Bronson Lakeview Hospital

All Charges

Charge

Type

Setting

Price

EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), SCALP, NECK, HANDS, FEET, GENITALIA; EXCISED DIAMETER 3.1 TO 4.0 CM

Facility

$1,205.21

Service Code	CPT 11424
Hospital Revenue Code	360
Min. Negotiated Rate	$1,147.75
Max. Negotiated Rate	$1,205.21
Rate for Payer: BCBS Complete	$1,205.21
Rate for Payer: Mclaren Medicaid	$1,147.75
Rate for Payer: Meridian Medicaid	$1,205.21
Rate for Payer: Priority Health Choice Medicaid	$1,147.75
Rate for Payer: UHCCP Medicaid	$1,147.75

EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), TRUNK, ARMS OR LEGS; EXCISED DIAMETER 1.1 TO 2.0 CM

Facility

$523.36

Service Code	CPT 11402
Hospital Revenue Code	360
Min. Negotiated Rate	$498.41
Max. Negotiated Rate	$523.36
Rate for Payer: BCBS Complete	$523.36
Rate for Payer: Mclaren Medicaid	$498.41
Rate for Payer: Meridian Medicaid	$523.36
Rate for Payer: Priority Health Choice Medicaid	$498.41
Rate for Payer: UHCCP Medicaid	$498.41

EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), TRUNK, ARMS OR LEGS; EXCISED DIAMETER 2.1 TO 3.0 CM

Facility

$523.36

Service Code	CPT 11403
Hospital Revenue Code	360
Min. Negotiated Rate	$498.41
Max. Negotiated Rate	$523.36
Rate for Payer: BCBS Complete	$523.36
Rate for Payer: Mclaren Medicaid	$498.41
Rate for Payer: Meridian Medicaid	$523.36
Rate for Payer: Priority Health Choice Medicaid	$498.41
Rate for Payer: UHCCP Medicaid	$498.41

EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), TRUNK, ARMS OR LEGS; EXCISED DIAMETER 3.1 TO 4.0 CM

Facility

$1,205.21

Service Code	CPT 11404
Hospital Revenue Code	360
Min. Negotiated Rate	$1,147.75
Max. Negotiated Rate	$1,205.21
Rate for Payer: BCBS Complete	$1,205.21
Rate for Payer: Mclaren Medicaid	$1,147.75
Rate for Payer: Meridian Medicaid	$1,205.21
Rate for Payer: Priority Health Choice Medicaid	$1,147.75
Rate for Payer: UHCCP Medicaid	$1,147.75

EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), TRUNK, ARMS OR LEGS; EXCISED DIAMETER OVER 4.0 CM

Facility

$1,205.21

Service Code	CPT 11406
Hospital Revenue Code	360
Min. Negotiated Rate	$1,147.75
Max. Negotiated Rate	$1,205.21
Rate for Payer: BCBS Complete	$1,205.21
Rate for Payer: Mclaren Medicaid	$1,147.75
Rate for Payer: Meridian Medicaid	$1,205.21
Rate for Payer: Priority Health Choice Medicaid	$1,147.75
Rate for Payer: UHCCP Medicaid	$1,147.75

EXCISION, MALIGNANT LESION INCLUDING MARGINS, SCALP, NECK, HANDS, FEET, GENITALIA; EXCISED DIAMETER 2.1 TO 3.0 CM

Facility

$1,205.21

Service Code	CPT 11623
Hospital Revenue Code	360
Min. Negotiated Rate	$1,147.75
Max. Negotiated Rate	$1,205.21
Rate for Payer: BCBS Complete	$1,205.21
Rate for Payer: Mclaren Medicaid	$1,147.75
Rate for Payer: Meridian Medicaid	$1,205.21
Rate for Payer: Priority Health Choice Medicaid	$1,147.75
Rate for Payer: UHCCP Medicaid	$1,147.75

EXCISION, MALIGNANT LESION INCLUDING MARGINS, SCALP, NECK, HANDS, FEET, GENITALIA; EXCISED DIAMETER OVER 4.0 CM

Facility

$2,128.93

Service Code	CPT 11626
Hospital Revenue Code	360
Min. Negotiated Rate	$2,027.42
Max. Negotiated Rate	$2,128.93
Rate for Payer: BCBS Complete	$2,128.93
Rate for Payer: Mclaren Medicaid	$2,027.42
Rate for Payer: Meridian Medicaid	$2,128.93
Rate for Payer: Priority Health Choice Medicaid	$2,027.42
Rate for Payer: UHCCP Medicaid	$2,027.42

EXCISION, MALIGNANT LESION INCLUDING MARGINS, TRUNK, ARMS, OR LEGS; EXCISED DIAMETER 3.1 TO 4.0 CM

Facility

$523.36

Service Code	CPT 11604
Hospital Revenue Code	360
Min. Negotiated Rate	$498.41
Max. Negotiated Rate	$523.36
Rate for Payer: BCBS Complete	$523.36
Rate for Payer: Mclaren Medicaid	$498.41
Rate for Payer: Meridian Medicaid	$523.36
Rate for Payer: Priority Health Choice Medicaid	$498.41
Rate for Payer: UHCCP Medicaid	$498.41

EXCISION OF CYST, FIBROADENOMA, OR OTHER BENIGN OR MALIGNANT TUMOR, ABERRANT BREAST TISSUE, DUCT LESION, NIPPLE OR AREOLAR LESION (EXCEPT 19300), OPEN, MALE OR FEMALE, 1 OR MORE LESIONS

Facility

$2,848.40

Service Code	CPT 19120
Hospital Revenue Code	360
Min. Negotiated Rate	$515.37
Max. Negotiated Rate	$2,848.40
Rate for Payer: BCBS Complete	$2,848.40
Rate for Payer: BCCCP Commercial	$515.37
Rate for Payer: Mclaren Medicaid	$2,712.59
Rate for Payer: Meridian Medicaid	$2,848.40
Rate for Payer: Priority Health Choice Medicaid	$2,712.59
Rate for Payer: UHCCP Medicaid	$2,712.59

EXCISION OF GANGLION, WRIST (DORSAL OR VOLAR); PRIMARY

Facility

$1,190.46

Service Code	CPT 25111
Hospital Revenue Code	360
Min. Negotiated Rate	$1,133.70
Max. Negotiated Rate	$1,190.46
Rate for Payer: BCBS Complete	$1,190.46
Rate for Payer: Mclaren Medicaid	$1,133.70
Rate for Payer: Meridian Medicaid	$1,190.46
Rate for Payer: Priority Health Choice Medicaid	$1,133.70
Rate for Payer: UHCCP Medicaid	$1,133.70

EXCISION OF LESION, TENDON, TENDON SHEATH, OR CAPSULE (INCLUDING SYNOVECTOMY) (EG, CYST OR GANGLION); FOOT

Facility

$1,190.46

Service Code	CPT 28090
Hospital Revenue Code	360
Min. Negotiated Rate	$1,133.70
Max. Negotiated Rate	$1,190.46
Rate for Payer: BCBS Complete	$1,190.46
Rate for Payer: Mclaren Medicaid	$1,133.70
Rate for Payer: Meridian Medicaid	$1,190.46
Rate for Payer: Priority Health Choice Medicaid	$1,133.70
Rate for Payer: UHCCP Medicaid	$1,133.70

EXCISION OF LESION, TENDON, TENDON SHEATH, OR CAPSULE (INCLUDING SYNOVECTOMY) (EG, CYST OR GANGLION); TOE(S), EACH

Facility

$1,190.46

Service Code	CPT 28092
Hospital Revenue Code	360
Min. Negotiated Rate	$1,133.70
Max. Negotiated Rate	$1,190.46
Rate for Payer: BCBS Complete	$1,190.46
Rate for Payer: Mclaren Medicaid	$1,133.70
Rate for Payer: Meridian Medicaid	$1,190.46
Rate for Payer: Priority Health Choice Medicaid	$1,133.70
Rate for Payer: UHCCP Medicaid	$1,133.70

EXCISION OF PILONIDAL CYST OR SINUS; COMPLICATED

Facility

$2,128.93

Service Code	CPT 11772
Hospital Revenue Code	360
Min. Negotiated Rate	$2,027.42
Max. Negotiated Rate	$2,128.93
Rate for Payer: BCBS Complete	$2,128.93
Rate for Payer: Mclaren Medicaid	$2,027.42
Rate for Payer: Meridian Medicaid	$2,128.93
Rate for Payer: Priority Health Choice Medicaid	$2,027.42
Rate for Payer: UHCCP Medicaid	$2,027.42

EXCISION OF PILONIDAL CYST OR SINUS; EXTENSIVE

Facility

$2,128.93

Service Code	CPT 11771
Hospital Revenue Code	360
Min. Negotiated Rate	$2,027.42
Max. Negotiated Rate	$2,128.93
Rate for Payer: BCBS Complete	$2,128.93
Rate for Payer: Mclaren Medicaid	$2,027.42
Rate for Payer: Meridian Medicaid	$2,128.93
Rate for Payer: Priority Health Choice Medicaid	$2,027.42
Rate for Payer: UHCCP Medicaid	$2,027.42

EXCISION OF SINGLE EXTERNAL PAPILLA OR TAG, ANUS

Facility

$877.06

Service Code	CPT 46220
Hospital Revenue Code	360
Min. Negotiated Rate	$835.24
Max. Negotiated Rate	$877.06
Rate for Payer: BCBS Complete	$877.06
Rate for Payer: Mclaren Medicaid	$835.24
Rate for Payer: Meridian Medicaid	$877.06
Rate for Payer: Priority Health Choice Medicaid	$835.24
Rate for Payer: UHCCP Medicaid	$835.24

EXCISION OF SKIN AND SUBCUTANEOUS TISSUE FOR HIDRADENITIS, AXILLARY; WITH COMPLEX REPAIR

Facility

$2,128.93

Service Code	CPT 11451
Hospital Revenue Code	360
Min. Negotiated Rate	$2,027.42
Max. Negotiated Rate	$2,128.93
Rate for Payer: BCBS Complete	$2,128.93
Rate for Payer: Mclaren Medicaid	$2,027.42
Rate for Payer: Meridian Medicaid	$2,128.93
Rate for Payer: Priority Health Choice Medicaid	$2,027.42
Rate for Payer: UHCCP Medicaid	$2,027.42

EXCISION OF SKIN AND SUBCUTANEOUS TISSUE FOR HIDRADENITIS, AXILLARY; WITH SIMPLE OR INTERMEDIATE REPAIR

Facility

$2,128.93

Service Code	CPT 11450
Hospital Revenue Code	360
Min. Negotiated Rate	$2,027.42
Max. Negotiated Rate	$2,128.93
Rate for Payer: BCBS Complete	$2,128.93
Rate for Payer: Mclaren Medicaid	$2,027.42
Rate for Payer: Meridian Medicaid	$2,128.93
Rate for Payer: Priority Health Choice Medicaid	$2,027.42
Rate for Payer: UHCCP Medicaid	$2,027.42

EXCISION OF SKIN AND SUBCUTANEOUS TISSUE FOR HIDRADENITIS, INGUINAL; WITH SIMPLE OR INTERMEDIATE REPAIR

Facility

$2,128.93

Service Code	CPT 11462
Hospital Revenue Code	360
Min. Negotiated Rate	$2,027.42
Max. Negotiated Rate	$2,128.93
Rate for Payer: BCBS Complete	$2,128.93
Rate for Payer: Mclaren Medicaid	$2,027.42
Rate for Payer: Meridian Medicaid	$2,128.93
Rate for Payer: Priority Health Choice Medicaid	$2,027.42
Rate for Payer: UHCCP Medicaid	$2,027.42

EXCISION OF TENDON, FOREARM AND/OR WRIST, FLEXOR OR EXTENSOR, EACH

Facility

$2,413.50

Service Code	CPT 25109
Hospital Revenue Code	360
Min. Negotiated Rate	$2,298.42
Max. Negotiated Rate	$2,413.50
Rate for Payer: BCBS Complete	$2,413.50
Rate for Payer: Mclaren Medicaid	$2,298.42
Rate for Payer: Meridian Medicaid	$2,413.50
Rate for Payer: Priority Health Choice Medicaid	$2,298.42
Rate for Payer: UHCCP Medicaid	$2,298.42

EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, TARSAL OR METATARSAL, EXCEPT TALUS OR CALCANEUS;

Facility

$2,413.50

Service Code	CPT 28104
Hospital Revenue Code	360
Min. Negotiated Rate	$2,298.42
Max. Negotiated Rate	$2,413.50
Rate for Payer: BCBS Complete	$2,413.50
Rate for Payer: Mclaren Medicaid	$2,298.42
Rate for Payer: Meridian Medicaid	$2,413.50
Rate for Payer: Priority Health Choice Medicaid	$2,298.42
Rate for Payer: UHCCP Medicaid	$2,298.42

EXCISION, OTHER BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; EXCISED DIAMETER 0.6 TO 1.0 CM

Facility

$523.36

Service Code	CPT 11441
Hospital Revenue Code	360
Min. Negotiated Rate	$498.41
Max. Negotiated Rate	$523.36
Rate for Payer: BCBS Complete	$523.36
Rate for Payer: Mclaren Medicaid	$498.41
Rate for Payer: Meridian Medicaid	$523.36
Rate for Payer: Priority Health Choice Medicaid	$498.41
Rate for Payer: UHCCP Medicaid	$498.41

EXCISION, OTHER BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; EXCISED DIAMETER 2.1 TO 3.0 CM

Facility

$1,205.21

Service Code	CPT 11443
Hospital Revenue Code	360
Min. Negotiated Rate	$1,147.75
Max. Negotiated Rate	$1,205.21
Rate for Payer: BCBS Complete	$1,205.21
Rate for Payer: Mclaren Medicaid	$1,147.75
Rate for Payer: Meridian Medicaid	$1,205.21
Rate for Payer: Priority Health Choice Medicaid	$1,147.75
Rate for Payer: UHCCP Medicaid	$1,147.75

EXCISION, OTHER BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; EXCISED DIAMETER OVER 4.0 CM

Facility

$2,128.93

Service Code	CPT 11446
Hospital Revenue Code	360
Min. Negotiated Rate	$2,027.42
Max. Negotiated Rate	$2,128.93
Rate for Payer: BCBS Complete	$2,128.93
Rate for Payer: Mclaren Medicaid	$2,027.42
Rate for Payer: Meridian Medicaid	$2,128.93
Rate for Payer: Priority Health Choice Medicaid	$2,027.42
Rate for Payer: UHCCP Medicaid	$2,027.42

EXCISION, PREPATELLAR BURSA

Facility

$2,413.50

Service Code	CPT 27340
Hospital Revenue Code	360
Min. Negotiated Rate	$2,298.42
Max. Negotiated Rate	$2,413.50
Rate for Payer: BCBS Complete	$2,413.50
Rate for Payer: Mclaren Medicaid	$2,298.42
Rate for Payer: Meridian Medicaid	$2,413.50
Rate for Payer: Priority Health Choice Medicaid	$2,298.42
Rate for Payer: UHCCP Medicaid	$2,298.42

EXCISION, TUMOR, SOFT TISSUE OF ABDOMINAL WALL, SUBFASCIAL (EG, INTRAMUSCULAR); LESS THAN 5 CM

Facility

$2,128.93

Service Code	CPT 22900
Hospital Revenue Code	360
Min. Negotiated Rate	$2,027.42
Max. Negotiated Rate	$2,128.93
Rate for Payer: BCBS Complete	$2,128.93
Rate for Payer: Mclaren Medicaid	$2,027.42
Rate for Payer: Meridian Medicaid	$2,128.93
Rate for Payer: Priority Health Choice Medicaid	$2,027.42
Rate for Payer: UHCCP Medicaid	$2,027.42

Know your out-of-pocket cost for care.

All Charges