Bronson Lakeview Hospital

All Charges

Charge

Type

Setting

Price

PR COMPLX CYSTOMETRO W/VOID PRESS & URETHRAL PROFIL

Professional

Both

$737.00

Service Code	HCPCS 51729
Min. Negotiated Rate	$368.50
Max. Negotiated Rate	$583.69
Rate for Payer: Aetna Commercial	$491.15
Rate for Payer: Aetna Medicare	$368.50
Rate for Payer: BCN Commercial	$535.83
Rate for Payer: Cash Price	$589.60
Rate for Payer: Cash Price	$589.60
Rate for Payer: Opus (Opus Packaging Group) HMA	$552.75
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$583.69
Rate for Payer: Priority Health Narrow/Tiered Network	$583.69

PR COMPLX INTRACRANIAL ARYSM CAROTID CIRCULATION

Professional

Both

$10,611.00

Service Code	HCPCS 61697
Min. Negotiated Rate	$2,553.66
Max. Negotiated Rate	$8,817.75
Rate for Payer: Aetna Commercial	$5,432.97
Rate for Payer: Aetna Medicare	$5,305.50
Rate for Payer: BCBS Complete	$2,681.34
Rate for Payer: BCN Commercial	$8,817.75
Rate for Payer: Cash Price	$8,488.80
Rate for Payer: Cash Price	$8,488.80
Rate for Payer: Mclaren Medicaid	$2,553.66
Rate for Payer: Meridian Medicaid	$2,681.34
Rate for Payer: Opus (Opus Packaging Group) HMA	$7,958.25
Rate for Payer: Priority Health Choice Medicaid	$2,553.66
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$7,413.29
Rate for Payer: Priority Health Narrow/Tiered Network	$7,413.29
Rate for Payer: UHC Medicaid	$2,553.66
Rate for Payer: UHCCP Medicaid	$2,553.66

PR COMPRE AUDIOMETRY THRESHOLD EVAL SP RECOGNIJ

Professional

Both

$81.00

Service Code	HCPCS 92557
Min. Negotiated Rate	$16.40
Max. Negotiated Rate	$60.75
Rate for Payer: Aetna Commercial	$36.02
Rate for Payer: Aetna Medicare	$40.50
Rate for Payer: BCBS Complete	$17.22
Rate for Payer: BCN Commercial	$47.31
Rate for Payer: Cash Price	$64.80
Rate for Payer: Cash Price	$64.80
Rate for Payer: Mclaren Medicaid	$16.40
Rate for Payer: Meridian Medicaid	$17.22
Rate for Payer: Opus (Opus Packaging Group) HMA	$60.75
Rate for Payer: Priority Health Choice Medicaid	$16.40
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$43.63
Rate for Payer: Priority Health Narrow/Tiered Network	$43.63
Rate for Payer: UHC Medicaid	$16.40
Rate for Payer: UHCCP Medicaid	$16.40

PR COMPRE EP EVAL ABLTJ 3D MAPG TX SVT

Professional

Both

$1,807.00

Service Code	HCPCS 93653
Min. Negotiated Rate	$453.69
Max. Negotiated Rate	$1,355.25
Rate for Payer: Aetna Commercial	$1,121.18
Rate for Payer: Aetna Medicare	$903.50
Rate for Payer: BCBS Complete	$476.37
Rate for Payer: BCN Commercial	$1,218.06
Rate for Payer: Cash Price	$1,445.60
Rate for Payer: Cash Price	$1,445.60
Rate for Payer: Mclaren Medicaid	$453.69
Rate for Payer: Meridian Medicaid	$476.37
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,355.25
Rate for Payer: Priority Health Choice Medicaid	$453.69
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,157.71
Rate for Payer: Priority Health Narrow/Tiered Network	$1,157.71
Rate for Payer: UHC Medicaid	$453.69
Rate for Payer: UHCCP Medicaid	$453.69

PR COMPRE EP EVAL ABLTJ 3D MAPG TX VT

Professional

Both

$2,421.00

Service Code	HCPCS 93654
Min. Negotiated Rate	$546.77
Max. Negotiated Rate	$1,815.75
Rate for Payer: Aetna Commercial	$1,500.62
Rate for Payer: Aetna Medicare	$1,210.50
Rate for Payer: BCBS Complete	$574.11
Rate for Payer: BCN Commercial	$1,468.04
Rate for Payer: Cash Price	$1,936.80
Rate for Payer: Cash Price	$1,936.80
Rate for Payer: Mclaren Medicaid	$546.77
Rate for Payer: Meridian Medicaid	$574.11
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,815.75
Rate for Payer: Priority Health Choice Medicaid	$546.77
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,395.30
Rate for Payer: Priority Health Narrow/Tiered Network	$1,395.30
Rate for Payer: UHC Medicaid	$546.77
Rate for Payer: UHCCP Medicaid	$546.77

PR COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION

Professional

Both

$1,897.00

Service Code	HCPCS 93656
Min. Negotiated Rate	$514.40
Max. Negotiated Rate	$1,505.46
Rate for Payer: Aetna Commercial	$1,505.46
Rate for Payer: Aetna Medicare	$948.50
Rate for Payer: BCBS Complete	$540.12
Rate for Payer: BCN Commercial	$1,380.41
Rate for Payer: Cash Price	$1,517.60
Rate for Payer: Cash Price	$1,517.60
Rate for Payer: Mclaren Medicaid	$514.40
Rate for Payer: Meridian Medicaid	$540.12
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,422.75
Rate for Payer: Priority Health Choice Medicaid	$514.40
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,312.00
Rate for Payer: Priority Health Narrow/Tiered Network	$1,312.00
Rate for Payer: UHC Medicaid	$514.40
Rate for Payer: UHCCP Medicaid	$514.40

PR COMPRE EP EVAL R ATR VNTRC PACG&REC HIS BNDL REC

Professional

Both

$1,359.00

Service Code	HCPCS 93620
Min. Negotiated Rate	$679.50
Max. Negotiated Rate	$1,136.41
Rate for Payer: Aetna Commercial	$1,103.18
Rate for Payer: Aetna Medicare	$679.50
Rate for Payer: BCN Commercial	$896.87
Rate for Payer: Cash Price	$1,087.20
Rate for Payer: Cash Price	$1,087.20
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,019.25
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,136.41
Rate for Payer: Priority Health Narrow/Tiered Network	$1,136.41

PR COMPRE EP EVAL W/L ATRIAL PACG&REC C SINS/L ATR

Professional

Both

$252.00

Service Code	HCPCS 93621
Min. Negotiated Rate	$126.00
Max. Negotiated Rate	$1,658.64
Rate for Payer: Aetna Commercial	$205.99
Rate for Payer: Aetna Medicare	$126.00
Rate for Payer: BCN Commercial	$1,658.64
Rate for Payer: Cash Price	$201.60
Rate for Payer: Cash Price	$201.60
Rate for Payer: Opus (Opus Packaging Group) HMA	$189.00
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$150.99
Rate for Payer: Priority Health Narrow/Tiered Network	$150.99

PR CONDITIONING PLAY AUDIOMETRY

Professional

Both

$135.00

Service Code	HCPCS 92582
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$133.46
Rate for Payer: Aetna Commercial	$78.02
Rate for Payer: Aetna Medicare	$67.50
Rate for Payer: BCN Commercial	$133.46
Rate for Payer: Cash Price	$108.00
Rate for Payer: Cash Price	$108.00
Rate for Payer: Opus (Opus Packaging Group) HMA	$101.25
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$123.08
Rate for Payer: Priority Health Narrow/Tiered Network	$123.08

PR CONIZATION CERVIX W/WO D&C RPR ELTRD EXC

Facility

$952.00

Service Code	CPT 57522
Hospital Charge Code	57522
Hospital Revenue Code	960
Min. Negotiated Rate	$662.59
Max. Negotiated Rate	$856.80
Rate for Payer: Aetna Commercial	$809.20
Rate for Payer: BCBS Trust/PPO	$786.26
Rate for Payer: BCN Commercial	$786.26
Rate for Payer: Cash Price	$761.60
Rate for Payer: Cofinity Commercial	$818.72
Rate for Payer: Encore Health Key Benefits Commercial	$761.60
Rate for Payer: Healthscope Commercial	$856.80
Rate for Payer: Lakeland Regional Health Systems Commercial	$714.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$809.20
Rate for Payer: Nomi Health Commercial	$780.64
Rate for Payer: Opus (Opus Packaging Group) HMA	$714.00
Rate for Payer: PHP Commercial	$809.20
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$828.24
Rate for Payer: Priority Health Narrow/Tiered Network	$662.59
Rate for Payer: UHC Core	$794.92
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$714.00

PR CONIZATION CERVIX W/WO D&C RPR ELTRD EXC

Professional

Both

$952.00

Service Code	HCPCS 57522
Hospital Charge Code	57522
Min. Negotiated Rate	$147.61
Max. Negotiated Rate	$714.00
Rate for Payer: Aetna Commercial	$300.68
Rate for Payer: Aetna Medicare	$476.00
Rate for Payer: BCBS Complete	$154.99
Rate for Payer: BCN Commercial	$384.94
Rate for Payer: Cash Price	$761.60
Rate for Payer: Cash Price	$761.60
Rate for Payer: Mclaren Medicaid	$147.61
Rate for Payer: Meridian Medicaid	$154.99
Rate for Payer: Opus (Opus Packaging Group) HMA	$714.00
Rate for Payer: Priority Health Choice Medicaid	$147.61
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$389.86
Rate for Payer: Priority Health Narrow/Tiered Network	$389.86
Rate for Payer: UHC Medicaid	$147.61
Rate for Payer: UHCCP Medicaid	$147.61

PR CONIZATION CERVIX W/WO D&C RPR ELTRD EXC

Professional

Both

$952.00

Service Code	HCPCS 57522
Min. Negotiated Rate	$147.61
Max. Negotiated Rate	$714.00
Rate for Payer: Aetna Commercial	$300.68
Rate for Payer: Aetna Medicare	$476.00
Rate for Payer: BCBS Complete	$154.99
Rate for Payer: BCN Commercial	$384.94
Rate for Payer: Cash Price	$761.60
Rate for Payer: Cash Price	$761.60
Rate for Payer: Mclaren Medicaid	$147.61
Rate for Payer: Meridian Medicaid	$154.99
Rate for Payer: Opus (Opus Packaging Group) HMA	$714.00
Rate for Payer: Priority Health Choice Medicaid	$147.61
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$389.86
Rate for Payer: Priority Health Narrow/Tiered Network	$389.86
Rate for Payer: UHC Medicaid	$147.61
Rate for Payer: UHCCP Medicaid	$147.61

PR CONIZATION CERVIX W/WO D&C RPR ELTRD EXC

Facility

$952.00

Service Code	CPT 57522
Hospital Charge Code	57522
Hospital Revenue Code	960
Min. Negotiated Rate	$167.84
Max. Negotiated Rate	$856.80
Rate for Payer: Aetna Commercial	$809.20
Rate for Payer: Aetna Medicare	$247.52
Rate for Payer: Allen County Amish Medical Aid Commercial	$297.50
Rate for Payer: Amish Plain Church Group Commercial	$297.50
Rate for Payer: BCBS Complete	$176.22
Rate for Payer: BCBS MAPPO	$238.00
Rate for Payer: BCBS Trust/PPO	$782.64
Rate for Payer: BCCCP Commercial	$293.81
Rate for Payer: BCN Commercial	$782.64
Rate for Payer: BCN Medicare Advantage	$238.00
Rate for Payer: Cash Price	$761.60
Rate for Payer: Cash Price	$761.60
Rate for Payer: Cofinity Commercial	$818.72
Rate for Payer: Encore Health Key Benefits Commercial	$761.60
Rate for Payer: Health Alliance Plan Medicare Advantage	$238.00
Rate for Payer: Healthscope Commercial	$856.80
Rate for Payer: Lakeland Regional Health Systems Commercial	$714.00
Rate for Payer: Mclaren Medicaid	$167.84
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$249.90
Rate for Payer: Meridian Medicaid	$176.22
Rate for Payer: MI Amish Medical Board Commercial	$273.70
Rate for Payer: Molina Medicare/Medicaid	$261.80
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$809.20
Rate for Payer: Nomi Health Commercial	$780.64
Rate for Payer: Opus (Opus Packaging Group) HMA	$714.00
Rate for Payer: PACE Senior Care Partners	$226.10
Rate for Payer: PACE SWMI	$238.00
Rate for Payer: PHP Commercial	$809.20
Rate for Payer: PHP Medicare Advantage	$238.00
Rate for Payer: Priority Health Choice Medicaid	$167.84
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$828.24
Rate for Payer: Priority Health Medicare	$240.38
Rate for Payer: Priority Health Narrow/Tiered Network	$662.59
Rate for Payer: Railroad Medicare Medicare	$238.00
Rate for Payer: UHC Core	$794.92
Rate for Payer: UHC Exchange	$238.00
Rate for Payer: UHC Medicaid	$167.84
Rate for Payer: UHC Medicare Advantage	$238.00
Rate for Payer: UHCCP Medicaid	$167.84
Rate for Payer: VA VA	$238.00
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$714.00

PR CONIZATION CERVIX W/WO D&C RPR KNIFE/LASER

Professional

Both

$1,070.00

Service Code	HCPCS 57520
Min. Negotiated Rate	$174.45
Max. Negotiated Rate	$802.50
Rate for Payer: Aetna Commercial	$346.33
Rate for Payer: Aetna Medicare	$535.00
Rate for Payer: BCBS Complete	$183.17
Rate for Payer: BCN Commercial	$447.69
Rate for Payer: Cash Price	$856.00
Rate for Payer: Cash Price	$856.00
Rate for Payer: Mclaren Medicaid	$174.45
Rate for Payer: Meridian Medicaid	$183.17
Rate for Payer: Opus (Opus Packaging Group) HMA	$802.50
Rate for Payer: Priority Health Choice Medicaid	$174.45
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$453.42
Rate for Payer: Priority Health Narrow/Tiered Network	$453.42
Rate for Payer: UHC Medicaid	$174.45
Rate for Payer: UHCCP Medicaid	$174.45

PR CONSTRUCTION ARTIFICIAL VAGINA W/O GRAFT

Professional

Both

$1,752.00

Service Code	HCPCS 57291
Min. Negotiated Rate	$311.41
Max. Negotiated Rate	$1,314.00
Rate for Payer: Aetna Commercial	$654.11
Rate for Payer: Aetna Medicare	$876.00
Rate for Payer: BCBS Complete	$326.98
Rate for Payer: BCN Commercial	$826.15
Rate for Payer: Cash Price	$1,401.60
Rate for Payer: Cash Price	$1,401.60
Rate for Payer: Mclaren Medicaid	$311.41
Rate for Payer: Meridian Medicaid	$326.98
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,314.00
Rate for Payer: Priority Health Choice Medicaid	$311.41
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$836.71
Rate for Payer: Priority Health Narrow/Tiered Network	$836.71
Rate for Payer: UHC Medicaid	$311.41
Rate for Payer: UHCCP Medicaid	$311.41

PR CONSULTS

Professional

Both

$525.00

Hospital Revenue Code	990
Min. Negotiated Rate	$210.00
Max. Negotiated Rate	$393.75
Rate for Payer: Aetna Medicare	$262.50
Rate for Payer: BCBS Complete	$210.00
Rate for Payer: Cash Price	$420.00
Rate for Payer: Opus (Opus Packaging Group) HMA	$393.75

PR CONT GLUC MNTR PHYSICIAN/QHP PROVIDED EQUIPMENT

Professional

Both

$282.00

Service Code	HCPCS 95250
Min. Negotiated Rate	$141.00
Max. Negotiated Rate	$214.63
Rate for Payer: Aetna Commercial	$160.67
Rate for Payer: Aetna Medicare	$141.00
Rate for Payer: BCN Commercial	$214.63
Rate for Payer: Cash Price	$225.60
Rate for Payer: Cash Price	$225.60
Rate for Payer: Opus (Opus Packaging Group) HMA	$211.50
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$197.93
Rate for Payer: Priority Health Narrow/Tiered Network	$197.93

PR CONT GLUC MONITORING PATIENT PROVIDED EQUIPMENT

Professional

Both

$95.00

Service Code	HCPCS 95249
Min. Negotiated Rate	$47.50
Max. Negotiated Rate	$98.60
Rate for Payer: Aetna Commercial	$59.92
Rate for Payer: Aetna Medicare	$47.50
Rate for Payer: BCN Commercial	$98.60
Rate for Payer: Cash Price	$76.00
Rate for Payer: Cash Price	$76.00
Rate for Payer: Opus (Opus Packaging Group) HMA	$71.25
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$90.94
Rate for Payer: Priority Health Narrow/Tiered Network	$90.94

PR CONTINENT DVRJ W/INT ANAST ANY SGM SM&/LG INTSTN

Professional

Both

$3,537.00

Service Code	HCPCS 50825
Min. Negotiated Rate	$933.79
Max. Negotiated Rate	$2,666.74
Rate for Payer: Aetna Commercial	$2,127.62
Rate for Payer: Aetna Medicare	$1,768.50
Rate for Payer: BCBS Complete	$980.48
Rate for Payer: BCN Commercial	$2,448.07
Rate for Payer: Cash Price	$2,829.60
Rate for Payer: Cash Price	$2,829.60
Rate for Payer: Mclaren Medicaid	$933.79
Rate for Payer: Meridian Medicaid	$980.48
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,652.75
Rate for Payer: Priority Health Choice Medicaid	$933.79
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$2,666.74
Rate for Payer: Priority Health Narrow/Tiered Network	$2,666.74
Rate for Payer: UHC Medicaid	$933.79
Rate for Payer: UHCCP Medicaid	$933.79

PR CONTINENT ILEOSTOMY KOCK PROCEDURE SPX

Professional

Both

$4,162.00

Service Code	HCPCS 44316
Min. Negotiated Rate	$844.55
Max. Negotiated Rate	$3,121.50
Rate for Payer: Aetna Commercial	$1,914.59
Rate for Payer: Aetna Medicare	$2,081.00
Rate for Payer: BCBS Complete	$886.78
Rate for Payer: BCN Commercial	$2,125.39
Rate for Payer: Cash Price	$3,329.60
Rate for Payer: Cash Price	$3,329.60
Rate for Payer: Mclaren Medicaid	$844.55
Rate for Payer: Meridian Medicaid	$886.78
Rate for Payer: Opus (Opus Packaging Group) HMA	$3,121.50
Rate for Payer: Priority Health Choice Medicaid	$844.55
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$2,589.64
Rate for Payer: Priority Health Narrow/Tiered Network	$2,589.64
Rate for Payer: UHC Medicaid	$844.55
Rate for Payer: UHCCP Medicaid	$844.55

PR CONT INTRAOP NEURO MONITOR

Professional

Both

$132.00

Service Code	HCPCS G0453
Min. Negotiated Rate	$32.50
Max. Negotiated Rate	$99.00
Rate for Payer: Aetna Commercial	$32.50
Rate for Payer: Aetna Medicare	$66.00
Rate for Payer: BCBS Complete	$52.80
Rate for Payer: BCN Commercial	$46.81
Rate for Payer: Cash Price	$105.60
Rate for Payer: Cash Price	$105.60
Rate for Payer: Opus (Opus Packaging Group) HMA	$99.00
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$43.18
Rate for Payer: Priority Health Narrow/Tiered Network	$43.18

PR CONTINUOUS GLUCOSE MONITORING ANALYSIS I&R

Professional

Both

$76.00

Service Code	HCPCS 95251
Min. Negotiated Rate	$22.37
Max. Negotiated Rate	$57.00
Rate for Payer: Aetna Commercial	$38.86
Rate for Payer: Aetna Medicare	$38.00
Rate for Payer: BCBS Complete	$23.49
Rate for Payer: BCN Commercial	$51.29
Rate for Payer: Cash Price	$60.80
Rate for Payer: Cash Price	$60.80
Rate for Payer: Mclaren Medicaid	$22.37
Rate for Payer: Meridian Medicaid	$23.49
Rate for Payer: Opus (Opus Packaging Group) HMA	$57.00
Rate for Payer: Priority Health Choice Medicaid	$22.37
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$47.31
Rate for Payer: Priority Health Narrow/Tiered Network	$47.31
Rate for Payer: UHC Medicaid	$22.37
Rate for Payer: UHCCP Medicaid	$22.37

PR CONTINUOUS INHALATION TREATMENT 1ST HR

Professional

Both

$87.00

Service Code	HCPCS 94644
Min. Negotiated Rate	$43.50
Max. Negotiated Rate	$86.15
Rate for Payer: Aetna Commercial	$62.69
Rate for Payer: Aetna Medicare	$43.50
Rate for Payer: BCN Commercial	$86.15
Rate for Payer: Cash Price	$69.60
Rate for Payer: Cash Price	$69.60
Rate for Payer: Opus (Opus Packaging Group) HMA	$65.25
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$79.45
Rate for Payer: Priority Health Narrow/Tiered Network	$79.45

PR CONTRAST INJECTION PERQ RADIOLOGIC EVAL GI TUBE

Professional

Both

$64.00

Service Code	HCPCS 49465
Min. Negotiated Rate	$16.40
Max. Negotiated Rate	$54.00
Rate for Payer: Aetna Commercial	$40.95
Rate for Payer: Aetna Medicare	$32.00
Rate for Payer: BCBS Complete	$17.22
Rate for Payer: BCN Commercial	$44.32
Rate for Payer: Cash Price	$51.20
Rate for Payer: Cash Price	$51.20
Rate for Payer: Mclaren Medicaid	$16.40
Rate for Payer: Meridian Medicaid	$17.22
Rate for Payer: Opus (Opus Packaging Group) HMA	$48.00
Rate for Payer: Priority Health Choice Medicaid	$16.40
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$54.00
Rate for Payer: Priority Health Narrow/Tiered Network	$54.00
Rate for Payer: UHC Medicaid	$16.40
Rate for Payer: UHCCP Medicaid	$16.40

PR CONTROL NASAL HEMORRHAGE ANTERIOR COMPLEX

Professional

Both

$408.00

Service Code	HCPCS 30903
Min. Negotiated Rate	$44.52
Max. Negotiated Rate	$306.00
Rate for Payer: Aetna Commercial	$100.82
Rate for Payer: Aetna Medicare	$204.00
Rate for Payer: BCBS Complete	$46.75
Rate for Payer: BCN Commercial	$115.53
Rate for Payer: Cash Price	$326.40
Rate for Payer: Cash Price	$326.40
Rate for Payer: Mclaren Medicaid	$44.52
Rate for Payer: Meridian Medicaid	$46.75
Rate for Payer: Opus (Opus Packaging Group) HMA	$306.00
Rate for Payer: Priority Health Choice Medicaid	$44.52
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$108.79
Rate for Payer: Priority Health Narrow/Tiered Network	$108.79
Rate for Payer: UHC Medicaid	$44.52
Rate for Payer: UHCCP Medicaid	$44.52

Know your out-of-pocket cost for care.

All Charges