Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC

Facility

$39,716.35

Service Code	MSDRG 580
Min. Negotiated Rate	$13,236.71
Max. Negotiated Rate	$39,716.35
Rate for Payer: Aetna Medicare	$14,490.72
Rate for Payer: Allen County Amish Medical Aid Commercial	$17,416.72
Rate for Payer: Amish Plain Church Group Commercial	$17,416.72
Rate for Payer: BCBS MAPPO	$13,933.38
Rate for Payer: BCBS Trust/PPO	$39,716.35
Rate for Payer: BCN Commercial	$39,716.35
Rate for Payer: BCN Medicare Advantage	$13,933.38
Rate for Payer: Health Alliance Plan Medicare Advantage	$13,933.38
Rate for Payer: Mclaren Medicare	$13,933.38
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$14,630.05
Rate for Payer: MI Amish Medical Board Commercial	$16,023.39
Rate for Payer: Molina Medicare/Medicaid	$15,326.72
Rate for Payer: Nomi Health Commercial	$22,291.20
Rate for Payer: PACE Medicare	$13,236.71
Rate for Payer: PACE SWMI	$13,933.38
Rate for Payer: PHP Medicare Advantage	$13,933.38
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$27,859.06
Rate for Payer: Priority Health Medicare	$13,933.38
Rate for Payer: Priority Health Tiered Network	$22,287.24
Rate for Payer: Railroad Medicare Medicare	$13,933.38
Rate for Payer: UHC All Payor (Choice/PPO)	$28,166.40
Rate for Payer: UHC Core	$23,564.74
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$13,933.38
Rate for Payer: UHC Exchange	$19,244.74
Rate for Payer: VA VA	$13,933.38

OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC

Facility

$52,787.55

Service Code	MSDRG 579
Min. Negotiated Rate	$24,326.52
Max. Negotiated Rate	$52,787.55
Rate for Payer: Aetna Medicare	$26,631.13
Rate for Payer: Allen County Amish Medical Aid Commercial	$32,008.58
Rate for Payer: Amish Plain Church Group Commercial	$32,008.58
Rate for Payer: BCBS MAPPO	$25,606.86
Rate for Payer: BCBS Trust/PPO	$43,405.45
Rate for Payer: BCN Commercial	$43,405.45
Rate for Payer: BCN Medicare Advantage	$25,606.86
Rate for Payer: Health Alliance Plan Medicare Advantage	$25,606.86
Rate for Payer: Mclaren Medicare	$25,606.86
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$26,887.20
Rate for Payer: MI Amish Medical Board Commercial	$29,447.89
Rate for Payer: Molina Medicare/Medicaid	$28,167.55
Rate for Payer: Nomi Health Commercial	$41,776.65
Rate for Payer: PACE Medicare	$24,326.52
Rate for Payer: PACE SWMI	$25,606.86
Rate for Payer: PHP Medicare Advantage	$25,606.86
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$52,211.55
Rate for Payer: Priority Health Medicare	$25,606.86
Rate for Payer: Priority Health Tiered Network	$41,769.23
Rate for Payer: Railroad Medicare Medicare	$25,606.86
Rate for Payer: UHC All Payor (Choice/PPO)	$52,787.55
Rate for Payer: UHC Core	$44,163.42
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$25,606.86
Rate for Payer: UHC Exchange	$36,067.17
Rate for Payer: VA VA	$25,606.86

OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC

Facility

$38,363.37

Service Code	MSDRG 581
Min. Negotiated Rate	$11,145.03
Max. Negotiated Rate	$38,363.37
Rate for Payer: Aetna Medicare	$12,200.87
Rate for Payer: Allen County Amish Medical Aid Commercial	$14,664.51
Rate for Payer: Amish Plain Church Group Commercial	$14,664.51
Rate for Payer: BCBS MAPPO	$11,731.61
Rate for Payer: BCBS Trust/PPO	$38,363.37
Rate for Payer: BCN Commercial	$38,363.37
Rate for Payer: BCN Medicare Advantage	$11,731.61
Rate for Payer: Health Alliance Plan Medicare Advantage	$11,731.61
Rate for Payer: Mclaren Medicare	$11,731.61
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$12,318.19
Rate for Payer: MI Amish Medical Board Commercial	$13,491.35
Rate for Payer: Molina Medicare/Medicaid	$12,904.77
Rate for Payer: Nomi Health Commercial	$18,615.99
Rate for Payer: PACE Medicare	$11,145.03
Rate for Payer: PACE SWMI	$11,731.61
Rate for Payer: PHP Medicare Advantage	$11,731.61
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$23,265.86
Rate for Payer: Priority Health Medicare	$11,731.61
Rate for Payer: Priority Health Tiered Network	$18,612.69
Rate for Payer: Railroad Medicare Medicare	$11,731.61
Rate for Payer: UHC All Payor (Choice/PPO)	$23,522.53
Rate for Payer: UHC Core	$19,679.55
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$11,731.61
Rate for Payer: UHC Exchange	$16,071.80
Rate for Payer: VA VA	$11,731.61

OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES

Facility

$6,561.99

Service Code	APR-DRG 3642
Min. Negotiated Rate	$6,249.52
Max. Negotiated Rate	$6,561.99
Rate for Payer: BCBS Complete	$6,561.99
Rate for Payer: Mclaren Medicaid	$6,249.52
Rate for Payer: Meridian Medicaid	$6,561.99
Rate for Payer: Priority Health Choice Medicaid	$6,249.52
Rate for Payer: UHC Medicaid	$6,249.52
Rate for Payer: UHCCP Medicaid	$6,249.52

OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES

Facility

$5,504.25

Service Code	APR-DRG 3641
Min. Negotiated Rate	$5,242.15
Max. Negotiated Rate	$5,504.25
Rate for Payer: BCBS Complete	$5,504.25
Rate for Payer: Mclaren Medicaid	$5,242.15
Rate for Payer: Meridian Medicaid	$5,504.25
Rate for Payer: Priority Health Choice Medicaid	$5,242.15
Rate for Payer: UHC Medicaid	$5,242.15
Rate for Payer: UHCCP Medicaid	$5,242.15

OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES

Facility

$10,310.23

Service Code	APR-DRG 3643
Min. Negotiated Rate	$9,819.26
Max. Negotiated Rate	$10,310.23
Rate for Payer: BCBS Complete	$10,310.23
Rate for Payer: Mclaren Medicaid	$9,819.26
Rate for Payer: Meridian Medicaid	$10,310.23
Rate for Payer: Priority Health Choice Medicaid	$9,819.26
Rate for Payer: UHC Medicaid	$9,819.26
Rate for Payer: UHCCP Medicaid	$9,819.26

OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES

Facility

$13,035.12

Service Code	APR-DRG 3644
Min. Negotiated Rate	$12,414.40
Max. Negotiated Rate	$13,035.12
Rate for Payer: BCBS Complete	$13,035.12
Rate for Payer: Mclaren Medicaid	$12,414.40
Rate for Payer: Meridian Medicaid	$13,035.12
Rate for Payer: Priority Health Choice Medicaid	$12,414.40
Rate for Payer: UHC Medicaid	$12,414.40
Rate for Payer: UHCCP Medicaid	$12,414.40

OTHER SMALL AND LARGE BOWEL PROCEDURES

Facility

$11,330.70

Service Code	APR-DRG 2232
Min. Negotiated Rate	$10,791.14
Max. Negotiated Rate	$11,330.70
Rate for Payer: BCBS Complete	$11,330.70
Rate for Payer: Mclaren Medicaid	$10,791.14
Rate for Payer: Meridian Medicaid	$11,330.70
Rate for Payer: Priority Health Choice Medicaid	$10,791.14
Rate for Payer: UHC Medicaid	$10,791.14
Rate for Payer: UHCCP Medicaid	$10,791.14

OTHER SMALL AND LARGE BOWEL PROCEDURES

Facility

$20,734.54

Service Code	APR-DRG 2234
Min. Negotiated Rate	$19,747.18
Max. Negotiated Rate	$20,734.54
Rate for Payer: BCBS Complete	$20,734.54
Rate for Payer: Mclaren Medicaid	$19,747.18
Rate for Payer: Meridian Medicaid	$20,734.54
Rate for Payer: Priority Health Choice Medicaid	$19,747.18
Rate for Payer: UHC Medicaid	$19,747.18
Rate for Payer: UHCCP Medicaid	$19,747.18

OTHER SMALL AND LARGE BOWEL PROCEDURES

Facility

$7,974.60

Service Code	APR-DRG 2231
Min. Negotiated Rate	$7,594.86
Max. Negotiated Rate	$7,974.60
Rate for Payer: BCBS Complete	$7,974.60
Rate for Payer: Mclaren Medicaid	$7,594.86
Rate for Payer: Meridian Medicaid	$7,974.60
Rate for Payer: Priority Health Choice Medicaid	$7,594.86
Rate for Payer: UHC Medicaid	$7,594.86
Rate for Payer: UHCCP Medicaid	$7,594.86

OTHER SMALL AND LARGE BOWEL PROCEDURES

Facility

$11,733.73

Service Code	APR-DRG 2233
Min. Negotiated Rate	$11,174.98
Max. Negotiated Rate	$11,733.73
Rate for Payer: BCBS Complete	$11,733.73
Rate for Payer: Mclaren Medicaid	$11,174.98
Rate for Payer: Meridian Medicaid	$11,733.73
Rate for Payer: Priority Health Choice Medicaid	$11,174.98
Rate for Payer: UHC Medicaid	$11,174.98
Rate for Payer: UHCCP Medicaid	$11,174.98

OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES

Facility

$9,076.49

Service Code	APR-DRG 2222
Min. Negotiated Rate	$8,644.27
Max. Negotiated Rate	$9,076.49
Rate for Payer: BCBS Complete	$9,076.49
Rate for Payer: Mclaren Medicaid	$8,644.27
Rate for Payer: Meridian Medicaid	$9,076.49
Rate for Payer: Priority Health Choice Medicaid	$8,644.27
Rate for Payer: UHC Medicaid	$8,644.27
Rate for Payer: UHCCP Medicaid	$8,644.27

OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES

Facility

$24,902.43

Service Code	APR-DRG 2224
Min. Negotiated Rate	$23,716.60
Max. Negotiated Rate	$24,902.43
Rate for Payer: BCBS Complete	$24,902.43
Rate for Payer: Mclaren Medicaid	$23,716.60
Rate for Payer: Meridian Medicaid	$24,902.43
Rate for Payer: Priority Health Choice Medicaid	$23,716.60
Rate for Payer: UHC Medicaid	$23,716.60
Rate for Payer: UHCCP Medicaid	$23,716.60

OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES

Facility

$13,830.86

Service Code	APR-DRG 2223
Min. Negotiated Rate	$13,172.25
Max. Negotiated Rate	$13,830.86
Rate for Payer: BCBS Complete	$13,830.86
Rate for Payer: Mclaren Medicaid	$13,172.25
Rate for Payer: Meridian Medicaid	$13,830.86
Rate for Payer: Priority Health Choice Medicaid	$13,172.25
Rate for Payer: UHC Medicaid	$13,172.25
Rate for Payer: UHCCP Medicaid	$13,172.25

OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES

Facility

$5,449.22

Service Code	APR-DRG 2221
Min. Negotiated Rate	$5,189.73
Max. Negotiated Rate	$5,449.22
Rate for Payer: BCBS Complete	$5,449.22
Rate for Payer: Mclaren Medicaid	$5,189.73
Rate for Payer: Meridian Medicaid	$5,449.22
Rate for Payer: Priority Health Choice Medicaid	$5,189.73
Rate for Payer: UHC Medicaid	$5,189.73
Rate for Payer: UHCCP Medicaid	$5,189.73

OTHER UPPER VASCULAR PROCEDURES

Facility

$10,933.40

Service Code	APR-DRG 1821
Min. Negotiated Rate	$10,412.77
Max. Negotiated Rate	$10,933.40
Rate for Payer: BCBS Complete	$10,933.40
Rate for Payer: Mclaren Medicaid	$10,412.77
Rate for Payer: Meridian Medicaid	$10,933.40
Rate for Payer: Priority Health Choice Medicaid	$10,412.77
Rate for Payer: UHC Medicaid	$10,412.77
Rate for Payer: UHCCP Medicaid	$10,412.77

OTHER UPPER VASCULAR PROCEDURES

Facility

$13,304.57

Service Code	APR-DRG 1822
Min. Negotiated Rate	$12,671.02
Max. Negotiated Rate	$13,304.57
Rate for Payer: BCBS Complete	$13,304.57
Rate for Payer: Mclaren Medicaid	$12,671.02
Rate for Payer: Meridian Medicaid	$13,304.57
Rate for Payer: Priority Health Choice Medicaid	$12,671.02
Rate for Payer: UHC Medicaid	$12,671.02
Rate for Payer: UHCCP Medicaid	$12,671.02

OTHER UPPER VASCULAR PROCEDURES

Facility

$25,934.37

Service Code	APR-DRG 1824
Min. Negotiated Rate	$24,699.40
Max. Negotiated Rate	$25,934.37
Rate for Payer: BCBS Complete	$25,934.37
Rate for Payer: Mclaren Medicaid	$24,699.40
Rate for Payer: Meridian Medicaid	$25,934.37
Rate for Payer: Priority Health Choice Medicaid	$24,699.40
Rate for Payer: UHC Medicaid	$24,699.40
Rate for Payer: UHCCP Medicaid	$24,699.40

OTHER UPPER VASCULAR PROCEDURES

Facility

$16,233.56

Service Code	APR-DRG 1823
Min. Negotiated Rate	$15,460.54
Max. Negotiated Rate	$16,233.56
Rate for Payer: BCBS Complete	$16,233.56
Rate for Payer: Mclaren Medicaid	$15,460.54
Rate for Payer: Meridian Medicaid	$16,233.56
Rate for Payer: Priority Health Choice Medicaid	$15,460.54
Rate for Payer: UHC Medicaid	$15,460.54
Rate for Payer: UHCCP Medicaid	$15,460.54

OTHER VASCULAR PROCEDURES WITH CC

Facility

$48,300.07

Service Code	MSDRG 253
Min. Negotiated Rate	$19,606.47
Max. Negotiated Rate	$48,300.07
Rate for Payer: Aetna Medicare	$21,463.93
Rate for Payer: Allen County Amish Medical Aid Commercial	$25,797.99
Rate for Payer: Amish Plain Church Group Commercial	$25,797.99
Rate for Payer: BCBS MAPPO	$20,638.39
Rate for Payer: BCBS Trust/PPO	$48,300.07
Rate for Payer: BCN Commercial	$48,300.07
Rate for Payer: BCN Medicare Advantage	$20,638.39
Rate for Payer: Health Alliance Plan Medicare Advantage	$20,638.39
Rate for Payer: Mclaren Medicare	$20,638.39
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$21,670.31
Rate for Payer: MI Amish Medical Board Commercial	$23,734.15
Rate for Payer: Molina Medicare/Medicaid	$22,702.23
Rate for Payer: Nomi Health Commercial	$33,483.24
Rate for Payer: PACE Medicare	$19,606.47
Rate for Payer: PACE SWMI	$20,638.39
Rate for Payer: PHP Medicare Advantage	$20,638.39
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$41,846.63
Rate for Payer: Priority Health Medicare	$20,638.39
Rate for Payer: Priority Health Tiered Network	$33,477.30
Rate for Payer: Railroad Medicare Medicare	$20,638.39
Rate for Payer: UHC All Payor (Choice/PPO)	$42,308.28
Rate for Payer: UHC Core	$35,396.20
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$20,638.39
Rate for Payer: UHC Exchange	$28,907.20
Rate for Payer: VA VA	$20,638.39

OTHER VASCULAR PROCEDURES WITH MCC

Facility

$88,278.59

Service Code	MSDRG 252
Min. Negotiated Rate	$26,160.51
Max. Negotiated Rate	$88,278.59
Rate for Payer: Aetna Medicare	$28,638.88
Rate for Payer: Allen County Amish Medical Aid Commercial	$34,421.72
Rate for Payer: Amish Plain Church Group Commercial	$34,421.72
Rate for Payer: BCBS MAPPO	$27,537.38
Rate for Payer: BCBS Trust/PPO	$88,278.59
Rate for Payer: BCN Commercial	$88,278.59
Rate for Payer: BCN Medicare Advantage	$27,537.38
Rate for Payer: Health Alliance Plan Medicare Advantage	$27,537.38
Rate for Payer: Mclaren Medicare	$27,537.38
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$28,914.25
Rate for Payer: MI Amish Medical Board Commercial	$31,667.99
Rate for Payer: Molina Medicare/Medicaid	$30,291.12
Rate for Payer: Nomi Health Commercial	$44,999.07
Rate for Payer: PACE Medicare	$26,160.51
Rate for Payer: PACE SWMI	$27,537.38
Rate for Payer: PHP Medicare Advantage	$27,537.38
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$56,238.86
Rate for Payer: Priority Health Medicare	$27,537.38
Rate for Payer: Priority Health Tiered Network	$44,991.08
Rate for Payer: Railroad Medicare Medicare	$27,537.38
Rate for Payer: UHC All Payor (Choice/PPO)	$56,859.29
Rate for Payer: UHC Core	$47,569.95
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$27,537.38
Rate for Payer: UHC Exchange	$38,849.20
Rate for Payer: VA VA	$27,537.38

OTHER VASCULAR PROCEDURES WITHOUT CC/MCC

Facility

$34,877.92

Service Code	MSDRG 254
Min. Negotiated Rate	$13,630.96
Max. Negotiated Rate	$34,877.92
Rate for Payer: Aetna Medicare	$14,922.32
Rate for Payer: Allen County Amish Medical Aid Commercial	$17,935.47
Rate for Payer: Amish Plain Church Group Commercial	$17,935.47
Rate for Payer: BCBS MAPPO	$14,348.38
Rate for Payer: BCBS Trust/PPO	$34,877.92
Rate for Payer: BCN Commercial	$34,877.92
Rate for Payer: BCN Medicare Advantage	$14,348.38
Rate for Payer: Health Alliance Plan Medicare Advantage	$14,348.38
Rate for Payer: Mclaren Medicare	$14,348.38
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$15,065.80
Rate for Payer: MI Amish Medical Board Commercial	$16,500.64
Rate for Payer: Molina Medicare/Medicaid	$15,783.22
Rate for Payer: Nomi Health Commercial	$22,983.93
Rate for Payer: PACE Medicare	$13,630.96
Rate for Payer: PACE SWMI	$14,348.38
Rate for Payer: PHP Medicare Advantage	$14,348.38
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$28,724.82
Rate for Payer: Priority Health Medicare	$14,348.38
Rate for Payer: Priority Health Tiered Network	$22,979.85
Rate for Payer: Railroad Medicare Medicare	$14,348.38
Rate for Payer: UHC All Payor (Choice/PPO)	$29,041.71
Rate for Payer: UHC Core	$24,297.04
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$14,348.38
Rate for Payer: UHC Exchange	$19,842.79
Rate for Payer: VA VA	$14,348.38

OTITIS MEDIA AND URI WITH MCC

Facility

$19,269.86

Service Code	MSDRG 152
Min. Negotiated Rate	$9,229.56
Max. Negotiated Rate	$19,269.86
Rate for Payer: Aetna Medicare	$10,103.94
Rate for Payer: Allen County Amish Medical Aid Commercial	$12,144.16
Rate for Payer: Amish Plain Church Group Commercial	$12,144.16
Rate for Payer: BCBS MAPPO	$9,715.33
Rate for Payer: BCBS Trust/PPO	$12,087.89
Rate for Payer: BCN Commercial	$12,087.89
Rate for Payer: BCN Medicare Advantage	$9,715.33
Rate for Payer: Health Alliance Plan Medicare Advantage	$9,715.33
Rate for Payer: Mclaren Medicare	$9,715.33
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$10,201.10
Rate for Payer: MI Amish Medical Board Commercial	$11,172.63
Rate for Payer: Molina Medicare/Medicaid	$10,686.86
Rate for Payer: Nomi Health Commercial	$15,250.38
Rate for Payer: PACE Medicare	$9,229.56
Rate for Payer: PACE SWMI	$9,715.33
Rate for Payer: PHP Medicare Advantage	$9,715.33
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$19,059.59
Rate for Payer: Priority Health Medicare	$9,715.33
Rate for Payer: Priority Health Tiered Network	$15,247.67
Rate for Payer: Railroad Medicare Medicare	$9,715.33
Rate for Payer: UHC All Payor (Choice/PPO)	$19,269.86
Rate for Payer: UHC Core	$16,121.66
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$9,715.33
Rate for Payer: UHC Exchange	$13,166.16
Rate for Payer: VA VA	$9,715.33

OTITIS MEDIA AND URI WITHOUT MCC

Facility

$12,032.66

Service Code	MSDRG 153
Min. Negotiated Rate	$5,969.79
Max. Negotiated Rate	$12,032.66
Rate for Payer: Aetna Medicare	$6,535.35
Rate for Payer: Allen County Amish Medical Aid Commercial	$7,854.99
Rate for Payer: Amish Plain Church Group Commercial	$7,854.99
Rate for Payer: BCBS MAPPO	$6,283.99
Rate for Payer: BCBS Trust/PPO	$8,366.02
Rate for Payer: BCN Commercial	$8,366.02
Rate for Payer: BCN Medicare Advantage	$6,283.99
Rate for Payer: Health Alliance Plan Medicare Advantage	$6,283.99
Rate for Payer: Mclaren Medicare	$6,283.99
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$6,598.19
Rate for Payer: MI Amish Medical Board Commercial	$7,226.59
Rate for Payer: Molina Medicare/Medicaid	$6,912.39
Rate for Payer: Nomi Health Commercial	$9,522.78
Rate for Payer: PACE Medicare	$5,969.79
Rate for Payer: PACE SWMI	$6,283.99
Rate for Payer: PHP Medicare Advantage	$6,283.99
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$11,901.36
Rate for Payer: Priority Health Medicare	$6,283.99
Rate for Payer: Priority Health Tiered Network	$9,521.09
Rate for Payer: Railroad Medicare Medicare	$6,283.99
Rate for Payer: UHC All Payor (Choice/PPO)	$12,032.66
Rate for Payer: UHC Core	$10,066.83
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$6,283.99
Rate for Payer: UHC Exchange	$8,221.33
Rate for Payer: VA VA	$6,283.99

OTOLARYNGOLOGIC EXAMINATION UNDER GENERAL ANESTHESIA

Facility

$1,737.88

Service Code	CPT 92502
Hospital Revenue Code	360
Min. Negotiated Rate	$281.05
Max. Negotiated Rate	$1,737.88
Rate for Payer: Aetna Medicare	$558.89
Rate for Payer: Allen County Amish Medical Aid Commercial	$671.74
Rate for Payer: Amish Plain Church Group Commercial	$671.74
Rate for Payer: BCBS Complete	$295.13
Rate for Payer: BCBS MAPPO	$537.39
Rate for Payer: BCBS Trust/PPO	$303.89
Rate for Payer: BCN Commercial	$303.89
Rate for Payer: BCN Medicare Advantage	$537.39
Rate for Payer: Health Alliance Plan Medicare Advantage	$537.39
Rate for Payer: Mclaren Medicaid	$281.05
Rate for Payer: Mclaren Medicare	$537.39
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$564.26
Rate for Payer: Meridian Medicaid	$564.26
Rate for Payer: MI Amish Medical Board Commercial	$618.00
Rate for Payer: Molina Medicare/Medicaid	$591.13
Rate for Payer: Nomi Health Commercial	$1,612.17
Rate for Payer: PACE Medicare	$510.52
Rate for Payer: PACE SWMI	$537.39
Rate for Payer: PHP Medicare Advantage	$537.39
Rate for Payer: Priority Health Choice Medicaid	$281.05
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$1,737.88
Rate for Payer: Priority Health Medicare	$537.39
Rate for Payer: Priority Health Tiered Network	$1,390.30
Rate for Payer: Railroad Medicare Medicare	$537.39
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$537.39
Rate for Payer: UHC Medicaid	$281.05
Rate for Payer: UHCCP Medicaid	$281.05
Rate for Payer: VA VA	$537.39

Know your out-of-pocket cost for care.

All Charges