Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PR EXC BRANCHIAL CLEFT CYST CONFINED SKN&SUBQ TIS

Professional

Both

$850.00

Service Code	HCPCS 42810
Min. Negotiated Rate	$183.18
Max. Negotiated Rate	$595.00
Rate for Payer: Aetna Commercial	$370.11
Rate for Payer: BCBS Complete	$192.34
Rate for Payer: BCBS Trust/PPO	$196.53
Rate for Payer: Cash Price	$680.00
Rate for Payer: Cash Price	$680.00
Rate for Payer: Mclaren Medicaid	$183.18
Rate for Payer: Meridian Medicaid	$192.34
Rate for Payer: Priority Health Choice Medicaid	$183.18
Rate for Payer: Priority Health Cigna Priority Health	$595.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$500.36
Rate for Payer: Priority Health Narrow Network	$500.36
Rate for Payer: Priority Health SBD	$500.36

PR EXC BREAST LES PREOP PLMT RAD MARKER OPEN 1 LES

Facility

$1,238.00

Service Code	CPT 19125
Hospital Charge Code	19125
Hospital Revenue Code	960
Min. Negotiated Rate	$458.42
Max. Negotiated Rate	$10,308.37
Rate for Payer: Aetna Commercial	$1,052.30
Rate for Payer: Aetna Medicare	$3,527.33
Rate for Payer: Aetna New Business (MI Preferred)	$804.70
Rate for Payer: Allen County Amish Medical Aid Commercial	$4,239.58
Rate for Payer: Amish Plain Church Group Commercial	$4,239.58
Rate for Payer: BCBS Complete	$1,948.17
Rate for Payer: BCBS MAPPO	$3,391.66
Rate for Payer: BCBS Trust/PPO	$1,512.30
Rate for Payer: BCCCP Commercial	$618.15
Rate for Payer: BCN Medicare Advantage	$3,391.66
Rate for Payer: Cash Price	$990.40
Rate for Payer: Cash Price	$990.40
Rate for Payer: Cofinity Commercial	$1,064.68
Rate for Payer: Cofinity Commercial	$866.60
Rate for Payer: Health Alliance Plan Medicare Advantage	$3,391.66
Rate for Payer: Healthscope Commercial	$1,114.20
Rate for Payer: Mclaren Medicaid	$1,855.24
Rate for Payer: Mclaren Medicare	$3,391.66
Rate for Payer: Meridian Medicaid	$1,948.17
Rate for Payer: Meridian Wellcare - Medicare Advantage	$3,561.24
Rate for Payer: MI Amish Medical Board Commercial	$3,900.41
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,052.30
Rate for Payer: PACE Medicare	$3,222.08
Rate for Payer: PACE SWMI	$3,391.66
Rate for Payer: PHP Commercial	$1,052.30
Rate for Payer: PHP Medicare Advantage	$3,391.66
Rate for Payer: Priority Health Choice Medicaid	$1,855.24
Rate for Payer: Priority Health Cigna Priority Health	$866.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$10,308.37
Rate for Payer: Priority Health Medicare	$3,391.66
Rate for Payer: Priority Health Narrow Network	$8,246.70
Rate for Payer: Priority Health SBD	$779.94
Rate for Payer: Railroad Medicare Medicare	$3,391.66
Rate for Payer: UHC All Payor (Choice/PPO)	$504.26
Rate for Payer: UHC Dual Complete DSNP	$3,391.66
Rate for Payer: UHC Exchange	$458.42
Rate for Payer: UHC Medicare Advantage	$3,493.41
Rate for Payer: VA VA	$3,391.66

PR EXC BREAST LES PREOP PLMT RAD MARKER OPEN 1 LES

Professional

Both

$1,238.00

Service Code	HCPCS 19125
Hospital Charge Code	19125
Min. Negotiated Rate	$13.80
Max. Negotiated Rate	$866.60
Rate for Payer: Aetna Commercial	$503.32
Rate for Payer: BCBS Complete	$313.11
Rate for Payer: BCBS Trust/PPO	$13.80
Rate for Payer: Cash Price	$990.40
Rate for Payer: Cash Price	$990.40
Rate for Payer: Mclaren Medicaid	$298.20
Rate for Payer: Meridian Medicaid	$313.11
Rate for Payer: Priority Health Choice Medicaid	$298.20
Rate for Payer: Priority Health Cigna Priority Health	$866.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$570.12
Rate for Payer: Priority Health Narrow Network	$570.12
Rate for Payer: Priority Health SBD	$570.12

PR EXC BREAST LES PREOP PLMT RAD MARKER OPEN 1 LES

Professional

Both

$1,238.00

Service Code	HCPCS 19125
Min. Negotiated Rate	$13.80
Max. Negotiated Rate	$866.60
Rate for Payer: Aetna Commercial	$503.32
Rate for Payer: BCBS Complete	$313.11
Rate for Payer: BCBS Trust/PPO	$13.80
Rate for Payer: Cash Price	$990.40
Rate for Payer: Cash Price	$990.40
Rate for Payer: Mclaren Medicaid	$298.20
Rate for Payer: Meridian Medicaid	$313.11
Rate for Payer: Priority Health Choice Medicaid	$298.20
Rate for Payer: Priority Health Cigna Priority Health	$866.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$570.12
Rate for Payer: Priority Health Narrow Network	$570.12
Rate for Payer: Priority Health SBD	$570.12

PR EXC BREAST LES PREOP PLMT RAD MARKER OPEN 1 LES

Facility

$1,238.00

Service Code	CPT 19125
Hospital Charge Code	19125
Hospital Revenue Code	960
Min. Negotiated Rate	$779.94
Max. Negotiated Rate	$1,114.20
Rate for Payer: Aetna Commercial	$1,052.30
Rate for Payer: Aetna New Business (MI Preferred)	$804.70
Rate for Payer: Cash Price	$990.40
Rate for Payer: Cofinity Commercial	$1,064.68
Rate for Payer: Cofinity Commercial	$866.60
Rate for Payer: Healthscope Commercial	$1,114.20
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,052.30
Rate for Payer: PHP Commercial	$1,052.30
Rate for Payer: Priority Health Cigna Priority Health	$866.60
Rate for Payer: Priority Health SBD	$779.94

PR EXC BRST LES PREOP PLMT RAD MARKER OPN EA ADDL

Professional

Both

$267.00

Service Code	HCPCS 19126
Min. Negotiated Rate	$12.95
Max. Negotiated Rate	$195.24
Rate for Payer: Aetna Commercial	$177.60
Rate for Payer: BCBS Complete	$106.68
Rate for Payer: BCBS Trust/PPO	$12.95
Rate for Payer: Cash Price	$213.60
Rate for Payer: Cash Price	$213.60
Rate for Payer: Mclaren Medicaid	$101.60
Rate for Payer: Meridian Medicaid	$106.68
Rate for Payer: Priority Health Choice Medicaid	$101.60
Rate for Payer: Priority Health Cigna Priority Health	$186.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$195.24
Rate for Payer: Priority Health Narrow Network	$195.24
Rate for Payer: Priority Health SBD	$195.24

PR EXC CAROTID BODY TUMOR W/O EXC CAROTID ARTERY

Professional

Both

$2,711.00

Service Code	HCPCS 60600
Min. Negotiated Rate	$529.36
Max. Negotiated Rate	$1,914.80
Rate for Payer: Aetna Commercial	$1,763.47
Rate for Payer: BCBS Complete	$909.14
Rate for Payer: BCBS Trust/PPO	$529.36
Rate for Payer: Cash Price	$2,168.80
Rate for Payer: Cash Price	$2,168.80
Rate for Payer: Mclaren Medicaid	$865.85
Rate for Payer: Meridian Medicaid	$909.14
Rate for Payer: Priority Health Choice Medicaid	$865.85
Rate for Payer: Priority Health Cigna Priority Health	$1,897.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,914.80
Rate for Payer: Priority Health Narrow Network	$1,914.80
Rate for Payer: Priority Health SBD	$1,914.80

PR EXC CONSTRICTING RING FNGR W/MLT Z-PLASTIES

Professional

Both

$1,301.00

Service Code	HCPCS 26596
Min. Negotiated Rate	$72.17
Max. Negotiated Rate	$1,267.95
Rate for Payer: Aetna Commercial	$1,076.67
Rate for Payer: BCBS Complete	$556.22
Rate for Payer: BCBS Trust/PPO	$72.17
Rate for Payer: Cash Price	$1,040.80
Rate for Payer: Cash Price	$1,040.80
Rate for Payer: Mclaren Medicaid	$529.73
Rate for Payer: Meridian Medicaid	$556.22
Rate for Payer: Priority Health Choice Medicaid	$529.73
Rate for Payer: Priority Health Cigna Priority Health	$910.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,267.95
Rate for Payer: Priority Health Narrow Network	$1,267.95
Rate for Payer: Priority Health SBD	$1,267.95

PR EXC CRV STUMP VAG APPR W/RPR NTRCL

Professional

Both

$1,257.00

Service Code	HCPCS 57556
Min. Negotiated Rate	$378.50
Max. Negotiated Rate	$1,301.73
Rate for Payer: Aetna Commercial	$698.98
Rate for Payer: BCBS Complete	$397.42
Rate for Payer: BCBS Trust/PPO	$1,301.73
Rate for Payer: Cash Price	$1,005.60
Rate for Payer: Cash Price	$1,005.60
Rate for Payer: Mclaren Medicaid	$378.50
Rate for Payer: Meridian Medicaid	$397.42
Rate for Payer: Priority Health Choice Medicaid	$378.50
Rate for Payer: Priority Health Cigna Priority Health	$879.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$837.96
Rate for Payer: Priority Health Narrow Network	$837.96
Rate for Payer: Priority Health SBD	$837.96

PR EXC CSTIC HYGROMA AX/CRV W/DP NEUROVASC DSJ

Professional

Both

$4,123.00

Service Code	HCPCS 38555
Min. Negotiated Rate	$556.83
Max. Negotiated Rate	$2,886.10
Rate for Payer: Aetna Commercial	$1,274.21
Rate for Payer: BCBS Complete	$691.30
Rate for Payer: BCBS Trust/PPO	$556.83
Rate for Payer: Cash Price	$3,298.40
Rate for Payer: Cash Price	$3,298.40
Rate for Payer: Mclaren Medicaid	$658.38
Rate for Payer: Meridian Medicaid	$691.30
Rate for Payer: Priority Health Choice Medicaid	$658.38
Rate for Payer: Priority Health Cigna Priority Health	$2,886.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,225.89
Rate for Payer: Priority Health Narrow Network	$2,225.89
Rate for Payer: Priority Health SBD	$2,225.89

PR EXC CSTIC HYGROMA AX/CRV W/O DP NEUROVASC DSJ

Professional

Both

$1,546.00

Service Code	HCPCS 38550
Min. Negotiated Rate	$337.18
Max. Negotiated Rate	$1,135.76
Rate for Payer: Aetna Commercial	$643.88
Rate for Payer: BCBS Complete	$354.04
Rate for Payer: BCBS Trust/PPO	$608.07
Rate for Payer: Cash Price	$1,236.80
Rate for Payer: Cash Price	$1,236.80
Rate for Payer: Mclaren Medicaid	$337.18
Rate for Payer: Meridian Medicaid	$354.04
Rate for Payer: Priority Health Choice Medicaid	$337.18
Rate for Payer: Priority Health Cigna Priority Health	$1,082.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,135.76
Rate for Payer: Priority Health Narrow Network	$1,135.76
Rate for Payer: Priority Health SBD	$1,135.76

PR EXC/CURETTAGE CYST/TUMOR METACARPAL W/AUTOGRAFT

Professional

Both

$2,315.00

Service Code	HCPCS 26205
Min. Negotiated Rate	$32.23
Max. Negotiated Rate	$1,620.50
Rate for Payer: Aetna Commercial	$808.63
Rate for Payer: BCBS Complete	$413.53
Rate for Payer: BCBS Trust/PPO	$32.23
Rate for Payer: Cash Price	$1,852.00
Rate for Payer: Cash Price	$1,852.00
Rate for Payer: Mclaren Medicaid	$393.84
Rate for Payer: Meridian Medicaid	$413.53
Rate for Payer: Priority Health Choice Medicaid	$393.84
Rate for Payer: Priority Health Cigna Priority Health	$1,620.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$935.51
Rate for Payer: Priority Health Narrow Network	$935.51
Rate for Payer: Priority Health SBD	$935.51

PR EXC/CURETTAGE CYST/TUMOR PHALANX FINGER W/AGRAFT

Professional

Both

$1,747.00

Service Code	HCPCS 26215
Min. Negotiated Rate	$119.40
Max. Negotiated Rate	$1,222.90
Rate for Payer: Aetna Commercial	$756.96
Rate for Payer: BCBS Complete	$388.48
Rate for Payer: BCBS Trust/PPO	$119.40
Rate for Payer: Cash Price	$1,397.60
Rate for Payer: Cash Price	$1,397.60
Rate for Payer: Mclaren Medicaid	$369.98
Rate for Payer: Meridian Medicaid	$388.48
Rate for Payer: Priority Health Choice Medicaid	$369.98
Rate for Payer: Priority Health Cigna Priority Health	$1,222.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$878.83
Rate for Payer: Priority Health Narrow Network	$878.83
Rate for Payer: Priority Health SBD	$878.83

PR EXC/CURETTAGE CYST/TUMOR TIBIA/FIBULA W/AGRAFT

Professional

Both

$2,721.00

Service Code	HCPCS 27637
Min. Negotiated Rate	$483.08
Max. Negotiated Rate	$1,904.70
Rate for Payer: Aetna Commercial	$989.60
Rate for Payer: BCBS Complete	$507.23
Rate for Payer: BCBS Trust/PPO	$1,170.18
Rate for Payer: Cash Price	$2,176.80
Rate for Payer: Cash Price	$2,176.80
Rate for Payer: Mclaren Medicaid	$483.08
Rate for Payer: Meridian Medicaid	$507.23
Rate for Payer: Priority Health Choice Medicaid	$483.08
Rate for Payer: Priority Health Cigna Priority Health	$1,904.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,138.25
Rate for Payer: Priority Health Narrow Network	$1,138.25
Rate for Payer: Priority Health SBD	$1,138.25

PR EXC/CURETTAGE CYST/TUMOR TIBIA/FIBULA W/ALGRAFT

Professional

Both

$2,170.00

Service Code	HCPCS 27638
Min. Negotiated Rate	$479.04
Max. Negotiated Rate	$1,612.37
Rate for Payer: Aetna Commercial	$1,011.80
Rate for Payer: BCBS Complete	$502.99
Rate for Payer: BCBS Trust/PPO	$1,612.37
Rate for Payer: Cash Price	$1,736.00
Rate for Payer: Cash Price	$1,736.00
Rate for Payer: Mclaren Medicaid	$479.04
Rate for Payer: Meridian Medicaid	$502.99
Rate for Payer: Priority Health Choice Medicaid	$479.04
Rate for Payer: Priority Health Cigna Priority Health	$1,519.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,146.41
Rate for Payer: Priority Health Narrow Network	$1,146.41
Rate for Payer: Priority Health SBD	$1,146.41

PR EXC/CURTG BONE CYST/B9 TUMORTARSAL/METATARSAL

Professional

Both

$950.00

Service Code	HCPCS 28104
Min. Negotiated Rate	$228.98
Max. Negotiated Rate	$1,143.77
Rate for Payer: Aetna Commercial	$469.02
Rate for Payer: BCBS Complete	$240.43
Rate for Payer: BCBS Trust/PPO	$1,143.77
Rate for Payer: Cash Price	$760.00
Rate for Payer: Cash Price	$760.00
Rate for Payer: Mclaren Medicaid	$228.98
Rate for Payer: Meridian Medicaid	$240.43
Rate for Payer: Priority Health Choice Medicaid	$228.98
Rate for Payer: Priority Health Cigna Priority Health	$665.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$538.22
Rate for Payer: Priority Health Narrow Network	$538.22
Rate for Payer: Priority Health SBD	$538.22

PR EXC/CURTG BONE CYST/BENIGN TUM HUMERUS W/ALGRFT

Professional

Both

$1,700.00

Service Code	HCPCS 24116
Min. Negotiated Rate	$82.41
Max. Negotiated Rate	$1,321.56
Rate for Payer: Aetna Commercial	$1,149.88
Rate for Payer: BCBS Complete	$583.51
Rate for Payer: BCBS Trust/PPO	$82.41
Rate for Payer: Cash Price	$1,360.00
Rate for Payer: Cash Price	$1,360.00
Rate for Payer: Mclaren Medicaid	$555.72
Rate for Payer: Meridian Medicaid	$583.51
Rate for Payer: Priority Health Choice Medicaid	$555.72
Rate for Payer: Priority Health Cigna Priority Health	$1,190.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,321.56
Rate for Payer: Priority Health Narrow Network	$1,321.56
Rate for Payer: Priority Health SBD	$1,321.56

PR EXC/CURTG BONE CYST/BENIGN TUMOR CLAV/SCAPULA

Professional

Both

$923.00

Service Code	HCPCS 23140
Min. Negotiated Rate	$27.17
Max. Negotiated Rate	$858.91
Rate for Payer: Aetna Commercial	$740.39
Rate for Payer: BCBS Complete	$380.20
Rate for Payer: BCBS Trust/PPO	$27.17
Rate for Payer: Cash Price	$738.40
Rate for Payer: Cash Price	$738.40
Rate for Payer: Mclaren Medicaid	$362.10
Rate for Payer: Meridian Medicaid	$380.20
Rate for Payer: Priority Health Choice Medicaid	$362.10
Rate for Payer: Priority Health Cigna Priority Health	$646.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$858.91
Rate for Payer: Priority Health Narrow Network	$858.91
Rate for Payer: Priority Health SBD	$858.91

PR EXC/CURTG BONE CYST/BENIGN TUMOR H/N RDS/OLECRN

Professional

Both

$1,228.00

Service Code	HCPCS 24120
Hospital Charge Code	24120
Min. Negotiated Rate	$114.64
Max. Negotiated Rate	$859.60
Rate for Payer: Aetna Commercial	$709.53
Rate for Payer: BCBS Complete	$364.77
Rate for Payer: BCBS Trust/PPO	$114.64
Rate for Payer: Cash Price	$982.40
Rate for Payer: Cash Price	$982.40
Rate for Payer: Mclaren Medicaid	$347.40
Rate for Payer: Meridian Medicaid	$364.77
Rate for Payer: Priority Health Choice Medicaid	$347.40
Rate for Payer: Priority Health Cigna Priority Health	$859.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$824.19
Rate for Payer: Priority Health Narrow Network	$824.19
Rate for Payer: Priority Health SBD	$824.19

PR EXC/CURTG BONE CYST/BENIGN TUMOR H/N RDS/OLECRN

Professional

Both

$1,228.00

Service Code	HCPCS 24120
Min. Negotiated Rate	$114.64
Max. Negotiated Rate	$859.60
Rate for Payer: Aetna Commercial	$709.53
Rate for Payer: BCBS Complete	$364.77
Rate for Payer: BCBS Trust/PPO	$114.64
Rate for Payer: Cash Price	$982.40
Rate for Payer: Cash Price	$982.40
Rate for Payer: Mclaren Medicaid	$347.40
Rate for Payer: Meridian Medicaid	$364.77
Rate for Payer: Priority Health Choice Medicaid	$347.40
Rate for Payer: Priority Health Cigna Priority Health	$859.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$824.19
Rate for Payer: Priority Health Narrow Network	$824.19
Rate for Payer: Priority Health SBD	$824.19

PR EXC/CURTG BONE CYST/BENIGN TUMOR H/N RDS/OLECRN

Facility

$1,228.00

Service Code	CPT 24120
Hospital Charge Code	24120
Min. Negotiated Rate	$534.06
Max. Negotiated Rate	$3,600.14
Rate for Payer: Aetna Commercial	$1,043.80
Rate for Payer: Aetna Medicare	$2,995.31
Rate for Payer: Aetna New Business (MI Preferred)	$798.20
Rate for Payer: Allen County Amish Medical Aid Commercial	$3,600.14
Rate for Payer: Amish Plain Church Group Commercial	$3,600.14
Rate for Payer: BCBS Complete	$1,654.34
Rate for Payer: BCBS MAPPO	$2,880.11
Rate for Payer: BCBS Trust/PPO	$1,058.03
Rate for Payer: BCN Medicare Advantage	$2,880.11
Rate for Payer: Cash Price	$982.40
Rate for Payer: Cash Price	$982.40
Rate for Payer: Cofinity Commercial	$859.60
Rate for Payer: Cofinity Commercial	$1,056.08
Rate for Payer: Health Alliance Plan Medicare Advantage	$2,880.11
Rate for Payer: Healthscope Commercial	$1,105.20
Rate for Payer: Mclaren Medicaid	$1,575.42
Rate for Payer: Mclaren Medicare	$2,880.11
Rate for Payer: Meridian Medicaid	$1,654.34
Rate for Payer: Meridian Wellcare - Medicare Advantage	$3,024.12
Rate for Payer: MI Amish Medical Board Commercial	$3,312.13
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,043.80
Rate for Payer: PACE Medicare	$2,736.10
Rate for Payer: PACE SWMI	$2,880.11
Rate for Payer: PHP Commercial	$1,043.80
Rate for Payer: PHP Medicare Advantage	$2,880.11
Rate for Payer: Priority Health Choice Medicaid	$1,575.42
Rate for Payer: Priority Health Cigna Priority Health	$859.60
Rate for Payer: Priority Health Medicare	$2,880.11
Rate for Payer: Priority Health SBD	$773.64
Rate for Payer: Railroad Medicare Medicare	$2,880.11
Rate for Payer: UHC All Payor (Choice/PPO)	$587.47
Rate for Payer: UHC Dual Complete DSNP	$2,880.11
Rate for Payer: UHC Exchange	$534.06
Rate for Payer: UHC Medicare Advantage	$2,966.51
Rate for Payer: VA VA	$2,880.11

PR EXC/CURTG BONE CYST/BENIGN TUMOR H/N RDS/OLECRN

Facility

$1,228.00

Service Code	CPT 24120
Hospital Charge Code	24120
Min. Negotiated Rate	$773.64
Max. Negotiated Rate	$1,105.20
Rate for Payer: Aetna Commercial	$1,043.80
Rate for Payer: Aetna New Business (MI Preferred)	$798.20
Rate for Payer: Cash Price	$982.40
Rate for Payer: Cofinity Commercial	$1,056.08
Rate for Payer: Cofinity Commercial	$859.60
Rate for Payer: Healthscope Commercial	$1,105.20
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,043.80
Rate for Payer: PHP Commercial	$1,043.80
Rate for Payer: Priority Health Cigna Priority Health	$859.60
Rate for Payer: Priority Health SBD	$773.64

PR EXC/CURTG BONE CYST/BENIGN TUM PROX HUM W/AGRFT

Professional

Both

$1,383.00

Service Code	HCPCS 23155
Min. Negotiated Rate	$59.01
Max. Negotiated Rate	$1,228.63
Rate for Payer: Aetna Commercial	$1,063.91
Rate for Payer: BCBS Complete	$542.36
Rate for Payer: BCBS Trust/PPO	$59.01
Rate for Payer: Cash Price	$1,106.40
Rate for Payer: Cash Price	$1,106.40
Rate for Payer: Mclaren Medicaid	$516.53
Rate for Payer: Meridian Medicaid	$542.36
Rate for Payer: Priority Health Choice Medicaid	$516.53
Rate for Payer: Priority Health Cigna Priority Health	$968.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,228.63
Rate for Payer: Priority Health Narrow Network	$1,228.63
Rate for Payer: Priority Health SBD	$1,228.63

PR EXC/CURTG BONE CYST/BENIGN TUM PROX HUM W/ALGRFT

Professional

Both

$1,274.00

Service Code	HCPCS 23156
Min. Negotiated Rate	$32.26
Max. Negotiated Rate	$1,047.86
Rate for Payer: Aetna Commercial	$906.58
Rate for Payer: BCBS Complete	$462.96
Rate for Payer: BCBS Trust/PPO	$32.26
Rate for Payer: Cash Price	$1,019.20
Rate for Payer: Cash Price	$1,019.20
Rate for Payer: Mclaren Medicaid	$440.91
Rate for Payer: Meridian Medicaid	$462.96
Rate for Payer: Priority Health Choice Medicaid	$440.91
Rate for Payer: Priority Health Cigna Priority Health	$891.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,047.86
Rate for Payer: Priority Health Narrow Network	$1,047.86
Rate for Payer: Priority Health SBD	$1,047.86

PR EXC/CURTG CST/B9 TUM PHALANGES FOOT

Professional

Both

$522.00

Service Code	HCPCS 28108
Min. Negotiated Rate	$186.38
Max. Negotiated Rate	$438.13
Rate for Payer: Aetna Commercial	$378.46
Rate for Payer: BCBS Complete	$195.70
Rate for Payer: BCBS Trust/PPO	$252.00
Rate for Payer: Cash Price	$417.60
Rate for Payer: Cash Price	$417.60
Rate for Payer: Mclaren Medicaid	$186.38
Rate for Payer: Meridian Medicaid	$195.70
Rate for Payer: Priority Health Choice Medicaid	$186.38
Rate for Payer: Priority Health Cigna Priority Health	$365.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$438.13
Rate for Payer: Priority Health Narrow Network	$438.13
Rate for Payer: Priority Health SBD	$438.13

Know your out-of-pocket cost for care.

All Charges