Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PR AUDIOMETRY FOR HEARING AID

Professional

Both

$79.00

Service Code	HCPCS S0618
Min. Negotiated Rate	$31.60
Max. Negotiated Rate	$51.35
Rate for Payer: Aetna Medicare	$39.50
Rate for Payer: BCBS Complete	$31.60
Rate for Payer: Cash Price	$63.20
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$51.35
Rate for Payer: Priority Health Cigna Priority Health	$51.35

PR AUDITORY EVOKED POTENTIAL

Professional

Both

$341.00

Service Code	HCPCS 92585
Min. Negotiated Rate	$136.40
Max. Negotiated Rate	$221.65
Rate for Payer: Aetna Medicare	$170.50
Rate for Payer: BCBS Complete	$136.40
Rate for Payer: Cash Price	$272.80
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$221.65
Rate for Payer: Priority Health Cigna Priority Health	$221.65

PR AUDITORY EVOKED POTENTIAL, LIMITED

Professional

Both

$148.00

Service Code	HCPCS 92586
Min. Negotiated Rate	$59.20
Max. Negotiated Rate	$96.20
Rate for Payer: Aetna Medicare	$74.00
Rate for Payer: BCBS Complete	$59.20
Rate for Payer: Cash Price	$118.40
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$96.20
Rate for Payer: Priority Health Cigna Priority Health	$96.20

PR AUTOGRAFT SPINE SURGERY BICORT/TRICORT SEP INC

Professional

Both

$1,210.00

Service Code	HCPCS 20938
Min. Negotiated Rate	$178.44
Max. Negotiated Rate	$786.50
Rate for Payer: Aetna Commercial	$239.11
Rate for Payer: Aetna Medicare	$185.58
Rate for Payer: Aetna New Business (MI Preferred)	$239.11
Rate for Payer: Aetna New Business (MI Preferred)	$256.95
Rate for Payer: BCBS Complete	$484.00
Rate for Payer: BCBS MAPPO	$178.44
Rate for Payer: BCN Medicare Advantage	$178.44
Rate for Payer: Cash Price	$968.00
Rate for Payer: Cash Price	$968.00
Rate for Payer: Cofinity Commercial	$239.11
Rate for Payer: Cofinity Commercial	$256.95
Rate for Payer: Health Alliance Plan Medicare Advantage	$178.44
Rate for Payer: Healthscope Commercial	$330.11
Rate for Payer: Healthscope Commercial	$285.50
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$187.36
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$786.50
Rate for Payer: Nomi Health Commercial	$214.13
Rate for Payer: PACE SWMI	$178.44
Rate for Payer: PHP Medicare Advantage	$178.44
Rate for Payer: Priority Health Cigna Priority Health	$786.50
Rate for Payer: Priority Health Medicare	$178.44
Rate for Payer: UHC Dual Complete DSNP	$178.44
Rate for Payer: UHC Medicare Advantage	$178.44

PR AUTOGRAFT SPINE SURGERY LOCAL FROM SAME INCISION

Professional

Both

$744.00

Service Code	HCPCS 20936
Min. Negotiated Rate	$297.60
Max. Negotiated Rate	$483.60
Rate for Payer: Aetna Medicare	$372.00
Rate for Payer: BCBS Complete	$297.60
Rate for Payer: Cash Price	$595.20
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$483.60
Rate for Payer: Priority Health Cigna Priority Health	$483.60

PR AUTOGRAFT SPINE SURGERY MORSELIZED SEP INCISION

Professional

Both

$971.00

Service Code	HCPCS 20937
Min. Negotiated Rate	$162.74
Max. Negotiated Rate	$631.15
Rate for Payer: Aetna Commercial	$218.07
Rate for Payer: Aetna Medicare	$169.25
Rate for Payer: Aetna New Business (MI Preferred)	$218.07
Rate for Payer: Aetna New Business (MI Preferred)	$234.35
Rate for Payer: BCBS Complete	$388.40
Rate for Payer: BCBS MAPPO	$162.74
Rate for Payer: BCN Medicare Advantage	$162.74
Rate for Payer: Cash Price	$776.80
Rate for Payer: Cash Price	$776.80
Rate for Payer: Cofinity Commercial	$234.35
Rate for Payer: Cofinity Commercial	$218.07
Rate for Payer: Health Alliance Plan Medicare Advantage	$162.74
Rate for Payer: Healthscope Commercial	$301.07
Rate for Payer: Healthscope Commercial	$260.38
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$170.88
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$631.15
Rate for Payer: Nomi Health Commercial	$195.29
Rate for Payer: PACE SWMI	$162.74
Rate for Payer: PHP Medicare Advantage	$162.74
Rate for Payer: Priority Health Cigna Priority Health	$631.15
Rate for Payer: Priority Health Medicare	$162.74
Rate for Payer: UHC Dual Complete DSNP	$162.74
Rate for Payer: UHC Medicare Advantage	$162.74

PR AUTOLOGOUS CHONDROCYTE IMPLANTATION KNEE

Professional

Both

$3,381.00

Service Code	HCPCS 27412
Min. Negotiated Rate	$1,352.40
Max. Negotiated Rate	$2,935.91
Rate for Payer: Aetna Commercial	$2,126.55
Rate for Payer: Aetna Medicare	$1,650.46
Rate for Payer: Aetna New Business (MI Preferred)	$2,126.55
Rate for Payer: Aetna New Business (MI Preferred)	$2,285.25
Rate for Payer: BCBS Complete	$1,352.40
Rate for Payer: BCBS MAPPO	$1,586.98
Rate for Payer: BCN Medicare Advantage	$1,586.98
Rate for Payer: Cash Price	$2,704.80
Rate for Payer: Cash Price	$2,704.80
Rate for Payer: Cofinity Commercial	$2,126.55
Rate for Payer: Cofinity Commercial	$2,285.25
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,586.98
Rate for Payer: Healthscope Commercial	$2,539.17
Rate for Payer: Healthscope Commercial	$2,935.91
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$1,666.33
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2,197.65
Rate for Payer: Nomi Health Commercial	$1,904.38
Rate for Payer: PACE SWMI	$1,586.98
Rate for Payer: PHP Medicare Advantage	$1,586.98
Rate for Payer: Priority Health Cigna Priority Health	$2,197.65
Rate for Payer: Priority Health Medicare	$1,586.98
Rate for Payer: UHC Dual Complete DSNP	$1,586.98
Rate for Payer: UHC Medicare Advantage	$1,586.98

PRAVASTATIN 10 MG TABLET

Facility

$323.00

Service Code	NDC 00904589161
Hospital Charge Code	11110
Hospital Revenue Code	637
Min. Negotiated Rate	$203.49
Max. Negotiated Rate	$290.70
Rate for Payer: Aetna Commercial	$274.55
Rate for Payer: Aetna New Business (MI Preferred)	$209.95
Rate for Payer: Cash Price	$258.40
Rate for Payer: Cofinity Commercial	$226.10
Rate for Payer: Cofinity Commercial	$277.78
Rate for Payer: Cofinity Medicare Advantage	$226.10
Rate for Payer: Encore Health Key Benefits Commercial	$258.40
Rate for Payer: Healthscope Commercial	$290.70
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$274.55
Rate for Payer: PHP Commercial	$274.55
Rate for Payer: Priority Health Cigna Priority Health	$209.95
Rate for Payer: Priority Health SBD	$203.49

PRAVASTATIN 10 MG TABLET

Facility

$323.00

Service Code	NDC 00904589161
Hospital Charge Code	11110
Hospital Revenue Code	637
Min. Negotiated Rate	$129.20
Max. Negotiated Rate	$290.70
Rate for Payer: Aetna Commercial	$274.55
Rate for Payer: Aetna Medicare	$161.50
Rate for Payer: Aetna New Business (MI Preferred)	$209.95
Rate for Payer: BCBS Complete	$129.20
Rate for Payer: Cash Price	$258.40
Rate for Payer: Cofinity Commercial	$226.10
Rate for Payer: Cofinity Commercial	$277.78
Rate for Payer: Cofinity Medicare Advantage	$226.10
Rate for Payer: Encore Health Key Benefits Commercial	$258.40
Rate for Payer: Healthscope Commercial	$290.70
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$274.55
Rate for Payer: PHP Commercial	$274.55
Rate for Payer: Priority Health Cigna Priority Health	$209.95
Rate for Payer: Priority Health SBD	$203.49

PRAVASTATIN 20 MG TABLET

Facility

$296.16

Service Code	NDC 51079045820
Hospital Charge Code	11111
Hospital Revenue Code	637
Min. Negotiated Rate	$118.46
Max. Negotiated Rate	$266.54
Rate for Payer: Aetna Commercial	$251.74
Rate for Payer: Aetna Medicare	$148.08
Rate for Payer: Aetna New Business (MI Preferred)	$192.50
Rate for Payer: BCBS Complete	$118.46
Rate for Payer: Cash Price	$236.93
Rate for Payer: Cofinity Commercial	$207.31
Rate for Payer: Cofinity Commercial	$254.70
Rate for Payer: Cofinity Medicare Advantage	$207.31
Rate for Payer: Encore Health Key Benefits Commercial	$236.93
Rate for Payer: Healthscope Commercial	$266.54
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$251.74
Rate for Payer: PHP Commercial	$251.74
Rate for Payer: Priority Health Cigna Priority Health	$192.50
Rate for Payer: Priority Health SBD	$186.58

PRAVASTATIN 20 MG TABLET

Facility

$2.97

Service Code	NDC 51079045801
Hospital Charge Code	11111
Hospital Revenue Code	637
Min. Negotiated Rate	$1.87
Max. Negotiated Rate	$2.67
Rate for Payer: Aetna Commercial	$2.52
Rate for Payer: Aetna New Business (MI Preferred)	$1.93
Rate for Payer: Cash Price	$2.38
Rate for Payer: Cofinity Commercial	$2.08
Rate for Payer: Cofinity Commercial	$2.55
Rate for Payer: Cofinity Medicare Advantage	$2.08
Rate for Payer: Encore Health Key Benefits Commercial	$2.38
Rate for Payer: Healthscope Commercial	$2.67
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2.52
Rate for Payer: PHP Commercial	$2.52
Rate for Payer: Priority Health Cigna Priority Health	$1.93
Rate for Payer: Priority Health SBD	$1.87

PRAVASTATIN 20 MG TABLET

Facility

$296.16

Service Code	NDC 51079045820
Hospital Charge Code	11111
Hospital Revenue Code	637
Min. Negotiated Rate	$186.58
Max. Negotiated Rate	$266.54
Rate for Payer: Aetna Commercial	$251.74
Rate for Payer: Aetna New Business (MI Preferred)	$192.50
Rate for Payer: Cash Price	$236.93
Rate for Payer: Cofinity Commercial	$207.31
Rate for Payer: Cofinity Commercial	$254.70
Rate for Payer: Cofinity Medicare Advantage	$207.31
Rate for Payer: Encore Health Key Benefits Commercial	$236.93
Rate for Payer: Healthscope Commercial	$266.54
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$251.74
Rate for Payer: PHP Commercial	$251.74
Rate for Payer: Priority Health Cigna Priority Health	$192.50
Rate for Payer: Priority Health SBD	$186.58

PRAVASTATIN 20 MG TABLET

Facility

$2.97

Service Code	NDC 51079045801
Hospital Charge Code	11111
Hospital Revenue Code	637
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$2.67
Rate for Payer: Aetna Commercial	$2.52
Rate for Payer: Aetna Medicare	$1.49
Rate for Payer: Aetna New Business (MI Preferred)	$1.93
Rate for Payer: BCBS Complete	$1.19
Rate for Payer: Cash Price	$2.38
Rate for Payer: Cofinity Commercial	$2.08
Rate for Payer: Cofinity Commercial	$2.55
Rate for Payer: Cofinity Medicare Advantage	$2.08
Rate for Payer: Encore Health Key Benefits Commercial	$2.38
Rate for Payer: Healthscope Commercial	$2.67
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2.52
Rate for Payer: PHP Commercial	$2.52
Rate for Payer: Priority Health Cigna Priority Health	$1.93
Rate for Payer: Priority Health SBD	$1.87

PRAVASTATIN 40 MG TABLET

Facility

$284.16

Service Code	NDC 00904589361
Hospital Charge Code	11112
Hospital Revenue Code	637
Min. Negotiated Rate	$113.66
Max. Negotiated Rate	$255.74
Rate for Payer: Aetna Commercial	$241.54
Rate for Payer: Aetna Medicare	$142.08
Rate for Payer: Aetna New Business (MI Preferred)	$184.70
Rate for Payer: BCBS Complete	$113.66
Rate for Payer: Cash Price	$227.33
Rate for Payer: Cofinity Commercial	$198.91
Rate for Payer: Cofinity Commercial	$244.38
Rate for Payer: Cofinity Medicare Advantage	$198.91
Rate for Payer: Encore Health Key Benefits Commercial	$227.33
Rate for Payer: Healthscope Commercial	$255.74
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$241.54
Rate for Payer: PHP Commercial	$241.54
Rate for Payer: Priority Health Cigna Priority Health	$184.70
Rate for Payer: Priority Health SBD	$179.02

PRAVASTATIN 40 MG TABLET

Facility

$137.52

Service Code	NDC 50268066715
Hospital Charge Code	11112
Hospital Revenue Code	637
Min. Negotiated Rate	$55.01
Max. Negotiated Rate	$123.77
Rate for Payer: Aetna Commercial	$116.89
Rate for Payer: Aetna Medicare	$68.76
Rate for Payer: Aetna New Business (MI Preferred)	$89.39
Rate for Payer: BCBS Complete	$55.01
Rate for Payer: Cash Price	$110.02
Rate for Payer: Cofinity Commercial	$118.27
Rate for Payer: Cofinity Commercial	$96.26
Rate for Payer: Cofinity Medicare Advantage	$96.26
Rate for Payer: Encore Health Key Benefits Commercial	$110.02
Rate for Payer: Healthscope Commercial	$123.77
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$116.89
Rate for Payer: PHP Commercial	$116.89
Rate for Payer: Priority Health Cigna Priority Health	$89.39
Rate for Payer: Priority Health SBD	$86.64

PRAVASTATIN 40 MG TABLET

Facility

$2.76

Service Code	NDC 50268066711
Hospital Charge Code	11112
Hospital Revenue Code	637
Min. Negotiated Rate	$1.74
Max. Negotiated Rate	$2.48
Rate for Payer: Aetna Commercial	$2.35
Rate for Payer: Aetna New Business (MI Preferred)	$1.79
Rate for Payer: Cash Price	$2.21
Rate for Payer: Cofinity Commercial	$1.93
Rate for Payer: Cofinity Commercial	$2.37
Rate for Payer: Cofinity Medicare Advantage	$1.93
Rate for Payer: Encore Health Key Benefits Commercial	$2.21
Rate for Payer: Healthscope Commercial	$2.48
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2.35
Rate for Payer: PHP Commercial	$2.35
Rate for Payer: Priority Health Cigna Priority Health	$1.79
Rate for Payer: Priority Health SBD	$1.74

PRAVASTATIN 40 MG TABLET

Facility

$137.52

Service Code	NDC 50268066715
Hospital Charge Code	11112
Hospital Revenue Code	637
Min. Negotiated Rate	$86.64
Max. Negotiated Rate	$123.77
Rate for Payer: Aetna Commercial	$116.89
Rate for Payer: Aetna New Business (MI Preferred)	$89.39
Rate for Payer: Cash Price	$110.02
Rate for Payer: Cofinity Commercial	$118.27
Rate for Payer: Cofinity Commercial	$96.26
Rate for Payer: Cofinity Medicare Advantage	$96.26
Rate for Payer: Encore Health Key Benefits Commercial	$110.02
Rate for Payer: Healthscope Commercial	$123.77
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$116.89
Rate for Payer: PHP Commercial	$116.89
Rate for Payer: Priority Health Cigna Priority Health	$89.39
Rate for Payer: Priority Health SBD	$86.64

PRAVASTATIN 40 MG TABLET

Facility

$2.76

Service Code	NDC 50268066711
Hospital Charge Code	11112
Hospital Revenue Code	637
Min. Negotiated Rate	$1.10
Max. Negotiated Rate	$2.48
Rate for Payer: Aetna Commercial	$2.35
Rate for Payer: Aetna Medicare	$1.38
Rate for Payer: Aetna New Business (MI Preferred)	$1.79
Rate for Payer: BCBS Complete	$1.10
Rate for Payer: Cash Price	$2.21
Rate for Payer: Cofinity Commercial	$1.93
Rate for Payer: Cofinity Commercial	$2.37
Rate for Payer: Cofinity Medicare Advantage	$1.93
Rate for Payer: Encore Health Key Benefits Commercial	$2.21
Rate for Payer: Healthscope Commercial	$2.48
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2.35
Rate for Payer: PHP Commercial	$2.35
Rate for Payer: Priority Health Cigna Priority Health	$1.79
Rate for Payer: Priority Health SBD	$1.74

PRAVASTATIN 40 MG TABLET

Facility

$284.16

Service Code	NDC 00904589361
Hospital Charge Code	11112
Hospital Revenue Code	637
Min. Negotiated Rate	$179.02
Max. Negotiated Rate	$255.74
Rate for Payer: Aetna Commercial	$241.54
Rate for Payer: Aetna New Business (MI Preferred)	$184.70
Rate for Payer: Cash Price	$227.33
Rate for Payer: Cofinity Commercial	$198.91
Rate for Payer: Cofinity Commercial	$244.38
Rate for Payer: Cofinity Medicare Advantage	$198.91
Rate for Payer: Encore Health Key Benefits Commercial	$227.33
Rate for Payer: Healthscope Commercial	$255.74
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$241.54
Rate for Payer: PHP Commercial	$241.54
Rate for Payer: Priority Health Cigna Priority Health	$184.70
Rate for Payer: Priority Health SBD	$179.02

PR AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1

Professional

Both

$160.00

Service Code	HCPCS 11730
Min. Negotiated Rate	$51.14
Max. Negotiated Rate	$104.00
Rate for Payer: Aetna Commercial	$68.53
Rate for Payer: Aetna Medicare	$53.19
Rate for Payer: Aetna New Business (MI Preferred)	$73.64
Rate for Payer: Aetna New Business (MI Preferred)	$68.53
Rate for Payer: BCBS Complete	$64.00
Rate for Payer: BCBS MAPPO	$51.14
Rate for Payer: BCN Medicare Advantage	$51.14
Rate for Payer: Cash Price	$128.00
Rate for Payer: Cash Price	$128.00
Rate for Payer: Cofinity Commercial	$73.64
Rate for Payer: Cofinity Commercial	$68.53
Rate for Payer: Health Alliance Plan Medicare Advantage	$51.14
Rate for Payer: Healthscope Commercial	$94.61
Rate for Payer: Healthscope Commercial	$81.82
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$53.70
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$104.00
Rate for Payer: Nomi Health Commercial	$61.37
Rate for Payer: PACE SWMI	$51.14
Rate for Payer: PHP Medicare Advantage	$51.14
Rate for Payer: Priority Health Cigna Priority Health	$104.00
Rate for Payer: Priority Health Medicare	$51.14
Rate for Payer: UHC Dual Complete DSNP	$51.14
Rate for Payer: UHC Medicare Advantage	$51.14

PR AVULSION NAIL PLATE PARTIAL/COMP SIMPLE EA ADDL

Professional

Both

$74.00

Service Code	HCPCS 11732
Min. Negotiated Rate	$16.08
Max. Negotiated Rate	$48.10
Rate for Payer: Aetna Commercial	$21.55
Rate for Payer: Aetna Medicare	$16.72
Rate for Payer: Aetna New Business (MI Preferred)	$23.16
Rate for Payer: Aetna New Business (MI Preferred)	$21.55
Rate for Payer: BCBS Complete	$29.60
Rate for Payer: BCBS MAPPO	$16.08
Rate for Payer: BCN Medicare Advantage	$16.08
Rate for Payer: Cash Price	$59.20
Rate for Payer: Cash Price	$59.20
Rate for Payer: Cofinity Commercial	$23.16
Rate for Payer: Cofinity Commercial	$21.55
Rate for Payer: Health Alliance Plan Medicare Advantage	$16.08
Rate for Payer: Healthscope Commercial	$25.73
Rate for Payer: Healthscope Commercial	$29.75
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$16.88
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$48.10
Rate for Payer: Nomi Health Commercial	$19.30
Rate for Payer: PACE SWMI	$16.08
Rate for Payer: PHP Medicare Advantage	$16.08
Rate for Payer: Priority Health Cigna Priority Health	$48.10
Rate for Payer: Priority Health Medicare	$16.08
Rate for Payer: UHC Dual Complete DSNP	$16.08
Rate for Payer: UHC Medicare Advantage	$16.08

PR AXILLARY LYMPHADENECTOMY COMPLETE

Professional

Both

$1,564.00

Service Code	HCPCS 38745
Min. Negotiated Rate	$625.60
Max. Negotiated Rate	$1,588.26
Rate for Payer: Aetna Commercial	$1,150.42
Rate for Payer: Aetna Medicare	$892.86
Rate for Payer: Aetna New Business (MI Preferred)	$1,236.27
Rate for Payer: Aetna New Business (MI Preferred)	$1,150.42
Rate for Payer: BCBS Complete	$625.60
Rate for Payer: BCBS MAPPO	$858.52
Rate for Payer: BCN Medicare Advantage	$858.52
Rate for Payer: Cash Price	$1,251.20
Rate for Payer: Cash Price	$1,251.20
Rate for Payer: Cofinity Commercial	$1,236.27
Rate for Payer: Cofinity Commercial	$1,150.42
Rate for Payer: Health Alliance Plan Medicare Advantage	$858.52
Rate for Payer: Healthscope Commercial	$1,588.26
Rate for Payer: Healthscope Commercial	$1,373.63
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$901.45
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,016.60
Rate for Payer: Nomi Health Commercial	$1,030.22
Rate for Payer: PACE SWMI	$858.52
Rate for Payer: PHP Medicare Advantage	$858.52
Rate for Payer: Priority Health Cigna Priority Health	$1,016.60
Rate for Payer: Priority Health Medicare	$858.52
Rate for Payer: UHC Dual Complete DSNP	$858.52
Rate for Payer: UHC Medicare Advantage	$858.52

PR AXILLARY LYMPHADENECTOMY COMPLETE

Facility

$1,564.00

Service Code	CPT 38745
Hospital Charge Code	38745
Min. Negotiated Rate	$985.32
Max. Negotiated Rate	$1,407.60
Rate for Payer: Aetna Commercial	$1,329.40
Rate for Payer: Aetna New Business (MI Preferred)	$1,016.60
Rate for Payer: Cash Price	$1,251.20
Rate for Payer: Cofinity Commercial	$1,094.80
Rate for Payer: Cofinity Commercial	$1,345.04
Rate for Payer: Cofinity Medicare Advantage	$1,094.80
Rate for Payer: Encore Health Key Benefits Commercial	$1,251.20
Rate for Payer: Healthscope Commercial	$1,407.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,329.40
Rate for Payer: PHP Commercial	$1,329.40
Rate for Payer: Priority Health Cigna Priority Health	$1,016.60
Rate for Payer: Priority Health SBD	$985.32

PR AXILLARY LYMPHADENECTOMY COMPLETE

Facility

$1,564.00

Service Code	CPT 38745
Hospital Charge Code	38745
Min. Negotiated Rate	$985.32
Max. Negotiated Rate	$16,017.15
Rate for Payer: Aetna Commercial	$1,329.40
Rate for Payer: Aetna Medicare	$5,917.74
Rate for Payer: Aetna New Business (MI Preferred)	$1,016.60
Rate for Payer: Allen County Amish Medical Aid Commercial	$7,112.66
Rate for Payer: Amish Plain Church Group Commercial	$7,112.66
Rate for Payer: BCBS Complete	$3,202.41
Rate for Payer: BCBS MAPPO	$5,690.13
Rate for Payer: BCN Medicare Advantage	$5,690.13
Rate for Payer: Cash Price	$1,251.20
Rate for Payer: Cash Price	$1,251.20
Rate for Payer: Cofinity Commercial	$1,094.80
Rate for Payer: Cofinity Commercial	$1,345.04
Rate for Payer: Cofinity Medicare Advantage	$1,094.80
Rate for Payer: Encore Health Key Benefits Commercial	$1,251.20
Rate for Payer: Health Alliance Plan Medicare Advantage	$5,690.13
Rate for Payer: Healthscope Commercial	$1,407.60
Rate for Payer: Mclaren Medicaid	$3,049.91
Rate for Payer: Mclaren Medicare	$5,690.13
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$5,974.64
Rate for Payer: Meridian Medicaid	$3,202.41
Rate for Payer: MI Amish Medical Board Commercial	$6,543.65
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,329.40
Rate for Payer: PACE Medicare	$5,405.62
Rate for Payer: PACE SWMI	$5,690.13
Rate for Payer: PHP Commercial	$1,329.40
Rate for Payer: PHP Medicare Advantage	$5,690.13
Rate for Payer: Priority Health Choice Medicaid	$3,049.91
Rate for Payer: Priority Health Cigna Priority Health	$1,016.60
Rate for Payer: Priority Health Medicare	$5,690.13
Rate for Payer: Priority Health SBD	$985.32
Rate for Payer: Railroad Medicare Medicare	$5,690.13
Rate for Payer: UHC All Payor (Choice/PPO)	$16,017.15
Rate for Payer: UHC Dual Complete DSNP	$5,690.13
Rate for Payer: UHC Medicare Advantage	$5,690.13
Rate for Payer: UHCCP Medicaid	$3,203.54
Rate for Payer: VA VA	$5,690.13

PR AXILLARY LYMPHADENECTOMY COMPLETE

Professional

Both

$1,564.00

Service Code	HCPCS 38745
Hospital Charge Code	38745
Min. Negotiated Rate	$625.60
Max. Negotiated Rate	$1,588.26
Rate for Payer: Aetna Commercial	$1,150.42
Rate for Payer: Aetna Medicare	$892.86
Rate for Payer: Aetna New Business (MI Preferred)	$1,150.42
Rate for Payer: Aetna New Business (MI Preferred)	$1,236.27
Rate for Payer: BCBS Complete	$625.60
Rate for Payer: BCBS MAPPO	$858.52
Rate for Payer: BCN Medicare Advantage	$858.52
Rate for Payer: Cash Price	$1,251.20
Rate for Payer: Cash Price	$1,251.20
Rate for Payer: Cofinity Commercial	$1,236.27
Rate for Payer: Cofinity Commercial	$1,150.42
Rate for Payer: Health Alliance Plan Medicare Advantage	$858.52
Rate for Payer: Healthscope Commercial	$1,373.63
Rate for Payer: Healthscope Commercial	$1,588.26
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$901.45
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,016.60
Rate for Payer: Nomi Health Commercial	$1,030.22
Rate for Payer: PACE SWMI	$858.52
Rate for Payer: PHP Medicare Advantage	$858.52
Rate for Payer: Priority Health Cigna Priority Health	$1,016.60
Rate for Payer: Priority Health Medicare	$858.52
Rate for Payer: UHC Dual Complete DSNP	$858.52
Rate for Payer: UHC Medicare Advantage	$858.52

Know your out-of-pocket cost for care.

All Charges