Bronson Lakeview Hospital

All Charges

Charge

Type

Setting

Price

PR ARTHRP FEM CONDYLES/TIBL PLATU KNE DBRDMT&PRTL

Professional

Both

$1,501.00

Service Code	HCPCS 27443
Min. Negotiated Rate	$485.85
Max. Negotiated Rate	$1,330.82
Rate for Payer: Aetna Commercial	$1,090.60
Rate for Payer: Aetna Medicare	$750.50
Rate for Payer: BCBS Complete	$510.14
Rate for Payer: BCN Commercial	$1,244.95
Rate for Payer: Cash Price	$1,200.80
Rate for Payer: Cash Price	$1,200.80
Rate for Payer: Mclaren Medicaid	$485.85
Rate for Payer: Meridian Medicaid	$510.14
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,125.75
Rate for Payer: Priority Health Choice Medicaid	$485.85
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,330.82
Rate for Payer: Priority Health Narrow/Tiered Network	$1,330.82
Rate for Payer: UHC Medicaid	$485.85
Rate for Payer: UHCCP Medicaid	$485.85

PR ARTHRP INTERCARPAL/CARP/MTCRPL JT INTERPOSITION

Professional

Both

$3,130.00

Service Code	HCPCS 25447
Min. Negotiated Rate	$474.35
Max. Negotiated Rate	$2,347.50
Rate for Payer: Aetna Commercial	$1,103.99
Rate for Payer: Aetna Medicare	$1,565.00
Rate for Payer: BCBS Complete	$498.07
Rate for Payer: BCN Commercial	$1,224.04
Rate for Payer: Cash Price	$2,504.00
Rate for Payer: Cash Price	$2,504.00
Rate for Payer: Mclaren Medicaid	$474.35
Rate for Payer: Meridian Medicaid	$498.07
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,347.50
Rate for Payer: Priority Health Choice Medicaid	$474.35
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,308.47
Rate for Payer: Priority Health Narrow/Tiered Network	$1,308.47
Rate for Payer: UHC Medicaid	$474.35
Rate for Payer: UHCCP Medicaid	$474.35

PR ARTHRP INTERCARPAL/CARP/MTCRPL JT SUSPENSION

Facility

$2,637.00

Service Code	CPT 25448
Hospital Charge Code	25448
Hospital Revenue Code	490
Min. Negotiated Rate	$1,835.35
Max. Negotiated Rate	$2,373.30
Rate for Payer: Aetna Commercial	$2,241.45
Rate for Payer: BCBS Trust/PPO	$2,177.90
Rate for Payer: BCN Commercial	$2,177.90
Rate for Payer: Cash Price	$2,109.60
Rate for Payer: Cofinity Commercial	$2,267.82
Rate for Payer: Encore Health Key Benefits Commercial	$2,109.60
Rate for Payer: Healthscope Commercial	$2,373.30
Rate for Payer: Lakeland Regional Health Systems Commercial	$1,977.75
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2,241.45
Rate for Payer: Nomi Health Commercial	$2,162.34
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,977.75
Rate for Payer: PHP Commercial	$2,241.45
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$2,294.19
Rate for Payer: Priority Health Narrow/Tiered Network	$1,835.35
Rate for Payer: UHC All Payor (Choice/PPO)	$2,320.56
Rate for Payer: UHC Core	$2,201.89
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$1,977.75

PR ARTHRP INTERCARPAL/CARP/MTCRPL JT SUSPENSION

Facility

$2,637.00

Service Code	CPT 25448
Hospital Charge Code	25448
Hospital Revenue Code	490
Min. Negotiated Rate	$464.90
Max. Negotiated Rate	$2,373.30
Rate for Payer: Aetna Commercial	$2,241.45
Rate for Payer: Aetna Medicare	$685.62
Rate for Payer: Allen County Amish Medical Aid Commercial	$824.06
Rate for Payer: Amish Plain Church Group Commercial	$824.06
Rate for Payer: BCBS Complete	$488.11
Rate for Payer: BCBS MAPPO	$659.25
Rate for Payer: BCBS Trust/PPO	$2,167.88
Rate for Payer: BCN Commercial	$2,167.88
Rate for Payer: BCN Medicare Advantage	$659.25
Rate for Payer: Cash Price	$2,109.60
Rate for Payer: Cofinity Commercial	$2,267.82
Rate for Payer: Encore Health Key Benefits Commercial	$2,109.60
Rate for Payer: Health Alliance Plan Medicare Advantage	$659.25
Rate for Payer: Healthscope Commercial	$2,373.30
Rate for Payer: Lakeland Regional Health Systems Commercial	$1,977.75
Rate for Payer: Mclaren Medicaid	$464.90
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$692.21
Rate for Payer: Meridian Medicaid	$488.11
Rate for Payer: MI Amish Medical Board Commercial	$758.14
Rate for Payer: Molina Medicare/Medicaid	$725.17
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2,241.45
Rate for Payer: Nomi Health Commercial	$2,162.34
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,977.75
Rate for Payer: PACE Senior Care Partners	$626.29
Rate for Payer: PACE SWMI	$659.25
Rate for Payer: PHP Commercial	$2,241.45
Rate for Payer: PHP Medicare Advantage	$659.25
Rate for Payer: Priority Health Choice Medicaid	$464.90
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$2,294.19
Rate for Payer: Priority Health Medicare	$665.84
Rate for Payer: Priority Health Narrow/Tiered Network	$1,835.35
Rate for Payer: Railroad Medicare Medicare	$659.25
Rate for Payer: UHC All Payor (Choice/PPO)	$2,320.56
Rate for Payer: UHC Core	$2,201.89
Rate for Payer: UHC Exchange	$659.25
Rate for Payer: UHC Medicaid	$464.90
Rate for Payer: UHC Medicare Advantage	$659.25
Rate for Payer: UHCCP Medicaid	$464.90
Rate for Payer: VA VA	$659.25
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$1,977.75

PR ARTHRP INTERCARPAL/CARP/MTCRPL JT SUSPENSION

Professional

Both

$2,637.00

Service Code	HCPCS 25448
Min. Negotiated Rate	$522.49
Max. Negotiated Rate	$1,977.75
Rate for Payer: Aetna Medicare	$1,318.50
Rate for Payer: BCBS Complete	$548.61
Rate for Payer: BCN Commercial	$1,351.52
Rate for Payer: Cash Price	$2,109.60
Rate for Payer: Cash Price	$2,109.60
Rate for Payer: Mclaren Medicaid	$522.49
Rate for Payer: Meridian Medicaid	$548.61
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,977.75
Rate for Payer: Priority Health Choice Medicaid	$522.49
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,444.73
Rate for Payer: Priority Health Narrow/Tiered Network	$1,444.73
Rate for Payer: UHC Medicaid	$522.49
Rate for Payer: UHCCP Medicaid	$522.49

PR ARTHRP INTERCARPAL/CARP/MTCRPL JT SUSPENSION

Professional

Both

$2,637.00

Service Code	HCPCS 25448
Hospital Charge Code	25448
Min. Negotiated Rate	$522.49
Max. Negotiated Rate	$1,977.75
Rate for Payer: Aetna Medicare	$1,318.50
Rate for Payer: BCBS Complete	$548.61
Rate for Payer: BCN Commercial	$1,351.52
Rate for Payer: Cash Price	$2,109.60
Rate for Payer: Cash Price	$2,109.60
Rate for Payer: Mclaren Medicaid	$522.49
Rate for Payer: Meridian Medicaid	$548.61
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,977.75
Rate for Payer: Priority Health Choice Medicaid	$522.49
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,444.73
Rate for Payer: Priority Health Narrow/Tiered Network	$1,444.73
Rate for Payer: UHC Medicaid	$522.49
Rate for Payer: UHCCP Medicaid	$522.49

PR ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS

Professional

Both

$5,157.00

Service Code	HCPCS 27447
Min. Negotiated Rate	$739.32
Max. Negotiated Rate	$3,867.75
Rate for Payer: Aetna Commercial	$1,718.87
Rate for Payer: Aetna Medicare	$2,578.50
Rate for Payer: BCBS Complete	$776.29
Rate for Payer: BCN Commercial	$2,127.00
Rate for Payer: Cash Price	$4,125.60
Rate for Payer: Cash Price	$4,125.60
Rate for Payer: Mclaren Medicaid	$739.32
Rate for Payer: Meridian Medicaid	$776.29
Rate for Payer: Opus (Opus Packaging Group) HMA	$3,867.75
Rate for Payer: Priority Health Choice Medicaid	$739.32
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$2,069.69
Rate for Payer: Priority Health Narrow/Tiered Network	$2,069.69
Rate for Payer: UHC Medicaid	$739.32
Rate for Payer: UHCCP Medicaid	$739.32

PR ARTHRP KNEE CONDYLE&PLATEAU MEDIAL/LAT CMPRT

Professional

Both

$3,318.00

Service Code	HCPCS 27446
Min. Negotiated Rate	$667.97
Max. Negotiated Rate	$2,488.50
Rate for Payer: Aetna Commercial	$1,544.64
Rate for Payer: Aetna Medicare	$1,659.00
Rate for Payer: BCBS Complete	$701.37
Rate for Payer: BCN Commercial	$1,736.46
Rate for Payer: Cash Price	$2,654.40
Rate for Payer: Cash Price	$2,654.40
Rate for Payer: Mclaren Medicaid	$667.97
Rate for Payer: Meridian Medicaid	$701.37
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,488.50
Rate for Payer: Priority Health Choice Medicaid	$667.97
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,856.22
Rate for Payer: Priority Health Narrow/Tiered Network	$1,856.22
Rate for Payer: UHC Medicaid	$667.97
Rate for Payer: UHCCP Medicaid	$667.97

PR ARTHRP KNEE TIBIAL PLATEAU DBRDMT&PRTL SYNVCT

Professional

Both

$1,741.00

Service Code	HCPCS 27441
Min. Negotiated Rate	$490.11
Max. Negotiated Rate	$1,343.06
Rate for Payer: Aetna Commercial	$1,100.22
Rate for Payer: Aetna Medicare	$870.50
Rate for Payer: BCBS Complete	$514.62
Rate for Payer: BCN Commercial	$1,256.41
Rate for Payer: Cash Price	$1,392.80
Rate for Payer: Cash Price	$1,392.80
Rate for Payer: Mclaren Medicaid	$490.11
Rate for Payer: Meridian Medicaid	$514.62
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,305.75
Rate for Payer: Priority Health Choice Medicaid	$490.11
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,343.06
Rate for Payer: Priority Health Narrow/Tiered Network	$1,343.06
Rate for Payer: UHC Medicaid	$490.11
Rate for Payer: UHCCP Medicaid	$490.11

PR ARTHRP MTCARPHLNGL JT W/PROSTC IMPLT EA JT

Professional

Both

$2,246.00

Service Code	HCPCS 26531
Min. Negotiated Rate	$375.09
Max. Negotiated Rate	$1,684.50
Rate for Payer: Aetna Commercial	$837.81
Rate for Payer: Aetna Medicare	$1,123.00
Rate for Payer: BCBS Complete	$393.84
Rate for Payer: BCN Commercial	$973.05
Rate for Payer: Cash Price	$1,796.80
Rate for Payer: Cash Price	$1,796.80
Rate for Payer: Mclaren Medicaid	$375.09
Rate for Payer: Meridian Medicaid	$393.84
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,684.50
Rate for Payer: Priority Health Choice Medicaid	$375.09
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,040.17
Rate for Payer: Priority Health Narrow/Tiered Network	$1,040.17
Rate for Payer: UHC Medicaid	$375.09
Rate for Payer: UHCCP Medicaid	$375.09

PR ARTHRP W/PROSTC RPLCMT DSTL RDS&PRTL/ENTIR CARPS

Professional

Both

$2,157.00

Service Code	HCPCS 25446
Min. Negotiated Rate	$670.74
Max. Negotiated Rate	$1,899.88
Rate for Payer: Aetna Commercial	$1,564.29
Rate for Payer: Aetna Medicare	$1,078.50
Rate for Payer: BCBS Complete	$704.28
Rate for Payer: BCN Commercial	$1,777.29
Rate for Payer: Cash Price	$1,725.60
Rate for Payer: Cash Price	$1,725.60
Rate for Payer: Mclaren Medicaid	$670.74
Rate for Payer: Meridian Medicaid	$704.28
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,617.75
Rate for Payer: Priority Health Choice Medicaid	$670.74
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,899.88
Rate for Payer: Priority Health Narrow/Tiered Network	$1,899.88
Rate for Payer: UHC Medicaid	$670.74
Rate for Payer: UHCCP Medicaid	$670.74

PR ARTHRP WRST W/WO INTERPOS W/WO XTRNL/INT FIXJ

Professional

Both

$3,795.00

Service Code	HCPCS 25332
Min. Negotiated Rate	$494.16
Max. Negotiated Rate	$2,846.25
Rate for Payer: Aetna Commercial	$1,126.09
Rate for Payer: Aetna Medicare	$1,897.50
Rate for Payer: BCBS Complete	$518.87
Rate for Payer: BCN Commercial	$1,290.77
Rate for Payer: Cash Price	$3,036.00
Rate for Payer: Cash Price	$3,036.00
Rate for Payer: Mclaren Medicaid	$494.16
Rate for Payer: Meridian Medicaid	$518.87
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,846.25
Rate for Payer: Priority Health Choice Medicaid	$494.16
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,379.79
Rate for Payer: Priority Health Narrow/Tiered Network	$1,379.79
Rate for Payer: UHC Medicaid	$494.16
Rate for Payer: UHCCP Medicaid	$494.16

PR ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ

Professional

Both

$4,200.00

Service Code	HCPCS 29888
Min. Negotiated Rate	$567.22
Max. Negotiated Rate	$3,150.00
Rate for Payer: Aetna Commercial	$1,306.22
Rate for Payer: Aetna Medicare	$2,100.00
Rate for Payer: BCBS Complete	$595.58
Rate for Payer: BCN Commercial	$1,619.33
Rate for Payer: Cash Price	$3,360.00
Rate for Payer: Cash Price	$3,360.00
Rate for Payer: Mclaren Medicaid	$567.22
Rate for Payer: Meridian Medicaid	$595.58
Rate for Payer: Opus (Opus Packaging Group) HMA	$3,150.00
Rate for Payer: Priority Health Choice Medicaid	$567.22
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,575.70
Rate for Payer: Priority Health Narrow/Tiered Network	$1,575.70
Rate for Payer: UHC Medicaid	$567.22
Rate for Payer: UHCCP Medicaid	$567.22

PR ARTHRS AIDED PST CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ

Professional

Both

$4,364.00

Service Code	HCPCS 29889
Min. Negotiated Rate	$722.07
Max. Negotiated Rate	$3,273.00
Rate for Payer: Aetna Commercial	$1,632.85
Rate for Payer: Aetna Medicare	$2,182.00
Rate for Payer: BCBS Complete	$758.17
Rate for Payer: BCN Commercial	$1,859.46
Rate for Payer: Cash Price	$3,491.20
Rate for Payer: Cash Price	$3,491.20
Rate for Payer: Mclaren Medicaid	$722.07
Rate for Payer: Meridian Medicaid	$758.17
Rate for Payer: Opus (Opus Packaging Group) HMA	$3,273.00
Rate for Payer: Priority Health Choice Medicaid	$722.07
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,987.71
Rate for Payer: Priority Health Narrow/Tiered Network	$1,987.71
Rate for Payer: UHC Medicaid	$722.07
Rate for Payer: UHCCP Medicaid	$722.07

PR ARTHRS AID RPR LES/TALAR DOME FX/TIBL PLAFOND FX

Professional

Both

$2,769.00

Service Code	HCPCS 29892
Min. Negotiated Rate	$381.06
Max. Negotiated Rate	$2,076.75
Rate for Payer: Aetna Commercial	$860.03
Rate for Payer: Aetna Medicare	$1,384.50
Rate for Payer: BCBS Complete	$400.11
Rate for Payer: BCN Commercial	$974.55
Rate for Payer: Cash Price	$2,215.20
Rate for Payer: Cash Price	$2,215.20
Rate for Payer: Mclaren Medicaid	$381.06
Rate for Payer: Meridian Medicaid	$400.11
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,076.75
Rate for Payer: Priority Health Choice Medicaid	$381.06
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,041.76
Rate for Payer: Priority Health Narrow/Tiered Network	$1,041.76
Rate for Payer: UHC Medicaid	$381.06
Rate for Payer: UHCCP Medicaid	$381.06

PR ARTHRS AID TIBIAL FRACTURE PROXIMAL UNICONDYLAR

Professional

Both

$2,618.00

Service Code	HCPCS 29855
Min. Negotiated Rate	$465.41
Max. Negotiated Rate	$1,963.50
Rate for Payer: Aetna Commercial	$1,041.85
Rate for Payer: Aetna Medicare	$1,309.00
Rate for Payer: BCBS Complete	$488.68
Rate for Payer: BCN Commercial	$1,189.68
Rate for Payer: Cash Price	$2,094.40
Rate for Payer: Cash Price	$2,094.40
Rate for Payer: Mclaren Medicaid	$465.41
Rate for Payer: Meridian Medicaid	$488.68
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,963.50
Rate for Payer: Priority Health Choice Medicaid	$465.41
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,271.73
Rate for Payer: Priority Health Narrow/Tiered Network	$1,271.73
Rate for Payer: UHC Medicaid	$465.41
Rate for Payer: UHCCP Medicaid	$465.41

PR ARTHRS AID TIBIAL FX PROX UNICONDYLAR BICONDYLAR

Professional

Both

$1,840.00

Service Code	HCPCS 29856
Min. Negotiated Rate	$585.32
Max. Negotiated Rate	$1,612.43
Rate for Payer: Aetna Commercial	$1,318.77
Rate for Payer: Aetna Medicare	$920.00
Rate for Payer: BCBS Complete	$614.59
Rate for Payer: BCN Commercial	$1,508.39
Rate for Payer: Cash Price	$1,472.00
Rate for Payer: Cash Price	$1,472.00
Rate for Payer: Mclaren Medicaid	$585.32
Rate for Payer: Meridian Medicaid	$614.59
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,380.00
Rate for Payer: Priority Health Choice Medicaid	$585.32
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	$585.32
Rate for Payer: UHCCP Medicaid	$585.32

PR ARTHRS ANKLE EXC OSTCHNDRL DFCT TALUS&/TIB DRLG

Professional

Both

$2,501.00

Service Code	HCPCS 29891
Min. Negotiated Rate	$404.27
Max. Negotiated Rate	$1,875.75
Rate for Payer: Aetna Commercial	$892.98
Rate for Payer: Aetna Medicare	$1,250.50
Rate for Payer: BCBS Complete	$424.48
Rate for Payer: BCN Commercial	$1,026.84
Rate for Payer: Cash Price	$2,000.80
Rate for Payer: Cash Price	$2,000.80
Rate for Payer: Mclaren Medicaid	$404.27
Rate for Payer: Meridian Medicaid	$424.48
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,875.75
Rate for Payer: Priority Health Choice Medicaid	$404.27
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,097.65
Rate for Payer: Priority Health Narrow/Tiered Network	$1,097.65
Rate for Payer: UHC Medicaid	$404.27
Rate for Payer: UHCCP Medicaid	$404.27

PR ARTHRS HIP DEBRIDEMENT/SHAVING ARTICULAR CRTLG

Professional

Both

$2,841.00

Service Code	HCPCS 29862
Min. Negotiated Rate	$484.58
Max. Negotiated Rate	$2,130.75
Rate for Payer: Aetna Commercial	$1,084.46
Rate for Payer: Aetna Medicare	$1,420.50
Rate for Payer: BCBS Complete	$508.81
Rate for Payer: BCN Commercial	$1,234.99
Rate for Payer: Cash Price	$2,272.80
Rate for Payer: Cash Price	$2,272.80
Rate for Payer: Mclaren Medicaid	$484.58
Rate for Payer: Meridian Medicaid	$508.81
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,130.75
Rate for Payer: Priority Health Choice Medicaid	$484.58
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,320.17
Rate for Payer: Priority Health Narrow/Tiered Network	$1,320.17
Rate for Payer: UHC Medicaid	$484.58
Rate for Payer: UHCCP Medicaid	$484.58

PR ARTHRS KNEE SURG DEBRIDEMENT/SHVG ARTCLR CRTLG

Professional

Both

$2,333.00

Service Code	HCPCS 29877
Min. Negotiated Rate	$374.24
Max. Negotiated Rate	$1,749.75
Rate for Payer: Aetna Commercial	$828.30
Rate for Payer: Aetna Medicare	$1,166.50
Rate for Payer: BCBS Complete	$392.95
Rate for Payer: BCN Commercial	$1,042.71
Rate for Payer: Cash Price	$1,866.40
Rate for Payer: Cash Price	$1,866.40
Rate for Payer: Mclaren Medicaid	$374.24
Rate for Payer: Meridian Medicaid	$392.95
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,749.75
Rate for Payer: Priority Health Choice Medicaid	$374.24
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,014.61
Rate for Payer: Priority Health Narrow/Tiered Network	$1,014.61
Rate for Payer: UHC Medicaid	$374.24
Rate for Payer: UHCCP Medicaid	$374.24

PR ARTHRS KNEE SURG DRILLING NTC OSTEO DISS LESION

Professional

Both

$2,467.00

Service Code	HCPCS 29886
Min. Negotiated Rate	$385.74
Max. Negotiated Rate	$1,850.25
Rate for Payer: Aetna Commercial	$848.21
Rate for Payer: Aetna Medicare	$1,233.50
Rate for Payer: BCBS Complete	$405.03
Rate for Payer: BCN Commercial	$976.05
Rate for Payer: Cash Price	$1,973.60
Rate for Payer: Cash Price	$1,973.60
Rate for Payer: Mclaren Medicaid	$385.74
Rate for Payer: Meridian Medicaid	$405.03
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,850.25
Rate for Payer: Priority Health Choice Medicaid	$385.74
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,043.36
Rate for Payer: Priority Health Narrow/Tiered Network	$1,043.36
Rate for Payer: UHC Medicaid	$385.74
Rate for Payer: UHCCP Medicaid	$385.74

PR ARTHRS KNEE SURG DRLG OSTEO DISS GRFG W/WO FIXJ

Professional

Both

$2,618.00

Service Code	HCPCS 29885
Min. Negotiated Rate	$454.33
Max. Negotiated Rate	$1,963.50
Rate for Payer: Aetna Commercial	$1,007.16
Rate for Payer: Aetna Medicare	$1,309.00
Rate for Payer: BCBS Complete	$477.05
Rate for Payer: BCN Commercial	$1,156.31
Rate for Payer: Cash Price	$2,094.40
Rate for Payer: Cash Price	$2,094.40
Rate for Payer: Mclaren Medicaid	$454.33
Rate for Payer: Meridian Medicaid	$477.05
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,963.50
Rate for Payer: Priority Health Choice Medicaid	$454.33
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,236.07
Rate for Payer: Priority Health Narrow/Tiered Network	$1,236.07
Rate for Payer: UHC Medicaid	$454.33
Rate for Payer: UHCCP Medicaid	$454.33

PR ARTHRS KNEE SURG DRLG OSTEO DISS LES W/INT FIXJ

Professional

Both

$2,601.00

Service Code	HCPCS 29887
Min. Negotiated Rate	$453.05
Max. Negotiated Rate	$1,950.75
Rate for Payer: Aetna Commercial	$1,003.49
Rate for Payer: Aetna Medicare	$1,300.50
Rate for Payer: BCBS Complete	$475.70
Rate for Payer: BCN Commercial	$1,151.83
Rate for Payer: Cash Price	$2,080.80
Rate for Payer: Cash Price	$2,080.80
Rate for Payer: Mclaren Medicaid	$453.05
Rate for Payer: Meridian Medicaid	$475.70
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,950.75
Rate for Payer: Priority Health Choice Medicaid	$453.05
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,231.27
Rate for Payer: Priority Health Narrow/Tiered Network	$1,231.27
Rate for Payer: UHC Medicaid	$453.05
Rate for Payer: UHCCP Medicaid	$453.05

PR ARTHRS KNEE SURG MENISCECTOMY MED&LAT W/SHAVING

Professional

Both

$2,667.00

Service Code	HCPCS 29880
Min. Negotiated Rate	$339.95
Max. Negotiated Rate	$2,000.25
Rate for Payer: Aetna Commercial	$749.27
Rate for Payer: Aetna Medicare	$1,333.50
Rate for Payer: BCBS Complete	$356.95
Rate for Payer: BCN Commercial	$944.24
Rate for Payer: Cash Price	$2,133.60
Rate for Payer: Cash Price	$2,133.60
Rate for Payer: Mclaren Medicaid	$339.95
Rate for Payer: Meridian Medicaid	$356.95
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,000.25
Rate for Payer: Priority Health Choice Medicaid	$339.95
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$918.80
Rate for Payer: Priority Health Narrow/Tiered Network	$918.80
Rate for Payer: UHC Medicaid	$339.95
Rate for Payer: UHCCP Medicaid	$339.95

PR ARTHRS KNEE SURG W/MENISCECTOMY MED/LAT W/SHVG

Professional

Both

$2,467.00

Service Code	HCPCS 29881
Min. Negotiated Rate	$328.87
Max. Negotiated Rate	$1,850.25
Rate for Payer: Aetna Commercial	$722.25
Rate for Payer: Aetna Medicare	$1,233.50
Rate for Payer: BCBS Complete	$345.31
Rate for Payer: BCN Commercial	$910.33
Rate for Payer: Cash Price	$1,973.60
Rate for Payer: Cash Price	$1,973.60
Rate for Payer: Mclaren Medicaid	$328.87
Rate for Payer: Meridian Medicaid	$345.31
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,850.25
Rate for Payer: Priority Health Choice Medicaid	$328.87
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$885.80
Rate for Payer: Priority Health Narrow/Tiered Network	$885.80
Rate for Payer: UHC Medicaid	$328.87
Rate for Payer: UHCCP Medicaid	$328.87

Know your out-of-pocket cost for care.

All Charges