Bronson Lakeview Hospital

All Charges

Charge

Type

Setting

Price

PR DERMAL FILLER VOLBELLA

Professional

Both

$515.00

Hospital Revenue Code	990
Min. Negotiated Rate	$206.00
Max. Negotiated Rate	$386.25
Rate for Payer: Aetna Medicare	$257.50
Rate for Payer: BCBS Complete	$206.00
Rate for Payer: Cash Price	$412.00
Rate for Payer: Opus (Opus Packaging Group) HMA	$386.25

PR DERMAL FILLER VOLBELLA >1

Professional

Both

$876.00

Hospital Revenue Code	990
Min. Negotiated Rate	$350.40
Max. Negotiated Rate	$657.00
Rate for Payer: Aetna Medicare	$438.00
Rate for Payer: BCBS Complete	$350.40
Rate for Payer: Cash Price	$700.80
Rate for Payer: Opus (Opus Packaging Group) HMA	$657.00

PR DESTROY NERVE,CERV SPINAL MUSCLES

Professional

Both

$372.00

Service Code	HCPCS 64613
Min. Negotiated Rate	$148.80
Max. Negotiated Rate	$279.00
Rate for Payer: Aetna Medicare	$186.00
Rate for Payer: BCBS Complete	$148.80
Rate for Payer: Cash Price	$297.60
Rate for Payer: Opus (Opus Packaging Group) HMA	$279.00

PR DESTRUCTION BENIGN LESIONS 15/>

Professional

Both

$224.00

Service Code	HCPCS 17111
Min. Negotiated Rate	$47.07
Max. Negotiated Rate	$168.00
Rate for Payer: Aetna Commercial	$85.72
Rate for Payer: Aetna Medicare	$112.00
Rate for Payer: BCBS Complete	$49.42
Rate for Payer: BCN Commercial	$100.14
Rate for Payer: Cash Price	$179.20
Rate for Payer: Cash Price	$179.20
Rate for Payer: Mclaren Medicaid	$47.07
Rate for Payer: Meridian Medicaid	$49.42
Rate for Payer: Opus (Opus Packaging Group) HMA	$168.00
Rate for Payer: Priority Health Choice Medicaid	$47.07
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$116.22
Rate for Payer: Priority Health Narrow/Tiered Network	$116.22
Rate for Payer: UHC Medicaid	$47.07
Rate for Payer: UHCCP Medicaid	$47.07

PR DESTRUCTION BENIGN LESIONS UP TO 14

Facility

$188.00

Service Code	CPT 17110
Hospital Charge Code	17110
Hospital Revenue Code	521
Min. Negotiated Rate	$33.14
Max. Negotiated Rate	$169.20
Rate for Payer: Aetna Commercial	$159.80
Rate for Payer: Aetna Medicare	$48.88
Rate for Payer: Allen County Amish Medical Aid Commercial	$58.75
Rate for Payer: Amish Plain Church Group Commercial	$58.75
Rate for Payer: BCBS Complete	$34.80
Rate for Payer: BCBS MAPPO	$47.00
Rate for Payer: BCBS Trust/PPO	$154.55
Rate for Payer: BCN Commercial	$154.55
Rate for Payer: BCN Medicare Advantage	$47.00
Rate for Payer: Cash Price	$150.40
Rate for Payer: Cofinity Commercial	$161.68
Rate for Payer: Encore Health Key Benefits Commercial	$150.40
Rate for Payer: Health Alliance Plan Medicare Advantage	$47.00
Rate for Payer: Healthscope Commercial	$169.20
Rate for Payer: Lakeland Regional Health Systems Commercial	$141.00
Rate for Payer: Mclaren Medicaid	$33.14
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$49.35
Rate for Payer: Meridian Medicaid	$34.80
Rate for Payer: MI Amish Medical Board Commercial	$54.05
Rate for Payer: Molina Medicare/Medicaid	$51.70
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$159.80
Rate for Payer: Nomi Health Commercial	$154.16
Rate for Payer: Opus (Opus Packaging Group) HMA	$141.00
Rate for Payer: PACE Senior Care Partners	$44.65
Rate for Payer: PACE SWMI	$47.00
Rate for Payer: PHP Commercial	$159.80
Rate for Payer: PHP Medicare Advantage	$47.00
Rate for Payer: Priority Health Choice Medicaid	$33.14
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$163.56
Rate for Payer: Priority Health Medicare	$47.47
Rate for Payer: Priority Health Narrow/Tiered Network	$130.85
Rate for Payer: Railroad Medicare Medicare	$47.00
Rate for Payer: UHC Core	$156.98
Rate for Payer: UHC Exchange	$47.00
Rate for Payer: UHC Medicaid	$33.14
Rate for Payer: UHC Medicare Advantage	$47.00
Rate for Payer: UHCCP Medicaid	$33.14
Rate for Payer: VA VA	$47.00
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$141.00

PR DESTRUCTION BENIGN LESIONS UP TO 14

Facility

$188.00

Service Code	CPT 17110
Hospital Charge Code	17110
Hospital Revenue Code	521
Min. Negotiated Rate	$130.85
Max. Negotiated Rate	$169.20
Rate for Payer: Aetna Commercial	$159.80
Rate for Payer: BCBS Trust/PPO	$155.27
Rate for Payer: BCN Commercial	$155.27
Rate for Payer: Cash Price	$150.40
Rate for Payer: Cofinity Commercial	$161.68
Rate for Payer: Encore Health Key Benefits Commercial	$150.40
Rate for Payer: Healthscope Commercial	$169.20
Rate for Payer: Lakeland Regional Health Systems Commercial	$141.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$159.80
Rate for Payer: Nomi Health Commercial	$154.16
Rate for Payer: Opus (Opus Packaging Group) HMA	$141.00
Rate for Payer: PHP Commercial	$159.80
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$163.56
Rate for Payer: Priority Health Narrow/Tiered Network	$130.85
Rate for Payer: UHC Core	$156.98
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$141.00

PR DESTRUCTION BENIGN LESIONS UP TO 14

Professional

Both

$188.00

Service Code	HCPCS 17110
Min. Negotiated Rate	$39.83
Max. Negotiated Rate	$141.00
Rate for Payer: Aetna Commercial	$69.33
Rate for Payer: Aetna Medicare	$94.00
Rate for Payer: BCBS Complete	$41.82
Rate for Payer: BCN Commercial	$82.07
Rate for Payer: Cash Price	$150.40
Rate for Payer: Cash Price	$150.40
Rate for Payer: Mclaren Medicaid	$39.83
Rate for Payer: Meridian Medicaid	$41.82
Rate for Payer: Opus (Opus Packaging Group) HMA	$141.00
Rate for Payer: Priority Health Choice Medicaid	$39.83
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$95.25
Rate for Payer: Priority Health Narrow/Tiered Network	$95.25
Rate for Payer: UHC Medicaid	$39.83
Rate for Payer: UHCCP Medicaid	$39.83

PR DESTRUCTION BENIGN LESIONS UP TO 14

Professional

Both

$188.00

Service Code	HCPCS 17110
Hospital Charge Code	17110
Min. Negotiated Rate	$39.83
Max. Negotiated Rate	$141.00
Rate for Payer: Aetna Commercial	$69.33
Rate for Payer: Aetna Medicare	$94.00
Rate for Payer: BCBS Complete	$41.82
Rate for Payer: BCN Commercial	$82.07
Rate for Payer: Cash Price	$150.40
Rate for Payer: Cash Price	$150.40
Rate for Payer: Mclaren Medicaid	$39.83
Rate for Payer: Meridian Medicaid	$41.82
Rate for Payer: Opus (Opus Packaging Group) HMA	$141.00
Rate for Payer: Priority Health Choice Medicaid	$39.83
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$95.25
Rate for Payer: Priority Health Narrow/Tiered Network	$95.25
Rate for Payer: UHC Medicaid	$39.83
Rate for Payer: UHCCP Medicaid	$39.83

PR DESTRUCTION CUTAN VASC PROLIFERATIVE LES<10SQCM

Professional

Both

$649.00

Service Code	HCPCS 17106
Min. Negotiated Rate	$152.72
Max. Negotiated Rate	$486.75
Rate for Payer: Aetna Commercial	$291.61
Rate for Payer: Aetna Medicare	$324.50
Rate for Payer: BCBS Complete	$160.36
Rate for Payer: BCN Commercial	$329.48
Rate for Payer: Cash Price	$519.20
Rate for Payer: Cash Price	$519.20
Rate for Payer: Mclaren Medicaid	$152.72
Rate for Payer: Meridian Medicaid	$160.36
Rate for Payer: Opus (Opus Packaging Group) HMA	$486.75
Rate for Payer: Priority Health Choice Medicaid	$152.72
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$382.40
Rate for Payer: Priority Health Narrow/Tiered Network	$382.40
Rate for Payer: UHC Medicaid	$152.72
Rate for Payer: UHCCP Medicaid	$152.72

PR DESTRUCTION CUTAN VASC PROLIFERATIVE LES<10SQCM

Facility

$649.00

Service Code	CPT 17106
Hospital Charge Code	17106
Hospital Revenue Code	521
Min. Negotiated Rate	$451.70
Max. Negotiated Rate	$584.10
Rate for Payer: Aetna Commercial	$551.65
Rate for Payer: BCBS Trust/PPO	$536.01
Rate for Payer: BCN Commercial	$536.01
Rate for Payer: Cash Price	$519.20
Rate for Payer: Cofinity Commercial	$558.14
Rate for Payer: Encore Health Key Benefits Commercial	$519.20
Rate for Payer: Healthscope Commercial	$584.10
Rate for Payer: Lakeland Regional Health Systems Commercial	$486.75
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$551.65
Rate for Payer: Nomi Health Commercial	$532.18
Rate for Payer: Opus (Opus Packaging Group) HMA	$486.75
Rate for Payer: PHP Commercial	$551.65
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$564.63
Rate for Payer: Priority Health Narrow/Tiered Network	$451.70
Rate for Payer: UHC Core	$541.91
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$486.75

PR DESTRUCTION CUTAN VASC PROLIFERATIVE LES<10SQCM

Facility

$649.00

Service Code	CPT 17106
Hospital Charge Code	17106
Hospital Revenue Code	521
Min. Negotiated Rate	$114.42
Max. Negotiated Rate	$584.10
Rate for Payer: Aetna Commercial	$551.65
Rate for Payer: Aetna Medicare	$168.74
Rate for Payer: Allen County Amish Medical Aid Commercial	$202.81
Rate for Payer: Amish Plain Church Group Commercial	$202.81
Rate for Payer: BCBS Complete	$120.13
Rate for Payer: BCBS MAPPO	$162.25
Rate for Payer: BCBS Trust/PPO	$533.54
Rate for Payer: BCN Commercial	$533.54
Rate for Payer: BCN Medicare Advantage	$162.25
Rate for Payer: Cash Price	$519.20
Rate for Payer: Cofinity Commercial	$558.14
Rate for Payer: Encore Health Key Benefits Commercial	$519.20
Rate for Payer: Health Alliance Plan Medicare Advantage	$162.25
Rate for Payer: Healthscope Commercial	$584.10
Rate for Payer: Lakeland Regional Health Systems Commercial	$486.75
Rate for Payer: Mclaren Medicaid	$114.42
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$170.36
Rate for Payer: Meridian Medicaid	$120.13
Rate for Payer: MI Amish Medical Board Commercial	$186.59
Rate for Payer: Molina Medicare/Medicaid	$178.47
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$551.65
Rate for Payer: Nomi Health Commercial	$532.18
Rate for Payer: Opus (Opus Packaging Group) HMA	$486.75
Rate for Payer: PACE Senior Care Partners	$154.14
Rate for Payer: PACE SWMI	$162.25
Rate for Payer: PHP Commercial	$551.65
Rate for Payer: PHP Medicare Advantage	$162.25
Rate for Payer: Priority Health Choice Medicaid	$114.42
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$564.63
Rate for Payer: Priority Health Medicare	$163.87
Rate for Payer: Priority Health Narrow/Tiered Network	$451.70
Rate for Payer: Railroad Medicare Medicare	$162.25
Rate for Payer: UHC Core	$541.91
Rate for Payer: UHC Exchange	$162.25
Rate for Payer: UHC Medicaid	$114.42
Rate for Payer: UHC Medicare Advantage	$162.25
Rate for Payer: UHCCP Medicaid	$114.42
Rate for Payer: VA VA	$162.25
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$486.75

PR DESTRUCTION CUTAN VASC PROLIFERATIVE LES<10SQCM

Professional

Both

$649.00

Service Code	HCPCS 17106
Hospital Charge Code	17106
Min. Negotiated Rate	$152.72
Max. Negotiated Rate	$486.75
Rate for Payer: Aetna Commercial	$291.61
Rate for Payer: Aetna Medicare	$324.50
Rate for Payer: BCBS Complete	$160.36
Rate for Payer: BCN Commercial	$329.48
Rate for Payer: Cash Price	$519.20
Rate for Payer: Cash Price	$519.20
Rate for Payer: Mclaren Medicaid	$152.72
Rate for Payer: Meridian Medicaid	$160.36
Rate for Payer: Opus (Opus Packaging Group) HMA	$486.75
Rate for Payer: Priority Health Choice Medicaid	$152.72
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$382.40
Rate for Payer: Priority Health Narrow/Tiered Network	$382.40
Rate for Payer: UHC Medicaid	$152.72
Rate for Payer: UHCCP Medicaid	$152.72

PR DESTRUCTION INTERNAL HEMORRHOID THERMAL ENERGY

Professional

Both

$348.00

Service Code	HCPCS 46930
Min. Negotiated Rate	$100.54
Max. Negotiated Rate	$283.36
Rate for Payer: Aetna Commercial	$200.96
Rate for Payer: Aetna Medicare	$174.00
Rate for Payer: BCBS Complete	$105.57
Rate for Payer: BCN Commercial	$183.39
Rate for Payer: Cash Price	$278.40
Rate for Payer: Cash Price	$278.40
Rate for Payer: Mclaren Medicaid	$100.54
Rate for Payer: Meridian Medicaid	$105.57
Rate for Payer: Opus (Opus Packaging Group) HMA	$261.00
Rate for Payer: Priority Health Choice Medicaid	$100.54
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$283.36
Rate for Payer: Priority Health Narrow/Tiered Network	$283.36
Rate for Payer: UHC Medicaid	$100.54
Rate for Payer: UHCCP Medicaid	$100.54

PR DESTRUCTION LESION LID MARGIN < 1 CM

Professional

Both

$502.00

Service Code	HCPCS 67850
Min. Negotiated Rate	$71.78
Max. Negotiated Rate	$376.50
Rate for Payer: Aetna Commercial	$169.96
Rate for Payer: Aetna Medicare	$251.00
Rate for Payer: BCBS Complete	$75.37
Rate for Payer: BCN Commercial	$196.20
Rate for Payer: Cash Price	$401.60
Rate for Payer: Cash Price	$401.60
Rate for Payer: Mclaren Medicaid	$71.78
Rate for Payer: Meridian Medicaid	$75.37
Rate for Payer: Opus (Opus Packaging Group) HMA	$376.50
Rate for Payer: Priority Health Choice Medicaid	$71.78
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$229.83
Rate for Payer: Priority Health Narrow/Tiered Network	$229.83
Rate for Payer: UHC Medicaid	$71.78
Rate for Payer: UHCCP Medicaid	$71.78

PR DESTRUCTION LESIONS VULVA EXTENSIVE

Professional

Both

$597.00

Service Code	HCPCS 56515
Min. Negotiated Rate	$121.20
Max. Negotiated Rate	$447.75
Rate for Payer: Aetna Commercial	$249.32
Rate for Payer: Aetna Medicare	$298.50
Rate for Payer: BCBS Complete	$127.26
Rate for Payer: BCN Commercial	$319.70
Rate for Payer: Cash Price	$477.60
Rate for Payer: Cash Price	$477.60
Rate for Payer: Mclaren Medicaid	$121.20
Rate for Payer: Meridian Medicaid	$127.26
Rate for Payer: Opus (Opus Packaging Group) HMA	$447.75
Rate for Payer: Priority Health Choice Medicaid	$121.20
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$323.78
Rate for Payer: Priority Health Narrow/Tiered Network	$323.78
Rate for Payer: UHC Medicaid	$121.20
Rate for Payer: UHCCP Medicaid	$121.20

PR DESTRUCTION LESIONS VULVA SIMPLE

Professional

Both

$396.00

Service Code	HCPCS 56501
Min. Negotiated Rate	$76.47
Max. Negotiated Rate	$297.00
Rate for Payer: Aetna Commercial	$152.26
Rate for Payer: Aetna Medicare	$198.00
Rate for Payer: BCBS Complete	$80.29
Rate for Payer: BCN Commercial	$158.65
Rate for Payer: Cash Price	$316.80
Rate for Payer: Cash Price	$316.80
Rate for Payer: Mclaren Medicaid	$76.47
Rate for Payer: Meridian Medicaid	$80.29
Rate for Payer: Opus (Opus Packaging Group) HMA	$297.00
Rate for Payer: Priority Health Choice Medicaid	$76.47
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$203.76
Rate for Payer: Priority Health Narrow/Tiered Network	$203.76
Rate for Payer: UHC Medicaid	$76.47
Rate for Payer: UHCCP Medicaid	$76.47

PR DESTRUCTION MALIGNANT LESION F/E/E/N/L/M 0.5CM/<

Professional

Both

$241.00

Service Code	HCPCS 17280
Min. Negotiated Rate	$47.50
Max. Negotiated Rate	$180.75
Rate for Payer: Aetna Commercial	$92.27
Rate for Payer: Aetna Medicare	$120.50
Rate for Payer: BCBS Complete	$49.88
Rate for Payer: BCN Commercial	$104.07
Rate for Payer: Cash Price	$192.80
Rate for Payer: Cash Price	$192.80
Rate for Payer: Mclaren Medicaid	$47.50
Rate for Payer: Meridian Medicaid	$49.88
Rate for Payer: Opus (Opus Packaging Group) HMA	$180.75
Rate for Payer: Priority Health Choice Medicaid	$47.50
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$120.78
Rate for Payer: Priority Health Narrow/Tiered Network	$120.78
Rate for Payer: UHC Medicaid	$47.50
Rate for Payer: UHCCP Medicaid	$47.50

PR DESTRUCTION MALIGNANT LESION S/N/H/F/G 0.5 CM/<

Professional

Both

$258.00

Service Code	HCPCS 17270
Min. Negotiated Rate	$51.76
Max. Negotiated Rate	$193.50
Rate for Payer: Aetna Commercial	$101.20
Rate for Payer: Aetna Medicare	$129.00
Rate for Payer: BCBS Complete	$54.35
Rate for Payer: BCN Commercial	$114.67
Rate for Payer: Cash Price	$206.40
Rate for Payer: Cash Price	$206.40
Rate for Payer: Mclaren Medicaid	$51.76
Rate for Payer: Meridian Medicaid	$54.35
Rate for Payer: Opus (Opus Packaging Group) HMA	$193.50
Rate for Payer: Priority Health Choice Medicaid	$51.76
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$133.09
Rate for Payer: Priority Health Narrow/Tiered Network	$133.09
Rate for Payer: UHC Medicaid	$51.76
Rate for Payer: UHCCP Medicaid	$51.76

PR DESTRUCTION MALIGNANT LESION S/N/H/F/G 0.6-1.0CM

Professional

Both

$279.00

Service Code	HCPCS 17271
Min. Negotiated Rate	$56.87
Max. Negotiated Rate	$209.25
Rate for Payer: Aetna Commercial	$111.95
Rate for Payer: Aetna Medicare	$139.50
Rate for Payer: BCBS Complete	$59.71
Rate for Payer: BCN Commercial	$125.27
Rate for Payer: Cash Price	$223.20
Rate for Payer: Cash Price	$223.20
Rate for Payer: Mclaren Medicaid	$56.87
Rate for Payer: Meridian Medicaid	$59.71
Rate for Payer: Opus (Opus Packaging Group) HMA	$209.25
Rate for Payer: Priority Health Choice Medicaid	$56.87
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$145.40
Rate for Payer: Priority Health Narrow/Tiered Network	$145.40
Rate for Payer: UHC Medicaid	$56.87
Rate for Payer: UHCCP Medicaid	$56.87

PR DESTRUCTION MALIGNANT LESION S/N/H/F/G 1.1-2.0CM

Professional

Both

$317.00

Service Code	HCPCS 17272
Min. Negotiated Rate	$64.75
Max. Negotiated Rate	$237.75
Rate for Payer: Aetna Commercial	$129.04
Rate for Payer: Aetna Medicare	$158.50
Rate for Payer: BCBS Complete	$67.99
Rate for Payer: BCN Commercial	$143.73
Rate for Payer: Cash Price	$253.60
Rate for Payer: Cash Price	$253.60
Rate for Payer: Mclaren Medicaid	$64.75
Rate for Payer: Meridian Medicaid	$67.99
Rate for Payer: Opus (Opus Packaging Group) HMA	$237.75
Rate for Payer: Priority Health Choice Medicaid	$64.75
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$166.82
Rate for Payer: Priority Health Narrow/Tiered Network	$166.82
Rate for Payer: UHC Medicaid	$64.75
Rate for Payer: UHCCP Medicaid	$64.75

PR DESTRUCTION MALIGNANT LESION S/N/H/F/G 2.1-3.0CM

Professional

Both

$354.00

Service Code	HCPCS 17273
Min. Negotiated Rate	$73.06
Max. Negotiated Rate	$265.50
Rate for Payer: Aetna Commercial	$146.89
Rate for Payer: Aetna Medicare	$177.00
Rate for Payer: BCBS Complete	$76.71
Rate for Payer: BCN Commercial	$162.58
Rate for Payer: Cash Price	$283.20
Rate for Payer: Cash Price	$283.20
Rate for Payer: Mclaren Medicaid	$73.06
Rate for Payer: Meridian Medicaid	$76.71
Rate for Payer: Opus (Opus Packaging Group) HMA	$265.50
Rate for Payer: Priority Health Choice Medicaid	$73.06
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$188.69
Rate for Payer: Priority Health Narrow/Tiered Network	$188.69
Rate for Payer: UHC Medicaid	$73.06
Rate for Payer: UHCCP Medicaid	$73.06

PR DESTRUCTION MALIGNANT LESION S/N/H/F/G 3.1-4.0CM

Professional

Both

$447.00

Service Code	HCPCS 17274
Min. Negotiated Rate	$88.61
Max. Negotiated Rate	$335.25
Rate for Payer: Aetna Commercial	$179.26
Rate for Payer: Aetna Medicare	$223.50
Rate for Payer: BCBS Complete	$93.04
Rate for Payer: BCN Commercial	$199.10
Rate for Payer: Cash Price	$357.60
Rate for Payer: Cash Price	$357.60
Rate for Payer: Mclaren Medicaid	$88.61
Rate for Payer: Meridian Medicaid	$93.04
Rate for Payer: Opus (Opus Packaging Group) HMA	$335.25
Rate for Payer: Priority Health Choice Medicaid	$88.61
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$231.09
Rate for Payer: Priority Health Narrow/Tiered Network	$231.09
Rate for Payer: UHC Medicaid	$88.61
Rate for Payer: UHCCP Medicaid	$88.61

PR DESTRUCTION MALIGNANT LESION T/A/L 0.5 CM/<

Professional

Both

$173.00

Service Code	HCPCS 17260
Min. Negotiated Rate	$37.70
Max. Negotiated Rate	$129.75
Rate for Payer: Aetna Commercial	$74.85
Rate for Payer: Aetna Medicare	$86.50
Rate for Payer: BCBS Complete	$39.59
Rate for Payer: BCN Commercial	$84.04
Rate for Payer: Cash Price	$138.40
Rate for Payer: Cash Price	$138.40
Rate for Payer: Mclaren Medicaid	$37.70
Rate for Payer: Meridian Medicaid	$39.59
Rate for Payer: Opus (Opus Packaging Group) HMA	$129.75
Rate for Payer: Priority Health Choice Medicaid	$37.70
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$97.54
Rate for Payer: Priority Health Narrow/Tiered Network	$97.54
Rate for Payer: UHC Medicaid	$37.70
Rate for Payer: UHCCP Medicaid	$37.70

PR DESTRUCTION MAL LESION F/E/E/N/L/M 0.6-1.0CM

Professional

Both

$304.00

Service Code	HCPCS 17281
Min. Negotiated Rate	$63.47
Max. Negotiated Rate	$228.00
Rate for Payer: Aetna Commercial	$125.70
Rate for Payer: Aetna Medicare	$152.00
Rate for Payer: BCBS Complete	$66.64
Rate for Payer: BCN Commercial	$140.59
Rate for Payer: Cash Price	$243.20
Rate for Payer: Cash Price	$243.20
Rate for Payer: Mclaren Medicaid	$63.47
Rate for Payer: Meridian Medicaid	$66.64
Rate for Payer: Opus (Opus Packaging Group) HMA	$228.00
Rate for Payer: Priority Health Choice Medicaid	$63.47
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$163.17
Rate for Payer: Priority Health Narrow/Tiered Network	$163.17
Rate for Payer: UHC Medicaid	$63.47
Rate for Payer: UHCCP Medicaid	$63.47

PR DESTRUCTION MAL LESION F/E/E/N/L/M 1.1-2.0CM

Professional

Both

$348.00

Service Code	HCPCS 17282
Min. Negotiated Rate	$72.63
Max. Negotiated Rate	$261.00
Rate for Payer: Aetna Commercial	$146.15
Rate for Payer: Aetna Medicare	$174.00
Rate for Payer: BCBS Complete	$76.26
Rate for Payer: BCN Commercial	$161.79
Rate for Payer: Cash Price	$278.40
Rate for Payer: Cash Price	$278.40
Rate for Payer: Mclaren Medicaid	$72.63
Rate for Payer: Meridian Medicaid	$76.26
Rate for Payer: Opus (Opus Packaging Group) HMA	$261.00
Rate for Payer: Priority Health Choice Medicaid	$72.63
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$187.79
Rate for Payer: Priority Health Narrow/Tiered Network	$187.79
Rate for Payer: UHC Medicaid	$72.63
Rate for Payer: UHCCP Medicaid	$72.63

Know your out-of-pocket cost for care.

All Charges