Bronson Lakeview Hospital

All Charges

Charge

Type

Setting

Price

PR ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT EXTENSIVE

Professional

Both

$2,267.00

Service Code	HCPCS 29838
Min. Negotiated Rate	$356.14
Max. Negotiated Rate	$1,700.25
Rate for Payer: Aetna Commercial	$790.94
Rate for Payer: Aetna Medicare	$1,133.50
Rate for Payer: BCBS Complete	$373.95
Rate for Payer: BCN Commercial	$910.31
Rate for Payer: Cash Price	$1,813.60
Rate for Payer: Cash Price	$1,813.60
Rate for Payer: Mclaren Medicaid	$356.14
Rate for Payer: Meridian Medicaid	$373.95
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,700.25
Rate for Payer: Priority Health Choice Medicaid	$356.14
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$973.09
Rate for Payer: Priority Health Narrow/Tiered Network	$973.09
Rate for Payer: UHC Medicaid	$356.14
Rate for Payer: UHCCP Medicaid	$356.14

PR ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT LIMITED

Professional

Both

$1,998.00

Service Code	HCPCS 29837
Min. Negotiated Rate	$323.12
Max. Negotiated Rate	$1,498.50
Rate for Payer: Aetna Commercial	$704.42
Rate for Payer: Aetna Medicare	$999.00
Rate for Payer: BCBS Complete	$339.28
Rate for Payer: BCN Commercial	$797.27
Rate for Payer: Cash Price	$1,598.40
Rate for Payer: Cash Price	$1,598.40
Rate for Payer: Mclaren Medicaid	$323.12
Rate for Payer: Meridian Medicaid	$339.28
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,498.50
Rate for Payer: Priority Health Choice Medicaid	$323.12
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$852.26
Rate for Payer: Priority Health Narrow/Tiered Network	$852.26
Rate for Payer: UHC Medicaid	$323.12
Rate for Payer: UHCCP Medicaid	$323.12

PR ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY COMPLETE

Professional

Both

$1,071.00

Service Code	HCPCS 29836
Min. Negotiated Rate	$349.53
Max. Negotiated Rate	$959.79
Rate for Payer: Aetna Commercial	$777.30
Rate for Payer: Aetna Medicare	$535.50
Rate for Payer: BCBS Complete	$367.01
Rate for Payer: BCN Commercial	$897.86
Rate for Payer: Cash Price	$856.80
Rate for Payer: Cash Price	$856.80
Rate for Payer: Mclaren Medicaid	$349.53
Rate for Payer: Meridian Medicaid	$367.01
Rate for Payer: Opus (Opus Packaging Group) HMA	$803.25
Rate for Payer: Priority Health Choice Medicaid	$349.53
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$959.79
Rate for Payer: Priority Health Narrow/Tiered Network	$959.79
Rate for Payer: UHC Medicaid	$349.53
Rate for Payer: UHCCP Medicaid	$349.53

PR ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY PARTIAL

Professional

Both

$2,028.00

Service Code	HCPCS 29835
Min. Negotiated Rate	$310.55
Max. Negotiated Rate	$1,521.00
Rate for Payer: Aetna Commercial	$679.61
Rate for Payer: Aetna Medicare	$1,014.00
Rate for Payer: BCBS Complete	$326.08
Rate for Payer: BCN Commercial	$783.32
Rate for Payer: Cash Price	$1,622.40
Rate for Payer: Cash Price	$1,622.40
Rate for Payer: Mclaren Medicaid	$310.55
Rate for Payer: Meridian Medicaid	$326.08
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,521.00
Rate for Payer: Priority Health Choice Medicaid	$310.55
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$837.35
Rate for Payer: Priority Health Narrow/Tiered Network	$837.35
Rate for Payer: UHC Medicaid	$310.55
Rate for Payer: UHCCP Medicaid	$310.55

PR ARTHROSCOPY ELBOW SURGICAL W/REMOVAL LOOSE/FB

Professional

Both

$1,900.00

Service Code	HCPCS 29834
Min. Negotiated Rate	$298.84
Max. Negotiated Rate	$1,425.00
Rate for Payer: Aetna Commercial	$657.85
Rate for Payer: Aetna Medicare	$950.00
Rate for Payer: BCBS Complete	$313.78
Rate for Payer: BCN Commercial	$758.92
Rate for Payer: Cash Price	$1,520.00
Rate for Payer: Cash Price	$1,520.00
Rate for Payer: Mclaren Medicaid	$298.84
Rate for Payer: Meridian Medicaid	$313.78
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,425.00
Rate for Payer: Priority Health Choice Medicaid	$298.84
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$811.27
Rate for Payer: Priority Health Narrow/Tiered Network	$811.27
Rate for Payer: UHC Medicaid	$298.84
Rate for Payer: UHCCP Medicaid	$298.84

PR ARTHROSCOPY HIP SURGICAL W/REMOVAL LOOSE/FB

Professional

Both

$2,517.00

Service Code	HCPCS 29861
Min. Negotiated Rate	$419.18
Max. Negotiated Rate	$1,887.75
Rate for Payer: Aetna Commercial	$964.85
Rate for Payer: Aetna Medicare	$1,258.50
Rate for Payer: BCBS Complete	$440.14
Rate for Payer: BCN Commercial	$1,058.21
Rate for Payer: Cash Price	$2,013.60
Rate for Payer: Cash Price	$2,013.60
Rate for Payer: Mclaren Medicaid	$419.18
Rate for Payer: Meridian Medicaid	$440.14
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,887.75
Rate for Payer: Priority Health Choice Medicaid	$419.18
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,131.19
Rate for Payer: Priority Health Narrow/Tiered Network	$1,131.19
Rate for Payer: UHC Medicaid	$419.18
Rate for Payer: UHCCP Medicaid	$419.18

PR ARTHROSCOPY HIP SURGICAL W/SYNOVECTOMY

Professional

Both

$1,696.00

Service Code	HCPCS 29863
Min. Negotiated Rate	$482.87
Max. Negotiated Rate	$1,327.10
Rate for Payer: Aetna Commercial	$1,082.78
Rate for Payer: Aetna Medicare	$848.00
Rate for Payer: BCBS Complete	$507.01
Rate for Payer: BCN Commercial	$1,241.46
Rate for Payer: Cash Price	$1,356.80
Rate for Payer: Cash Price	$1,356.80
Rate for Payer: Mclaren Medicaid	$482.87
Rate for Payer: Meridian Medicaid	$507.01
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,272.00
Rate for Payer: Priority Health Choice Medicaid	$482.87
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,327.10
Rate for Payer: Priority Health Narrow/Tiered Network	$1,327.10
Rate for Payer: UHC Medicaid	$482.87
Rate for Payer: UHCCP Medicaid	$482.87

PR ARTHROSCOPY HIP W/ACETABULOPLASTY

Professional

Both

$3,357.00

Service Code	HCPCS 29915
Min. Negotiated Rate	$594.48
Max. Negotiated Rate	$2,517.75
Rate for Payer: Aetna Commercial	$1,365.58
Rate for Payer: Aetna Medicare	$1,678.50
Rate for Payer: BCBS Complete	$624.20
Rate for Payer: BCN Commercial	$1,537.27
Rate for Payer: Cash Price	$2,685.60
Rate for Payer: Cash Price	$2,685.60
Rate for Payer: Mclaren Medicaid	$594.48
Rate for Payer: Meridian Medicaid	$624.20
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,517.75
Rate for Payer: Priority Health Choice Medicaid	$594.48
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,643.30
Rate for Payer: Priority Health Narrow/Tiered Network	$1,643.30
Rate for Payer: UHC Medicaid	$594.48
Rate for Payer: UHCCP Medicaid	$594.48

PR ARTHROSCOPY HIP W/FEMOROPLASTY

Professional

Both

$3,155.00

Service Code	HCPCS 29914
Min. Negotiated Rate	$583.62
Max. Negotiated Rate	$2,366.25
Rate for Payer: Aetna Commercial	$1,332.42
Rate for Payer: Aetna Medicare	$1,577.50
Rate for Payer: BCBS Complete	$612.80
Rate for Payer: BCN Commercial	$1,508.39
Rate for Payer: Cash Price	$2,524.00
Rate for Payer: Cash Price	$2,524.00
Rate for Payer: Mclaren Medicaid	$583.62
Rate for Payer: Meridian Medicaid	$612.80
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,366.25
Rate for Payer: Priority Health Choice Medicaid	$583.62
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,612.43
Rate for Payer: Priority Health Narrow/Tiered Network	$1,612.43
Rate for Payer: UHC Medicaid	$583.62
Rate for Payer: UHCCP Medicaid	$583.62

PR ARTHROSCOPY HIP W/LABRAL REPAIR

Professional

Both

$3,372.00

Service Code	HCPCS 29916
Min. Negotiated Rate	$593.42
Max. Negotiated Rate	$2,529.00
Rate for Payer: Aetna Commercial	$1,365.49
Rate for Payer: Aetna Medicare	$1,686.00
Rate for Payer: BCBS Complete	$623.09
Rate for Payer: BCN Commercial	$1,539.26
Rate for Payer: Cash Price	$2,697.60
Rate for Payer: Cash Price	$2,697.60
Rate for Payer: Mclaren Medicaid	$593.42
Rate for Payer: Meridian Medicaid	$623.09
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,529.00
Rate for Payer: Priority Health Choice Medicaid	$593.42
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,645.42
Rate for Payer: Priority Health Narrow/Tiered Network	$1,645.42
Rate for Payer: UHC Medicaid	$593.42
Rate for Payer: UHCCP Medicaid	$593.42

PR ARTHROSCOPY KNEE DIAGNOSTIC W/WO SYNOVIAL BX SPX

Professional

Both

$1,167.00

Service Code	HCPCS 29870
Min. Negotiated Rate	$254.96
Max. Negotiated Rate	$875.25
Rate for Payer: Aetna Commercial	$540.25
Rate for Payer: Aetna Medicare	$583.50
Rate for Payer: BCBS Complete	$267.71
Rate for Payer: BCN Commercial	$635.43
Rate for Payer: Cash Price	$933.60
Rate for Payer: Cash Price	$933.60
Rate for Payer: Mclaren Medicaid	$254.96
Rate for Payer: Meridian Medicaid	$267.71
Rate for Payer: Opus (Opus Packaging Group) HMA	$875.25
Rate for Payer: Priority Health Choice Medicaid	$254.96
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$679.25
Rate for Payer: Priority Health Narrow/Tiered Network	$679.25
Rate for Payer: UHC Medicaid	$254.96
Rate for Payer: UHCCP Medicaid	$254.96

PR ARTHROSCOPY KNEE MENISCAL TRNSPLJ MED/LAT

Professional

Both

$3,093.00

Service Code	HCPCS 29868
Min. Negotiated Rate	$964.46
Max. Negotiated Rate	$2,693.05
Rate for Payer: Aetna Commercial	$2,231.26
Rate for Payer: Aetna Medicare	$1,546.50
Rate for Payer: BCBS Complete	$1,012.68
Rate for Payer: BCN Commercial	$2,519.28
Rate for Payer: Cash Price	$2,474.40
Rate for Payer: Cash Price	$2,474.40
Rate for Payer: Mclaren Medicaid	$964.46
Rate for Payer: Meridian Medicaid	$1,012.68
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,319.75
Rate for Payer: Priority Health Choice Medicaid	$964.46
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$2,693.05
Rate for Payer: Priority Health Narrow/Tiered Network	$2,693.05
Rate for Payer: UHC Medicaid	$964.46
Rate for Payer: UHCCP Medicaid	$964.46

PR ARTHROSCOPY KNEE OSTEOCHONDRAL AGRFT MOSAICPLAST

Professional

Both

$3,190.00

Service Code	HCPCS 29866
Min. Negotiated Rate	$624.52
Max. Negotiated Rate	$2,392.50
Rate for Payer: Aetna Commercial	$1,401.56
Rate for Payer: Aetna Medicare	$1,595.00
Rate for Payer: BCBS Complete	$655.75
Rate for Payer: BCN Commercial	$1,601.51
Rate for Payer: Cash Price	$2,552.00
Rate for Payer: Cash Price	$2,552.00
Rate for Payer: Mclaren Medicaid	$624.52
Rate for Payer: Meridian Medicaid	$655.75
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,392.50
Rate for Payer: Priority Health Choice Medicaid	$624.52
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,711.96
Rate for Payer: Priority Health Narrow/Tiered Network	$1,711.96
Rate for Payer: UHC Medicaid	$624.52
Rate for Payer: UHCCP Medicaid	$624.52

PR ARTHROSCOPY KNEE OSTEOCHONDRAL ALLOGRAFT

Professional

Both

$2,333.00

Service Code	HCPCS 29867
Min. Negotiated Rate	$751.68
Max. Negotiated Rate	$2,073.42
Rate for Payer: Aetna Commercial	$1,707.15
Rate for Payer: Aetna Medicare	$1,166.50
Rate for Payer: BCBS Complete	$789.26
Rate for Payer: BCN Commercial	$1,939.64
Rate for Payer: Cash Price	$1,866.40
Rate for Payer: Cash Price	$1,866.40
Rate for Payer: Mclaren Medicaid	$751.68
Rate for Payer: Meridian Medicaid	$789.26
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,749.75
Rate for Payer: Priority Health Choice Medicaid	$751.68
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$2,073.42
Rate for Payer: Priority Health Narrow/Tiered Network	$2,073.42
Rate for Payer: UHC Medicaid	$751.68
Rate for Payer: UHCCP Medicaid	$751.68

PR ARTHROSCOPY KNEE SURGICAL WITH LATERAL RELEASE

Professional

Both

$2,033.00

Service Code	HCPCS 29873
Min. Negotiated Rate	$332.28
Max. Negotiated Rate	$1,524.75
Rate for Payer: Aetna Commercial	$709.91
Rate for Payer: Aetna Medicare	$1,016.50
Rate for Payer: BCBS Complete	$348.89
Rate for Payer: BCN Commercial	$825.16
Rate for Payer: Cash Price	$1,626.40
Rate for Payer: Cash Price	$1,626.40
Rate for Payer: Mclaren Medicaid	$332.28
Rate for Payer: Meridian Medicaid	$348.89
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,524.75
Rate for Payer: Priority Health Choice Medicaid	$332.28
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$882.06
Rate for Payer: Priority Health Narrow/Tiered Network	$882.06
Rate for Payer: UHC Medicaid	$332.28
Rate for Payer: UHCCP Medicaid	$332.28

PR ARTHROSCOPY KNEE SURG INFECTION LAVAGE&DRAINAGE

Professional

Both

$1,667.00

Service Code	HCPCS 29871
Min. Negotiated Rate	$313.32
Max. Negotiated Rate	$1,250.25
Rate for Payer: Aetna Commercial	$684.95
Rate for Payer: Aetna Medicare	$833.50
Rate for Payer: BCBS Complete	$328.99
Rate for Payer: BCN Commercial	$790.30
Rate for Payer: Cash Price	$1,333.60
Rate for Payer: Cash Price	$1,333.60
Rate for Payer: Mclaren Medicaid	$313.32
Rate for Payer: Meridian Medicaid	$328.99
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,250.25
Rate for Payer: Priority Health Choice Medicaid	$313.32
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$844.81
Rate for Payer: Priority Health Narrow/Tiered Network	$844.81
Rate for Payer: UHC Medicaid	$313.32
Rate for Payer: UHCCP Medicaid	$313.32

PR ARTHROSCOPY KNEE SURG LYSIS ADHESIONS W/WO MNPJ

Professional

Both

$2,333.00

Service Code	HCPCS 29884
Min. Negotiated Rate	$373.82
Max. Negotiated Rate	$1,749.75
Rate for Payer: Aetna Commercial	$825.18
Rate for Payer: Aetna Medicare	$1,166.50
Rate for Payer: BCBS Complete	$392.51
Rate for Payer: BCN Commercial	$947.16
Rate for Payer: Cash Price	$1,866.40
Rate for Payer: Cash Price	$1,866.40
Rate for Payer: Mclaren Medicaid	$373.82
Rate for Payer: Meridian Medicaid	$392.51
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,749.75
Rate for Payer: Priority Health Choice Medicaid	$373.82
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,012.49
Rate for Payer: Priority Health Narrow/Tiered Network	$1,012.49
Rate for Payer: UHC Medicaid	$373.82
Rate for Payer: UHCCP Medicaid	$373.82

PR ARTHROSCOPY KNEE SURG REMOVAL LOOSE/FOREIGN BODY

Professional

Both

$2,100.00

Service Code	HCPCS 29874
Min. Negotiated Rate	$322.70
Max. Negotiated Rate	$1,575.00
Rate for Payer: Aetna Commercial	$716.98
Rate for Payer: Aetna Medicare	$1,050.00
Rate for Payer: BCBS Complete	$338.83
Rate for Payer: BCN Commercial	$900.47
Rate for Payer: Cash Price	$1,680.00
Rate for Payer: Cash Price	$1,680.00
Rate for Payer: Mclaren Medicaid	$322.70
Rate for Payer: Meridian Medicaid	$338.83
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,575.00
Rate for Payer: Priority Health Choice Medicaid	$322.70
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$876.21
Rate for Payer: Priority Health Narrow/Tiered Network	$876.21
Rate for Payer: UHC Medicaid	$322.70
Rate for Payer: UHCCP Medicaid	$322.70

PR ARTHROSCOPY KNEE SURG SYNOVECTOMY LIMITED SPX

Professional

Both

$1,933.00

Service Code	HCPCS 29875
Min. Negotiated Rate	$302.46
Max. Negotiated Rate	$1,449.75
Rate for Payer: Aetna Commercial	$661.47
Rate for Payer: Aetna Medicare	$966.50
Rate for Payer: BCBS Complete	$317.58
Rate for Payer: BCN Commercial	$835.92
Rate for Payer: Cash Price	$1,546.40
Rate for Payer: Cash Price	$1,546.40
Rate for Payer: Mclaren Medicaid	$302.46
Rate for Payer: Meridian Medicaid	$317.58
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,449.75
Rate for Payer: Priority Health Choice Medicaid	$302.46
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$813.39
Rate for Payer: Priority Health Narrow/Tiered Network	$813.39
Rate for Payer: UHC Medicaid	$302.46
Rate for Payer: UHCCP Medicaid	$302.46

PR ARTHROSCOPY KNEE SURG SYNOVECTOMY MAJ 2/>CMPRT

Professional

Both

$2,467.00

Service Code	HCPCS 29876
Min. Negotiated Rate	$392.13
Max. Negotiated Rate	$1,850.25
Rate for Payer: Aetna Commercial	$871.38
Rate for Payer: Aetna Medicare	$1,233.50
Rate for Payer: BCBS Complete	$411.74
Rate for Payer: BCN Commercial	$1,095.78
Rate for Payer: Cash Price	$1,973.60
Rate for Payer: Cash Price	$1,973.60
Rate for Payer: Mclaren Medicaid	$392.13
Rate for Payer: Meridian Medicaid	$411.74
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,850.25
Rate for Payer: Priority Health Choice Medicaid	$392.13
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,066.25
Rate for Payer: Priority Health Narrow/Tiered Network	$1,066.25
Rate for Payer: UHC Medicaid	$392.13
Rate for Payer: UHCCP Medicaid	$392.13

PR ARTHROSCOPY KNE SURG MENISCUS RPR MEDIAL&LATERAL

Professional

Both

$2,841.00

Service Code	HCPCS 29883
Min. Negotiated Rate	$501.19
Max. Negotiated Rate	$2,130.75
Rate for Payer: Aetna Commercial	$1,118.78
Rate for Payer: Aetna Medicare	$1,420.50
Rate for Payer: BCBS Complete	$526.25
Rate for Payer: BCN Commercial	$1,276.32
Rate for Payer: Cash Price	$2,272.80
Rate for Payer: Cash Price	$2,272.80
Rate for Payer: Mclaren Medicaid	$501.19
Rate for Payer: Meridian Medicaid	$526.25
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,130.75
Rate for Payer: Priority Health Choice Medicaid	$501.19
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,364.35
Rate for Payer: Priority Health Narrow/Tiered Network	$1,364.35
Rate for Payer: UHC Medicaid	$501.19
Rate for Payer: UHCCP Medicaid	$501.19

PR ARTHROSCOPY KNE SURG MENISCUS RPR MEDIAL/LATERAL

Professional

Both

$2,501.00

Service Code	HCPCS 29882
Min. Negotiated Rate	$409.39
Max. Negotiated Rate	$1,875.75
Rate for Payer: Aetna Commercial	$922.00
Rate for Payer: Aetna Medicare	$1,250.50
Rate for Payer: BCBS Complete	$429.86
Rate for Payer: BCN Commercial	$1,153.22
Rate for Payer: Cash Price	$2,000.80
Rate for Payer: Cash Price	$2,000.80
Rate for Payer: Mclaren Medicaid	$409.39
Rate for Payer: Meridian Medicaid	$429.86
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,875.75
Rate for Payer: Priority Health Choice Medicaid	$409.39
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,122.14
Rate for Payer: Priority Health Narrow/Tiered Network	$1,122.14
Rate for Payer: UHC Medicaid	$409.39
Rate for Payer: UHCCP Medicaid	$409.39

PR ARTHROSCOPY SUBTALAR JOINT WITH DEBRIDEMENT

Professional

Both

$2,501.00

Service Code	HCPCS 29906
Min. Negotiated Rate	$399.16
Max. Negotiated Rate	$1,875.75
Rate for Payer: Aetna Commercial	$876.36
Rate for Payer: Aetna Medicare	$1,250.50
Rate for Payer: BCBS Complete	$419.12
Rate for Payer: BCN Commercial	$1,013.39
Rate for Payer: Cash Price	$2,000.80
Rate for Payer: Cash Price	$2,000.80
Rate for Payer: Mclaren Medicaid	$399.16
Rate for Payer: Meridian Medicaid	$419.12
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,875.75
Rate for Payer: Priority Health Choice Medicaid	$399.16
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,083.28
Rate for Payer: Priority Health Narrow/Tiered Network	$1,083.28
Rate for Payer: UHC Medicaid	$399.16
Rate for Payer: UHCCP Medicaid	$399.16

PR ARTHROSCOPY WRIST DIAG W/WO SYNOVIAL BIOPSY SPX

Professional

Both

$945.00

Service Code	HCPCS 29840
Min. Negotiated Rate	$281.37
Max. Negotiated Rate	$749.52
Rate for Payer: Aetna Commercial	$600.40
Rate for Payer: Aetna Medicare	$472.50
Rate for Payer: BCBS Complete	$295.44
Rate for Payer: BCN Commercial	$701.16
Rate for Payer: Cash Price	$756.00
Rate for Payer: Cash Price	$756.00
Rate for Payer: Mclaren Medicaid	$281.37
Rate for Payer: Meridian Medicaid	$295.44
Rate for Payer: Opus (Opus Packaging Group) HMA	$708.75
Rate for Payer: Priority Health Choice Medicaid	$281.37
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$749.52
Rate for Payer: Priority Health Narrow/Tiered Network	$749.52
Rate for Payer: UHC Medicaid	$281.37
Rate for Payer: UHCCP Medicaid	$281.37

PR ARTHROSCOPY WRIST INFECTION LAVAGE&DRAINAGE

Professional

Both

$1,943.00

Service Code	HCPCS 29843
Min. Negotiated Rate	$299.48
Max. Negotiated Rate	$1,457.25
Rate for Payer: Aetna Commercial	$648.17
Rate for Payer: Aetna Medicare	$971.50
Rate for Payer: BCBS Complete	$314.45
Rate for Payer: BCN Commercial	$748.96
Rate for Payer: Cash Price	$1,554.40
Rate for Payer: Cash Price	$1,554.40
Rate for Payer: Mclaren Medicaid	$299.48
Rate for Payer: Meridian Medicaid	$314.45
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,457.25
Rate for Payer: Priority Health Choice Medicaid	$299.48
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$800.62
Rate for Payer: Priority Health Narrow/Tiered Network	$800.62
Rate for Payer: UHC Medicaid	$299.48
Rate for Payer: UHCCP Medicaid	$299.48

Know your out-of-pocket cost for care.

All Charges