Bronson Lakeview Hospital

All Charges

Charge

Type

Setting

Price

PR OSTEOTOMY PHALANX FINGER EACH

Professional

Both

$1,634.00

Service Code	HCPCS 26567
Min. Negotiated Rate	$446.45
Max. Negotiated Rate	$1,225.50
Rate for Payer: Aetna Commercial	$952.97
Rate for Payer: Aetna Medicare	$817.00
Rate for Payer: BCBS Complete	$468.77
Rate for Payer: BCN Commercial	$1,087.10
Rate for Payer: Cash Price	$1,307.20
Rate for Payer: Cash Price	$1,307.20
Rate for Payer: Mclaren Medicaid	$446.45
Rate for Payer: Meridian Medicaid	$468.77
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,225.50
Rate for Payer: Priority Health Choice Medicaid	$446.45
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,162.06
Rate for Payer: Priority Health Narrow/Tiered Network	$1,162.06
Rate for Payer: UHC Medicaid	$446.45
Rate for Payer: UHCCP Medicaid	$446.45

PR OSTEOTOMY RADIUS DISTAL THIRD

Professional

Both

$2,295.00

Service Code	HCPCS 25350
Min. Negotiated Rate	$399.80
Max. Negotiated Rate	$1,721.25
Rate for Payer: Aetna Commercial	$899.05
Rate for Payer: Aetna Medicare	$1,147.50
Rate for Payer: BCBS Complete	$419.79
Rate for Payer: BCN Commercial	$1,033.32
Rate for Payer: Cash Price	$1,836.00
Rate for Payer: Cash Price	$1,836.00
Rate for Payer: Mclaren Medicaid	$399.80
Rate for Payer: Meridian Medicaid	$419.79
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,721.25
Rate for Payer: Priority Health Choice Medicaid	$399.80
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,104.58
Rate for Payer: Priority Health Narrow/Tiered Network	$1,104.58
Rate for Payer: UHC Medicaid	$399.80
Rate for Payer: UHCCP Medicaid	$399.80

PR OSTEOTOMY RADIUS MIDDLE/PROXIMAL THIRD

Professional

Both

$1,747.00

Service Code	HCPCS 25355
Min. Negotiated Rate	$458.16
Max. Negotiated Rate	$1,310.25
Rate for Payer: Aetna Commercial	$1,022.43
Rate for Payer: Aetna Medicare	$873.50
Rate for Payer: BCBS Complete	$481.07
Rate for Payer: BCN Commercial	$1,169.25
Rate for Payer: Cash Price	$1,397.60
Rate for Payer: Cash Price	$1,397.60
Rate for Payer: Mclaren Medicaid	$458.16
Rate for Payer: Meridian Medicaid	$481.07
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,310.25
Rate for Payer: Priority Health Choice Medicaid	$458.16
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,249.91
Rate for Payer: Priority Health Narrow/Tiered Network	$1,249.91
Rate for Payer: UHC Medicaid	$458.16
Rate for Payer: UHCCP Medicaid	$458.16

PR OSTEOTOMY SPINE POSTERIOR 3 COLUMN EA ADDL SGM

Professional

Both

$2,791.00

Service Code	HCPCS 22208
Min. Negotiated Rate	$336.75
Max. Negotiated Rate	$2,093.25
Rate for Payer: Aetna Commercial	$790.71
Rate for Payer: Aetna Medicare	$1,395.50
Rate for Payer: BCBS Complete	$353.59
Rate for Payer: BCN Commercial	$883.92
Rate for Payer: Cash Price	$2,232.80
Rate for Payer: Cash Price	$2,232.80
Rate for Payer: Mclaren Medicaid	$336.75
Rate for Payer: Meridian Medicaid	$353.59
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,093.25
Rate for Payer: Priority Health Choice Medicaid	$336.75
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$944.88
Rate for Payer: Priority Health Narrow/Tiered Network	$944.88
Rate for Payer: UHC Medicaid	$336.75
Rate for Payer: UHCCP Medicaid	$336.75

PR OSTEOTOMY SPINE POSTERIOR 3 COLUMN LUMBAR

Professional

Both

$5,165.00

Service Code	HCPCS 22207
Min. Negotiated Rate	$1,412.19
Max. Negotiated Rate	$3,873.75
Rate for Payer: Aetna Commercial	$3,215.31
Rate for Payer: Aetna Medicare	$2,582.50
Rate for Payer: BCBS Complete	$1,482.80
Rate for Payer: BCN Commercial	$3,617.34
Rate for Payer: Cash Price	$4,132.00
Rate for Payer: Cash Price	$4,132.00
Rate for Payer: Mclaren Medicaid	$1,412.19
Rate for Payer: Meridian Medicaid	$1,482.80
Rate for Payer: Opus (Opus Packaging Group) HMA	$3,873.75
Rate for Payer: Priority Health Choice Medicaid	$1,412.19
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$3,866.83
Rate for Payer: Priority Health Narrow/Tiered Network	$3,866.83
Rate for Payer: UHC Medicaid	$1,412.19
Rate for Payer: UHCCP Medicaid	$1,412.19

PR OSTEOTOMY SPINE POSTERIOR 3 COLUMN THORACIC

Professional

Both

$5,275.00

Service Code	HCPCS 22206
Min. Negotiated Rate	$1,457.35
Max. Negotiated Rate	$3,970.10
Rate for Payer: Aetna Commercial	$3,283.38
Rate for Payer: Aetna Medicare	$2,637.50
Rate for Payer: BCBS Complete	$1,530.22
Rate for Payer: BCN Commercial	$3,713.94
Rate for Payer: Cash Price	$4,220.00
Rate for Payer: Cash Price	$4,220.00
Rate for Payer: Mclaren Medicaid	$1,457.35
Rate for Payer: Meridian Medicaid	$1,530.22
Rate for Payer: Opus (Opus Packaging Group) HMA	$3,956.25
Rate for Payer: Priority Health Choice Medicaid	$1,457.35
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$3,970.10
Rate for Payer: Priority Health Narrow/Tiered Network	$3,970.10
Rate for Payer: UHC Medicaid	$1,457.35
Rate for Payer: UHCCP Medicaid	$1,457.35

PR OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM CRV

Professional

Both

$3,838.00

Service Code	HCPCS 22210
Min. Negotiated Rate	$1,092.69
Max. Negotiated Rate	$2,980.98
Rate for Payer: Aetna Commercial	$2,400.84
Rate for Payer: Aetna Medicare	$1,919.00
Rate for Payer: BCBS Complete	$1,147.32
Rate for Payer: BCN Commercial	$2,980.98
Rate for Payer: Cash Price	$3,070.40
Rate for Payer: Cash Price	$3,070.40
Rate for Payer: Mclaren Medicaid	$1,092.69
Rate for Payer: Meridian Medicaid	$1,147.32
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,878.50
Rate for Payer: Priority Health Choice Medicaid	$1,092.69
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$2,900.65
Rate for Payer: Priority Health Narrow/Tiered Network	$2,900.65
Rate for Payer: UHC Medicaid	$1,092.69
Rate for Payer: UHCCP Medicaid	$1,092.69

PR OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM LMBR

Professional

Both

$3,193.00

Service Code	HCPCS 22214
Min. Negotiated Rate	$921.01
Max. Negotiated Rate	$2,462.55
Rate for Payer: Aetna Commercial	$2,016.15
Rate for Payer: Aetna Medicare	$1,596.50
Rate for Payer: BCBS Complete	$967.06
Rate for Payer: BCN Commercial	$2,303.66
Rate for Payer: Cash Price	$2,554.40
Rate for Payer: Cash Price	$2,554.40
Rate for Payer: Mclaren Medicaid	$921.01
Rate for Payer: Meridian Medicaid	$967.06
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,394.75
Rate for Payer: Priority Health Choice Medicaid	$921.01
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$2,462.55
Rate for Payer: Priority Health Narrow/Tiered Network	$2,462.55
Rate for Payer: UHC Medicaid	$921.01
Rate for Payer: UHCCP Medicaid	$921.01

PR OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM THRC

Professional

Both

$3,180.00

Service Code	HCPCS 22212
Min. Negotiated Rate	$928.47
Max. Negotiated Rate	$2,466.27
Rate for Payer: Aetna Commercial	$2,011.70
Rate for Payer: Aetna Medicare	$1,590.00
Rate for Payer: BCBS Complete	$974.89
Rate for Payer: BCN Commercial	$2,307.15
Rate for Payer: Cash Price	$2,544.00
Rate for Payer: Cash Price	$2,544.00
Rate for Payer: Mclaren Medicaid	$928.47
Rate for Payer: Meridian Medicaid	$974.89
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,385.00
Rate for Payer: Priority Health Choice Medicaid	$928.47
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$2,466.27
Rate for Payer: Priority Health Narrow/Tiered Network	$2,466.27
Rate for Payer: UHC Medicaid	$928.47
Rate for Payer: UHCCP Medicaid	$928.47

PR OSTEOTOMY SPINE W/DSC ANT APPR 1 VRT SGM CRV

Professional

Both

$3,389.00

Service Code	HCPCS 22220
Min. Negotiated Rate	$994.07
Max. Negotiated Rate	$2,718.38
Rate for Payer: Aetna Commercial	$2,167.65
Rate for Payer: Aetna Medicare	$1,694.50
Rate for Payer: BCBS Complete	$1,043.77
Rate for Payer: BCN Commercial	$2,718.38
Rate for Payer: Cash Price	$2,711.20
Rate for Payer: Cash Price	$2,711.20
Rate for Payer: Mclaren Medicaid	$994.07
Rate for Payer: Meridian Medicaid	$1,043.77
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,541.75
Rate for Payer: Priority Health Choice Medicaid	$994.07
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$2,645.14
Rate for Payer: Priority Health Narrow/Tiered Network	$2,645.14
Rate for Payer: UHC Medicaid	$994.07
Rate for Payer: UHCCP Medicaid	$994.07

PR OSTEOTOMY SPINE W/DSC ANT APPR 1 VRT SGM EA ADDL

Professional

Both

$689.00

Service Code	HCPCS 22226
Min. Negotiated Rate	$203.84
Max. Negotiated Rate	$591.38
Rate for Payer: Aetna Commercial	$486.64
Rate for Payer: Aetna Medicare	$344.50
Rate for Payer: BCBS Complete	$214.03
Rate for Payer: BCN Commercial	$591.38
Rate for Payer: Cash Price	$551.20
Rate for Payer: Cash Price	$551.20
Rate for Payer: Mclaren Medicaid	$203.84
Rate for Payer: Meridian Medicaid	$214.03
Rate for Payer: Opus (Opus Packaging Group) HMA	$516.75
Rate for Payer: Priority Health Choice Medicaid	$203.84
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$575.45
Rate for Payer: Priority Health Narrow/Tiered Network	$575.45
Rate for Payer: UHC Medicaid	$203.84
Rate for Payer: UHCCP Medicaid	$203.84

PR OSTEOTOMY SPINE W/DSC ANT APPR 1 VRT SGM LUMBAR

Professional

Both

$3,378.00

Service Code	HCPCS 22224
Min. Negotiated Rate	$944.02
Max. Negotiated Rate	$2,570.61
Rate for Payer: Aetna Commercial	$2,126.35
Rate for Payer: Aetna Medicare	$1,689.00
Rate for Payer: BCBS Complete	$991.22
Rate for Payer: BCN Commercial	$2,404.75
Rate for Payer: Cash Price	$2,702.40
Rate for Payer: Cash Price	$2,702.40
Rate for Payer: Mclaren Medicaid	$944.02
Rate for Payer: Meridian Medicaid	$991.22
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,533.50
Rate for Payer: Priority Health Choice Medicaid	$944.02
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$2,570.61
Rate for Payer: Priority Health Narrow/Tiered Network	$2,570.61
Rate for Payer: UHC Medicaid	$944.02
Rate for Payer: UHCCP Medicaid	$944.02

PR OSTEOTOMY TARSAL BONES OTH/THN CALCANEUS/TALUS

Professional

Both

$1,561.00

Service Code	HCPCS 28304
Min. Negotiated Rate	$370.83
Max. Negotiated Rate	$1,170.75
Rate for Payer: Aetna Commercial	$807.84
Rate for Payer: Aetna Medicare	$780.50
Rate for Payer: BCBS Complete	$389.37
Rate for Payer: BCN Commercial	$934.71
Rate for Payer: Cash Price	$1,248.80
Rate for Payer: Cash Price	$1,248.80
Rate for Payer: Mclaren Medicaid	$370.83
Rate for Payer: Meridian Medicaid	$389.37
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,170.75
Rate for Payer: Priority Health Choice Medicaid	$370.83
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$999.17
Rate for Payer: Priority Health Narrow/Tiered Network	$999.17
Rate for Payer: UHC Medicaid	$370.83
Rate for Payer: UHCCP Medicaid	$370.83

PR OSTEOTOMY TIBIA

Professional

Both

$3,127.00

Service Code	HCPCS 27705
Min. Negotiated Rate	$441.76
Max. Negotiated Rate	$2,345.25
Rate for Payer: Aetna Commercial	$1,009.73
Rate for Payer: Aetna Medicare	$1,563.50
Rate for Payer: BCBS Complete	$463.85
Rate for Payer: BCN Commercial	$1,129.92
Rate for Payer: Cash Price	$2,501.60
Rate for Payer: Cash Price	$2,501.60
Rate for Payer: Mclaren Medicaid	$441.76
Rate for Payer: Meridian Medicaid	$463.85
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,345.25
Rate for Payer: Priority Health Choice Medicaid	$441.76
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,207.85
Rate for Payer: Priority Health Narrow/Tiered Network	$1,207.85
Rate for Payer: UHC Medicaid	$441.76
Rate for Payer: UHCCP Medicaid	$441.76

PR OSTEOTOMY TIBIA & FIBULA

Professional

Both

$3,573.00

Service Code	HCPCS 27709
Min. Negotiated Rate	$670.31
Max. Negotiated Rate	$2,679.75
Rate for Payer: Aetna Commercial	$1,543.67
Rate for Payer: Aetna Medicare	$1,786.50
Rate for Payer: BCBS Complete	$703.83
Rate for Payer: BCN Commercial	$1,725.01
Rate for Payer: Cash Price	$2,858.40
Rate for Payer: Cash Price	$2,858.40
Rate for Payer: Mclaren Medicaid	$670.31
Rate for Payer: Meridian Medicaid	$703.83
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,679.75
Rate for Payer: Priority Health Choice Medicaid	$670.31
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,843.98
Rate for Payer: Priority Health Narrow/Tiered Network	$1,843.98
Rate for Payer: UHC Medicaid	$670.31
Rate for Payer: UHCCP Medicaid	$670.31

PR OSTEOTOMY&TRANSFER GREATER TROCHANTER SPX

Professional

Both

$3,259.00

Service Code	HCPCS 27140
Min. Negotiated Rate	$529.52
Max. Negotiated Rate	$2,444.25
Rate for Payer: Aetna Commercial	$1,192.72
Rate for Payer: Aetna Medicare	$1,629.50
Rate for Payer: BCBS Complete	$556.00
Rate for Payer: BCN Commercial	$1,364.46
Rate for Payer: Cash Price	$2,607.20
Rate for Payer: Cash Price	$2,607.20
Rate for Payer: Mclaren Medicaid	$529.52
Rate for Payer: Meridian Medicaid	$556.00
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,444.25
Rate for Payer: Priority Health Choice Medicaid	$529.52
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,458.57
Rate for Payer: Priority Health Narrow/Tiered Network	$1,458.57
Rate for Payer: UHC Medicaid	$529.52
Rate for Payer: UHCCP Medicaid	$529.52

PR OSTEOTOMY ULNA

Professional

Both

$2,295.00

Service Code	HCPCS 25360
Min. Negotiated Rate	$388.94
Max. Negotiated Rate	$1,721.25
Rate for Payer: Aetna Commercial	$871.38
Rate for Payer: Aetna Medicare	$1,147.50
Rate for Payer: BCBS Complete	$408.39
Rate for Payer: BCN Commercial	$1,006.42
Rate for Payer: Cash Price	$1,836.00
Rate for Payer: Cash Price	$1,836.00
Rate for Payer: Mclaren Medicaid	$388.94
Rate for Payer: Meridian Medicaid	$408.39
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,721.25
Rate for Payer: Priority Health Choice Medicaid	$388.94
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,075.83
Rate for Payer: Priority Health Narrow/Tiered Network	$1,075.83
Rate for Payer: UHC Medicaid	$388.94
Rate for Payer: UHCCP Medicaid	$388.94

PR OSTEOT PROX TIBIA FIB EXC/OSTEOT AFTER EPIPHYSL

Professional

Both

$2,805.00

Service Code	HCPCS 27457
Min. Negotiated Rate	$561.26
Max. Negotiated Rate	$2,103.75
Rate for Payer: Aetna Commercial	$1,285.67
Rate for Payer: Aetna Medicare	$1,402.50
Rate for Payer: BCBS Complete	$589.32
Rate for Payer: BCN Commercial	$1,449.13
Rate for Payer: Cash Price	$2,244.00
Rate for Payer: Cash Price	$2,244.00
Rate for Payer: Mclaren Medicaid	$561.26
Rate for Payer: Meridian Medicaid	$589.32
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,103.75
Rate for Payer: Priority Health Choice Medicaid	$561.26
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,549.07
Rate for Payer: Priority Health Narrow/Tiered Network	$1,549.07
Rate for Payer: UHC Medicaid	$561.26
Rate for Payer: UHCCP Medicaid	$561.26

PR OSTEOT PROX TIBIA FIB EXC/OSTEOT BEFORE EPIPHYSL

Professional

Both

$2,094.00

Service Code	HCPCS 27455
Min. Negotiated Rate	$569.35
Max. Negotiated Rate	$1,570.50
Rate for Payer: Aetna Commercial	$1,279.84
Rate for Payer: Aetna Medicare	$1,047.00
Rate for Payer: BCBS Complete	$597.82
Rate for Payer: BCN Commercial	$1,458.09
Rate for Payer: Cash Price	$1,675.20
Rate for Payer: Cash Price	$1,675.20
Rate for Payer: Mclaren Medicaid	$569.35
Rate for Payer: Meridian Medicaid	$597.82
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,570.50
Rate for Payer: Priority Health Choice Medicaid	$569.35
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,558.66
Rate for Payer: Priority Health Narrow/Tiered Network	$1,558.66
Rate for Payer: UHC Medicaid	$569.35
Rate for Payer: UHCCP Medicaid	$569.35

PR OSTEOT SHRT CORRJ OTH PHALANGES ANY TOE

Professional

Both

$835.00

Service Code	HCPCS 28312
Min. Negotiated Rate	$221.09
Max. Negotiated Rate	$626.25
Rate for Payer: Aetna Commercial	$424.19
Rate for Payer: Aetna Medicare	$417.50
Rate for Payer: BCBS Complete	$232.14
Rate for Payer: BCN Commercial	$541.80
Rate for Payer: Cash Price	$668.00
Rate for Payer: Cash Price	$668.00
Rate for Payer: Mclaren Medicaid	$221.09
Rate for Payer: Meridian Medicaid	$232.14
Rate for Payer: Opus (Opus Packaging Group) HMA	$626.25
Rate for Payer: Priority Health Choice Medicaid	$221.09
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$579.17
Rate for Payer: Priority Health Narrow/Tiered Network	$579.17
Rate for Payer: UHC Medicaid	$221.09
Rate for Payer: UHCCP Medicaid	$221.09

PR OSTEOT SHRT CORRJ PROX PHALANX 1ST TOE

Professional

Both

$985.00

Service Code	HCPCS 28310
Min. Negotiated Rate	$223.01
Max. Negotiated Rate	$738.75
Rate for Payer: Aetna Commercial	$478.50
Rate for Payer: Aetna Medicare	$492.50
Rate for Payer: BCBS Complete	$234.16
Rate for Payer: BCN Commercial	$558.23
Rate for Payer: Cash Price	$788.00
Rate for Payer: Cash Price	$788.00
Rate for Payer: Mclaren Medicaid	$223.01
Rate for Payer: Meridian Medicaid	$234.16
Rate for Payer: Opus (Opus Packaging Group) HMA	$738.75
Rate for Payer: Priority Health Choice Medicaid	$223.01
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$596.73
Rate for Payer: Priority Health Narrow/Tiered Network	$596.73
Rate for Payer: UHC Medicaid	$223.01
Rate for Payer: UHCCP Medicaid	$223.01

PR OSTEOT SPI PST/PSTLAT APPR 1 VRT SGM EA VRT SGM

Professional

Both

$2,716.00

Service Code	HCPCS 22216
Min. Negotiated Rate	$204.48
Max. Negotiated Rate	$2,037.00
Rate for Payer: Aetna Commercial	$489.31
Rate for Payer: Aetna Medicare	$1,358.00
Rate for Payer: BCBS Complete	$214.70
Rate for Payer: BCN Commercial	$596.31
Rate for Payer: Cash Price	$2,172.80
Rate for Payer: Cash Price	$2,172.80
Rate for Payer: Mclaren Medicaid	$204.48
Rate for Payer: Meridian Medicaid	$214.70
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,037.00
Rate for Payer: Priority Health Choice Medicaid	$204.48
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$580.24
Rate for Payer: Priority Health Narrow/Tiered Network	$580.24
Rate for Payer: UHC Medicaid	$204.48
Rate for Payer: UHCCP Medicaid	$204.48

PR OSTEOT TARSAL OTH/THN CALCANEUS/TALUS W/AGRFT

Professional

Both

$1,774.00

Service Code	HCPCS 28305
Min. Negotiated Rate	$398.74
Max. Negotiated Rate	$1,330.50
Rate for Payer: Aetna Commercial	$901.63
Rate for Payer: Aetna Medicare	$887.00
Rate for Payer: BCBS Complete	$418.68
Rate for Payer: BCN Commercial	$1,019.86
Rate for Payer: Cash Price	$1,419.20
Rate for Payer: Cash Price	$1,419.20
Rate for Payer: Mclaren Medicaid	$398.74
Rate for Payer: Meridian Medicaid	$418.68
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,330.50
Rate for Payer: Priority Health Choice Medicaid	$398.74
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,090.21
Rate for Payer: Priority Health Narrow/Tiered Network	$1,090.21
Rate for Payer: UHC Medicaid	$398.74
Rate for Payer: UHCCP Medicaid	$398.74

PR OSTEOT W/WO LNGTH SHRT/ANGULAR CORRJ METAR MLT

Professional

Both

$4,081.00

Service Code	HCPCS 28309
Min. Negotiated Rate	$532.93
Max. Negotiated Rate	$3,060.75
Rate for Payer: Aetna Commercial	$1,184.22
Rate for Payer: Aetna Medicare	$2,040.50
Rate for Payer: BCBS Complete	$559.58
Rate for Payer: BCN Commercial	$1,371.44
Rate for Payer: Cash Price	$3,264.80
Rate for Payer: Cash Price	$3,264.80
Rate for Payer: Mclaren Medicaid	$532.93
Rate for Payer: Meridian Medicaid	$559.58
Rate for Payer: Opus (Opus Packaging Group) HMA	$3,060.75
Rate for Payer: Priority Health Choice Medicaid	$532.93
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,466.03
Rate for Payer: Priority Health Narrow/Tiered Network	$1,466.03
Rate for Payer: UHC Medicaid	$532.93
Rate for Payer: UHCCP Medicaid	$532.93

PR OSTEOT W/WO LNGTH SHRT/CORRJ 1ST METAR

Professional

Both

$1,460.00

Service Code	HCPCS 28306
Min. Negotiated Rate	$246.02
Max. Negotiated Rate	$1,095.00
Rate for Payer: Aetna Commercial	$529.18
Rate for Payer: Aetna Medicare	$730.00
Rate for Payer: BCBS Complete	$258.32
Rate for Payer: BCN Commercial	$618.99
Rate for Payer: Cash Price	$1,168.00
Rate for Payer: Cash Price	$1,168.00
Rate for Payer: Mclaren Medicaid	$246.02
Rate for Payer: Meridian Medicaid	$258.32
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,095.00
Rate for Payer: Priority Health Choice Medicaid	$246.02
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$661.69
Rate for Payer: Priority Health Narrow/Tiered Network	$661.69
Rate for Payer: UHC Medicaid	$246.02
Rate for Payer: UHCCP Medicaid	$246.02

Know your out-of-pocket cost for care.

All Charges