Bronson Lakeview Hospital

All Charges

Charge

Type

Setting

Price

PR EVASC RPR DPLMNT AORTO-BI-ILIAC NDGFT

Professional

Both

$3,261.00

Service Code	HCPCS 34705
Min. Negotiated Rate	$876.71
Max. Negotiated Rate	$2,445.75
Rate for Payer: Aetna Commercial	$2,056.06
Rate for Payer: Aetna Medicare	$1,630.50
Rate for Payer: BCBS Complete	$920.55
Rate for Payer: BCN Commercial	$2,222.99
Rate for Payer: Cash Price	$2,608.80
Rate for Payer: Cash Price	$2,608.80
Rate for Payer: Mclaren Medicaid	$876.71
Rate for Payer: Meridian Medicaid	$920.55
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,445.75
Rate for Payer: Priority Health Choice Medicaid	$876.71
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$2,390.54
Rate for Payer: Priority Health Narrow/Tiered Network	$2,390.54
Rate for Payer: UHC Medicaid	$876.71
Rate for Payer: UHCCP Medicaid	$876.71

PR EVASC RPR DPLMNT AORTO-BI-ILIAC NDGFT RPT

Professional

Both

$4,985.00

Service Code	HCPCS 34706
Min. Negotiated Rate	$1,307.82
Max. Negotiated Rate	$3,738.75
Rate for Payer: Aetna Commercial	$3,096.26
Rate for Payer: Aetna Medicare	$2,492.50
Rate for Payer: BCBS Complete	$1,373.21
Rate for Payer: BCN Commercial	$3,319.04
Rate for Payer: Cash Price	$3,988.00
Rate for Payer: Cash Price	$3,988.00
Rate for Payer: Mclaren Medicaid	$1,307.82
Rate for Payer: Meridian Medicaid	$1,373.21
Rate for Payer: Opus (Opus Packaging Group) HMA	$3,738.75
Rate for Payer: Priority Health Choice Medicaid	$1,307.82
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$3,569.20
Rate for Payer: Priority Health Narrow/Tiered Network	$3,569.20
Rate for Payer: UHC Medicaid	$1,307.82
Rate for Payer: UHCCP Medicaid	$1,307.82

PR EVASC RPR DPLMNT AORTO-UN-ILIAC NDGFT

Professional

Both

$3,005.00

Service Code	HCPCS 34703
Min. Negotiated Rate	$789.38
Max. Negotiated Rate	$2,253.75
Rate for Payer: Aetna Commercial	$1,848.30
Rate for Payer: Aetna Medicare	$1,502.50
Rate for Payer: BCBS Complete	$828.85
Rate for Payer: BCN Commercial	$2,000.39
Rate for Payer: Cash Price	$2,404.00
Rate for Payer: Cash Price	$2,404.00
Rate for Payer: Mclaren Medicaid	$789.38
Rate for Payer: Meridian Medicaid	$828.85
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,253.75
Rate for Payer: Priority Health Choice Medicaid	$789.38
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$2,151.17
Rate for Payer: Priority Health Narrow/Tiered Network	$2,151.17
Rate for Payer: UHC Medicaid	$789.38
Rate for Payer: UHCCP Medicaid	$789.38

PR EVASC RPR DPLMNT ILIO-ILIAC NDGFT

Professional

Both

$2,486.00

Service Code	HCPCS 34707
Min. Negotiated Rate	$670.10
Max. Negotiated Rate	$1,864.50
Rate for Payer: Aetna Commercial	$1,567.17
Rate for Payer: Aetna Medicare	$1,243.00
Rate for Payer: BCBS Complete	$703.61
Rate for Payer: BCN Commercial	$1,696.13
Rate for Payer: Cash Price	$1,988.80
Rate for Payer: Cash Price	$1,988.80
Rate for Payer: Mclaren Medicaid	$670.10
Rate for Payer: Meridian Medicaid	$703.61
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,864.50
Rate for Payer: Priority Health Choice Medicaid	$670.10
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,823.96
Rate for Payer: Priority Health Narrow/Tiered Network	$1,823.96
Rate for Payer: UHC Medicaid	$670.10
Rate for Payer: UHCCP Medicaid	$670.10

PR EVASC RPR DPLMNT ILIO-ILIAC NDGFT RPT

Professional

Both

$4,016.00

Service Code	HCPCS 34708
Min. Negotiated Rate	$1,051.79
Max. Negotiated Rate	$3,012.00
Rate for Payer: Aetna Commercial	$2,493.77
Rate for Payer: Aetna Medicare	$2,008.00
Rate for Payer: BCBS Complete	$1,104.38
Rate for Payer: BCN Commercial	$2,652.25
Rate for Payer: Cash Price	$3,212.80
Rate for Payer: Cash Price	$3,212.80
Rate for Payer: Mclaren Medicaid	$1,051.79
Rate for Payer: Meridian Medicaid	$1,104.38
Rate for Payer: Opus (Opus Packaging Group) HMA	$3,012.00
Rate for Payer: Priority Health Choice Medicaid	$1,051.79
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$2,852.15
Rate for Payer: Priority Health Narrow/Tiered Network	$2,852.15
Rate for Payer: UHC Medicaid	$1,051.79
Rate for Payer: UHCCP Medicaid	$1,051.79

PR EVASC RPR ILAC ART BIFUR ENDGRFT CATHJ RS&I UNI

Professional

Both

$988.00

Service Code	HCPCS 0254T
Min. Negotiated Rate	$395.20
Max. Negotiated Rate	$741.00
Rate for Payer: Aetna Medicare	$494.00
Rate for Payer: BCBS Complete	$395.20
Rate for Payer: Cash Price	$790.40
Rate for Payer: Opus (Opus Packaging Group) HMA	$741.00

PR EVASC RPR ILIAC ART N/A A-ILIAC ART NDGFT UNI

Professional

Both

$2,227.00

Service Code	HCPCS 34718
Min. Negotiated Rate	$709.50
Max. Negotiated Rate	$1,937.50
Rate for Payer: Aetna Commercial	$1,652.85
Rate for Payer: Aetna Medicare	$1,113.50
Rate for Payer: BCBS Complete	$744.98
Rate for Payer: BCN Commercial	$1,801.70
Rate for Payer: Cash Price	$1,781.60
Rate for Payer: Cash Price	$1,781.60
Rate for Payer: Mclaren Medicaid	$709.50
Rate for Payer: Meridian Medicaid	$744.98
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,670.25
Rate for Payer: Priority Health Choice Medicaid	$709.50
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,937.50
Rate for Payer: Priority Health Narrow/Tiered Network	$1,937.50
Rate for Payer: UHC Medicaid	$709.50
Rate for Payer: UHCCP Medicaid	$709.50

PR EVASC RPR ILIAC ART TM OF A-ILIAC ART NDGFT UNI

Professional

Both

$833.00

Service Code	HCPCS 34717
Min. Negotiated Rate	$253.04
Max. Negotiated Rate	$690.82
Rate for Payer: Aetna Commercial	$594.51
Rate for Payer: Aetna Medicare	$416.50
Rate for Payer: BCBS Complete	$265.69
Rate for Payer: BCN Commercial	$642.39
Rate for Payer: Cash Price	$666.40
Rate for Payer: Cash Price	$666.40
Rate for Payer: Mclaren Medicaid	$253.04
Rate for Payer: Meridian Medicaid	$265.69
Rate for Payer: Opus (Opus Packaging Group) HMA	$624.75
Rate for Payer: Priority Health Choice Medicaid	$253.04
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$690.82
Rate for Payer: Priority Health Narrow/Tiered Network	$690.82
Rate for Payer: UHC Medicaid	$253.04
Rate for Payer: UHCCP Medicaid	$253.04

PR EVASC RPR TA DPLMNT AORT-ARTC TUBE NDGFT COV LSA

Professional

Both

$8,492.00

Service Code	HCPCS 33880
Min. Negotiated Rate	$820.90
Max. Negotiated Rate	$6,369.00
Rate for Payer: Aetna Commercial	$2,407.28
Rate for Payer: Aetna Medicare	$4,246.00
Rate for Payer: BCBS Complete	$861.95
Rate for Payer: BCN Commercial	$2,603.44
Rate for Payer: Cash Price	$6,793.60
Rate for Payer: Cash Price	$6,793.60
Rate for Payer: Mclaren Medicaid	$820.90
Rate for Payer: Meridian Medicaid	$861.95
Rate for Payer: Opus (Opus Packaging Group) HMA	$6,369.00
Rate for Payer: Priority Health Choice Medicaid	$820.90
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$2,799.68
Rate for Payer: Priority Health Narrow/Tiered Network	$2,799.68
Rate for Payer: UHC Medicaid	$820.90
Rate for Payer: UHCCP Medicaid	$820.90

PR EVASC RPR TA DPLMNT AORT-ARTC TUB NDGFT XCOV LSA

Professional

Both

$5,669.00

Service Code	HCPCS 33881
Min. Negotiated Rate	$689.27
Max. Negotiated Rate	$4,251.75
Rate for Payer: Aetna Commercial	$2,063.09
Rate for Payer: Aetna Medicare	$2,834.50
Rate for Payer: BCBS Complete	$723.73
Rate for Payer: BCN Commercial	$2,236.44
Rate for Payer: Cash Price	$4,535.20
Rate for Payer: Cash Price	$4,535.20
Rate for Payer: Mclaren Medicaid	$689.27
Rate for Payer: Meridian Medicaid	$723.73
Rate for Payer: Opus (Opus Packaging Group) HMA	$4,251.75
Rate for Payer: Priority Health Choice Medicaid	$689.27
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$2,405.00
Rate for Payer: Priority Health Narrow/Tiered Network	$2,405.00
Rate for Payer: UHC Medicaid	$689.27
Rate for Payer: UHCCP Medicaid	$689.27

PR EVASC TEMP BALLOON ARTL OCCLUSION HEAD/NECK

Professional

Both

$3,436.00

Service Code	HCPCS 61623
Min. Negotiated Rate	$330.58
Max. Negotiated Rate	$2,577.00
Rate for Payer: Aetna Commercial	$737.47
Rate for Payer: Aetna Medicare	$1,718.00
Rate for Payer: BCBS Complete	$347.11
Rate for Payer: BCN Commercial	$861.51
Rate for Payer: Cash Price	$2,748.80
Rate for Payer: Cash Price	$2,748.80
Rate for Payer: Mclaren Medicaid	$330.58
Rate for Payer: Meridian Medicaid	$347.11
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,577.00
Rate for Payer: Priority Health Choice Medicaid	$330.58
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,000.62
Rate for Payer: Priority Health Narrow/Tiered Network	$1,000.62
Rate for Payer: UHC Medicaid	$330.58
Rate for Payer: UHCCP Medicaid	$330.58

PR EWHO RIGID W/O JNTS CF

Professional

Both

$720.00

Service Code	HCPCS L3763
Min. Negotiated Rate	$288.00
Max. Negotiated Rate	$801.35
Rate for Payer: Aetna Commercial	$410.20
Rate for Payer: Aetna Medicare	$360.00
Rate for Payer: BCBS Complete	$288.00
Rate for Payer: BCN Commercial	$801.35
Rate for Payer: Cash Price	$576.00
Rate for Payer: Cash Price	$576.00
Rate for Payer: Opus (Opus Packaging Group) HMA	$540.00

PR EWHO W/JOINT(S) CF

Professional

Both

$753.00

Service Code	HCPCS L3764
Min. Negotiated Rate	$301.20
Max. Negotiated Rate	$838.63
Rate for Payer: Aetna Commercial	$429.28
Rate for Payer: Aetna Medicare	$376.50
Rate for Payer: BCBS Complete	$301.20
Rate for Payer: BCN Commercial	$838.63
Rate for Payer: Cash Price	$602.40
Rate for Payer: Cash Price	$602.40
Rate for Payer: Opus (Opus Packaging Group) HMA	$564.75

PR EXC 1/> SMALL/LARGE LESIONS INTESTINE ENTEROTOM

Professional

Both

$2,450.00

Service Code	HCPCS 44110
Min. Negotiated Rate	$508.43
Max. Negotiated Rate	$1,837.50
Rate for Payer: Aetna Commercial	$1,141.78
Rate for Payer: Aetna Medicare	$1,225.00
Rate for Payer: BCBS Complete	$533.85
Rate for Payer: BCN Commercial	$1,275.83
Rate for Payer: Cash Price	$1,960.00
Rate for Payer: Cash Price	$1,960.00
Rate for Payer: Mclaren Medicaid	$508.43
Rate for Payer: Meridian Medicaid	$533.85
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,837.50
Rate for Payer: Priority Health Choice Medicaid	$508.43
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,554.52
Rate for Payer: Priority Health Narrow/Tiered Network	$1,554.52
Rate for Payer: UHC Medicaid	$508.43
Rate for Payer: UHCCP Medicaid	$508.43

PR EXC 1/> SM/LG LESIONS INTESTNE MULT ENTEROTOMIE

Professional

Both

$3,713.00

Service Code	HCPCS 44111
Min. Negotiated Rate	$577.44
Max. Negotiated Rate	$2,784.75
Rate for Payer: Aetna Commercial	$1,314.35
Rate for Payer: Aetna Medicare	$1,856.50
Rate for Payer: BCBS Complete	$606.31
Rate for Payer: BCN Commercial	$1,468.04
Rate for Payer: Cash Price	$2,970.40
Rate for Payer: Cash Price	$2,970.40
Rate for Payer: Mclaren Medicaid	$577.44
Rate for Payer: Meridian Medicaid	$606.31
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,784.75
Rate for Payer: Priority Health Choice Medicaid	$577.44
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,788.71
Rate for Payer: Priority Health Narrow/Tiered Network	$1,788.71
Rate for Payer: UHC Medicaid	$577.44
Rate for Payer: UHCCP Medicaid	$577.44

PR EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/<

Facility

$231.00

Service Code	CPT 11440
Hospital Charge Code	11440
Hospital Revenue Code	521
Min. Negotiated Rate	$40.73
Max. Negotiated Rate	$207.90
Rate for Payer: Aetna Commercial	$196.35
Rate for Payer: Aetna Medicare	$60.06
Rate for Payer: Allen County Amish Medical Aid Commercial	$72.19
Rate for Payer: Amish Plain Church Group Commercial	$72.19
Rate for Payer: BCBS Complete	$42.76
Rate for Payer: BCBS MAPPO	$57.75
Rate for Payer: BCBS Trust/PPO	$189.91
Rate for Payer: BCN Commercial	$189.91
Rate for Payer: BCN Medicare Advantage	$57.75
Rate for Payer: Cash Price	$184.80
Rate for Payer: Cofinity Commercial	$198.66
Rate for Payer: Encore Health Key Benefits Commercial	$184.80
Rate for Payer: Health Alliance Plan Medicare Advantage	$57.75
Rate for Payer: Healthscope Commercial	$207.90
Rate for Payer: Lakeland Regional Health Systems Commercial	$173.25
Rate for Payer: Mclaren Medicaid	$40.73
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$60.64
Rate for Payer: Meridian Medicaid	$42.76
Rate for Payer: MI Amish Medical Board Commercial	$66.41
Rate for Payer: Molina Medicare/Medicaid	$63.52
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$196.35
Rate for Payer: Nomi Health Commercial	$189.42
Rate for Payer: Opus (Opus Packaging Group) HMA	$173.25
Rate for Payer: PACE Senior Care Partners	$54.86
Rate for Payer: PACE SWMI	$57.75
Rate for Payer: PHP Commercial	$196.35
Rate for Payer: PHP Medicare Advantage	$57.75
Rate for Payer: Priority Health Choice Medicaid	$40.73
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$200.97
Rate for Payer: Priority Health Medicare	$58.33
Rate for Payer: Priority Health Narrow/Tiered Network	$160.78
Rate for Payer: Railroad Medicare Medicare	$57.75
Rate for Payer: UHC Core	$192.88
Rate for Payer: UHC Exchange	$57.75
Rate for Payer: UHC Medicaid	$40.73
Rate for Payer: UHC Medicare Advantage	$57.75
Rate for Payer: UHCCP Medicaid	$40.73
Rate for Payer: VA VA	$57.75
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$173.25

PR EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/<

Facility

$231.00

Service Code	CPT 11440
Hospital Charge Code	11440
Hospital Revenue Code	521
Min. Negotiated Rate	$160.78
Max. Negotiated Rate	$207.90
Rate for Payer: Aetna Commercial	$196.35
Rate for Payer: BCBS Trust/PPO	$190.78
Rate for Payer: BCN Commercial	$190.78
Rate for Payer: Cash Price	$184.80
Rate for Payer: Cofinity Commercial	$198.66
Rate for Payer: Encore Health Key Benefits Commercial	$184.80
Rate for Payer: Healthscope Commercial	$207.90
Rate for Payer: Lakeland Regional Health Systems Commercial	$173.25
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$196.35
Rate for Payer: Nomi Health Commercial	$189.42
Rate for Payer: Opus (Opus Packaging Group) HMA	$173.25
Rate for Payer: PHP Commercial	$196.35
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$200.97
Rate for Payer: Priority Health Narrow/Tiered Network	$160.78
Rate for Payer: UHC Core	$192.88
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$173.25

PR EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/<

Professional

Both

$231.00

Service Code	HCPCS 11440
Hospital Charge Code	11440
Min. Negotiated Rate	$62.41
Max. Negotiated Rate	$173.25
Rate for Payer: Aetna Commercial	$109.82
Rate for Payer: Aetna Medicare	$115.50
Rate for Payer: BCBS Complete	$65.53
Rate for Payer: BCN Commercial	$128.02
Rate for Payer: Cash Price	$184.80
Rate for Payer: Cash Price	$184.80
Rate for Payer: Mclaren Medicaid	$62.41
Rate for Payer: Meridian Medicaid	$65.53
Rate for Payer: Opus (Opus Packaging Group) HMA	$173.25
Rate for Payer: Priority Health Choice Medicaid	$62.41
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$148.59
Rate for Payer: Priority Health Narrow/Tiered Network	$148.59
Rate for Payer: UHC Medicaid	$62.41
Rate for Payer: UHCCP Medicaid	$62.41

PR EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/<

Professional

Both

$231.00

Service Code	HCPCS 11440
Min. Negotiated Rate	$62.41
Max. Negotiated Rate	$173.25
Rate for Payer: Aetna Commercial	$109.82
Rate for Payer: Aetna Medicare	$115.50
Rate for Payer: BCBS Complete	$65.53
Rate for Payer: BCN Commercial	$128.02
Rate for Payer: Cash Price	$184.80
Rate for Payer: Cash Price	$184.80
Rate for Payer: Mclaren Medicaid	$62.41
Rate for Payer: Meridian Medicaid	$65.53
Rate for Payer: Opus (Opus Packaging Group) HMA	$173.25
Rate for Payer: Priority Health Choice Medicaid	$62.41
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$148.59
Rate for Payer: Priority Health Narrow/Tiered Network	$148.59
Rate for Payer: UHC Medicaid	$62.41
Rate for Payer: UHCCP Medicaid	$62.41

PR EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M > 4.0CM

Professional

Both

$851.00

Service Code	HCPCS 11446
Min. Negotiated Rate	$180.20
Max. Negotiated Rate	$638.25
Rate for Payer: Aetna Commercial	$345.75
Rate for Payer: Aetna Medicare	$425.50
Rate for Payer: BCBS Complete	$189.21
Rate for Payer: BCN Commercial	$378.96
Rate for Payer: Cash Price	$680.80
Rate for Payer: Cash Price	$680.80
Rate for Payer: Mclaren Medicaid	$180.20
Rate for Payer: Meridian Medicaid	$189.21
Rate for Payer: Opus (Opus Packaging Group) HMA	$638.25
Rate for Payer: Priority Health Choice Medicaid	$180.20
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$439.82
Rate for Payer: Priority Health Narrow/Tiered Network	$439.82
Rate for Payer: UHC Medicaid	$180.20
Rate for Payer: UHCCP Medicaid	$180.20

PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.5 CM/<

Professional

Both

$209.00

Service Code	HCPCS 11420
Min. Negotiated Rate	$48.56
Max. Negotiated Rate	$156.75
Rate for Payer: Aetna Commercial	$87.38
Rate for Payer: Aetna Medicare	$104.50
Rate for Payer: BCBS Complete	$50.99
Rate for Payer: BCN Commercial	$98.57
Rate for Payer: Cash Price	$167.20
Rate for Payer: Cash Price	$167.20
Rate for Payer: Mclaren Medicaid	$48.56
Rate for Payer: Meridian Medicaid	$50.99
Rate for Payer: Opus (Opus Packaging Group) HMA	$156.75
Rate for Payer: Priority Health Choice Medicaid	$48.56
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$114.40
Rate for Payer: Priority Health Narrow/Tiered Network	$114.40
Rate for Payer: UHC Medicaid	$48.56
Rate for Payer: UHCCP Medicaid	$48.56

PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.5 CM/<

Professional

Both

$209.00

Service Code	HCPCS 11420
Hospital Charge Code	11420
Min. Negotiated Rate	$48.56
Max. Negotiated Rate	$156.75
Rate for Payer: Aetna Commercial	$87.38
Rate for Payer: Aetna Medicare	$104.50
Rate for Payer: BCBS Complete	$50.99
Rate for Payer: BCN Commercial	$98.57
Rate for Payer: Cash Price	$167.20
Rate for Payer: Cash Price	$167.20
Rate for Payer: Mclaren Medicaid	$48.56
Rate for Payer: Meridian Medicaid	$50.99
Rate for Payer: Opus (Opus Packaging Group) HMA	$156.75
Rate for Payer: Priority Health Choice Medicaid	$48.56
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$114.40
Rate for Payer: Priority Health Narrow/Tiered Network	$114.40
Rate for Payer: UHC Medicaid	$48.56
Rate for Payer: UHCCP Medicaid	$48.56

PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.5 CM/<

Facility

$209.00

Service Code	CPT 11420
Hospital Charge Code	11420
Hospital Revenue Code	521
Min. Negotiated Rate	$145.46
Max. Negotiated Rate	$188.10
Rate for Payer: Aetna Commercial	$177.65
Rate for Payer: BCBS Trust/PPO	$172.61
Rate for Payer: BCN Commercial	$172.61
Rate for Payer: Cash Price	$167.20
Rate for Payer: Cofinity Commercial	$179.74
Rate for Payer: Encore Health Key Benefits Commercial	$167.20
Rate for Payer: Healthscope Commercial	$188.10
Rate for Payer: Lakeland Regional Health Systems Commercial	$156.75
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$177.65
Rate for Payer: Nomi Health Commercial	$171.38
Rate for Payer: Opus (Opus Packaging Group) HMA	$156.75
Rate for Payer: PHP Commercial	$177.65
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$181.83
Rate for Payer: Priority Health Narrow/Tiered Network	$145.46
Rate for Payer: UHC Core	$174.51
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$156.75

PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.5 CM/<

Facility

$209.00

Service Code	CPT 11420
Hospital Charge Code	11420
Hospital Revenue Code	521
Min. Negotiated Rate	$36.85
Max. Negotiated Rate	$188.10
Rate for Payer: Aetna Commercial	$177.65
Rate for Payer: Aetna Medicare	$54.34
Rate for Payer: Allen County Amish Medical Aid Commercial	$65.31
Rate for Payer: Amish Plain Church Group Commercial	$65.31
Rate for Payer: BCBS Complete	$38.69
Rate for Payer: BCBS MAPPO	$52.25
Rate for Payer: BCBS Trust/PPO	$171.82
Rate for Payer: BCN Commercial	$171.82
Rate for Payer: BCN Medicare Advantage	$52.25
Rate for Payer: Cash Price	$167.20
Rate for Payer: Cofinity Commercial	$179.74
Rate for Payer: Encore Health Key Benefits Commercial	$167.20
Rate for Payer: Health Alliance Plan Medicare Advantage	$52.25
Rate for Payer: Healthscope Commercial	$188.10
Rate for Payer: Lakeland Regional Health Systems Commercial	$156.75
Rate for Payer: Mclaren Medicaid	$36.85
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$54.86
Rate for Payer: Meridian Medicaid	$38.69
Rate for Payer: MI Amish Medical Board Commercial	$60.09
Rate for Payer: Molina Medicare/Medicaid	$57.48
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$177.65
Rate for Payer: Nomi Health Commercial	$171.38
Rate for Payer: Opus (Opus Packaging Group) HMA	$156.75
Rate for Payer: PACE Senior Care Partners	$49.64
Rate for Payer: PACE SWMI	$52.25
Rate for Payer: PHP Commercial	$177.65
Rate for Payer: PHP Medicare Advantage	$52.25
Rate for Payer: Priority Health Choice Medicaid	$36.85
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$181.83
Rate for Payer: Priority Health Medicare	$52.77
Rate for Payer: Priority Health Narrow/Tiered Network	$145.46
Rate for Payer: Railroad Medicare Medicare	$52.25
Rate for Payer: UHC Core	$174.51
Rate for Payer: UHC Exchange	$52.25
Rate for Payer: UHC Medicaid	$36.85
Rate for Payer: UHC Medicare Advantage	$52.25
Rate for Payer: UHCCP Medicaid	$36.85
Rate for Payer: VA VA	$52.25
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$156.75

PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.6-1.0CM

Facility

$269.00

Service Code	CPT 11421
Hospital Charge Code	11421
Hospital Revenue Code	521
Min. Negotiated Rate	$47.42
Max. Negotiated Rate	$242.10
Rate for Payer: Aetna Commercial	$228.65
Rate for Payer: Aetna Medicare	$69.94
Rate for Payer: Allen County Amish Medical Aid Commercial	$84.06
Rate for Payer: Amish Plain Church Group Commercial	$84.06
Rate for Payer: BCBS Complete	$49.79
Rate for Payer: BCBS MAPPO	$67.25
Rate for Payer: BCBS Trust/PPO	$221.14
Rate for Payer: BCN Commercial	$221.14
Rate for Payer: BCN Medicare Advantage	$67.25
Rate for Payer: Cash Price	$215.20
Rate for Payer: Cofinity Commercial	$231.34
Rate for Payer: Encore Health Key Benefits Commercial	$215.20
Rate for Payer: Health Alliance Plan Medicare Advantage	$67.25
Rate for Payer: Healthscope Commercial	$242.10
Rate for Payer: Lakeland Regional Health Systems Commercial	$201.75
Rate for Payer: Mclaren Medicaid	$47.42
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$70.61
Rate for Payer: Meridian Medicaid	$49.79
Rate for Payer: MI Amish Medical Board Commercial	$77.34
Rate for Payer: Molina Medicare/Medicaid	$73.97
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$228.65
Rate for Payer: Nomi Health Commercial	$220.58
Rate for Payer: Opus (Opus Packaging Group) HMA	$201.75
Rate for Payer: PACE Senior Care Partners	$63.89
Rate for Payer: PACE SWMI	$67.25
Rate for Payer: PHP Commercial	$228.65
Rate for Payer: PHP Medicare Advantage	$67.25
Rate for Payer: Priority Health Choice Medicaid	$47.42
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$234.03
Rate for Payer: Priority Health Medicare	$67.92
Rate for Payer: Priority Health Narrow/Tiered Network	$187.22
Rate for Payer: Railroad Medicare Medicare	$67.25
Rate for Payer: UHC Core	$224.62
Rate for Payer: UHC Exchange	$67.25
Rate for Payer: UHC Medicaid	$47.42
Rate for Payer: UHC Medicare Advantage	$67.25
Rate for Payer: UHCCP Medicaid	$47.42
Rate for Payer: VA VA	$67.25
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$201.75

Know your out-of-pocket cost for care.

All Charges