Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PR IMM ADMN SARSCOV2 BIVALENT 3 MCG/0.2 ML ADDL

Professional

Both

$41.00

Service Code	HCPCS 0174A
Min. Negotiated Rate	$16.40
Max. Negotiated Rate	$26.65
Rate for Payer: Aetna Medicare	$20.50
Rate for Payer: BCBS Complete	$16.40
Rate for Payer: Cash Price	$32.80
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$26.65
Rate for Payer: Priority Health Cigna Priority Health	$26.65

PR IMM ADMN SARSCOV2 BIVALENT 50 MCG/0.5 ML ADDL

Professional

Both

$41.00

Service Code	HCPCS 0134A
Min. Negotiated Rate	$16.40
Max. Negotiated Rate	$26.65
Rate for Payer: Aetna Medicare	$20.50
Rate for Payer: BCBS Complete	$16.40
Rate for Payer: Cash Price	$32.80
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$26.65
Rate for Payer: Priority Health Cigna Priority Health	$26.65

PR IMM ADMN SARSCOV2 VACCINE SINGLE DOSE

Professional

Both

$85.00

Service Code	HCPCS 90480
Min. Negotiated Rate	$34.00
Max. Negotiated Rate	$55.25
Rate for Payer: Aetna Medicare	$42.50
Rate for Payer: BCBS Complete	$34.00
Rate for Payer: Cash Price	$68.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$55.25
Rate for Payer: Priority Health Cigna Priority Health	$55.25

PR IMMUNIZE COUNS < 21YR 5-15 M

Professional

Both

$31.00

Service Code	HCPCS G0312
Min. Negotiated Rate	$12.40
Max. Negotiated Rate	$20.15
Rate for Payer: Aetna Medicare	$15.50
Rate for Payer: BCBS Complete	$12.40
Rate for Payer: Cash Price	$24.80
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$20.15
Rate for Payer: Priority Health Cigna Priority Health	$20.15

PR IMMUNIZE COUNS < 21YR 6-30 M

Professional

Both

$46.00

Service Code	HCPCS G0313
Min. Negotiated Rate	$18.40
Max. Negotiated Rate	$29.90
Rate for Payer: Aetna Medicare	$23.00
Rate for Payer: BCBS Complete	$18.40
Rate for Payer: Cash Price	$36.80
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$29.90
Rate for Payer: Priority Health Cigna Priority Health	$29.90

PR IMMUNIZE COUNSEL 16-30 MINS

Professional

Both

$46.00

Service Code	HCPCS G0311
Min. Negotiated Rate	$18.40
Max. Negotiated Rate	$29.90
Rate for Payer: Aetna Medicare	$23.00
Rate for Payer: BCBS Complete	$18.40
Rate for Payer: Cash Price	$36.80
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$29.90
Rate for Payer: Priority Health Cigna Priority Health	$29.90

PR IMMUNIZE COUNSEL 5-15 MIN

Professional

Both

$31.00

Service Code	HCPCS G0310
Min. Negotiated Rate	$12.40
Max. Negotiated Rate	$20.15
Rate for Payer: Aetna Medicare	$15.50
Rate for Payer: BCBS Complete	$12.40
Rate for Payer: Cash Price	$24.80
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$20.15
Rate for Payer: Priority Health Cigna Priority Health	$20.15

PR IMPL ABSRB MESH/PRSTH DLYD CLSR DFCT INFCTJ/TRMA

Professional

Both

$802.00

Service Code	HCPCS 15778
Min. Negotiated Rate	$320.80
Max. Negotiated Rate	$705.61
Rate for Payer: Aetna Commercial	$511.09
Rate for Payer: Aetna Medicare	$396.67
Rate for Payer: Aetna New Business (MI Preferred)	$549.23
Rate for Payer: Aetna New Business (MI Preferred)	$511.09
Rate for Payer: BCBS Complete	$320.80
Rate for Payer: BCBS MAPPO	$381.41
Rate for Payer: BCN Medicare Advantage	$381.41
Rate for Payer: Cash Price	$641.60
Rate for Payer: Cash Price	$641.60
Rate for Payer: Cofinity Commercial	$511.09
Rate for Payer: Cofinity Commercial	$549.23
Rate for Payer: Health Alliance Plan Medicare Advantage	$381.41
Rate for Payer: Healthscope Commercial	$705.61
Rate for Payer: Healthscope Commercial	$610.26
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$400.48
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$521.30
Rate for Payer: Nomi Health Commercial	$457.69
Rate for Payer: PACE SWMI	$381.41
Rate for Payer: PHP Medicare Advantage	$381.41
Rate for Payer: Priority Health Cigna Priority Health	$521.30
Rate for Payer: Priority Health Medicare	$381.41
Rate for Payer: UHC Dual Complete DSNP	$381.41
Rate for Payer: UHC Medicare Advantage	$381.41

PR IMPLANTABLE TISSUE MARKER

Professional

Both

$1,224.00

Service Code	HCPCS A4648
Min. Negotiated Rate	$489.60
Max. Negotiated Rate	$795.60
Rate for Payer: Aetna Medicare	$612.00
Rate for Payer: BCBS Complete	$489.60
Rate for Payer: Cash Price	$979.20
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$795.60
Rate for Payer: Priority Health Cigna Priority Health	$795.60

PR IMPLANTATION NERVE END BONE/MUSCLE

Professional

Both

$1,853.00

Service Code	HCPCS 64787
Min. Negotiated Rate	$225.69
Max. Negotiated Rate	$1,204.45
Rate for Payer: Aetna Commercial	$302.42
Rate for Payer: Aetna Medicare	$234.72
Rate for Payer: Aetna New Business (MI Preferred)	$324.99
Rate for Payer: Aetna New Business (MI Preferred)	$302.42
Rate for Payer: BCBS Complete	$741.20
Rate for Payer: BCBS MAPPO	$225.69
Rate for Payer: BCN Medicare Advantage	$225.69
Rate for Payer: Cash Price	$1,482.40
Rate for Payer: Cash Price	$1,482.40
Rate for Payer: Cofinity Commercial	$302.42
Rate for Payer: Cofinity Commercial	$324.99
Rate for Payer: Health Alliance Plan Medicare Advantage	$225.69
Rate for Payer: Healthscope Commercial	$417.53
Rate for Payer: Healthscope Commercial	$361.10
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$236.97
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,204.45
Rate for Payer: Nomi Health Commercial	$270.83
Rate for Payer: PACE SWMI	$225.69
Rate for Payer: PHP Medicare Advantage	$225.69
Rate for Payer: Priority Health Cigna Priority Health	$1,204.45
Rate for Payer: Priority Health Medicare	$225.69
Rate for Payer: UHC Dual Complete DSNP	$225.69
Rate for Payer: UHC Medicare Advantage	$225.69

PR IMPLANTATION PT-ACTIVATED CARDIAC EVENT RECORDER

Professional

Both

$630.00

Service Code	HCPCS 33282
Min. Negotiated Rate	$252.00
Max. Negotiated Rate	$409.50
Rate for Payer: Aetna Medicare	$315.00
Rate for Payer: BCBS Complete	$252.00
Rate for Payer: Cash Price	$504.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$409.50
Rate for Payer: Priority Health Cigna Priority Health	$409.50

PR IMPLANT MESH OPN HERNIA RPR/DEBRIDEMENT CLOSURE

Professional

Both

$1,010.00

Service Code	HCPCS 49568
Min. Negotiated Rate	$404.00
Max. Negotiated Rate	$656.50
Rate for Payer: Aetna Medicare	$505.00
Rate for Payer: BCBS Complete	$404.00
Rate for Payer: Cash Price	$808.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$656.50
Rate for Payer: Priority Health Cigna Priority Health	$656.50

PR IMPLNT BIO IMPLNT FOR SOFT TISSUE REINFORCEMENT

Professional

Both

$448.00

Service Code	HCPCS 15777
Min. Negotiated Rate	$179.20
Max. Negotiated Rate	$380.25
Rate for Payer: Aetna Commercial	$275.42
Rate for Payer: Aetna Medicare	$213.76
Rate for Payer: Aetna New Business (MI Preferred)	$275.42
Rate for Payer: Aetna New Business (MI Preferred)	$295.98
Rate for Payer: BCBS Complete	$179.20
Rate for Payer: BCBS MAPPO	$205.54
Rate for Payer: BCN Medicare Advantage	$205.54
Rate for Payer: Cash Price	$358.40
Rate for Payer: Cash Price	$358.40
Rate for Payer: Cofinity Commercial	$295.98
Rate for Payer: Cofinity Commercial	$275.42
Rate for Payer: Health Alliance Plan Medicare Advantage	$205.54
Rate for Payer: Healthscope Commercial	$380.25
Rate for Payer: Healthscope Commercial	$328.86
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$215.82
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$291.20
Rate for Payer: Nomi Health Commercial	$246.65
Rate for Payer: PACE SWMI	$205.54
Rate for Payer: PHP Medicare Advantage	$205.54
Rate for Payer: Priority Health Cigna Priority Health	$291.20
Rate for Payer: Priority Health Medicare	$205.54
Rate for Payer: UHC Dual Complete DSNP	$205.54
Rate for Payer: UHC Medicare Advantage	$205.54

PR IMPL OI IMPLT SKULL MAG TC ATTACHMENT ESP<100

Professional

Both

$1,343.00

Service Code	HCPCS 69716
Min. Negotiated Rate	$537.20
Max. Negotiated Rate	$1,087.36
Rate for Payer: Aetna Commercial	$787.60
Rate for Payer: Aetna Medicare	$611.27
Rate for Payer: Aetna New Business (MI Preferred)	$787.60
Rate for Payer: Aetna New Business (MI Preferred)	$846.37
Rate for Payer: BCBS Complete	$537.20
Rate for Payer: BCBS MAPPO	$587.76
Rate for Payer: BCN Medicare Advantage	$587.76
Rate for Payer: Cash Price	$1,074.40
Rate for Payer: Cash Price	$1,074.40
Rate for Payer: Cofinity Commercial	$787.60
Rate for Payer: Cofinity Commercial	$846.37
Rate for Payer: Health Alliance Plan Medicare Advantage	$587.76
Rate for Payer: Healthscope Commercial	$1,087.36
Rate for Payer: Healthscope Commercial	$940.42
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$617.15
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$872.95
Rate for Payer: Nomi Health Commercial	$705.31
Rate for Payer: PACE SWMI	$587.76
Rate for Payer: PHP Medicare Advantage	$587.76
Rate for Payer: Priority Health Cigna Priority Health	$872.95
Rate for Payer: Priority Health Medicare	$587.76
Rate for Payer: UHC Dual Complete DSNP	$587.76
Rate for Payer: UHC Medicare Advantage	$587.76

PR IMPL OI IMPLT SKULL PERQ ATTACHMENT ESP

Professional

Both

$1,953.00

Service Code	HCPCS 69714
Min. Negotiated Rate	$467.49
Max. Negotiated Rate	$1,269.45
Rate for Payer: Aetna Commercial	$626.44
Rate for Payer: Aetna Medicare	$486.19
Rate for Payer: Aetna New Business (MI Preferred)	$673.19
Rate for Payer: Aetna New Business (MI Preferred)	$626.44
Rate for Payer: BCBS Complete	$781.20
Rate for Payer: BCBS MAPPO	$467.49
Rate for Payer: BCN Medicare Advantage	$467.49
Rate for Payer: Cash Price	$1,562.40
Rate for Payer: Cash Price	$1,562.40
Rate for Payer: Cofinity Commercial	$673.19
Rate for Payer: Cofinity Commercial	$626.44
Rate for Payer: Health Alliance Plan Medicare Advantage	$467.49
Rate for Payer: Healthscope Commercial	$864.86
Rate for Payer: Healthscope Commercial	$747.98
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$490.86
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,269.45
Rate for Payer: Nomi Health Commercial	$560.99
Rate for Payer: PACE SWMI	$467.49
Rate for Payer: PHP Medicare Advantage	$467.49
Rate for Payer: Priority Health Cigna Priority Health	$1,269.45
Rate for Payer: Priority Health Medicare	$467.49
Rate for Payer: UHC Dual Complete DSNP	$467.49
Rate for Payer: UHC Medicare Advantage	$467.49

PR IMPLTJ BRAIN INTRACAVITARY CHEMOTHERAPY AGENT

Professional

Both

$419.00

Service Code	HCPCS 61517
Min. Negotiated Rate	$86.68
Max. Negotiated Rate	$272.35
Rate for Payer: Aetna Commercial	$116.15
Rate for Payer: Aetna Medicare	$90.15
Rate for Payer: Aetna New Business (MI Preferred)	$124.82
Rate for Payer: Aetna New Business (MI Preferred)	$116.15
Rate for Payer: BCBS Complete	$167.60
Rate for Payer: BCBS MAPPO	$86.68
Rate for Payer: BCN Medicare Advantage	$86.68
Rate for Payer: Cash Price	$335.20
Rate for Payer: Cash Price	$335.20
Rate for Payer: Cofinity Commercial	$124.82
Rate for Payer: Cofinity Commercial	$116.15
Rate for Payer: Health Alliance Plan Medicare Advantage	$86.68
Rate for Payer: Healthscope Commercial	$138.69
Rate for Payer: Healthscope Commercial	$160.36
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$91.01
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$272.35
Rate for Payer: Nomi Health Commercial	$104.02
Rate for Payer: PACE SWMI	$86.68
Rate for Payer: PHP Medicare Advantage	$86.68
Rate for Payer: Priority Health Cigna Priority Health	$272.35
Rate for Payer: Priority Health Medicare	$86.68
Rate for Payer: UHC Dual Complete DSNP	$86.68
Rate for Payer: UHC Medicare Advantage	$86.68

PR IMPLTJ NONBIOL/SYNTH IMPLT FASC RNFCMT ABDL WALL

Professional

Both

$490.00

Service Code	HCPCS 0437T
Min. Negotiated Rate	$196.00
Max. Negotiated Rate	$318.50
Rate for Payer: Aetna Medicare	$245.00
Rate for Payer: BCBS Complete	$196.00
Rate for Payer: Cash Price	$392.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$318.50
Rate for Payer: Priority Health Cigna Priority Health	$318.50

PR IMPLTJ REVJ/RPSG ITHCL/EDRL CATH PMP W/O LAM

Professional

Both

$821.00

Service Code	HCPCS 62350
Min. Negotiated Rate	$328.40
Max. Negotiated Rate	$713.32
Rate for Payer: Aetna Commercial	$516.68
Rate for Payer: Aetna Medicare	$401.00
Rate for Payer: Aetna New Business (MI Preferred)	$516.68
Rate for Payer: Aetna New Business (MI Preferred)	$555.24
Rate for Payer: BCBS Complete	$328.40
Rate for Payer: BCBS MAPPO	$385.58
Rate for Payer: BCN Medicare Advantage	$385.58
Rate for Payer: Cash Price	$656.80
Rate for Payer: Cash Price	$656.80
Rate for Payer: Cofinity Commercial	$555.24
Rate for Payer: Cofinity Commercial	$516.68
Rate for Payer: Health Alliance Plan Medicare Advantage	$385.58
Rate for Payer: Healthscope Commercial	$713.32
Rate for Payer: Healthscope Commercial	$616.93
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$404.86
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$533.65
Rate for Payer: Nomi Health Commercial	$462.70
Rate for Payer: PACE SWMI	$385.58
Rate for Payer: PHP Medicare Advantage	$385.58
Rate for Payer: Priority Health Cigna Priority Health	$533.65
Rate for Payer: Priority Health Medicare	$385.58
Rate for Payer: UHC Dual Complete DSNP	$385.58
Rate for Payer: UHC Medicare Advantage	$385.58

PR IMPLTJ/RPLCMT ITHCL/EDRL DRUG NFS PRGRBL PUMP

Professional

Both

$2,526.00

Service Code	HCPCS 62362
Min. Negotiated Rate	$373.09
Max. Negotiated Rate	$1,641.90
Rate for Payer: Aetna Commercial	$499.94
Rate for Payer: Aetna Medicare	$388.01
Rate for Payer: Aetna New Business (MI Preferred)	$499.94
Rate for Payer: Aetna New Business (MI Preferred)	$537.25
Rate for Payer: BCBS Complete	$1,010.40
Rate for Payer: BCBS MAPPO	$373.09
Rate for Payer: BCN Medicare Advantage	$373.09
Rate for Payer: Cash Price	$2,020.80
Rate for Payer: Cash Price	$2,020.80
Rate for Payer: Cofinity Commercial	$499.94
Rate for Payer: Cofinity Commercial	$537.25
Rate for Payer: Health Alliance Plan Medicare Advantage	$373.09
Rate for Payer: Healthscope Commercial	$596.94
Rate for Payer: Healthscope Commercial	$690.22
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$391.74
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,641.90
Rate for Payer: Nomi Health Commercial	$447.71
Rate for Payer: PACE SWMI	$373.09
Rate for Payer: PHP Medicare Advantage	$373.09
Rate for Payer: Priority Health Cigna Priority Health	$1,641.90
Rate for Payer: Priority Health Medicare	$373.09
Rate for Payer: UHC Dual Complete DSNP	$373.09
Rate for Payer: UHC Medicare Advantage	$373.09

PR IMPREG GAUZE NO H20/SAL/YARD

Professional

Both

$7.00

Service Code	HCPCS A6266
Min. Negotiated Rate	$2.67
Max. Negotiated Rate	$4.94
Rate for Payer: Aetna Commercial	$3.58
Rate for Payer: Aetna Medicare	$2.78
Rate for Payer: Aetna New Business (MI Preferred)	$3.84
Rate for Payer: Aetna New Business (MI Preferred)	$3.58
Rate for Payer: BCBS Complete	$2.80
Rate for Payer: BCBS MAPPO	$2.67
Rate for Payer: BCN Medicare Advantage	$2.67
Rate for Payer: Cash Price	$5.60
Rate for Payer: Cash Price	$5.60
Rate for Payer: Cofinity Commercial	$3.84
Rate for Payer: Cofinity Commercial	$3.58
Rate for Payer: Health Alliance Plan Medicare Advantage	$2.67
Rate for Payer: Healthscope Commercial	$4.94
Rate for Payer: Healthscope Commercial	$4.27
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$2.80
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4.55
Rate for Payer: Nomi Health Commercial	$3.20
Rate for Payer: PACE SWMI	$2.67
Rate for Payer: PHP Medicare Advantage	$2.67
Rate for Payer: Priority Health Cigna Priority Health	$4.55
Rate for Payer: Priority Health Medicare	$2.67
Rate for Payer: UHC Dual Complete DSNP	$2.67
Rate for Payer: UHC Medicare Advantage	$2.67

PR INC DEEP W/OPENING BONE CORTEX HUMERUS/ELBOW

Professional

Both

$1,497.00

Service Code	HCPCS 23935
Min. Negotiated Rate	$496.78
Max. Negotiated Rate	$973.05
Rate for Payer: Aetna Commercial	$665.69
Rate for Payer: Aetna Medicare	$516.65
Rate for Payer: Aetna New Business (MI Preferred)	$715.36
Rate for Payer: Aetna New Business (MI Preferred)	$665.69
Rate for Payer: BCBS Complete	$598.80
Rate for Payer: BCBS MAPPO	$496.78
Rate for Payer: BCN Medicare Advantage	$496.78
Rate for Payer: Cash Price	$1,197.60
Rate for Payer: Cash Price	$1,197.60
Rate for Payer: Cofinity Commercial	$715.36
Rate for Payer: Cofinity Commercial	$665.69
Rate for Payer: Health Alliance Plan Medicare Advantage	$496.78
Rate for Payer: Healthscope Commercial	$794.85
Rate for Payer: Healthscope Commercial	$919.04
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$521.62
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$973.05
Rate for Payer: Nomi Health Commercial	$596.14
Rate for Payer: PACE SWMI	$496.78
Rate for Payer: PHP Medicare Advantage	$496.78
Rate for Payer: Priority Health Cigna Priority Health	$973.05
Rate for Payer: Priority Health Medicare	$496.78
Rate for Payer: UHC Dual Complete DSNP	$496.78
Rate for Payer: UHC Medicare Advantage	$496.78

PR INC DEEP W/OPNG BONE CORTEX FEMUR/KNEE

Professional

Both

$1,570.00

Service Code	HCPCS 27303
Min. Negotiated Rate	$620.65
Max. Negotiated Rate	$1,148.20
Rate for Payer: Aetna Commercial	$831.67
Rate for Payer: Aetna Medicare	$645.48
Rate for Payer: Aetna New Business (MI Preferred)	$893.74
Rate for Payer: Aetna New Business (MI Preferred)	$831.67
Rate for Payer: BCBS Complete	$628.00
Rate for Payer: BCBS MAPPO	$620.65
Rate for Payer: BCN Medicare Advantage	$620.65
Rate for Payer: Cash Price	$1,256.00
Rate for Payer: Cash Price	$1,256.00
Rate for Payer: Cofinity Commercial	$893.74
Rate for Payer: Cofinity Commercial	$831.67
Rate for Payer: Health Alliance Plan Medicare Advantage	$620.65
Rate for Payer: Healthscope Commercial	$993.04
Rate for Payer: Healthscope Commercial	$1,148.20
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$651.68
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,020.50
Rate for Payer: Nomi Health Commercial	$744.78
Rate for Payer: PACE SWMI	$620.65
Rate for Payer: PHP Medicare Advantage	$620.65
Rate for Payer: Priority Health Cigna Priority Health	$1,020.50
Rate for Payer: Priority Health Medicare	$620.65
Rate for Payer: UHC Dual Complete DSNP	$620.65
Rate for Payer: UHC Medicare Advantage	$620.65

PR INCISE&RETRIEVAL SUBQ CRANIOPLASTY BONE GRAFT

Professional

Both

$588.00

Service Code	HCPCS 62148
Min. Negotiated Rate	$124.68
Max. Negotiated Rate	$382.20
Rate for Payer: Aetna Commercial	$167.07
Rate for Payer: Aetna Medicare	$129.67
Rate for Payer: Aetna New Business (MI Preferred)	$179.54
Rate for Payer: Aetna New Business (MI Preferred)	$167.07
Rate for Payer: BCBS Complete	$235.20
Rate for Payer: BCBS MAPPO	$124.68
Rate for Payer: BCN Medicare Advantage	$124.68
Rate for Payer: Cash Price	$470.40
Rate for Payer: Cash Price	$470.40
Rate for Payer: Cofinity Commercial	$179.54
Rate for Payer: Cofinity Commercial	$167.07
Rate for Payer: Health Alliance Plan Medicare Advantage	$124.68
Rate for Payer: Healthscope Commercial	$199.49
Rate for Payer: Healthscope Commercial	$230.66
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$130.91
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$382.20
Rate for Payer: Nomi Health Commercial	$149.62
Rate for Payer: PACE SWMI	$124.68
Rate for Payer: PHP Medicare Advantage	$124.68
Rate for Payer: Priority Health Cigna Priority Health	$382.20
Rate for Payer: Priority Health Medicare	$124.68
Rate for Payer: UHC Dual Complete DSNP	$124.68
Rate for Payer: UHC Medicare Advantage	$124.68

PR INCIS HEART SAC TUBE

Professional

Both

$1,683.00

Service Code	HCPCS 33015
Min. Negotiated Rate	$673.20
Max. Negotiated Rate	$1,093.95
Rate for Payer: Aetna Medicare	$841.50
Rate for Payer: BCBS Complete	$673.20
Rate for Payer: Cash Price	$1,346.40
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,093.95
Rate for Payer: Priority Health Cigna Priority Health	$1,093.95

PR INCISIONAL BIOPSY EYELID SKIN W/LID MARGIN

Professional

Both

$365.00

Service Code	HCPCS 67810
Min. Negotiated Rate	$64.53
Max. Negotiated Rate	$237.25
Rate for Payer: Aetna Commercial	$86.47
Rate for Payer: Aetna Medicare	$67.11
Rate for Payer: Aetna New Business (MI Preferred)	$86.47
Rate for Payer: Aetna New Business (MI Preferred)	$92.92
Rate for Payer: BCBS Complete	$146.00
Rate for Payer: BCBS MAPPO	$64.53
Rate for Payer: BCN Medicare Advantage	$64.53
Rate for Payer: Cash Price	$292.00
Rate for Payer: Cash Price	$292.00
Rate for Payer: Cofinity Commercial	$92.92
Rate for Payer: Cofinity Commercial	$86.47
Rate for Payer: Health Alliance Plan Medicare Advantage	$64.53
Rate for Payer: Healthscope Commercial	$119.38
Rate for Payer: Healthscope Commercial	$103.25
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$67.76
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$237.25
Rate for Payer: Nomi Health Commercial	$77.44
Rate for Payer: PACE SWMI	$64.53
Rate for Payer: PHP Medicare Advantage	$64.53
Rate for Payer: Priority Health Cigna Priority Health	$237.25
Rate for Payer: Priority Health Medicare	$64.53
Rate for Payer: UHC Dual Complete DSNP	$64.53
Rate for Payer: UHC Medicare Advantage	$64.53

Know your out-of-pocket cost for care.

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