Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PR COLPOSCOPY VULVA W/BIOPSY

Facility

$344.00

Service Code	CPT 56821
Hospital Charge Code	56821
Hospital Revenue Code	521
Min. Negotiated Rate	$216.72
Max. Negotiated Rate	$309.60
Rate for Payer: Aetna Commercial	$292.40
Rate for Payer: Aetna New Business (MI Preferred)	$223.60
Rate for Payer: Cash Price	$275.20
Rate for Payer: Cofinity Commercial	$240.80
Rate for Payer: Cofinity Commercial	$295.84
Rate for Payer: Healthscope Commercial	$309.60
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$292.40
Rate for Payer: PHP Commercial	$292.40
Rate for Payer: Priority Health Cigna Priority Health	$240.80
Rate for Payer: Priority Health SBD	$216.72

PR COLPOSCOPY VULVA W/BIOPSY

Professional

Both

$344.00

Service Code	HCPCS 56821
Hospital Charge Code	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

PR COLPOTOMY W/DRAINAGE PELVIC ABSCESS

Professional

Both

$983.00

Service Code	HCPCS 57010
Min. Negotiated Rate	$295.43
Max. Negotiated Rate	$1,747.09
Rate for Payer: Aetna Commercial	$541.29
Rate for Payer: BCBS Complete	$310.20
Rate for Payer: BCBS Trust/PPO	$1,747.09
Rate for Payer: Cash Price	$786.40
Rate for Payer: Cash Price	$786.40
Rate for Payer: Mclaren Medicaid	$295.43
Rate for Payer: Meridian Medicaid	$310.20
Rate for Payer: Priority Health Choice Medicaid	$295.43
Rate for Payer: Priority Health Cigna Priority Health	$688.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$652.85
Rate for Payer: Priority Health Narrow Network	$652.85
Rate for Payer: Priority Health SBD	$652.85

PR COLSC FLEXIBLE W/CONTROL BLEEDING ANY METHOD

Facility

$1,396.00

Service Code	CPT 45382
Hospital Charge Code	45382
Min. Negotiated Rate	$879.48
Max. Negotiated Rate	$1,256.40
Rate for Payer: Aetna Commercial	$1,186.60
Rate for Payer: Aetna New Business (MI Preferred)	$907.40
Rate for Payer: Cash Price	$1,116.80
Rate for Payer: Cofinity Commercial	$1,200.56
Rate for Payer: Cofinity Commercial	$977.20
Rate for Payer: Healthscope Commercial	$1,256.40
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,186.60
Rate for Payer: PHP Commercial	$1,186.60
Rate for Payer: Priority Health Cigna Priority Health	$977.20
Rate for Payer: Priority Health SBD	$879.48

PR COLSC FLEXIBLE W/CONTROL BLEEDING ANY METHOD

Professional

Both

$1,396.00

Service Code	HCPCS 45382
Min. Negotiated Rate	$162.31
Max. Negotiated Rate	$977.20
Rate for Payer: Aetna Commercial	$344.31
Rate for Payer: BCBS Complete	$170.43
Rate for Payer: BCBS Trust/PPO	$315.92
Rate for Payer: Cash Price	$1,116.80
Rate for Payer: Cash Price	$1,116.80
Rate for Payer: Mclaren Medicaid	$162.31
Rate for Payer: Meridian Medicaid	$170.43
Rate for Payer: Priority Health Choice Medicaid	$162.31
Rate for Payer: Priority Health Cigna Priority Health	$977.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$446.26
Rate for Payer: Priority Health Narrow Network	$446.26
Rate for Payer: Priority Health SBD	$446.26

PR COLSC FLEXIBLE W/CONTROL BLEEDING ANY METHOD

Facility

$1,396.00

Service Code	CPT 45382
Hospital Charge Code	45382
Min. Negotiated Rate	$249.51
Max. Negotiated Rate	$3,228.76
Rate for Payer: Aetna Commercial	$1,186.60
Rate for Payer: Aetna Medicare	$1,092.02
Rate for Payer: Aetna New Business (MI Preferred)	$907.40
Rate for Payer: Allen County Amish Medical Aid Commercial	$1,312.52
Rate for Payer: Amish Plain Church Group Commercial	$1,312.52
Rate for Payer: BCBS Complete	$603.13
Rate for Payer: BCBS MAPPO	$1,050.02
Rate for Payer: BCBS Trust/PPO	$802.59
Rate for Payer: BCN Medicare Advantage	$1,050.02
Rate for Payer: Cash Price	$1,116.80
Rate for Payer: Cash Price	$1,116.80
Rate for Payer: Cofinity Commercial	$977.20
Rate for Payer: Cofinity Commercial	$1,200.56
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,050.02
Rate for Payer: Healthscope Commercial	$1,256.40
Rate for Payer: Mclaren Medicaid	$574.36
Rate for Payer: Mclaren Medicare	$1,050.02
Rate for Payer: Meridian Medicaid	$603.13
Rate for Payer: Meridian Wellcare - Medicare Advantage	$1,102.52
Rate for Payer: MI Amish Medical Board Commercial	$1,207.52
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,186.60
Rate for Payer: PACE Medicare	$997.52
Rate for Payer: PACE SWMI	$1,050.02
Rate for Payer: PHP Commercial	$1,186.60
Rate for Payer: PHP Medicare Advantage	$1,050.02
Rate for Payer: Priority Health Choice Medicaid	$574.36
Rate for Payer: Priority Health Cigna Priority Health	$977.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$3,228.76
Rate for Payer: Priority Health Medicare	$1,050.02
Rate for Payer: Priority Health Narrow Network	$2,583.01
Rate for Payer: Priority Health SBD	$879.48
Rate for Payer: Railroad Medicare Medicare	$1,050.02
Rate for Payer: UHC All Payor (Choice/PPO)	$274.46
Rate for Payer: UHC Dual Complete DSNP	$1,050.02
Rate for Payer: UHC Exchange	$249.51
Rate for Payer: UHC Medicare Advantage	$1,081.52
Rate for Payer: VA VA	$1,050.02

PR COLSC FLEXIBLE W/CONTROL BLEEDING ANY METHOD

Professional

Both

$1,396.00

Service Code	HCPCS 45382
Hospital Charge Code	45382
Min. Negotiated Rate	$162.31
Max. Negotiated Rate	$977.20
Rate for Payer: Aetna Commercial	$344.31
Rate for Payer: BCBS Complete	$170.43
Rate for Payer: BCBS Trust/PPO	$315.92
Rate for Payer: Cash Price	$1,116.80
Rate for Payer: Cash Price	$1,116.80
Rate for Payer: Mclaren Medicaid	$162.31
Rate for Payer: Meridian Medicaid	$170.43
Rate for Payer: Priority Health Choice Medicaid	$162.31
Rate for Payer: Priority Health Cigna Priority Health	$977.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$446.26
Rate for Payer: Priority Health Narrow Network	$446.26
Rate for Payer: Priority Health SBD	$446.26

PR COLSC FLEXIBLE W/TRANSENDOSCOPIC BALLOON DILAT

Professional

Both

$1,294.00

Service Code	HCPCS 45386
Min. Negotiated Rate	$118.34
Max. Negotiated Rate	$905.80
Rate for Payer: Aetna Commercial	$281.59
Rate for Payer: BCBS Complete	$139.79
Rate for Payer: BCBS Trust/PPO	$118.34
Rate for Payer: Cash Price	$1,035.20
Rate for Payer: Cash Price	$1,035.20
Rate for Payer: Mclaren Medicaid	$133.13
Rate for Payer: Meridian Medicaid	$139.79
Rate for Payer: Priority Health Choice Medicaid	$133.13
Rate for Payer: Priority Health Cigna Priority Health	$905.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$365.13
Rate for Payer: Priority Health Narrow Network	$365.13
Rate for Payer: Priority Health SBD	$365.13

PR COLSC FLX WITH DIRECTED SUBMUCOSAL NJX ANY SBST

Facility

$1,378.00

Service Code	CPT 45381
Hospital Charge Code	45381
Hospital Revenue Code	960
Min. Negotiated Rate	$193.52
Max. Negotiated Rate	$3,228.76
Rate for Payer: Aetna Commercial	$1,171.30
Rate for Payer: Aetna Medicare	$1,092.02
Rate for Payer: Aetna New Business (MI Preferred)	$895.70
Rate for Payer: Allen County Amish Medical Aid Commercial	$1,312.52
Rate for Payer: Amish Plain Church Group Commercial	$1,312.52
Rate for Payer: BCBS Complete	$603.13
Rate for Payer: BCBS MAPPO	$1,050.02
Rate for Payer: BCBS Trust/PPO	$944.08
Rate for Payer: BCN Medicare Advantage	$1,050.02
Rate for Payer: Cash Price	$1,102.40
Rate for Payer: Cash Price	$1,102.40
Rate for Payer: Cofinity Commercial	$964.60
Rate for Payer: Cofinity Commercial	$1,185.08
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,050.02
Rate for Payer: Healthscope Commercial	$1,240.20
Rate for Payer: Mclaren Medicaid	$574.36
Rate for Payer: Mclaren Medicare	$1,050.02
Rate for Payer: Meridian Medicaid	$603.13
Rate for Payer: Meridian Wellcare - Medicare Advantage	$1,102.52
Rate for Payer: MI Amish Medical Board Commercial	$1,207.52
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,171.30
Rate for Payer: PACE Medicare	$997.52
Rate for Payer: PACE SWMI	$1,050.02
Rate for Payer: PHP Commercial	$1,171.30
Rate for Payer: PHP Medicare Advantage	$1,050.02
Rate for Payer: Priority Health Choice Medicaid	$574.36
Rate for Payer: Priority Health Cigna Priority Health	$964.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$3,228.76
Rate for Payer: Priority Health Medicare	$1,050.02
Rate for Payer: Priority Health Narrow Network	$2,583.01
Rate for Payer: Priority Health SBD	$868.14
Rate for Payer: Railroad Medicare Medicare	$1,050.02
Rate for Payer: UHC All Payor (Choice/PPO)	$212.87
Rate for Payer: UHC Dual Complete DSNP	$1,050.02
Rate for Payer: UHC Exchange	$193.52
Rate for Payer: UHC Medicare Advantage	$1,081.52
Rate for Payer: VA VA	$1,050.02

PR COLSC FLX WITH DIRECTED SUBMUCOSAL NJX ANY SBST

Professional

Both

$1,378.00

Service Code	HCPCS 45381
Hospital Charge Code	45381
Min. Negotiated Rate	$125.88
Max. Negotiated Rate	$964.60
Rate for Payer: Aetna Commercial	$267.31
Rate for Payer: BCBS Complete	$132.17
Rate for Payer: BCBS Trust/PPO	$218.19
Rate for Payer: Cash Price	$1,102.40
Rate for Payer: Cash Price	$1,102.40
Rate for Payer: Mclaren Medicaid	$125.88
Rate for Payer: Meridian Medicaid	$132.17
Rate for Payer: Priority Health Choice Medicaid	$125.88
Rate for Payer: Priority Health Cigna Priority Health	$964.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$345.73
Rate for Payer: Priority Health Narrow Network	$345.73
Rate for Payer: Priority Health SBD	$345.73

PR COLSC FLX WITH DIRECTED SUBMUCOSAL NJX ANY SBST

Professional

Both

$1,378.00

Service Code	HCPCS 45381
Min. Negotiated Rate	$125.88
Max. Negotiated Rate	$964.60
Rate for Payer: Aetna Commercial	$267.31
Rate for Payer: BCBS Complete	$132.17
Rate for Payer: BCBS Trust/PPO	$218.19
Rate for Payer: Cash Price	$1,102.40
Rate for Payer: Cash Price	$1,102.40
Rate for Payer: Mclaren Medicaid	$125.88
Rate for Payer: Meridian Medicaid	$132.17
Rate for Payer: Priority Health Choice Medicaid	$125.88
Rate for Payer: Priority Health Cigna Priority Health	$964.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$345.73
Rate for Payer: Priority Health Narrow Network	$345.73
Rate for Payer: Priority Health SBD	$345.73

PR COLSC FLX WITH DIRECTED SUBMUCOSAL NJX ANY SBST

Facility

$1,378.00

Service Code	CPT 45381
Hospital Charge Code	45381
Hospital Revenue Code	960
Min. Negotiated Rate	$868.14
Max. Negotiated Rate	$1,240.20
Rate for Payer: Aetna Commercial	$1,171.30
Rate for Payer: Aetna New Business (MI Preferred)	$895.70
Rate for Payer: Cash Price	$1,102.40
Rate for Payer: Cofinity Commercial	$1,185.08
Rate for Payer: Cofinity Commercial	$964.60
Rate for Payer: Healthscope Commercial	$1,240.20
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,171.30
Rate for Payer: PHP Commercial	$1,171.30
Rate for Payer: Priority Health Cigna Priority Health	$964.60
Rate for Payer: Priority Health SBD	$868.14

PR COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX

Professional

Both

$533.00

Service Code	HCPCS 45391
Min. Negotiated Rate	$161.67
Max. Negotiated Rate	$444.51
Rate for Payer: Aetna Commercial	$341.98
Rate for Payer: BCBS Complete	$169.75
Rate for Payer: BCBS Trust/PPO	$304.83
Rate for Payer: Cash Price	$426.40
Rate for Payer: Cash Price	$426.40
Rate for Payer: Mclaren Medicaid	$161.67
Rate for Payer: Meridian Medicaid	$169.75
Rate for Payer: Priority Health Choice Medicaid	$161.67
Rate for Payer: Priority Health Cigna Priority Health	$373.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$444.51
Rate for Payer: Priority Health Narrow Network	$444.51
Rate for Payer: Priority Health SBD	$444.51

PR COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS

Facility

$1,420.00

Service Code	CPT 45384
Hospital Charge Code	45384
Hospital Revenue Code	960
Min. Negotiated Rate	$894.60
Max. Negotiated Rate	$1,278.00
Rate for Payer: Aetna Commercial	$1,207.00
Rate for Payer: Aetna New Business (MI Preferred)	$923.00
Rate for Payer: Cash Price	$1,136.00
Rate for Payer: Cofinity Commercial	$1,221.20
Rate for Payer: Cofinity Commercial	$994.00
Rate for Payer: Healthscope Commercial	$1,278.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,207.00
Rate for Payer: PHP Commercial	$1,207.00
Rate for Payer: Priority Health Cigna Priority Health	$994.00
Rate for Payer: Priority Health SBD	$894.60

PR COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS

Professional

Both

$1,420.00

Service Code	HCPCS 45384
Hospital Charge Code	45384
Min. Negotiated Rate	$143.56
Max. Negotiated Rate	$994.00
Rate for Payer: Aetna Commercial	$303.80
Rate for Payer: BCBS Complete	$150.74
Rate for Payer: BCBS Trust/PPO	$302.72
Rate for Payer: Cash Price	$1,136.00
Rate for Payer: Cash Price	$1,136.00
Rate for Payer: Mclaren Medicaid	$143.56
Rate for Payer: Meridian Medicaid	$150.74
Rate for Payer: Priority Health Choice Medicaid	$143.56
Rate for Payer: Priority Health Cigna Priority Health	$994.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$393.36
Rate for Payer: Priority Health Narrow Network	$393.36
Rate for Payer: Priority Health SBD	$393.36

PR COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS

Professional

Both

$1,420.00

Service Code	HCPCS 45384
Min. Negotiated Rate	$143.56
Max. Negotiated Rate	$994.00
Rate for Payer: Aetna Commercial	$303.80
Rate for Payer: BCBS Complete	$150.74
Rate for Payer: BCBS Trust/PPO	$302.72
Rate for Payer: Cash Price	$1,136.00
Rate for Payer: Cash Price	$1,136.00
Rate for Payer: Mclaren Medicaid	$143.56
Rate for Payer: Meridian Medicaid	$150.74
Rate for Payer: Priority Health Choice Medicaid	$143.56
Rate for Payer: Priority Health Cigna Priority Health	$994.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$393.36
Rate for Payer: Priority Health Narrow Network	$393.36
Rate for Payer: Priority Health SBD	$393.36

PR COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS

Facility

$1,420.00

Service Code	CPT 45384
Hospital Charge Code	45384
Hospital Revenue Code	960
Min. Negotiated Rate	$220.70
Max. Negotiated Rate	$3,228.76
Rate for Payer: Aetna Commercial	$1,207.00
Rate for Payer: Aetna Medicare	$1,092.02
Rate for Payer: Aetna New Business (MI Preferred)	$923.00
Rate for Payer: Allen County Amish Medical Aid Commercial	$1,312.52
Rate for Payer: Amish Plain Church Group Commercial	$1,312.52
Rate for Payer: BCBS Complete	$603.13
Rate for Payer: BCBS MAPPO	$1,050.02
Rate for Payer: BCBS Trust/PPO	$557.15
Rate for Payer: BCN Medicare Advantage	$1,050.02
Rate for Payer: Cash Price	$1,136.00
Rate for Payer: Cash Price	$1,136.00
Rate for Payer: Cofinity Commercial	$994.00
Rate for Payer: Cofinity Commercial	$1,221.20
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,050.02
Rate for Payer: Healthscope Commercial	$1,278.00
Rate for Payer: Mclaren Medicaid	$574.36
Rate for Payer: Mclaren Medicare	$1,050.02
Rate for Payer: Meridian Medicaid	$603.13
Rate for Payer: Meridian Wellcare - Medicare Advantage	$1,102.52
Rate for Payer: MI Amish Medical Board Commercial	$1,207.52
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,207.00
Rate for Payer: PACE Medicare	$997.52
Rate for Payer: PACE SWMI	$1,050.02
Rate for Payer: PHP Commercial	$1,207.00
Rate for Payer: PHP Medicare Advantage	$1,050.02
Rate for Payer: Priority Health Choice Medicaid	$574.36
Rate for Payer: Priority Health Cigna Priority Health	$994.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$3,228.76
Rate for Payer: Priority Health Medicare	$1,050.02
Rate for Payer: Priority Health Narrow Network	$2,583.01
Rate for Payer: Priority Health SBD	$894.60
Rate for Payer: Railroad Medicare Medicare	$1,050.02
Rate for Payer: UHC All Payor (Choice/PPO)	$242.77
Rate for Payer: UHC Dual Complete DSNP	$1,050.02
Rate for Payer: UHC Exchange	$220.70
Rate for Payer: UHC Medicare Advantage	$1,081.52
Rate for Payer: VA VA	$1,050.02

PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ

Professional

Both

$1,420.00

Service Code	HCPCS 45385
Hospital Charge Code	45385
Min. Negotiated Rate	$103.02
Max. Negotiated Rate	$994.00
Rate for Payer: Aetna Commercial	$337.92
Rate for Payer: BCBS Complete	$167.52
Rate for Payer: BCBS Trust/PPO	$103.02
Rate for Payer: Cash Price	$1,136.00
Rate for Payer: Cash Price	$1,136.00
Rate for Payer: Mclaren Medicaid	$159.54
Rate for Payer: Meridian Medicaid	$167.52
Rate for Payer: Priority Health Choice Medicaid	$159.54
Rate for Payer: Priority Health Cigna Priority Health	$994.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$438.04
Rate for Payer: Priority Health Narrow Network	$438.04
Rate for Payer: Priority Health SBD	$438.04

PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ

Facility

$1,420.00

Service Code	CPT 45385
Hospital Charge Code	45385
Hospital Revenue Code	960
Min. Negotiated Rate	$894.60
Max. Negotiated Rate	$1,278.00
Rate for Payer: Aetna Commercial	$1,207.00
Rate for Payer: Aetna New Business (MI Preferred)	$923.00
Rate for Payer: Cash Price	$1,136.00
Rate for Payer: Cofinity Commercial	$994.00
Rate for Payer: Cofinity Commercial	$1,221.20
Rate for Payer: Healthscope Commercial	$1,278.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,207.00
Rate for Payer: PHP Commercial	$1,207.00
Rate for Payer: Priority Health Cigna Priority Health	$994.00
Rate for Payer: Priority Health SBD	$894.60

PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ

Professional

Both

$1,420.00

Service Code	HCPCS 45385
Min. Negotiated Rate	$103.02
Max. Negotiated Rate	$994.00
Rate for Payer: Aetna Commercial	$337.92
Rate for Payer: BCBS Complete	$167.52
Rate for Payer: BCBS Trust/PPO	$103.02
Rate for Payer: Cash Price	$1,136.00
Rate for Payer: Cash Price	$1,136.00
Rate for Payer: Mclaren Medicaid	$159.54
Rate for Payer: Meridian Medicaid	$167.52
Rate for Payer: Priority Health Choice Medicaid	$159.54
Rate for Payer: Priority Health Cigna Priority Health	$994.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$438.04
Rate for Payer: Priority Health Narrow Network	$438.04
Rate for Payer: Priority Health SBD	$438.04

PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ

Facility

$1,420.00

Service Code	CPT 45385
Hospital Charge Code	45385
Hospital Revenue Code	960
Min. Negotiated Rate	$245.25
Max. Negotiated Rate	$3,228.76
Rate for Payer: Aetna Commercial	$1,207.00
Rate for Payer: Aetna Medicare	$1,092.02
Rate for Payer: Aetna New Business (MI Preferred)	$923.00
Rate for Payer: Allen County Amish Medical Aid Commercial	$1,312.52
Rate for Payer: Amish Plain Church Group Commercial	$1,312.52
Rate for Payer: BCBS Complete	$603.13
Rate for Payer: BCBS MAPPO	$1,050.02
Rate for Payer: BCBS Trust/PPO	$448.96
Rate for Payer: BCN Medicare Advantage	$1,050.02
Rate for Payer: Cash Price	$1,136.00
Rate for Payer: Cash Price	$1,136.00
Rate for Payer: Cofinity Commercial	$994.00
Rate for Payer: Cofinity Commercial	$1,221.20
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,050.02
Rate for Payer: Healthscope Commercial	$1,278.00
Rate for Payer: Mclaren Medicaid	$574.36
Rate for Payer: Mclaren Medicare	$1,050.02
Rate for Payer: Meridian Medicaid	$603.13
Rate for Payer: Meridian Wellcare - Medicare Advantage	$1,102.52
Rate for Payer: MI Amish Medical Board Commercial	$1,207.52
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,207.00
Rate for Payer: PACE Medicare	$997.52
Rate for Payer: PACE SWMI	$1,050.02
Rate for Payer: PHP Commercial	$1,207.00
Rate for Payer: PHP Medicare Advantage	$1,050.02
Rate for Payer: Priority Health Choice Medicaid	$574.36
Rate for Payer: Priority Health Cigna Priority Health	$994.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$3,228.76
Rate for Payer: Priority Health Medicare	$1,050.02
Rate for Payer: Priority Health Narrow Network	$2,583.01
Rate for Payer: Priority Health SBD	$894.60
Rate for Payer: Railroad Medicare Medicare	$1,050.02
Rate for Payer: UHC All Payor (Choice/PPO)	$269.78
Rate for Payer: UHC Dual Complete DSNP	$1,050.02
Rate for Payer: UHC Exchange	$245.25
Rate for Payer: UHC Medicare Advantage	$1,081.52
Rate for Payer: VA VA	$1,050.02

PR COLSC FLX W/US GUID NDL ASPIR/BX W/US RCTM ET AL

Professional

Both

$975.00

Service Code	HCPCS 45392
Min. Negotiated Rate	$190.85
Max. Negotiated Rate	$682.50
Rate for Payer: Aetna Commercial	$405.72
Rate for Payer: BCBS Complete	$200.39
Rate for Payer: BCBS Trust/PPO	$308.53
Rate for Payer: Cash Price	$780.00
Rate for Payer: Cash Price	$780.00
Rate for Payer: Mclaren Medicaid	$190.85
Rate for Payer: Meridian Medicaid	$200.39
Rate for Payer: Priority Health Choice Medicaid	$190.85
Rate for Payer: Priority Health Cigna Priority Health	$682.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$524.47
Rate for Payer: Priority Health Narrow Network	$524.47
Rate for Payer: Priority Health SBD	$524.47

PR COMM SVCS BY RHC/FQHC 5 MIN

Professional

Both

$48.00

Service Code	HCPCS G0071
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$1,575.92
Rate for Payer: Aetna Commercial	$23.13
Rate for Payer: BCBS Complete	$19.20
Rate for Payer: BCBS Trust/PPO	$1,575.92
Rate for Payer: Cash Price	$38.40
Rate for Payer: Cash Price	$38.40
Rate for Payer: Priority Health Cigna Priority Health	$33.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$31.44
Rate for Payer: Priority Health Narrow Network	$31.44
Rate for Payer: Priority Health SBD	$31.44

PR COMPLETE REPLACEMENT PICC RS&I

Professional

Both

$394.00

Service Code	HCPCS 36584
Min. Negotiated Rate	$36.42
Max. Negotiated Rate	$275.80
Rate for Payer: Aetna Commercial	$80.12
Rate for Payer: BCBS Complete	$38.24
Rate for Payer: BCBS Trust/PPO	$79.77
Rate for Payer: Cash Price	$315.20
Rate for Payer: Cash Price	$315.20
Rate for Payer: Mclaren Medicaid	$36.42
Rate for Payer: Meridian Medicaid	$38.24
Rate for Payer: Priority Health Choice Medicaid	$36.42
Rate for Payer: Priority Health Cigna Priority Health	$275.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$91.50
Rate for Payer: Priority Health Narrow Network	$91.50
Rate for Payer: Priority Health SBD	$91.50

PR COMPLETE TTHRC ECHO CONGENITAL CARDIAC ANOMALY

Professional

Both

$356.00

Service Code	HCPCS 93303
Min. Negotiated Rate	$85.12
Max. Negotiated Rate	$1,712.22
Rate for Payer: Aetna Commercial	$298.31
Rate for Payer: BCBS Complete	$142.40
Rate for Payer: BCBS Trust/PPO	$1,712.22
Rate for Payer: Cash Price	$284.80
Rate for Payer: Cash Price	$284.80
Rate for Payer: Priority Health Cigna Priority Health	$249.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$85.12
Rate for Payer: Priority Health Narrow Network	$85.12
Rate for Payer: Priority Health SBD	$311.62

Know your out-of-pocket cost for care.

All Charges