Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PR ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 2ND+ VEINS

Professional

Both

$320.00

Service Code	HCPCS 36476
Min. Negotiated Rate	$83.07
Max. Negotiated Rate	$510.87
Rate for Payer: Aetna Commercial	$180.63
Rate for Payer: BCBS Complete	$87.22
Rate for Payer: BCBS Trust/PPO	$510.87
Rate for Payer: Cash Price	$256.00
Rate for Payer: Cash Price	$256.00
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	$224.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$208.53
Rate for Payer: Priority Health Narrow Network	$208.53
Rate for Payer: Priority Health SBD	$208.53

PR ENTERECTOMY RESCJ SMALL INTESTINE EA RESCJ & ANA

Professional

Both

$1,626.00

Service Code	HCPCS 44121
Min. Negotiated Rate	$152.30
Max. Negotiated Rate	$1,138.20
Rate for Payer: Aetna Commercial	$326.50
Rate for Payer: BCBS Complete	$159.92
Rate for Payer: BCBS Trust/PPO	$1,080.90
Rate for Payer: Cash Price	$1,300.80
Rate for Payer: Cash Price	$1,300.80
Rate for Payer: Mclaren Medicaid	$152.30
Rate for Payer: Meridian Medicaid	$159.92
Rate for Payer: Priority Health Choice Medicaid	$152.30
Rate for Payer: Priority Health Cigna Priority Health	$1,138.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$419.23
Rate for Payer: Priority Health Narrow Network	$419.23
Rate for Payer: Priority Health SBD	$419.23

PR ENTERECTOMY RESCJ SMALL INTESTINE W/ENTEROSTOMY

Professional

Both

$3,428.00

Service Code	HCPCS 44125
Min. Negotiated Rate	$749.76
Max. Negotiated Rate	$2,399.60
Rate for Payer: Aetna Commercial	$1,588.54
Rate for Payer: BCBS Complete	$787.25
Rate for Payer: BCBS Trust/PPO	$1,185.51
Rate for Payer: Cash Price	$2,742.40
Rate for Payer: Cash Price	$2,742.40
Rate for Payer: Mclaren Medicaid	$749.76
Rate for Payer: Meridian Medicaid	$787.25
Rate for Payer: Priority Health Choice Medicaid	$749.76
Rate for Payer: Priority Health Cigna Priority Health	$2,399.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,056.15
Rate for Payer: Priority Health Narrow Network	$2,056.15
Rate for Payer: Priority Health SBD	$2,056.15

PR ENTEROCYSTOPLASTY W/INTESTINAL ANASTOMOSIS

Professional

Both

$2,821.00

Service Code	HCPCS 51960
Min. Negotiated Rate	$876.50
Max. Negotiated Rate	$2,198.72
Rate for Payer: Aetna Commercial	$1,776.46
Rate for Payer: BCBS Complete	$920.32
Rate for Payer: BCBS Trust/PPO	$1,931.99
Rate for Payer: Cash Price	$2,256.80
Rate for Payer: Cash Price	$2,256.80
Rate for Payer: Mclaren Medicaid	$876.50
Rate for Payer: Meridian Medicaid	$920.32
Rate for Payer: Priority Health Choice Medicaid	$876.50
Rate for Payer: Priority Health Cigna Priority Health	$1,974.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,198.72
Rate for Payer: Priority Health Narrow Network	$2,198.72
Rate for Payer: Priority Health SBD	$2,198.72

PR ENTEROENTEROST ANAST INT W/WO CUTAN NTRSTM SPX

Professional

Both

$3,110.00

Service Code	HCPCS 44130
Min. Negotiated Rate	$605.43
Max. Negotiated Rate	$2,305.45
Rate for Payer: Aetna Commercial	$1,773.78
Rate for Payer: BCBS Complete	$881.63
Rate for Payer: BCBS Trust/PPO	$605.43
Rate for Payer: Cash Price	$2,488.00
Rate for Payer: Cash Price	$2,488.00
Rate for Payer: Mclaren Medicaid	$839.65
Rate for Payer: Meridian Medicaid	$881.63
Rate for Payer: Priority Health Choice Medicaid	$839.65
Rate for Payer: Priority Health Cigna Priority Health	$2,177.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,305.45
Rate for Payer: Priority Health Narrow Network	$2,305.45
Rate for Payer: Priority Health SBD	$2,305.45

PR ENTEROLSS FRING INTSTINAL ADHESION SPX

Facility

$2,761.00

Service Code	CPT 44005
Hospital Charge Code	44005
Hospital Revenue Code	960
Min. Negotiated Rate	$1,071.06
Max. Negotiated Rate	$2,484.90
Rate for Payer: Aetna Commercial	$2,346.85
Rate for Payer: Aetna New Business (MI Preferred)	$1,794.65
Rate for Payer: BCBS Complete	$1,104.40
Rate for Payer: BCBS Trust/PPO	$2,234.33
Rate for Payer: Cash Price	$2,208.80
Rate for Payer: Cash Price	$2,208.80
Rate for Payer: Cofinity Commercial	$2,374.46
Rate for Payer: Cofinity Commercial	$1,932.70
Rate for Payer: Healthscope Commercial	$2,484.90
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,346.85
Rate for Payer: PHP Commercial	$2,346.85
Rate for Payer: Priority Health Cigna Priority Health	$1,932.70
Rate for Payer: Priority Health SBD	$1,739.43
Rate for Payer: UHC All Payor (Choice/PPO)	$1,178.17
Rate for Payer: UHC Exchange	$1,071.06

PR ENTEROLSS FRING INTSTINAL ADHESION SPX

Professional

Both

$2,761.00

Service Code	HCPCS 44005
Min. Negotiated Rate	$696.72
Max. Negotiated Rate	$1,932.70
Rate for Payer: Aetna Commercial	$1,475.02
Rate for Payer: BCBS Complete	$731.56
Rate for Payer: BCBS Trust/PPO	$784.00
Rate for Payer: Cash Price	$2,208.80
Rate for Payer: Cash Price	$2,208.80
Rate for Payer: Mclaren Medicaid	$696.72
Rate for Payer: Meridian Medicaid	$731.56
Rate for Payer: Priority Health Choice Medicaid	$696.72
Rate for Payer: Priority Health Cigna Priority Health	$1,932.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,913.26
Rate for Payer: Priority Health Narrow Network	$1,913.26
Rate for Payer: Priority Health SBD	$1,913.26

PR ENTEROLSS FRING INTSTINAL ADHESION SPX

Facility

$2,761.00

Service Code	CPT 44005
Hospital Charge Code	44005
Hospital Revenue Code	960
Min. Negotiated Rate	$1,739.43
Max. Negotiated Rate	$2,484.90
Rate for Payer: Aetna Commercial	$2,346.85
Rate for Payer: Aetna New Business (MI Preferred)	$1,794.65
Rate for Payer: Cash Price	$2,208.80
Rate for Payer: Cofinity Commercial	$1,932.70
Rate for Payer: Cofinity Commercial	$2,374.46
Rate for Payer: Healthscope Commercial	$2,484.90
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,346.85
Rate for Payer: PHP Commercial	$2,346.85
Rate for Payer: Priority Health Cigna Priority Health	$1,932.70
Rate for Payer: Priority Health SBD	$1,739.43

PR ENTEROLSS FRING INTSTINAL ADHESION SPX

Professional

Both

$2,761.00

Service Code	HCPCS 44005
Hospital Charge Code	44005
Min. Negotiated Rate	$696.72
Max. Negotiated Rate	$1,932.70
Rate for Payer: Aetna Commercial	$1,475.02
Rate for Payer: BCBS Complete	$731.56
Rate for Payer: BCBS Trust/PPO	$784.00
Rate for Payer: Cash Price	$2,208.80
Rate for Payer: Cash Price	$2,208.80
Rate for Payer: Mclaren Medicaid	$696.72
Rate for Payer: Meridian Medicaid	$731.56
Rate for Payer: Priority Health Choice Medicaid	$696.72
Rate for Payer: Priority Health Cigna Priority Health	$1,932.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,913.26
Rate for Payer: Priority Health Narrow Network	$1,913.26
Rate for Payer: Priority Health SBD	$1,913.26

PR ENTERORRHAPHY MULTIPLE PERFORATIONS

Professional

Both

$3,021.00

Service Code	HCPCS 44603
Min. Negotiated Rate	$220.30
Max. Negotiated Rate	$2,826.39
Rate for Payer: Aetna Commercial	$2,183.13
Rate for Payer: BCBS Complete	$1,079.56
Rate for Payer: BCBS Trust/PPO	$220.30
Rate for Payer: Cash Price	$2,416.80
Rate for Payer: Cash Price	$2,416.80
Rate for Payer: Mclaren Medicaid	$1,028.15
Rate for Payer: Meridian Medicaid	$1,079.56
Rate for Payer: Priority Health Choice Medicaid	$1,028.15
Rate for Payer: Priority Health Cigna Priority Health	$2,114.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,826.39
Rate for Payer: Priority Health Narrow Network	$2,826.39
Rate for Payer: Priority Health SBD	$2,826.39

PR ENTERORRHAPHY SINGLE PERFORATION

Professional

Both

$2,377.00

Service Code	HCPCS 44602
Min. Negotiated Rate	$894.81
Max. Negotiated Rate	$2,461.85
Rate for Payer: Aetna Commercial	$1,903.43
Rate for Payer: BCBS Complete	$939.55
Rate for Payer: BCBS Trust/PPO	$1,323.39
Rate for Payer: Cash Price	$1,901.60
Rate for Payer: Cash Price	$1,901.60
Rate for Payer: Mclaren Medicaid	$894.81
Rate for Payer: Meridian Medicaid	$939.55
Rate for Payer: Priority Health Choice Medicaid	$894.81
Rate for Payer: Priority Health Cigna Priority Health	$1,663.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,461.85
Rate for Payer: Priority Health Narrow Network	$2,461.85
Rate for Payer: Priority Health SBD	$2,461.85

PR ENTEROSC >2ND PRTN W/ILEUM W/BX SINGLE/MULTIPLE

Professional

Both

$1,114.00

Service Code	HCPCS 44377
Min. Negotiated Rate	$187.65
Max. Negotiated Rate	$1,573.28
Rate for Payer: Aetna Commercial	$397.53
Rate for Payer: BCBS Complete	$197.03
Rate for Payer: BCBS Trust/PPO	$1,573.28
Rate for Payer: Cash Price	$891.20
Rate for Payer: Cash Price	$891.20
Rate for Payer: Mclaren Medicaid	$187.65
Rate for Payer: Meridian Medicaid	$197.03
Rate for Payer: Priority Health Choice Medicaid	$187.65
Rate for Payer: Priority Health Cigna Priority Health	$779.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$515.65
Rate for Payer: Priority Health Narrow Network	$515.65
Rate for Payer: Priority Health SBD	$515.65

PR ENTEROSC >2ND PRTN W/ILEUM W/WO COLLJ SPEC SPX

Professional

Both

$1,016.00

Service Code	HCPCS 44376
Min. Negotiated Rate	$177.86
Max. Negotiated Rate	$1,925.65
Rate for Payer: Aetna Commercial	$377.32
Rate for Payer: BCBS Complete	$186.75
Rate for Payer: BCBS Trust/PPO	$1,925.65
Rate for Payer: Cash Price	$812.80
Rate for Payer: Cash Price	$812.80
Rate for Payer: Mclaren Medicaid	$177.86
Rate for Payer: Meridian Medicaid	$186.75
Rate for Payer: Priority Health Choice Medicaid	$177.86
Rate for Payer: Priority Health Cigna Priority Health	$711.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$489.19
Rate for Payer: Priority Health Narrow Network	$489.19
Rate for Payer: Priority Health SBD	$489.19

PR ENTEROSCOPY > 2ND PRTN ABLTJ LESION

Professional

Both

$1,098.00

Service Code	HCPCS 44369
Min. Negotiated Rate	$154.00
Max. Negotiated Rate	$768.60
Rate for Payer: Aetna Commercial	$326.36
Rate for Payer: BCBS Complete	$161.70
Rate for Payer: BCBS Trust/PPO	$593.28
Rate for Payer: Cash Price	$878.40
Rate for Payer: Cash Price	$878.40
Rate for Payer: Mclaren Medicaid	$154.00
Rate for Payer: Meridian Medicaid	$161.70
Rate for Payer: Priority Health Choice Medicaid	$154.00
Rate for Payer: Priority Health Cigna Priority Health	$768.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$422.75
Rate for Payer: Priority Health Narrow Network	$422.75
Rate for Payer: Priority Health SBD	$422.75

PR ENTEROSCOPY > 2ND PRTN CONV GSTRST TUBE

Professional

Both

$904.00

Service Code	HCPCS 44373
Min. Negotiated Rate	$120.13
Max. Negotiated Rate	$1,809.96
Rate for Payer: Aetna Commercial	$255.47
Rate for Payer: BCBS Complete	$126.14
Rate for Payer: BCBS Trust/PPO	$1,809.96
Rate for Payer: Cash Price	$723.20
Rate for Payer: Cash Price	$723.20
Rate for Payer: Mclaren Medicaid	$120.13
Rate for Payer: Meridian Medicaid	$126.14
Rate for Payer: Priority Health Choice Medicaid	$120.13
Rate for Payer: Priority Health Cigna Priority Health	$632.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$330.45
Rate for Payer: Priority Health Narrow Network	$330.45
Rate for Payer: Priority Health SBD	$330.45

PR ENTEROSCOPY > 2ND PRTN ILEUM CONTROL BLEEDING

Professional

Both

$1,518.00

Service Code	HCPCS 44378
Hospital Charge Code	44378
Min. Negotiated Rate	$240.90
Max. Negotiated Rate	$1,701.65
Rate for Payer: Aetna Commercial	$511.57
Rate for Payer: BCBS Complete	$252.94
Rate for Payer: BCBS Trust/PPO	$1,701.65
Rate for Payer: Cash Price	$1,214.40
Rate for Payer: Cash Price	$1,214.40
Rate for Payer: Mclaren Medicaid	$240.90
Rate for Payer: Meridian Medicaid	$252.94
Rate for Payer: Priority Health Choice Medicaid	$240.90
Rate for Payer: Priority Health Cigna Priority Health	$1,062.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$661.47
Rate for Payer: Priority Health Narrow Network	$661.47
Rate for Payer: Priority Health SBD	$661.47

PR ENTEROSCOPY > 2ND PRTN ILEUM CONTROL BLEEDING

Facility

$1,518.00

Service Code	CPT 44378
Hospital Charge Code	44378
Min. Negotiated Rate	$370.34
Max. Negotiated Rate	$5,222.22
Rate for Payer: Aetna Commercial	$1,290.30
Rate for Payer: Aetna Medicare	$1,760.84
Rate for Payer: Aetna New Business (MI Preferred)	$986.70
Rate for Payer: Allen County Amish Medical Aid Commercial	$2,116.40
Rate for Payer: Amish Plain Church Group Commercial	$2,116.40
Rate for Payer: BCBS Complete	$972.53
Rate for Payer: BCBS MAPPO	$1,693.12
Rate for Payer: BCBS Trust/PPO	$615.94
Rate for Payer: BCN Medicare Advantage	$1,693.12
Rate for Payer: Cash Price	$1,214.40
Rate for Payer: Cash Price	$1,214.40
Rate for Payer: Cofinity Commercial	$1,305.48
Rate for Payer: Cofinity Commercial	$1,062.60
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,693.12
Rate for Payer: Healthscope Commercial	$1,366.20
Rate for Payer: Mclaren Medicaid	$926.14
Rate for Payer: Mclaren Medicare	$1,693.12
Rate for Payer: Meridian Medicaid	$972.53
Rate for Payer: Meridian Wellcare - Medicare Advantage	$1,777.78
Rate for Payer: MI Amish Medical Board Commercial	$1,947.09
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,290.30
Rate for Payer: PACE Medicare	$1,608.46
Rate for Payer: PACE SWMI	$1,693.12
Rate for Payer: PHP Commercial	$1,290.30
Rate for Payer: PHP Medicare Advantage	$1,693.12
Rate for Payer: Priority Health Choice Medicaid	$926.14
Rate for Payer: Priority Health Cigna Priority Health	$1,062.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$5,222.22
Rate for Payer: Priority Health Medicare	$1,693.12
Rate for Payer: Priority Health Narrow Network	$4,177.77
Rate for Payer: Priority Health SBD	$956.34
Rate for Payer: Railroad Medicare Medicare	$1,693.12
Rate for Payer: UHC All Payor (Choice/PPO)	$407.37
Rate for Payer: UHC Dual Complete DSNP	$1,693.12
Rate for Payer: UHC Exchange	$370.34
Rate for Payer: UHC Medicare Advantage	$1,743.91
Rate for Payer: VA VA	$1,693.12

PR ENTEROSCOPY > 2ND PRTN ILEUM CONTROL BLEEDING

Professional

Both

$1,518.00

Service Code	HCPCS 44378
Min. Negotiated Rate	$240.90
Max. Negotiated Rate	$1,701.65
Rate for Payer: Aetna Commercial	$511.57
Rate for Payer: BCBS Complete	$252.94
Rate for Payer: BCBS Trust/PPO	$1,701.65
Rate for Payer: Cash Price	$1,214.40
Rate for Payer: Cash Price	$1,214.40
Rate for Payer: Mclaren Medicaid	$240.90
Rate for Payer: Meridian Medicaid	$252.94
Rate for Payer: Priority Health Choice Medicaid	$240.90
Rate for Payer: Priority Health Cigna Priority Health	$1,062.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$661.47
Rate for Payer: Priority Health Narrow Network	$661.47
Rate for Payer: Priority Health SBD	$661.47

PR ENTEROSCOPY > 2ND PRTN ILEUM CONTROL BLEEDING

Facility

$1,518.00

Service Code	CPT 44378
Hospital Charge Code	44378
Min. Negotiated Rate	$956.34
Max. Negotiated Rate	$1,366.20
Rate for Payer: Aetna Commercial	$1,290.30
Rate for Payer: Aetna New Business (MI Preferred)	$986.70
Rate for Payer: Cash Price	$1,214.40
Rate for Payer: Cofinity Commercial	$1,062.60
Rate for Payer: Cofinity Commercial	$1,305.48
Rate for Payer: Healthscope Commercial	$1,366.20
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,290.30
Rate for Payer: PHP Commercial	$1,290.30
Rate for Payer: Priority Health Cigna Priority Health	$1,062.60
Rate for Payer: Priority Health SBD	$956.34

PR ENTEROSCOPY > 2ND PRTN TNDSC STENT PLMT

Professional

Both

$1,357.00

Service Code	HCPCS 44370
Min. Negotiated Rate	$167.63
Max. Negotiated Rate	$949.90
Rate for Payer: Aetna Commercial	$352.95
Rate for Payer: BCBS Complete	$176.01
Rate for Payer: BCBS Trust/PPO	$316.98
Rate for Payer: Cash Price	$1,085.60
Rate for Payer: Cash Price	$1,085.60
Rate for Payer: Mclaren Medicaid	$167.63
Rate for Payer: Meridian Medicaid	$176.01
Rate for Payer: Priority Health Choice Medicaid	$167.63
Rate for Payer: Priority Health Cigna Priority Health	$949.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$459.80
Rate for Payer: Priority Health Narrow Network	$459.80
Rate for Payer: Priority Health SBD	$459.80

PR ENTEROSCOPY > 2ND PRTN W/CONTROL BLEEDING

Professional

Both

$1,292.00

Service Code	HCPCS 44366
Min. Negotiated Rate	$150.38
Max. Negotiated Rate	$904.40
Rate for Payer: Aetna Commercial	$318.57
Rate for Payer: BCBS Complete	$157.90
Rate for Payer: BCBS Trust/PPO	$416.83
Rate for Payer: Cash Price	$1,033.60
Rate for Payer: Cash Price	$1,033.60
Rate for Payer: Mclaren Medicaid	$150.38
Rate for Payer: Meridian Medicaid	$157.90
Rate for Payer: Priority Health Choice Medicaid	$150.38
Rate for Payer: Priority Health Cigna Priority Health	$904.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$413.35
Rate for Payer: Priority Health Narrow Network	$413.35
Rate for Payer: Priority Health SBD	$413.35

PR ENTEROSCOPY > 2ND PRTN W/ILEUM W/STENT PLMT

Professional

Both

$1,502.00

Service Code	HCPCS 44379
Min. Negotiated Rate	$256.88
Max. Negotiated Rate	$1,943.09
Rate for Payer: Aetna Commercial	$543.16
Rate for Payer: BCBS Complete	$269.72
Rate for Payer: BCBS Trust/PPO	$1,943.09
Rate for Payer: Cash Price	$1,201.60
Rate for Payer: Cash Price	$1,201.60
Rate for Payer: Mclaren Medicaid	$256.88
Rate for Payer: Meridian Medicaid	$269.72
Rate for Payer: Priority Health Choice Medicaid	$256.88
Rate for Payer: Priority Health Cigna Priority Health	$1,051.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$703.80
Rate for Payer: Priority Health Narrow Network	$703.80
Rate for Payer: Priority Health SBD	$703.80

PR ENTEROSCOPY > 2ND PRTN W/PLMT PRQ TUBE

Professional

Both

$922.00

Service Code	HCPCS 44372
Min. Negotiated Rate	$150.38
Max. Negotiated Rate	$645.40
Rate for Payer: Aetna Commercial	$318.37
Rate for Payer: BCBS Complete	$157.90
Rate for Payer: BCBS Trust/PPO	$368.23
Rate for Payer: Cash Price	$737.60
Rate for Payer: Cash Price	$737.60
Rate for Payer: Mclaren Medicaid	$150.38
Rate for Payer: Meridian Medicaid	$157.90
Rate for Payer: Priority Health Choice Medicaid	$150.38
Rate for Payer: Priority Health Cigna Priority Health	$645.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$412.76
Rate for Payer: Priority Health Narrow Network	$412.76
Rate for Payer: Priority Health SBD	$412.76

PR ENTEROSCOPY > 2ND PRTN W/RMVL FOREIGN BODY

Professional

Both

$955.00

Service Code	HCPCS 44363
Min. Negotiated Rate	$120.35
Max. Negotiated Rate	$668.50
Rate for Payer: Aetna Commercial	$254.46
Rate for Payer: BCBS Complete	$126.37
Rate for Payer: BCBS Trust/PPO	$283.17
Rate for Payer: Cash Price	$764.00
Rate for Payer: Cash Price	$764.00
Rate for Payer: Mclaren Medicaid	$120.35
Rate for Payer: Meridian Medicaid	$126.37
Rate for Payer: Priority Health Choice Medicaid	$120.35
Rate for Payer: Priority Health Cigna Priority Health	$668.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$330.45
Rate for Payer: Priority Health Narrow Network	$330.45
Rate for Payer: Priority Health SBD	$330.45

PR ENTEROSCOPY > 2ND PRTN W/RMVL LESION CAUTERY

Professional

Both

$1,098.00

Service Code	HCPCS 44365
Min. Negotiated Rate	$114.59
Max. Negotiated Rate	$768.60
Rate for Payer: Aetna Commercial	$241.56
Rate for Payer: BCBS Complete	$120.32
Rate for Payer: BCBS Trust/PPO	$740.68
Rate for Payer: Cash Price	$878.40
Rate for Payer: Cash Price	$878.40
Rate for Payer: Mclaren Medicaid	$114.59
Rate for Payer: Meridian Medicaid	$120.32
Rate for Payer: Priority Health Choice Medicaid	$114.59
Rate for Payer: Priority Health Cigna Priority Health	$768.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$313.39
Rate for Payer: Priority Health Narrow Network	$313.39
Rate for Payer: Priority Health SBD	$313.39

Know your out-of-pocket cost for care.

All Charges