Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PR LAPAROSCOPY W TOTAL HYSTERECTOMY UTERUS 250 GM/<

Professional

Both

$2,426.00

Service Code	HCPCS 58570
Min. Negotiated Rate	$2.14
Max. Negotiated Rate	$1,698.20
Rate for Payer: Aetna Commercial	$956.81
Rate for Payer: BCBS Complete	$544.81
Rate for Payer: BCBS Trust/PPO	$2.14
Rate for Payer: Cash Price	$1,940.80
Rate for Payer: Cash Price	$1,940.80
Rate for Payer: Mclaren Medicaid	$518.87
Rate for Payer: Meridian Medicaid	$544.81
Rate for Payer: Priority Health Choice Medicaid	$518.87
Rate for Payer: Priority Health Cigna Priority Health	$1,698.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,147.11
Rate for Payer: Priority Health Narrow Network	$1,147.11
Rate for Payer: Priority Health SBD	$1,147.11

PR LAP RPR HRNA XCPT INCAL/INGUN NCRC8/STRANGULATED

Professional

Both

$2,766.00

Service Code	HCPCS 49654
Min. Negotiated Rate	$1,106.40
Max. Negotiated Rate	$1,936.20
Rate for Payer: BCBS Complete	$1,106.40
Rate for Payer: Cash Price	$2,212.80
Rate for Payer: Priority Health Cigna Priority Health	$1,936.20

PR LAP RPR HRNA XCPT INCAL/INGUN NCRC8/STRANGULATED

Professional

Both

$3,055.00

Service Code	HCPCS 49653
Min. Negotiated Rate	$1,222.00
Max. Negotiated Rate	$2,138.50
Rate for Payer: BCBS Complete	$1,222.00
Rate for Payer: Cash Price	$2,444.00
Rate for Payer: Priority Health Cigna Priority Health	$2,138.50

PR LAPS ABD PRTM&OMENTUM DX W/WO SPEC BR/WA SPX

Professional

Both

$1,379.00

Service Code	HCPCS 49320
Hospital Charge Code	49320
Min. Negotiated Rate	$211.72
Max. Negotiated Rate	$1,309.66
Rate for Payer: Aetna Commercial	$441.92
Rate for Payer: BCBS Complete	$222.31
Rate for Payer: BCBS Trust/PPO	$1,309.66
Rate for Payer: Cash Price	$1,103.20
Rate for Payer: Cash Price	$1,103.20
Rate for Payer: Mclaren Medicaid	$211.72
Rate for Payer: Meridian Medicaid	$222.31
Rate for Payer: Priority Health Choice Medicaid	$211.72
Rate for Payer: Priority Health Cigna Priority Health	$965.30
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 LAPS ABD PRTM&OMENTUM DX W/WO SPEC BR/WA SPX

Facility

$1,379.00

Service Code	CPT 49320
Hospital Charge Code	49320
Hospital Revenue Code	960
Min. Negotiated Rate	$868.77
Max. Negotiated Rate	$1,241.10
Rate for Payer: Aetna Commercial	$1,172.15
Rate for Payer: Aetna New Business (MI Preferred)	$896.35
Rate for Payer: Cash Price	$1,103.20
Rate for Payer: Cofinity Commercial	$1,185.94
Rate for Payer: Cofinity Commercial	$965.30
Rate for Payer: Healthscope Commercial	$1,241.10
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,172.15
Rate for Payer: PHP Commercial	$1,172.15
Rate for Payer: Priority Health Cigna Priority Health	$965.30
Rate for Payer: Priority Health SBD	$868.77

PR LAPS ABD PRTM&OMENTUM DX W/WO SPEC BR/WA SPX

Facility

$1,379.00

Service Code	CPT 49320
Hospital Charge Code	49320
Hospital Revenue Code	960
Min. Negotiated Rate	$325.48
Max. Negotiated Rate	$15,754.72
Rate for Payer: Aetna Commercial	$1,172.15
Rate for Payer: Aetna Medicare	$5,339.45
Rate for Payer: Aetna New Business (MI Preferred)	$896.35
Rate for Payer: Allen County Amish Medical Aid Commercial	$6,417.61
Rate for Payer: Amish Plain Church Group Commercial	$6,417.61
Rate for Payer: BCBS Complete	$2,949.02
Rate for Payer: BCBS MAPPO	$5,134.09
Rate for Payer: BCBS Trust/PPO	$2,308.45
Rate for Payer: BCN Medicare Advantage	$5,134.09
Rate for Payer: Cash Price	$1,103.20
Rate for Payer: Cash Price	$1,103.20
Rate for Payer: Cofinity Commercial	$965.30
Rate for Payer: Cofinity Commercial	$1,185.94
Rate for Payer: Health Alliance Plan Medicare Advantage	$5,134.09
Rate for Payer: Healthscope Commercial	$1,241.10
Rate for Payer: Mclaren Medicaid	$2,808.35
Rate for Payer: Mclaren Medicare	$5,134.09
Rate for Payer: Meridian Medicaid	$2,949.02
Rate for Payer: Meridian Wellcare - Medicare Advantage	$5,390.79
Rate for Payer: MI Amish Medical Board Commercial	$5,904.20
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,172.15
Rate for Payer: PACE Medicare	$4,877.39
Rate for Payer: PACE SWMI	$5,134.09
Rate for Payer: PHP Commercial	$1,172.15
Rate for Payer: PHP Medicare Advantage	$5,134.09
Rate for Payer: Priority Health Choice Medicaid	$2,808.35
Rate for Payer: Priority Health Cigna Priority Health	$965.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$15,754.72
Rate for Payer: Priority Health Medicare	$5,134.09
Rate for Payer: Priority Health Narrow Network	$12,603.78
Rate for Payer: Priority Health SBD	$868.77
Rate for Payer: Railroad Medicare Medicare	$5,134.09
Rate for Payer: UHC All Payor (Choice/PPO)	$358.03
Rate for Payer: UHC Dual Complete DSNP	$5,134.09
Rate for Payer: UHC Exchange	$325.48
Rate for Payer: UHC Medicare Advantage	$5,288.11
Rate for Payer: VA VA	$5,134.09

PR LAPS ABD PRTM&OMENTUM DX W/WO SPEC BR/WA SPX

Professional

Both

$1,379.00

Service Code	HCPCS 49320
Min. Negotiated Rate	$211.72
Max. Negotiated Rate	$1,309.66
Rate for Payer: Aetna Commercial	$441.92
Rate for Payer: BCBS Complete	$222.31
Rate for Payer: BCBS Trust/PPO	$1,309.66
Rate for Payer: Cash Price	$1,103.20
Rate for Payer: Cash Price	$1,103.20
Rate for Payer: Mclaren Medicaid	$211.72
Rate for Payer: Meridian Medicaid	$222.31
Rate for Payer: Priority Health Choice Medicaid	$211.72
Rate for Payer: Priority Health Cigna Priority Health	$965.30
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 LAPS ABLTJ RENAL MASS LESION W/INTRAOP US

Professional

Both

$2,074.00

Service Code	HCPCS 50542
Min. Negotiated Rate	$735.28
Max. Negotiated Rate	$3,188.29
Rate for Payer: Aetna Commercial	$1,499.49
Rate for Payer: BCBS Complete	$772.04
Rate for Payer: BCBS Trust/PPO	$3,188.29
Rate for Payer: Cash Price	$1,659.20
Rate for Payer: Cash Price	$1,659.20
Rate for Payer: Mclaren Medicaid	$735.28
Rate for Payer: Meridian Medicaid	$772.04
Rate for Payer: Priority Health Choice Medicaid	$735.28
Rate for Payer: Priority Health Cigna Priority Health	$1,451.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,856.14
Rate for Payer: Priority Health Narrow Network	$1,856.14
Rate for Payer: Priority Health SBD	$1,856.14

PR LAPS BI TOT PEL LMPHADEC & PRI-AORTIC LYMPH BX 1

Professional

Both

$1,832.00

Service Code	HCPCS 38572
Min. Negotiated Rate	$503.47
Max. Negotiated Rate	$1,950.65
Rate for Payer: Aetna Commercial	$1,126.54
Rate for Payer: BCBS Complete	$602.07
Rate for Payer: BCBS Trust/PPO	$503.47
Rate for Payer: Cash Price	$1,465.60
Rate for Payer: Cash Price	$1,465.60
Rate for Payer: Mclaren Medicaid	$573.40
Rate for Payer: Meridian Medicaid	$602.07
Rate for Payer: Priority Health Choice Medicaid	$573.40
Rate for Payer: Priority Health Cigna Priority Health	$1,282.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,950.65
Rate for Payer: Priority Health Narrow Network	$1,950.65
Rate for Payer: Priority Health SBD	$1,950.65

PR LAPS CLSR NTRSTM LG/SM INT W/RESCJ & ANASTOMOSIS

Professional

Both

$3,758.00

Service Code	HCPCS 44227
Min. Negotiated Rate	$1,051.58
Max. Negotiated Rate	$2,894.01
Rate for Payer: Aetna Commercial	$2,238.05
Rate for Payer: BCBS Complete	$1,104.16
Rate for Payer: BCBS Trust/PPO	$1,489.81
Rate for Payer: Cash Price	$3,006.40
Rate for Payer: Cash Price	$3,006.40
Rate for Payer: Mclaren Medicaid	$1,051.58
Rate for Payer: Meridian Medicaid	$1,104.16
Rate for Payer: Priority Health Choice Medicaid	$1,051.58
Rate for Payer: Priority Health Cigna Priority Health	$2,630.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,894.01
Rate for Payer: Priority Health Narrow Network	$2,894.01
Rate for Payer: Priority Health SBD	$2,894.01

PR LAPS COLCT TTL ABD W/PRCTECT ILEOANAL ANASTOMSIS

Professional

Both

$6,185.00

Service Code	HCPCS 44211
Min. Negotiated Rate	$1,335.51
Max. Negotiated Rate	$4,329.50
Rate for Payer: Aetna Commercial	$2,816.64
Rate for Payer: BCBS Complete	$1,402.29
Rate for Payer: BCBS Trust/PPO	$1,775.09
Rate for Payer: Cash Price	$4,948.00
Rate for Payer: Cash Price	$4,948.00
Rate for Payer: Mclaren Medicaid	$1,335.51
Rate for Payer: Meridian Medicaid	$1,402.29
Rate for Payer: Priority Health Choice Medicaid	$1,335.51
Rate for Payer: Priority Health Cigna Priority Health	$4,329.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$3,674.24
Rate for Payer: Priority Health Narrow Network	$3,674.24
Rate for Payer: Priority Health SBD	$3,674.24

PR LAPS COLECTMY PRTL W/COLOPXTSTMY LW ANAST W/CLST

Professional

Both

$4,570.00

Service Code	HCPCS 44208
Min. Negotiated Rate	$1,248.61
Max. Negotiated Rate	$3,433.76
Rate for Payer: Aetna Commercial	$2,648.24
Rate for Payer: BCBS Complete	$1,311.04
Rate for Payer: BCBS Trust/PPO	$1,882.86
Rate for Payer: Cash Price	$3,656.00
Rate for Payer: Cash Price	$3,656.00
Rate for Payer: Mclaren Medicaid	$1,248.61
Rate for Payer: Meridian Medicaid	$1,311.04
Rate for Payer: Priority Health Choice Medicaid	$1,248.61
Rate for Payer: Priority Health Cigna Priority Health	$3,199.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$3,433.76
Rate for Payer: Priority Health Narrow Network	$3,433.76
Rate for Payer: Priority Health SBD	$3,433.76

PR LAPS COLECTOMY ABDL W/PROCTECTOMY W/ILEOSTOMY

Professional

Both

$6,139.00

Service Code	HCPCS 44212
Min. Negotiated Rate	$994.79
Max. Negotiated Rate	$4,297.30
Rate for Payer: Aetna Commercial	$2,718.21
Rate for Payer: BCBS Complete	$1,344.81
Rate for Payer: BCBS Trust/PPO	$994.79
Rate for Payer: Cash Price	$4,911.20
Rate for Payer: Cash Price	$4,911.20
Rate for Payer: Mclaren Medicaid	$1,280.77
Rate for Payer: Meridian Medicaid	$1,344.81
Rate for Payer: Priority Health Choice Medicaid	$1,280.77
Rate for Payer: Priority Health Cigna Priority Health	$4,297.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$3,520.20
Rate for Payer: Priority Health Narrow Network	$3,520.20
Rate for Payer: Priority Health SBD	$3,520.20

PR LAPS COLECTOMY PRTL W/COLOPXTSTMY LW ANAST

Professional

Both

$4,502.00

Service Code	HCPCS 44207
Min. Negotiated Rate	$1,146.79
Max. Negotiated Rate	$3,154.48
Rate for Payer: Aetna Commercial	$2,434.39
Rate for Payer: BCBS Complete	$1,204.13
Rate for Payer: BCBS Trust/PPO	$1,992.75
Rate for Payer: Cash Price	$3,601.60
Rate for Payer: Cash Price	$3,601.60
Rate for Payer: Mclaren Medicaid	$1,146.79
Rate for Payer: Meridian Medicaid	$1,204.13
Rate for Payer: Priority Health Choice Medicaid	$1,146.79
Rate for Payer: Priority Health Cigna Priority Health	$3,151.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$3,154.48
Rate for Payer: Priority Health Narrow Network	$3,154.48
Rate for Payer: Priority Health SBD	$3,154.48

PR LAPS COLECTOMY PRTL W/END CLST & CLSR DSTL SGM

Professional

Both

$4,643.00

Service Code	HCPCS 44206
Min. Negotiated Rate	$1,105.04
Max. Negotiated Rate	$3,250.10
Rate for Payer: Aetna Commercial	$2,349.86
Rate for Payer: BCBS Complete	$1,160.29
Rate for Payer: BCBS Trust/PPO	$1,931.99
Rate for Payer: Cash Price	$3,714.40
Rate for Payer: Cash Price	$3,714.40
Rate for Payer: Mclaren Medicaid	$1,105.04
Rate for Payer: Meridian Medicaid	$1,160.29
Rate for Payer: Priority Health Choice Medicaid	$1,105.04
Rate for Payer: Priority Health Cigna Priority Health	$3,250.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$3,038.64
Rate for Payer: Priority Health Narrow Network	$3,038.64
Rate for Payer: Priority Health SBD	$3,038.64

PR LAPS COLECTOMY PRTL W/RMVL TERMINAL ILEUM

Professional

Both

$4,117.00

Service Code	HCPCS 44205
Min. Negotiated Rate	$846.89
Max. Negotiated Rate	$2,881.90
Rate for Payer: Aetna Commercial	$1,793.71
Rate for Payer: BCBS Complete	$889.23
Rate for Payer: BCBS Trust/PPO	$1,868.07
Rate for Payer: Cash Price	$3,293.60
Rate for Payer: Cash Price	$3,293.60
Rate for Payer: Mclaren Medicaid	$846.89
Rate for Payer: Meridian Medicaid	$889.23
Rate for Payer: Priority Health Choice Medicaid	$846.89
Rate for Payer: Priority Health Cigna Priority Health	$2,881.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,329.55
Rate for Payer: Priority Health Narrow Network	$2,329.55
Rate for Payer: Priority Health SBD	$2,329.55

PR LAPS COLECTOMY TOT W/O PRCTECT W/ILEOST/ILEOPXTS

Professional

Both

$5,178.00

Service Code	HCPCS 44210
Min. Negotiated Rate	$1,121.66
Max. Negotiated Rate	$3,624.60
Rate for Payer: Aetna Commercial	$2,365.94
Rate for Payer: BCBS Complete	$1,177.74
Rate for Payer: BCBS Trust/PPO	$1,790.41
Rate for Payer: Cash Price	$4,142.40
Rate for Payer: Cash Price	$4,142.40
Rate for Payer: Mclaren Medicaid	$1,121.66
Rate for Payer: Meridian Medicaid	$1,177.74
Rate for Payer: Priority Health Choice Medicaid	$1,121.66
Rate for Payer: Priority Health Cigna Priority Health	$3,624.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$3,085.09
Rate for Payer: Priority Health Narrow Network	$3,085.09
Rate for Payer: Priority Health SBD	$3,085.09

PR LAPS ENTERECT RESCJ 1 SMALL INTEST RESCJ & ANA

Professional

Both

$4,561.00

Service Code	HCPCS 44202
Hospital Charge Code	44202
Min. Negotiated Rate	$764.98
Max. Negotiated Rate	$3,192.70
Rate for Payer: Aetna Commercial	$1,868.47
Rate for Payer: BCBS Complete	$928.15
Rate for Payer: BCBS Trust/PPO	$764.98
Rate for Payer: Cash Price	$3,648.80
Rate for Payer: Cash Price	$3,648.80
Rate for Payer: Mclaren Medicaid	$883.95
Rate for Payer: Meridian Medicaid	$928.15
Rate for Payer: Priority Health Choice Medicaid	$883.95
Rate for Payer: Priority Health Cigna Priority Health	$3,192.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,430.10
Rate for Payer: Priority Health Narrow Network	$2,430.10
Rate for Payer: Priority Health SBD	$2,430.10

PR LAPS ENTERECT RESCJ 1 SMALL INTEST RESCJ & ANA

Facility

$4,561.00

Service Code	CPT 44202
Hospital Charge Code	44202
Min. Negotiated Rate	$2,873.43
Max. Negotiated Rate	$4,104.90
Rate for Payer: Aetna Commercial	$3,876.85
Rate for Payer: Aetna New Business (MI Preferred)	$2,964.65
Rate for Payer: Cash Price	$3,648.80
Rate for Payer: Cofinity Commercial	$3,192.70
Rate for Payer: Cofinity Commercial	$3,922.46
Rate for Payer: Healthscope Commercial	$4,104.90
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3,876.85
Rate for Payer: PHP Commercial	$3,876.85
Rate for Payer: Priority Health Cigna Priority Health	$3,192.70
Rate for Payer: Priority Health SBD	$2,873.43

PR LAPS ENTERECT RESCJ 1 SMALL INTEST RESCJ & ANA

Professional

Both

$4,561.00

Service Code	HCPCS 44202
Min. Negotiated Rate	$764.98
Max. Negotiated Rate	$3,192.70
Rate for Payer: Aetna Commercial	$1,868.47
Rate for Payer: BCBS Complete	$928.15
Rate for Payer: BCBS Trust/PPO	$764.98
Rate for Payer: Cash Price	$3,648.80
Rate for Payer: Cash Price	$3,648.80
Rate for Payer: Mclaren Medicaid	$883.95
Rate for Payer: Meridian Medicaid	$928.15
Rate for Payer: Priority Health Choice Medicaid	$883.95
Rate for Payer: Priority Health Cigna Priority Health	$3,192.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,430.10
Rate for Payer: Priority Health Narrow Network	$2,430.10
Rate for Payer: Priority Health SBD	$2,430.10

PR LAPS ENTERECT RESCJ 1 SMALL INTEST RESCJ & ANA

Facility

$4,561.00

Service Code	CPT 44202
Hospital Charge Code	44202
Min. Negotiated Rate	$1,358.88
Max. Negotiated Rate	$4,104.90
Rate for Payer: Aetna Commercial	$3,876.85
Rate for Payer: Aetna New Business (MI Preferred)	$2,964.65
Rate for Payer: BCBS Complete	$1,824.40
Rate for Payer: BCBS Trust/PPO	$2,828.65
Rate for Payer: Cash Price	$3,648.80
Rate for Payer: Cash Price	$3,648.80
Rate for Payer: Cofinity Commercial	$3,192.70
Rate for Payer: Cofinity Commercial	$3,922.46
Rate for Payer: Healthscope Commercial	$4,104.90
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3,876.85
Rate for Payer: PHP Commercial	$3,876.85
Rate for Payer: Priority Health Cigna Priority Health	$3,192.70
Rate for Payer: Priority Health SBD	$2,873.43
Rate for Payer: UHC All Payor (Choice/PPO)	$1,494.77
Rate for Payer: UHC Exchange	$1,358.88

PR LAPS ESOPHAGEAL LENGTHENING ADDL

Professional

Both

$288.00

Service Code	HCPCS 43283
Min. Negotiated Rate	$99.47
Max. Negotiated Rate	$868.53
Rate for Payer: Aetna Commercial	$214.16
Rate for Payer: BCBS Complete	$104.44
Rate for Payer: BCBS Trust/PPO	$868.53
Rate for Payer: Cash Price	$230.40
Rate for Payer: Cash Price	$230.40
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	$201.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$273.42
Rate for Payer: Priority Health Narrow Network	$273.42
Rate for Payer: Priority Health SBD	$273.42

PR LAPS ESOPHAGOMYOTOMY W/FUNDOPLASTY IF PERFORMED

Professional

Both

$2,356.00

Service Code	HCPCS 43279
Min. Negotiated Rate	$777.66
Max. Negotiated Rate	$2,245.46
Rate for Payer: Aetna Commercial	$1,737.87
Rate for Payer: BCBS Complete	$858.36
Rate for Payer: BCBS Trust/PPO	$777.66
Rate for Payer: Cash Price	$1,884.80
Rate for Payer: Cash Price	$1,884.80
Rate for Payer: Mclaren Medicaid	$817.49
Rate for Payer: Meridian Medicaid	$858.36
Rate for Payer: Priority Health Choice Medicaid	$817.49
Rate for Payer: Priority Health Cigna Priority Health	$1,649.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,245.46
Rate for Payer: Priority Health Narrow Network	$2,245.46
Rate for Payer: Priority Health SBD	$2,245.46

PR LAPS FULG/EXC OVARY VISCERA/PERITONEAL SURFACE

Professional

Both

$2,184.00

Service Code	HCPCS 58662
Min. Negotiated Rate	$237.21
Max. Negotiated Rate	$1,528.80
Rate for Payer: Aetna Commercial	$851.14
Rate for Payer: BCBS Complete	$481.07
Rate for Payer: BCBS Trust/PPO	$237.21
Rate for Payer: Cash Price	$1,747.20
Rate for Payer: Cash Price	$1,747.20
Rate for Payer: Mclaren Medicaid	$458.16
Rate for Payer: Meridian Medicaid	$481.07
Rate for Payer: Priority Health Choice Medicaid	$458.16
Rate for Payer: Priority Health Cigna Priority Health	$1,528.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,010.76
Rate for Payer: Priority Health Narrow Network	$1,010.76
Rate for Payer: Priority Health SBD	$1,010.76

PR LAPS GASTRIC RESTRICTIVE PX REMOVE DEVICE & PORT

Professional

Both

$1,692.00

Service Code	HCPCS 43774
Min. Negotiated Rate	$530.94
Max. Negotiated Rate	$1,690.43
Rate for Payer: Aetna Commercial	$1,298.33
Rate for Payer: BCBS Complete	$646.35
Rate for Payer: BCBS Trust/PPO	$530.94
Rate for Payer: Cash Price	$1,353.60
Rate for Payer: Cash Price	$1,353.60
Rate for Payer: Mclaren Medicaid	$615.57
Rate for Payer: Meridian Medicaid	$646.35
Rate for Payer: Priority Health Choice Medicaid	$615.57
Rate for Payer: Priority Health Cigna Priority Health	$1,184.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,690.43
Rate for Payer: Priority Health Narrow Network	$1,690.43
Rate for Payer: Priority Health SBD	$1,690.43

Know your out-of-pocket cost for care.

All Charges