Bronson Lakeview Hospital

All Charges

Charge

Type

Setting

Price

PR LAPS RPR RECURRENT INCAL HRNA NCRC8/STRANGULATED

Professional

Both

$4,204.00

Service Code	HCPCS 49657
Min. Negotiated Rate	$1,681.60
Max. Negotiated Rate	$3,153.00
Rate for Payer: Aetna Medicare	$2,102.00
Rate for Payer: BCBS Complete	$1,681.60
Rate for Payer: Cash Price	$3,363.20
Rate for Payer: Opus (Opus Packaging Group) HMA	$3,153.00

PR LAPS RPR RECURRENT INCISIONAL HERNIA REDUCIBLE

Professional

Both

$1,538.00

Service Code	HCPCS 49656
Min. Negotiated Rate	$615.20
Max. Negotiated Rate	$1,153.50
Rate for Payer: Aetna Medicare	$769.00
Rate for Payer: BCBS Complete	$615.20
Rate for Payer: Cash Price	$1,230.40
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,153.50

PR LAPS SUPRACERVICAL HYSTERECTOMY >250

Professional

Both

$2,324.00

Service Code	HCPCS 58543
Min. Negotiated Rate	$473.50
Max. Negotiated Rate	$1,743.00
Rate for Payer: Aetna Commercial	$1,009.17
Rate for Payer: Aetna Medicare	$1,162.00
Rate for Payer: BCBS Complete	$497.18
Rate for Payer: BCN Commercial	$1,262.38
Rate for Payer: Cash Price	$1,859.20
Rate for Payer: Cash Price	$1,859.20
Rate for Payer: Mclaren Medicaid	$473.50
Rate for Payer: Meridian Medicaid	$497.18
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,743.00
Rate for Payer: Priority Health Choice Medicaid	$473.50
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,278.51
Rate for Payer: Priority Health Narrow/Tiered Network	$1,278.51
Rate for Payer: UHC Medicaid	$473.50
Rate for Payer: UHCCP Medicaid	$473.50

PR LAPS SUPRACRV HYSTEREC >250 G RMVL TUBE/OVARY

Professional

Both

$2,532.00

Service Code	HCPCS 58544
Min. Negotiated Rate	$511.41
Max. Negotiated Rate	$1,899.00
Rate for Payer: Aetna Commercial	$1,086.55
Rate for Payer: Aetna Medicare	$1,266.00
Rate for Payer: BCBS Complete	$536.98
Rate for Payer: BCN Commercial	$1,357.99
Rate for Payer: Cash Price	$2,025.60
Rate for Payer: Cash Price	$2,025.60
Rate for Payer: Mclaren Medicaid	$511.41
Rate for Payer: Meridian Medicaid	$536.98
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,899.00
Rate for Payer: Priority Health Choice Medicaid	$511.41
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,375.36
Rate for Payer: Priority Health Narrow/Tiered Network	$1,375.36
Rate for Payer: UHC Medicaid	$511.41
Rate for Payer: UHCCP Medicaid	$511.41

PR LAPS SUPRACRV HYSTERECT 250 GM/< RMVL TUBE/OVAR

Professional

Both

$2,294.00

Service Code	HCPCS 58542
Min. Negotiated Rate	$467.75
Max. Negotiated Rate	$1,720.50
Rate for Payer: Aetna Commercial	$993.97
Rate for Payer: Aetna Medicare	$1,147.00
Rate for Payer: BCBS Complete	$491.14
Rate for Payer: BCN Commercial	$1,243.95
Rate for Payer: Cash Price	$1,835.20
Rate for Payer: Cash Price	$1,835.20
Rate for Payer: Mclaren Medicaid	$467.75
Rate for Payer: Meridian Medicaid	$491.14
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,720.50
Rate for Payer: Priority Health Choice Medicaid	$467.75
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,259.87
Rate for Payer: Priority Health Narrow/Tiered Network	$1,259.87
Rate for Payer: UHC Medicaid	$467.75
Rate for Payer: UHCCP Medicaid	$467.75

PR LAPS SURG BILATERAL TOTAL PELVIC LMPHADECTOMY

Professional

Both

$1,601.00

Service Code	HCPCS 38571
Min. Negotiated Rate	$380.42
Max. Negotiated Rate	$1,317.91
Rate for Payer: Aetna Commercial	$820.26
Rate for Payer: Aetna Medicare	$800.50
Rate for Payer: BCBS Complete	$399.44
Rate for Payer: BCN Commercial	$990.48
Rate for Payer: Cash Price	$1,280.80
Rate for Payer: Cash Price	$1,280.80
Rate for Payer: Mclaren Medicaid	$380.42
Rate for Payer: Meridian Medicaid	$399.44
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,200.75
Rate for Payer: Priority Health Choice Medicaid	$380.42
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,317.91
Rate for Payer: Priority Health Narrow/Tiered Network	$1,317.91
Rate for Payer: UHC Medicaid	$380.42
Rate for Payer: UHCCP Medicaid	$380.42

PR LAPS SURG CHOLECSTC W/EXPL COMMON DUCT

Professional

Both

$3,459.00

Service Code	HCPCS 47564
Min. Negotiated Rate	$676.91
Max. Negotiated Rate	$2,594.25
Rate for Payer: Aetna Commercial	$1,509.43
Rate for Payer: Aetna Medicare	$1,729.50
Rate for Payer: BCBS Complete	$710.76
Rate for Payer: BCN Commercial	$1,686.67
Rate for Payer: Cash Price	$2,767.20
Rate for Payer: Cash Price	$2,767.20
Rate for Payer: Mclaren Medicaid	$676.91
Rate for Payer: Meridian Medicaid	$710.76
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,594.25
Rate for Payer: Priority Health Choice Medicaid	$676.91
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$2,055.10
Rate for Payer: Priority Health Narrow/Tiered Network	$2,055.10
Rate for Payer: UHC Medicaid	$676.91
Rate for Payer: UHCCP Medicaid	$676.91

PR LAPS SURG CHOLECYSTECTOMY W/CHOLANGIOGRAPHY

Facility

$2,876.00

Service Code	CPT 47563
Hospital Charge Code	47563
Hospital Revenue Code	960
Min. Negotiated Rate	$2,001.70
Max. Negotiated Rate	$2,588.40
Rate for Payer: Aetna Commercial	$2,444.60
Rate for Payer: BCBS Trust/PPO	$2,375.29
Rate for Payer: BCN Commercial	$2,375.29
Rate for Payer: Cash Price	$2,300.80
Rate for Payer: Cofinity Commercial	$2,473.36
Rate for Payer: Encore Health Key Benefits Commercial	$2,300.80
Rate for Payer: Healthscope Commercial	$2,588.40
Rate for Payer: Lakeland Regional Health Systems Commercial	$2,157.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2,444.60
Rate for Payer: Nomi Health Commercial	$2,358.32
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,157.00
Rate for Payer: PHP Commercial	$2,444.60
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$2,502.12
Rate for Payer: Priority Health Narrow/Tiered Network	$2,001.70
Rate for Payer: UHC Core	$2,401.46
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$2,157.00

PR LAPS SURG CHOLECYSTECTOMY W/CHOLANGIOGRAPHY

Professional

Both

$2,876.00

Service Code	HCPCS 47563
Hospital Charge Code	47563
Min. Negotiated Rate	$436.44
Max. Negotiated Rate	$2,157.00
Rate for Payer: Aetna Commercial	$969.23
Rate for Payer: Aetna Medicare	$1,438.00
Rate for Payer: BCBS Complete	$458.26
Rate for Payer: BCN Commercial	$1,086.10
Rate for Payer: Cash Price	$2,300.80
Rate for Payer: Cash Price	$2,300.80
Rate for Payer: Mclaren Medicaid	$436.44
Rate for Payer: Meridian Medicaid	$458.26
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,157.00
Rate for Payer: Priority Health Choice Medicaid	$436.44
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,323.34
Rate for Payer: Priority Health Narrow/Tiered Network	$1,323.34
Rate for Payer: UHC Medicaid	$436.44
Rate for Payer: UHCCP Medicaid	$436.44

PR LAPS SURG CHOLECYSTECTOMY W/CHOLANGIOGRAPHY

Facility

$2,876.00

Service Code	CPT 47563
Hospital Charge Code	47563
Hospital Revenue Code	960
Min. Negotiated Rate	$507.04
Max. Negotiated Rate	$2,588.40
Rate for Payer: Aetna Commercial	$2,444.60
Rate for Payer: Aetna Medicare	$747.76
Rate for Payer: Allen County Amish Medical Aid Commercial	$898.75
Rate for Payer: Amish Plain Church Group Commercial	$898.75
Rate for Payer: BCBS Complete	$532.35
Rate for Payer: BCBS MAPPO	$719.00
Rate for Payer: BCBS Trust/PPO	$2,364.36
Rate for Payer: BCN Commercial	$2,364.36
Rate for Payer: BCN Medicare Advantage	$719.00
Rate for Payer: Cash Price	$2,300.80
Rate for Payer: Cofinity Commercial	$2,473.36
Rate for Payer: Encore Health Key Benefits Commercial	$2,300.80
Rate for Payer: Health Alliance Plan Medicare Advantage	$719.00
Rate for Payer: Healthscope Commercial	$2,588.40
Rate for Payer: Lakeland Regional Health Systems Commercial	$2,157.00
Rate for Payer: Mclaren Medicaid	$507.04
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$754.95
Rate for Payer: Meridian Medicaid	$532.35
Rate for Payer: MI Amish Medical Board Commercial	$826.85
Rate for Payer: Molina Medicare/Medicaid	$790.90
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2,444.60
Rate for Payer: Nomi Health Commercial	$2,358.32
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,157.00
Rate for Payer: PACE Senior Care Partners	$683.05
Rate for Payer: PACE SWMI	$719.00
Rate for Payer: PHP Commercial	$2,444.60
Rate for Payer: PHP Medicare Advantage	$719.00
Rate for Payer: Priority Health Choice Medicaid	$507.04
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$2,502.12
Rate for Payer: Priority Health Medicare	$726.19
Rate for Payer: Priority Health Narrow/Tiered Network	$2,001.70
Rate for Payer: Railroad Medicare Medicare	$719.00
Rate for Payer: UHC Core	$2,401.46
Rate for Payer: UHC Exchange	$719.00
Rate for Payer: UHC Medicaid	$507.04
Rate for Payer: UHC Medicare Advantage	$719.00
Rate for Payer: UHCCP Medicaid	$507.04
Rate for Payer: VA VA	$719.00
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$2,157.00

PR LAPS SURG CHOLECYSTECTOMY W/CHOLANGIOGRAPHY

Professional

Both

$2,876.00

Service Code	HCPCS 47563
Min. Negotiated Rate	$436.44
Max. Negotiated Rate	$2,157.00
Rate for Payer: Aetna Commercial	$969.23
Rate for Payer: Aetna Medicare	$1,438.00
Rate for Payer: BCBS Complete	$458.26
Rate for Payer: BCN Commercial	$1,086.10
Rate for Payer: Cash Price	$2,300.80
Rate for Payer: Cash Price	$2,300.80
Rate for Payer: Mclaren Medicaid	$436.44
Rate for Payer: Meridian Medicaid	$458.26
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,157.00
Rate for Payer: Priority Health Choice Medicaid	$436.44
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,323.34
Rate for Payer: Priority Health Narrow/Tiered Network	$1,323.34
Rate for Payer: UHC Medicaid	$436.44
Rate for Payer: UHCCP Medicaid	$436.44

PR LAPS SURG ESOPG/GSTR FUNDOPLASTY

Professional

Both

$4,273.00

Service Code	HCPCS 43280
Min. Negotiated Rate	$645.39
Max. Negotiated Rate	$3,204.75
Rate for Payer: Aetna Commercial	$1,458.26
Rate for Payer: Aetna Medicare	$2,136.50
Rate for Payer: BCBS Complete	$677.66
Rate for Payer: BCN Commercial	$1,617.94
Rate for Payer: Cash Price	$3,418.40
Rate for Payer: Cash Price	$3,418.40
Rate for Payer: Mclaren Medicaid	$645.39
Rate for Payer: Meridian Medicaid	$677.66
Rate for Payer: Opus (Opus Packaging Group) HMA	$3,204.75
Rate for Payer: Priority Health Choice Medicaid	$645.39
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,971.36
Rate for Payer: Priority Health Narrow/Tiered Network	$1,971.36
Rate for Payer: UHC Medicaid	$645.39
Rate for Payer: UHCCP Medicaid	$645.39

PR LAPS SURG GASTROSTOMY W/O CONSTJ GSTR TUBE SPX

Professional

Both

$2,363.00

Service Code	HCPCS 43653
Min. Negotiated Rate	$360.40
Max. Negotiated Rate	$1,772.25
Rate for Payer: Aetna Commercial	$777.16
Rate for Payer: Aetna Medicare	$1,181.50
Rate for Payer: BCBS Complete	$378.42
Rate for Payer: BCN Commercial	$876.45
Rate for Payer: Cash Price	$1,890.40
Rate for Payer: Cash Price	$1,890.40
Rate for Payer: Mclaren Medicaid	$360.40
Rate for Payer: Meridian Medicaid	$378.42
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,772.25
Rate for Payer: Priority Health Choice Medicaid	$360.40
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,067.90
Rate for Payer: Priority Health Narrow/Tiered Network	$1,067.90
Rate for Payer: UHC Medicaid	$360.40
Rate for Payer: UHCCP Medicaid	$360.40

PR LAPS SURG PRST8ECT RPBIC RADICAL W/LYMPH NODE BX

Professional

Both

$2,649.00

Service Code	HCPCS 55868
Min. Negotiated Rate	$706.31
Max. Negotiated Rate	$1,986.75
Rate for Payer: Aetna Medicare	$1,324.50
Rate for Payer: BCBS Complete	$741.63
Rate for Payer: Cash Price	$2,119.20
Rate for Payer: Cash Price	$2,119.20
Rate for Payer: Mclaren Medicaid	$706.31
Rate for Payer: Meridian Medicaid	$741.63
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,986.75
Rate for Payer: Priority Health Choice Medicaid	$706.31
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,633.08
Rate for Payer: Priority Health Narrow/Tiered Network	$1,633.08
Rate for Payer: UHC Medicaid	$706.31
Rate for Payer: UHCCP Medicaid	$706.31

PR LAPS SURG PRST8ECT RPBIC RAD W/BI PEL LYMPHADEC

Professional

Both

$3,296.00

Service Code	HCPCS 55869
Min. Negotiated Rate	$847.31
Max. Negotiated Rate	$2,472.00
Rate for Payer: Aetna Medicare	$1,648.00
Rate for Payer: BCBS Complete	$889.68
Rate for Payer: Cash Price	$2,636.80
Rate for Payer: Cash Price	$2,636.80
Rate for Payer: Mclaren Medicaid	$847.31
Rate for Payer: Meridian Medicaid	$889.68
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,472.00
Rate for Payer: Priority Health Choice Medicaid	$847.31
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,959.10
Rate for Payer: Priority Health Narrow/Tiered Network	$1,959.10
Rate for Payer: UHC Medicaid	$847.31
Rate for Payer: UHCCP Medicaid	$847.31

PR LAPS SURG PRST8ECT RPBIC RAD W/NERVE SPARING

Professional

Both

$3,439.00

Service Code	HCPCS 55866
Min. Negotiated Rate	$689.91
Max. Negotiated Rate	$2,579.25
Rate for Payer: Aetna Commercial	$1,851.29
Rate for Payer: Aetna Medicare	$1,719.50
Rate for Payer: BCBS Complete	$724.41
Rate for Payer: BCN Commercial	$1,780.78
Rate for Payer: Cash Price	$2,751.20
Rate for Payer: Cash Price	$2,751.20
Rate for Payer: Mclaren Medicaid	$689.91
Rate for Payer: Meridian Medicaid	$724.41
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,579.25
Rate for Payer: Priority Health Choice Medicaid	$689.91
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,939.85
Rate for Payer: Priority Health Narrow/Tiered Network	$1,939.85
Rate for Payer: UHC Medicaid	$689.91
Rate for Payer: UHCCP Medicaid	$689.91

PR LAPS SURG PRST8ECT SMPL STOT ROBOTIC ASSISTANCE

Professional

Both

$2,580.00

Service Code	HCPCS 55867
Min. Negotiated Rate	$603.22
Max. Negotiated Rate	$1,935.00
Rate for Payer: Aetna Commercial	$1,333.20
Rate for Payer: Aetna Medicare	$1,290.00
Rate for Payer: BCBS Complete	$633.38
Rate for Payer: BCN Commercial	$1,564.66
Rate for Payer: Cash Price	$2,064.00
Rate for Payer: Cash Price	$2,064.00
Rate for Payer: Mclaren Medicaid	$603.22
Rate for Payer: Meridian Medicaid	$633.38
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,935.00
Rate for Payer: Priority Health Choice Medicaid	$603.22
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,704.42
Rate for Payer: Priority Health Narrow/Tiered Network	$1,704.42
Rate for Payer: UHC Medicaid	$603.22
Rate for Payer: UHCCP Medicaid	$603.22

PR LAPS SURG RETROPERITONEAL LYMPH NODE BX 1/MLT

Facility

$1,010.00

Service Code	CPT 38570
Hospital Charge Code	38570
Hospital Revenue Code	960
Min. Negotiated Rate	$178.06
Max. Negotiated Rate	$909.00
Rate for Payer: Aetna Commercial	$858.50
Rate for Payer: Aetna Medicare	$262.60
Rate for Payer: Allen County Amish Medical Aid Commercial	$315.62
Rate for Payer: Amish Plain Church Group Commercial	$315.62
Rate for Payer: BCBS Complete	$186.95
Rate for Payer: BCBS MAPPO	$252.50
Rate for Payer: BCBS Trust/PPO	$830.32
Rate for Payer: BCN Commercial	$830.32
Rate for Payer: BCN Medicare Advantage	$252.50
Rate for Payer: Cash Price	$808.00
Rate for Payer: Cofinity Commercial	$868.60
Rate for Payer: Encore Health Key Benefits Commercial	$808.00
Rate for Payer: Health Alliance Plan Medicare Advantage	$252.50
Rate for Payer: Healthscope Commercial	$909.00
Rate for Payer: Lakeland Regional Health Systems Commercial	$757.50
Rate for Payer: Mclaren Medicaid	$178.06
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$265.12
Rate for Payer: Meridian Medicaid	$186.95
Rate for Payer: MI Amish Medical Board Commercial	$290.38
Rate for Payer: Molina Medicare/Medicaid	$277.75
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$858.50
Rate for Payer: Nomi Health Commercial	$828.20
Rate for Payer: Opus (Opus Packaging Group) HMA	$757.50
Rate for Payer: PACE Senior Care Partners	$239.88
Rate for Payer: PACE SWMI	$252.50
Rate for Payer: PHP Commercial	$858.50
Rate for Payer: PHP Medicare Advantage	$252.50
Rate for Payer: Priority Health Choice Medicaid	$178.06
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$878.70
Rate for Payer: Priority Health Medicare	$255.03
Rate for Payer: Priority Health Narrow/Tiered Network	$702.96
Rate for Payer: Railroad Medicare Medicare	$252.50
Rate for Payer: UHC Core	$843.35
Rate for Payer: UHC Exchange	$252.50
Rate for Payer: UHC Medicaid	$178.06
Rate for Payer: UHC Medicare Advantage	$252.50
Rate for Payer: UHCCP Medicaid	$178.06
Rate for Payer: VA VA	$252.50
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$757.50

PR LAPS SURG RETROPERITONEAL LYMPH NODE BX 1/MLT

Professional

Both

$1,010.00

Service Code	HCPCS 38570
Min. Negotiated Rate	$306.51
Max. Negotiated Rate	$1,033.00
Rate for Payer: Aetna Commercial	$637.62
Rate for Payer: Aetna Medicare	$505.00
Rate for Payer: BCBS Complete	$321.84
Rate for Payer: BCN Commercial	$776.35
Rate for Payer: Cash Price	$808.00
Rate for Payer: Cash Price	$808.00
Rate for Payer: Mclaren Medicaid	$306.51
Rate for Payer: Meridian Medicaid	$321.84
Rate for Payer: Opus (Opus Packaging Group) HMA	$757.50
Rate for Payer: Priority Health Choice Medicaid	$306.51
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,033.00
Rate for Payer: Priority Health Narrow/Tiered Network	$1,033.00
Rate for Payer: UHC Medicaid	$306.51
Rate for Payer: UHCCP Medicaid	$306.51

PR LAPS SURG RETROPERITONEAL LYMPH NODE BX 1/MLT

Facility

$1,010.00

Service Code	CPT 38570
Hospital Charge Code	38570
Hospital Revenue Code	960
Min. Negotiated Rate	$702.96
Max. Negotiated Rate	$909.00
Rate for Payer: Aetna Commercial	$858.50
Rate for Payer: BCBS Trust/PPO	$834.16
Rate for Payer: BCN Commercial	$834.16
Rate for Payer: Cash Price	$808.00
Rate for Payer: Cofinity Commercial	$868.60
Rate for Payer: Encore Health Key Benefits Commercial	$808.00
Rate for Payer: Healthscope Commercial	$909.00
Rate for Payer: Lakeland Regional Health Systems Commercial	$757.50
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$858.50
Rate for Payer: Nomi Health Commercial	$828.20
Rate for Payer: Opus (Opus Packaging Group) HMA	$757.50
Rate for Payer: PHP Commercial	$858.50
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$878.70
Rate for Payer: Priority Health Narrow/Tiered Network	$702.96
Rate for Payer: UHC Core	$843.35
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$757.50

PR LAPS SURG RETROPERITONEAL LYMPH NODE BX 1/MLT

Professional

Both

$1,010.00

Service Code	HCPCS 38570
Hospital Charge Code	38570
Min. Negotiated Rate	$306.51
Max. Negotiated Rate	$1,033.00
Rate for Payer: Aetna Commercial	$637.62
Rate for Payer: Aetna Medicare	$505.00
Rate for Payer: BCBS Complete	$321.84
Rate for Payer: BCN Commercial	$776.35
Rate for Payer: Cash Price	$808.00
Rate for Payer: Cash Price	$808.00
Rate for Payer: Mclaren Medicaid	$306.51
Rate for Payer: Meridian Medicaid	$321.84
Rate for Payer: Opus (Opus Packaging Group) HMA	$757.50
Rate for Payer: Priority Health Choice Medicaid	$306.51
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,033.00
Rate for Payer: Priority Health Narrow/Tiered Network	$1,033.00
Rate for Payer: UHC Medicaid	$306.51
Rate for Payer: UHCCP Medicaid	$306.51

PR LAPS SURG RPR RECURRENT INGUINAL HERNIA

Professional

Both

$2,133.00

Service Code	HCPCS 49651
Hospital Charge Code	49651
Min. Negotiated Rate	$350.81
Max. Negotiated Rate	$1,599.75
Rate for Payer: Aetna Commercial	$756.01
Rate for Payer: Aetna Medicare	$1,066.50
Rate for Payer: BCBS Complete	$368.35
Rate for Payer: BCN Commercial	$858.52
Rate for Payer: Cash Price	$1,706.40
Rate for Payer: Cash Price	$1,706.40
Rate for Payer: Mclaren Medicaid	$350.81
Rate for Payer: Meridian Medicaid	$368.35
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,599.75
Rate for Payer: Priority Health Choice Medicaid	$350.81
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,046.04
Rate for Payer: Priority Health Narrow/Tiered Network	$1,046.04
Rate for Payer: UHC Medicaid	$350.81
Rate for Payer: UHCCP Medicaid	$350.81

PR LAPS SURG RPR RECURRENT INGUINAL HERNIA

Facility

$2,133.00

Service Code	CPT 49651
Hospital Charge Code	49651
Hospital Revenue Code	960
Min. Negotiated Rate	$376.05
Max. Negotiated Rate	$1,919.70
Rate for Payer: Aetna Commercial	$1,813.05
Rate for Payer: Aetna Medicare	$554.58
Rate for Payer: Allen County Amish Medical Aid Commercial	$666.56
Rate for Payer: Amish Plain Church Group Commercial	$666.56
Rate for Payer: BCBS Complete	$394.82
Rate for Payer: BCBS MAPPO	$533.25
Rate for Payer: BCBS Trust/PPO	$1,753.54
Rate for Payer: BCN Commercial	$1,753.54
Rate for Payer: BCN Medicare Advantage	$533.25
Rate for Payer: Cash Price	$1,706.40
Rate for Payer: Cofinity Commercial	$1,834.38
Rate for Payer: Encore Health Key Benefits Commercial	$1,706.40
Rate for Payer: Health Alliance Plan Medicare Advantage	$533.25
Rate for Payer: Healthscope Commercial	$1,919.70
Rate for Payer: Lakeland Regional Health Systems Commercial	$1,599.75
Rate for Payer: Mclaren Medicaid	$376.05
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$559.91
Rate for Payer: Meridian Medicaid	$394.82
Rate for Payer: MI Amish Medical Board Commercial	$613.24
Rate for Payer: Molina Medicare/Medicaid	$586.58
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,813.05
Rate for Payer: Nomi Health Commercial	$1,749.06
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,599.75
Rate for Payer: PACE Senior Care Partners	$506.59
Rate for Payer: PACE SWMI	$533.25
Rate for Payer: PHP Commercial	$1,813.05
Rate for Payer: PHP Medicare Advantage	$533.25
Rate for Payer: Priority Health Choice Medicaid	$376.05
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,855.71
Rate for Payer: Priority Health Medicare	$538.58
Rate for Payer: Priority Health Narrow/Tiered Network	$1,484.57
Rate for Payer: Railroad Medicare Medicare	$533.25
Rate for Payer: UHC Core	$1,781.06
Rate for Payer: UHC Exchange	$533.25
Rate for Payer: UHC Medicaid	$376.05
Rate for Payer: UHC Medicare Advantage	$533.25
Rate for Payer: UHCCP Medicaid	$376.05
Rate for Payer: VA VA	$533.25
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$1,599.75

PR LAPS SURG RPR RECURRENT INGUINAL HERNIA

Professional

Both

$2,133.00

Service Code	HCPCS 49651
Min. Negotiated Rate	$350.81
Max. Negotiated Rate	$1,599.75
Rate for Payer: Aetna Commercial	$756.01
Rate for Payer: Aetna Medicare	$1,066.50
Rate for Payer: BCBS Complete	$368.35
Rate for Payer: BCN Commercial	$858.52
Rate for Payer: Cash Price	$1,706.40
Rate for Payer: Cash Price	$1,706.40
Rate for Payer: Mclaren Medicaid	$350.81
Rate for Payer: Meridian Medicaid	$368.35
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,599.75
Rate for Payer: Priority Health Choice Medicaid	$350.81
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,046.04
Rate for Payer: Priority Health Narrow/Tiered Network	$1,046.04
Rate for Payer: UHC Medicaid	$350.81
Rate for Payer: UHCCP Medicaid	$350.81

PR LAPS SURG RPR RECURRENT INGUINAL HERNIA

Facility

$2,133.00

Service Code	CPT 49651
Hospital Charge Code	49651
Hospital Revenue Code	960
Min. Negotiated Rate	$1,484.57
Max. Negotiated Rate	$1,919.70
Rate for Payer: Aetna Commercial	$1,813.05
Rate for Payer: BCBS Trust/PPO	$1,761.64
Rate for Payer: BCN Commercial	$1,761.64
Rate for Payer: Cash Price	$1,706.40
Rate for Payer: Cofinity Commercial	$1,834.38
Rate for Payer: Encore Health Key Benefits Commercial	$1,706.40
Rate for Payer: Healthscope Commercial	$1,919.70
Rate for Payer: Lakeland Regional Health Systems Commercial	$1,599.75
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,813.05
Rate for Payer: Nomi Health Commercial	$1,749.06
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,599.75
Rate for Payer: PHP Commercial	$1,813.05
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,855.71
Rate for Payer: Priority Health Narrow/Tiered Network	$1,484.57
Rate for Payer: UHC Core	$1,781.06
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$1,599.75

Know your out-of-pocket cost for care.

All Charges