGE

Professional

Both

$357.00

Service Code	HCPCS 57456
Min. Negotiated Rate	$64.54
Max. Negotiated Rate	$1,290.64
Rate for Payer: Aetna Commercial	$120.98
Rate for Payer: BCBS Complete	$67.77
Rate for Payer: BCBS Trust/PPO	$1,290.64
Rate for Payer: Cash Price	$285.60
Rate for Payer: Cash Price	$285.60
Rate for Payer: Mclaren Medicaid	$64.54
Rate for Payer: Meridian Medicaid	$67.77
Rate for Payer: Priority Health Choice Medicaid	$64.54
Rate for Payer: Priority Health Cigna Priority Health	$249.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$142.50
Rate for Payer: Priority Health Narrow Network	$142.50
Rate for Payer: Priority Health SBD	$142.50

PR COLPOSCOPY CERVIX UPPER/ADJACENT VAGINA

Professional

Both

$274.00

Service Code	HCPCS 57452
Min. Negotiated Rate	$58.15
Max. Negotiated Rate	$304.30
Rate for Payer: Aetna Commercial	$107.71
Rate for Payer: BCBS Complete	$61.06
Rate for Payer: BCBS Trust/PPO	$304.30
Rate for Payer: Cash Price	$219.20
Rate for Payer: Cash Price	$219.20
Rate for Payer: Mclaren Medicaid	$58.15
Rate for Payer: Meridian Medicaid	$61.06
Rate for Payer: Priority Health Choice Medicaid	$58.15
Rate for Payer: Priority Health Cigna Priority Health	$191.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$128.29
Rate for Payer: Priority Health Narrow Network	$128.29
Rate for Payer: Priority Health SBD	$128.29

PR COLPOSCOPY CERVIX UPPR/ADJCNT VAGINA W/CERVIX BX

Professional

Both

$357.00

Service Code	HCPCS 57455
Min. Negotiated Rate	$69.23
Max. Negotiated Rate	$1,460.22
Rate for Payer: Aetna Commercial	$130.36
Rate for Payer: BCBS Complete	$72.69
Rate for Payer: BCBS Trust/PPO	$1,460.22
Rate for Payer: Cash Price	$285.60
Rate for Payer: Cash Price	$285.60
Rate for Payer: Mclaren Medicaid	$69.23
Rate for Payer: Meridian Medicaid	$72.69
Rate for Payer: Priority Health Choice Medicaid	$69.23
Rate for Payer: Priority Health Cigna Priority Health	$249.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$152.92
Rate for Payer: Priority Health Narrow Network	$152.92
Rate for Payer: Priority Health SBD	$152.92

PR COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX

Professional

Both

$941.00

Service Code	HCPCS 57461
Hospital Charge Code	57461
Min. Negotiated Rate	$116.51
Max. Negotiated Rate	$1,582.26
Rate for Payer: Aetna Commercial	$221.07
Rate for Payer: BCBS Complete	$122.34
Rate for Payer: BCBS Trust/PPO	$1,582.26
Rate for Payer: Cash Price	$752.80
Rate for Payer: Cash Price	$752.80
Rate for Payer: Mclaren Medicaid	$116.51
Rate for Payer: Meridian Medicaid	$122.34
Rate for Payer: Priority Health Choice Medicaid	$116.51
Rate for Payer: Priority Health Cigna Priority Health	$658.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$258.48
Rate for Payer: Priority Health Narrow Network	$258.48
Rate for Payer: Priority Health SBD	$258.48

PR COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX

Facility

$941.00

Service Code	CPT 57461
Hospital Charge Code	57461
Min. Negotiated Rate	$592.83
Max. Negotiated Rate	$846.90
Rate for Payer: Aetna Commercial	$799.85
Rate for Payer: Aetna New Business (MI Preferred)	$611.65
Rate for Payer: Cash Price	$752.80
Rate for Payer: Cofinity Commercial	$658.70
Rate for Payer: Cofinity Commercial	$809.26
Rate for Payer: Healthscope Commercial	$846.90
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$799.85
Rate for Payer: PHP Commercial	$799.85
Rate for Payer: Priority Health Cigna Priority Health	$658.70
Rate for Payer: Priority Health SBD	$592.83

PR COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX

Facility

$941.00

Service Code	CPT 57461
Hospital Charge Code	57461
Min. Negotiated Rate	$179.11
Max. Negotiated Rate	$3,477.26
Rate for Payer: Aetna Commercial	$799.85
Rate for Payer: Aetna Medicare	$2,893.08
Rate for Payer: Aetna New Business (MI Preferred)	$611.65
Rate for Payer: Allen County Amish Medical Aid Commercial	$3,477.26
Rate for Payer: Amish Plain Church Group Commercial	$3,477.26
Rate for Payer: BCBS Complete	$1,597.87
Rate for Payer: BCBS MAPPO	$2,781.81
Rate for Payer: BCBS Trust/PPO	$1,767.43
Rate for Payer: BCCCP Commercial	$370.46
Rate for Payer: BCN Medicare Advantage	$2,781.81
Rate for Payer: Cash Price	$752.80
Rate for Payer: Cash Price	$752.80
Rate for Payer: Cofinity Commercial	$658.70
Rate for Payer: Cofinity Commercial	$809.26
Rate for Payer: Health Alliance Plan Medicare Advantage	$2,781.81
Rate for Payer: Healthscope Commercial	$846.90
Rate for Payer: Mclaren Medicaid	$1,521.65
Rate for Payer: Mclaren Medicare	$2,781.81
Rate for Payer: Meridian Medicaid	$1,597.87
Rate for Payer: Meridian Wellcare - Medicare Advantage	$2,920.90
Rate for Payer: MI Amish Medical Board Commercial	$3,199.08
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$799.85
Rate for Payer: PACE Medicare	$2,642.72
Rate for Payer: PACE SWMI	$2,781.81
Rate for Payer: PHP Commercial	$799.85
Rate for Payer: PHP Medicare Advantage	$2,781.81
Rate for Payer: Priority Health Choice Medicaid	$1,521.65
Rate for Payer: Priority Health Cigna Priority Health	$658.70
Rate for Payer: Priority Health Medicare	$2,781.81
Rate for Payer: Priority Health SBD	$592.83
Rate for Payer: Railroad Medicare Medicare	$2,781.81
Rate for Payer: UHC All Payor (Choice/PPO)	$197.02
Rate for Payer: UHC Dual Complete DSNP	$2,781.81
Rate for Payer: UHC Exchange	$179.11
Rate for Payer: UHC Medicare Advantage	$2,865.26
Rate for Payer: VA VA	$2,781.81

PR COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX

Professional

Both

$941.00

Service Code	HCPCS 57461
Min. Negotiated Rate	$116.51
Max. Negotiated Rate	$1,582.26
Rate for Payer: Aetna Commercial	$221.07
Rate for Payer: BCBS Complete	$122.34
Rate for Payer: BCBS Trust/PPO	$1,582.26
Rate for Payer: Cash Price	$752.80
Rate for Payer: Cash Price	$752.80
Rate for Payer: Mclaren Medicaid	$116.51
Rate for Payer: Meridian Medicaid	$122.34
Rate for Payer: Priority Health Choice Medicaid	$116.51
Rate for Payer: Priority Health Cigna Priority Health	$658.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$258.48
Rate for Payer: Priority Health Narrow Network	$258.48
Rate for Payer: Priority Health SBD	$258.48

PR COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX

Professional

Both

$634.00

Service Code	HCPCS 57460
Min. Negotiated Rate	$101.81
Max. Negotiated Rate	$1,524.15
Rate for Payer: Aetna Commercial	$191.11
Rate for Payer: BCBS Complete	$106.90
Rate for Payer: BCBS Trust/PPO	$1,524.15
Rate for Payer: Cash Price	$507.20
Rate for Payer: Cash Price	$507.20
Rate for Payer: Mclaren Medicaid	$101.81
Rate for Payer: Meridian Medicaid	$106.90
Rate for Payer: Priority Health Choice Medicaid	$101.81
Rate for Payer: Priority Health Cigna Priority Health	$443.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$224.87
Rate for Payer: Priority Health Narrow Network	$224.87
Rate for Payer: Priority Health SBD	$224.87

PR COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX

Professional

Both

$634.00

Service Code	HCPCS 57460
Hospital Charge Code	57460
Min. Negotiated Rate	$101.81
Max. Negotiated Rate	$1,524.15
Rate for Payer: Aetna Commercial	$191.11
Rate for Payer: BCBS Complete	$106.90
Rate for Payer: BCBS Trust/PPO	$1,524.15
Rate for Payer: Cash Price	$507.20
Rate for Payer: Cash Price	$507.20
Rate for Payer: Mclaren Medicaid	$101.81
Rate for Payer: Meridian Medicaid	$106.90
Rate for Payer: Priority Health Choice Medicaid	$101.81
Rate for Payer: Priority Health Cigna Priority Health	$443.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$224.87
Rate for Payer: Priority Health Narrow Network	$224.87
Rate for Payer: Priority Health SBD	$224.87

PR COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX

Facility

$634.00

Service Code	CPT 57460
Hospital Charge Code	57460
Min. Negotiated Rate	$156.52
Max. Negotiated Rate	$3,477.26
Rate for Payer: Aetna Commercial	$538.90
Rate for Payer: Aetna Medicare	$2,893.08
Rate for Payer: Aetna New Business (MI Preferred)	$412.10
Rate for Payer: Allen County Amish Medical Aid Commercial	$3,477.26
Rate for Payer: Amish Plain Church Group Commercial	$3,477.26
Rate for Payer: BCBS Complete	$1,597.87
Rate for Payer: BCBS MAPPO	$2,781.81
Rate for Payer: BCBS Trust/PPO	$1,767.43
Rate for Payer: BCCCP Commercial	$331.36
Rate for Payer: BCN Medicare Advantage	$2,781.81
Rate for Payer: Cash Price	$507.20
Rate for Payer: Cash Price	$507.20
Rate for Payer: Cofinity Commercial	$545.24
Rate for Payer: Cofinity Commercial	$443.80
Rate for Payer: Health Alliance Plan Medicare Advantage	$2,781.81
Rate for Payer: Healthscope Commercial	$570.60
Rate for Payer: Mclaren Medicaid	$1,521.65
Rate for Payer: Mclaren Medicare	$2,781.81
Rate for Payer: Meridian Medicaid	$1,597.87
Rate for Payer: Meridian Wellcare - Medicare Advantage	$2,920.90
Rate for Payer: MI Amish Medical Board Commercial	$3,199.08
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$538.90
Rate for Payer: PACE Medicare	$2,642.72
Rate for Payer: PACE SWMI	$2,781.81
Rate for Payer: PHP Commercial	$538.90
Rate for Payer: PHP Medicare Advantage	$2,781.81
Rate for Payer: Priority Health Choice Medicaid	$1,521.65
Rate for Payer: Priority Health Cigna Priority Health	$443.80
Rate for Payer: Priority Health Medicare	$2,781.81
Rate for Payer: Priority Health SBD	$399.42
Rate for Payer: Railroad Medicare Medicare	$2,781.81
Rate for Payer: UHC All Payor (Choice/PPO)	$172.17
Rate for Payer: UHC Dual Complete DSNP	$2,781.81
Rate for Payer: UHC Exchange	$156.52
Rate for Payer: UHC Medicare Advantage	$2,865.26
Rate for Payer: VA VA	$2,781.81

PR COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX

Facility

$634.00

Service Code	CPT 57460
Hospital Charge Code	57460
Min. Negotiated Rate	$399.42
Max. Negotiated Rate	$570.60
Rate for Payer: Aetna Commercial	$538.90
Rate for Payer: Aetna New Business (MI Preferred)	$412.10
Rate for Payer: Cash Price	$507.20
Rate for Payer: Cofinity Commercial	$443.80
Rate for Payer: Cofinity Commercial	$545.24
Rate for Payer: Healthscope Commercial	$570.60
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$538.90
Rate for Payer: PHP Commercial	$538.90
Rate for Payer: Priority Health Cigna Priority Health	$443.80
Rate for Payer: Priority Health SBD	$399.42

PR COLPOSCOPY ENTIRE VAGINA W/CERVIX IF PRESENT

Professional

Both

$230.00

Service Code	HCPCS 57420
Min. Negotiated Rate	$57.30
Max. Negotiated Rate	$1,752.90
Rate for Payer: Aetna Commercial	$107.00
Rate for Payer: BCBS Complete	$60.16
Rate for Payer: BCBS Trust/PPO	$1,752.90
Rate for Payer: Cash Price	$184.00
Rate for Payer: Cash Price	$184.00
Rate for Payer: Mclaren Medicaid	$57.30
Rate for Payer: Meridian Medicaid	$60.16
Rate for Payer: Priority Health Choice Medicaid	$57.30
Rate for Payer: Priority Health Cigna Priority Health	$161.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$125.93
Rate for Payer: Priority Health Narrow Network	$125.93
Rate for Payer: Priority Health SBD	$125.93

PR COLPOSCOPY ENTIRE VAGINA W/VAGINA/CERVIX BX

Professional

Both

$299.00

Service Code	HCPCS 57421
Min. Negotiated Rate	$77.75
Max. Negotiated Rate	$209.30
Rate for Payer: Aetna Commercial	$144.96
Rate for Payer: BCBS Complete	$81.64
Rate for Payer: BCBS Trust/PPO	$122.57
Rate for Payer: Cash Price	$239.20
Rate for Payer: Cash Price	$239.20
Rate for Payer: Mclaren Medicaid	$77.75
Rate for Payer: Meridian Medicaid	$81.64
Rate for Payer: Priority Health Choice Medicaid	$77.75
Rate for Payer: Priority Health Cigna Priority Health	$209.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$170.90
Rate for Payer: Priority Health Narrow Network	$170.90
Rate for Payer: Priority Health SBD	$170.90

PR COLPOSCOPY VULVA

Professional

Both

$316.00

Service Code	HCPCS 56820
Min. Negotiated Rate	$53.68
Max. Negotiated Rate	$1,801.50
Rate for Payer: Aetna Commercial	$100.46
Rate for Payer: BCBS Complete	$56.36
Rate for Payer: BCBS Trust/PPO	$1,801.50
Rate for Payer: Cash Price	$252.80
Rate for Payer: Cash Price	$252.80
Rate for Payer: Mclaren Medicaid	$53.68
Rate for Payer: Meridian Medicaid	$56.36
Rate for Payer: Priority Health Choice Medicaid	$53.68
Rate for Payer: Priority Health Cigna Priority Health	$221.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$119.31
Rate for Payer: Priority Health Narrow Network	$119.31
Rate for Payer: Priority Health SBD	$119.31

PR COLPOSCOPY VULVA W/BIOPSY

Facility

$344.00

Service Code	CPT 56821
Hospital Charge Code	56821
Hospital Revenue Code	521
Min. Negotiated Rate	$49.22
Max. Negotiated Rate	$356.81
Rate for Payer: Aetna Commercial	$292.40
Rate for Payer: Aetna Medicare	$296.87
Rate for Payer: Aetna New Business (MI Preferred)	$223.60
Rate for Payer: Allen County Amish Medical Aid Commercial	$356.81
Rate for Payer: Amish Plain Church Group Commercial	$356.81
Rate for Payer: BCBS Complete	$163.96
Rate for Payer: BCBS MAPPO	$285.45
Rate for Payer: BCBS Trust/PPO	$49.22
Rate for Payer: BCN Medicare Advantage	$285.45
Rate for Payer: Cash Price	$275.20
Rate for Payer: Cash Price	$275.20
Rate for Payer: Cofinity Commercial	$240.80
Rate for Payer: Cofinity Commercial	$295.84
Rate for Payer: Health Alliance Plan Medicare Advantage	$285.45
Rate for Payer: Healthscope Commercial	$309.60
Rate for Payer: Mclaren Medicaid	$156.14
Rate for Payer: Mclaren Medicare	$285.45
Rate for Payer: Meridian Medicaid	$163.96
Rate for Payer: Meridian Wellcare - Medicare Advantage	$299.72
Rate for Payer: MI Amish Medical Board Commercial	$328.27
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$292.40
Rate for Payer: PACE Medicare	$271.18
Rate for Payer: PACE SWMI	$285.45
Rate for Payer: PHP Commercial	$292.40
Rate for Payer: PHP Medicare Advantage	$285.45
Rate for Payer: Priority Health Choice Medicaid	$156.14
Rate for Payer: Priority Health Cigna Priority Health	$240.80
Rate for Payer: Priority Health Medicare	$285.45
Rate for Payer: Priority Health SBD	$216.72
Rate for Payer: Railroad Medicare Medicare	$285.45
Rate for Payer: UHC All Payor (Choice/PPO)	$122.46
Rate for Payer: UHC Dual Complete DSNP	$285.45
Rate for Payer: UHC Exchange	$111.33
Rate for Payer: UHC Medicare Advantage	$294.01
Rate for Payer: VA VA	$285.45

PR COLPOSCOPY VULVA W/BIOPSY

Professional

Both

$344.00

Service Code	HCPCS 56821
Min. Negotiated Rate	$72.42
Max. Negotiated Rate	$1,953.65
Rate for Payer: Aetna Commercial	$135.19
Rate for Payer: BCBS Complete	$76.04
Rate for Payer: BCBS Trust/PPO	$1,953.65
Rate for Payer: Cash Price	$275.20
Rate for Payer: Cash Price	$275.20
Rate for Payer: Mclaren Medicaid	$72.42
Rate for Payer: Meridian Medicaid	$76.04
Rate for Payer: Priority Health Choice Medicaid	$72.42
Rate for Payer: Priority Health Cigna Priority Health	$240.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$160.02
Rate for Payer: Priority Health Narrow Network	$160.02
Rate for Payer: Priority Health SBD	$160.02

Know your out-of-pocket cost for care.

All Charges