Bronson Lakeview Hospital

All Charges

Charge

Type

Setting

Price

PR EXCISION TUMOR SOFT TISSUE PELVIS&HIP SUBQ 3CM/>

Professional

Both

$1,016.00

Service Code	HCPCS 27043
Min. Negotiated Rate	$289.47
Max. Negotiated Rate	$763.36
Rate for Payer: Aetna Commercial	$627.36
Rate for Payer: Aetna Medicare	$508.00
Rate for Payer: BCBS Complete	$303.94
Rate for Payer: BCN Commercial	$714.11
Rate for Payer: Cash Price	$812.80
Rate for Payer: Cash Price	$812.80
Rate for Payer: Mclaren Medicaid	$289.47
Rate for Payer: Meridian Medicaid	$303.94
Rate for Payer: Opus (Opus Packaging Group) HMA	$762.00
Rate for Payer: Priority Health Choice Medicaid	$289.47
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$763.36
Rate for Payer: Priority Health Narrow/Tiered Network	$763.36
Rate for Payer: UHC Medicaid	$289.47
Rate for Payer: UHCCP Medicaid	$289.47

PR EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ 3 CM/>

Professional

Both

$773.00

Service Code	HCPCS 23071
Min. Negotiated Rate	$259.65
Max. Negotiated Rate	$685.63
Rate for Payer: Aetna Commercial	$562.05
Rate for Payer: Aetna Medicare	$386.50
Rate for Payer: BCBS Complete	$272.63
Rate for Payer: BCN Commercial	$641.40
Rate for Payer: Cash Price	$618.40
Rate for Payer: Cash Price	$618.40
Rate for Payer: Mclaren Medicaid	$259.65
Rate for Payer: Meridian Medicaid	$272.63
Rate for Payer: Opus (Opus Packaging Group) HMA	$579.75
Rate for Payer: Priority Health Choice Medicaid	$259.65
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$685.63
Rate for Payer: Priority Health Narrow/Tiered Network	$685.63
Rate for Payer: UHC Medicaid	$259.65
Rate for Payer: UHCCP Medicaid	$259.65

PR EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ <3CM

Professional

Both

$893.00

Service Code	HCPCS 23075
Min. Negotiated Rate	$204.91
Max. Negotiated Rate	$669.75
Rate for Payer: Aetna Commercial	$435.38
Rate for Payer: Aetna Medicare	$446.50
Rate for Payer: BCBS Complete	$215.16
Rate for Payer: BCN Commercial	$503.46
Rate for Payer: Cash Price	$714.40
Rate for Payer: Cash Price	$714.40
Rate for Payer: Mclaren Medicaid	$204.91
Rate for Payer: Meridian Medicaid	$215.16
Rate for Payer: Opus (Opus Packaging Group) HMA	$669.75
Rate for Payer: Priority Health Choice Medicaid	$204.91
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$538.18
Rate for Payer: Priority Health Narrow/Tiered Network	$538.18
Rate for Payer: UHC Medicaid	$204.91
Rate for Payer: UHCCP Medicaid	$204.91

PR EXCISION TUMOR SOFT TISSUE THIGH/KNEE SUBQ <3CM

Professional

Both

$1,344.00

Service Code	HCPCS 27327
Min. Negotiated Rate	$197.03
Max. Negotiated Rate	$1,008.00
Rate for Payer: Aetna Commercial	$414.89
Rate for Payer: Aetna Medicare	$672.00
Rate for Payer: BCBS Complete	$206.88
Rate for Payer: BCN Commercial	$481.54
Rate for Payer: Cash Price	$1,075.20
Rate for Payer: Cash Price	$1,075.20
Rate for Payer: Mclaren Medicaid	$197.03
Rate for Payer: Meridian Medicaid	$206.88
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,008.00
Rate for Payer: Priority Health Choice Medicaid	$197.03
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$514.76
Rate for Payer: Priority Health Narrow/Tiered Network	$514.76
Rate for Payer: UHC Medicaid	$197.03
Rate for Payer: UHCCP Medicaid	$197.03

PR EXCISION TUMOR SOFT TISSUE THIGH/KNEE SUBQ <3CM

Professional

Both

$1,344.00

Service Code	HCPCS 27327
Hospital Charge Code	27327
Min. Negotiated Rate	$197.03
Max. Negotiated Rate	$1,008.00
Rate for Payer: Aetna Commercial	$414.89
Rate for Payer: Aetna Medicare	$672.00
Rate for Payer: BCBS Complete	$206.88
Rate for Payer: BCN Commercial	$481.54
Rate for Payer: Cash Price	$1,075.20
Rate for Payer: Cash Price	$1,075.20
Rate for Payer: Mclaren Medicaid	$197.03
Rate for Payer: Meridian Medicaid	$206.88
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,008.00
Rate for Payer: Priority Health Choice Medicaid	$197.03
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$514.76
Rate for Payer: Priority Health Narrow/Tiered Network	$514.76
Rate for Payer: UHC Medicaid	$197.03
Rate for Payer: UHCCP Medicaid	$197.03

PR EXCISION TUMOR SOFT TISSUE THIGH/KNEE SUBQ <3CM

Facility

$1,344.00

Service Code	CPT 27327
Hospital Charge Code	27327
Hospital Revenue Code	960
Min. Negotiated Rate	$935.42
Max. Negotiated Rate	$1,209.60
Rate for Payer: Aetna Commercial	$1,142.40
Rate for Payer: BCBS Trust/PPO	$1,110.01
Rate for Payer: BCN Commercial	$1,110.01
Rate for Payer: Cash Price	$1,075.20
Rate for Payer: Cofinity Commercial	$1,155.84
Rate for Payer: Encore Health Key Benefits Commercial	$1,075.20
Rate for Payer: Healthscope Commercial	$1,209.60
Rate for Payer: Lakeland Regional Health Systems Commercial	$1,008.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,142.40
Rate for Payer: Nomi Health Commercial	$1,102.08
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,008.00
Rate for Payer: PHP Commercial	$1,142.40
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,169.28
Rate for Payer: Priority Health Narrow/Tiered Network	$935.42
Rate for Payer: UHC Core	$1,122.24
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$1,008.00

PR EXCISION TUMOR SOFT TISSUE THIGH/KNEE SUBQ <3CM

Facility

$1,344.00

Service Code	CPT 27327
Hospital Charge Code	27327
Hospital Revenue Code	960
Min. Negotiated Rate	$236.95
Max. Negotiated Rate	$1,209.60
Rate for Payer: Aetna Commercial	$1,142.40
Rate for Payer: Aetna Medicare	$349.44
Rate for Payer: Allen County Amish Medical Aid Commercial	$420.00
Rate for Payer: Amish Plain Church Group Commercial	$420.00
Rate for Payer: BCBS Complete	$248.77
Rate for Payer: BCBS MAPPO	$336.00
Rate for Payer: BCBS Trust/PPO	$1,104.90
Rate for Payer: BCN Commercial	$1,104.90
Rate for Payer: BCN Medicare Advantage	$336.00
Rate for Payer: Cash Price	$1,075.20
Rate for Payer: Cofinity Commercial	$1,155.84
Rate for Payer: Encore Health Key Benefits Commercial	$1,075.20
Rate for Payer: Health Alliance Plan Medicare Advantage	$336.00
Rate for Payer: Healthscope Commercial	$1,209.60
Rate for Payer: Lakeland Regional Health Systems Commercial	$1,008.00
Rate for Payer: Mclaren Medicaid	$236.95
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$352.80
Rate for Payer: Meridian Medicaid	$248.77
Rate for Payer: MI Amish Medical Board Commercial	$386.40
Rate for Payer: Molina Medicare/Medicaid	$369.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,142.40
Rate for Payer: Nomi Health Commercial	$1,102.08
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,008.00
Rate for Payer: PACE Senior Care Partners	$319.20
Rate for Payer: PACE SWMI	$336.00
Rate for Payer: PHP Commercial	$1,142.40
Rate for Payer: PHP Medicare Advantage	$336.00
Rate for Payer: Priority Health Choice Medicaid	$236.95
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,169.28
Rate for Payer: Priority Health Medicare	$339.36
Rate for Payer: Priority Health Narrow/Tiered Network	$935.42
Rate for Payer: Railroad Medicare Medicare	$336.00
Rate for Payer: UHC Core	$1,122.24
Rate for Payer: UHC Exchange	$336.00
Rate for Payer: UHC Medicaid	$236.95
Rate for Payer: UHC Medicare Advantage	$336.00
Rate for Payer: UHCCP Medicaid	$236.95
Rate for Payer: VA VA	$336.00
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$1,008.00

PR EXCISION/UNROOFING CYST KIDNEY

Professional

Both

$3,012.00

Service Code	HCPCS 50280
Min. Negotiated Rate	$542.51
Max. Negotiated Rate	$2,259.00
Rate for Payer: Aetna Commercial	$1,243.00
Rate for Payer: Aetna Medicare	$1,506.00
Rate for Payer: BCBS Complete	$569.64
Rate for Payer: BCN Commercial	$1,413.27
Rate for Payer: Cash Price	$2,409.60
Rate for Payer: Cash Price	$2,409.60
Rate for Payer: Mclaren Medicaid	$542.51
Rate for Payer: Meridian Medicaid	$569.64
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,259.00
Rate for Payer: Priority Health Choice Medicaid	$542.51
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,539.50
Rate for Payer: Priority Health Narrow/Tiered Network	$1,539.50
Rate for Payer: UHC Medicaid	$542.51
Rate for Payer: UHCCP Medicaid	$542.51

PR EXCISION VAGINAL CYST/TUMOR

Professional

Both

$691.00

Service Code	HCPCS 57135
Min. Negotiated Rate	$107.35
Max. Negotiated Rate	$518.25
Rate for Payer: Aetna Commercial	$220.32
Rate for Payer: Aetna Medicare	$345.50
Rate for Payer: BCBS Complete	$112.72
Rate for Payer: BCN Commercial	$283.35
Rate for Payer: Cash Price	$552.80
Rate for Payer: Cash Price	$552.80
Rate for Payer: Mclaren Medicaid	$107.35
Rate for Payer: Meridian Medicaid	$112.72
Rate for Payer: Opus (Opus Packaging Group) HMA	$518.25
Rate for Payer: Priority Health Choice Medicaid	$107.35
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$286.97
Rate for Payer: Priority Health Narrow/Tiered Network	$286.97
Rate for Payer: UHC Medicaid	$107.35
Rate for Payer: UHCCP Medicaid	$107.35

PR EXCISION VAGINAL SEPTUM

Professional

Both

$1,190.00

Service Code	HCPCS 57130
Min. Negotiated Rate	$98.19
Max. Negotiated Rate	$892.50
Rate for Payer: Aetna Commercial	$202.91
Rate for Payer: Aetna Medicare	$595.00
Rate for Payer: BCBS Complete	$103.10
Rate for Payer: BCN Commercial	$260.44
Rate for Payer: Cash Price	$952.00
Rate for Payer: Cash Price	$952.00
Rate for Payer: Mclaren Medicaid	$98.19
Rate for Payer: Meridian Medicaid	$103.10
Rate for Payer: Opus (Opus Packaging Group) HMA	$892.50
Rate for Payer: Priority Health Choice Medicaid	$98.19
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$263.77
Rate for Payer: Priority Health Narrow/Tiered Network	$263.77
Rate for Payer: UHC Medicaid	$98.19
Rate for Payer: UHCCP Medicaid	$98.19

PR EXCISON TUMOR SOFT TISSUE THIGH/KNEE SUBQ 3 CM/>

Professional

Both

$1,527.00

Service Code	HCPCS 27337
Min. Negotiated Rate	$260.29
Max. Negotiated Rate	$1,145.25
Rate for Payer: Aetna Commercial	$560.76
Rate for Payer: Aetna Medicare	$763.50
Rate for Payer: BCBS Complete	$273.30
Rate for Payer: BCN Commercial	$640.91
Rate for Payer: Cash Price	$1,221.60
Rate for Payer: Cash Price	$1,221.60
Rate for Payer: Mclaren Medicaid	$260.29
Rate for Payer: Meridian Medicaid	$273.30
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,145.25
Rate for Payer: Priority Health Choice Medicaid	$260.29
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$685.11
Rate for Payer: Priority Health Narrow/Tiered Network	$685.11
Rate for Payer: UHC Medicaid	$260.29
Rate for Payer: UHCCP Medicaid	$260.29

PR EXC LESION ESOPHAGUS W/PRIM RPR THRC/ABDL APPR

Professional

Both

$1,926.00

Service Code	HCPCS 43101
Min. Negotiated Rate	$617.70
Max. Negotiated Rate	$1,822.70
Rate for Payer: Aetna Commercial	$1,352.24
Rate for Payer: Aetna Medicare	$963.00
Rate for Payer: BCBS Complete	$648.59
Rate for Payer: BCN Commercial	$1,495.93
Rate for Payer: Cash Price	$1,540.80
Rate for Payer: Cash Price	$1,540.80
Rate for Payer: Mclaren Medicaid	$617.70
Rate for Payer: Meridian Medicaid	$648.59
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,444.50
Rate for Payer: Priority Health Choice Medicaid	$617.70
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,822.70
Rate for Payer: Priority Health Narrow/Tiered Network	$1,822.70
Rate for Payer: UHC Medicaid	$617.70
Rate for Payer: UHCCP Medicaid	$617.70

PR EXC LESION ESOPHOGUS W/PRIM RPR CERVICAL APPR

Professional

Both

$1,540.00

Service Code	HCPCS 43100
Min. Negotiated Rate	$355.92
Max. Negotiated Rate	$1,169.83
Rate for Payer: Aetna Commercial	$835.68
Rate for Payer: Aetna Medicare	$770.00
Rate for Payer: BCBS Complete	$373.72
Rate for Payer: BCN Commercial	$960.10
Rate for Payer: Cash Price	$1,232.00
Rate for Payer: Cash Price	$1,232.00
Rate for Payer: Mclaren Medicaid	$355.92
Rate for Payer: Meridian Medicaid	$373.72
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,155.00
Rate for Payer: Priority Health Choice Medicaid	$355.92
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,169.83
Rate for Payer: Priority Health Narrow/Tiered Network	$1,169.83
Rate for Payer: UHC Medicaid	$355.92
Rate for Payer: UHCCP Medicaid	$355.92

PR EXC LESION EYELID W/O CLSR/W/SIMPLE DIR CLOSURE

Professional

Both

$469.00

Service Code	HCPCS 67840
Min. Negotiated Rate	$85.63
Max. Negotiated Rate	$351.75
Rate for Payer: Aetna Commercial	$203.67
Rate for Payer: Aetna Medicare	$234.50
Rate for Payer: BCBS Complete	$89.91
Rate for Payer: BCN Commercial	$232.55
Rate for Payer: Cash Price	$375.20
Rate for Payer: Cash Price	$375.20
Rate for Payer: Mclaren Medicaid	$85.63
Rate for Payer: Meridian Medicaid	$89.91
Rate for Payer: Opus (Opus Packaging Group) HMA	$351.75
Rate for Payer: Priority Health Choice Medicaid	$85.63
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$272.41
Rate for Payer: Priority Health Narrow/Tiered Network	$272.41
Rate for Payer: UHC Medicaid	$85.63
Rate for Payer: UHCCP Medicaid	$85.63

PR EXC LESION MUCOSA&SBMCSL VESTIBULE CPLX EXC MUSC

Professional

Both

$1,260.00

Service Code	HCPCS 40816
Min. Negotiated Rate	$178.49
Max. Negotiated Rate	$945.00
Rate for Payer: Aetna Commercial	$397.82
Rate for Payer: Aetna Medicare	$630.00
Rate for Payer: BCBS Complete	$187.41
Rate for Payer: BCN Commercial	$459.64
Rate for Payer: Cash Price	$1,008.00
Rate for Payer: Cash Price	$1,008.00
Rate for Payer: Mclaren Medicaid	$178.49
Rate for Payer: Meridian Medicaid	$187.41
Rate for Payer: Opus (Opus Packaging Group) HMA	$945.00
Rate for Payer: Priority Health Choice Medicaid	$178.49
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$560.04
Rate for Payer: Priority Health Narrow/Tiered Network	$560.04
Rate for Payer: UHC Medicaid	$178.49
Rate for Payer: UHCCP Medicaid	$178.49

PR EXC LESION MUCOSA & SBMCSL VESTIBULE CPLX RPR

Professional

Both

$699.00

Service Code	HCPCS 40814
Min. Negotiated Rate	$168.70
Max. Negotiated Rate	$524.25
Rate for Payer: Aetna Commercial	$377.24
Rate for Payer: Aetna Medicare	$349.50
Rate for Payer: BCBS Complete	$177.13
Rate for Payer: BCN Commercial	$429.75
Rate for Payer: Cash Price	$559.20
Rate for Payer: Cash Price	$559.20
Rate for Payer: Mclaren Medicaid	$168.70
Rate for Payer: Meridian Medicaid	$177.13
Rate for Payer: Opus (Opus Packaging Group) HMA	$524.25
Rate for Payer: Priority Health Choice Medicaid	$168.70
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$523.63
Rate for Payer: Priority Health Narrow/Tiered Network	$523.63
Rate for Payer: UHC Medicaid	$168.70
Rate for Payer: UHCCP Medicaid	$168.70

PR EXC LESION MUCOSA & SBMCSL VESTIBULE SMPL RPR

Professional

Both

$592.00

Service Code	HCPCS 40812
Min. Negotiated Rate	$107.35
Max. Negotiated Rate	$444.00
Rate for Payer: Aetna Commercial	$245.47
Rate for Payer: Aetna Medicare	$296.00
Rate for Payer: BCBS Complete	$112.72
Rate for Payer: BCN Commercial	$216.38
Rate for Payer: Cash Price	$473.60
Rate for Payer: Cash Price	$473.60
Rate for Payer: Mclaren Medicaid	$107.35
Rate for Payer: Meridian Medicaid	$112.72
Rate for Payer: Opus (Opus Packaging Group) HMA	$444.00
Rate for Payer: Priority Health Choice Medicaid	$107.35
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$334.32
Rate for Payer: Priority Health Narrow/Tiered Network	$334.32
Rate for Payer: UHC Medicaid	$107.35
Rate for Payer: UHCCP Medicaid	$107.35

PR EXC LESION PALATE UVULA W/LOCAL FLAP CLOSURE

Professional

Both

$929.00

Service Code	HCPCS 42107
Min. Negotiated Rate	$194.26
Max. Negotiated Rate	$696.75
Rate for Payer: Aetna Commercial	$443.54
Rate for Payer: Aetna Medicare	$464.50
Rate for Payer: BCBS Complete	$203.97
Rate for Payer: BCN Commercial	$492.50
Rate for Payer: Cash Price	$743.20
Rate for Payer: Cash Price	$743.20
Rate for Payer: Mclaren Medicaid	$194.26
Rate for Payer: Meridian Medicaid	$203.97
Rate for Payer: Opus (Opus Packaging Group) HMA	$696.75
Rate for Payer: Priority Health Choice Medicaid	$194.26
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$600.09
Rate for Payer: Priority Health Narrow/Tiered Network	$600.09
Rate for Payer: UHC Medicaid	$194.26
Rate for Payer: UHCCP Medicaid	$194.26

PR EXC LESION PALATE UVULA W/O CLOSURE

Professional

Both

$397.00

Service Code	HCPCS 42104
Min. Negotiated Rate	$78.17
Max. Negotiated Rate	$297.75
Rate for Payer: Aetna Commercial	$176.41
Rate for Payer: Aetna Medicare	$198.50
Rate for Payer: BCBS Complete	$82.08
Rate for Payer: BCN Commercial	$204.18
Rate for Payer: Cash Price	$317.60
Rate for Payer: Cash Price	$317.60
Rate for Payer: Mclaren Medicaid	$78.17
Rate for Payer: Meridian Medicaid	$82.08
Rate for Payer: Opus (Opus Packaging Group) HMA	$297.75
Rate for Payer: Priority Health Choice Medicaid	$78.17
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$248.77
Rate for Payer: Priority Health Narrow/Tiered Network	$248.77
Rate for Payer: UHC Medicaid	$78.17
Rate for Payer: UHCCP Medicaid	$78.17

PR EXC LESION PALATE UVULA W/SMPL PRIM CLOSURE

Professional

Both

$521.00

Service Code	HCPCS 42106
Min. Negotiated Rate	$95.64
Max. Negotiated Rate	$390.75
Rate for Payer: Aetna Commercial	$217.85
Rate for Payer: Aetna Medicare	$260.50
Rate for Payer: BCBS Complete	$100.42
Rate for Payer: BCN Commercial	$243.51
Rate for Payer: Cash Price	$416.80
Rate for Payer: Cash Price	$416.80
Rate for Payer: Mclaren Medicaid	$95.64
Rate for Payer: Meridian Medicaid	$100.42
Rate for Payer: Opus (Opus Packaging Group) HMA	$390.75
Rate for Payer: Priority Health Choice Medicaid	$95.64
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$296.70
Rate for Payer: Priority Health Narrow/Tiered Network	$296.70
Rate for Payer: UHC Medicaid	$95.64
Rate for Payer: UHCCP Medicaid	$95.64

PR EXC LESION SPERMATIC CORD SEPARATE PROCEDURE

Professional

Both

$1,308.00

Service Code	HCPCS 55520
Hospital Charge Code	55520
Min. Negotiated Rate	$286.70
Max. Negotiated Rate	$981.00
Rate for Payer: Aetna Commercial	$590.37
Rate for Payer: Aetna Medicare	$654.00
Rate for Payer: BCBS Complete	$301.04
Rate for Payer: BCN Commercial	$697.17
Rate for Payer: Cash Price	$1,046.40
Rate for Payer: Cash Price	$1,046.40
Rate for Payer: Mclaren Medicaid	$286.70
Rate for Payer: Meridian Medicaid	$301.04
Rate for Payer: Opus (Opus Packaging Group) HMA	$981.00
Rate for Payer: Priority Health Choice Medicaid	$286.70
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$759.45
Rate for Payer: Priority Health Narrow/Tiered Network	$759.45
Rate for Payer: UHC Medicaid	$286.70
Rate for Payer: UHCCP Medicaid	$286.70

PR EXC LESION SPERMATIC CORD SEPARATE PROCEDURE

Professional

Both

$1,308.00

Service Code	HCPCS 55520
Min. Negotiated Rate	$286.70
Max. Negotiated Rate	$981.00
Rate for Payer: Aetna Commercial	$590.37
Rate for Payer: Aetna Medicare	$654.00
Rate for Payer: BCBS Complete	$301.04
Rate for Payer: BCN Commercial	$697.17
Rate for Payer: Cash Price	$1,046.40
Rate for Payer: Cash Price	$1,046.40
Rate for Payer: Mclaren Medicaid	$286.70
Rate for Payer: Meridian Medicaid	$301.04
Rate for Payer: Opus (Opus Packaging Group) HMA	$981.00
Rate for Payer: Priority Health Choice Medicaid	$286.70
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$759.45
Rate for Payer: Priority Health Narrow/Tiered Network	$759.45
Rate for Payer: UHC Medicaid	$286.70
Rate for Payer: UHCCP Medicaid	$286.70

PR EXC LESION SPERMATIC CORD SEPARATE PROCEDURE

Facility

$1,308.00

Service Code	CPT 55520
Hospital Charge Code	55520
Hospital Revenue Code	960
Min. Negotiated Rate	$230.60
Max. Negotiated Rate	$1,177.20
Rate for Payer: Aetna Commercial	$1,111.80
Rate for Payer: Aetna Medicare	$340.08
Rate for Payer: Allen County Amish Medical Aid Commercial	$408.75
Rate for Payer: Amish Plain Church Group Commercial	$408.75
Rate for Payer: BCBS Complete	$242.11
Rate for Payer: BCBS MAPPO	$327.00
Rate for Payer: BCBS Trust/PPO	$1,075.31
Rate for Payer: BCN Commercial	$1,075.31
Rate for Payer: BCN Medicare Advantage	$327.00
Rate for Payer: Cash Price	$1,046.40
Rate for Payer: Cofinity Commercial	$1,124.88
Rate for Payer: Encore Health Key Benefits Commercial	$1,046.40
Rate for Payer: Health Alliance Plan Medicare Advantage	$327.00
Rate for Payer: Healthscope Commercial	$1,177.20
Rate for Payer: Lakeland Regional Health Systems Commercial	$981.00
Rate for Payer: Mclaren Medicaid	$230.60
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$343.35
Rate for Payer: Meridian Medicaid	$242.11
Rate for Payer: MI Amish Medical Board Commercial	$376.05
Rate for Payer: Molina Medicare/Medicaid	$359.70
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,111.80
Rate for Payer: Nomi Health Commercial	$1,072.56
Rate for Payer: Opus (Opus Packaging Group) HMA	$981.00
Rate for Payer: PACE Senior Care Partners	$310.65
Rate for Payer: PACE SWMI	$327.00
Rate for Payer: PHP Commercial	$1,111.80
Rate for Payer: PHP Medicare Advantage	$327.00
Rate for Payer: Priority Health Choice Medicaid	$230.60
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,137.96
Rate for Payer: Priority Health Medicare	$330.27
Rate for Payer: Priority Health Narrow/Tiered Network	$910.37
Rate for Payer: Railroad Medicare Medicare	$327.00
Rate for Payer: UHC Core	$1,092.18
Rate for Payer: UHC Exchange	$327.00
Rate for Payer: UHC Medicaid	$230.60
Rate for Payer: UHC Medicare Advantage	$327.00
Rate for Payer: UHCCP Medicaid	$230.60
Rate for Payer: VA VA	$327.00
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$981.00

PR EXC LESION SPERMATIC CORD SEPARATE PROCEDURE

Facility

$1,308.00

Service Code	CPT 55520
Hospital Charge Code	55520
Hospital Revenue Code	960
Min. Negotiated Rate	$910.37
Max. Negotiated Rate	$1,177.20
Rate for Payer: Aetna Commercial	$1,111.80
Rate for Payer: BCBS Trust/PPO	$1,080.28
Rate for Payer: BCN Commercial	$1,080.28
Rate for Payer: Cash Price	$1,046.40
Rate for Payer: Cofinity Commercial	$1,124.88
Rate for Payer: Encore Health Key Benefits Commercial	$1,046.40
Rate for Payer: Healthscope Commercial	$1,177.20
Rate for Payer: Lakeland Regional Health Systems Commercial	$981.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,111.80
Rate for Payer: Nomi Health Commercial	$1,072.56
Rate for Payer: Opus (Opus Packaging Group) HMA	$981.00
Rate for Payer: PHP Commercial	$1,111.80
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,137.96
Rate for Payer: Priority Health Narrow/Tiered Network	$910.37
Rate for Payer: UHC Core	$1,092.18
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$981.00

PR EXC LESION TDN SHTH/JT CAPSL HAND/FNGR

Facility

$1,088.00

Service Code	CPT 26160
Hospital Charge Code	26160
Hospital Revenue Code	960
Min. Negotiated Rate	$757.25
Max. Negotiated Rate	$979.20
Rate for Payer: Aetna Commercial	$924.80
Rate for Payer: BCBS Trust/PPO	$898.58
Rate for Payer: BCN Commercial	$898.58
Rate for Payer: Cash Price	$870.40
Rate for Payer: Cofinity Commercial	$935.68
Rate for Payer: Encore Health Key Benefits Commercial	$870.40
Rate for Payer: Healthscope Commercial	$979.20
Rate for Payer: Lakeland Regional Health Systems Commercial	$816.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$924.80
Rate for Payer: Nomi Health Commercial	$892.16
Rate for Payer: Opus (Opus Packaging Group) HMA	$816.00
Rate for Payer: PHP Commercial	$924.80
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$946.56
Rate for Payer: Priority Health Narrow/Tiered Network	$757.25
Rate for Payer: UHC Core	$908.48
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$816.00

Know your out-of-pocket cost for care.

All Charges