Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PR EWHO RIGID W/O JNTS CF

Professional

Both

$685.00

Service Code	HCPCS L3763
Min. Negotiated Rate	$274.00
Max. Negotiated Rate	$479.50
Rate for Payer: Aetna Commercial	$410.20
Rate for Payer: BCBS Complete	$274.00
Rate for Payer: Cash Price	$548.00
Rate for Payer: Cash Price	$548.00
Rate for Payer: Priority Health Cigna Priority Health	$479.50

PR EWHO W/JOINT(S) CF

Professional

Both

$717.00

Service Code	HCPCS L3764
Min. Negotiated Rate	$286.80
Max. Negotiated Rate	$501.90
Rate for Payer: Aetna Commercial	$429.28
Rate for Payer: BCBS Complete	$286.80
Rate for Payer: Cash Price	$573.60
Rate for Payer: Cash Price	$573.60
Rate for Payer: Priority Health Cigna Priority Health	$501.90

PR EXC 1/> SMALL/LARGE LESIONS INTESTINE ENTEROTOM

Professional

Both

$2,332.00

Service Code	HCPCS 44110
Min. Negotiated Rate	$543.79
Max. Negotiated Rate	$1,643.01
Rate for Payer: Aetna Commercial	$1,141.78
Rate for Payer: BCBS Complete	$570.98
Rate for Payer: BCBS Trust/PPO	$1,643.01
Rate for Payer: Cash Price	$1,865.60
Rate for Payer: Cash Price	$1,865.60
Rate for Payer: Mclaren Medicaid	$543.79
Rate for Payer: Meridian Medicaid	$570.98
Rate for Payer: Priority Health Choice Medicaid	$543.79
Rate for Payer: Priority Health Cigna Priority Health	$1,632.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,485.81
Rate for Payer: Priority Health Narrow Network	$1,485.81
Rate for Payer: Priority Health SBD	$1,485.81

PR EXC 1/> SM/LG LESIONS INTESTNE MULT ENTEROTOMIE

Professional

Both

$3,534.00

Service Code	HCPCS 44111
Min. Negotiated Rate	$266.79
Max. Negotiated Rate	$2,473.80
Rate for Payer: Aetna Commercial	$1,314.35
Rate for Payer: BCBS Complete	$655.52
Rate for Payer: BCBS Trust/PPO	$266.79
Rate for Payer: Cash Price	$2,827.20
Rate for Payer: Cash Price	$2,827.20
Rate for Payer: Mclaren Medicaid	$624.30
Rate for Payer: Meridian Medicaid	$655.52
Rate for Payer: Priority Health Choice Medicaid	$624.30
Rate for Payer: Priority Health Cigna Priority Health	$2,473.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,726.88
Rate for Payer: Priority Health Narrow Network	$1,726.88
Rate for Payer: Priority Health SBD	$1,726.88

PR EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/<

Professional

Both

$220.00

Service Code	HCPCS 11440
Hospital Charge Code	11440
Min. Negotiated Rate	$28.95
Max. Negotiated Rate	$154.00
Rate for Payer: Aetna Commercial	$109.82
Rate for Payer: BCBS Complete	$72.46
Rate for Payer: BCBS Trust/PPO	$28.95
Rate for Payer: Cash Price	$176.00
Rate for Payer: Cash Price	$176.00
Rate for Payer: Mclaren Medicaid	$69.01
Rate for Payer: Meridian Medicaid	$72.46
Rate for Payer: Priority Health Choice Medicaid	$69.01
Rate for Payer: Priority Health Cigna Priority Health	$154.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$130.30
Rate for Payer: Priority Health Narrow Network	$130.30
Rate for Payer: Priority Health SBD	$130.30

PR EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/<

Professional

Both

$220.00

Service Code	HCPCS 11440
Min. Negotiated Rate	$28.95
Max. Negotiated Rate	$154.00
Rate for Payer: Aetna Commercial	$109.82
Rate for Payer: BCBS Complete	$72.46
Rate for Payer: BCBS Trust/PPO	$28.95
Rate for Payer: Cash Price	$176.00
Rate for Payer: Cash Price	$176.00
Rate for Payer: Mclaren Medicaid	$69.01
Rate for Payer: Meridian Medicaid	$72.46
Rate for Payer: Priority Health Choice Medicaid	$69.01
Rate for Payer: Priority Health Cigna Priority Health	$154.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$130.30
Rate for Payer: Priority Health Narrow Network	$130.30
Rate for Payer: Priority Health SBD	$130.30

PR EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/<

Facility

$220.00

Service Code	CPT 11440
Hospital Charge Code	11440
Hospital Revenue Code	521
Min. Negotiated Rate	$138.60
Max. Negotiated Rate	$198.00
Rate for Payer: Aetna Commercial	$187.00
Rate for Payer: Aetna New Business (MI Preferred)	$143.00
Rate for Payer: Cash Price	$176.00
Rate for Payer: Cofinity Commercial	$154.00
Rate for Payer: Cofinity Commercial	$189.20
Rate for Payer: Healthscope Commercial	$198.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$187.00
Rate for Payer: PHP Commercial	$187.00
Rate for Payer: Priority Health Cigna Priority Health	$154.00
Rate for Payer: Priority Health SBD	$138.60

PR EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/<

Facility

$220.00

Service Code	CPT 11440
Hospital Charge Code	11440
Hospital Revenue Code	521
Min. Negotiated Rate	$106.09
Max. Negotiated Rate	$1,937.58
Rate for Payer: Aetna Commercial	$187.00
Rate for Payer: Aetna Medicare	$651.08
Rate for Payer: Aetna New Business (MI Preferred)	$143.00
Rate for Payer: Allen County Amish Medical Aid Commercial	$782.55
Rate for Payer: Amish Plain Church Group Commercial	$782.55
Rate for Payer: BCBS Complete	$359.60
Rate for Payer: BCBS MAPPO	$626.04
Rate for Payer: BCBS Trust/PPO	$405.67
Rate for Payer: BCN Medicare Advantage	$626.04
Rate for Payer: Cash Price	$176.00
Rate for Payer: Cash Price	$176.00
Rate for Payer: Cofinity Commercial	$189.20
Rate for Payer: Cofinity Commercial	$154.00
Rate for Payer: Health Alliance Plan Medicare Advantage	$626.04
Rate for Payer: Healthscope Commercial	$198.00
Rate for Payer: Mclaren Medicaid	$342.44
Rate for Payer: Mclaren Medicare	$626.04
Rate for Payer: Meridian Medicaid	$359.60
Rate for Payer: Meridian Wellcare - Medicare Advantage	$657.34
Rate for Payer: MI Amish Medical Board Commercial	$719.95
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$187.00
Rate for Payer: PACE Medicare	$594.74
Rate for Payer: PACE SWMI	$626.04
Rate for Payer: PHP Commercial	$187.00
Rate for Payer: PHP Medicare Advantage	$626.04
Rate for Payer: Priority Health Choice Medicaid	$342.44
Rate for Payer: Priority Health Cigna Priority Health	$154.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,937.58
Rate for Payer: Priority Health Medicare	$626.04
Rate for Payer: Priority Health Narrow Network	$1,550.06
Rate for Payer: Priority Health SBD	$138.60
Rate for Payer: Railroad Medicare Medicare	$626.04
Rate for Payer: UHC All Payor (Choice/PPO)	$116.70
Rate for Payer: UHC Dual Complete DSNP	$626.04
Rate for Payer: UHC Exchange	$106.09
Rate for Payer: UHC Medicare Advantage	$644.82
Rate for Payer: VA VA	$626.04

PR EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M > 4.0CM

Professional

Both

$810.00

Service Code	HCPCS 11446
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$567.00
Rate for Payer: Aetna Commercial	$345.75
Rate for Payer: BCBS Complete	$213.14
Rate for Payer: BCBS Trust/PPO	$150.00
Rate for Payer: Cash Price	$648.00
Rate for Payer: Cash Price	$648.00
Rate for Payer: Mclaren Medicaid	$202.99
Rate for Payer: Meridian Medicaid	$213.14
Rate for Payer: Priority Health Choice Medicaid	$202.99
Rate for Payer: Priority Health Cigna Priority Health	$567.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$386.79
Rate for Payer: Priority Health Narrow Network	$386.79
Rate for Payer: Priority Health SBD	$386.79

PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.5 CM/<

Professional

Both

$199.00

Service Code	HCPCS 11420
Min. Negotiated Rate	$52.82
Max. Negotiated Rate	$139.30
Rate for Payer: Aetna Commercial	$87.38
Rate for Payer: BCBS Complete	$55.46
Rate for Payer: BCBS Trust/PPO	$100.72
Rate for Payer: Cash Price	$159.20
Rate for Payer: Cash Price	$159.20
Rate for Payer: Mclaren Medicaid	$52.82
Rate for Payer: Meridian Medicaid	$55.46
Rate for Payer: Priority Health Choice Medicaid	$52.82
Rate for Payer: Priority Health Cigna Priority Health	$139.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$100.70
Rate for Payer: Priority Health Narrow Network	$100.70
Rate for Payer: Priority Health SBD	$100.70

PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.6-1.0CM

Facility

$256.00

Service Code	CPT 11421
Hospital Charge Code	11421
Hospital Revenue Code	521
Min. Negotiated Rate	$107.73
Max. Negotiated Rate	$1,937.58
Rate for Payer: Aetna Commercial	$217.60
Rate for Payer: Aetna Medicare	$651.08
Rate for Payer: Aetna New Business (MI Preferred)	$166.40
Rate for Payer: Allen County Amish Medical Aid Commercial	$782.55
Rate for Payer: Amish Plain Church Group Commercial	$782.55
Rate for Payer: BCBS Complete	$359.60
Rate for Payer: BCBS MAPPO	$626.04
Rate for Payer: BCBS Trust/PPO	$405.67
Rate for Payer: BCN Medicare Advantage	$626.04
Rate for Payer: Cash Price	$204.80
Rate for Payer: Cash Price	$204.80
Rate for Payer: Cofinity Commercial	$179.20
Rate for Payer: Cofinity Commercial	$220.16
Rate for Payer: Health Alliance Plan Medicare Advantage	$626.04
Rate for Payer: Healthscope Commercial	$230.40
Rate for Payer: Mclaren Medicaid	$342.44
Rate for Payer: Mclaren Medicare	$626.04
Rate for Payer: Meridian Medicaid	$359.60
Rate for Payer: Meridian Wellcare - Medicare Advantage	$657.34
Rate for Payer: MI Amish Medical Board Commercial	$719.95
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$217.60
Rate for Payer: PACE Medicare	$594.74
Rate for Payer: PACE SWMI	$626.04
Rate for Payer: PHP Commercial	$217.60
Rate for Payer: PHP Medicare Advantage	$626.04
Rate for Payer: Priority Health Choice Medicaid	$342.44
Rate for Payer: Priority Health Cigna Priority Health	$179.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,937.58
Rate for Payer: Priority Health Medicare	$626.04
Rate for Payer: Priority Health Narrow Network	$1,550.06
Rate for Payer: Priority Health SBD	$161.28
Rate for Payer: Railroad Medicare Medicare	$626.04
Rate for Payer: UHC All Payor (Choice/PPO)	$118.50
Rate for Payer: UHC Dual Complete DSNP	$626.04
Rate for Payer: UHC Exchange	$107.73
Rate for Payer: UHC Medicare Advantage	$644.82
Rate for Payer: VA VA	$626.04

PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.6-1.0CM

Facility

$256.00

Service Code	CPT 11421
Hospital Charge Code	11421
Hospital Revenue Code	521
Min. Negotiated Rate	$161.28
Max. Negotiated Rate	$230.40
Rate for Payer: Aetna Commercial	$217.60
Rate for Payer: Aetna New Business (MI Preferred)	$166.40
Rate for Payer: Cash Price	$204.80
Rate for Payer: Cofinity Commercial	$179.20
Rate for Payer: Cofinity Commercial	$220.16
Rate for Payer: Healthscope Commercial	$230.40
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$217.60
Rate for Payer: PHP Commercial	$217.60
Rate for Payer: Priority Health Cigna Priority Health	$179.20
Rate for Payer: Priority Health SBD	$161.28

PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.6-1.0CM

Professional

Both

$256.00

Service Code	HCPCS 11421
Min. Negotiated Rate	$70.08
Max. Negotiated Rate	$338.18
Rate for Payer: Aetna Commercial	$116.28
Rate for Payer: BCBS Complete	$73.58
Rate for Payer: BCBS Trust/PPO	$338.18
Rate for Payer: Cash Price	$204.80
Rate for Payer: Cash Price	$204.80
Rate for Payer: Mclaren Medicaid	$70.08
Rate for Payer: Meridian Medicaid	$73.58
Rate for Payer: Priority Health Choice Medicaid	$70.08
Rate for Payer: Priority Health Cigna Priority Health	$179.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$134.41
Rate for Payer: Priority Health Narrow Network	$134.41
Rate for Payer: Priority Health SBD	$134.41

PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.6-1.0CM

Professional

Both

$256.00

Service Code	HCPCS 11421
Hospital Charge Code	11421
Min. Negotiated Rate	$70.08
Max. Negotiated Rate	$338.18
Rate for Payer: Aetna Commercial	$116.28
Rate for Payer: BCBS Complete	$73.58
Rate for Payer: BCBS Trust/PPO	$338.18
Rate for Payer: Cash Price	$204.80
Rate for Payer: Cash Price	$204.80
Rate for Payer: Mclaren Medicaid	$70.08
Rate for Payer: Meridian Medicaid	$73.58
Rate for Payer: Priority Health Choice Medicaid	$70.08
Rate for Payer: Priority Health Cigna Priority Health	$179.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$134.41
Rate for Payer: Priority Health Narrow Network	$134.41
Rate for Payer: Priority Health SBD	$134.41

PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 1.1-2.0CM

Professional

Both

$285.00

Service Code	HCPCS 11422
Hospital Charge Code	11422
Min. Negotiated Rate	$32.57
Max. Negotiated Rate	$199.50
Rate for Payer: Aetna Commercial	$143.70
Rate for Payer: BCBS Complete	$91.70
Rate for Payer: BCBS Trust/PPO	$32.57
Rate for Payer: Cash Price	$228.00
Rate for Payer: Cash Price	$228.00
Rate for Payer: Mclaren Medicaid	$87.33
Rate for Payer: Meridian Medicaid	$91.70
Rate for Payer: Priority Health Choice Medicaid	$87.33
Rate for Payer: Priority Health Cigna Priority Health	$199.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$166.47
Rate for Payer: Priority Health Narrow Network	$166.47
Rate for Payer: Priority Health SBD	$166.47

PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 1.1-2.0CM

Professional

Both

$285.00

Service Code	HCPCS 11422
Min. Negotiated Rate	$32.57
Max. Negotiated Rate	$199.50
Rate for Payer: Aetna Commercial	$143.70
Rate for Payer: BCBS Complete	$91.70
Rate for Payer: BCBS Trust/PPO	$32.57
Rate for Payer: Cash Price	$228.00
Rate for Payer: Cash Price	$228.00
Rate for Payer: Mclaren Medicaid	$87.33
Rate for Payer: Meridian Medicaid	$91.70
Rate for Payer: Priority Health Choice Medicaid	$87.33
Rate for Payer: Priority Health Cigna Priority Health	$199.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$166.47
Rate for Payer: Priority Health Narrow Network	$166.47
Rate for Payer: Priority Health SBD	$166.47

PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 1.1-2.0CM

Facility

$285.00

Service Code	CPT 11422
Hospital Charge Code	11422
Hospital Revenue Code	521
Min. Negotiated Rate	$134.25
Max. Negotiated Rate	$4,536.73
Rate for Payer: Aetna Commercial	$242.25
Rate for Payer: Aetna Medicare	$1,500.31
Rate for Payer: Aetna New Business (MI Preferred)	$185.25
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	$937.37
Rate for Payer: BCN Medicare Advantage	$1,442.61
Rate for Payer: Cash Price	$228.00
Rate for Payer: Cash Price	$228.00
Rate for Payer: Cofinity Commercial	$245.10
Rate for Payer: Cofinity Commercial	$199.50
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,442.61
Rate for Payer: Healthscope Commercial	$256.50
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	$242.25
Rate for Payer: PACE Medicare	$1,370.48
Rate for Payer: PACE SWMI	$1,442.61
Rate for Payer: PHP Commercial	$242.25
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	$199.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$4,536.73
Rate for Payer: Priority Health Medicare	$1,442.61
Rate for Payer: Priority Health Narrow Network	$3,629.38
Rate for Payer: Priority Health SBD	$179.55
Rate for Payer: Railroad Medicare Medicare	$1,442.61
Rate for Payer: UHC All Payor (Choice/PPO)	$147.68
Rate for Payer: UHC Dual Complete DSNP	$1,442.61
Rate for Payer: UHC Exchange	$134.25
Rate for Payer: UHC Medicare Advantage	$1,485.89
Rate for Payer: VA VA	$1,442.61

PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 1.1-2.0CM

Facility

$285.00

Service Code	CPT 11422
Hospital Charge Code	11422
Hospital Revenue Code	521
Min. Negotiated Rate	$179.55
Max. Negotiated Rate	$256.50
Rate for Payer: Aetna Commercial	$242.25
Rate for Payer: Aetna New Business (MI Preferred)	$185.25
Rate for Payer: Cash Price	$228.00
Rate for Payer: Cofinity Commercial	$199.50
Rate for Payer: Cofinity Commercial	$245.10
Rate for Payer: Healthscope Commercial	$256.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$242.25
Rate for Payer: PHP Commercial	$242.25
Rate for Payer: Priority Health Cigna Priority Health	$199.50
Rate for Payer: Priority Health SBD	$179.55

PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 2.1-3.0CM

Facility

$393.00

Service Code	CPT 11423
Hospital Charge Code	11423
Hospital Revenue Code	521
Min. Negotiated Rate	$247.59
Max. Negotiated Rate	$353.70
Rate for Payer: Aetna Commercial	$334.05
Rate for Payer: Aetna New Business (MI Preferred)	$255.45
Rate for Payer: Cash Price	$314.40
Rate for Payer: Cofinity Commercial	$275.10
Rate for Payer: Cofinity Commercial	$337.98
Rate for Payer: Healthscope Commercial	$353.70
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$334.05
Rate for Payer: PHP Commercial	$334.05
Rate for Payer: Priority Health Cigna Priority Health	$275.10
Rate for Payer: Priority Health SBD	$247.59

PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 2.1-3.0CM

Professional

Both

$393.00

Service Code	HCPCS 11423
Min. Negotiated Rate	$100.96
Max. Negotiated Rate	$338.18
Rate for Payer: Aetna Commercial	$165.79
Rate for Payer: BCBS Complete	$106.01
Rate for Payer: BCBS Trust/PPO	$338.18
Rate for Payer: Cash Price	$314.40
Rate for Payer: Cash Price	$314.40
Rate for Payer: Mclaren Medicaid	$100.96
Rate for Payer: Meridian Medicaid	$106.01
Rate for Payer: Priority Health Choice Medicaid	$100.96
Rate for Payer: Priority Health Cigna Priority Health	$275.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$191.54
Rate for Payer: Priority Health Narrow Network	$191.54
Rate for Payer: Priority Health SBD	$191.54

PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 2.1-3.0CM

Professional

Both

$393.00

Service Code	HCPCS 11423
Hospital Charge Code	11423
Min. Negotiated Rate	$100.96
Max. Negotiated Rate	$338.18
Rate for Payer: Aetna Commercial	$165.79
Rate for Payer: BCBS Complete	$106.01
Rate for Payer: BCBS Trust/PPO	$338.18
Rate for Payer: Cash Price	$314.40
Rate for Payer: Cash Price	$314.40
Rate for Payer: Mclaren Medicaid	$100.96
Rate for Payer: Meridian Medicaid	$106.01
Rate for Payer: Priority Health Choice Medicaid	$100.96
Rate for Payer: Priority Health Cigna Priority Health	$275.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$191.54
Rate for Payer: Priority Health Narrow Network	$191.54
Rate for Payer: Priority Health SBD	$191.54

PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 2.1-3.0CM

Facility

$393.00

Service Code	CPT 11423
Hospital Charge Code	11423
Hospital Revenue Code	521
Min. Negotiated Rate	$155.21
Max. Negotiated Rate	$4,536.73
Rate for Payer: Aetna Commercial	$334.05
Rate for Payer: Aetna Medicare	$1,500.31
Rate for Payer: Aetna New Business (MI Preferred)	$255.45
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	$937.37
Rate for Payer: BCN Medicare Advantage	$1,442.61
Rate for Payer: Cash Price	$314.40
Rate for Payer: Cash Price	$314.40
Rate for Payer: Cofinity Commercial	$337.98
Rate for Payer: Cofinity Commercial	$275.10
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,442.61
Rate for Payer: Healthscope Commercial	$353.70
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	$334.05
Rate for Payer: PACE Medicare	$1,370.48
Rate for Payer: PACE SWMI	$1,442.61
Rate for Payer: PHP Commercial	$334.05
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	$275.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$4,536.73
Rate for Payer: Priority Health Medicare	$1,442.61
Rate for Payer: Priority Health Narrow Network	$3,629.38
Rate for Payer: Priority Health SBD	$247.59
Rate for Payer: Railroad Medicare Medicare	$1,442.61
Rate for Payer: UHC All Payor (Choice/PPO)	$170.73
Rate for Payer: UHC Dual Complete DSNP	$1,442.61
Rate for Payer: UHC Exchange	$155.21
Rate for Payer: UHC Medicare Advantage	$1,485.89
Rate for Payer: VA VA	$1,442.61

PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 3.1-4.0CM

Professional

Both

$503.00

Service Code	HCPCS 11424
Min. Negotiated Rate	$116.30
Max. Negotiated Rate	$2,640.00
Rate for Payer: Aetna Commercial	$189.84
Rate for Payer: BCBS Complete	$122.12
Rate for Payer: BCBS Trust/PPO	$2,640.00
Rate for Payer: Cash Price	$402.40
Rate for Payer: Cash Price	$402.40
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	$352.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$218.67
Rate for Payer: Priority Health Narrow Network	$218.67
Rate for Payer: Priority Health SBD	$218.67

PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 3.1-4.0CM

Facility

$503.00

Service Code	CPT 11424
Hospital Charge Code	11424
Hospital Revenue Code	521
Min. Negotiated Rate	$316.89
Max. Negotiated Rate	$452.70
Rate for Payer: Aetna Commercial	$427.55
Rate for Payer: Aetna New Business (MI Preferred)	$326.95
Rate for Payer: Cash Price	$402.40
Rate for Payer: Cofinity Commercial	$352.10
Rate for Payer: Cofinity Commercial	$432.58
Rate for Payer: Healthscope Commercial	$452.70
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$427.55
Rate for Payer: PHP Commercial	$427.55
Rate for Payer: Priority Health Cigna Priority Health	$352.10
Rate for Payer: Priority Health SBD	$316.89

PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 3.1-4.0CM

Professional

Both

$503.00

Service Code	HCPCS 11424
Hospital Charge Code	11424
Min. Negotiated Rate	$116.30
Max. Negotiated Rate	$2,640.00
Rate for Payer: Aetna Commercial	$189.84
Rate for Payer: BCBS Complete	$122.12
Rate for Payer: BCBS Trust/PPO	$2,640.00
Rate for Payer: Cash Price	$402.40
Rate for Payer: Cash Price	$402.40
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	$352.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$218.67
Rate for Payer: Priority Health Narrow Network	$218.67
Rate for Payer: Priority Health SBD	$218.67

Know your out-of-pocket cost for care.

All Charges