Bronson Lakeview Hospital

All Charges

Charge

Type

Setting

Price

PR OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W/XTN

Professional

Both

$4,529.00

Service Code	HCPCS 27513
Min. Negotiated Rate	$705.88
Max. Negotiated Rate	$3,396.75
Rate for Payer: Aetna Commercial	$1,659.27
Rate for Payer: Aetna Medicare	$2,264.50
Rate for Payer: BCBS Complete	$741.17
Rate for Payer: BCN Commercial	$1,858.97
Rate for Payer: Cash Price	$3,623.20
Rate for Payer: Cash Price	$3,623.20
Rate for Payer: Mclaren Medicaid	$705.88
Rate for Payer: Meridian Medicaid	$741.17
Rate for Payer: Opus (Opus Packaging Group) HMA	$3,396.75
Rate for Payer: Priority Health Choice Medicaid	$705.88
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,987.17
Rate for Payer: Priority Health Narrow/Tiered Network	$1,987.17
Rate for Payer: UHC Medicaid	$705.88
Rate for Payer: UHCCP Medicaid	$705.88

PR OPEN TX FRACTURE GREAT TOE/PHALANX/PHALANGES

Professional

Both

$1,479.00

Service Code	HCPCS 28505
Min. Negotiated Rate	$300.12
Max. Negotiated Rate	$1,109.25
Rate for Payer: Aetna Commercial	$658.49
Rate for Payer: Aetna Medicare	$739.50
Rate for Payer: BCBS Complete	$315.13
Rate for Payer: BCN Commercial	$753.95
Rate for Payer: Cash Price	$1,183.20
Rate for Payer: Cash Price	$1,183.20
Rate for Payer: Mclaren Medicaid	$300.12
Rate for Payer: Meridian Medicaid	$315.13
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,109.25
Rate for Payer: Priority Health Choice Medicaid	$300.12
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$805.95
Rate for Payer: Priority Health Narrow/Tiered Network	$805.95
Rate for Payer: UHC Medicaid	$300.12
Rate for Payer: UHCCP Medicaid	$300.12

PR OPEN TX FRACTURE PHALANX/PHALANGES NOT GREAT TOE

Professional

Both

$634.00

Service Code	HCPCS 28525
Min. Negotiated Rate	$246.02
Max. Negotiated Rate	$655.83
Rate for Payer: Aetna Commercial	$533.40
Rate for Payer: Aetna Medicare	$317.00
Rate for Payer: BCBS Complete	$258.32
Rate for Payer: BCN Commercial	$613.51
Rate for Payer: Cash Price	$507.20
Rate for Payer: Cash Price	$507.20
Rate for Payer: Mclaren Medicaid	$246.02
Rate for Payer: Meridian Medicaid	$258.32
Rate for Payer: Opus (Opus Packaging Group) HMA	$475.50
Rate for Payer: Priority Health Choice Medicaid	$246.02
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$655.83
Rate for Payer: Priority Health Narrow/Tiered Network	$655.83
Rate for Payer: UHC Medicaid	$246.02
Rate for Payer: UHCCP Medicaid	$246.02

PR OPEN TX FX ORBIT EXCEPT BLOWOUT W/IMPLANT

Professional

Both

$1,207.00

Service Code	HCPCS 21407
Min. Negotiated Rate	$368.28
Max. Negotiated Rate	$1,047.10
Rate for Payer: Aetna Commercial	$848.33
Rate for Payer: Aetna Medicare	$603.50
Rate for Payer: BCBS Complete	$386.69
Rate for Payer: BCN Commercial	$979.52
Rate for Payer: Cash Price	$965.60
Rate for Payer: Cash Price	$965.60
Rate for Payer: Mclaren Medicaid	$368.28
Rate for Payer: Meridian Medicaid	$386.69
Rate for Payer: Opus (Opus Packaging Group) HMA	$905.25
Rate for Payer: Priority Health Choice Medicaid	$368.28
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,047.10
Rate for Payer: Priority Health Narrow/Tiered Network	$1,047.10
Rate for Payer: UHC Medicaid	$368.28
Rate for Payer: UHCCP Medicaid	$368.28

PR OPEN TX HUMERAL EPICONDYLAR FRACTURE

Professional

Both

$2,509.00

Service Code	HCPCS 24575
Min. Negotiated Rate	$443.04
Max. Negotiated Rate	$1,881.75
Rate for Payer: Aetna Commercial	$974.52
Rate for Payer: Aetna Medicare	$1,254.50
Rate for Payer: BCBS Complete	$465.19
Rate for Payer: BCN Commercial	$1,124.44
Rate for Payer: Cash Price	$2,007.20
Rate for Payer: Cash Price	$2,007.20
Rate for Payer: Mclaren Medicaid	$443.04
Rate for Payer: Meridian Medicaid	$465.19
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,881.75
Rate for Payer: Priority Health Choice Medicaid	$443.04
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,201.99
Rate for Payer: Priority Health Narrow/Tiered Network	$1,201.99
Rate for Payer: UHC Medicaid	$443.04
Rate for Payer: UHCCP Medicaid	$443.04

PR OPEN TX ILIAC SPINE UNI/BIL

Professional

Both

$2,713.00

Service Code	HCPCS G0412
Min. Negotiated Rate	$426.64
Max. Negotiated Rate	$2,034.75
Rate for Payer: Aetna Commercial	$725.83
Rate for Payer: Aetna Medicare	$1,356.50
Rate for Payer: BCBS Complete	$447.97
Rate for Payer: BCN Commercial	$1,100.04
Rate for Payer: Cash Price	$2,170.40
Rate for Payer: Cash Price	$2,170.40
Rate for Payer: Mclaren Medicaid	$426.64
Rate for Payer: Meridian Medicaid	$447.97
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,034.75
Rate for Payer: Priority Health Choice Medicaid	$426.64
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,175.91
Rate for Payer: Priority Health Narrow/Tiered Network	$1,175.91
Rate for Payer: UHC Medicaid	$426.64
Rate for Payer: UHCCP Medicaid	$426.64

PR OPEN TX INTERCONDYLAR SPINE/TUBRST FRACTURE KNEE

Professional

Both

$2,831.00

Service Code	HCPCS 27540
Min. Negotiated Rate	$486.28
Max. Negotiated Rate	$2,123.25
Rate for Payer: Aetna Commercial	$1,086.55
Rate for Payer: Aetna Medicare	$1,415.50
Rate for Payer: BCBS Complete	$510.59
Rate for Payer: BCN Commercial	$1,242.47
Rate for Payer: Cash Price	$2,264.80
Rate for Payer: Cash Price	$2,264.80
Rate for Payer: Mclaren Medicaid	$486.28
Rate for Payer: Meridian Medicaid	$510.59
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,123.25
Rate for Payer: Priority Health Choice Medicaid	$486.28
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,328.17
Rate for Payer: Priority Health Narrow/Tiered Network	$1,328.17
Rate for Payer: UHC Medicaid	$486.28
Rate for Payer: UHCCP Medicaid	$486.28

PR OPEN TX INTERPHALANGEAL JOINT DISLOCATION

Professional

Both

$1,586.00

Service Code	HCPCS 26785
Min. Negotiated Rate	$334.41
Max. Negotiated Rate	$1,189.50
Rate for Payer: Aetna Commercial	$725.42
Rate for Payer: Aetna Medicare	$793.00
Rate for Payer: BCBS Complete	$351.13
Rate for Payer: BCN Commercial	$847.57
Rate for Payer: Cash Price	$1,268.80
Rate for Payer: Cash Price	$1,268.80
Rate for Payer: Mclaren Medicaid	$334.41
Rate for Payer: Meridian Medicaid	$351.13
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,189.50
Rate for Payer: Priority Health Choice Medicaid	$334.41
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$906.03
Rate for Payer: Priority Health Narrow/Tiered Network	$906.03
Rate for Payer: UHC Medicaid	$334.41
Rate for Payer: UHCCP Medicaid	$334.41

PR OPEN TX KNEE DISLOCATION W/LIGAMENTOUS REPAIR

Professional

Both

$2,215.00

Service Code	HCPCS 27557
Min. Negotiated Rate	$601.51
Max. Negotiated Rate	$1,684.28
Rate for Payer: Aetna Commercial	$1,401.09
Rate for Payer: Aetna Medicare	$1,107.50
Rate for Payer: BCBS Complete	$631.59
Rate for Payer: BCN Commercial	$1,575.62
Rate for Payer: Cash Price	$1,772.00
Rate for Payer: Cash Price	$1,772.00
Rate for Payer: Mclaren Medicaid	$601.51
Rate for Payer: Meridian Medicaid	$631.59
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,661.25
Rate for Payer: Priority Health Choice Medicaid	$601.51
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,684.28
Rate for Payer: Priority Health Narrow/Tiered Network	$1,684.28
Rate for Payer: UHC Medicaid	$601.51
Rate for Payer: UHCCP Medicaid	$601.51

PR OPEN TX KNEE DISLOCATION W/O LIGAMENTOUS REPAIR

Professional

Both

$1,828.00

Service Code	HCPCS 27556
Min. Negotiated Rate	$509.28
Max. Negotiated Rate	$1,416.00
Rate for Payer: Aetna Commercial	$1,174.25
Rate for Payer: Aetna Medicare	$914.00
Rate for Payer: BCBS Complete	$534.74
Rate for Payer: BCN Commercial	$1,324.63
Rate for Payer: Cash Price	$1,462.40
Rate for Payer: Cash Price	$1,462.40
Rate for Payer: Mclaren Medicaid	$509.28
Rate for Payer: Meridian Medicaid	$534.74
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,371.00
Rate for Payer: Priority Health Choice Medicaid	$509.28
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,416.00
Rate for Payer: Priority Health Narrow/Tiered Network	$1,416.00
Rate for Payer: UHC Medicaid	$509.28
Rate for Payer: UHCCP Medicaid	$509.28

PR OPEN TX KNEE DISLOCATION W/REPAIR/RECONSTRUCTION

Professional

Both

$5,511.00

Service Code	HCPCS 27558
Min. Negotiated Rate	$680.75
Max. Negotiated Rate	$4,133.25
Rate for Payer: Aetna Commercial	$1,597.29
Rate for Payer: Aetna Medicare	$2,755.50
Rate for Payer: BCBS Complete	$714.79
Rate for Payer: BCN Commercial	$1,790.74
Rate for Payer: Cash Price	$4,408.80
Rate for Payer: Cash Price	$4,408.80
Rate for Payer: Mclaren Medicaid	$680.75
Rate for Payer: Meridian Medicaid	$714.79
Rate for Payer: Opus (Opus Packaging Group) HMA	$4,133.25
Rate for Payer: Priority Health Choice Medicaid	$680.75
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,914.25
Rate for Payer: Priority Health Narrow/Tiered Network	$1,914.25
Rate for Payer: UHC Medicaid	$680.75
Rate for Payer: UHCCP Medicaid	$680.75

PR OPEN TX MANDIBULAR FX W/INTERDENTAL FIXATION

Professional

Both

$3,503.00

Service Code	HCPCS 21462
Min. Negotiated Rate	$705.67
Max. Negotiated Rate	$2,627.25
Rate for Payer: Aetna Commercial	$1,544.26
Rate for Payer: Aetna Medicare	$1,751.50
Rate for Payer: BCBS Complete	$740.95
Rate for Payer: BCN Commercial	$1,729.98
Rate for Payer: Cash Price	$2,802.40
Rate for Payer: Cash Price	$2,802.40
Rate for Payer: Mclaren Medicaid	$705.67
Rate for Payer: Meridian Medicaid	$740.95
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,627.25
Rate for Payer: Priority Health Choice Medicaid	$705.67
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,849.31
Rate for Payer: Priority Health Narrow/Tiered Network	$1,849.31
Rate for Payer: UHC Medicaid	$705.67
Rate for Payer: UHCCP Medicaid	$705.67

PR OPEN TX MANDIBULAR FX W/O INTERDENTAL FIXATION

Professional

Both

$4,316.00

Service Code	HCPCS 21461
Min. Negotiated Rate	$618.77
Max. Negotiated Rate	$3,237.00
Rate for Payer: Aetna Commercial	$1,379.62
Rate for Payer: Aetna Medicare	$2,158.00
Rate for Payer: BCBS Complete	$649.71
Rate for Payer: BCN Commercial	$1,557.19
Rate for Payer: Cash Price	$3,452.80
Rate for Payer: Cash Price	$3,452.80
Rate for Payer: Mclaren Medicaid	$618.77
Rate for Payer: Meridian Medicaid	$649.71
Rate for Payer: Opus (Opus Packaging Group) HMA	$3,237.00
Rate for Payer: Priority Health Choice Medicaid	$618.77
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,664.60
Rate for Payer: Priority Health Narrow/Tiered Network	$1,664.60
Rate for Payer: UHC Medicaid	$618.77
Rate for Payer: UHCCP Medicaid	$618.77

PR OPEN TX METACARPAL FRACTURE SINGLE EA BONE

Professional

Both

$1,983.00

Service Code	HCPCS 26615
Min. Negotiated Rate	$349.32
Max. Negotiated Rate	$1,487.25
Rate for Payer: Aetna Commercial	$765.08
Rate for Payer: Aetna Medicare	$991.50
Rate for Payer: BCBS Complete	$366.79
Rate for Payer: BCN Commercial	$887.90
Rate for Payer: Cash Price	$1,586.40
Rate for Payer: Cash Price	$1,586.40
Rate for Payer: Mclaren Medicaid	$349.32
Rate for Payer: Meridian Medicaid	$366.79
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,487.25
Rate for Payer: Priority Health Choice Medicaid	$349.32
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$949.14
Rate for Payer: Priority Health Narrow/Tiered Network	$949.14
Rate for Payer: UHC Medicaid	$349.32
Rate for Payer: UHCCP Medicaid	$349.32

PR OPEN TX METATARSOPHALANGEAL JOINT DISLOCATION

Professional

Both

$1,068.00

Service Code	HCPCS 28645
Min. Negotiated Rate	$294.15
Max. Negotiated Rate	$801.00
Rate for Payer: Aetna Commercial	$643.68
Rate for Payer: Aetna Medicare	$534.00
Rate for Payer: BCBS Complete	$308.86
Rate for Payer: BCN Commercial	$740.00
Rate for Payer: Cash Price	$854.40
Rate for Payer: Cash Price	$854.40
Rate for Payer: Mclaren Medicaid	$294.15
Rate for Payer: Meridian Medicaid	$308.86
Rate for Payer: Opus (Opus Packaging Group) HMA	$801.00
Rate for Payer: Priority Health Choice Medicaid	$294.15
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$791.04
Rate for Payer: Priority Health Narrow/Tiered Network	$791.04
Rate for Payer: UHC Medicaid	$294.15
Rate for Payer: UHCCP Medicaid	$294.15

PR OPEN TX MONTEGGIA FRACTURE DISLOCATION ELBOW

Professional

Both

$3,547.00

Service Code	HCPCS 24635
Min. Negotiated Rate	$408.11
Max. Negotiated Rate	$2,660.25
Rate for Payer: Aetna Commercial	$899.81
Rate for Payer: Aetna Medicare	$1,773.50
Rate for Payer: BCBS Complete	$428.52
Rate for Payer: BCN Commercial	$1,040.28
Rate for Payer: Cash Price	$2,837.60
Rate for Payer: Cash Price	$2,837.60
Rate for Payer: Mclaren Medicaid	$408.11
Rate for Payer: Meridian Medicaid	$428.52
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,660.25
Rate for Payer: Priority Health Choice Medicaid	$408.11
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,112.04
Rate for Payer: Priority Health Narrow/Tiered Network	$1,112.04
Rate for Payer: UHC Medicaid	$408.11
Rate for Payer: UHCCP Medicaid	$408.11

PR OPEN TX NASAL FX COMP W/INT&/XTRNL SKELETAL FI

Professional

Both

$1,705.00

Service Code	HCPCS 21330
Min. Negotiated Rate	$312.68
Max. Negotiated Rate	$1,278.75
Rate for Payer: Aetna Commercial	$702.66
Rate for Payer: Aetna Medicare	$852.50
Rate for Payer: BCBS Complete	$328.31
Rate for Payer: BCN Commercial	$803.24
Rate for Payer: Cash Price	$1,364.00
Rate for Payer: Cash Price	$1,364.00
Rate for Payer: Mclaren Medicaid	$312.68
Rate for Payer: Meridian Medicaid	$328.31
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,278.75
Rate for Payer: Priority Health Choice Medicaid	$312.68
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$858.65
Rate for Payer: Priority Health Narrow/Tiered Network	$858.65
Rate for Payer: UHC Medicaid	$312.68
Rate for Payer: UHCCP Medicaid	$312.68

PR OPEN TX NASAL SEPTAL FRACTURE W/WO STABILIZATION

Professional

Both

$1,520.00

Service Code	HCPCS 21336
Min. Negotiated Rate	$371.90
Max. Negotiated Rate	$1,140.00
Rate for Payer: Aetna Commercial	$851.72
Rate for Payer: Aetna Medicare	$760.00
Rate for Payer: BCBS Complete	$390.50
Rate for Payer: BCN Commercial	$957.12
Rate for Payer: Cash Price	$1,216.00
Rate for Payer: Cash Price	$1,216.00
Rate for Payer: Mclaren Medicaid	$371.90
Rate for Payer: Meridian Medicaid	$390.50
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,140.00
Rate for Payer: Priority Health Choice Medicaid	$371.90
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,023.13
Rate for Payer: Priority Health Narrow/Tiered Network	$1,023.13
Rate for Payer: UHC Medicaid	$371.90
Rate for Payer: UHCCP Medicaid	$371.90

PR OPEN TX NASOETHMOID FX W/O EXTERNAL FIXATION

Professional

Both

$1,930.00

Service Code	HCPCS 21338
Min. Negotiated Rate	$399.80
Max. Negotiated Rate	$1,447.50
Rate for Payer: Aetna Commercial	$881.10
Rate for Payer: Aetna Medicare	$965.00
Rate for Payer: BCBS Complete	$419.79
Rate for Payer: BCN Commercial	$1,010.90
Rate for Payer: Cash Price	$1,544.00
Rate for Payer: Cash Price	$1,544.00
Rate for Payer: Mclaren Medicaid	$399.80
Rate for Payer: Meridian Medicaid	$419.79
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,447.50
Rate for Payer: Priority Health Choice Medicaid	$399.80
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,080.62
Rate for Payer: Priority Health Narrow/Tiered Network	$1,080.62
Rate for Payer: UHC Medicaid	$399.80
Rate for Payer: UHCCP Medicaid	$399.80

PR OPEN TX ORBITAL FLOOR BLOWOUT FX PERIORBITAL

Professional

Both

$1,232.00

Service Code	HCPCS 21386
Min. Negotiated Rate	$402.36
Max. Negotiated Rate	$1,121.09
Rate for Payer: Aetna Commercial	$917.96
Rate for Payer: Aetna Medicare	$616.00
Rate for Payer: BCBS Complete	$422.48
Rate for Payer: BCN Commercial	$1,048.75
Rate for Payer: Cash Price	$985.60
Rate for Payer: Cash Price	$985.60
Rate for Payer: Mclaren Medicaid	$402.36
Rate for Payer: Meridian Medicaid	$422.48
Rate for Payer: Opus (Opus Packaging Group) HMA	$924.00
Rate for Payer: Priority Health Choice Medicaid	$402.36
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,121.09
Rate for Payer: Priority Health Narrow/Tiered Network	$1,121.09
Rate for Payer: UHC Medicaid	$402.36
Rate for Payer: UHCCP Medicaid	$402.36

PR OPEN TX ORBITAL FLOOR BLOWOUT FX TRANSANTRAL

Professional

Both

$1,591.00

Service Code	HCPCS 21385
Min. Negotiated Rate	$430.05
Max. Negotiated Rate	$1,193.25
Rate for Payer: Aetna Commercial	$985.76
Rate for Payer: Aetna Medicare	$795.50
Rate for Payer: BCBS Complete	$451.55
Rate for Payer: BCN Commercial	$1,106.52
Rate for Payer: Cash Price	$1,272.80
Rate for Payer: Cash Price	$1,272.80
Rate for Payer: Mclaren Medicaid	$430.05
Rate for Payer: Meridian Medicaid	$451.55
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,193.25
Rate for Payer: Priority Health Choice Medicaid	$430.05
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,182.83
Rate for Payer: Priority Health Narrow/Tiered Network	$1,182.83
Rate for Payer: UHC Medicaid	$430.05
Rate for Payer: UHCCP Medicaid	$430.05

PR OPEN TX PALATAL/MAXILLARY FX COMP MULTIPLE APPR

Professional

Both

$1,626.00

Service Code	HCPCS 21423
Min. Negotiated Rate	$460.29
Max. Negotiated Rate	$1,281.84
Rate for Payer: Aetna Commercial	$1,075.12
Rate for Payer: Aetna Medicare	$813.00
Rate for Payer: BCBS Complete	$483.30
Rate for Payer: BCN Commercial	$1,199.14
Rate for Payer: Cash Price	$1,300.80
Rate for Payer: Cash Price	$1,300.80
Rate for Payer: Mclaren Medicaid	$460.29
Rate for Payer: Meridian Medicaid	$483.30
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,219.50
Rate for Payer: Priority Health Choice Medicaid	$460.29
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,281.84
Rate for Payer: Priority Health Narrow/Tiered Network	$1,281.84
Rate for Payer: UHC Medicaid	$460.29
Rate for Payer: UHCCP Medicaid	$460.29

PR OPEN TX PHALANGEAL SHAFT FRACTURE PROX/MIDDLE EA

Professional

Both

$1,869.00

Service Code	HCPCS 26735
Min. Negotiated Rate	$359.97
Max. Negotiated Rate	$1,401.75
Rate for Payer: Aetna Commercial	$790.77
Rate for Payer: Aetna Medicare	$934.50
Rate for Payer: BCBS Complete	$377.97
Rate for Payer: BCN Commercial	$916.28
Rate for Payer: Cash Price	$1,495.20
Rate for Payer: Cash Price	$1,495.20
Rate for Payer: Mclaren Medicaid	$359.97
Rate for Payer: Meridian Medicaid	$377.97
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,401.75
Rate for Payer: Priority Health Choice Medicaid	$359.97
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$979.49
Rate for Payer: Priority Health Narrow/Tiered Network	$979.49
Rate for Payer: UHC Medicaid	$359.97
Rate for Payer: UHCCP Medicaid	$359.97

PR OPEN TX POST PELVIC FXCTURE

Professional

Both

$2,438.00

Service Code	HCPCS G0415
Min. Negotiated Rate	$790.23
Max. Negotiated Rate	$2,217.14
Rate for Payer: Aetna Commercial	$1,373.54
Rate for Payer: Aetna Medicare	$1,219.00
Rate for Payer: BCBS Complete	$829.74
Rate for Payer: BCN Commercial	$2,074.09
Rate for Payer: Cash Price	$1,950.40
Rate for Payer: Cash Price	$1,950.40
Rate for Payer: Mclaren Medicaid	$790.23
Rate for Payer: Meridian Medicaid	$829.74
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,828.50
Rate for Payer: Priority Health Choice Medicaid	$790.23
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$2,217.14
Rate for Payer: Priority Health Narrow/Tiered Network	$2,217.14
Rate for Payer: UHC Medicaid	$790.23
Rate for Payer: UHCCP Medicaid	$790.23

PR OPEN TX PROX TIBFIB JOINT DISLOCATE EXC PROX FIB

Professional

Both

$1,898.00

Service Code	HCPCS 27832
Min. Negotiated Rate	$457.10
Max. Negotiated Rate	$1,423.50
Rate for Payer: Aetna Commercial	$1,009.97
Rate for Payer: Aetna Medicare	$949.00
Rate for Payer: BCBS Complete	$479.95
Rate for Payer: BCN Commercial	$1,160.79
Rate for Payer: Cash Price	$1,518.40
Rate for Payer: Cash Price	$1,518.40
Rate for Payer: Mclaren Medicaid	$457.10
Rate for Payer: Meridian Medicaid	$479.95
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,423.50
Rate for Payer: Priority Health Choice Medicaid	$457.10
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,240.86
Rate for Payer: Priority Health Narrow/Tiered Network	$1,240.86
Rate for Payer: UHC Medicaid	$457.10
Rate for Payer: UHCCP Medicaid	$457.10

Know your out-of-pocket cost for care.

All Charges