Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PR EXCISION HIDRADENITIS INGUINAL SMPL/INTRM RPR

Facility

$464.00

Service Code	CPT 11462
Hospital Charge Code	11462
Min. Negotiated Rate	$292.32
Max. Negotiated Rate	$417.60
Rate for Payer: Aetna Commercial	$394.40
Rate for Payer: Aetna New Business (MI Preferred)	$301.60
Rate for Payer: Cash Price	$371.20
Rate for Payer: Cofinity Commercial	$324.80
Rate for Payer: Cofinity Commercial	$399.04
Rate for Payer: Healthscope Commercial	$417.60
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$394.40
Rate for Payer: PHP Commercial	$394.40
Rate for Payer: Priority Health Cigna Priority Health	$324.80
Rate for Payer: Priority Health SBD	$292.32

PR EXCISION H/P/P/U COMPLEX REPAIR

Facility

$967.00

Service Code	CPT 11471
Hospital Charge Code	11471
Min. Negotiated Rate	$347.74
Max. Negotiated Rate	$7,382.58
Rate for Payer: Aetna Commercial	$821.95
Rate for Payer: Aetna Medicare	$2,629.47
Rate for Payer: Aetna New Business (MI Preferred)	$628.55
Rate for Payer: Allen County Amish Medical Aid Commercial	$3,160.42
Rate for Payer: Amish Plain Church Group Commercial	$3,160.42
Rate for Payer: BCBS Complete	$1,452.28
Rate for Payer: BCBS MAPPO	$2,528.34
Rate for Payer: BCBS Trust/PPO	$1,044.57
Rate for Payer: BCN Medicare Advantage	$2,528.34
Rate for Payer: Cash Price	$773.60
Rate for Payer: Cash Price	$773.60
Rate for Payer: Cofinity Commercial	$676.90
Rate for Payer: Cofinity Commercial	$831.62
Rate for Payer: Health Alliance Plan Medicare Advantage	$2,528.34
Rate for Payer: Healthscope Commercial	$870.30
Rate for Payer: Mclaren Medicaid	$1,383.00
Rate for Payer: Mclaren Medicare	$2,528.34
Rate for Payer: Meridian Medicaid	$1,452.28
Rate for Payer: Meridian Wellcare - Medicare Advantage	$2,654.76
Rate for Payer: MI Amish Medical Board Commercial	$2,907.59
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$821.95
Rate for Payer: PACE Medicare	$2,401.92
Rate for Payer: PACE SWMI	$2,528.34
Rate for Payer: PHP Commercial	$821.95
Rate for Payer: PHP Medicare Advantage	$2,528.34
Rate for Payer: Priority Health Choice Medicaid	$1,383.00
Rate for Payer: Priority Health Cigna Priority Health	$676.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$7,382.58
Rate for Payer: Priority Health Medicare	$2,528.34
Rate for Payer: Priority Health Narrow Network	$5,906.06
Rate for Payer: Priority Health SBD	$609.21
Rate for Payer: Railroad Medicare Medicare	$2,528.34
Rate for Payer: UHC All Payor (Choice/PPO)	$382.51
Rate for Payer: UHC Dual Complete DSNP	$2,528.34
Rate for Payer: UHC Exchange	$347.74
Rate for Payer: UHC Medicare Advantage	$2,604.19
Rate for Payer: VA VA	$2,528.34

PR EXCISION H/P/P/U COMPLEX REPAIR

Professional

Both

$967.00

Service Code	HCPCS 11471
Min. Negotiated Rate	$28.95
Max. Negotiated Rate	$676.90
Rate for Payer: Aetna Commercial	$377.56
Rate for Payer: BCBS Complete	$237.52
Rate for Payer: BCBS Trust/PPO	$28.95
Rate for Payer: Cash Price	$773.60
Rate for Payer: Cash Price	$773.60
Rate for Payer: Mclaren Medicaid	$226.21
Rate for Payer: Meridian Medicaid	$237.52
Rate for Payer: Priority Health Choice Medicaid	$226.21
Rate for Payer: Priority Health Cigna Priority Health	$676.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$430.77
Rate for Payer: Priority Health Narrow Network	$430.77
Rate for Payer: Priority Health SBD	$430.77

PR EXCISION H/P/P/U COMPLEX REPAIR

Professional

Both

$967.00

Service Code	HCPCS 11471
Hospital Charge Code	11471
Min. Negotiated Rate	$28.95
Max. Negotiated Rate	$676.90
Rate for Payer: Aetna Commercial	$377.56
Rate for Payer: BCBS Complete	$237.52
Rate for Payer: BCBS Trust/PPO	$28.95
Rate for Payer: Cash Price	$773.60
Rate for Payer: Cash Price	$773.60
Rate for Payer: Mclaren Medicaid	$226.21
Rate for Payer: Meridian Medicaid	$237.52
Rate for Payer: Priority Health Choice Medicaid	$226.21
Rate for Payer: Priority Health Cigna Priority Health	$676.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$430.77
Rate for Payer: Priority Health Narrow Network	$430.77
Rate for Payer: Priority Health SBD	$430.77

PR EXCISION H/P/P/U COMPLEX REPAIR

Facility

$967.00

Service Code	CPT 11471
Hospital Charge Code	11471
Min. Negotiated Rate	$609.21
Max. Negotiated Rate	$870.30
Rate for Payer: Aetna Commercial	$821.95
Rate for Payer: Aetna New Business (MI Preferred)	$628.55
Rate for Payer: Cash Price	$773.60
Rate for Payer: Cofinity Commercial	$676.90
Rate for Payer: Cofinity Commercial	$831.62
Rate for Payer: Healthscope Commercial	$870.30
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$821.95
Rate for Payer: PHP Commercial	$821.95
Rate for Payer: Priority Health Cigna Priority Health	$676.90
Rate for Payer: Priority Health SBD	$609.21

PR EXCISION H/P/P/U SIMPLE/INTERMEDIATE REPAIR

Professional

Both

$892.00

Service Code	HCPCS 11470
Min. Negotiated Rate	$28.95
Max. Negotiated Rate	$624.40
Rate for Payer: Aetna Commercial	$305.63
Rate for Payer: BCBS Complete	$194.12
Rate for Payer: BCBS Trust/PPO	$28.95
Rate for Payer: Cash Price	$713.60
Rate for Payer: Cash Price	$713.60
Rate for Payer: Mclaren Medicaid	$184.88
Rate for Payer: Meridian Medicaid	$194.12
Rate for Payer: Priority Health Choice Medicaid	$184.88
Rate for Payer: Priority Health Cigna Priority Health	$624.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$354.32
Rate for Payer: Priority Health Narrow Network	$354.32
Rate for Payer: Priority Health SBD	$354.32

PR EXCISION HYDROCELE BILATERAL

Professional

Both

$1,807.00

Service Code	HCPCS 55041
Hospital Charge Code	55041
Min. Negotiated Rate	$327.81
Max. Negotiated Rate	$1,449.66
Rate for Payer: Aetna Commercial	$655.83
Rate for Payer: BCBS Complete	$344.20
Rate for Payer: BCBS Trust/PPO	$1,449.66
Rate for Payer: Cash Price	$1,445.60
Rate for Payer: Cash Price	$1,445.60
Rate for Payer: Mclaren Medicaid	$327.81
Rate for Payer: Meridian Medicaid	$344.20
Rate for Payer: Priority Health Choice Medicaid	$327.81
Rate for Payer: Priority Health Cigna Priority Health	$1,264.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$819.18
Rate for Payer: Priority Health Narrow Network	$819.18
Rate for Payer: Priority Health SBD	$819.18

PR EXCISION HYDROCELE BILATERAL

Facility

$1,807.00

Service Code	CPT 55041
Hospital Charge Code	55041
Min. Negotiated Rate	$1,138.41
Max. Negotiated Rate	$1,626.30
Rate for Payer: Aetna Commercial	$1,535.95
Rate for Payer: Aetna New Business (MI Preferred)	$1,174.55
Rate for Payer: Cash Price	$1,445.60
Rate for Payer: Cofinity Commercial	$1,264.90
Rate for Payer: Cofinity Commercial	$1,554.02
Rate for Payer: Healthscope Commercial	$1,626.30
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,535.95
Rate for Payer: PHP Commercial	$1,535.95
Rate for Payer: Priority Health Cigna Priority Health	$1,264.90
Rate for Payer: Priority Health SBD	$1,138.41

PR EXCISION HYDROCELE BILATERAL

Professional

Both

$1,807.00

Service Code	HCPCS 55041
Min. Negotiated Rate	$327.81
Max. Negotiated Rate	$1,449.66
Rate for Payer: Aetna Commercial	$655.83
Rate for Payer: BCBS Complete	$344.20
Rate for Payer: BCBS Trust/PPO	$1,449.66
Rate for Payer: Cash Price	$1,445.60
Rate for Payer: Cash Price	$1,445.60
Rate for Payer: Mclaren Medicaid	$327.81
Rate for Payer: Meridian Medicaid	$344.20
Rate for Payer: Priority Health Choice Medicaid	$327.81
Rate for Payer: Priority Health Cigna Priority Health	$1,264.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$819.18
Rate for Payer: Priority Health Narrow Network	$819.18
Rate for Payer: Priority Health SBD	$819.18

PR EXCISION HYDROCELE BILATERAL

Facility

$1,807.00

Service Code	CPT 55041
Hospital Charge Code	55041
Min. Negotiated Rate	$503.93
Max. Negotiated Rate	$9,906.28
Rate for Payer: Aetna Commercial	$1,535.95
Rate for Payer: Aetna Medicare	$3,201.53
Rate for Payer: Aetna New Business (MI Preferred)	$1,174.55
Rate for Payer: Allen County Amish Medical Aid Commercial	$3,847.99
Rate for Payer: Amish Plain Church Group Commercial	$3,847.99
Rate for Payer: BCBS Complete	$1,768.23
Rate for Payer: BCBS MAPPO	$3,078.39
Rate for Payer: BCBS Trust/PPO	$1,472.51
Rate for Payer: BCN Medicare Advantage	$3,078.39
Rate for Payer: Cash Price	$1,445.60
Rate for Payer: Cash Price	$1,445.60
Rate for Payer: Cofinity Commercial	$1,554.02
Rate for Payer: Cofinity Commercial	$1,264.90
Rate for Payer: Health Alliance Plan Medicare Advantage	$3,078.39
Rate for Payer: Healthscope Commercial	$1,626.30
Rate for Payer: Mclaren Medicaid	$1,683.88
Rate for Payer: Mclaren Medicare	$3,078.39
Rate for Payer: Meridian Medicaid	$1,768.23
Rate for Payer: Meridian Wellcare - Medicare Advantage	$3,232.31
Rate for Payer: MI Amish Medical Board Commercial	$3,540.15
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,535.95
Rate for Payer: PACE Medicare	$2,924.47
Rate for Payer: PACE SWMI	$3,078.39
Rate for Payer: PHP Commercial	$1,535.95
Rate for Payer: PHP Medicare Advantage	$3,078.39
Rate for Payer: Priority Health Choice Medicaid	$1,683.88
Rate for Payer: Priority Health Cigna Priority Health	$1,264.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$9,906.28
Rate for Payer: Priority Health Medicare	$3,078.39
Rate for Payer: Priority Health Narrow Network	$7,925.02
Rate for Payer: Priority Health SBD	$1,138.41
Rate for Payer: Railroad Medicare Medicare	$3,078.39
Rate for Payer: UHC All Payor (Choice/PPO)	$554.32
Rate for Payer: UHC Dual Complete DSNP	$3,078.39
Rate for Payer: UHC Exchange	$503.93
Rate for Payer: UHC Medicare Advantage	$3,170.74
Rate for Payer: VA VA	$3,078.39

PR EXCISION HYDROCELE UNILATERAL

Facility

$1,231.00

Service Code	CPT 55040
Hospital Charge Code	55040
Hospital Revenue Code	960
Min. Negotiated Rate	$775.53
Max. Negotiated Rate	$1,107.90
Rate for Payer: Aetna Commercial	$1,046.35
Rate for Payer: Aetna New Business (MI Preferred)	$800.15
Rate for Payer: Cash Price	$984.80
Rate for Payer: Cofinity Commercial	$1,058.66
Rate for Payer: Cofinity Commercial	$861.70
Rate for Payer: Healthscope Commercial	$1,107.90
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,046.35
Rate for Payer: PHP Commercial	$1,046.35
Rate for Payer: Priority Health Cigna Priority Health	$861.70
Rate for Payer: Priority Health SBD	$775.53

PR EXCISION HYDROCELE UNILATERAL

Facility

$1,231.00

Service Code	CPT 55040
Hospital Charge Code	55040
Hospital Revenue Code	960
Min. Negotiated Rate	$334.32
Max. Negotiated Rate	$9,906.28
Rate for Payer: Aetna Commercial	$1,046.35
Rate for Payer: Aetna Medicare	$3,201.53
Rate for Payer: Aetna New Business (MI Preferred)	$800.15
Rate for Payer: Allen County Amish Medical Aid Commercial	$3,847.99
Rate for Payer: Amish Plain Church Group Commercial	$3,847.99
Rate for Payer: BCBS Complete	$1,768.23
Rate for Payer: BCBS MAPPO	$3,078.39
Rate for Payer: BCBS Trust/PPO	$1,741.15
Rate for Payer: BCN Medicare Advantage	$3,078.39
Rate for Payer: Cash Price	$984.80
Rate for Payer: Cash Price	$984.80
Rate for Payer: Cofinity Commercial	$861.70
Rate for Payer: Cofinity Commercial	$1,058.66
Rate for Payer: Health Alliance Plan Medicare Advantage	$3,078.39
Rate for Payer: Healthscope Commercial	$1,107.90
Rate for Payer: Mclaren Medicaid	$1,683.88
Rate for Payer: Mclaren Medicare	$3,078.39
Rate for Payer: Meridian Medicaid	$1,768.23
Rate for Payer: Meridian Wellcare - Medicare Advantage	$3,232.31
Rate for Payer: MI Amish Medical Board Commercial	$3,540.15
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,046.35
Rate for Payer: PACE Medicare	$2,924.47
Rate for Payer: PACE SWMI	$3,078.39
Rate for Payer: PHP Commercial	$1,046.35
Rate for Payer: PHP Medicare Advantage	$3,078.39
Rate for Payer: Priority Health Choice Medicaid	$1,683.88
Rate for Payer: Priority Health Cigna Priority Health	$861.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$9,906.28
Rate for Payer: Priority Health Medicare	$3,078.39
Rate for Payer: Priority Health Narrow Network	$7,925.02
Rate for Payer: Priority Health SBD	$775.53
Rate for Payer: Railroad Medicare Medicare	$3,078.39
Rate for Payer: UHC All Payor (Choice/PPO)	$367.75
Rate for Payer: UHC Dual Complete DSNP	$3,078.39
Rate for Payer: UHC Exchange	$334.32
Rate for Payer: UHC Medicare Advantage	$3,170.74
Rate for Payer: VA VA	$3,078.39

PR EXCISION HYDROCELE UNILATERAL

Professional

Both

$1,231.00

Service Code	HCPCS 55040
Hospital Charge Code	55040
Min. Negotiated Rate	$217.47
Max. Negotiated Rate	$1,183.92
Rate for Payer: Aetna Commercial	$433.14
Rate for Payer: BCBS Complete	$228.34
Rate for Payer: BCBS Trust/PPO	$1,183.92
Rate for Payer: Cash Price	$984.80
Rate for Payer: Cash Price	$984.80
Rate for Payer: Mclaren Medicaid	$217.47
Rate for Payer: Meridian Medicaid	$228.34
Rate for Payer: Priority Health Choice Medicaid	$217.47
Rate for Payer: Priority Health Cigna Priority Health	$861.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$541.98
Rate for Payer: Priority Health Narrow Network	$541.98
Rate for Payer: Priority Health SBD	$541.98

PR EXCISION HYDROCELE UNILATERAL

Professional

Both

$1,231.00

Service Code	HCPCS 55040
Min. Negotiated Rate	$217.47
Max. Negotiated Rate	$1,183.92
Rate for Payer: Aetna Commercial	$433.14
Rate for Payer: BCBS Complete	$228.34
Rate for Payer: BCBS Trust/PPO	$1,183.92
Rate for Payer: Cash Price	$984.80
Rate for Payer: Cash Price	$984.80
Rate for Payer: Mclaren Medicaid	$217.47
Rate for Payer: Meridian Medicaid	$228.34
Rate for Payer: Priority Health Choice Medicaid	$217.47
Rate for Payer: Priority Health Cigna Priority Health	$861.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$541.98
Rate for Payer: Priority Health Narrow Network	$541.98
Rate for Payer: Priority Health SBD	$541.98

PR EXCISION INFECTED GRAFT ABDOMEN

Professional

Both

$3,964.00

Service Code	HCPCS 35907
Min. Negotiated Rate	$1,120.00
Max. Negotiated Rate	$2,949.71
Rate for Payer: Aetna Commercial	$2,561.49
Rate for Payer: BCBS Complete	$1,249.75
Rate for Payer: BCBS Trust/PPO	$1,120.00
Rate for Payer: Cash Price	$3,171.20
Rate for Payer: Cash Price	$3,171.20
Rate for Payer: Mclaren Medicaid	$1,190.24
Rate for Payer: Meridian Medicaid	$1,249.75
Rate for Payer: Priority Health Choice Medicaid	$1,190.24
Rate for Payer: Priority Health Cigna Priority Health	$2,774.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,949.71
Rate for Payer: Priority Health Narrow Network	$2,949.71
Rate for Payer: Priority Health SBD	$2,949.71

PR EXCISION INFECTED GRAFT EXTREMITY

Professional

Both

$1,966.00

Service Code	HCPCS 35903
Min. Negotiated Rate	$354.43
Max. Negotiated Rate	$1,376.20
Rate for Payer: Aetna Commercial	$757.47
Rate for Payer: BCBS Complete	$372.15
Rate for Payer: BCBS Trust/PPO	$1,048.68
Rate for Payer: Cash Price	$1,572.80
Rate for Payer: Cash Price	$1,572.80
Rate for Payer: Mclaren Medicaid	$354.43
Rate for Payer: Meridian Medicaid	$372.15
Rate for Payer: Priority Health Choice Medicaid	$354.43
Rate for Payer: Priority Health Cigna Priority Health	$1,376.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$882.52
Rate for Payer: Priority Health Narrow Network	$882.52
Rate for Payer: Priority Health SBD	$882.52

PR EXCISION INFERIOR TURBINATE PARTIAL/COMPLETE

Professional

Both

$789.00

Service Code	HCPCS 30130
Min. Negotiated Rate	$268.38
Max. Negotiated Rate	$674.64
Rate for Payer: Aetna Commercial	$522.89
Rate for Payer: BCBS Complete	$281.80
Rate for Payer: BCBS Trust/PPO	$674.64
Rate for Payer: Cash Price	$631.20
Rate for Payer: Cash Price	$631.20
Rate for Payer: Mclaren Medicaid	$268.38
Rate for Payer: Meridian Medicaid	$281.80
Rate for Payer: Priority Health Choice Medicaid	$268.38
Rate for Payer: Priority Health Cigna Priority Health	$552.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$586.68
Rate for Payer: Priority Health Narrow Network	$586.68
Rate for Payer: Priority Health SBD	$586.68

PR EXCISION INTERDIGITAL MORTON NEUROMA SINGLE EACH

Professional

Both

$869.00

Service Code	HCPCS 28080
Min. Negotiated Rate	$244.74
Max. Negotiated Rate	$1,100.45
Rate for Payer: Aetna Commercial	$488.84
Rate for Payer: BCBS Complete	$256.98
Rate for Payer: BCBS Trust/PPO	$1,100.45
Rate for Payer: Cash Price	$695.20
Rate for Payer: Cash Price	$695.20
Rate for Payer: Mclaren Medicaid	$244.74
Rate for Payer: Meridian Medicaid	$256.98
Rate for Payer: Priority Health Choice Medicaid	$244.74
Rate for Payer: Priority Health Cigna Priority Health	$608.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$576.02
Rate for Payer: Priority Health Narrow Network	$576.02
Rate for Payer: Priority Health SBD	$576.02

PR EXCISION LACTIFEROUS DUCT FISTULA

Professional

Both

$778.00

Service Code	HCPCS 19112
Min. Negotiated Rate	$12.95
Max. Negotiated Rate	$544.60
Rate for Payer: Aetna Commercial	$346.57
Rate for Payer: BCBS Complete	$219.63
Rate for Payer: BCBS Trust/PPO	$12.95
Rate for Payer: Cash Price	$622.40
Rate for Payer: Cash Price	$622.40
Rate for Payer: Mclaren Medicaid	$209.17
Rate for Payer: Meridian Medicaid	$219.63
Rate for Payer: Priority Health Choice Medicaid	$209.17
Rate for Payer: Priority Health Cigna Priority Health	$544.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$398.30
Rate for Payer: Priority Health Narrow Network	$398.30
Rate for Payer: Priority Health SBD	$398.30

PR EXCISION LESION FLOOR MOUTH

Professional

Both

$576.00

Service Code	HCPCS 41116
Min. Negotiated Rate	$139.30
Max. Negotiated Rate	$916.07
Rate for Payer: Aetna Commercial	$281.48
Rate for Payer: BCBS Complete	$146.26
Rate for Payer: BCBS Trust/PPO	$916.07
Rate for Payer: Cash Price	$460.80
Rate for Payer: Cash Price	$460.80
Rate for Payer: Mclaren Medicaid	$139.30
Rate for Payer: Meridian Medicaid	$146.26
Rate for Payer: Priority Health Choice Medicaid	$139.30
Rate for Payer: Priority Health Cigna Priority Health	$403.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$381.01
Rate for Payer: Priority Health Narrow Network	$381.01
Rate for Payer: Priority Health SBD	$381.01

PR EXCISION LESION MENISCUS/CAPSULE KNEE

Professional

Both

$2,294.00

Service Code	HCPCS 27347
Min. Negotiated Rate	$343.78
Max. Negotiated Rate	$1,605.80
Rate for Payer: Aetna Commercial	$702.81
Rate for Payer: BCBS Complete	$360.97
Rate for Payer: BCBS Trust/PPO	$1,496.67
Rate for Payer: Cash Price	$1,835.20
Rate for Payer: Cash Price	$1,835.20
Rate for Payer: Mclaren Medicaid	$343.78
Rate for Payer: Meridian Medicaid	$360.97
Rate for Payer: Priority Health Choice Medicaid	$343.78
Rate for Payer: Priority Health Cigna Priority Health	$1,605.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$816.02
Rate for Payer: Priority Health Narrow Network	$816.02
Rate for Payer: Priority Health SBD	$816.02

PR EXCISION LESION MESENTERY SEPARATE PROCEDURE

Professional

Both

$1,478.00

Service Code	HCPCS 44820
Min. Negotiated Rate	$295.85
Max. Negotiated Rate	$1,498.16
Rate for Payer: Aetna Commercial	$1,133.59
Rate for Payer: BCBS Complete	$573.44
Rate for Payer: BCBS Trust/PPO	$295.85
Rate for Payer: Cash Price	$1,182.40
Rate for Payer: Cash Price	$1,182.40
Rate for Payer: Mclaren Medicaid	$546.13
Rate for Payer: Meridian Medicaid	$573.44
Rate for Payer: Priority Health Choice Medicaid	$546.13
Rate for Payer: Priority Health Cigna Priority Health	$1,034.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,498.16
Rate for Payer: Priority Health Narrow Network	$1,498.16
Rate for Payer: Priority Health SBD	$1,498.16

PR EXCISION LESION PANCREAS

Professional

Both

$2,230.00

Service Code	HCPCS 48120
Min. Negotiated Rate	$203.40
Max. Negotiated Rate	$1,959.12
Rate for Payer: Aetna Commercial	$1,496.65
Rate for Payer: BCBS Complete	$748.11
Rate for Payer: BCBS Trust/PPO	$203.40
Rate for Payer: Cash Price	$1,784.00
Rate for Payer: Cash Price	$1,784.00
Rate for Payer: Mclaren Medicaid	$712.49
Rate for Payer: Meridian Medicaid	$748.11
Rate for Payer: Priority Health Choice Medicaid	$712.49
Rate for Payer: Priority Health Cigna Priority Health	$1,561.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,959.12
Rate for Payer: Priority Health Narrow Network	$1,959.12
Rate for Payer: Priority Health SBD	$1,959.12

PR EXCISION LESION TENDON SHEATH/CAPSULE LEG&/ANK

Professional

Both

$1,318.00

Service Code	HCPCS 27630
Min. Negotiated Rate	$231.74
Max. Negotiated Rate	$922.60
Rate for Payer: Aetna Commercial	$477.87
Rate for Payer: BCBS Complete	$243.33
Rate for Payer: BCBS Trust/PPO	$600.15
Rate for Payer: Cash Price	$1,054.40
Rate for Payer: Cash Price	$1,054.40
Rate for Payer: Mclaren Medicaid	$231.74
Rate for Payer: Meridian Medicaid	$243.33
Rate for Payer: Priority Health Choice Medicaid	$231.74
Rate for Payer: Priority Health Cigna Priority Health	$922.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$544.87
Rate for Payer: Priority Health Narrow Network	$544.87
Rate for Payer: Priority Health SBD	$544.87

PR EXCISION LESION TENDON SHEATH FOREARM&/WRIST

Professional

Both

$1,132.00

Service Code	HCPCS 25110
Min. Negotiated Rate	$212.38
Max. Negotiated Rate	$792.40
Rate for Payer: Aetna Commercial	$456.59
Rate for Payer: BCBS Complete	$238.41
Rate for Payer: BCBS Trust/PPO	$212.38
Rate for Payer: Cash Price	$905.60
Rate for Payer: Cash Price	$905.60
Rate for Payer: Mclaren Medicaid	$227.06
Rate for Payer: Meridian Medicaid	$238.41
Rate for Payer: Priority Health Choice Medicaid	$227.06
Rate for Payer: Priority Health Cigna Priority Health	$792.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$539.25
Rate for Payer: Priority Health Narrow Network	$539.25
Rate for Payer: Priority Health SBD	$539.25

Know your out-of-pocket cost for care.

All Charges