Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PR DSTRJ CUTANEOUS VASCULAR LESIONS >50.0 SQ CM

Professional

Both

$1,147.00

Service Code	HCPCS 17108
Min. Negotiated Rate	$337.82
Max. Negotiated Rate	$2,400.00
Rate for Payer: Aetna Commercial	$559.13
Rate for Payer: BCBS Complete	$354.71
Rate for Payer: BCBS Trust/PPO	$2,400.00
Rate for Payer: Cash Price	$917.60
Rate for Payer: Cash Price	$917.60
Rate for Payer: Mclaren Medicaid	$337.82
Rate for Payer: Meridian Medicaid	$354.71
Rate for Payer: Priority Health Choice Medicaid	$337.82
Rate for Payer: Priority Health Cigna Priority Health	$802.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$642.46
Rate for Payer: Priority Health Narrow Network	$642.46
Rate for Payer: Priority Health SBD	$642.46

PR DSTRJ LESION ANUS EXTENSIVE

Professional

Both

$848.00

Service Code	HCPCS 46924
Hospital Charge Code	46924
Min. Negotiated Rate	$116.30
Max. Negotiated Rate	$1,253.66
Rate for Payer: Aetna Commercial	$239.74
Rate for Payer: BCBS Complete	$122.12
Rate for Payer: BCBS Trust/PPO	$1,253.66
Rate for Payer: Cash Price	$678.40
Rate for Payer: Cash Price	$678.40
Rate for Payer: Mclaren Medicaid	$116.30
Rate for Payer: Meridian Medicaid	$122.12
Rate for Payer: Priority Health Choice Medicaid	$116.30
Rate for Payer: Priority Health Cigna Priority Health	$593.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$316.91
Rate for Payer: Priority Health Narrow Network	$316.91
Rate for Payer: Priority Health SBD	$316.91

PR DSTRJ LESION ANUS EXTENSIVE

Facility

$848.00

Service Code	CPT 46924
Hospital Charge Code	46924
Hospital Revenue Code	960
Min. Negotiated Rate	$534.24
Max. Negotiated Rate	$763.20
Rate for Payer: Aetna Commercial	$720.80
Rate for Payer: Aetna New Business (MI Preferred)	$551.20
Rate for Payer: Cash Price	$678.40
Rate for Payer: Cofinity Commercial	$593.60
Rate for Payer: Cofinity Commercial	$729.28
Rate for Payer: Healthscope Commercial	$763.20
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$720.80
Rate for Payer: PHP Commercial	$720.80
Rate for Payer: Priority Health Cigna Priority Health	$593.60
Rate for Payer: Priority Health SBD	$534.24

PR DSTRJ LESION ANUS EXTENSIVE

Facility

$848.00

Service Code	CPT 46924
Hospital Charge Code	46924
Hospital Revenue Code	960
Min. Negotiated Rate	$178.78
Max. Negotiated Rate	$3,122.94
Rate for Payer: Aetna Commercial	$720.80
Rate for Payer: Aetna Medicare	$2,598.28
Rate for Payer: Aetna New Business (MI Preferred)	$551.20
Rate for Payer: Allen County Amish Medical Aid Commercial	$3,122.94
Rate for Payer: Amish Plain Church Group Commercial	$3,122.94
Rate for Payer: BCBS Complete	$1,435.05
Rate for Payer: BCBS MAPPO	$2,498.35
Rate for Payer: BCBS Trust/PPO	$1,612.09
Rate for Payer: BCN Medicare Advantage	$2,498.35
Rate for Payer: Cash Price	$678.40
Rate for Payer: Cash Price	$678.40
Rate for Payer: Cofinity Commercial	$729.28
Rate for Payer: Cofinity Commercial	$593.60
Rate for Payer: Health Alliance Plan Medicare Advantage	$2,498.35
Rate for Payer: Healthscope Commercial	$763.20
Rate for Payer: Mclaren Medicaid	$1,366.60
Rate for Payer: Mclaren Medicare	$2,498.35
Rate for Payer: Meridian Medicaid	$1,435.05
Rate for Payer: Meridian Wellcare - Medicare Advantage	$2,623.27
Rate for Payer: MI Amish Medical Board Commercial	$2,873.10
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$720.80
Rate for Payer: PACE Medicare	$2,373.43
Rate for Payer: PACE SWMI	$2,498.35
Rate for Payer: PHP Commercial	$720.80
Rate for Payer: PHP Medicare Advantage	$2,498.35
Rate for Payer: Priority Health Choice Medicaid	$1,366.60
Rate for Payer: Priority Health Cigna Priority Health	$593.60
Rate for Payer: Priority Health Medicare	$2,498.35
Rate for Payer: Priority Health SBD	$534.24
Rate for Payer: Railroad Medicare Medicare	$2,498.35
Rate for Payer: UHC All Payor (Choice/PPO)	$196.66
Rate for Payer: UHC Dual Complete DSNP	$2,498.35
Rate for Payer: UHC Exchange	$178.78
Rate for Payer: UHC Medicare Advantage	$2,573.30
Rate for Payer: VA VA	$2,498.35

PR DSTRJ LESION ANUS EXTENSIVE

Professional

Both

$848.00

Service Code	HCPCS 46924
Min. Negotiated Rate	$116.30
Max. Negotiated Rate	$1,253.66
Rate for Payer: Aetna Commercial	$239.74
Rate for Payer: BCBS Complete	$122.12
Rate for Payer: BCBS Trust/PPO	$1,253.66
Rate for Payer: Cash Price	$678.40
Rate for Payer: Cash Price	$678.40
Rate for Payer: Mclaren Medicaid	$116.30
Rate for Payer: Meridian Medicaid	$122.12
Rate for Payer: Priority Health Choice Medicaid	$116.30
Rate for Payer: Priority Health Cigna Priority Health	$593.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$316.91
Rate for Payer: Priority Health Narrow Network	$316.91
Rate for Payer: Priority Health SBD	$316.91

PR DSTRJ LESION ANUS SIMPLE CHEMICAL

Professional

Both

$375.00

Service Code	HCPCS 46900
Min. Negotiated Rate	$88.40
Max. Negotiated Rate	$1,703.77
Rate for Payer: Aetna Commercial	$179.17
Rate for Payer: BCBS Complete	$92.82
Rate for Payer: BCBS Trust/PPO	$1,703.77
Rate for Payer: Cash Price	$300.00
Rate for Payer: Cash Price	$300.00
Rate for Payer: Mclaren Medicaid	$88.40
Rate for Payer: Meridian Medicaid	$92.82
Rate for Payer: Priority Health Choice Medicaid	$88.40
Rate for Payer: Priority Health Cigna Priority Health	$262.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$241.07
Rate for Payer: Priority Health Narrow Network	$241.07
Rate for Payer: Priority Health SBD	$241.07

PR DSTRJ LESION ANUS SIMPLE CHEMICAL

Facility

$375.00

Service Code	CPT 46900
Hospital Charge Code	46900
Min. Negotiated Rate	$236.25
Max. Negotiated Rate	$337.50
Rate for Payer: Aetna Commercial	$318.75
Rate for Payer: Aetna New Business (MI Preferred)	$243.75
Rate for Payer: Cash Price	$300.00
Rate for Payer: Cofinity Commercial	$262.50
Rate for Payer: Cofinity Commercial	$322.50
Rate for Payer: Healthscope Commercial	$337.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$318.75
Rate for Payer: PHP Commercial	$318.75
Rate for Payer: Priority Health Cigna Priority Health	$262.50
Rate for Payer: Priority Health SBD	$236.25

PR DSTRJ LESION ANUS SIMPLE CHEMICAL

Professional

Both

$375.00

Service Code	HCPCS 46900
Hospital Charge Code	46900
Min. Negotiated Rate	$88.40
Max. Negotiated Rate	$1,703.77
Rate for Payer: Aetna Commercial	$179.17
Rate for Payer: BCBS Complete	$92.82
Rate for Payer: BCBS Trust/PPO	$1,703.77
Rate for Payer: Cash Price	$300.00
Rate for Payer: Cash Price	$300.00
Rate for Payer: Mclaren Medicaid	$88.40
Rate for Payer: Meridian Medicaid	$92.82
Rate for Payer: Priority Health Choice Medicaid	$88.40
Rate for Payer: Priority Health Cigna Priority Health	$262.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$241.07
Rate for Payer: Priority Health Narrow Network	$241.07
Rate for Payer: Priority Health SBD	$241.07

PR DSTRJ LESION ANUS SIMPLE CHEMICAL

Facility

$375.00

Service Code	CPT 46900
Hospital Charge Code	46900
Min. Negotiated Rate	$116.67
Max. Negotiated Rate	$443.50
Rate for Payer: Aetna Commercial	$318.75
Rate for Payer: Aetna Medicare	$368.99
Rate for Payer: Aetna New Business (MI Preferred)	$243.75
Rate for Payer: Allen County Amish Medical Aid Commercial	$443.50
Rate for Payer: Amish Plain Church Group Commercial	$443.50
Rate for Payer: BCBS Complete	$203.80
Rate for Payer: BCBS MAPPO	$354.80
Rate for Payer: BCBS Trust/PPO	$116.67
Rate for Payer: BCN Medicare Advantage	$354.80
Rate for Payer: Cash Price	$300.00
Rate for Payer: Cash Price	$300.00
Rate for Payer: Cofinity Commercial	$322.50
Rate for Payer: Cofinity Commercial	$262.50
Rate for Payer: Health Alliance Plan Medicare Advantage	$354.80
Rate for Payer: Healthscope Commercial	$337.50
Rate for Payer: Mclaren Medicaid	$194.08
Rate for Payer: Mclaren Medicare	$354.80
Rate for Payer: Meridian Medicaid	$203.80
Rate for Payer: Meridian Wellcare - Medicare Advantage	$372.54
Rate for Payer: MI Amish Medical Board Commercial	$408.02
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$318.75
Rate for Payer: PACE Medicare	$337.06
Rate for Payer: PACE SWMI	$354.80
Rate for Payer: PHP Commercial	$318.75
Rate for Payer: PHP Medicare Advantage	$354.80
Rate for Payer: Priority Health Choice Medicaid	$194.08
Rate for Payer: Priority Health Cigna Priority Health	$262.50
Rate for Payer: Priority Health Medicare	$354.80
Rate for Payer: Priority Health SBD	$236.25
Rate for Payer: Railroad Medicare Medicare	$354.80
Rate for Payer: UHC All Payor (Choice/PPO)	$149.48
Rate for Payer: UHC Dual Complete DSNP	$354.80
Rate for Payer: UHC Exchange	$135.89
Rate for Payer: UHC Medicare Advantage	$365.44
Rate for Payer: VA VA	$354.80

PR DSTRJ LESION ANUS SIMPLE CRYOSURGERY

Professional

Both

$404.00

Service Code	HCPCS 46916
Min. Negotiated Rate	$91.16
Max. Negotiated Rate	$1,647.77
Rate for Payer: Aetna Commercial	$184.99
Rate for Payer: BCBS Complete	$95.72
Rate for Payer: BCBS Trust/PPO	$1,647.77
Rate for Payer: Cash Price	$323.20
Rate for Payer: Cash Price	$323.20
Rate for Payer: Mclaren Medicaid	$91.16
Rate for Payer: Meridian Medicaid	$95.72
Rate for Payer: Priority Health Choice Medicaid	$91.16
Rate for Payer: Priority Health Cigna Priority Health	$282.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$248.12
Rate for Payer: Priority Health Narrow Network	$248.12
Rate for Payer: Priority Health SBD	$248.12

PR DSTRJ LESION ANUS SIMPLE LASER SURG

Professional

Both

$700.00

Service Code	HCPCS 46917
Min. Negotiated Rate	$83.07
Max. Negotiated Rate	$1,832.14
Rate for Payer: Aetna Commercial	$169.46
Rate for Payer: BCBS Complete	$87.22
Rate for Payer: BCBS Trust/PPO	$1,832.14
Rate for Payer: Cash Price	$560.00
Rate for Payer: Cash Price	$560.00
Rate for Payer: Mclaren Medicaid	$83.07
Rate for Payer: Meridian Medicaid	$87.22
Rate for Payer: Priority Health Choice Medicaid	$83.07
Rate for Payer: Priority Health Cigna Priority Health	$490.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$226.38
Rate for Payer: Priority Health Narrow Network	$226.38
Rate for Payer: Priority Health SBD	$226.38

PR DSTRJ LESION ANUS SIMPLE SURG EXCISION

Facility

$461.00

Service Code	CPT 46922
Hospital Charge Code	46922
Hospital Revenue Code	960
Min. Negotiated Rate	$136.54
Max. Negotiated Rate	$3,122.94
Rate for Payer: Aetna Commercial	$391.85
Rate for Payer: Aetna Medicare	$2,598.28
Rate for Payer: Aetna New Business (MI Preferred)	$299.65
Rate for Payer: Allen County Amish Medical Aid Commercial	$3,122.94
Rate for Payer: Amish Plain Church Group Commercial	$3,122.94
Rate for Payer: BCBS Complete	$1,435.05
Rate for Payer: BCBS MAPPO	$2,498.35
Rate for Payer: BCBS Trust/PPO	$1,341.35
Rate for Payer: BCN Medicare Advantage	$2,498.35
Rate for Payer: Cash Price	$368.80
Rate for Payer: Cash Price	$368.80
Rate for Payer: Cofinity Commercial	$396.46
Rate for Payer: Cofinity Commercial	$322.70
Rate for Payer: Health Alliance Plan Medicare Advantage	$2,498.35
Rate for Payer: Healthscope Commercial	$414.90
Rate for Payer: Mclaren Medicaid	$1,366.60
Rate for Payer: Mclaren Medicare	$2,498.35
Rate for Payer: Meridian Medicaid	$1,435.05
Rate for Payer: Meridian Wellcare - Medicare Advantage	$2,623.27
Rate for Payer: MI Amish Medical Board Commercial	$2,873.10
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$391.85
Rate for Payer: PACE Medicare	$2,373.43
Rate for Payer: PACE SWMI	$2,498.35
Rate for Payer: PHP Commercial	$391.85
Rate for Payer: PHP Medicare Advantage	$2,498.35
Rate for Payer: Priority Health Choice Medicaid	$1,366.60
Rate for Payer: Priority Health Cigna Priority Health	$322.70
Rate for Payer: Priority Health Medicare	$2,498.35
Rate for Payer: Priority Health SBD	$290.43
Rate for Payer: Railroad Medicare Medicare	$2,498.35
Rate for Payer: UHC All Payor (Choice/PPO)	$150.19
Rate for Payer: UHC Dual Complete DSNP	$2,498.35
Rate for Payer: UHC Exchange	$136.54
Rate for Payer: UHC Medicare Advantage	$2,573.30
Rate for Payer: VA VA	$2,498.35

PR DSTRJ LESION ANUS SIMPLE SURG EXCISION

Professional

Both

$507.00

Service Code	HCPCS 46922
Min. Negotiated Rate	$88.82
Max. Negotiated Rate	$1,491.39
Rate for Payer: Aetna Commercial	$181.18
Rate for Payer: BCBS Complete	$93.26
Rate for Payer: BCBS Trust/PPO	$1,491.39
Rate for Payer: Cash Price	$405.60
Rate for Payer: Cash Price	$405.60
Rate for Payer: Mclaren Medicaid	$88.82
Rate for Payer: Meridian Medicaid	$93.26
Rate for Payer: Priority Health Choice Medicaid	$88.82
Rate for Payer: Priority Health Cigna Priority Health	$354.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$242.83
Rate for Payer: Priority Health Narrow Network	$242.83
Rate for Payer: Priority Health SBD	$242.83

PR DSTRJ LESION ANUS SIMPLE SURG EXCISION

Professional

Both

$507.00

Service Code	HCPCS 46922
Hospital Charge Code	46922
Min. Negotiated Rate	$88.82
Max. Negotiated Rate	$1,491.39
Rate for Payer: Aetna Commercial	$181.18
Rate for Payer: BCBS Complete	$93.26
Rate for Payer: BCBS Trust/PPO	$1,491.39
Rate for Payer: Cash Price	$405.60
Rate for Payer: Cash Price	$405.60
Rate for Payer: Mclaren Medicaid	$88.82
Rate for Payer: Meridian Medicaid	$93.26
Rate for Payer: Priority Health Choice Medicaid	$88.82
Rate for Payer: Priority Health Cigna Priority Health	$354.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$242.83
Rate for Payer: Priority Health Narrow Network	$242.83
Rate for Payer: Priority Health SBD	$242.83

PR DSTRJ LESION ANUS SIMPLE SURG EXCISION

Facility

$461.00

Service Code	CPT 46922
Hospital Charge Code	46922
Hospital Revenue Code	960
Min. Negotiated Rate	$290.43
Max. Negotiated Rate	$414.90
Rate for Payer: Aetna Commercial	$391.85
Rate for Payer: Aetna New Business (MI Preferred)	$299.65
Rate for Payer: Cash Price	$368.80
Rate for Payer: Cofinity Commercial	$322.70
Rate for Payer: Cofinity Commercial	$396.46
Rate for Payer: Healthscope Commercial	$414.90
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$391.85
Rate for Payer: PHP Commercial	$391.85
Rate for Payer: Priority Health Cigna Priority Health	$322.70
Rate for Payer: Priority Health SBD	$290.43

PR DSTRJ LESION ANUS SMPL ELTRDSICCATION

Professional

Both

$407.00

Service Code	HCPCS 46910
Min. Negotiated Rate	$87.12
Max. Negotiated Rate	$2,583.92
Rate for Payer: Aetna Commercial	$178.48
Rate for Payer: BCBS Complete	$91.48
Rate for Payer: BCBS Trust/PPO	$2,583.92
Rate for Payer: Cash Price	$325.60
Rate for Payer: Cash Price	$325.60
Rate for Payer: Mclaren Medicaid	$87.12
Rate for Payer: Meridian Medicaid	$91.48
Rate for Payer: Priority Health Choice Medicaid	$87.12
Rate for Payer: Priority Health Cigna Priority Health	$284.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$236.37
Rate for Payer: Priority Health Narrow Network	$236.37
Rate for Payer: Priority Health SBD	$236.37

PR DSTRJ LESION PALATE/UVULA THERMAL CRYO/CHEM

Professional

Both

$422.00

Service Code	HCPCS 42160
Min. Negotiated Rate	$90.53
Max. Negotiated Rate	$295.40
Rate for Payer: Aetna Commercial	$189.22
Rate for Payer: BCBS Complete	$95.06
Rate for Payer: BCBS Trust/PPO	$264.46
Rate for Payer: Cash Price	$337.60
Rate for Payer: Cash Price	$337.60
Rate for Payer: Mclaren Medicaid	$90.53
Rate for Payer: Meridian Medicaid	$95.06
Rate for Payer: Priority Health Choice Medicaid	$90.53
Rate for Payer: Priority Health Cigna Priority Health	$295.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$252.82
Rate for Payer: Priority Health Narrow Network	$252.82
Rate for Payer: Priority Health SBD	$252.82

PR DSTRJ LESION PENIS EXTENSIVE

Professional

Both

$456.00

Service Code	HCPCS 54065
Min. Negotiated Rate	$110.12
Max. Negotiated Rate	$1,527.84
Rate for Payer: Aetna Commercial	$215.30
Rate for Payer: BCBS Complete	$115.63
Rate for Payer: BCBS Trust/PPO	$1,527.84
Rate for Payer: Cash Price	$364.80
Rate for Payer: Cash Price	$364.80
Rate for Payer: Mclaren Medicaid	$110.12
Rate for Payer: Meridian Medicaid	$115.63
Rate for Payer: Priority Health Choice Medicaid	$110.12
Rate for Payer: Priority Health Cigna Priority Health	$319.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$275.57
Rate for Payer: Priority Health Narrow Network	$275.57
Rate for Payer: Priority Health SBD	$275.57

PR DSTRJ LESION PENIS SIMPLE CHEMICAL

Professional

Both

$220.00

Service Code	HCPCS 54050
Min. Negotiated Rate	$68.80
Max. Negotiated Rate	$1,664.67
Rate for Payer: Aetna Commercial	$132.50
Rate for Payer: BCBS Complete	$72.24
Rate for Payer: BCBS Trust/PPO	$1,664.67
Rate for Payer: Cash Price	$176.00
Rate for Payer: Cash Price	$176.00
Rate for Payer: Mclaren Medicaid	$68.80
Rate for Payer: Meridian Medicaid	$72.24
Rate for Payer: Priority Health Choice Medicaid	$68.80
Rate for Payer: Priority Health Cigna Priority Health	$154.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$172.37
Rate for Payer: Priority Health Narrow Network	$172.37
Rate for Payer: Priority Health SBD	$172.37

PR DSTRJ LESION PENIS SIMPLE CRYOSURGERY

Professional

Both

$265.00

Service Code	HCPCS 54056
Min. Negotiated Rate	$71.99
Max. Negotiated Rate	$1,380.45
Rate for Payer: Aetna Commercial	$137.02
Rate for Payer: BCBS Complete	$75.59
Rate for Payer: BCBS Trust/PPO	$1,380.45
Rate for Payer: Cash Price	$212.00
Rate for Payer: Cash Price	$212.00
Rate for Payer: Mclaren Medicaid	$71.99
Rate for Payer: Meridian Medicaid	$75.59
Rate for Payer: Priority Health Choice Medicaid	$71.99
Rate for Payer: Priority Health Cigna Priority Health	$185.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$179.41
Rate for Payer: Priority Health Narrow Network	$179.41
Rate for Payer: Priority Health SBD	$179.41

PR DSTRJ LESION PENIS SIMPLE ELECTRODESICCATION

Professional

Both

$207.00

Service Code	HCPCS 54055
Min. Negotiated Rate	$61.77
Max. Negotiated Rate	$1,009.58
Rate for Payer: Aetna Commercial	$119.53
Rate for Payer: BCBS Complete	$64.86
Rate for Payer: BCBS Trust/PPO	$1,009.58
Rate for Payer: Cash Price	$165.60
Rate for Payer: Cash Price	$165.60
Rate for Payer: Mclaren Medicaid	$61.77
Rate for Payer: Meridian Medicaid	$64.86
Rate for Payer: Priority Health Choice Medicaid	$61.77
Rate for Payer: Priority Health Cigna Priority Health	$144.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$154.55
Rate for Payer: Priority Health Narrow Network	$154.55
Rate for Payer: Priority Health SBD	$154.55

PR DSTRJ LESION PENIS SIMPLE LASER

Professional

Both

$244.00

Service Code	HCPCS 54057
Min. Negotiated Rate	$63.05
Max. Negotiated Rate	$2,378.41
Rate for Payer: Aetna Commercial	$121.38
Rate for Payer: BCBS Complete	$66.20
Rate for Payer: BCBS Trust/PPO	$2,378.41
Rate for Payer: Cash Price	$195.20
Rate for Payer: Cash Price	$195.20
Rate for Payer: Mclaren Medicaid	$63.05
Rate for Payer: Meridian Medicaid	$66.20
Rate for Payer: Priority Health Choice Medicaid	$63.05
Rate for Payer: Priority Health Cigna Priority Health	$170.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$157.78
Rate for Payer: Priority Health Narrow Network	$157.78
Rate for Payer: Priority Health SBD	$157.78

PR DSTRJ LESION PENIS SIMPLE SURG EXCISION

Professional

Both

$360.00

Service Code	HCPCS 54060
Min. Negotiated Rate	$84.56
Max. Negotiated Rate	$1,575.39
Rate for Payer: Aetna Commercial	$165.73
Rate for Payer: BCBS Complete	$88.79
Rate for Payer: BCBS Trust/PPO	$1,575.39
Rate for Payer: Cash Price	$288.00
Rate for Payer: Cash Price	$288.00
Rate for Payer: Mclaren Medicaid	$84.56
Rate for Payer: Meridian Medicaid	$88.79
Rate for Payer: Priority Health Choice Medicaid	$84.56
Rate for Payer: Priority Health Cigna Priority Health	$252.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$210.20
Rate for Payer: Priority Health Narrow Network	$210.20
Rate for Payer: Priority Health SBD	$210.20

PR DSTRJ LES/SCAR VESTIBULE MOUTH PHYSICAL METHS

Professional

Both

$460.00

Service Code	HCPCS 40820
Min. Negotiated Rate	$106.71
Max. Negotiated Rate	$963.62
Rate for Payer: Aetna Commercial	$221.49
Rate for Payer: BCBS Complete	$112.05
Rate for Payer: BCBS Trust/PPO	$963.62
Rate for Payer: Cash Price	$368.00
Rate for Payer: Cash Price	$368.00
Rate for Payer: Mclaren Medicaid	$106.71
Rate for Payer: Meridian Medicaid	$112.05
Rate for Payer: Priority Health Choice Medicaid	$106.71
Rate for Payer: Priority Health Cigna Priority Health	$322.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$292.81
Rate for Payer: Priority Health Narrow Network	$292.81
Rate for Payer: Priority Health SBD	$292.81

PR DSTRJ MAL LESION S/N/H/F/G LESION DIAM > 4.0 CM

Professional

Both

$557.00

Service Code	HCPCS 17276
Min. Negotiated Rate	$128.44
Max. Negotiated Rate	$456.13
Rate for Payer: Aetna Commercial	$216.11
Rate for Payer: BCBS Complete	$134.86
Rate for Payer: BCBS Trust/PPO	$456.13
Rate for Payer: Cash Price	$445.60
Rate for Payer: Cash Price	$445.60
Rate for Payer: Mclaren Medicaid	$128.44
Rate for Payer: Meridian Medicaid	$134.86
Rate for Payer: Priority Health Choice Medicaid	$128.44
Rate for Payer: Priority Health Cigna Priority Health	$389.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$246.21
Rate for Payer: Priority Health Narrow Network	$246.21
Rate for Payer: Priority Health SBD	$246.21

Know your out-of-pocket cost for care.

All Charges