Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PR INITIAL PED CRITICAL CARE 2 THRU 5 YEARS

Professional

Both

$1,219.00

Service Code	HCPCS 99475
Min. Negotiated Rate	$94.66
Max. Negotiated Rate	$853.30
Rate for Payer: Aetna Commercial	$564.10
Rate for Payer: BCBS Complete	$550.97
Rate for Payer: BCBS Trust/PPO	$94.66
Rate for Payer: Cash Price	$975.20
Rate for Payer: Cash Price	$975.20
Rate for Payer: Mclaren Medicaid	$524.73
Rate for Payer: Meridian Medicaid	$550.97
Rate for Payer: Priority Health Choice Medicaid	$524.73
Rate for Payer: Priority Health Cigna Priority Health	$853.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$705.44
Rate for Payer: Priority Health Narrow Network	$705.44
Rate for Payer: Priority Health SBD	$705.44

PR INITIAL PREVENTIVE EXAM

Professional

Both

$258.00

Service Code	HCPCS G0402
Min. Negotiated Rate	$103.20
Max. Negotiated Rate	$1,427.47
Rate for Payer: Aetna Commercial	$133.40
Rate for Payer: BCBS Complete	$103.20
Rate for Payer: BCBS Trust/PPO	$1,427.47
Rate for Payer: Cash Price	$206.40
Rate for Payer: Cash Price	$206.40
Rate for Payer: Priority Health Cigna Priority Health	$180.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$169.49
Rate for Payer: Priority Health Narrow Network	$169.49
Rate for Payer: Priority Health SBD	$169.49

PR INITIAL PREVENTIVE MEDICINE NEW PATIENT <1YEAR

Professional

Both

$168.00

Service Code	HCPCS 99381
Min. Negotiated Rate	$66.69
Max. Negotiated Rate	$275.77
Rate for Payer: Aetna Commercial	$78.23
Rate for Payer: BCBS Complete	$70.02
Rate for Payer: BCBS Trust/PPO	$275.77
Rate for Payer: Cash Price	$134.40
Rate for Payer: Cash Price	$134.40
Rate for Payer: Mclaren Medicaid	$66.69
Rate for Payer: Meridian Medicaid	$70.02
Rate for Payer: Priority Health Choice Medicaid	$66.69
Rate for Payer: Priority Health Cigna Priority Health	$117.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$155.18
Rate for Payer: Priority Health Narrow Network	$155.18
Rate for Payer: Priority Health SBD	$155.18

PR INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS

Professional

Both

$217.00

Service Code	HCPCS 99386
Min. Negotiated Rate	$72.38
Max. Negotiated Rate	$151.90
Rate for Payer: Aetna Commercial	$121.06
Rate for Payer: BCBS Complete	$109.68
Rate for Payer: BCBS Trust/PPO	$72.38
Rate for Payer: Cash Price	$173.60
Rate for Payer: Cash Price	$173.60
Rate for Payer: Mclaren Medicaid	$104.46
Rate for Payer: Meridian Medicaid	$109.68
Rate for Payer: Priority Health Choice Medicaid	$104.46
Rate for Payer: Priority Health Cigna Priority Health	$151.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$147.21
Rate for Payer: Priority Health Narrow Network	$147.21
Rate for Payer: Priority Health SBD	$147.21

PR INITIAL PREVENTIVE MEDICINE NEW PATIENT 65YRS&>

Professional

Both

$235.00

Service Code	HCPCS 99387
Min. Negotiated Rate	$75.55
Max. Negotiated Rate	$164.50
Rate for Payer: Aetna Commercial	$130.25
Rate for Payer: BCBS Complete	$117.67
Rate for Payer: BCBS Trust/PPO	$75.55
Rate for Payer: Cash Price	$188.00
Rate for Payer: Cash Price	$188.00
Rate for Payer: Mclaren Medicaid	$112.07
Rate for Payer: Meridian Medicaid	$117.67
Rate for Payer: Priority Health Choice Medicaid	$112.07
Rate for Payer: Priority Health Cigna Priority Health	$164.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$158.57
Rate for Payer: Priority Health Narrow Network	$158.57
Rate for Payer: Priority Health SBD	$158.57

PR INITIAL PREVENTIVE MEDICINE NEW PT AGE 12-17 YR

Professional

Both

$192.00

Service Code	HCPCS 99384
Min. Negotiated Rate	$89.84
Max. Negotiated Rate	$445.89
Rate for Payer: Aetna Commercial	$103.72
Rate for Payer: BCBS Complete	$94.33
Rate for Payer: BCBS Trust/PPO	$445.89
Rate for Payer: Cash Price	$153.60
Rate for Payer: Cash Price	$153.60
Rate for Payer: Mclaren Medicaid	$89.84
Rate for Payer: Meridian Medicaid	$94.33
Rate for Payer: Priority Health Choice Medicaid	$89.84
Rate for Payer: Priority Health Cigna Priority Health	$134.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$126.24
Rate for Payer: Priority Health Narrow Network	$126.24
Rate for Payer: Priority Health SBD	$126.24

PR INITIAL PREVENTIVE MEDICINE NEW PT AGE 1-4 YRS

Professional

Both

$175.00

Service Code	HCPCS 99382
Min. Negotiated Rate	$71.26
Max. Negotiated Rate	$299.02
Rate for Payer: Aetna Commercial	$83.18
Rate for Payer: BCBS Complete	$74.82
Rate for Payer: BCBS Trust/PPO	$299.02
Rate for Payer: Cash Price	$140.00
Rate for Payer: Cash Price	$140.00
Rate for Payer: Mclaren Medicaid	$71.26
Rate for Payer: Meridian Medicaid	$74.82
Rate for Payer: Priority Health Choice Medicaid	$71.26
Rate for Payer: Priority Health Cigna Priority Health	$122.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$162.62
Rate for Payer: Priority Health Narrow Network	$162.62
Rate for Payer: Priority Health SBD	$162.62

PR INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS

Professional

Both

$187.00

Service Code	HCPCS 99385
Min. Negotiated Rate	$86.18
Max. Negotiated Rate	$238.26
Rate for Payer: Aetna Commercial	$99.47
Rate for Payer: BCBS Complete	$90.49
Rate for Payer: BCBS Trust/PPO	$238.26
Rate for Payer: Cash Price	$149.60
Rate for Payer: Cash Price	$149.60
Rate for Payer: Mclaren Medicaid	$86.18
Rate for Payer: Meridian Medicaid	$90.49
Rate for Payer: Priority Health Choice Medicaid	$86.18
Rate for Payer: Priority Health Cigna Priority Health	$130.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$121.44
Rate for Payer: Priority Health Narrow Network	$121.44
Rate for Payer: Priority Health SBD	$121.44

PR INITIAL PREVENTIVE MEDICINE NEW PT AGE 5-11 YRS

Professional

Both

$170.00

Service Code	HCPCS 99383
Min. Negotiated Rate	$40.68
Max. Negotiated Rate	$119.00
Rate for Payer: Aetna Commercial	$88.48
Rate for Payer: BCBS Complete	$79.30
Rate for Payer: BCBS Trust/PPO	$40.68
Rate for Payer: Cash Price	$136.00
Rate for Payer: Cash Price	$136.00
Rate for Payer: Mclaren Medicaid	$75.52
Rate for Payer: Meridian Medicaid	$79.30
Rate for Payer: Priority Health Choice Medicaid	$75.52
Rate for Payer: Priority Health Cigna Priority Health	$119.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$107.46
Rate for Payer: Priority Health Narrow Network	$107.46
Rate for Payer: Priority Health SBD	$107.46

PR INITIAL TX 1ST DEGREE BURN LOCAL TX

Professional

Both

$112.00

Service Code	HCPCS 16000
Min. Negotiated Rate	$28.97
Max. Negotiated Rate	$569.29
Rate for Payer: Aetna Commercial	$49.54
Rate for Payer: BCBS Complete	$30.42
Rate for Payer: BCBS Trust/PPO	$569.29
Rate for Payer: Cash Price	$89.60
Rate for Payer: Cash Price	$89.60
Rate for Payer: Mclaren Medicaid	$28.97
Rate for Payer: Meridian Medicaid	$30.42
Rate for Payer: Priority Health Choice Medicaid	$28.97
Rate for Payer: Priority Health Cigna Priority Health	$78.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$55.91
Rate for Payer: Priority Health Narrow Network	$55.91
Rate for Payer: Priority Health SBD	$55.91

PR INIT/SUB PSYCH CARE M 1ST 30

Professional

Both

$92.00

Service Code	HCPCS G2214
Min. Negotiated Rate	$24.28
Max. Negotiated Rate	$590.64
Rate for Payer: Aetna Commercial	$38.17
Rate for Payer: BCBS Complete	$25.49
Rate for Payer: BCBS Trust/PPO	$590.64
Rate for Payer: Cash Price	$73.60
Rate for Payer: Cash Price	$73.60
Rate for Payer: Mclaren Medicaid	$24.28
Rate for Payer: Meridian Medicaid	$25.49
Rate for Payer: Priority Health Choice Medicaid	$24.28
Rate for Payer: Priority Health Cigna Priority Health	$64.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$73.20
Rate for Payer: Priority Health Narrow Network	$73.20
Rate for Payer: Priority Health SBD	$73.20

PR INJ DEXAMETHASONE ACETATE

Professional

Both

$2.00

Service Code	HCPCS J1094
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$1.40
Rate for Payer: Aetna Commercial	$0.27
Rate for Payer: BCBS Complete	$0.80
Rate for Payer: Cash Price	$1.60
Rate for Payer: Cash Price	$1.60
Rate for Payer: Priority Health Cigna Priority Health	$1.40

PR INJ, DUROLANE 1 MG

Professional

Both

$20.67

Service Code	HCPCS J7318
Min. Negotiated Rate	$6.14
Max. Negotiated Rate	$14.47
Rate for Payer: Aetna Commercial	$6.33
Rate for Payer: BCBS Complete	$8.27
Rate for Payer: BCBS Trust/PPO	$6.14
Rate for Payer: Cash Price	$16.54
Rate for Payer: Cash Price	$16.54
Rate for Payer: Priority Health Cigna Priority Health	$14.47

PR INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS

Facility

$142.00

Service Code	CPT 20550
Hospital Charge Code	20550
Hospital Revenue Code	521
Min. Negotiated Rate	$89.46
Max. Negotiated Rate	$127.80
Rate for Payer: Aetna Commercial	$120.70
Rate for Payer: Aetna New Business (MI Preferred)	$92.30
Rate for Payer: Cash Price	$113.60
Rate for Payer: Cofinity Commercial	$122.12
Rate for Payer: Cofinity Commercial	$99.40
Rate for Payer: Healthscope Commercial	$127.80
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$120.70
Rate for Payer: PHP Commercial	$120.70
Rate for Payer: Priority Health Cigna Priority Health	$99.40
Rate for Payer: Priority Health SBD	$89.46

PR INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS

Facility

$142.00

Service Code	CPT 20550
Hospital Charge Code	20550
Hospital Revenue Code	521
Min. Negotiated Rate	$37.98
Max. Negotiated Rate	$329.42
Rate for Payer: Aetna Commercial	$120.70
Rate for Payer: Aetna Medicare	$274.08
Rate for Payer: Aetna New Business (MI Preferred)	$92.30
Rate for Payer: Allen County Amish Medical Aid Commercial	$329.42
Rate for Payer: Amish Plain Church Group Commercial	$329.42
Rate for Payer: BCBS Complete	$151.38
Rate for Payer: BCBS MAPPO	$263.54
Rate for Payer: BCBS Trust/PPO	$169.96
Rate for Payer: BCN Medicare Advantage	$263.54
Rate for Payer: Cash Price	$113.60
Rate for Payer: Cash Price	$113.60
Rate for Payer: Cofinity Commercial	$99.40
Rate for Payer: Cofinity Commercial	$122.12
Rate for Payer: Health Alliance Plan Medicare Advantage	$263.54
Rate for Payer: Healthscope Commercial	$127.80
Rate for Payer: Mclaren Medicaid	$144.16
Rate for Payer: Mclaren Medicare	$263.54
Rate for Payer: Meridian Medicaid	$151.38
Rate for Payer: Meridian Wellcare - Medicare Advantage	$276.72
Rate for Payer: MI Amish Medical Board Commercial	$303.07
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$120.70
Rate for Payer: PACE Medicare	$250.36
Rate for Payer: PACE SWMI	$263.54
Rate for Payer: PHP Commercial	$120.70
Rate for Payer: PHP Medicare Advantage	$263.54
Rate for Payer: Priority Health Choice Medicaid	$144.16
Rate for Payer: Priority Health Cigna Priority Health	$99.40
Rate for Payer: Priority Health Medicare	$263.54
Rate for Payer: Priority Health SBD	$89.46
Rate for Payer: Railroad Medicare Medicare	$263.54
Rate for Payer: UHC All Payor (Choice/PPO)	$41.78
Rate for Payer: UHC Dual Complete DSNP	$263.54
Rate for Payer: UHC Exchange	$37.98
Rate for Payer: UHC Medicare Advantage	$271.45
Rate for Payer: VA VA	$263.54

PR INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS

Professional

Both

$142.00

Service Code	HCPCS 20550
Min. Negotiated Rate	$24.71
Max. Negotiated Rate	$99.40
Rate for Payer: Aetna Commercial	$52.35
Rate for Payer: BCBS Complete	$25.95
Rate for Payer: BCBS Trust/PPO	$26.32
Rate for Payer: Cash Price	$113.60
Rate for Payer: Cash Price	$113.60
Rate for Payer: Mclaren Medicaid	$24.71
Rate for Payer: Meridian Medicaid	$25.95
Rate for Payer: Priority Health Choice Medicaid	$24.71
Rate for Payer: Priority Health Cigna Priority Health	$99.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$59.24
Rate for Payer: Priority Health Narrow Network	$59.24
Rate for Payer: Priority Health SBD	$59.24

PR INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS

Professional

Both

$142.00

Service Code	HCPCS 20550
Hospital Charge Code	20550
Min. Negotiated Rate	$24.71
Max. Negotiated Rate	$99.40
Rate for Payer: Aetna Commercial	$52.35
Rate for Payer: BCBS Complete	$25.95
Rate for Payer: BCBS Trust/PPO	$26.32
Rate for Payer: Cash Price	$113.60
Rate for Payer: Cash Price	$113.60
Rate for Payer: Mclaren Medicaid	$24.71
Rate for Payer: Meridian Medicaid	$25.95
Rate for Payer: Priority Health Choice Medicaid	$24.71
Rate for Payer: Priority Health Cigna Priority Health	$99.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$59.24
Rate for Payer: Priority Health Narrow Network	$59.24
Rate for Payer: Priority Health SBD	$59.24

PR INJECTION AA&/STRD AXILLARY NERVE W/IMG GDN

Professional

Both

$283.00

Service Code	HCPCS 64417
Min. Negotiated Rate	$40.47
Max. Negotiated Rate	$198.10
Rate for Payer: Aetna Commercial	$78.61
Rate for Payer: BCBS Complete	$42.49
Rate for Payer: BCBS Trust/PPO	$82.94
Rate for Payer: Cash Price	$226.40
Rate for Payer: Cash Price	$226.40
Rate for Payer: Mclaren Medicaid	$40.47
Rate for Payer: Meridian Medicaid	$42.49
Rate for Payer: Priority Health Choice Medicaid	$40.47
Rate for Payer: Priority Health Cigna Priority Health	$198.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$105.89
Rate for Payer: Priority Health Narrow Network	$105.89
Rate for Payer: Priority Health SBD	$105.89

PR INJECTION AA&/STRD BRACHIAL PLEXUS W/IMG GDN

Professional

Both

$514.00

Service Code	HCPCS 64415
Min. Negotiated Rate	$43.88
Max. Negotiated Rate	$547.85
Rate for Payer: Aetna Commercial	$81.83
Rate for Payer: BCBS Complete	$46.07
Rate for Payer: BCBS Trust/PPO	$547.85
Rate for Payer: Cash Price	$411.20
Rate for Payer: Cash Price	$411.20
Rate for Payer: Mclaren Medicaid	$43.88
Rate for Payer: Meridian Medicaid	$46.07
Rate for Payer: Priority Health Choice Medicaid	$43.88
Rate for Payer: Priority Health Cigna Priority Health	$359.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$116.08
Rate for Payer: Priority Health Narrow Network	$116.08
Rate for Payer: Priority Health SBD	$116.08

PR INJECTION AA&/STRD FEMORAL NERVE W/IMG GDN

Professional

Both

$180.00

Service Code	HCPCS 64447
Min. Negotiated Rate	$39.83
Max. Negotiated Rate	$2,134.86
Rate for Payer: Aetna Commercial	$68.36
Rate for Payer: BCBS Complete	$41.82
Rate for Payer: BCBS Trust/PPO	$2,134.86
Rate for Payer: Cash Price	$144.00
Rate for Payer: Cash Price	$144.00
Rate for Payer: Mclaren Medicaid	$39.83
Rate for Payer: Meridian Medicaid	$41.82
Rate for Payer: Priority Health Choice Medicaid	$39.83
Rate for Payer: Priority Health Cigna Priority Health	$126.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$105.32
Rate for Payer: Priority Health Narrow Network	$105.32
Rate for Payer: Priority Health SBD	$105.32

PR INJECTION AA&/STRD GENICULAR NRV BRANCHES W/IMG

Professional

Both

$408.00

Service Code	HCPCS 64454
Min. Negotiated Rate	$52.19
Max. Negotiated Rate	$550.49
Rate for Payer: Aetna Commercial	$104.95
Rate for Payer: BCBS Complete	$54.80
Rate for Payer: BCBS Trust/PPO	$550.49
Rate for Payer: Cash Price	$326.40
Rate for Payer: Cash Price	$326.40
Rate for Payer: Mclaren Medicaid	$52.19
Rate for Payer: Meridian Medicaid	$54.80
Rate for Payer: Priority Health Choice Medicaid	$52.19
Rate for Payer: Priority Health Cigna Priority Health	$285.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$137.03
Rate for Payer: Priority Health Narrow Network	$137.03
Rate for Payer: Priority Health SBD	$137.03

PR INJECTION AA&/STRD GENICULAR NRV BRANCHES W/IMG

Facility

$408.00

Service Code	CPT 64454
Hospital Charge Code	64454
Min. Negotiated Rate	$80.22
Max. Negotiated Rate	$769.16
Rate for Payer: Aetna Commercial	$346.80
Rate for Payer: Aetna Medicare	$639.94
Rate for Payer: Aetna New Business (MI Preferred)	$265.20
Rate for Payer: Allen County Amish Medical Aid Commercial	$769.16
Rate for Payer: Amish Plain Church Group Commercial	$769.16
Rate for Payer: BCBS Complete	$353.45
Rate for Payer: BCBS MAPPO	$615.33
Rate for Payer: BCN Medicare Advantage	$615.33
Rate for Payer: Cash Price	$326.40
Rate for Payer: Cash Price	$326.40
Rate for Payer: Cofinity Commercial	$285.60
Rate for Payer: Cofinity Commercial	$350.88
Rate for Payer: Health Alliance Plan Medicare Advantage	$615.33
Rate for Payer: Healthscope Commercial	$367.20
Rate for Payer: Mclaren Medicaid	$336.59
Rate for Payer: Mclaren Medicare	$615.33
Rate for Payer: Meridian Medicaid	$353.45
Rate for Payer: Meridian Wellcare - Medicare Advantage	$646.10
Rate for Payer: MI Amish Medical Board Commercial	$707.63
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$346.80
Rate for Payer: PACE Medicare	$584.56
Rate for Payer: PACE SWMI	$615.33
Rate for Payer: PHP Commercial	$346.80
Rate for Payer: PHP Medicare Advantage	$615.33
Rate for Payer: Priority Health Choice Medicaid	$336.59
Rate for Payer: Priority Health Cigna Priority Health	$285.60
Rate for Payer: Priority Health Medicare	$615.33
Rate for Payer: Priority Health SBD	$257.04
Rate for Payer: Railroad Medicare Medicare	$615.33
Rate for Payer: UHC All Payor (Choice/PPO)	$88.24
Rate for Payer: UHC Dual Complete DSNP	$615.33
Rate for Payer: UHC Exchange	$80.22
Rate for Payer: UHC Medicare Advantage	$633.79
Rate for Payer: VA VA	$615.33

PR INJECTION AA&/STRD GENICULAR NRV BRANCHES W/IMG

Facility

$408.00

Service Code	CPT 64454
Hospital Charge Code	64454
Min. Negotiated Rate	$257.04
Max. Negotiated Rate	$367.20
Rate for Payer: Aetna Commercial	$346.80
Rate for Payer: Aetna New Business (MI Preferred)	$265.20
Rate for Payer: Cash Price	$326.40
Rate for Payer: Cofinity Commercial	$350.88
Rate for Payer: Cofinity Commercial	$285.60
Rate for Payer: Healthscope Commercial	$367.20
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$346.80
Rate for Payer: PHP Commercial	$346.80
Rate for Payer: Priority Health Cigna Priority Health	$285.60
Rate for Payer: Priority Health SBD	$257.04

PR INJECTION AA&/STRD GENICULAR NRV BRANCHES W/IMG

Professional

Both

$408.00

Service Code	HCPCS 64454
Hospital Charge Code	64454
Min. Negotiated Rate	$52.19
Max. Negotiated Rate	$550.49
Rate for Payer: Aetna Commercial	$104.95
Rate for Payer: BCBS Complete	$54.80
Rate for Payer: BCBS Trust/PPO	$550.49
Rate for Payer: Cash Price	$326.40
Rate for Payer: Cash Price	$326.40
Rate for Payer: Mclaren Medicaid	$52.19
Rate for Payer: Meridian Medicaid	$54.80
Rate for Payer: Priority Health Choice Medicaid	$52.19
Rate for Payer: Priority Health Cigna Priority Health	$285.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$137.03
Rate for Payer: Priority Health Narrow Network	$137.03
Rate for Payer: Priority Health SBD	$137.03

PR INJECTION AA&/STRD GREATER OCCIPITAL NERVE

Facility

$492.00

Service Code	CPT 64405
Hospital Charge Code	64405
Hospital Revenue Code	361
Min. Negotiated Rate	$51.74
Max. Negotiated Rate	$878.00
Rate for Payer: Aetna Commercial	$418.20
Rate for Payer: Aetna Medicare	$274.08
Rate for Payer: Aetna New Business (MI Preferred)	$319.80
Rate for Payer: Allen County Amish Medical Aid Commercial	$329.42
Rate for Payer: Amish Plain Church Group Commercial	$329.42
Rate for Payer: BCBS Complete	$151.38
Rate for Payer: BCBS MAPPO	$263.54
Rate for Payer: BCBS Trust/PPO	$169.96
Rate for Payer: BCN Medicare Advantage	$263.54
Rate for Payer: Cash Price	$393.60
Rate for Payer: Cash Price	$393.60
Rate for Payer: Cofinity Commercial	$344.40
Rate for Payer: Cofinity Commercial	$423.12
Rate for Payer: Health Alliance Plan Medicare Advantage	$263.54
Rate for Payer: Healthscope Commercial	$442.80
Rate for Payer: Mclaren Medicaid	$144.16
Rate for Payer: Mclaren Medicare	$263.54
Rate for Payer: Meridian Medicaid	$151.38
Rate for Payer: Meridian Wellcare - Medicare Advantage	$276.72
Rate for Payer: MI Amish Medical Board Commercial	$303.07
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$418.20
Rate for Payer: PACE Medicare	$250.36
Rate for Payer: PACE SWMI	$263.54
Rate for Payer: PHP Commercial	$418.20
Rate for Payer: PHP Medicare Advantage	$263.54
Rate for Payer: Priority Health Choice Medicaid	$144.16
Rate for Payer: Priority Health Cigna Priority Health	$344.40
Rate for Payer: Priority Health Medicare	$263.54
Rate for Payer: Priority Health SBD	$309.96
Rate for Payer: Railroad Medicare Medicare	$263.54
Rate for Payer: UHC All Payor (Choice/PPO)	$56.91
Rate for Payer: UHC Core	$878.00
Rate for Payer: UHC Dual Complete DSNP	$263.54
Rate for Payer: UHC Exchange	$51.74
Rate for Payer: UHC Medicare Advantage	$271.45
Rate for Payer: VA VA	$263.54

Know your out-of-pocket cost for care.

All Charges