Bronson Lakeview Hospital

All Charges

Charge

Type

Setting

Price

PR CURETTAGE POSTPARTUM

Professional

Both

$562.00

Service Code	HCPCS 59160
Min. Negotiated Rate	$106.93
Max. Negotiated Rate	$421.50
Rate for Payer: Aetna Commercial	$203.67
Rate for Payer: Aetna Medicare	$281.00
Rate for Payer: BCBS Complete	$112.28
Rate for Payer: BCN Commercial	$282.35
Rate for Payer: Cash Price	$449.60
Rate for Payer: Cash Price	$449.60
Rate for Payer: Mclaren Medicaid	$106.93
Rate for Payer: Meridian Medicaid	$112.28
Rate for Payer: Opus (Opus Packaging Group) HMA	$421.50
Rate for Payer: Priority Health Choice Medicaid	$106.93
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$266.54
Rate for Payer: Priority Health Narrow/Tiered Network	$266.54
Rate for Payer: UHC Medicaid	$106.93
Rate for Payer: UHCCP Medicaid	$106.93

PR CURTG/CAUT ANAL FISSURE W/DILAT SPHNCTR SPX 1ST

Professional

Both

$493.00

Service Code	HCPCS 46940
Min. Negotiated Rate	$87.12
Max. Negotiated Rate	$369.75
Rate for Payer: Aetna Commercial	$193.32
Rate for Payer: Aetna Medicare	$246.50
Rate for Payer: BCBS Complete	$91.48
Rate for Payer: BCN Commercial	$218.12
Rate for Payer: Cash Price	$394.40
Rate for Payer: Cash Price	$394.40
Rate for Payer: Mclaren Medicaid	$87.12
Rate for Payer: Meridian Medicaid	$91.48
Rate for Payer: Opus (Opus Packaging Group) HMA	$369.75
Rate for Payer: Priority Health Choice Medicaid	$87.12
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$265.76
Rate for Payer: Priority Health Narrow/Tiered Network	$265.76
Rate for Payer: UHC Medicaid	$87.12
Rate for Payer: UHCCP Medicaid	$87.12

PR CURTG/CAUT ANAL FISSURE W/DILAT SPHNCTR SPX SBSQ

Professional

Both

$345.00

Service Code	HCPCS 46942
Min. Negotiated Rate	$78.81
Max. Negotiated Rate	$258.75
Rate for Payer: Aetna Commercial	$172.65
Rate for Payer: Aetna Medicare	$172.50
Rate for Payer: BCBS Complete	$82.75
Rate for Payer: BCN Commercial	$195.70
Rate for Payer: Cash Price	$276.00
Rate for Payer: Cash Price	$276.00
Rate for Payer: Mclaren Medicaid	$78.81
Rate for Payer: Meridian Medicaid	$82.75
Rate for Payer: Opus (Opus Packaging Group) HMA	$258.75
Rate for Payer: Priority Health Choice Medicaid	$78.81
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$238.45
Rate for Payer: Priority Health Narrow/Tiered Network	$238.45
Rate for Payer: UHC Medicaid	$78.81
Rate for Payer: UHCCP Medicaid	$78.81

PR CUSTOM EAR PLUGS

Professional

Both

$263.00

Hospital Revenue Code	990
Min. Negotiated Rate	$105.20
Max. Negotiated Rate	$197.25
Rate for Payer: Aetna Medicare	$131.50
Rate for Payer: BCBS Complete	$105.20
Rate for Payer: Cash Price	$210.40
Rate for Payer: Opus (Opus Packaging Group) HMA	$197.25

PR CUTANANEOUS APPENDICO-VESICOSTOMY

Professional

Both

$2,665.00

Service Code	HCPCS 50845
Min. Negotiated Rate	$719.73
Max. Negotiated Rate	$2,041.83
Rate for Payer: Aetna Commercial	$1,606.57
Rate for Payer: Aetna Medicare	$1,332.50
Rate for Payer: BCBS Complete	$755.72
Rate for Payer: BCN Commercial	$1,874.40
Rate for Payer: Cash Price	$2,132.00
Rate for Payer: Cash Price	$2,132.00
Rate for Payer: Mclaren Medicaid	$719.73
Rate for Payer: Meridian Medicaid	$755.72
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,998.75
Rate for Payer: Priority Health Choice Medicaid	$719.73
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$2,041.83
Rate for Payer: Priority Health Narrow/Tiered Network	$2,041.83
Rate for Payer: UHC Medicaid	$719.73
Rate for Payer: UHCCP Medicaid	$719.73

PR CUTANEOUS VESICOSTOMY

Professional

Both

$1,504.00

Service Code	HCPCS 51980
Min. Negotiated Rate	$412.58
Max. Negotiated Rate	$1,165.21
Rate for Payer: Aetna Commercial	$916.03
Rate for Payer: Aetna Medicare	$752.00
Rate for Payer: BCBS Complete	$433.21
Rate for Payer: BCN Commercial	$1,069.66
Rate for Payer: Cash Price	$1,203.20
Rate for Payer: Cash Price	$1,203.20
Rate for Payer: Mclaren Medicaid	$412.58
Rate for Payer: Meridian Medicaid	$433.21
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,128.00
Rate for Payer: Priority Health Choice Medicaid	$412.58
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,165.21
Rate for Payer: Priority Health Narrow/Tiered Network	$1,165.21
Rate for Payer: UHC Medicaid	$412.58
Rate for Payer: UHCCP Medicaid	$412.58

PR CV STRESS TST XERS&/RX CONT ECG W/SI&R

Professional

Both

$466.00

Service Code	HCPCS 93015
Min. Negotiated Rate	$91.71
Max. Negotiated Rate	$349.50
Rate for Payer: Aetna Commercial	$91.71
Rate for Payer: Aetna Medicare	$233.00
Rate for Payer: BCN Commercial	$109.06
Rate for Payer: Cash Price	$372.80
Rate for Payer: Cash Price	$372.80
Rate for Payer: Opus (Opus Packaging Group) HMA	$349.50
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$103.66
Rate for Payer: Priority Health Narrow/Tiered Network	$103.66

PR CV STRS TST XERS&/RX CONT ECG I&R ONLY

Professional

Both

$175.00

Service Code	HCPCS 93018
Min. Negotiated Rate	$8.73
Max. Negotiated Rate	$131.25
Rate for Payer: Aetna Commercial	$19.31
Rate for Payer: Aetna Medicare	$87.50
Rate for Payer: BCBS Complete	$9.17
Rate for Payer: BCN Commercial	$20.92
Rate for Payer: Cash Price	$140.00
Rate for Payer: Cash Price	$140.00
Rate for Payer: Mclaren Medicaid	$8.73
Rate for Payer: Meridian Medicaid	$9.17
Rate for Payer: Opus (Opus Packaging Group) HMA	$131.25
Rate for Payer: Priority Health Choice Medicaid	$8.73
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$19.89
Rate for Payer: Priority Health Narrow/Tiered Network	$19.89
Rate for Payer: UHC Medicaid	$8.73
Rate for Payer: UHCCP Medicaid	$8.73

PR CV STRS TST XERS&/RX CONT ECG SUPVJ ONLY W/O I&R

Professional

Both

$116.00

Service Code	HCPCS 93016
Min. Negotiated Rate	$13.21
Max. Negotiated Rate	$87.00
Rate for Payer: Aetna Commercial	$28.99
Rate for Payer: Aetna Medicare	$58.00
Rate for Payer: BCBS Complete	$13.87
Rate for Payer: BCN Commercial	$30.87
Rate for Payer: Cash Price	$92.80
Rate for Payer: Cash Price	$92.80
Rate for Payer: Mclaren Medicaid	$13.21
Rate for Payer: Meridian Medicaid	$13.87
Rate for Payer: Opus (Opus Packaging Group) HMA	$87.00
Rate for Payer: Priority Health Choice Medicaid	$13.21
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$29.34
Rate for Payer: Priority Health Narrow/Tiered Network	$29.34
Rate for Payer: UHC Medicaid	$13.21
Rate for Payer: UHCCP Medicaid	$13.21

PR CV STRS TST XERS&/RX CONT ECG TRCG ONLY W/O I&R

Professional

Both

$116.00

Service Code	HCPCS 93017
Min. Negotiated Rate	$43.41
Max. Negotiated Rate	$87.00
Rate for Payer: Aetna Commercial	$43.41
Rate for Payer: Aetna Medicare	$58.00
Rate for Payer: BCBS Complete	$46.40
Rate for Payer: BCN Commercial	$57.27
Rate for Payer: Cash Price	$92.80
Rate for Payer: Cash Price	$92.80
Rate for Payer: Opus (Opus Packaging Group) HMA	$87.00
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$54.43
Rate for Payer: Priority Health Narrow/Tiered Network	$54.43

PR CYSTECTOMY COMPLETE SEPARATE PROCEDURE

Professional

Both

$2,895.00

Service Code	HCPCS 51570
Min. Negotiated Rate	$831.77
Max. Negotiated Rate	$2,383.04
Rate for Payer: Aetna Commercial	$1,887.68
Rate for Payer: Aetna Medicare	$1,447.50
Rate for Payer: BCBS Complete	$873.36
Rate for Payer: BCN Commercial	$2,187.63
Rate for Payer: Cash Price	$2,316.00
Rate for Payer: Cash Price	$2,316.00
Rate for Payer: Mclaren Medicaid	$831.77
Rate for Payer: Meridian Medicaid	$873.36
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,171.25
Rate for Payer: Priority Health Choice Medicaid	$831.77
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$2,383.04
Rate for Payer: Priority Health Narrow/Tiered Network	$2,383.04
Rate for Payer: UHC Medicaid	$831.77
Rate for Payer: UHCCP Medicaid	$831.77

PR CYSTECTOMY PARTIAL COMPLICATED

Professional

Both

$7,985.00

Service Code	HCPCS 51555
Min. Negotiated Rate	$720.15
Max. Negotiated Rate	$5,988.75
Rate for Payer: Aetna Commercial	$1,622.71
Rate for Payer: Aetna Medicare	$3,992.50
Rate for Payer: BCBS Complete	$756.16
Rate for Payer: BCN Commercial	$1,878.88
Rate for Payer: Cash Price	$6,388.00
Rate for Payer: Cash Price	$6,388.00
Rate for Payer: Mclaren Medicaid	$720.15
Rate for Payer: Meridian Medicaid	$756.16
Rate for Payer: Opus (Opus Packaging Group) HMA	$5,988.75
Rate for Payer: Priority Health Choice Medicaid	$720.15
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$2,046.71
Rate for Payer: Priority Health Narrow/Tiered Network	$2,046.71
Rate for Payer: UHC Medicaid	$720.15
Rate for Payer: UHCCP Medicaid	$720.15

PR CYSTECTOMY PARTIAL SIMPLE

Professional

Both

$1,591.00

Service Code	HCPCS 51550
Min. Negotiated Rate	$555.72
Max. Negotiated Rate	$1,567.18
Rate for Payer: Aetna Commercial	$1,235.96
Rate for Payer: Aetna Medicare	$795.50
Rate for Payer: BCBS Complete	$583.51
Rate for Payer: BCN Commercial	$1,438.67
Rate for Payer: Cash Price	$1,272.80
Rate for Payer: Cash Price	$1,272.80
Rate for Payer: Mclaren Medicaid	$555.72
Rate for Payer: Meridian Medicaid	$583.51
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,193.25
Rate for Payer: Priority Health Choice Medicaid	$555.72
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,567.18
Rate for Payer: Priority Health Narrow/Tiered Network	$1,567.18
Rate for Payer: UHC Medicaid	$555.72
Rate for Payer: UHCCP Medicaid	$555.72

PR CYSTECTOMY W/BI PELVIC LYMPHADENECTOMY

Professional

Both

$3,910.00

Service Code	HCPCS 51575
Min. Negotiated Rate	$1,026.23
Max. Negotiated Rate	$2,936.36
Rate for Payer: Aetna Commercial	$2,337.60
Rate for Payer: Aetna Medicare	$1,955.00
Rate for Payer: BCBS Complete	$1,077.54
Rate for Payer: BCN Commercial	$2,695.57
Rate for Payer: Cash Price	$3,128.00
Rate for Payer: Cash Price	$3,128.00
Rate for Payer: Mclaren Medicaid	$1,026.23
Rate for Payer: Meridian Medicaid	$1,077.54
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,932.50
Rate for Payer: Priority Health Choice Medicaid	$1,026.23
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$2,936.36
Rate for Payer: Priority Health Narrow/Tiered Network	$2,936.36
Rate for Payer: UHC Medicaid	$1,026.23
Rate for Payer: UHCCP Medicaid	$1,026.23

PR CYSTO CALIBRATION DILAT URTL STRIX/STENOSIS

Professional

Both

$796.00

Service Code	HCPCS 52281
Min. Negotiated Rate	$87.12
Max. Negotiated Rate	$597.00
Rate for Payer: Aetna Commercial	$193.91
Rate for Payer: Aetna Medicare	$398.00
Rate for Payer: BCBS Complete	$91.48
Rate for Payer: BCN Commercial	$226.08
Rate for Payer: Cash Price	$636.80
Rate for Payer: Cash Price	$636.80
Rate for Payer: Mclaren Medicaid	$87.12
Rate for Payer: Meridian Medicaid	$91.48
Rate for Payer: Opus (Opus Packaging Group) HMA	$597.00
Rate for Payer: Priority Health Choice Medicaid	$87.12
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$246.27
Rate for Payer: Priority Health Narrow/Tiered Network	$246.27
Rate for Payer: UHC Medicaid	$87.12
Rate for Payer: UHCCP Medicaid	$87.12

PR CYSTO FRAGMENTATION URETERAL STONE

Professional

Both

$685.00

Service Code	HCPCS 52325
Min. Negotiated Rate	$179.56
Max. Negotiated Rate	$514.25
Rate for Payer: Aetna Commercial	$410.09
Rate for Payer: Aetna Medicare	$342.50
Rate for Payer: BCBS Complete	$188.54
Rate for Payer: BCN Commercial	$472.08
Rate for Payer: Cash Price	$548.00
Rate for Payer: Cash Price	$548.00
Rate for Payer: Mclaren Medicaid	$179.56
Rate for Payer: Meridian Medicaid	$188.54
Rate for Payer: Opus (Opus Packaging Group) HMA	$513.75
Rate for Payer: Priority Health Choice Medicaid	$179.56
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$514.25
Rate for Payer: Priority Health Narrow/Tiered Network	$514.25
Rate for Payer: UHC Medicaid	$179.56
Rate for Payer: UHCCP Medicaid	$179.56

PR CYSTO INC/RESCJ ORIFICE BLDR DIVERTICULUM 1/MLT

Professional

Both

$563.00

Service Code	HCPCS 52305
Min. Negotiated Rate	$156.13
Max. Negotiated Rate	$447.00
Rate for Payer: Aetna Commercial	$356.38
Rate for Payer: Aetna Medicare	$281.50
Rate for Payer: BCBS Complete	$163.94
Rate for Payer: BCN Commercial	$410.33
Rate for Payer: Cash Price	$450.40
Rate for Payer: Cash Price	$450.40
Rate for Payer: Mclaren Medicaid	$156.13
Rate for Payer: Meridian Medicaid	$163.94
Rate for Payer: Opus (Opus Packaging Group) HMA	$422.25
Rate for Payer: Priority Health Choice Medicaid	$156.13
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$447.00
Rate for Payer: Priority Health Narrow/Tiered Network	$447.00
Rate for Payer: UHC Medicaid	$156.13
Rate for Payer: UHCCP Medicaid	$156.13

PR CYSTO INSJ PERM ADJTBL TRANSPROSTATIC 1 IMPLANT

Professional

Both

$2,315.00

Service Code	HCPCS 52441
Min. Negotiated Rate	$117.36
Max. Negotiated Rate	$1,736.25
Rate for Payer: Aetna Commercial	$268.82
Rate for Payer: Aetna Medicare	$1,157.50
Rate for Payer: BCBS Complete	$123.23
Rate for Payer: BCN Commercial	$310.74
Rate for Payer: Cash Price	$1,852.00
Rate for Payer: Cash Price	$1,852.00
Rate for Payer: Mclaren Medicaid	$117.36
Rate for Payer: Meridian Medicaid	$123.23
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,736.25
Rate for Payer: Priority Health Choice Medicaid	$117.36
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$338.49
Rate for Payer: Priority Health Narrow/Tiered Network	$338.49
Rate for Payer: UHC Medicaid	$117.36
Rate for Payer: UHCCP Medicaid	$117.36

PR CYSTO INSJ PERM ADJTBL TRANSPROSTATIC IMPLANT EA

Professional

Both

$1,772.00

Service Code	HCPCS 52442
Min. Negotiated Rate	$28.12
Max. Negotiated Rate	$1,329.00
Rate for Payer: Aetna Commercial	$66.05
Rate for Payer: Aetna Medicare	$886.00
Rate for Payer: BCBS Complete	$29.53
Rate for Payer: BCN Commercial	$75.19
Rate for Payer: Cash Price	$1,417.60
Rate for Payer: Cash Price	$1,417.60
Rate for Payer: Mclaren Medicaid	$28.12
Rate for Payer: Meridian Medicaid	$29.53
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,329.00
Rate for Payer: Priority Health Choice Medicaid	$28.12
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$81.91
Rate for Payer: Priority Health Narrow/Tiered Network	$81.91
Rate for Payer: UHC Medicaid	$28.12
Rate for Payer: UHCCP Medicaid	$28.12

PR CYSTO INSJ URTRL GD WIRE PRQ NFROS RTRGR

Professional

Both

$972.00

Service Code	HCPCS 52334
Min. Negotiated Rate	$104.16
Max. Negotiated Rate	$729.00
Rate for Payer: Aetna Commercial	$233.82
Rate for Payer: Aetna Medicare	$486.00
Rate for Payer: BCBS Complete	$109.37
Rate for Payer: BCN Commercial	$271.90
Rate for Payer: Cash Price	$777.60
Rate for Payer: Cash Price	$777.60
Rate for Payer: Mclaren Medicaid	$104.16
Rate for Payer: Meridian Medicaid	$109.37
Rate for Payer: Opus (Opus Packaging Group) HMA	$729.00
Rate for Payer: Priority Health Choice Medicaid	$104.16
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$296.18
Rate for Payer: Priority Health Narrow/Tiered Network	$296.18
Rate for Payer: UHC Medicaid	$104.16
Rate for Payer: UHCCP Medicaid	$104.16

PR CYSTOLITHOTOMY CYSTOTOMY W/RMVL CALCULUS

Professional

Both

$1,069.00

Service Code	HCPCS 51050
Min. Negotiated Rate	$276.69
Max. Negotiated Rate	$801.75
Rate for Payer: Aetna Commercial	$604.90
Rate for Payer: Aetna Medicare	$534.50
Rate for Payer: BCBS Complete	$290.52
Rate for Payer: BCN Commercial	$712.11
Rate for Payer: Cash Price	$855.20
Rate for Payer: Cash Price	$855.20
Rate for Payer: Mclaren Medicaid	$276.69
Rate for Payer: Meridian Medicaid	$290.52
Rate for Payer: Opus (Opus Packaging Group) HMA	$801.75
Rate for Payer: Priority Health Choice Medicaid	$276.69
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$775.71
Rate for Payer: Priority Health Narrow/Tiered Network	$775.71
Rate for Payer: UHC Medicaid	$276.69
Rate for Payer: UHCCP Medicaid	$276.69

PR CYSTO MANJ W/O RMVL URETERAL STONE

Professional

Both

$1,082.00

Service Code	HCPCS 52330
Min. Negotiated Rate	$147.40
Max. Negotiated Rate	$811.50
Rate for Payer: Aetna Commercial	$337.43
Rate for Payer: Aetna Medicare	$541.00
Rate for Payer: BCBS Complete	$154.77
Rate for Payer: BCN Commercial	$388.92
Rate for Payer: Cash Price	$865.60
Rate for Payer: Cash Price	$865.60
Rate for Payer: Mclaren Medicaid	$147.40
Rate for Payer: Meridian Medicaid	$154.77
Rate for Payer: Opus (Opus Packaging Group) HMA	$811.50
Rate for Payer: Priority Health Choice Medicaid	$147.40
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$423.67
Rate for Payer: Priority Health Narrow/Tiered Network	$423.67
Rate for Payer: UHC Medicaid	$147.40
Rate for Payer: UHCCP Medicaid	$147.40

PR CYSTO/PYELOSCOPY BX&/FULGURATION PELIVC LESION

Professional

Both

$785.00

Service Code	HCPCS 52354
Min. Negotiated Rate	$233.66
Max. Negotiated Rate	$671.03
Rate for Payer: Aetna Commercial	$534.36
Rate for Payer: Aetna Medicare	$392.50
Rate for Payer: BCBS Complete	$245.34
Rate for Payer: BCN Commercial	$616.01
Rate for Payer: Cash Price	$628.00
Rate for Payer: Cash Price	$628.00
Rate for Payer: Mclaren Medicaid	$233.66
Rate for Payer: Meridian Medicaid	$245.34
Rate for Payer: Opus (Opus Packaging Group) HMA	$588.75
Rate for Payer: Priority Health Choice Medicaid	$233.66
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$671.03
Rate for Payer: Priority Health Narrow/Tiered Network	$671.03
Rate for Payer: UHC Medicaid	$233.66
Rate for Payer: UHCCP Medicaid	$233.66

PR CYSTO/PYELOSCOPY RESCJ PELVIC TUMOR

Professional

Both

$1,496.00

Service Code	HCPCS 52355
Min. Negotiated Rate	$261.35
Max. Negotiated Rate	$1,122.00
Rate for Payer: Aetna Commercial	$598.21
Rate for Payer: Aetna Medicare	$748.00
Rate for Payer: BCBS Complete	$274.42
Rate for Payer: BCN Commercial	$690.20
Rate for Payer: Cash Price	$1,196.80
Rate for Payer: Cash Price	$1,196.80
Rate for Payer: Mclaren Medicaid	$261.35
Rate for Payer: Meridian Medicaid	$274.42
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,122.00
Rate for Payer: Priority Health Choice Medicaid	$261.35
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$751.85
Rate for Payer: Priority Health Narrow/Tiered Network	$751.85
Rate for Payer: UHC Medicaid	$261.35
Rate for Payer: UHCCP Medicaid	$261.35

PR CYSTORRHAPHY SUTR BLDR WND INJ/RPT COMPLICATED

Professional

Both

$3,293.00

Service Code	HCPCS 51865
Min. Negotiated Rate	$516.53
Max. Negotiated Rate	$2,469.75
Rate for Payer: Aetna Commercial	$1,154.60
Rate for Payer: Aetna Medicare	$1,646.50
Rate for Payer: BCBS Complete	$542.36
Rate for Payer: BCN Commercial	$1,337.08
Rate for Payer: Cash Price	$2,634.40
Rate for Payer: Cash Price	$2,634.40
Rate for Payer: Mclaren Medicaid	$516.53
Rate for Payer: Meridian Medicaid	$542.36
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,469.75
Rate for Payer: Priority Health Choice Medicaid	$516.53
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,456.51
Rate for Payer: Priority Health Narrow/Tiered Network	$1,456.51
Rate for Payer: UHC Medicaid	$516.53
Rate for Payer: UHCCP Medicaid	$516.53

Know your out-of-pocket cost for care.

All Charges