Bronson Lakeview Hospital

All Charges

Charge

Type

Setting

Price

PR LARYNGOSCOPY DIRECT OPERATIVE W/BIOPSY

Professional

Both

$401.00

Service Code	HCPCS 31535
Min. Negotiated Rate	$103.31
Max. Negotiated Rate	$300.75
Rate for Payer: Aetna Commercial	$239.77
Rate for Payer: Aetna Medicare	$200.50
Rate for Payer: BCBS Complete	$108.48
Rate for Payer: BCN Commercial	$283.35
Rate for Payer: Cash Price	$320.80
Rate for Payer: Cash Price	$320.80
Rate for Payer: Mclaren Medicaid	$103.31
Rate for Payer: Meridian Medicaid	$108.48
Rate for Payer: Opus (Opus Packaging Group) HMA	$300.75
Rate for Payer: Priority Health Choice Medicaid	$103.31
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$266.83
Rate for Payer: Priority Health Narrow/Tiered Network	$266.83
Rate for Payer: UHC Medicaid	$103.31
Rate for Payer: UHCCP Medicaid	$103.31

PR LARYNGOSCOPY EXC TUM&/STRIPPING CORDS/EPIGLOTT

Professional

Both

$459.00

Service Code	HCPCS 31540
Min. Negotiated Rate	$131.00
Max. Negotiated Rate	$359.54
Rate for Payer: Aetna Commercial	$306.04
Rate for Payer: Aetna Medicare	$229.50
Rate for Payer: BCBS Complete	$137.55
Rate for Payer: BCN Commercial	$359.54
Rate for Payer: Cash Price	$367.20
Rate for Payer: Cash Price	$367.20
Rate for Payer: Mclaren Medicaid	$131.00
Rate for Payer: Meridian Medicaid	$137.55
Rate for Payer: Opus (Opus Packaging Group) HMA	$344.25
Rate for Payer: Priority Health Choice Medicaid	$131.00
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$338.58
Rate for Payer: Priority Health Narrow/Tiered Network	$338.58
Rate for Payer: UHC Medicaid	$131.00
Rate for Payer: UHCCP Medicaid	$131.00

PR LARYNGOSCOPY FLEXIBLE ABLATJ DESTJ LESION(S) UNI

Professional

Both

$778.00

Service Code	HCPCS 31572
Min. Negotiated Rate	$98.83
Max. Negotiated Rate	$583.50
Rate for Payer: Aetna Commercial	$228.78
Rate for Payer: Aetna Medicare	$389.00
Rate for Payer: BCBS Complete	$103.77
Rate for Payer: BCN Commercial	$270.40
Rate for Payer: Cash Price	$622.40
Rate for Payer: Cash Price	$622.40
Rate for Payer: Mclaren Medicaid	$98.83
Rate for Payer: Meridian Medicaid	$103.77
Rate for Payer: Opus (Opus Packaging Group) HMA	$583.50
Rate for Payer: Priority Health Choice Medicaid	$98.83
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$254.64
Rate for Payer: Priority Health Narrow/Tiered Network	$254.64
Rate for Payer: UHC Medicaid	$98.83
Rate for Payer: UHCCP Medicaid	$98.83

PR LARYNGOSCOPY FLEXIBLE DIAGNOSTIC

Professional

Both

$304.00

Service Code	HCPCS 31575
Min. Negotiated Rate	$38.98
Max. Negotiated Rate	$228.00
Rate for Payer: Aetna Commercial	$84.36
Rate for Payer: Aetna Medicare	$152.00
Rate for Payer: BCBS Complete	$40.93
Rate for Payer: BCN Commercial	$82.07
Rate for Payer: Cash Price	$243.20
Rate for Payer: Cash Price	$243.20
Rate for Payer: Mclaren Medicaid	$38.98
Rate for Payer: Meridian Medicaid	$40.93
Rate for Payer: Opus (Opus Packaging Group) HMA	$228.00
Rate for Payer: Priority Health Choice Medicaid	$38.98
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$98.00
Rate for Payer: Priority Health Narrow/Tiered Network	$98.00
Rate for Payer: UHC Medicaid	$38.98
Rate for Payer: UHCCP Medicaid	$38.98

PR LARYNGOSCOPY FLEXIBLE THERAPEUTIC INJECTION UNI

Professional

Both

$582.00

Service Code	HCPCS 31573
Min. Negotiated Rate	$82.22
Max. Negotiated Rate	$436.50
Rate for Payer: Aetna Commercial	$188.11
Rate for Payer: Aetna Medicare	$291.00
Rate for Payer: BCBS Complete	$86.33
Rate for Payer: BCN Commercial	$222.60
Rate for Payer: Cash Price	$465.60
Rate for Payer: Cash Price	$465.60
Rate for Payer: Mclaren Medicaid	$82.22
Rate for Payer: Meridian Medicaid	$86.33
Rate for Payer: Opus (Opus Packaging Group) HMA	$436.50
Rate for Payer: Priority Health Choice Medicaid	$82.22
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$209.62
Rate for Payer: Priority Health Narrow/Tiered Network	$209.62
Rate for Payer: UHC Medicaid	$82.22
Rate for Payer: UHCCP Medicaid	$82.22

PR LARYNGOSCOPY FLEXIBLE W/BIOPSY(IES)

Professional

Both

$415.00

Service Code	HCPCS 31576
Min. Negotiated Rate	$66.24
Max. Negotiated Rate	$311.25
Rate for Payer: Aetna Commercial	$149.73
Rate for Payer: Aetna Medicare	$207.50
Rate for Payer: BCBS Complete	$69.55
Rate for Payer: BCN Commercial	$179.77
Rate for Payer: Cash Price	$332.00
Rate for Payer: Cash Price	$332.00
Rate for Payer: Mclaren Medicaid	$66.24
Rate for Payer: Meridian Medicaid	$69.55
Rate for Payer: Opus (Opus Packaging Group) HMA	$311.25
Rate for Payer: Priority Health Choice Medicaid	$66.24
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$169.29
Rate for Payer: Priority Health Narrow/Tiered Network	$169.29
Rate for Payer: UHC Medicaid	$66.24
Rate for Payer: UHCCP Medicaid	$66.24

PR LARYNGOSCOPY FLX/RGD TELESCOPIC W/STROBOSCOPY

Professional

Both

$396.00

Service Code	HCPCS 31579
Min. Negotiated Rate	$81.48
Max. Negotiated Rate	$297.00
Rate for Payer: Aetna Commercial	$150.52
Rate for Payer: Aetna Medicare	$198.00
Rate for Payer: BCBS Complete	$85.55
Rate for Payer: BCN Commercial	$179.77
Rate for Payer: Cash Price	$316.80
Rate for Payer: Cash Price	$316.80
Rate for Payer: Mclaren Medicaid	$81.48
Rate for Payer: Meridian Medicaid	$85.55
Rate for Payer: Opus (Opus Packaging Group) HMA	$297.00
Rate for Payer: Priority Health Choice Medicaid	$81.48
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$169.29
Rate for Payer: Priority Health Narrow/Tiered Network	$169.29
Rate for Payer: UHC Medicaid	$81.48
Rate for Payer: UHCCP Medicaid	$81.48

PR LARYNGOSCOPY FLX RMVL FOREIGN BODY(S)

Professional

Both

$423.00

Service Code	HCPCS 31577
Min. Negotiated Rate	$75.83
Max. Negotiated Rate	$317.25
Rate for Payer: Aetna Commercial	$169.34
Rate for Payer: Aetna Medicare	$211.50
Rate for Payer: BCBS Complete	$79.62
Rate for Payer: BCN Commercial	$200.19
Rate for Payer: Cash Price	$338.40
Rate for Payer: Cash Price	$338.40
Rate for Payer: Mclaren Medicaid	$75.83
Rate for Payer: Meridian Medicaid	$79.62
Rate for Payer: Opus (Opus Packaging Group) HMA	$317.25
Rate for Payer: Priority Health Choice Medicaid	$75.83
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$188.51
Rate for Payer: Priority Health Narrow/Tiered Network	$188.51
Rate for Payer: UHC Medicaid	$75.83
Rate for Payer: UHCCP Medicaid	$75.83

PR LARYNGOSCOPY FOREIGN BODY RMVL MICRO/TELESCOPE

Professional

Both

$478.00

Service Code	HCPCS 31531
Min. Negotiated Rate	$115.87
Max. Negotiated Rate	$358.50
Rate for Payer: Aetna Commercial	$266.77
Rate for Payer: Aetna Medicare	$239.00
Rate for Payer: BCBS Complete	$121.66
Rate for Payer: BCN Commercial	$314.23
Rate for Payer: Cash Price	$382.40
Rate for Payer: Cash Price	$382.40
Rate for Payer: Mclaren Medicaid	$115.87
Rate for Payer: Meridian Medicaid	$121.66
Rate for Payer: Opus (Opus Packaging Group) HMA	$358.50
Rate for Payer: Priority Health Choice Medicaid	$115.87
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$295.91
Rate for Payer: Priority Health Narrow/Tiered Network	$295.91
Rate for Payer: UHC Medicaid	$115.87
Rate for Payer: UHCCP Medicaid	$115.87

PR LARYNGOSCOPY INDIRECT DIAGNOSTIC SPX

Professional

Both

$217.00

Service Code	HCPCS 31505
Min. Negotiated Rate	$28.54
Max. Negotiated Rate	$162.75
Rate for Payer: Aetna Commercial	$61.01
Rate for Payer: Aetna Medicare	$108.50
Rate for Payer: BCBS Complete	$29.97
Rate for Payer: BCN Commercial	$74.70
Rate for Payer: Cash Price	$173.60
Rate for Payer: Cash Price	$173.60
Rate for Payer: Mclaren Medicaid	$28.54
Rate for Payer: Meridian Medicaid	$29.97
Rate for Payer: Opus (Opus Packaging Group) HMA	$162.75
Rate for Payer: Priority Health Choice Medicaid	$28.54
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$70.34
Rate for Payer: Priority Health Narrow/Tiered Network	$70.34
Rate for Payer: UHC Medicaid	$28.54
Rate for Payer: UHCCP Medicaid	$28.54

PR LARYNGOSCOPY INDIRECT W/BIOPSY

Professional

Both

$456.00

Service Code	HCPCS 31510
Min. Negotiated Rate	$152.77
Max. Negotiated Rate	$342.00
Rate for Payer: Aetna Commercial	$152.77
Rate for Payer: Aetna Medicare	$228.00
Rate for Payer: BCBS Complete	$182.40
Rate for Payer: BCN Commercial	$182.26
Rate for Payer: Cash Price	$364.80
Rate for Payer: Cash Price	$364.80
Rate for Payer: Opus (Opus Packaging Group) HMA	$342.00
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$171.64
Rate for Payer: Priority Health Narrow/Tiered Network	$171.64

PR LARYNGOSCOPY INDIRECT W/REMOVAL FOREIGN BODY

Professional

Both

$587.00

Service Code	HCPCS 31511
Min. Negotiated Rate	$168.39
Max. Negotiated Rate	$440.25
Rate for Payer: Aetna Commercial	$168.39
Rate for Payer: Aetna Medicare	$293.50
Rate for Payer: BCBS Complete	$234.80
Rate for Payer: BCN Commercial	$200.69
Rate for Payer: Cash Price	$469.60
Rate for Payer: Cash Price	$469.60
Rate for Payer: Opus (Opus Packaging Group) HMA	$440.25
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$188.99
Rate for Payer: Priority Health Narrow/Tiered Network	$188.99

PR LARYNGOSCOPY W/BIOPSY MICROSCOPE/TELESCOPE

Professional

Both

$979.00

Service Code	HCPCS 31536
Min. Negotiated Rate	$114.17
Max. Negotiated Rate	$734.25
Rate for Payer: Aetna Commercial	$265.82
Rate for Payer: Aetna Medicare	$489.50
Rate for Payer: BCBS Complete	$119.88
Rate for Payer: BCN Commercial	$313.23
Rate for Payer: Cash Price	$783.20
Rate for Payer: Cash Price	$783.20
Rate for Payer: Mclaren Medicaid	$114.17
Rate for Payer: Meridian Medicaid	$119.88
Rate for Payer: Opus (Opus Packaging Group) HMA	$734.25
Rate for Payer: Priority Health Choice Medicaid	$114.17
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$294.97
Rate for Payer: Priority Health Narrow/Tiered Network	$294.97
Rate for Payer: UHC Medicaid	$114.17
Rate for Payer: UHCCP Medicaid	$114.17

PR LARYNGOSCOPY W/FOREIGN BODY REMOVAL

Professional

Both

$375.00

Service Code	HCPCS 31530
Min. Negotiated Rate	$110.33
Max. Negotiated Rate	$296.80
Rate for Payer: Aetna Commercial	$251.91
Rate for Payer: Aetna Medicare	$187.50
Rate for Payer: BCBS Complete	$115.85
Rate for Payer: BCN Commercial	$296.80
Rate for Payer: Cash Price	$300.00
Rate for Payer: Cash Price	$300.00
Rate for Payer: Mclaren Medicaid	$110.33
Rate for Payer: Meridian Medicaid	$115.85
Rate for Payer: Opus (Opus Packaging Group) HMA	$281.25
Rate for Payer: Priority Health Choice Medicaid	$110.33
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$279.50
Rate for Payer: Priority Health Narrow/Tiered Network	$279.50
Rate for Payer: UHC Medicaid	$110.33
Rate for Payer: UHCCP Medicaid	$110.33

PR LARYNGOSCOPY W/WO TRACHEOSCOPY ASPIRATION

Professional

Both

$383.00

Service Code	HCPCS 31515
Min. Negotiated Rate	$64.75
Max. Negotiated Rate	$287.25
Rate for Payer: Aetna Commercial	$140.69
Rate for Payer: Aetna Medicare	$191.50
Rate for Payer: BCBS Complete	$67.99
Rate for Payer: BCN Commercial	$166.82
Rate for Payer: Cash Price	$306.40
Rate for Payer: Cash Price	$306.40
Rate for Payer: Mclaren Medicaid	$64.75
Rate for Payer: Meridian Medicaid	$67.99
Rate for Payer: Opus (Opus Packaging Group) HMA	$287.25
Rate for Payer: Priority Health Choice Medicaid	$64.75
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$157.10
Rate for Payer: Priority Health Narrow/Tiered Network	$157.10
Rate for Payer: UHC Medicaid	$64.75
Rate for Payer: UHCCP Medicaid	$64.75

PR LARYNGOSCOPY W/WO TRACHEOSCOPY DILATION SUBSQ

Professional

Both

$338.00

Service Code	HCPCS 31529
Min. Negotiated Rate	$87.97
Max. Negotiated Rate	$253.50
Rate for Payer: Aetna Commercial	$204.12
Rate for Payer: Aetna Medicare	$169.00
Rate for Payer: BCBS Complete	$92.37
Rate for Payer: BCN Commercial	$240.53
Rate for Payer: Cash Price	$270.40
Rate for Payer: Cash Price	$270.40
Rate for Payer: Mclaren Medicaid	$87.97
Rate for Payer: Meridian Medicaid	$92.37
Rate for Payer: Opus (Opus Packaging Group) HMA	$253.50
Rate for Payer: Priority Health Choice Medicaid	$87.97
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$226.50
Rate for Payer: Priority Health Narrow/Tiered Network	$226.50
Rate for Payer: UHC Medicaid	$87.97
Rate for Payer: UHCCP Medicaid	$87.97

PR LARYNGOSCOPY W/WO TRACHEOSCOPY DX EXCEPT NEWBORN

Professional

Both

$643.00

Service Code	HCPCS 31525
Min. Negotiated Rate	$87.76
Max. Negotiated Rate	$482.25
Rate for Payer: Aetna Commercial	$202.26
Rate for Payer: Aetna Medicare	$321.50
Rate for Payer: BCBS Complete	$92.15
Rate for Payer: BCN Commercial	$239.53
Rate for Payer: Cash Price	$514.40
Rate for Payer: Cash Price	$514.40
Rate for Payer: Mclaren Medicaid	$87.76
Rate for Payer: Meridian Medicaid	$92.15
Rate for Payer: Opus (Opus Packaging Group) HMA	$482.25
Rate for Payer: Priority Health Choice Medicaid	$87.76
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$225.57
Rate for Payer: Priority Health Narrow/Tiered Network	$225.57
Rate for Payer: UHC Medicaid	$87.76
Rate for Payer: UHCCP Medicaid	$87.76

PR LARYNGOSCOPY W/WO TRACHEOSCOPY W/DILATION IN

Professional

Both

$816.00

Service Code	HCPCS 31528
Min. Negotiated Rate	$79.66
Max. Negotiated Rate	$612.00
Rate for Payer: Aetna Commercial	$182.08
Rate for Payer: Aetna Medicare	$408.00
Rate for Payer: BCBS Complete	$83.64
Rate for Payer: BCN Commercial	$216.13
Rate for Payer: Cash Price	$652.80
Rate for Payer: Cash Price	$652.80
Rate for Payer: Mclaren Medicaid	$79.66
Rate for Payer: Meridian Medicaid	$83.64
Rate for Payer: Opus (Opus Packaging Group) HMA	$612.00
Rate for Payer: Priority Health Choice Medicaid	$79.66
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$203.52
Rate for Payer: Priority Health Narrow/Tiered Network	$203.52
Rate for Payer: UHC Medicaid	$79.66
Rate for Payer: UHCCP Medicaid	$79.66

PR LARYNGOSCOPY W/WO TRACHEOSCOPY W/MICRO/TELESCOPE

Professional

Both

$332.00

Service Code	HCPCS 31526
Min. Negotiated Rate	$86.27
Max. Negotiated Rate	$249.00
Rate for Payer: Aetna Commercial	$198.68
Rate for Payer: Aetna Medicare	$166.00
Rate for Payer: BCBS Complete	$90.58
Rate for Payer: BCN Commercial	$235.55
Rate for Payer: Cash Price	$265.60
Rate for Payer: Cash Price	$265.60
Rate for Payer: Mclaren Medicaid	$86.27
Rate for Payer: Meridian Medicaid	$90.58
Rate for Payer: Opus (Opus Packaging Group) HMA	$249.00
Rate for Payer: Priority Health Choice Medicaid	$86.27
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$221.82
Rate for Payer: Priority Health Narrow/Tiered Network	$221.82
Rate for Payer: UHC Medicaid	$86.27
Rate for Payer: UHCCP Medicaid	$86.27

PR LARYNGOTOMY W/RMVL TUMOR/LARYNGOCELE CORDECTOMY

Professional

Both

$2,339.00

Service Code	HCPCS 31300
Min. Negotiated Rate	$715.25
Max. Negotiated Rate	$1,870.92
Rate for Payer: Aetna Commercial	$1,611.16
Rate for Payer: Aetna Medicare	$1,169.50
Rate for Payer: BCBS Complete	$751.01
Rate for Payer: BCN Commercial	$1,870.92
Rate for Payer: Cash Price	$1,871.20
Rate for Payer: Cash Price	$1,871.20
Rate for Payer: Mclaren Medicaid	$715.25
Rate for Payer: Meridian Medicaid	$751.01
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,754.25
Rate for Payer: Priority Health Choice Medicaid	$715.25
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,761.85
Rate for Payer: Priority Health Narrow/Tiered Network	$1,761.85
Rate for Payer: UHC Medicaid	$715.25
Rate for Payer: UHCCP Medicaid	$715.25

PR LASER CO2 - FULL FACE

Professional

Both

$2,889.00

Hospital Revenue Code	990
Min. Negotiated Rate	$1,155.60
Max. Negotiated Rate	$2,166.75
Rate for Payer: Aetna Medicare	$1,444.50
Rate for Payer: BCBS Complete	$1,155.60
Rate for Payer: Cash Price	$2,311.20
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,166.75

PR LASER CO2 - ONE AREA

Professional

Both

$1,839.00

Hospital Revenue Code	990
Min. Negotiated Rate	$735.60
Max. Negotiated Rate	$1,379.25
Rate for Payer: Aetna Medicare	$919.50
Rate for Payer: BCBS Complete	$735.60
Rate for Payer: Cash Price	$1,471.20
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,379.25

PR LASER CO2 - TWO AREAS

Professional

Both

$2,364.00

Hospital Revenue Code	990
Min. Negotiated Rate	$945.60
Max. Negotiated Rate	$1,773.00
Rate for Payer: Aetna Medicare	$1,182.00
Rate for Payer: BCBS Complete	$945.60
Rate for Payer: Cash Price	$1,891.20
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,773.00

PR LASER ENUCLEATION PROSTATE W/MORCELLATION

Professional

Both

$1,760.00

Service Code	HCPCS 52649
Min. Negotiated Rate	$418.97
Max. Negotiated Rate	$1,344.77
Rate for Payer: Aetna Commercial	$1,059.01
Rate for Payer: Aetna Medicare	$880.00
Rate for Payer: BCBS Complete	$439.92
Rate for Payer: BCN Commercial	$1,234.50
Rate for Payer: Cash Price	$1,408.00
Rate for Payer: Cash Price	$1,408.00
Rate for Payer: Mclaren Medicaid	$418.97
Rate for Payer: Meridian Medicaid	$439.92
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,320.00
Rate for Payer: Priority Health Choice Medicaid	$418.97
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,344.77
Rate for Payer: Priority Health Narrow/Tiered Network	$1,344.77
Rate for Payer: UHC Medicaid	$418.97
Rate for Payer: UHCCP Medicaid	$418.97

PR LASER VAPORIZATION OF PROSTATE FOR URINE FLOW

Professional

Both

$3,407.00

Service Code	HCPCS 52648
Min. Negotiated Rate	$336.97
Max. Negotiated Rate	$2,555.25
Rate for Payer: Aetna Commercial	$886.93
Rate for Payer: Aetna Medicare	$1,703.50
Rate for Payer: BCBS Complete	$353.82
Rate for Payer: BCN Commercial	$1,038.79
Rate for Payer: Cash Price	$2,725.60
Rate for Payer: Cash Price	$2,725.60
Rate for Payer: Mclaren Medicaid	$336.97
Rate for Payer: Meridian Medicaid	$353.82
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,555.25
Rate for Payer: Priority Health Choice Medicaid	$336.97
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,131.58
Rate for Payer: Priority Health Narrow/Tiered Network	$1,131.58
Rate for Payer: UHC Medicaid	$336.97
Rate for Payer: UHCCP Medicaid	$336.97

Know your out-of-pocket cost for care.

All Charges