Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PR EXCISON TUMOR SOFT TISSUE THIGH/KNEE SUBQ 3 CM/>

Facility

$1,454.00

Service Code	CPT 27337
Hospital Charge Code	27337
Min. Negotiated Rate	$916.02
Max. Negotiated Rate	$1,308.60
Rate for Payer: Aetna Commercial	$1,235.90
Rate for Payer: Aetna New Business (MI Preferred)	$945.10
Rate for Payer: Cash Price	$1,163.20
Rate for Payer: Cofinity Commercial	$1,017.80
Rate for Payer: Cofinity Commercial	$1,250.44
Rate for Payer: Healthscope Commercial	$1,308.60
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,235.90
Rate for Payer: PHP Commercial	$1,235.90
Rate for Payer: Priority Health Cigna Priority Health	$1,017.80
Rate for Payer: Priority Health SBD	$916.02

PR EXCISON TUMOR SOFT TISSUE THIGH/KNEE SUBQ 3 CM/>

Facility

$1,454.00

Service Code	CPT 27337
Hospital Charge Code	27337
Min. Negotiated Rate	$417.16
Max. Negotiated Rate	$7,382.58
Rate for Payer: Aetna Commercial	$1,235.90
Rate for Payer: Aetna Medicare	$2,629.47
Rate for Payer: Aetna New Business (MI Preferred)	$945.10
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	$1,360.17
Rate for Payer: BCN Medicare Advantage	$2,528.34
Rate for Payer: Cash Price	$1,163.20
Rate for Payer: Cash Price	$1,163.20
Rate for Payer: Cofinity Commercial	$1,250.44
Rate for Payer: Cofinity Commercial	$1,017.80
Rate for Payer: Health Alliance Plan Medicare Advantage	$2,528.34
Rate for Payer: Healthscope Commercial	$1,308.60
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	$1,235.90
Rate for Payer: PACE Medicare	$2,401.92
Rate for Payer: PACE SWMI	$2,528.34
Rate for Payer: PHP Commercial	$1,235.90
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	$1,017.80
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	$916.02
Rate for Payer: Railroad Medicare Medicare	$2,528.34
Rate for Payer: UHC All Payor (Choice/PPO)	$458.88
Rate for Payer: UHC Dual Complete DSNP	$2,528.34
Rate for Payer: UHC Exchange	$417.16
Rate for Payer: UHC Medicare Advantage	$2,604.19
Rate for Payer: VA VA	$2,528.34

PR EXCISON TUMOR SOFT TISSUE THIGH/KNEE SUBQ 3 CM/>

Professional

Both

$1,454.00

Service Code	HCPCS 27337
Min. Negotiated Rate	$271.36
Max. Negotiated Rate	$1,659.39
Rate for Payer: Aetna Commercial	$560.76
Rate for Payer: BCBS Complete	$284.93
Rate for Payer: BCBS Trust/PPO	$1,659.39
Rate for Payer: Cash Price	$1,163.20
Rate for Payer: Cash Price	$1,163.20
Rate for Payer: Mclaren Medicaid	$271.36
Rate for Payer: Meridian Medicaid	$284.93
Rate for Payer: Priority Health Choice Medicaid	$271.36
Rate for Payer: Priority Health Cigna Priority Health	$1,017.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$643.93
Rate for Payer: Priority Health Narrow Network	$643.93
Rate for Payer: Priority Health SBD	$643.93

PR EXCISON TUMOR SOFT TISSUE THIGH/KNEE SUBQ 3 CM/>

Professional

Both

$1,454.00

Service Code	HCPCS 27337
Hospital Charge Code	27337
Min. Negotiated Rate	$271.36
Max. Negotiated Rate	$1,659.39
Rate for Payer: Aetna Commercial	$560.76
Rate for Payer: BCBS Complete	$284.93
Rate for Payer: BCBS Trust/PPO	$1,659.39
Rate for Payer: Cash Price	$1,163.20
Rate for Payer: Cash Price	$1,163.20
Rate for Payer: Mclaren Medicaid	$271.36
Rate for Payer: Meridian Medicaid	$284.93
Rate for Payer: Priority Health Choice Medicaid	$271.36
Rate for Payer: Priority Health Cigna Priority Health	$1,017.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$643.93
Rate for Payer: Priority Health Narrow Network	$643.93
Rate for Payer: Priority Health SBD	$643.93

PR EXC LESION ESOPHAGUS W/PRIM RPR THRC/ABDL APPR

Professional

Both

$1,833.00

Service Code	HCPCS 43101
Min. Negotiated Rate	$263.62
Max. Negotiated Rate	$1,750.39
Rate for Payer: Aetna Commercial	$1,352.24
Rate for Payer: BCBS Complete	$669.16
Rate for Payer: BCBS Trust/PPO	$263.62
Rate for Payer: Cash Price	$1,466.40
Rate for Payer: Cash Price	$1,466.40
Rate for Payer: Mclaren Medicaid	$637.30
Rate for Payer: Meridian Medicaid	$669.16
Rate for Payer: Priority Health Choice Medicaid	$637.30
Rate for Payer: Priority Health Cigna Priority Health	$1,283.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,750.39
Rate for Payer: Priority Health Narrow Network	$1,750.39
Rate for Payer: Priority Health SBD	$1,750.39

PR EXC LESION EYELID W/O CLSR/W/SIMPLE DIR CLOSURE

Professional

Both

$446.00

Service Code	HCPCS 67840
Min. Negotiated Rate	$99.47
Max. Negotiated Rate	$337.06
Rate for Payer: Aetna Commercial	$203.67
Rate for Payer: BCBS Complete	$104.44
Rate for Payer: BCBS Trust/PPO	$337.06
Rate for Payer: Cash Price	$356.80
Rate for Payer: Cash Price	$356.80
Rate for Payer: Mclaren Medicaid	$99.47
Rate for Payer: Meridian Medicaid	$104.44
Rate for Payer: Priority Health Choice Medicaid	$99.47
Rate for Payer: Priority Health Cigna Priority Health	$312.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$271.64
Rate for Payer: Priority Health Narrow Network	$271.64
Rate for Payer: Priority Health SBD	$271.64

PR EXC LESION MUCOSA&SBMCSL VESTIBULE CPLX EXC MUSC

Professional

Both

$1,199.00

Service Code	HCPCS 40816
Min. Negotiated Rate	$195.32
Max. Negotiated Rate	$839.30
Rate for Payer: Aetna Commercial	$397.82
Rate for Payer: BCBS Complete	$205.09
Rate for Payer: BCBS Trust/PPO	$726.41
Rate for Payer: Cash Price	$959.20
Rate for Payer: Cash Price	$959.20
Rate for Payer: Mclaren Medicaid	$195.32
Rate for Payer: Meridian Medicaid	$205.09
Rate for Payer: Priority Health Choice Medicaid	$195.32
Rate for Payer: Priority Health Cigna Priority Health	$839.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$533.30
Rate for Payer: Priority Health Narrow Network	$533.30
Rate for Payer: Priority Health SBD	$533.30

PR EXC LESION MUCOSA & SBMCSL VESTIBULE CPLX RPR

Professional

Both

$666.00

Service Code	HCPCS 40814
Min. Negotiated Rate	$181.48
Max. Negotiated Rate	$684.68
Rate for Payer: Aetna Commercial	$377.24
Rate for Payer: BCBS Complete	$190.55
Rate for Payer: BCBS Trust/PPO	$684.68
Rate for Payer: Cash Price	$532.80
Rate for Payer: Cash Price	$532.80
Rate for Payer: Mclaren Medicaid	$181.48
Rate for Payer: Meridian Medicaid	$190.55
Rate for Payer: Priority Health Choice Medicaid	$181.48
Rate for Payer: Priority Health Cigna Priority Health	$466.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$499.77
Rate for Payer: Priority Health Narrow Network	$499.77
Rate for Payer: Priority Health SBD	$499.77

PR EXC LESION MUCOSA & SBMCSL VESTIBULE SMPL RPR

Professional

Both

$564.00

Service Code	HCPCS 40812
Min. Negotiated Rate	$116.72
Max. Negotiated Rate	$465.43
Rate for Payer: Aetna Commercial	$245.47
Rate for Payer: BCBS Complete	$122.56
Rate for Payer: BCBS Trust/PPO	$465.43
Rate for Payer: Cash Price	$451.20
Rate for Payer: Cash Price	$451.20
Rate for Payer: Mclaren Medicaid	$116.72
Rate for Payer: Meridian Medicaid	$122.56
Rate for Payer: Priority Health Choice Medicaid	$116.72
Rate for Payer: Priority Health Cigna Priority Health	$394.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$323.39
Rate for Payer: Priority Health Narrow Network	$323.39
Rate for Payer: Priority Health SBD	$323.39

PR EXC LESION PALATE UVULA W/LOCAL FLAP CLOSURE

Professional

Both

$884.00

Service Code	HCPCS 42107
Min. Negotiated Rate	$207.46
Max. Negotiated Rate	$618.80
Rate for Payer: Aetna Commercial	$443.54
Rate for Payer: BCBS Complete	$217.83
Rate for Payer: BCBS Trust/PPO	$306.41
Rate for Payer: Cash Price	$707.20
Rate for Payer: Cash Price	$707.20
Rate for Payer: Mclaren Medicaid	$207.46
Rate for Payer: Meridian Medicaid	$217.83
Rate for Payer: Priority Health Choice Medicaid	$207.46
Rate for Payer: Priority Health Cigna Priority Health	$618.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$578.57
Rate for Payer: Priority Health Narrow Network	$578.57
Rate for Payer: Priority Health SBD	$578.57

PR EXC LESION PALATE UVULA W/O CLOSURE

Professional

Both

$377.00

Service Code	HCPCS 42104
Min. Negotiated Rate	$86.90
Max. Negotiated Rate	$1,644.60
Rate for Payer: Aetna Commercial	$176.41
Rate for Payer: BCBS Complete	$91.24
Rate for Payer: BCBS Trust/PPO	$1,644.60
Rate for Payer: Cash Price	$301.60
Rate for Payer: Cash Price	$301.60
Rate for Payer: Mclaren Medicaid	$86.90
Rate for Payer: Meridian Medicaid	$91.24
Rate for Payer: Priority Health Choice Medicaid	$86.90
Rate for Payer: Priority Health Cigna Priority Health	$263.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$237.53
Rate for Payer: Priority Health Narrow Network	$237.53
Rate for Payer: Priority Health SBD	$237.53

PR EXC LESION PALATE UVULA W/SMPL PRIM CLOSURE

Professional

Both

$496.00

Service Code	HCPCS 42106
Min. Negotiated Rate	$102.88
Max. Negotiated Rate	$1,938.86
Rate for Payer: Aetna Commercial	$217.85
Rate for Payer: BCBS Complete	$108.02
Rate for Payer: BCBS Trust/PPO	$1,938.86
Rate for Payer: Cash Price	$396.80
Rate for Payer: Cash Price	$396.80
Rate for Payer: Mclaren Medicaid	$102.88
Rate for Payer: Meridian Medicaid	$108.02
Rate for Payer: Priority Health Choice Medicaid	$102.88
Rate for Payer: Priority Health Cigna Priority Health	$347.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$285.75
Rate for Payer: Priority Health Narrow Network	$285.75
Rate for Payer: Priority Health SBD	$285.75

PR EXC LESION SPERMATIC CORD SEPARATE PROCEDURE

Professional

Both

$1,245.00

Service Code	HCPCS 55520
Min. Negotiated Rate	$295.64
Max. Negotiated Rate	$2,718.10
Rate for Payer: Aetna Commercial	$590.37
Rate for Payer: BCBS Complete	$310.42
Rate for Payer: BCBS Trust/PPO	$2,718.10
Rate for Payer: Cash Price	$996.00
Rate for Payer: Cash Price	$996.00
Rate for Payer: Mclaren Medicaid	$295.64
Rate for Payer: Meridian Medicaid	$310.42
Rate for Payer: Priority Health Choice Medicaid	$295.64
Rate for Payer: Priority Health Cigna Priority Health	$871.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$742.99
Rate for Payer: Priority Health Narrow Network	$742.99
Rate for Payer: Priority Health SBD	$742.99

PR EXC LESION TDN SHTH/JT CAPSL HAND/FNGR

Facility

$1,035.00

Service Code	CPT 26160
Hospital Charge Code	26160
Hospital Revenue Code	960
Min. Negotiated Rate	$652.05
Max. Negotiated Rate	$931.50
Rate for Payer: Aetna Commercial	$879.75
Rate for Payer: Aetna New Business (MI Preferred)	$672.75
Rate for Payer: Cash Price	$828.00
Rate for Payer: Cofinity Commercial	$724.50
Rate for Payer: Cofinity Commercial	$890.10
Rate for Payer: Healthscope Commercial	$931.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$879.75
Rate for Payer: PHP Commercial	$879.75
Rate for Payer: Priority Health Cigna Priority Health	$724.50
Rate for Payer: Priority Health SBD	$652.05

PR EXC LESION TDN SHTH/JT CAPSL HAND/FNGR

Professional

Both

$1,035.00

Service Code	HCPCS 26160
Hospital Charge Code	26160
Min. Negotiated Rate	$78.72
Max. Negotiated Rate	$724.50
Rate for Payer: Aetna Commercial	$417.83
Rate for Payer: BCBS Complete	$217.83
Rate for Payer: BCBS Trust/PPO	$78.72
Rate for Payer: Cash Price	$828.00
Rate for Payer: Cash Price	$828.00
Rate for Payer: Mclaren Medicaid	$207.46
Rate for Payer: Meridian Medicaid	$217.83
Rate for Payer: Priority Health Choice Medicaid	$207.46
Rate for Payer: Priority Health Cigna Priority Health	$724.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$490.74
Rate for Payer: Priority Health Narrow Network	$490.74
Rate for Payer: Priority Health SBD	$490.74

PR EXC LESION TDN SHTH/JT CAPSL HAND/FNGR

Facility

$1,035.00

Service Code	CPT 26160
Hospital Charge Code	26160
Hospital Revenue Code	960
Min. Negotiated Rate	$318.93
Max. Negotiated Rate	$4,301.45
Rate for Payer: Aetna Commercial	$879.75
Rate for Payer: Aetna Medicare	$1,487.28
Rate for Payer: Aetna New Business (MI Preferred)	$672.75
Rate for Payer: Allen County Amish Medical Aid Commercial	$1,787.60
Rate for Payer: Amish Plain Church Group Commercial	$1,787.60
Rate for Payer: BCBS Complete	$821.44
Rate for Payer: BCBS MAPPO	$1,430.08
Rate for Payer: BCBS Trust/PPO	$968.49
Rate for Payer: BCN Medicare Advantage	$1,430.08
Rate for Payer: Cash Price	$828.00
Rate for Payer: Cash Price	$828.00
Rate for Payer: Cofinity Commercial	$724.50
Rate for Payer: Cofinity Commercial	$890.10
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,430.08
Rate for Payer: Healthscope Commercial	$931.50
Rate for Payer: Mclaren Medicaid	$782.25
Rate for Payer: Mclaren Medicare	$1,430.08
Rate for Payer: Meridian Medicaid	$821.44
Rate for Payer: Meridian Wellcare - Medicare Advantage	$1,501.58
Rate for Payer: MI Amish Medical Board Commercial	$1,644.59
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$879.75
Rate for Payer: PACE Medicare	$1,358.58
Rate for Payer: PACE SWMI	$1,430.08
Rate for Payer: PHP Commercial	$879.75
Rate for Payer: PHP Medicare Advantage	$1,430.08
Rate for Payer: Priority Health Choice Medicaid	$782.25
Rate for Payer: Priority Health Cigna Priority Health	$724.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$4,301.45
Rate for Payer: Priority Health Medicare	$1,430.08
Rate for Payer: Priority Health Narrow Network	$3,441.16
Rate for Payer: Priority Health SBD	$652.05
Rate for Payer: Railroad Medicare Medicare	$1,430.08
Rate for Payer: UHC All Payor (Choice/PPO)	$350.82
Rate for Payer: UHC Dual Complete DSNP	$1,430.08
Rate for Payer: UHC Exchange	$318.93
Rate for Payer: UHC Medicare Advantage	$1,472.98
Rate for Payer: VA VA	$1,430.08

PR EXC LESION TDN SHTH/JT CAPSL HAND/FNGR

Professional

Both

$1,035.00

Service Code	HCPCS 26160
Min. Negotiated Rate	$78.72
Max. Negotiated Rate	$724.50
Rate for Payer: Aetna Commercial	$417.83
Rate for Payer: BCBS Complete	$217.83
Rate for Payer: BCBS Trust/PPO	$78.72
Rate for Payer: Cash Price	$828.00
Rate for Payer: Cash Price	$828.00
Rate for Payer: Mclaren Medicaid	$207.46
Rate for Payer: Meridian Medicaid	$217.83
Rate for Payer: Priority Health Choice Medicaid	$207.46
Rate for Payer: Priority Health Cigna Priority Health	$724.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$490.74
Rate for Payer: Priority Health Narrow Network	$490.74
Rate for Payer: Priority Health SBD	$490.74

PR EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT FOOT

Professional

Both

$869.00

Service Code	HCPCS 28090
Min. Negotiated Rate	$199.37
Max. Negotiated Rate	$608.30
Rate for Payer: Aetna Commercial	$404.59
Rate for Payer: BCBS Complete	$209.34
Rate for Payer: BCBS Trust/PPO	$404.15
Rate for Payer: Cash Price	$695.20
Rate for Payer: Cash Price	$695.20
Rate for Payer: Mclaren Medicaid	$199.37
Rate for Payer: Meridian Medicaid	$209.34
Rate for Payer: Priority Health Choice Medicaid	$199.37
Rate for Payer: Priority Health Cigna Priority Health	$608.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$469.79
Rate for Payer: Priority Health Narrow Network	$469.79
Rate for Payer: Priority Health SBD	$469.79

PR EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT FOOT

Professional

Both

$869.00

Service Code	HCPCS 28090
Hospital Charge Code	28090
Min. Negotiated Rate	$199.37
Max. Negotiated Rate	$608.30
Rate for Payer: Aetna Commercial	$404.59
Rate for Payer: BCBS Complete	$209.34
Rate for Payer: BCBS Trust/PPO	$404.15
Rate for Payer: Cash Price	$695.20
Rate for Payer: Cash Price	$695.20
Rate for Payer: Mclaren Medicaid	$199.37
Rate for Payer: Meridian Medicaid	$209.34
Rate for Payer: Priority Health Choice Medicaid	$199.37
Rate for Payer: Priority Health Cigna Priority Health	$608.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$469.79
Rate for Payer: Priority Health Narrow Network	$469.79
Rate for Payer: Priority Health SBD	$469.79

PR EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT FOOT

Facility

$869.00

Service Code	CPT 28090
Hospital Charge Code	28090
Hospital Revenue Code	960
Min. Negotiated Rate	$547.47
Max. Negotiated Rate	$782.10
Rate for Payer: Aetna Commercial	$738.65
Rate for Payer: Aetna New Business (MI Preferred)	$564.85
Rate for Payer: Cash Price	$695.20
Rate for Payer: Cofinity Commercial	$608.30
Rate for Payer: Cofinity Commercial	$747.34
Rate for Payer: Healthscope Commercial	$782.10
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$738.65
Rate for Payer: PHP Commercial	$738.65
Rate for Payer: Priority Health Cigna Priority Health	$608.30
Rate for Payer: Priority Health SBD	$547.47

PR EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT FOOT

Facility

$869.00

Service Code	CPT 28090
Hospital Charge Code	28090
Hospital Revenue Code	960
Min. Negotiated Rate	$306.49
Max. Negotiated Rate	$4,336.79
Rate for Payer: Aetna Commercial	$738.65
Rate for Payer: Aetna Medicare	$1,487.28
Rate for Payer: Aetna New Business (MI Preferred)	$564.85
Rate for Payer: Allen County Amish Medical Aid Commercial	$1,787.60
Rate for Payer: Amish Plain Church Group Commercial	$1,787.60
Rate for Payer: BCBS Complete	$821.44
Rate for Payer: BCBS MAPPO	$1,430.08
Rate for Payer: BCBS Trust/PPO	$1,058.03
Rate for Payer: BCN Medicare Advantage	$1,430.08
Rate for Payer: Cash Price	$695.20
Rate for Payer: Cash Price	$695.20
Rate for Payer: Cofinity Commercial	$747.34
Rate for Payer: Cofinity Commercial	$608.30
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,430.08
Rate for Payer: Healthscope Commercial	$782.10
Rate for Payer: Mclaren Medicaid	$782.25
Rate for Payer: Mclaren Medicare	$1,430.08
Rate for Payer: Meridian Medicaid	$821.44
Rate for Payer: Meridian Wellcare - Medicare Advantage	$1,501.58
Rate for Payer: MI Amish Medical Board Commercial	$1,644.59
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$738.65
Rate for Payer: PACE Medicare	$1,358.58
Rate for Payer: PACE SWMI	$1,430.08
Rate for Payer: PHP Commercial	$738.65
Rate for Payer: PHP Medicare Advantage	$1,430.08
Rate for Payer: Priority Health Choice Medicaid	$782.25
Rate for Payer: Priority Health Cigna Priority Health	$608.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$4,336.79
Rate for Payer: Priority Health Medicare	$1,430.08
Rate for Payer: Priority Health Narrow Network	$3,469.43
Rate for Payer: Priority Health SBD	$547.47
Rate for Payer: Railroad Medicare Medicare	$1,430.08
Rate for Payer: UHC All Payor (Choice/PPO)	$337.14
Rate for Payer: UHC Dual Complete DSNP	$1,430.08
Rate for Payer: UHC Exchange	$306.49
Rate for Payer: UHC Medicare Advantage	$1,472.98
Rate for Payer: VA VA	$1,430.08

PR EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT TOE EA

Professional

Both

$813.00

Service Code	HCPCS 28092
Min. Negotiated Rate	$176.36
Max. Negotiated Rate	$569.10
Rate for Payer: Aetna Commercial	$353.01
Rate for Payer: BCBS Complete	$185.18
Rate for Payer: BCBS Trust/PPO	$353.43
Rate for Payer: Cash Price	$650.40
Rate for Payer: Cash Price	$650.40
Rate for Payer: Mclaren Medicaid	$176.36
Rate for Payer: Meridian Medicaid	$185.18
Rate for Payer: Priority Health Choice Medicaid	$176.36
Rate for Payer: Priority Health Cigna Priority Health	$569.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$413.12
Rate for Payer: Priority Health Narrow Network	$413.12
Rate for Payer: Priority Health SBD	$413.12

PR EXC LESION TONGUE W/CLSR ANTERIOR TWO-THIRDS

Professional

Both

$581.00

Service Code	HCPCS 41112
Min. Negotiated Rate	$156.13
Max. Negotiated Rate	$534.11
Rate for Payer: Aetna Commercial	$318.43
Rate for Payer: BCBS Complete	$163.94
Rate for Payer: BCBS Trust/PPO	$534.11
Rate for Payer: Cash Price	$464.80
Rate for Payer: Cash Price	$464.80
Rate for Payer: Mclaren Medicaid	$156.13
Rate for Payer: Meridian Medicaid	$163.94
Rate for Payer: Priority Health Choice Medicaid	$156.13
Rate for Payer: Priority Health Cigna Priority Health	$406.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$429.23
Rate for Payer: Priority Health Narrow Network	$429.23
Rate for Payer: Priority Health SBD	$429.23

PR EXC LESION TONGUE W/CLSR POSTERIOR ONE-THIRD

Professional

Both

$742.00

Service Code	HCPCS 41113
Min. Negotiated Rate	$169.34
Max. Negotiated Rate	$569.51
Rate for Payer: Aetna Commercial	$350.99
Rate for Payer: BCBS Complete	$177.81
Rate for Payer: BCBS Trust/PPO	$569.51
Rate for Payer: Cash Price	$593.60
Rate for Payer: Cash Price	$593.60
Rate for Payer: Mclaren Medicaid	$169.34
Rate for Payer: Meridian Medicaid	$177.81
Rate for Payer: Priority Health Choice Medicaid	$169.34
Rate for Payer: Priority Health Cigna Priority Health	$519.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$467.43
Rate for Payer: Priority Health Narrow Network	$467.43
Rate for Payer: Priority Health SBD	$467.43

PR EXC LESION TONGUE W/CLSR W/LOCAL TONGUE FLAP

Professional

Both

$1,132.00

Service Code	HCPCS 41114
Min. Negotiated Rate	$398.95
Max. Negotiated Rate	$1,097.17
Rate for Payer: Aetna Commercial	$810.36
Rate for Payer: BCBS Complete	$418.90
Rate for Payer: BCBS Trust/PPO	$515.09
Rate for Payer: Cash Price	$905.60
Rate for Payer: Cash Price	$905.60
Rate for Payer: Mclaren Medicaid	$398.95
Rate for Payer: Meridian Medicaid	$418.90
Rate for Payer: Priority Health Choice Medicaid	$398.95
Rate for Payer: Priority Health Cigna Priority Health	$792.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,097.17
Rate for Payer: Priority Health Narrow Network	$1,097.17
Rate for Payer: Priority Health SBD	$1,097.17

Know your out-of-pocket cost for care.

All Charges