Bronson Lakeview Hospital

All Charges

Charge

Type

Setting

Price

PR EXCISION/SURGICAL PLANING SKIN NOSE RHINOPHYMA

Professional

Both

$1,066.00

Service Code	HCPCS 30120
Min. Negotiated Rate	$238.77
Max. Negotiated Rate	$799.50
Rate for Payer: Aetna Commercial	$537.29
Rate for Payer: Aetna Medicare	$533.00
Rate for Payer: BCBS Complete	$250.71
Rate for Payer: BCN Commercial	$634.43
Rate for Payer: Cash Price	$852.80
Rate for Payer: Cash Price	$852.80
Rate for Payer: Mclaren Medicaid	$238.77
Rate for Payer: Meridian Medicaid	$250.71
Rate for Payer: Opus (Opus Packaging Group) HMA	$799.50
Rate for Payer: Priority Health Choice Medicaid	$238.77
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$597.44
Rate for Payer: Priority Health Narrow/Tiered Network	$597.44
Rate for Payer: UHC Medicaid	$238.77
Rate for Payer: UHCCP Medicaid	$238.77

PR EXCISION SYNOVIAL CYST POPLITEAL SPACE

Professional

Both

$1,689.00

Service Code	HCPCS 27345
Min. Negotiated Rate	$298.63
Max. Negotiated Rate	$1,266.75
Rate for Payer: Aetna Commercial	$645.18
Rate for Payer: Aetna Medicare	$844.50
Rate for Payer: BCBS Complete	$313.56
Rate for Payer: BCN Commercial	$751.96
Rate for Payer: Cash Price	$1,351.20
Rate for Payer: Cash Price	$1,351.20
Rate for Payer: Mclaren Medicaid	$298.63
Rate for Payer: Meridian Medicaid	$313.56
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,266.75
Rate for Payer: Priority Health Choice Medicaid	$298.63
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$803.81
Rate for Payer: Priority Health Narrow/Tiered Network	$803.81
Rate for Payer: UHC Medicaid	$298.63
Rate for Payer: UHCCP Medicaid	$298.63

PR EXCISION TENDON FINGER FLEXOR/EXTENSOR EACH

Professional

Both

$1,310.00

Service Code	HCPCS 26180
Min. Negotiated Rate	$274.98
Max. Negotiated Rate	$982.50
Rate for Payer: Aetna Commercial	$596.15
Rate for Payer: Aetna Medicare	$655.00
Rate for Payer: BCBS Complete	$288.73
Rate for Payer: BCN Commercial	$697.67
Rate for Payer: Cash Price	$1,048.00
Rate for Payer: Cash Price	$1,048.00
Rate for Payer: Mclaren Medicaid	$274.98
Rate for Payer: Meridian Medicaid	$288.73
Rate for Payer: Opus (Opus Packaging Group) HMA	$982.50
Rate for Payer: Priority Health Choice Medicaid	$274.98
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$745.78
Rate for Payer: Priority Health Narrow/Tiered Network	$745.78
Rate for Payer: UHC Medicaid	$274.98
Rate for Payer: UHCCP Medicaid	$274.98

PR EXCISION TENDON PALM FLEXOR/EXTENSOR SINGLE EACH

Professional

Both

$1,147.00

Service Code	HCPCS 26170
Min. Negotiated Rate	$249.85
Max. Negotiated Rate	$860.25
Rate for Payer: Aetna Commercial	$541.73
Rate for Payer: Aetna Medicare	$573.50
Rate for Payer: BCBS Complete	$262.34
Rate for Payer: BCN Commercial	$630.44
Rate for Payer: Cash Price	$917.60
Rate for Payer: Cash Price	$917.60
Rate for Payer: Mclaren Medicaid	$249.85
Rate for Payer: Meridian Medicaid	$262.34
Rate for Payer: Opus (Opus Packaging Group) HMA	$860.25
Rate for Payer: Priority Health Choice Medicaid	$249.85
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$673.93
Rate for Payer: Priority Health Narrow/Tiered Network	$673.93
Rate for Payer: UHC Medicaid	$249.85
Rate for Payer: UHCCP Medicaid	$249.85

PR EXCISION THYROGLOSSAL DUCT CYST/SINUS

Professional

Both

$2,136.00

Service Code	HCPCS 60280
Min. Negotiated Rate	$261.35
Max. Negotiated Rate	$1,602.00
Rate for Payer: Aetna Commercial	$571.08
Rate for Payer: Aetna Medicare	$1,068.00
Rate for Payer: BCBS Complete	$274.42
Rate for Payer: BCN Commercial	$688.21
Rate for Payer: Cash Price	$1,708.80
Rate for Payer: Cash Price	$1,708.80
Rate for Payer: Mclaren Medicaid	$261.35
Rate for Payer: Meridian Medicaid	$274.42
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,602.00
Rate for Payer: Priority Health Choice Medicaid	$261.35
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$746.26
Rate for Payer: Priority Health Narrow/Tiered Network	$746.26
Rate for Payer: UHC Medicaid	$261.35
Rate for Payer: UHCCP Medicaid	$261.35

PR EXCISION THYROGLOSSAL DUCT CYST/SINUS RECURRENT

Professional

Both

$2,263.00

Service Code	HCPCS 60281
Min. Negotiated Rate	$335.05
Max. Negotiated Rate	$1,697.25
Rate for Payer: Aetna Commercial	$753.00
Rate for Payer: Aetna Medicare	$1,131.50
Rate for Payer: BCBS Complete	$351.80
Rate for Payer: BCN Commercial	$900.35
Rate for Payer: Cash Price	$1,810.40
Rate for Payer: Cash Price	$1,810.40
Rate for Payer: Mclaren Medicaid	$335.05
Rate for Payer: Meridian Medicaid	$351.80
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,697.25
Rate for Payer: Priority Health Choice Medicaid	$335.05
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$976.28
Rate for Payer: Priority Health Narrow/Tiered Network	$976.28
Rate for Payer: UHC Medicaid	$335.05
Rate for Payer: UHCCP Medicaid	$335.05

PR EXCISION TONSIL TAGS

Professional

Both

$391.00

Service Code	HCPCS 42860
Min. Negotiated Rate	$114.59
Max. Negotiated Rate	$361.64
Rate for Payer: Aetna Commercial	$249.27
Rate for Payer: Aetna Medicare	$195.50
Rate for Payer: BCBS Complete	$120.32
Rate for Payer: BCN Commercial	$296.80
Rate for Payer: Cash Price	$312.80
Rate for Payer: Cash Price	$312.80
Rate for Payer: Mclaren Medicaid	$114.59
Rate for Payer: Meridian Medicaid	$120.32
Rate for Payer: Opus (Opus Packaging Group) HMA	$293.25
Rate for Payer: Priority Health Choice Medicaid	$114.59
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$361.64
Rate for Payer: Priority Health Narrow/Tiered Network	$361.64
Rate for Payer: UHC Medicaid	$114.59
Rate for Payer: UHCCP Medicaid	$114.59

PR EXCISION TRACHEAL TUMOR/CARCINOMA CERVICAL

Professional

Both

$4,066.00

Service Code	HCPCS 31785
Min. Negotiated Rate	$585.96
Max. Negotiated Rate	$3,049.50
Rate for Payer: Aetna Commercial	$1,372.02
Rate for Payer: Aetna Medicare	$2,033.00
Rate for Payer: BCBS Complete	$615.26
Rate for Payer: BCN Commercial	$1,608.48
Rate for Payer: Cash Price	$3,252.80
Rate for Payer: Cash Price	$3,252.80
Rate for Payer: Mclaren Medicaid	$585.96
Rate for Payer: Meridian Medicaid	$615.26
Rate for Payer: Opus (Opus Packaging Group) HMA	$3,049.50
Rate for Payer: Priority Health Choice Medicaid	$585.96
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,514.71
Rate for Payer: Priority Health Narrow/Tiered Network	$1,514.71
Rate for Payer: UHC Medicaid	$585.96
Rate for Payer: UHCCP Medicaid	$585.96

PR EXCISION TROCHANTERIC BURSA/CALCIFICATION

Professional

Both

$1,728.00

Service Code	HCPCS 27062
Min. Negotiated Rate	$276.05
Max. Negotiated Rate	$1,296.00
Rate for Payer: Aetna Commercial	$606.20
Rate for Payer: Aetna Medicare	$864.00
Rate for Payer: BCBS Complete	$289.85
Rate for Payer: BCN Commercial	$696.17
Rate for Payer: Cash Price	$1,382.40
Rate for Payer: Cash Price	$1,382.40
Rate for Payer: Mclaren Medicaid	$276.05
Rate for Payer: Meridian Medicaid	$289.85
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,296.00
Rate for Payer: Priority Health Choice Medicaid	$276.05
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$744.19
Rate for Payer: Priority Health Narrow/Tiered Network	$744.19
Rate for Payer: UHC Medicaid	$276.05
Rate for Payer: UHCCP Medicaid	$276.05

PR EXCISION TUMOR SOFT TIS BACK/FLANK SUBQ 3 CM/>

Professional

Both

$767.00

Service Code	HCPCS 21931
Hospital Charge Code	21931
Min. Negotiated Rate	$289.25
Max. Negotiated Rate	$764.96
Rate for Payer: Aetna Commercial	$629.51
Rate for Payer: Aetna Medicare	$383.50
Rate for Payer: BCBS Complete	$303.71
Rate for Payer: BCN Commercial	$715.60
Rate for Payer: Cash Price	$613.60
Rate for Payer: Cash Price	$613.60
Rate for Payer: Mclaren Medicaid	$289.25
Rate for Payer: Meridian Medicaid	$303.71
Rate for Payer: Opus (Opus Packaging Group) HMA	$575.25
Rate for Payer: Priority Health Choice Medicaid	$289.25
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$764.96
Rate for Payer: Priority Health Narrow/Tiered Network	$764.96
Rate for Payer: UHC Medicaid	$289.25
Rate for Payer: UHCCP Medicaid	$289.25

PR EXCISION TUMOR SOFT TIS BACK/FLANK SUBQ 3 CM/>

Facility

$767.00

Service Code	CPT 21931
Hospital Charge Code	21931
Hospital Revenue Code	521
Min. Negotiated Rate	$135.22
Max. Negotiated Rate	$690.30
Rate for Payer: Aetna Commercial	$651.95
Rate for Payer: Aetna Medicare	$199.42
Rate for Payer: Allen County Amish Medical Aid Commercial	$239.69
Rate for Payer: Amish Plain Church Group Commercial	$239.69
Rate for Payer: BCBS Complete	$141.97
Rate for Payer: BCBS MAPPO	$191.75
Rate for Payer: BCBS Trust/PPO	$630.55
Rate for Payer: BCN Commercial	$630.55
Rate for Payer: BCN Medicare Advantage	$191.75
Rate for Payer: Cash Price	$613.60
Rate for Payer: Cofinity Commercial	$659.62
Rate for Payer: Encore Health Key Benefits Commercial	$613.60
Rate for Payer: Health Alliance Plan Medicare Advantage	$191.75
Rate for Payer: Healthscope Commercial	$690.30
Rate for Payer: Lakeland Regional Health Systems Commercial	$575.25
Rate for Payer: Mclaren Medicaid	$135.22
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$201.34
Rate for Payer: Meridian Medicaid	$141.97
Rate for Payer: MI Amish Medical Board Commercial	$220.51
Rate for Payer: Molina Medicare/Medicaid	$210.93
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$651.95
Rate for Payer: Nomi Health Commercial	$628.94
Rate for Payer: Opus (Opus Packaging Group) HMA	$575.25
Rate for Payer: PACE Senior Care Partners	$182.16
Rate for Payer: PACE SWMI	$191.75
Rate for Payer: PHP Commercial	$651.95
Rate for Payer: PHP Medicare Advantage	$191.75
Rate for Payer: Priority Health Choice Medicaid	$135.22
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$667.29
Rate for Payer: Priority Health Medicare	$193.67
Rate for Payer: Priority Health Narrow/Tiered Network	$533.83
Rate for Payer: Railroad Medicare Medicare	$191.75
Rate for Payer: UHC Core	$640.45
Rate for Payer: UHC Exchange	$191.75
Rate for Payer: UHC Medicaid	$135.22
Rate for Payer: UHC Medicare Advantage	$191.75
Rate for Payer: UHCCP Medicaid	$135.22
Rate for Payer: VA VA	$191.75
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$575.25

PR EXCISION TUMOR SOFT TIS BACK/FLANK SUBQ 3 CM/>

Professional

Both

$767.00

Service Code	HCPCS 21931
Min. Negotiated Rate	$289.25
Max. Negotiated Rate	$764.96
Rate for Payer: Aetna Commercial	$629.51
Rate for Payer: Aetna Medicare	$383.50
Rate for Payer: BCBS Complete	$303.71
Rate for Payer: BCN Commercial	$715.60
Rate for Payer: Cash Price	$613.60
Rate for Payer: Cash Price	$613.60
Rate for Payer: Mclaren Medicaid	$289.25
Rate for Payer: Meridian Medicaid	$303.71
Rate for Payer: Opus (Opus Packaging Group) HMA	$575.25
Rate for Payer: Priority Health Choice Medicaid	$289.25
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$764.96
Rate for Payer: Priority Health Narrow/Tiered Network	$764.96
Rate for Payer: UHC Medicaid	$289.25
Rate for Payer: UHCCP Medicaid	$289.25

PR EXCISION TUMOR SOFT TIS BACK/FLANK SUBQ 3 CM/>

Facility

$767.00

Service Code	CPT 21931
Hospital Charge Code	21931
Hospital Revenue Code	521
Min. Negotiated Rate	$533.83
Max. Negotiated Rate	$690.30
Rate for Payer: Aetna Commercial	$651.95
Rate for Payer: BCBS Trust/PPO	$633.47
Rate for Payer: BCN Commercial	$633.47
Rate for Payer: Cash Price	$613.60
Rate for Payer: Cofinity Commercial	$659.62
Rate for Payer: Encore Health Key Benefits Commercial	$613.60
Rate for Payer: Healthscope Commercial	$690.30
Rate for Payer: Lakeland Regional Health Systems Commercial	$575.25
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$651.95
Rate for Payer: Nomi Health Commercial	$628.94
Rate for Payer: Opus (Opus Packaging Group) HMA	$575.25
Rate for Payer: PHP Commercial	$651.95
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$667.29
Rate for Payer: Priority Health Narrow/Tiered Network	$533.83
Rate for Payer: UHC Core	$640.45
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$575.25

PR EXCISION TUMOR SOFT TIS FOOT/TOE SUBQ 1.5 CM/>

Professional

Both

$941.00

Service Code	HCPCS 28039
Min. Negotiated Rate	$201.07
Max. Negotiated Rate	$705.75
Rate for Payer: Aetna Commercial	$461.09
Rate for Payer: Aetna Medicare	$470.50
Rate for Payer: BCBS Complete	$211.12
Rate for Payer: BCN Commercial	$509.43
Rate for Payer: Cash Price	$752.80
Rate for Payer: Cash Price	$752.80
Rate for Payer: Mclaren Medicaid	$201.07
Rate for Payer: Meridian Medicaid	$211.12
Rate for Payer: Opus (Opus Packaging Group) HMA	$705.75
Rate for Payer: Priority Health Choice Medicaid	$201.07
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$544.56
Rate for Payer: Priority Health Narrow/Tiered Network	$544.56
Rate for Payer: UHC Medicaid	$201.07
Rate for Payer: UHCCP Medicaid	$201.07

PR EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ 2 CM/>

Professional

Both

$672.00

Service Code	HCPCS 21012
Min. Negotiated Rate	$206.61
Max. Negotiated Rate	$552.02
Rate for Payer: Aetna Commercial	$448.00
Rate for Payer: Aetna Medicare	$336.00
Rate for Payer: BCBS Complete	$216.94
Rate for Payer: BCN Commercial	$516.41
Rate for Payer: Cash Price	$537.60
Rate for Payer: Cash Price	$537.60
Rate for Payer: Mclaren Medicaid	$206.61
Rate for Payer: Meridian Medicaid	$216.94
Rate for Payer: Opus (Opus Packaging Group) HMA	$504.00
Rate for Payer: Priority Health Choice Medicaid	$206.61
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$552.02
Rate for Payer: Priority Health Narrow/Tiered Network	$552.02
Rate for Payer: UHC Medicaid	$206.61
Rate for Payer: UHCCP Medicaid	$206.61

PR EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ <2CM

Professional

Both

$570.00

Service Code	HCPCS 21011
Min. Negotiated Rate	$159.54
Max. Negotiated Rate	$427.50
Rate for Payer: Aetna Commercial	$338.16
Rate for Payer: Aetna Medicare	$285.00
Rate for Payer: BCBS Complete	$167.52
Rate for Payer: BCN Commercial	$399.39
Rate for Payer: Cash Price	$456.00
Rate for Payer: Cash Price	$456.00
Rate for Payer: Mclaren Medicaid	$159.54
Rate for Payer: Meridian Medicaid	$167.52
Rate for Payer: Opus (Opus Packaging Group) HMA	$427.50
Rate for Payer: Priority Health Choice Medicaid	$159.54
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$426.93
Rate for Payer: Priority Health Narrow/Tiered Network	$426.93
Rate for Payer: UHC Medicaid	$159.54
Rate for Payer: UHCCP Medicaid	$159.54

PR EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ <3CM

Facility

$1,297.00

Service Code	CPT 21930
Hospital Charge Code	21930
Hospital Revenue Code	960
Min. Negotiated Rate	$902.71
Max. Negotiated Rate	$1,167.30
Rate for Payer: Aetna Commercial	$1,102.45
Rate for Payer: BCBS Trust/PPO	$1,071.19
Rate for Payer: BCN Commercial	$1,071.19
Rate for Payer: Cash Price	$1,037.60
Rate for Payer: Cofinity Commercial	$1,115.42
Rate for Payer: Encore Health Key Benefits Commercial	$1,037.60
Rate for Payer: Healthscope Commercial	$1,167.30
Rate for Payer: Lakeland Regional Health Systems Commercial	$972.75
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,102.45
Rate for Payer: Nomi Health Commercial	$1,063.54
Rate for Payer: Opus (Opus Packaging Group) HMA	$972.75
Rate for Payer: PHP Commercial	$1,102.45
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,128.39
Rate for Payer: Priority Health Narrow/Tiered Network	$902.71
Rate for Payer: UHC Core	$1,082.99
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$972.75

PR EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ <3CM

Professional

Both

$1,297.00

Service Code	HCPCS 21930
Min. Negotiated Rate	$224.08
Max. Negotiated Rate	$972.75
Rate for Payer: Aetna Commercial	$484.47
Rate for Payer: Aetna Medicare	$648.50
Rate for Payer: BCBS Complete	$235.28
Rate for Payer: BCN Commercial	$555.75
Rate for Payer: Cash Price	$1,037.60
Rate for Payer: Cash Price	$1,037.60
Rate for Payer: Mclaren Medicaid	$224.08
Rate for Payer: Meridian Medicaid	$235.28
Rate for Payer: Opus (Opus Packaging Group) HMA	$972.75
Rate for Payer: Priority Health Choice Medicaid	$224.08
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$594.08
Rate for Payer: Priority Health Narrow/Tiered Network	$594.08
Rate for Payer: UHC Medicaid	$224.08
Rate for Payer: UHCCP Medicaid	$224.08

PR EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ <3CM

Facility

$1,297.00

Service Code	CPT 21930
Hospital Charge Code	21930
Hospital Revenue Code	960
Min. Negotiated Rate	$228.66
Max. Negotiated Rate	$1,167.30
Rate for Payer: Aetna Commercial	$1,102.45
Rate for Payer: Aetna Medicare	$337.22
Rate for Payer: Allen County Amish Medical Aid Commercial	$405.31
Rate for Payer: Amish Plain Church Group Commercial	$405.31
Rate for Payer: BCBS Complete	$240.07
Rate for Payer: BCBS MAPPO	$324.25
Rate for Payer: BCBS Trust/PPO	$1,066.26
Rate for Payer: BCN Commercial	$1,066.26
Rate for Payer: BCN Medicare Advantage	$324.25
Rate for Payer: Cash Price	$1,037.60
Rate for Payer: Cofinity Commercial	$1,115.42
Rate for Payer: Encore Health Key Benefits Commercial	$1,037.60
Rate for Payer: Health Alliance Plan Medicare Advantage	$324.25
Rate for Payer: Healthscope Commercial	$1,167.30
Rate for Payer: Lakeland Regional Health Systems Commercial	$972.75
Rate for Payer: Mclaren Medicaid	$228.66
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$340.46
Rate for Payer: Meridian Medicaid	$240.07
Rate for Payer: MI Amish Medical Board Commercial	$372.89
Rate for Payer: Molina Medicare/Medicaid	$356.68
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,102.45
Rate for Payer: Nomi Health Commercial	$1,063.54
Rate for Payer: Opus (Opus Packaging Group) HMA	$972.75
Rate for Payer: PACE Senior Care Partners	$308.04
Rate for Payer: PACE SWMI	$324.25
Rate for Payer: PHP Commercial	$1,102.45
Rate for Payer: PHP Medicare Advantage	$324.25
Rate for Payer: Priority Health Choice Medicaid	$228.66
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,128.39
Rate for Payer: Priority Health Medicare	$327.49
Rate for Payer: Priority Health Narrow/Tiered Network	$902.71
Rate for Payer: Railroad Medicare Medicare	$324.25
Rate for Payer: UHC Core	$1,082.99
Rate for Payer: UHC Exchange	$324.25
Rate for Payer: UHC Medicaid	$228.66
Rate for Payer: UHC Medicare Advantage	$324.25
Rate for Payer: UHCCP Medicaid	$228.66
Rate for Payer: VA VA	$324.25
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$972.75

PR EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ <3CM

Professional

Both

$1,297.00

Service Code	HCPCS 21930
Hospital Charge Code	21930
Min. Negotiated Rate	$224.08
Max. Negotiated Rate	$972.75
Rate for Payer: Aetna Commercial	$484.47
Rate for Payer: Aetna Medicare	$648.50
Rate for Payer: BCBS Complete	$235.28
Rate for Payer: BCN Commercial	$555.75
Rate for Payer: Cash Price	$1,037.60
Rate for Payer: Cash Price	$1,037.60
Rate for Payer: Mclaren Medicaid	$224.08
Rate for Payer: Meridian Medicaid	$235.28
Rate for Payer: Opus (Opus Packaging Group) HMA	$972.75
Rate for Payer: Priority Health Choice Medicaid	$224.08
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$594.08
Rate for Payer: Priority Health Narrow/Tiered Network	$594.08
Rate for Payer: UHC Medicaid	$224.08
Rate for Payer: UHCCP Medicaid	$224.08

PR EXCISION TUMOR SOFT TISSUE FOOT/TOE SUBQ <1.5CM

Professional

Both

$691.00

Service Code	HCPCS 28043
Min. Negotiated Rate	$157.83
Max. Negotiated Rate	$518.25
Rate for Payer: Aetna Commercial	$343.53
Rate for Payer: Aetna Medicare	$345.50
Rate for Payer: BCBS Complete	$165.72
Rate for Payer: BCN Commercial	$395.90
Rate for Payer: Cash Price	$552.80
Rate for Payer: Cash Price	$552.80
Rate for Payer: Mclaren Medicaid	$157.83
Rate for Payer: Meridian Medicaid	$165.72
Rate for Payer: Opus (Opus Packaging Group) HMA	$518.25
Rate for Payer: Priority Health Choice Medicaid	$157.83
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$423.19
Rate for Payer: Priority Health Narrow/Tiered Network	$423.19
Rate for Payer: UHC Medicaid	$157.83
Rate for Payer: UHCCP Medicaid	$157.83

PR EXCISION TUMOR SOFT TISSUE LEG/ANKLE SUBQ 3 CM/>

Facility

$1,074.00

Service Code	CPT 27632
Hospital Charge Code	27632
Hospital Revenue Code	960
Min. Negotiated Rate	$189.35
Max. Negotiated Rate	$966.60
Rate for Payer: Aetna Commercial	$912.90
Rate for Payer: Aetna Medicare	$279.24
Rate for Payer: Allen County Amish Medical Aid Commercial	$335.62
Rate for Payer: Amish Plain Church Group Commercial	$335.62
Rate for Payer: BCBS Complete	$198.80
Rate for Payer: BCBS MAPPO	$268.50
Rate for Payer: BCBS Trust/PPO	$882.94
Rate for Payer: BCN Commercial	$882.94
Rate for Payer: BCN Medicare Advantage	$268.50
Rate for Payer: Cash Price	$859.20
Rate for Payer: Cofinity Commercial	$923.64
Rate for Payer: Encore Health Key Benefits Commercial	$859.20
Rate for Payer: Health Alliance Plan Medicare Advantage	$268.50
Rate for Payer: Healthscope Commercial	$966.60
Rate for Payer: Lakeland Regional Health Systems Commercial	$805.50
Rate for Payer: Mclaren Medicaid	$189.35
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$281.93
Rate for Payer: Meridian Medicaid	$198.80
Rate for Payer: MI Amish Medical Board Commercial	$308.77
Rate for Payer: Molina Medicare/Medicaid	$295.35
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$912.90
Rate for Payer: Nomi Health Commercial	$880.68
Rate for Payer: Opus (Opus Packaging Group) HMA	$805.50
Rate for Payer: PACE Senior Care Partners	$255.07
Rate for Payer: PACE SWMI	$268.50
Rate for Payer: PHP Commercial	$912.90
Rate for Payer: PHP Medicare Advantage	$268.50
Rate for Payer: Priority Health Choice Medicaid	$189.35
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$934.38
Rate for Payer: Priority Health Medicare	$271.19
Rate for Payer: Priority Health Narrow/Tiered Network	$747.50
Rate for Payer: Railroad Medicare Medicare	$268.50
Rate for Payer: UHC Core	$896.79
Rate for Payer: UHC Exchange	$268.50
Rate for Payer: UHC Medicaid	$189.35
Rate for Payer: UHC Medicare Advantage	$268.50
Rate for Payer: UHCCP Medicaid	$189.35
Rate for Payer: VA VA	$268.50
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$805.50

PR EXCISION TUMOR SOFT TISSUE LEG/ANKLE SUBQ 3 CM/>

Facility

$1,074.00

Service Code	CPT 27632
Hospital Charge Code	27632
Hospital Revenue Code	960
Min. Negotiated Rate	$747.50
Max. Negotiated Rate	$966.60
Rate for Payer: Aetna Commercial	$912.90
Rate for Payer: BCBS Trust/PPO	$887.02
Rate for Payer: BCN Commercial	$887.02
Rate for Payer: Cash Price	$859.20
Rate for Payer: Cofinity Commercial	$923.64
Rate for Payer: Encore Health Key Benefits Commercial	$859.20
Rate for Payer: Healthscope Commercial	$966.60
Rate for Payer: Lakeland Regional Health Systems Commercial	$805.50
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$912.90
Rate for Payer: Nomi Health Commercial	$880.68
Rate for Payer: Opus (Opus Packaging Group) HMA	$805.50
Rate for Payer: PHP Commercial	$912.90
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$934.38
Rate for Payer: Priority Health Narrow/Tiered Network	$747.50
Rate for Payer: UHC Core	$896.79
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$805.50

PR EXCISION TUMOR SOFT TISSUE LEG/ANKLE SUBQ 3 CM/>

Professional

Both

$1,074.00

Service Code	HCPCS 27632
Min. Negotiated Rate	$250.70
Max. Negotiated Rate	$805.50
Rate for Payer: Aetna Commercial	$551.46
Rate for Payer: Aetna Medicare	$537.00
Rate for Payer: BCBS Complete	$263.24
Rate for Payer: BCN Commercial	$623.48
Rate for Payer: Cash Price	$859.20
Rate for Payer: Cash Price	$859.20
Rate for Payer: Mclaren Medicaid	$250.70
Rate for Payer: Meridian Medicaid	$263.24
Rate for Payer: Opus (Opus Packaging Group) HMA	$805.50
Rate for Payer: Priority Health Choice Medicaid	$250.70
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$666.48
Rate for Payer: Priority Health Narrow/Tiered Network	$666.48
Rate for Payer: UHC Medicaid	$250.70
Rate for Payer: UHCCP Medicaid	$250.70

PR EXCISION TUMOR SOFT TISSUE LEG/ANKLE SUBQ 3 CM/>

Professional

Both

$1,074.00

Service Code	HCPCS 27632
Hospital Charge Code	27632
Min. Negotiated Rate	$250.70
Max. Negotiated Rate	$805.50
Rate for Payer: Aetna Commercial	$551.46
Rate for Payer: Aetna Medicare	$537.00
Rate for Payer: BCBS Complete	$263.24
Rate for Payer: BCN Commercial	$623.48
Rate for Payer: Cash Price	$859.20
Rate for Payer: Cash Price	$859.20
Rate for Payer: Mclaren Medicaid	$250.70
Rate for Payer: Meridian Medicaid	$263.24
Rate for Payer: Opus (Opus Packaging Group) HMA	$805.50
Rate for Payer: Priority Health Choice Medicaid	$250.70
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$666.48
Rate for Payer: Priority Health Narrow/Tiered Network	$666.48
Rate for Payer: UHC Medicaid	$250.70
Rate for Payer: UHCCP Medicaid	$250.70

Know your out-of-pocket cost for care.

All Charges