Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PR ORBITOTOMY BONE FLAP/WINDOW LAT RMVL BONE DCMPRN

Professional

Both

$3,518.00

Service Code	HCPCS 67445
Min. Negotiated Rate	$348.68
Max. Negotiated Rate	$2,656.05
Rate for Payer: Aetna Commercial	$1,975.12
Rate for Payer: BCBS Complete	$1,017.61
Rate for Payer: BCBS Trust/PPO	$348.68
Rate for Payer: Cash Price	$2,814.40
Rate for Payer: Cash Price	$2,814.40
Rate for Payer: Mclaren Medicaid	$969.15
Rate for Payer: Meridian Medicaid	$1,017.61
Rate for Payer: Priority Health Choice Medicaid	$969.15
Rate for Payer: Priority Health Cigna Priority Health	$2,462.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,656.05
Rate for Payer: Priority Health Narrow Network	$2,656.05
Rate for Payer: Priority Health SBD	$2,656.05

PR ORBITOTOMY W/O BONE FLAP EXPL W/WO BIOPSY

Professional

Both

$1,629.00

Service Code	HCPCS 67400
Min. Negotiated Rate	$359.77
Max. Negotiated Rate	$1,807.79
Rate for Payer: Aetna Commercial	$1,329.81
Rate for Payer: BCBS Complete	$691.97
Rate for Payer: BCBS Trust/PPO	$359.77
Rate for Payer: Cash Price	$1,303.20
Rate for Payer: Cash Price	$1,303.20
Rate for Payer: Mclaren Medicaid	$659.02
Rate for Payer: Meridian Medicaid	$691.97
Rate for Payer: Priority Health Choice Medicaid	$659.02
Rate for Payer: Priority Health Cigna Priority Health	$1,140.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,807.79
Rate for Payer: Priority Health Narrow Network	$1,807.79
Rate for Payer: Priority Health SBD	$1,807.79

PR ORCHIECTOMY PARTIAL

Professional

Both

$1,081.00

Service Code	HCPCS 54522
Min. Negotiated Rate	$374.88
Max. Negotiated Rate	$1,501.96
Rate for Payer: Aetna Commercial	$755.38
Rate for Payer: BCBS Complete	$393.62
Rate for Payer: BCBS Trust/PPO	$1,501.96
Rate for Payer: Cash Price	$864.80
Rate for Payer: Cash Price	$864.80
Rate for Payer: Mclaren Medicaid	$374.88
Rate for Payer: Meridian Medicaid	$393.62
Rate for Payer: Priority Health Choice Medicaid	$374.88
Rate for Payer: Priority Health Cigna Priority Health	$756.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$938.60
Rate for Payer: Priority Health Narrow Network	$938.60
Rate for Payer: Priority Health SBD	$938.60

PR ORCHIECTOMY RADICAL TUMOR INGUINAL APPROACH

Professional

Both

$950.00

Service Code	HCPCS 54530
Min. Negotiated Rate	$325.89
Max. Negotiated Rate	$2,667.39
Rate for Payer: Aetna Commercial	$650.96
Rate for Payer: BCBS Complete	$342.18
Rate for Payer: BCBS Trust/PPO	$2,667.39
Rate for Payer: Cash Price	$760.00
Rate for Payer: Cash Price	$760.00
Rate for Payer: Mclaren Medicaid	$325.89
Rate for Payer: Meridian Medicaid	$342.18
Rate for Payer: Priority Health Choice Medicaid	$325.89
Rate for Payer: Priority Health Cigna Priority Health	$665.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$814.86
Rate for Payer: Priority Health Narrow Network	$814.86
Rate for Payer: Priority Health SBD	$814.86

PR ORCHIECTOMY RADICAL TUMOR W/ABDOMINAL EXPL

Professional

Both

$1,374.00

Service Code	HCPCS 54535
Min. Negotiated Rate	$474.14
Max. Negotiated Rate	$3,333.04
Rate for Payer: Aetna Commercial	$955.05
Rate for Payer: BCBS Complete	$497.85
Rate for Payer: BCBS Trust/PPO	$3,333.04
Rate for Payer: Cash Price	$1,099.20
Rate for Payer: Cash Price	$1,099.20
Rate for Payer: Mclaren Medicaid	$474.14
Rate for Payer: Meridian Medicaid	$497.85
Rate for Payer: Priority Health Choice Medicaid	$474.14
Rate for Payer: Priority Health Cigna Priority Health	$961.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,187.16
Rate for Payer: Priority Health Narrow Network	$1,187.16
Rate for Payer: Priority Health SBD	$1,187.16

PR ORCHIECTOMY SIMPLE SCROTAL/INGUINAL APPROACH

Professional

Both

$603.00

Service Code	HCPCS 54520
Min. Negotiated Rate	$210.66
Max. Negotiated Rate	$2,233.12
Rate for Payer: Aetna Commercial	$419.79
Rate for Payer: BCBS Complete	$221.19
Rate for Payer: BCBS Trust/PPO	$2,233.12
Rate for Payer: Cash Price	$482.40
Rate for Payer: Cash Price	$482.40
Rate for Payer: Mclaren Medicaid	$210.66
Rate for Payer: Meridian Medicaid	$221.19
Rate for Payer: Priority Health Choice Medicaid	$210.66
Rate for Payer: Priority Health Cigna Priority Health	$422.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$525.76
Rate for Payer: Priority Health Narrow Network	$525.76
Rate for Payer: Priority Health SBD	$525.76

PR ORCHIOPEXY ABDL APPROACH INTRA-ABDOMINAL TESTIS

Professional

Both

$1,470.00

Service Code	HCPCS 54650
Min. Negotiated Rate	$454.54
Max. Negotiated Rate	$2,517.35
Rate for Payer: Aetna Commercial	$913.59
Rate for Payer: BCBS Complete	$477.27
Rate for Payer: BCBS Trust/PPO	$2,517.35
Rate for Payer: Cash Price	$1,176.00
Rate for Payer: Cash Price	$1,176.00
Rate for Payer: Mclaren Medicaid	$454.54
Rate for Payer: Meridian Medicaid	$477.27
Rate for Payer: Priority Health Choice Medicaid	$454.54
Rate for Payer: Priority Health Cigna Priority Health	$1,029.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,137.46
Rate for Payer: Priority Health Narrow Network	$1,137.46
Rate for Payer: Priority Health SBD	$1,137.46

PR ORCHIOPEXY INGUINAL OR SCROTAL APPROACH

Professional

Both

$1,722.00

Service Code	HCPCS 54640
Min. Negotiated Rate	$275.20
Max. Negotiated Rate	$2,048.75
Rate for Payer: Aetna Commercial	$557.83
Rate for Payer: BCBS Complete	$288.96
Rate for Payer: BCBS Trust/PPO	$2,048.75
Rate for Payer: Cash Price	$1,377.60
Rate for Payer: Cash Price	$1,377.60
Rate for Payer: Mclaren Medicaid	$275.20
Rate for Payer: Meridian Medicaid	$288.96
Rate for Payer: Priority Health Choice Medicaid	$275.20
Rate for Payer: Priority Health Cigna Priority Health	$1,205.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$689.50
Rate for Payer: Priority Health Narrow Network	$689.50
Rate for Payer: Priority Health SBD	$689.50

PR ORPHENADRINE INJECTION

Professional

Both

$29.00

Service Code	HCPCS J2360
Min. Negotiated Rate	$9.88
Max. Negotiated Rate	$20.30
Rate for Payer: Aetna Commercial	$10.00
Rate for Payer: BCBS Complete	$11.60
Rate for Payer: BCBS Trust/PPO	$9.88
Rate for Payer: Cash Price	$23.20
Rate for Payer: Cash Price	$23.20
Rate for Payer: Priority Health Cigna Priority Health	$20.30

PR ORTHOTICS MGMT & TRAING INITIAL ENCTR EA 15 MINS

Professional

Both

$71.00

Service Code	HCPCS 97760
Min. Negotiated Rate	$28.40
Max. Negotiated Rate	$466.49
Rate for Payer: Aetna Commercial	$35.53
Rate for Payer: BCBS Complete	$28.40
Rate for Payer: BCBS Trust/PPO	$466.49
Rate for Payer: Cash Price	$56.80
Rate for Payer: Cash Price	$56.80
Rate for Payer: Priority Health Cigna Priority Health	$49.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$75.00
Rate for Payer: Priority Health Narrow Network	$75.00
Rate for Payer: Priority Health SBD	$75.00

PR ORTHOTICS/PROSTH MGMT &/TRAING SBSQ ENCTR 15 MIN

Professional

Both

$104.00

Service Code	HCPCS 97763
Min. Negotiated Rate	$41.60
Max. Negotiated Rate	$674.11
Rate for Payer: Aetna Commercial	$57.97
Rate for Payer: BCBS Complete	$41.60
Rate for Payer: BCBS Trust/PPO	$674.11
Rate for Payer: Cash Price	$83.20
Rate for Payer: Cash Price	$83.20
Rate for Payer: Priority Health Cigna Priority Health	$72.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$75.00
Rate for Payer: Priority Health Narrow Network	$75.00
Rate for Payer: Priority Health SBD	$75.00

PROSTATECTOMY WITH CC

Facility

$26,197.22

Service Code	MS-DRG 666
Min. Negotiated Rate	$12,218.04
Max. Negotiated Rate	$26,197.22
Rate for Payer: Aetna Medicare	$13,375.53
Rate for Payer: Allen County Amish Medical Aid Commercial	$16,076.36
Rate for Payer: Amish Plain Church Group Commercial	$16,076.36
Rate for Payer: BCBS MAPPO	$12,861.09
Rate for Payer: BCBS Trust/PPO	$25,096.94
Rate for Payer: BCN Medicare Advantage	$12,861.09
Rate for Payer: Health Alliance Plan Medicare Advantage	$12,861.09
Rate for Payer: Mclaren Medicare	$12,861.09
Rate for Payer: Meridian Wellcare - Medicare Advantage	$13,504.14
Rate for Payer: MI Amish Medical Board Commercial	$14,790.25
Rate for Payer: PACE Medicare	$12,218.04
Rate for Payer: PACE SWMI	$12,861.09
Rate for Payer: PHP Medicare Advantage	$12,861.09
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$24,644.55
Rate for Payer: Priority Health Medicare	$12,861.09
Rate for Payer: Priority Health Narrow Network	$19,715.64
Rate for Payer: Railroad Medicare Medicare	$12,861.09
Rate for Payer: UHC All Payor (Choice/PPO)	$26,197.22
Rate for Payer: UHC Core	$16,074.86
Rate for Payer: UHC Dual Complete DSNP	$12,861.09
Rate for Payer: UHC Exchange	$17,216.94
Rate for Payer: UHC Medicare Advantage	$13,246.92
Rate for Payer: VA VA	$12,861.09

PROSTATECTOMY WITH MCC

Facility

$47,956.26

Service Code	MS-DRG 665
Min. Negotiated Rate	$21,602.78
Max. Negotiated Rate	$47,956.26
Rate for Payer: Aetna Medicare	$23,649.36
Rate for Payer: Allen County Amish Medical Aid Commercial	$28,424.71
Rate for Payer: Amish Plain Church Group Commercial	$28,424.71
Rate for Payer: BCBS MAPPO	$22,739.77
Rate for Payer: BCBS Trust/PPO	$47,956.26
Rate for Payer: BCN Medicare Advantage	$22,739.77
Rate for Payer: Health Alliance Plan Medicare Advantage	$22,739.77
Rate for Payer: Mclaren Medicare	$22,739.77
Rate for Payer: Meridian Wellcare - Medicare Advantage	$23,876.76
Rate for Payer: MI Amish Medical Board Commercial	$26,150.74
Rate for Payer: PACE Medicare	$21,602.78
Rate for Payer: PACE SWMI	$22,739.77
Rate for Payer: PHP Medicare Advantage	$22,739.77
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$44,328.34
Rate for Payer: Priority Health Medicare	$22,739.77
Rate for Payer: Priority Health Narrow Network	$35,462.67
Rate for Payer: Railroad Medicare Medicare	$22,739.77
Rate for Payer: UHC All Payor (Choice/PPO)	$47,121.13
Rate for Payer: UHC Core	$28,913.98
Rate for Payer: UHC Dual Complete DSNP	$22,739.77
Rate for Payer: UHC Exchange	$30,968.23
Rate for Payer: UHC Medicare Advantage	$23,421.96
Rate for Payer: VA VA	$22,739.77

PROSTATECTOMY WITHOUT CC/MCC

Facility

$16,010.60

Service Code	MS-DRG 667
Min. Negotiated Rate	$7,649.14
Max. Negotiated Rate	$16,010.60
Rate for Payer: Aetna Medicare	$8,373.80
Rate for Payer: Allen County Amish Medical Aid Commercial	$10,064.66
Rate for Payer: Amish Plain Church Group Commercial	$10,064.66
Rate for Payer: BCBS MAPPO	$8,051.73
Rate for Payer: BCBS Trust/PPO	$15,338.36
Rate for Payer: BCN Medicare Advantage	$8,051.73
Rate for Payer: Health Alliance Plan Medicare Advantage	$8,051.73
Rate for Payer: Mclaren Medicare	$8,051.73
Rate for Payer: Meridian Wellcare - Medicare Advantage	$8,454.32
Rate for Payer: MI Amish Medical Board Commercial	$9,259.49
Rate for Payer: PACE Medicare	$7,649.14
Rate for Payer: PACE SWMI	$8,051.73
Rate for Payer: PHP Medicare Advantage	$8,051.73
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$15,061.68
Rate for Payer: Priority Health Medicare	$8,051.73
Rate for Payer: Priority Health Narrow Network	$12,049.34
Rate for Payer: Railroad Medicare Medicare	$8,051.73
Rate for Payer: UHC All Payor (Choice/PPO)	$16,010.60
Rate for Payer: UHC Core	$9,824.26
Rate for Payer: UHC Dual Complete DSNP	$8,051.73
Rate for Payer: UHC Exchange	$10,522.24
Rate for Payer: UHC Medicare Advantage	$8,293.28
Rate for Payer: VA VA	$8,051.73

PR OSTC COMPL ALL METAR HEADS W/PRTL PROX PHALANGC

Professional

Both

$1,900.00

Service Code	HCPCS 28114
Min. Negotiated Rate	$539.10
Max. Negotiated Rate	$1,330.00
Rate for Payer: Aetna Commercial	$1,103.34
Rate for Payer: BCBS Complete	$566.06
Rate for Payer: BCBS Trust/PPO	$864.83
Rate for Payer: Cash Price	$1,520.00
Rate for Payer: Cash Price	$1,520.00
Rate for Payer: Mclaren Medicaid	$539.10
Rate for Payer: Meridian Medicaid	$566.06
Rate for Payer: Priority Health Choice Medicaid	$539.10
Rate for Payer: Priority Health Cigna Priority Health	$1,330.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,277.14
Rate for Payer: Priority Health Narrow Network	$1,277.14
Rate for Payer: Priority Health SBD	$1,277.14

PR OSTC PRTL EXOSTC/CONDYLC METAR HEAD

Professional

Both

$969.00

Service Code	HCPCS 28288
Min. Negotiated Rate	$78.19
Max. Negotiated Rate	$678.30
Rate for Payer: Aetna Commercial	$571.03
Rate for Payer: BCBS Complete	$295.44
Rate for Payer: BCBS Trust/PPO	$78.19
Rate for Payer: Cash Price	$775.20
Rate for Payer: Cash Price	$775.20
Rate for Payer: Mclaren Medicaid	$281.37
Rate for Payer: Meridian Medicaid	$295.44
Rate for Payer: Priority Health Choice Medicaid	$281.37
Rate for Payer: Priority Health Cigna Priority Health	$678.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$661.81
Rate for Payer: Priority Health Narrow Network	$661.81
Rate for Payer: Priority Health SBD	$661.81

PR OSTECTOMY CALCANEUS

Professional

Both

$1,009.00

Service Code	HCPCS 28118
Min. Negotiated Rate	$273.07
Max. Negotiated Rate	$2,262.71
Rate for Payer: Aetna Commercial	$555.17
Rate for Payer: BCBS Complete	$286.72
Rate for Payer: BCBS Trust/PPO	$2,262.71
Rate for Payer: Cash Price	$807.20
Rate for Payer: Cash Price	$807.20
Rate for Payer: Mclaren Medicaid	$273.07
Rate for Payer: Meridian Medicaid	$286.72
Rate for Payer: Priority Health Choice Medicaid	$273.07
Rate for Payer: Priority Health Cigna Priority Health	$706.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$641.88
Rate for Payer: Priority Health Narrow Network	$641.88
Rate for Payer: Priority Health SBD	$641.88

PR OSTECTOMY CALCANEUS SPUR W/WO PLNTAR FASCIAL RLS

Professional

Both

$1,198.00

Service Code	HCPCS 28119
Min. Negotiated Rate	$235.37
Max. Negotiated Rate	$838.60
Rate for Payer: Aetna Commercial	$477.77
Rate for Payer: BCBS Complete	$247.14
Rate for Payer: BCBS Trust/PPO	$811.47
Rate for Payer: Cash Price	$958.40
Rate for Payer: Cash Price	$958.40
Rate for Payer: Mclaren Medicaid	$235.37
Rate for Payer: Meridian Medicaid	$247.14
Rate for Payer: Priority Health Choice Medicaid	$235.37
Rate for Payer: Priority Health Cigna Priority Health	$838.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$553.55
Rate for Payer: Priority Health Narrow Network	$553.55
Rate for Payer: Priority Health SBD	$553.55

PR OSTECTOMY COMPLETE 1ST METATARSAL HEAD

Professional

Both

$815.00

Service Code	HCPCS 28111
Min. Negotiated Rate	$205.33
Max. Negotiated Rate	$667.24
Rate for Payer: Aetna Commercial	$427.63
Rate for Payer: BCBS Complete	$215.60
Rate for Payer: BCBS Trust/PPO	$667.24
Rate for Payer: Cash Price	$652.00
Rate for Payer: Cash Price	$652.00
Rate for Payer: Mclaren Medicaid	$205.33
Rate for Payer: Meridian Medicaid	$215.60
Rate for Payer: Priority Health Choice Medicaid	$205.33
Rate for Payer: Priority Health Cigna Priority Health	$570.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$486.66
Rate for Payer: Priority Health Narrow Network	$486.66
Rate for Payer: Priority Health SBD	$486.66

PR OSTECTOMY COMPLETE 5TH METATARSAL HEAD

Professional

Both

$1,014.00

Service Code	HCPCS 28113
Min. Negotiated Rate	$275.41
Max. Negotiated Rate	$709.80
Rate for Payer: Aetna Commercial	$559.27
Rate for Payer: BCBS Complete	$289.18
Rate for Payer: BCBS Trust/PPO	$522.49
Rate for Payer: Cash Price	$811.20
Rate for Payer: Cash Price	$811.20
Rate for Payer: Mclaren Medicaid	$275.41
Rate for Payer: Meridian Medicaid	$289.18
Rate for Payer: Priority Health Choice Medicaid	$275.41
Rate for Payer: Priority Health Cigna Priority Health	$709.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$649.04
Rate for Payer: Priority Health Narrow Network	$649.04
Rate for Payer: Priority Health SBD	$649.04

PR OSTECTOMY COMPLETE OTHER METATARSAL HEAD 2/3/4

Professional

Both

$952.00

Service Code	HCPCS 28112
Min. Negotiated Rate	$202.14
Max. Negotiated Rate	$1,106.26
Rate for Payer: Aetna Commercial	$411.03
Rate for Payer: BCBS Complete	$212.25
Rate for Payer: BCBS Trust/PPO	$1,106.26
Rate for Payer: Cash Price	$761.60
Rate for Payer: Cash Price	$761.60
Rate for Payer: Mclaren Medicaid	$202.14
Rate for Payer: Meridian Medicaid	$212.25
Rate for Payer: Priority Health Choice Medicaid	$202.14
Rate for Payer: Priority Health Cigna Priority Health	$666.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$477.96
Rate for Payer: Priority Health Narrow Network	$477.96
Rate for Payer: Priority Health SBD	$477.96

PR OSTECTOMY PRTL 5TH METAR HEAD SPX

Professional

Both

$896.00

Service Code	HCPCS 28110
Min. Negotiated Rate	$189.78
Max. Negotiated Rate	$627.20
Rate for Payer: Aetna Commercial	$382.12
Rate for Payer: BCBS Complete	$199.27
Rate for Payer: BCBS Trust/PPO	$583.24
Rate for Payer: Cash Price	$716.80
Rate for Payer: Cash Price	$716.80
Rate for Payer: Mclaren Medicaid	$189.78
Rate for Payer: Meridian Medicaid	$199.27
Rate for Payer: Priority Health Choice Medicaid	$189.78
Rate for Payer: Priority Health Cigna Priority Health	$627.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$444.27
Rate for Payer: Priority Health Narrow Network	$444.27
Rate for Payer: Priority Health SBD	$444.27

PR OSTECTOMY STERNUM PARTIAL

Professional

Both

$3,875.00

Service Code	HCPCS 21620
Min. Negotiated Rate	$322.91
Max. Negotiated Rate	$3,350.93
Rate for Payer: Aetna Commercial	$678.09
Rate for Payer: BCBS Complete	$339.06
Rate for Payer: BCBS Trust/PPO	$3,350.93
Rate for Payer: Cash Price	$3,100.00
Rate for Payer: Cash Price	$3,100.00
Rate for Payer: Mclaren Medicaid	$322.91
Rate for Payer: Meridian Medicaid	$339.06
Rate for Payer: Priority Health Choice Medicaid	$322.91
Rate for Payer: Priority Health Cigna Priority Health	$2,712.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$771.09
Rate for Payer: Priority Health Narrow Network	$771.09
Rate for Payer: Priority Health SBD	$771.09

PR OSTECTOMY TARSAL COALITION

Professional

Both

$1,411.00

Service Code	HCPCS 28116
Min. Negotiated Rate	$374.88
Max. Negotiated Rate	$1,784.07
Rate for Payer: Aetna Commercial	$769.13
Rate for Payer: BCBS Complete	$393.62
Rate for Payer: BCBS Trust/PPO	$1,784.07
Rate for Payer: Cash Price	$1,128.80
Rate for Payer: Cash Price	$1,128.80
Rate for Payer: Mclaren Medicaid	$374.88
Rate for Payer: Meridian Medicaid	$393.62
Rate for Payer: Priority Health Choice Medicaid	$374.88
Rate for Payer: Priority Health Cigna Priority Health	$987.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$900.27
Rate for Payer: Priority Health Narrow Network	$900.27
Rate for Payer: Priority Health SBD	$900.27

PR OSTEOCHONDRAL ALLOGRAFT KNEE OPEN

Professional

Both

$4,485.00

Service Code	HCPCS 27415
Min. Negotiated Rate	$709.51
Max. Negotiated Rate	$3,139.50
Rate for Payer: Aetna Commercial	$1,833.39
Rate for Payer: BCBS Complete	$925.91
Rate for Payer: BCBS Trust/PPO	$709.51
Rate for Payer: Cash Price	$3,588.00
Rate for Payer: Cash Price	$3,588.00
Rate for Payer: Mclaren Medicaid	$881.82
Rate for Payer: Meridian Medicaid	$925.91
Rate for Payer: Priority Health Choice Medicaid	$881.82
Rate for Payer: Priority Health Cigna Priority Health	$3,139.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,098.27
Rate for Payer: Priority Health Narrow Network	$2,098.27
Rate for Payer: Priority Health SBD	$2,098.27

Know your out-of-pocket cost for care.

All Charges