Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PR HEARING AID, PROG, BIN, BTE

Professional

Both

$5,408.00

Service Code	HCPCS V5253
Min. Negotiated Rate	$1,350.00
Max. Negotiated Rate	$3,785.60
Rate for Payer: Aetna Commercial	$1,350.00
Rate for Payer: BCBS Complete	$2,163.20
Rate for Payer: Cash Price	$4,326.40
Rate for Payer: Cash Price	$4,326.40
Rate for Payer: Priority Health Cigna Priority Health	$3,785.60

PR HEARING AID REPAIR/MODIFYING

Professional

Both

$300.00

Service Code	HCPCS V5014
Min. Negotiated Rate	$88.69
Max. Negotiated Rate	$210.00
Rate for Payer: Aetna Commercial	$88.69
Rate for Payer: Aetna Commercial	$88.69
Rate for Payer: Aetna Commercial	$88.69
Rate for Payer: BCBS Complete	$170.00
Rate for Payer: BCBS Complete	$40.00
Rate for Payer: BCBS Complete	$120.00
Rate for Payer: Cash Price	$240.00
Rate for Payer: Cash Price	$340.00
Rate for Payer: Cash Price	$240.00
Rate for Payer: Cash Price	$80.00
Rate for Payer: Cash Price	$340.00
Rate for Payer: Cash Price	$80.00
Rate for Payer: Priority Health Cigna Priority Health	$210.00
Rate for Payer: Priority Health Cigna Priority Health	$70.00
Rate for Payer: Priority Health Cigna Priority Health	$297.50

PR HEARING AID RESTOCKING FEE

Professional

Both

$130.00

Service Code	HCPCS 00663
Hospital Revenue Code	990
Min. Negotiated Rate	$52.00
Max. Negotiated Rate	$91.00
Rate for Payer: BCBS Complete	$52.00
Rate for Payer: Cash Price	$104.00
Rate for Payer: Priority Health Cigna Priority Health	$91.00

PR HEMIARTHROPLASTY HIP PARTIAL

Professional

Both

$2,287.54

Service Code	HCPCS 27125
Min. Negotiated Rate	$726.97
Max. Negotiated Rate	$1,730.08
Rate for Payer: Aetna Commercial	$1,512.35
Rate for Payer: BCBS Complete	$763.32
Rate for Payer: BCBS Trust/PPO	$984.22
Rate for Payer: Cash Price	$1,830.03
Rate for Payer: Cash Price	$1,830.03
Rate for Payer: Mclaren Medicaid	$726.97
Rate for Payer: Meridian Medicaid	$763.32
Rate for Payer: Priority Health Choice Medicaid	$726.97
Rate for Payer: Priority Health Cigna Priority Health	$1,601.28
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,730.08
Rate for Payer: Priority Health Narrow Network	$1,730.08
Rate for Payer: Priority Health SBD	$1,730.08

PR HEMIPHALANGECTOMY/INTERPHALANGEAL JOINT EXC TOE

Professional

Both

$683.00

Service Code	HCPCS 28160
Min. Negotiated Rate	$172.53
Max. Negotiated Rate	$888.60
Rate for Payer: Aetna Commercial	$351.28
Rate for Payer: BCBS Complete	$181.16
Rate for Payer: BCBS Trust/PPO	$888.60
Rate for Payer: Cash Price	$546.40
Rate for Payer: Cash Price	$546.40
Rate for Payer: Mclaren Medicaid	$172.53
Rate for Payer: Meridian Medicaid	$181.16
Rate for Payer: Priority Health Choice Medicaid	$172.53
Rate for Payer: Priority Health Cigna Priority Health	$478.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$404.95
Rate for Payer: Priority Health Narrow Network	$404.95
Rate for Payer: Priority Health SBD	$404.95

PR HEMODIALYSIS PROCEDURE W/ PHYS/QHP EVALUATION

Professional

Both

$123.00

Service Code	HCPCS 90935
Min. Negotiated Rate	$44.73
Max. Negotiated Rate	$293.73
Rate for Payer: Aetna Commercial	$80.15
Rate for Payer: BCBS Complete	$46.97
Rate for Payer: BCBS Trust/PPO	$293.73
Rate for Payer: Cash Price	$98.40
Rate for Payer: Cash Price	$98.40
Rate for Payer: Mclaren Medicaid	$44.73
Rate for Payer: Meridian Medicaid	$46.97
Rate for Payer: Priority Health Choice Medicaid	$44.73
Rate for Payer: Priority Health Cigna Priority Health	$86.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$94.77
Rate for Payer: Priority Health Narrow Network	$94.77
Rate for Payer: Priority Health SBD	$94.77

PR HEMODIALYSIS PX REPEAT EVAL W/WO REVJ DIALYS RX

Professional

Both

$584.00

Service Code	HCPCS 90937
Min. Negotiated Rate	$64.33
Max. Negotiated Rate	$408.80
Rate for Payer: Aetna Commercial	$115.20
Rate for Payer: BCBS Complete	$67.55
Rate for Payer: BCBS Trust/PPO	$314.34
Rate for Payer: Cash Price	$467.20
Rate for Payer: Cash Price	$467.20
Rate for Payer: Mclaren Medicaid	$64.33
Rate for Payer: Meridian Medicaid	$67.55
Rate for Payer: Priority Health Choice Medicaid	$64.33
Rate for Payer: Priority Health Cigna Priority Health	$408.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$134.74
Rate for Payer: Priority Health Narrow Network	$134.74
Rate for Payer: Priority Health SBD	$134.74

PR HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS

Facility

$407.00

Service Code	CPT 46221
Hospital Charge Code	46221
Min. Negotiated Rate	$256.41
Max. Negotiated Rate	$366.30
Rate for Payer: Aetna Commercial	$345.95
Rate for Payer: Aetna New Business (MI Preferred)	$264.55
Rate for Payer: Cash Price	$325.60
Rate for Payer: Cofinity Commercial	$284.90
Rate for Payer: Cofinity Commercial	$350.02
Rate for Payer: Healthscope Commercial	$366.30
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$345.95
Rate for Payer: PHP Commercial	$345.95
Rate for Payer: Priority Health Cigna Priority Health	$284.90
Rate for Payer: Priority Health SBD	$256.41

PR HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS

Facility

$407.00

Service Code	CPT 46221
Hospital Charge Code	46221
Min. Negotiated Rate	$189.92
Max. Negotiated Rate	$1,016.54
Rate for Payer: Aetna Commercial	$345.95
Rate for Payer: Aetna Medicare	$845.76
Rate for Payer: Aetna New Business (MI Preferred)	$264.55
Rate for Payer: Allen County Amish Medical Aid Commercial	$1,016.54
Rate for Payer: Amish Plain Church Group Commercial	$1,016.54
Rate for Payer: BCBS Complete	$467.12
Rate for Payer: BCBS MAPPO	$813.23
Rate for Payer: BCBS Trust/PPO	$355.27
Rate for Payer: BCN Medicare Advantage	$813.23
Rate for Payer: Cash Price	$325.60
Rate for Payer: Cash Price	$325.60
Rate for Payer: Cofinity Commercial	$350.02
Rate for Payer: Cofinity Commercial	$284.90
Rate for Payer: Health Alliance Plan Medicare Advantage	$813.23
Rate for Payer: Healthscope Commercial	$366.30
Rate for Payer: Mclaren Medicaid	$444.84
Rate for Payer: Mclaren Medicare	$813.23
Rate for Payer: Meridian Medicaid	$467.12
Rate for Payer: Meridian Wellcare - Medicare Advantage	$853.89
Rate for Payer: MI Amish Medical Board Commercial	$935.21
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$345.95
Rate for Payer: PACE Medicare	$772.57
Rate for Payer: PACE SWMI	$813.23
Rate for Payer: PHP Commercial	$345.95
Rate for Payer: PHP Medicare Advantage	$813.23
Rate for Payer: Priority Health Choice Medicaid	$444.84
Rate for Payer: Priority Health Cigna Priority Health	$284.90
Rate for Payer: Priority Health Medicare	$813.23
Rate for Payer: Priority Health SBD	$256.41
Rate for Payer: Railroad Medicare Medicare	$813.23
Rate for Payer: UHC All Payor (Choice/PPO)	$208.91
Rate for Payer: UHC Dual Complete DSNP	$813.23
Rate for Payer: UHC Exchange	$189.92
Rate for Payer: UHC Medicare Advantage	$837.63
Rate for Payer: VA VA	$813.23

PR HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS

Professional

Both

$407.00

Service Code	HCPCS 46221
Min. Negotiated Rate	$123.54
Max. Negotiated Rate	$1,246.26
Rate for Payer: Aetna Commercial	$256.42
Rate for Payer: BCBS Complete	$129.72
Rate for Payer: BCBS Trust/PPO	$1,246.26
Rate for Payer: Cash Price	$325.60
Rate for Payer: Cash Price	$325.60
Rate for Payer: Mclaren Medicaid	$123.54
Rate for Payer: Meridian Medicaid	$129.72
Rate for Payer: Priority Health Choice Medicaid	$123.54
Rate for Payer: Priority Health Cigna Priority Health	$284.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$339.26
Rate for Payer: Priority Health Narrow Network	$339.26
Rate for Payer: Priority Health SBD	$339.26

PR HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS

Professional

Both

$407.00

Service Code	HCPCS 46221
Hospital Charge Code	46221
Min. Negotiated Rate	$123.54
Max. Negotiated Rate	$1,246.26
Rate for Payer: Aetna Commercial	$256.42
Rate for Payer: BCBS Complete	$129.72
Rate for Payer: BCBS Trust/PPO	$1,246.26
Rate for Payer: Cash Price	$325.60
Rate for Payer: Cash Price	$325.60
Rate for Payer: Mclaren Medicaid	$123.54
Rate for Payer: Meridian Medicaid	$129.72
Rate for Payer: Priority Health Choice Medicaid	$123.54
Rate for Payer: Priority Health Cigna Priority Health	$284.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$339.26
Rate for Payer: Priority Health Narrow Network	$339.26
Rate for Payer: Priority Health SBD	$339.26

PR HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO

Professional

Both

$1,582.00

Service Code	HCPCS 46260
Hospital Charge Code	46260
Min. Negotiated Rate	$310.13
Max. Negotiated Rate	$2,501.50
Rate for Payer: Aetna Commercial	$644.26
Rate for Payer: BCBS Complete	$325.64
Rate for Payer: BCBS Trust/PPO	$2,501.50
Rate for Payer: Cash Price	$1,265.60
Rate for Payer: Cash Price	$1,265.60
Rate for Payer: Mclaren Medicaid	$310.13
Rate for Payer: Meridian Medicaid	$325.64
Rate for Payer: Priority Health Choice Medicaid	$310.13
Rate for Payer: Priority Health Cigna Priority Health	$1,107.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$851.39
Rate for Payer: Priority Health Narrow Network	$851.39
Rate for Payer: Priority Health SBD	$851.39

PR HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO

Facility

$1,582.00

Service Code	CPT 46260
Hospital Charge Code	46260
Hospital Revenue Code	960
Min. Negotiated Rate	$996.66
Max. Negotiated Rate	$1,423.80
Rate for Payer: Aetna Commercial	$1,344.70
Rate for Payer: Aetna New Business (MI Preferred)	$1,028.30
Rate for Payer: Cash Price	$1,265.60
Rate for Payer: Cofinity Commercial	$1,360.52
Rate for Payer: Cofinity Commercial	$1,107.40
Rate for Payer: Healthscope Commercial	$1,423.80
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,344.70
Rate for Payer: PHP Commercial	$1,344.70
Rate for Payer: Priority Health Cigna Priority Health	$1,107.40
Rate for Payer: Priority Health SBD	$996.66

PR HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO

Professional

Both

$1,582.00

Service Code	HCPCS 46260
Min. Negotiated Rate	$310.13
Max. Negotiated Rate	$2,501.50
Rate for Payer: Aetna Commercial	$644.26
Rate for Payer: BCBS Complete	$325.64
Rate for Payer: BCBS Trust/PPO	$2,501.50
Rate for Payer: Cash Price	$1,265.60
Rate for Payer: Cash Price	$1,265.60
Rate for Payer: Mclaren Medicaid	$310.13
Rate for Payer: Meridian Medicaid	$325.64
Rate for Payer: Priority Health Choice Medicaid	$310.13
Rate for Payer: Priority Health Cigna Priority Health	$1,107.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$851.39
Rate for Payer: Priority Health Narrow Network	$851.39
Rate for Payer: Priority Health SBD	$851.39

PR HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO

Facility

$1,582.00

Service Code	CPT 46260
Hospital Charge Code	46260
Hospital Revenue Code	960
Min. Negotiated Rate	$476.76
Max. Negotiated Rate	$3,122.94
Rate for Payer: Aetna Commercial	$1,344.70
Rate for Payer: Aetna Medicare	$2,598.28
Rate for Payer: Aetna New Business (MI Preferred)	$1,028.30
Rate for Payer: Allen County Amish Medical Aid Commercial	$3,122.94
Rate for Payer: Amish Plain Church Group Commercial	$3,122.94
Rate for Payer: BCBS Complete	$1,435.05
Rate for Payer: BCBS MAPPO	$2,498.35
Rate for Payer: BCBS Trust/PPO	$1,610.64
Rate for Payer: BCN Medicare Advantage	$2,498.35
Rate for Payer: Cash Price	$1,265.60
Rate for Payer: Cash Price	$1,265.60
Rate for Payer: Cofinity Commercial	$1,107.40
Rate for Payer: Cofinity Commercial	$1,360.52
Rate for Payer: Health Alliance Plan Medicare Advantage	$2,498.35
Rate for Payer: Healthscope Commercial	$1,423.80
Rate for Payer: Mclaren Medicaid	$1,366.60
Rate for Payer: Mclaren Medicare	$2,498.35
Rate for Payer: Meridian Medicaid	$1,435.05
Rate for Payer: Meridian Wellcare - Medicare Advantage	$2,623.27
Rate for Payer: MI Amish Medical Board Commercial	$2,873.10
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,344.70
Rate for Payer: PACE Medicare	$2,373.43
Rate for Payer: PACE SWMI	$2,498.35
Rate for Payer: PHP Commercial	$1,344.70
Rate for Payer: PHP Medicare Advantage	$2,498.35
Rate for Payer: Priority Health Choice Medicaid	$1,366.60
Rate for Payer: Priority Health Cigna Priority Health	$1,107.40
Rate for Payer: Priority Health Medicare	$2,498.35
Rate for Payer: Priority Health SBD	$996.66
Rate for Payer: Railroad Medicare Medicare	$2,498.35
Rate for Payer: UHC All Payor (Choice/PPO)	$524.44
Rate for Payer: UHC Dual Complete DSNP	$2,498.35
Rate for Payer: UHC Exchange	$476.76
Rate for Payer: UHC Medicare Advantage	$2,573.30
Rate for Payer: VA VA	$2,498.35

PR HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP

Professional

Both

$1,076.00

Service Code	HCPCS 46255
Min. Negotiated Rate	$228.34
Max. Negotiated Rate	$2,489.35
Rate for Payer: Aetna Commercial	$477.30
Rate for Payer: BCBS Complete	$239.76
Rate for Payer: BCBS Trust/PPO	$2,489.35
Rate for Payer: Cash Price	$860.80
Rate for Payer: Cash Price	$860.80
Rate for Payer: Mclaren Medicaid	$228.34
Rate for Payer: Meridian Medicaid	$239.76
Rate for Payer: Priority Health Choice Medicaid	$228.34
Rate for Payer: Priority Health Cigna Priority Health	$753.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$627.37
Rate for Payer: Priority Health Narrow Network	$627.37
Rate for Payer: Priority Health SBD	$627.37

PR HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP

Facility

$1,076.00

Service Code	CPT 46255
Hospital Charge Code	46255
Hospital Revenue Code	960
Min. Negotiated Rate	$677.88
Max. Negotiated Rate	$968.40
Rate for Payer: Aetna Commercial	$914.60
Rate for Payer: Aetna New Business (MI Preferred)	$699.40
Rate for Payer: Cash Price	$860.80
Rate for Payer: Cofinity Commercial	$753.20
Rate for Payer: Cofinity Commercial	$925.36
Rate for Payer: Healthscope Commercial	$968.40
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$914.60
Rate for Payer: PHP Commercial	$914.60
Rate for Payer: Priority Health Cigna Priority Health	$753.20
Rate for Payer: Priority Health SBD	$677.88

PR HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP

Professional

Both

$1,076.00

Service Code	HCPCS 46255
Hospital Charge Code	46255
Min. Negotiated Rate	$228.34
Max. Negotiated Rate	$2,489.35
Rate for Payer: Aetna Commercial	$477.30
Rate for Payer: BCBS Complete	$239.76
Rate for Payer: BCBS Trust/PPO	$2,489.35
Rate for Payer: Cash Price	$860.80
Rate for Payer: Cash Price	$860.80
Rate for Payer: Mclaren Medicaid	$228.34
Rate for Payer: Meridian Medicaid	$239.76
Rate for Payer: Priority Health Choice Medicaid	$228.34
Rate for Payer: Priority Health Cigna Priority Health	$753.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$627.37
Rate for Payer: Priority Health Narrow Network	$627.37
Rate for Payer: Priority Health SBD	$627.37

PR HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP

Facility

$1,076.00

Service Code	CPT 46255
Hospital Charge Code	46255
Hospital Revenue Code	960
Min. Negotiated Rate	$351.02
Max. Negotiated Rate	$3,122.94
Rate for Payer: Aetna Commercial	$914.60
Rate for Payer: Aetna Medicare	$2,598.28
Rate for Payer: Aetna New Business (MI Preferred)	$699.40
Rate for Payer: Allen County Amish Medical Aid Commercial	$3,122.94
Rate for Payer: Amish Plain Church Group Commercial	$3,122.94
Rate for Payer: BCBS Complete	$1,435.05
Rate for Payer: BCBS MAPPO	$2,498.35
Rate for Payer: BCBS Trust/PPO	$1,585.67
Rate for Payer: BCN Medicare Advantage	$2,498.35
Rate for Payer: Cash Price	$860.80
Rate for Payer: Cash Price	$860.80
Rate for Payer: Cofinity Commercial	$925.36
Rate for Payer: Cofinity Commercial	$753.20
Rate for Payer: Health Alliance Plan Medicare Advantage	$2,498.35
Rate for Payer: Healthscope Commercial	$968.40
Rate for Payer: Mclaren Medicaid	$1,366.60
Rate for Payer: Mclaren Medicare	$2,498.35
Rate for Payer: Meridian Medicaid	$1,435.05
Rate for Payer: Meridian Wellcare - Medicare Advantage	$2,623.27
Rate for Payer: MI Amish Medical Board Commercial	$2,873.10
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$914.60
Rate for Payer: PACE Medicare	$2,373.43
Rate for Payer: PACE SWMI	$2,498.35
Rate for Payer: PHP Commercial	$914.60
Rate for Payer: PHP Medicare Advantage	$2,498.35
Rate for Payer: Priority Health Choice Medicaid	$1,366.60
Rate for Payer: Priority Health Cigna Priority Health	$753.20
Rate for Payer: Priority Health Medicare	$2,498.35
Rate for Payer: Priority Health SBD	$677.88
Rate for Payer: Railroad Medicare Medicare	$2,498.35
Rate for Payer: UHC All Payor (Choice/PPO)	$386.12
Rate for Payer: UHC Dual Complete DSNP	$2,498.35
Rate for Payer: UHC Exchange	$351.02
Rate for Payer: UHC Medicare Advantage	$2,573.30
Rate for Payer: VA VA	$2,498.35

PR HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP

Facility

$1,107.00

Service Code	CPT 46250
Hospital Charge Code	46250
Hospital Revenue Code	960
Min. Negotiated Rate	$315.33
Max. Negotiated Rate	$3,122.94
Rate for Payer: Aetna Commercial	$940.95
Rate for Payer: Aetna Medicare	$2,598.28
Rate for Payer: Aetna New Business (MI Preferred)	$719.55
Rate for Payer: Allen County Amish Medical Aid Commercial	$3,122.94
Rate for Payer: Amish Plain Church Group Commercial	$3,122.94
Rate for Payer: BCBS Complete	$1,435.05
Rate for Payer: BCBS MAPPO	$2,498.35
Rate for Payer: BCBS Trust/PPO	$1,667.71
Rate for Payer: BCN Medicare Advantage	$2,498.35
Rate for Payer: Cash Price	$885.60
Rate for Payer: Cash Price	$885.60
Rate for Payer: Cofinity Commercial	$952.02
Rate for Payer: Cofinity Commercial	$774.90
Rate for Payer: Health Alliance Plan Medicare Advantage	$2,498.35
Rate for Payer: Healthscope Commercial	$996.30
Rate for Payer: Mclaren Medicaid	$1,366.60
Rate for Payer: Mclaren Medicare	$2,498.35
Rate for Payer: Meridian Medicaid	$1,435.05
Rate for Payer: Meridian Wellcare - Medicare Advantage	$2,623.27
Rate for Payer: MI Amish Medical Board Commercial	$2,873.10
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$940.95
Rate for Payer: PACE Medicare	$2,373.43
Rate for Payer: PACE SWMI	$2,498.35
Rate for Payer: PHP Commercial	$940.95
Rate for Payer: PHP Medicare Advantage	$2,498.35
Rate for Payer: Priority Health Choice Medicaid	$1,366.60
Rate for Payer: Priority Health Cigna Priority Health	$774.90
Rate for Payer: Priority Health Medicare	$2,498.35
Rate for Payer: Priority Health SBD	$697.41
Rate for Payer: Railroad Medicare Medicare	$2,498.35
Rate for Payer: UHC All Payor (Choice/PPO)	$346.86
Rate for Payer: UHC Dual Complete DSNP	$2,498.35
Rate for Payer: UHC Exchange	$315.33
Rate for Payer: UHC Medicare Advantage	$2,573.30
Rate for Payer: VA VA	$2,498.35

PR HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP

Professional

Both

$1,107.00

Service Code	HCPCS 46250
Min. Negotiated Rate	$205.12
Max. Negotiated Rate	$1,253.13
Rate for Payer: Aetna Commercial	$425.75
Rate for Payer: BCBS Complete	$215.38
Rate for Payer: BCBS Trust/PPO	$1,253.13
Rate for Payer: Cash Price	$885.60
Rate for Payer: Cash Price	$885.60
Rate for Payer: Mclaren Medicaid	$205.12
Rate for Payer: Meridian Medicaid	$215.38
Rate for Payer: Priority Health Choice Medicaid	$205.12
Rate for Payer: Priority Health Cigna Priority Health	$774.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$563.28
Rate for Payer: Priority Health Narrow Network	$563.28
Rate for Payer: Priority Health SBD	$563.28

PR HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP

Facility

$1,107.00

Service Code	CPT 46250
Hospital Charge Code	46250
Hospital Revenue Code	960
Min. Negotiated Rate	$697.41
Max. Negotiated Rate	$996.30
Rate for Payer: Aetna Commercial	$940.95
Rate for Payer: Aetna New Business (MI Preferred)	$719.55
Rate for Payer: Cash Price	$885.60
Rate for Payer: Cofinity Commercial	$774.90
Rate for Payer: Cofinity Commercial	$952.02
Rate for Payer: Healthscope Commercial	$996.30
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$940.95
Rate for Payer: PHP Commercial	$940.95
Rate for Payer: Priority Health Cigna Priority Health	$774.90
Rate for Payer: Priority Health SBD	$697.41

PR HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP

Professional

Both

$1,107.00

Service Code	HCPCS 46250
Hospital Charge Code	46250
Min. Negotiated Rate	$205.12
Max. Negotiated Rate	$1,253.13
Rate for Payer: Aetna Commercial	$425.75
Rate for Payer: BCBS Complete	$215.38
Rate for Payer: BCBS Trust/PPO	$1,253.13
Rate for Payer: Cash Price	$885.60
Rate for Payer: Cash Price	$885.60
Rate for Payer: Mclaren Medicaid	$205.12
Rate for Payer: Meridian Medicaid	$215.38
Rate for Payer: Priority Health Choice Medicaid	$205.12
Rate for Payer: Priority Health Cigna Priority Health	$774.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$563.28
Rate for Payer: Priority Health Narrow Network	$563.28
Rate for Payer: Priority Health SBD	$563.28

PR HEMORRHOID NTRNL & XTRNL 1 COLUMN W/FISSURECTO

Professional

Both

$728.00

Service Code	HCPCS 46257
Min. Negotiated Rate	$267.95
Max. Negotiated Rate	$1,554.26
Rate for Payer: Aetna Commercial	$570.73
Rate for Payer: BCBS Complete	$281.35
Rate for Payer: BCBS Trust/PPO	$1,554.26
Rate for Payer: Cash Price	$582.40
Rate for Payer: Cash Price	$582.40
Rate for Payer: Mclaren Medicaid	$267.95
Rate for Payer: Meridian Medicaid	$281.35
Rate for Payer: Priority Health Choice Medicaid	$267.95
Rate for Payer: Priority Health Cigna Priority Health	$509.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$734.38
Rate for Payer: Priority Health Narrow Network	$734.38
Rate for Payer: Priority Health SBD	$734.38

PR HEMORRHOIDOPEXY STAPLING

Professional

Both

$633.00

Service Code	HCPCS 46947
Min. Negotiated Rate	$250.91
Max. Negotiated Rate	$2,172.37
Rate for Payer: Aetna Commercial	$517.14
Rate for Payer: BCBS Complete	$263.46
Rate for Payer: BCBS Trust/PPO	$2,172.37
Rate for Payer: Cash Price	$506.40
Rate for Payer: Cash Price	$506.40
Rate for Payer: Mclaren Medicaid	$250.91
Rate for Payer: Meridian Medicaid	$263.46
Rate for Payer: Priority Health Choice Medicaid	$250.91
Rate for Payer: Priority Health Cigna Priority Health	$443.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$686.16
Rate for Payer: Priority Health Narrow Network	$686.16
Rate for Payer: Priority Health SBD	$686.16

Know your out-of-pocket cost for care.

All Charges