Bronson Lakeview Hospital

All Charges

Charge

Type

Setting

Price

PR OPEN TREAT RIB FRACTURE W/INT FIXATION, UNILATERAL, 3-4 RIBS

Professional

Both

$3,800.00

Service Code	HCPCS 0246T
Min. Negotiated Rate	$1,520.00
Max. Negotiated Rate	$2,850.00
Rate for Payer: Aetna Medicare	$1,900.00
Rate for Payer: BCBS Complete	$1,520.00
Rate for Payer: Cash Price	$3,040.00
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,850.00

PR OPEN TREAT RIB FRACTURE W/INT FIXATION, UNILATERAL, 5-6 RIBS

Professional

Both

$4,202.00

Service Code	HCPCS 0247T
Min. Negotiated Rate	$1,680.80
Max. Negotiated Rate	$3,151.50
Rate for Payer: Aetna Medicare	$2,101.00
Rate for Payer: BCBS Complete	$1,680.80
Rate for Payer: Cash Price	$3,361.60
Rate for Payer: Opus (Opus Packaging Group) HMA	$3,151.50

PR OPEN TREAT RIB FRACTURE W/INT FIXATION, UNILATERAL, 7+ RIBS

Professional

Both

$4,850.00

Service Code	HCPCS 0248T
Min. Negotiated Rate	$1,940.00
Max. Negotiated Rate	$3,637.50
Rate for Payer: Aetna Medicare	$2,425.00
Rate for Payer: BCBS Complete	$1,940.00
Rate for Payer: Cash Price	$3,880.00
Rate for Payer: Opus (Opus Packaging Group) HMA	$3,637.50

PR OPEN TX ACROMIOCLAVICULAR DISLC ACUTE/CHRONIC

Professional

Both

$2,825.00

Service Code	HCPCS 23550
Min. Negotiated Rate	$344.85
Max. Negotiated Rate	$2,118.75
Rate for Payer: Aetna Commercial	$763.42
Rate for Payer: Aetna Medicare	$1,412.50
Rate for Payer: BCBS Complete	$362.09
Rate for Payer: BCN Commercial	$875.95
Rate for Payer: Cash Price	$2,260.00
Rate for Payer: Cash Price	$2,260.00
Rate for Payer: Mclaren Medicaid	$344.85
Rate for Payer: Meridian Medicaid	$362.09
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,118.75
Rate for Payer: Priority Health Choice Medicaid	$344.85
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$936.36
Rate for Payer: Priority Health Narrow/Tiered Network	$936.36
Rate for Payer: UHC Medicaid	$344.85
Rate for Payer: UHCCP Medicaid	$344.85

PR OPEN TX ACUTE/CHRONIC ELBOW DISLOCATION

Professional

Both

$2,654.00

Service Code	HCPCS 24615
Min. Negotiated Rate	$423.87
Max. Negotiated Rate	$1,990.50
Rate for Payer: Aetna Commercial	$952.27
Rate for Payer: Aetna Medicare	$1,327.00
Rate for Payer: BCBS Complete	$445.06
Rate for Payer: BCN Commercial	$1,090.57
Rate for Payer: Cash Price	$2,123.20
Rate for Payer: Cash Price	$2,123.20
Rate for Payer: Mclaren Medicaid	$423.87
Rate for Payer: Meridian Medicaid	$445.06
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,990.50
Rate for Payer: Priority Health Choice Medicaid	$423.87
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,165.80
Rate for Payer: Priority Health Narrow/Tiered Network	$1,165.80
Rate for Payer: UHC Medicaid	$423.87
Rate for Payer: UHCCP Medicaid	$423.87

PR OPEN TX ACUTE SHOULDER DISLOCATION

Professional

Both

$2,802.00

Service Code	HCPCS 23660
Min. Negotiated Rate	$351.45
Max. Negotiated Rate	$2,101.50
Rate for Payer: Aetna Commercial	$780.08
Rate for Payer: Aetna Medicare	$1,401.00
Rate for Payer: BCBS Complete	$369.02
Rate for Payer: BCN Commercial	$897.86
Rate for Payer: Cash Price	$2,241.60
Rate for Payer: Cash Price	$2,241.60
Rate for Payer: Mclaren Medicaid	$351.45
Rate for Payer: Meridian Medicaid	$369.02
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,101.50
Rate for Payer: Priority Health Choice Medicaid	$351.45
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$959.79
Rate for Payer: Priority Health Narrow/Tiered Network	$959.79
Rate for Payer: UHC Medicaid	$351.45
Rate for Payer: UHCCP Medicaid	$351.45

PR OPEN TX ARTICULAR FRACTURE MCP/IP JOINT EA

Professional

Both

$2,606.00

Service Code	HCPCS 26746
Min. Negotiated Rate	$438.99
Max. Negotiated Rate	$1,954.50
Rate for Payer: Aetna Commercial	$988.24
Rate for Payer: Aetna Medicare	$1,303.00
Rate for Payer: BCBS Complete	$460.94
Rate for Payer: BCN Commercial	$1,136.89
Rate for Payer: Cash Price	$2,084.80
Rate for Payer: Cash Price	$2,084.80
Rate for Payer: Mclaren Medicaid	$438.99
Rate for Payer: Meridian Medicaid	$460.94
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,954.50
Rate for Payer: Priority Health Choice Medicaid	$438.99
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,215.30
Rate for Payer: Priority Health Narrow/Tiered Network	$1,215.30
Rate for Payer: UHC Medicaid	$438.99
Rate for Payer: UHCCP Medicaid	$438.99

PR OPEN TX CARPAL BONE FRACTURE OTH/THN SCAPHOID EA

Professional

Both

$1,553.00

Service Code	HCPCS 25645
Min. Negotiated Rate	$348.26
Max. Negotiated Rate	$1,164.75
Rate for Payer: Aetna Commercial	$762.34
Rate for Payer: Aetna Medicare	$776.50
Rate for Payer: BCBS Complete	$365.67
Rate for Payer: BCN Commercial	$878.94
Rate for Payer: Cash Price	$1,242.40
Rate for Payer: Cash Price	$1,242.40
Rate for Payer: Mclaren Medicaid	$348.26
Rate for Payer: Meridian Medicaid	$365.67
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,164.75
Rate for Payer: Priority Health Choice Medicaid	$348.26
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$939.57
Rate for Payer: Priority Health Narrow/Tiered Network	$939.57
Rate for Payer: UHC Medicaid	$348.26
Rate for Payer: UHCCP Medicaid	$348.26

PR OPEN TX CARPAL SCAPHOID NAVICULAR FX W/INT FIXJ

Professional

Both

$2,085.00

Service Code	HCPCS 25628
Min. Negotiated Rate	$426.64
Max. Negotiated Rate	$1,563.75
Rate for Payer: Aetna Commercial	$959.80
Rate for Payer: Aetna Medicare	$1,042.50
Rate for Payer: BCBS Complete	$447.97
Rate for Payer: BCN Commercial	$1,103.03
Rate for Payer: Cash Price	$1,668.00
Rate for Payer: Cash Price	$1,668.00
Rate for Payer: Mclaren Medicaid	$426.64
Rate for Payer: Meridian Medicaid	$447.97
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,563.75
Rate for Payer: Priority Health Choice Medicaid	$426.64
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,179.10
Rate for Payer: Priority Health Narrow/Tiered Network	$1,179.10
Rate for Payer: UHC Medicaid	$426.64
Rate for Payer: UHCCP Medicaid	$426.64

PR OPEN TX CARPOMETACARPAL DISLOCATE NOT THUMB

Professional

Both

$2,323.00

Service Code	HCPCS 26685
Min. Negotiated Rate	$341.44
Max. Negotiated Rate	$1,742.25
Rate for Payer: Aetna Commercial	$764.98
Rate for Payer: Aetna Medicare	$1,161.50
Rate for Payer: BCBS Complete	$358.51
Rate for Payer: BCN Commercial	$890.39
Rate for Payer: Cash Price	$1,858.40
Rate for Payer: Cash Price	$1,858.40
Rate for Payer: Mclaren Medicaid	$341.44
Rate for Payer: Meridian Medicaid	$358.51
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,742.25
Rate for Payer: Priority Health Choice Medicaid	$341.44
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$951.81
Rate for Payer: Priority Health Narrow/Tiered Network	$951.81
Rate for Payer: UHC Medicaid	$341.44
Rate for Payer: UHCCP Medicaid	$341.44

PR OPEN TX CARPOMETACARPAL FRACTURE DISLOCATE THUMB

Professional

Both

$2,975.00

Service Code	HCPCS 26665
Min. Negotiated Rate	$368.49
Max. Negotiated Rate	$2,231.25
Rate for Payer: Aetna Commercial	$832.65
Rate for Payer: Aetna Medicare	$1,487.50
Rate for Payer: BCBS Complete	$386.91
Rate for Payer: BCN Commercial	$966.08
Rate for Payer: Cash Price	$2,380.00
Rate for Payer: Cash Price	$2,380.00
Rate for Payer: Mclaren Medicaid	$368.49
Rate for Payer: Meridian Medicaid	$386.91
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,231.25
Rate for Payer: Priority Health Choice Medicaid	$368.49
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,032.71
Rate for Payer: Priority Health Narrow/Tiered Network	$1,032.71
Rate for Payer: UHC Medicaid	$368.49
Rate for Payer: UHCCP Medicaid	$368.49

PR OPEN TX CLAVICULAR FRACTURE INTERNAL FIXATION

Professional

Both

$2,529.00

Service Code	HCPCS 23515
Min. Negotiated Rate	$433.03
Max. Negotiated Rate	$1,896.75
Rate for Payer: Aetna Commercial	$959.84
Rate for Payer: Aetna Medicare	$1,264.50
Rate for Payer: BCBS Complete	$454.68
Rate for Payer: BCN Commercial	$1,101.04
Rate for Payer: Cash Price	$2,023.20
Rate for Payer: Cash Price	$2,023.20
Rate for Payer: Mclaren Medicaid	$433.03
Rate for Payer: Meridian Medicaid	$454.68
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,896.75
Rate for Payer: Priority Health Choice Medicaid	$433.03
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,176.97
Rate for Payer: Priority Health Narrow/Tiered Network	$1,176.97
Rate for Payer: UHC Medicaid	$433.03
Rate for Payer: UHCCP Medicaid	$433.03

PR OPEN TX COMP FX MALAR W/INTERNAL FX&MULT SURG

Professional

Both

$2,079.00

Service Code	HCPCS 21365
Min. Negotiated Rate	$613.87
Max. Negotiated Rate	$1,745.50
Rate for Payer: Aetna Commercial	$1,448.48
Rate for Payer: Aetna Medicare	$1,039.50
Rate for Payer: BCBS Complete	$644.56
Rate for Payer: BCN Commercial	$1,632.88
Rate for Payer: Cash Price	$1,663.20
Rate for Payer: Cash Price	$1,663.20
Rate for Payer: Mclaren Medicaid	$613.87
Rate for Payer: Meridian Medicaid	$644.56
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,559.25
Rate for Payer: Priority Health Choice Medicaid	$613.87
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,745.50
Rate for Payer: Priority Health Narrow/Tiered Network	$1,745.50
Rate for Payer: UHC Medicaid	$613.87
Rate for Payer: UHCCP Medicaid	$613.87

PR OPEN TX COMPLICATED FRONTAL SINUS FRACTURE

Professional

Both

$3,579.00

Service Code	HCPCS 21344
Min. Negotiated Rate	$775.11
Max. Negotiated Rate	$2,684.25
Rate for Payer: Aetna Commercial	$1,845.66
Rate for Payer: Aetna Medicare	$1,789.50
Rate for Payer: BCBS Complete	$813.87
Rate for Payer: BCN Commercial	$2,088.03
Rate for Payer: Cash Price	$2,863.20
Rate for Payer: Cash Price	$2,863.20
Rate for Payer: Mclaren Medicaid	$775.11
Rate for Payer: Meridian Medicaid	$813.87
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,684.25
Rate for Payer: Priority Health Choice Medicaid	$775.11
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$2,232.05
Rate for Payer: Priority Health Narrow/Tiered Network	$2,232.05
Rate for Payer: UHC Medicaid	$775.11
Rate for Payer: UHCCP Medicaid	$775.11

PR OPEN TX CRANIOFACIAL SEP COMPLICATED MLT APPR

Professional

Both

$3,103.00

Service Code	HCPCS 21433
Min. Negotiated Rate	$973.41
Max. Negotiated Rate	$2,785.67
Rate for Payer: Aetna Commercial	$2,312.83
Rate for Payer: Aetna Medicare	$1,551.50
Rate for Payer: BCBS Complete	$1,022.08
Rate for Payer: BCN Commercial	$2,605.94
Rate for Payer: Cash Price	$2,482.40
Rate for Payer: Cash Price	$2,482.40
Rate for Payer: Mclaren Medicaid	$973.41
Rate for Payer: Meridian Medicaid	$1,022.08
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,327.25
Rate for Payer: Priority Health Choice Medicaid	$973.41
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$2,785.67
Rate for Payer: Priority Health Narrow/Tiered Network	$2,785.67
Rate for Payer: UHC Medicaid	$973.41
Rate for Payer: UHCCP Medicaid	$973.41

PR OPEN TX DEPRESSED FRONTAL SINUS FRACTURE

Professional

Both

$2,527.00

Service Code	HCPCS 21343
Min. Negotiated Rate	$621.53
Max. Negotiated Rate	$1,895.25
Rate for Payer: Aetna Commercial	$1,431.81
Rate for Payer: Aetna Medicare	$1,263.50
Rate for Payer: BCBS Complete	$652.61
Rate for Payer: BCN Commercial	$1,633.88
Rate for Payer: Cash Price	$2,021.60
Rate for Payer: Cash Price	$2,021.60
Rate for Payer: Mclaren Medicaid	$621.53
Rate for Payer: Meridian Medicaid	$652.61
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,895.25
Rate for Payer: Priority Health Choice Medicaid	$621.53
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,746.57
Rate for Payer: Priority Health Narrow/Tiered Network	$1,746.57
Rate for Payer: UHC Medicaid	$621.53
Rate for Payer: UHCCP Medicaid	$621.53

PR OPEN TX DEPRESSED MALAR FRACTURE

Professional

Both

$1,068.00

Service Code	HCPCS 21360
Min. Negotiated Rate	$298.84
Max. Negotiated Rate	$850.12
Rate for Payer: Aetna Commercial	$680.88
Rate for Payer: Aetna Medicare	$534.00
Rate for Payer: BCBS Complete	$313.78
Rate for Payer: BCN Commercial	$795.27
Rate for Payer: Cash Price	$854.40
Rate for Payer: Cash Price	$854.40
Rate for Payer: Mclaren Medicaid	$298.84
Rate for Payer: Meridian Medicaid	$313.78
Rate for Payer: Opus (Opus Packaging Group) HMA	$801.00
Rate for Payer: Priority Health Choice Medicaid	$298.84
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$850.12
Rate for Payer: Priority Health Narrow/Tiered Network	$850.12
Rate for Payer: UHC Medicaid	$298.84
Rate for Payer: UHCCP Medicaid	$298.84

PR OPEN TX DEPRESSED ZYGOMATIC ARCH FRACTURE

Professional

Both

$849.00

Service Code	HCPCS 21356
Min. Negotiated Rate	$242.18
Max. Negotiated Rate	$653.71
Rate for Payer: Aetna Commercial	$497.11
Rate for Payer: Aetna Medicare	$424.50
Rate for Payer: BCBS Complete	$254.29
Rate for Payer: BCN Commercial	$611.52
Rate for Payer: Cash Price	$679.20
Rate for Payer: Cash Price	$679.20
Rate for Payer: Mclaren Medicaid	$242.18
Rate for Payer: Meridian Medicaid	$254.29
Rate for Payer: Opus (Opus Packaging Group) HMA	$636.75
Rate for Payer: Priority Health Choice Medicaid	$242.18
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$653.71
Rate for Payer: Priority Health Narrow/Tiered Network	$653.71
Rate for Payer: UHC Medicaid	$242.18
Rate for Payer: UHCCP Medicaid	$242.18

PR OPEN TX DISTAL FIBULAR FRACTURE LAT MALLEOLUS

Professional

Both

$2,545.00

Service Code	HCPCS 27792
Min. Negotiated Rate	$387.66
Max. Negotiated Rate	$1,908.75
Rate for Payer: Aetna Commercial	$860.56
Rate for Payer: Aetna Medicare	$1,272.50
Rate for Payer: BCBS Complete	$407.04
Rate for Payer: BCN Commercial	$1,078.27
Rate for Payer: Cash Price	$2,036.00
Rate for Payer: Cash Price	$2,036.00
Rate for Payer: Mclaren Medicaid	$387.66
Rate for Payer: Meridian Medicaid	$407.04
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,908.75
Rate for Payer: Priority Health Choice Medicaid	$387.66
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,049.22
Rate for Payer: Priority Health Narrow/Tiered Network	$1,049.22
Rate for Payer: UHC Medicaid	$387.66
Rate for Payer: UHCCP Medicaid	$387.66

PR OPEN TX DISTAL PHALANGEAL FRACTURE EACH

Professional

Both

$903.00

Service Code	HCPCS 26765
Min. Negotiated Rate	$310.34
Max. Negotiated Rate	$831.49
Rate for Payer: Aetna Commercial	$664.73
Rate for Payer: Aetna Medicare	$451.50
Rate for Payer: BCBS Complete	$325.86
Rate for Payer: BCN Commercial	$777.85
Rate for Payer: Cash Price	$722.40
Rate for Payer: Cash Price	$722.40
Rate for Payer: Mclaren Medicaid	$310.34
Rate for Payer: Meridian Medicaid	$325.86
Rate for Payer: Opus (Opus Packaging Group) HMA	$677.25
Rate for Payer: Priority Health Choice Medicaid	$310.34
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$831.49
Rate for Payer: Priority Health Narrow/Tiered Network	$831.49
Rate for Payer: UHC Medicaid	$310.34
Rate for Payer: UHCCP Medicaid	$310.34

PR OPEN TX DISTAL RADIOULNAR DISLC ACUTE/CHRONIC

Professional

Both

$1,839.00

Service Code	HCPCS 25676
Min. Negotiated Rate	$379.57
Max. Negotiated Rate	$1,379.25
Rate for Payer: Aetna Commercial	$841.44
Rate for Payer: Aetna Medicare	$919.50
Rate for Payer: BCBS Complete	$398.55
Rate for Payer: BCN Commercial	$967.58
Rate for Payer: Cash Price	$1,471.20
Rate for Payer: Cash Price	$1,471.20
Rate for Payer: Mclaren Medicaid	$379.57
Rate for Payer: Meridian Medicaid	$398.55
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,379.25
Rate for Payer: Priority Health Choice Medicaid	$379.57
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,034.31
Rate for Payer: Priority Health Narrow/Tiered Network	$1,034.31
Rate for Payer: UHC Medicaid	$379.57
Rate for Payer: UHCCP Medicaid	$379.57

PR OPEN TX DISTAL TIBIOFIBULAR JOINT DISRUPTION

Professional

Both

$2,371.00

Service Code	HCPCS 27829
Min. Negotiated Rate	$429.20
Max. Negotiated Rate	$1,778.25
Rate for Payer: Aetna Commercial	$942.40
Rate for Payer: Aetna Medicare	$1,185.50
Rate for Payer: BCBS Complete	$450.66
Rate for Payer: BCN Commercial	$1,070.66
Rate for Payer: Cash Price	$1,896.80
Rate for Payer: Cash Price	$1,896.80
Rate for Payer: Mclaren Medicaid	$429.20
Rate for Payer: Meridian Medicaid	$450.66
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,778.25
Rate for Payer: Priority Health Choice Medicaid	$429.20
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,144.51
Rate for Payer: Priority Health Narrow/Tiered Network	$1,144.51
Rate for Payer: UHC Medicaid	$429.20
Rate for Payer: UHCCP Medicaid	$429.20

PR OPEN TX FEMORAL FRACTURE DISTAL MED/LAT CONDYLE

Professional

Both

$4,039.00

Service Code	HCPCS 27514
Min. Negotiated Rate	$558.06
Max. Negotiated Rate	$3,029.25
Rate for Payer: Aetna Commercial	$1,295.18
Rate for Payer: Aetna Medicare	$2,019.50
Rate for Payer: BCBS Complete	$585.96
Rate for Payer: BCN Commercial	$1,460.08
Rate for Payer: Cash Price	$3,231.20
Rate for Payer: Cash Price	$3,231.20
Rate for Payer: Mclaren Medicaid	$558.06
Rate for Payer: Meridian Medicaid	$585.96
Rate for Payer: Opus (Opus Packaging Group) HMA	$3,029.25
Rate for Payer: Priority Health Choice Medicaid	$558.06
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,560.79
Rate for Payer: Priority Health Narrow/Tiered Network	$1,560.79
Rate for Payer: UHC Medicaid	$558.06
Rate for Payer: UHCCP Medicaid	$558.06

PR OPEN TX FEMORAL FRACTURE PROXIMAL END HEAD

Professional

Both

$4,037.00

Service Code	HCPCS 27269
Min. Negotiated Rate	$715.04
Max. Negotiated Rate	$3,027.75
Rate for Payer: Aetna Commercial	$1,661.80
Rate for Payer: Aetna Medicare	$2,018.50
Rate for Payer: BCBS Complete	$750.79
Rate for Payer: BCN Commercial	$1,873.90
Rate for Payer: Cash Price	$3,229.60
Rate for Payer: Cash Price	$3,229.60
Rate for Payer: Mclaren Medicaid	$715.04
Rate for Payer: Meridian Medicaid	$750.79
Rate for Payer: Opus (Opus Packaging Group) HMA	$3,027.75
Rate for Payer: Priority Health Choice Medicaid	$715.04
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$2,003.15
Rate for Payer: Priority Health Narrow/Tiered Network	$2,003.15
Rate for Payer: UHC Medicaid	$715.04
Rate for Payer: UHCCP Medicaid	$715.04

PR OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W/O XTN

Professional

Both

$3,963.00

Service Code	HCPCS 27511
Min. Negotiated Rate	$574.46
Max. Negotiated Rate	$2,972.25
Rate for Payer: Aetna Commercial	$1,335.40
Rate for Payer: Aetna Medicare	$1,981.50
Rate for Payer: BCBS Complete	$603.18
Rate for Payer: BCN Commercial	$1,502.40
Rate for Payer: Cash Price	$3,170.40
Rate for Payer: Cash Price	$3,170.40
Rate for Payer: Mclaren Medicaid	$574.46
Rate for Payer: Meridian Medicaid	$603.18
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,972.25
Rate for Payer: Priority Health Choice Medicaid	$574.46
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,606.03
Rate for Payer: Priority Health Narrow/Tiered Network	$1,606.03
Rate for Payer: UHC Medicaid	$574.46
Rate for Payer: UHCCP Medicaid	$574.46

Know your out-of-pocket cost for care.

All Charges