Bronson Lakeview Hospital

All Charges

Charge

Type

Setting

Price

PR REPAIR MYELOMENINGOCELE > 5 CM DIAMETER

Professional

Both

$5,522.00

Service Code	HCPCS 63706
Min. Negotiated Rate	$1,172.99
Max. Negotiated Rate	$4,141.50
Rate for Payer: Aetna Commercial	$2,385.55
Rate for Payer: Aetna Medicare	$2,761.00
Rate for Payer: BCBS Complete	$1,231.64
Rate for Payer: BCN Commercial	$2,831.02
Rate for Payer: Cash Price	$4,417.60
Rate for Payer: Cash Price	$4,417.60
Rate for Payer: Mclaren Medicaid	$1,172.99
Rate for Payer: Meridian Medicaid	$1,231.64
Rate for Payer: Opus (Opus Packaging Group) HMA	$4,141.50
Rate for Payer: Priority Health Choice Medicaid	$1,172.99
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$3,288.18
Rate for Payer: Priority Health Narrow/Tiered Network	$3,288.18
Rate for Payer: UHC Medicaid	$1,172.99
Rate for Payer: UHCCP Medicaid	$1,172.99

PR REPAIR NAIL BED

Professional

Both

$408.00

Service Code	HCPCS 11760
Min. Negotiated Rate	$66.24
Max. Negotiated Rate	$306.00
Rate for Payer: Aetna Commercial	$116.65
Rate for Payer: Aetna Medicare	$204.00
Rate for Payer: BCBS Complete	$69.55
Rate for Payer: BCN Commercial	$164.34
Rate for Payer: Cash Price	$326.40
Rate for Payer: Cash Price	$326.40
Rate for Payer: Mclaren Medicaid	$66.24
Rate for Payer: Meridian Medicaid	$69.55
Rate for Payer: Opus (Opus Packaging Group) HMA	$306.00
Rate for Payer: Priority Health Choice Medicaid	$66.24
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$150.40
Rate for Payer: Priority Health Narrow/Tiered Network	$150.40
Rate for Payer: UHC Medicaid	$66.24
Rate for Payer: UHCCP Medicaid	$66.24

PR REPAIR NASAL SEPTAL PERFORATIONS

Professional

Both

$1,870.00

Service Code	HCPCS 30630
Min. Negotiated Rate	$387.66
Max. Negotiated Rate	$1,402.50
Rate for Payer: Aetna Commercial	$847.07
Rate for Payer: Aetna Medicare	$935.00
Rate for Payer: BCBS Complete	$407.04
Rate for Payer: BCN Commercial	$998.95
Rate for Payer: Cash Price	$1,496.00
Rate for Payer: Cash Price	$1,496.00
Rate for Payer: Mclaren Medicaid	$387.66
Rate for Payer: Meridian Medicaid	$407.04
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,402.50
Rate for Payer: Priority Health Choice Medicaid	$387.66
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$940.71
Rate for Payer: Priority Health Narrow/Tiered Network	$940.71
Rate for Payer: UHC Medicaid	$387.66
Rate for Payer: UHCCP Medicaid	$387.66

PR REPAIR NASAL VESTIBULAR STENOSIS

Professional

Both

$1,738.00

Service Code	HCPCS 30465
Min. Negotiated Rate	$588.52
Max. Negotiated Rate	$1,530.79
Rate for Payer: Aetna Commercial	$1,304.87
Rate for Payer: Aetna Medicare	$869.00
Rate for Payer: BCBS Complete	$617.95
Rate for Payer: BCN Commercial	$1,530.79
Rate for Payer: Cash Price	$1,390.40
Rate for Payer: Cash Price	$1,390.40
Rate for Payer: Mclaren Medicaid	$588.52
Rate for Payer: Meridian Medicaid	$617.95
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,303.50
Rate for Payer: Priority Health Choice Medicaid	$588.52
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,441.55
Rate for Payer: Priority Health Narrow/Tiered Network	$1,441.55
Rate for Payer: UHC Medicaid	$588.52
Rate for Payer: UHCCP Medicaid	$588.52

PR REPAIR NON/MALUNION HUMERUS W/ILIAC/OTH AGRFT

Professional

Both

$4,740.00

Service Code	HCPCS 24435
Min. Negotiated Rate	$640.28
Max. Negotiated Rate	$3,555.00
Rate for Payer: Aetna Commercial	$1,440.34
Rate for Payer: Aetna Medicare	$2,370.00
Rate for Payer: BCBS Complete	$672.29
Rate for Payer: BCN Commercial	$1,642.84
Rate for Payer: Cash Price	$3,792.00
Rate for Payer: Cash Price	$3,792.00
Rate for Payer: Mclaren Medicaid	$640.28
Rate for Payer: Meridian Medicaid	$672.29
Rate for Payer: Opus (Opus Packaging Group) HMA	$3,555.00
Rate for Payer: Priority Health Choice Medicaid	$640.28
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,756.15
Rate for Payer: Priority Health Narrow/Tiered Network	$1,756.15
Rate for Payer: UHC Medicaid	$640.28
Rate for Payer: UHCCP Medicaid	$640.28

PR REPAIR NON/MALUNION HUMERUS W/O GRAFT

Professional

Both

$2,978.00

Service Code	HCPCS 24430
Min. Negotiated Rate	$618.34
Max. Negotiated Rate	$2,233.50
Rate for Payer: Aetna Commercial	$1,409.77
Rate for Payer: Aetna Medicare	$1,489.00
Rate for Payer: BCBS Complete	$649.26
Rate for Payer: BCN Commercial	$1,603.50
Rate for Payer: Cash Price	$2,382.40
Rate for Payer: Cash Price	$2,382.40
Rate for Payer: Mclaren Medicaid	$618.34
Rate for Payer: Meridian Medicaid	$649.26
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,233.50
Rate for Payer: Priority Health Choice Medicaid	$618.34
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,714.10
Rate for Payer: Priority Health Narrow/Tiered Network	$1,714.10
Rate for Payer: UHC Medicaid	$618.34
Rate for Payer: UHCCP Medicaid	$618.34

PR REPAIR NONUNION CARPAL BONE EACH BONE

Professional

Both

$1,443.00

Service Code	HCPCS 25431
Min. Negotiated Rate	$471.16
Max. Negotiated Rate	$1,287.17
Rate for Payer: Aetna Commercial	$1,052.49
Rate for Payer: Aetna Medicare	$721.50
Rate for Payer: BCBS Complete	$494.72
Rate for Payer: BCN Commercial	$1,204.12
Rate for Payer: Cash Price	$1,154.40
Rate for Payer: Cash Price	$1,154.40
Rate for Payer: Mclaren Medicaid	$471.16
Rate for Payer: Meridian Medicaid	$494.72
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,082.25
Rate for Payer: Priority Health Choice Medicaid	$471.16
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,287.17
Rate for Payer: Priority Health Narrow/Tiered Network	$1,287.17
Rate for Payer: UHC Medicaid	$471.16
Rate for Payer: UHCCP Medicaid	$471.16

PR REPAIR NONUNION/MALUNION TARSAL BONES

Professional

Both

$1,358.00

Service Code	HCPCS 28320
Min. Negotiated Rate	$368.49
Max. Negotiated Rate	$1,018.50
Rate for Payer: Aetna Commercial	$821.23
Rate for Payer: Aetna Medicare	$679.00
Rate for Payer: BCBS Complete	$386.91
Rate for Payer: BCN Commercial	$935.21
Rate for Payer: Cash Price	$1,086.40
Rate for Payer: Cash Price	$1,086.40
Rate for Payer: Mclaren Medicaid	$368.49
Rate for Payer: Meridian Medicaid	$386.91
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,018.50
Rate for Payer: Priority Health Choice Medicaid	$368.49
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$999.72
Rate for Payer: Priority Health Narrow/Tiered Network	$999.72
Rate for Payer: UHC Medicaid	$368.49
Rate for Payer: UHCCP Medicaid	$368.49

PR REPAIR NONUNION/MALUNION TIBIA W/O GRAFT

Professional

Both

$4,020.00

Service Code	HCPCS 27720
Min. Negotiated Rate	$517.38
Max. Negotiated Rate	$3,015.00
Rate for Payer: Aetna Commercial	$1,167.83
Rate for Payer: Aetna Medicare	$2,010.00
Rate for Payer: BCBS Complete	$543.25
Rate for Payer: BCN Commercial	$1,327.62
Rate for Payer: Cash Price	$3,216.00
Rate for Payer: Cash Price	$3,216.00
Rate for Payer: Mclaren Medicaid	$517.38
Rate for Payer: Meridian Medicaid	$543.25
Rate for Payer: Opus (Opus Packaging Group) HMA	$3,015.00
Rate for Payer: Priority Health Choice Medicaid	$517.38
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,419.19
Rate for Payer: Priority Health Narrow/Tiered Network	$1,419.19
Rate for Payer: UHC Medicaid	$517.38
Rate for Payer: UHCCP Medicaid	$517.38

PR REPAIR NONUNION/MALUNION TIBIA W/SLIDING GRAFT

Professional

Both

$3,942.00

Service Code	HCPCS 27722
Min. Negotiated Rate	$531.44
Max. Negotiated Rate	$2,956.50
Rate for Payer: Aetna Commercial	$1,193.91
Rate for Payer: Aetna Medicare	$1,971.00
Rate for Payer: BCBS Complete	$558.01
Rate for Payer: BCN Commercial	$1,362.98
Rate for Payer: Cash Price	$3,153.60
Rate for Payer: Cash Price	$3,153.60
Rate for Payer: Mclaren Medicaid	$531.44
Rate for Payer: Meridian Medicaid	$558.01
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,956.50
Rate for Payer: Priority Health Choice Medicaid	$531.44
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,456.97
Rate for Payer: Priority Health Narrow/Tiered Network	$1,456.97
Rate for Payer: UHC Medicaid	$531.44
Rate for Payer: UHCCP Medicaid	$531.44

PR REPAIR OF TRAUMATIC CORPOREAL TEAR(S)

Professional

Both

$1,430.00

Service Code	HCPCS 54437
Min. Negotiated Rate	$395.12
Max. Negotiated Rate	$1,112.60
Rate for Payer: Aetna Commercial	$867.12
Rate for Payer: Aetna Medicare	$715.00
Rate for Payer: BCBS Complete	$414.88
Rate for Payer: BCN Commercial	$1,021.36
Rate for Payer: Cash Price	$1,144.00
Rate for Payer: Cash Price	$1,144.00
Rate for Payer: Mclaren Medicaid	$395.12
Rate for Payer: Meridian Medicaid	$414.88
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,072.50
Rate for Payer: Priority Health Choice Medicaid	$395.12
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,112.60
Rate for Payer: Priority Health Narrow/Tiered Network	$1,112.60
Rate for Payer: UHC Medicaid	$395.12
Rate for Payer: UHCCP Medicaid	$395.12

PR REPAIR PATENT DUCTUS ARTERIOSUS BY LIGATION

Professional

Both

$4,534.00

Service Code	HCPCS 33820
Min. Negotiated Rate	$590.01
Max. Negotiated Rate	$3,400.50
Rate for Payer: Aetna Commercial	$1,297.11
Rate for Payer: Aetna Medicare	$2,267.00
Rate for Payer: BCBS Complete	$619.51
Rate for Payer: BCN Commercial	$1,433.69
Rate for Payer: Cash Price	$3,627.20
Rate for Payer: Cash Price	$3,627.20
Rate for Payer: Mclaren Medicaid	$590.01
Rate for Payer: Meridian Medicaid	$619.51
Rate for Payer: Opus (Opus Packaging Group) HMA	$3,400.50
Rate for Payer: Priority Health Choice Medicaid	$590.01
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,541.76
Rate for Payer: Priority Health Narrow/Tiered Network	$1,541.76
Rate for Payer: UHC Medicaid	$590.01
Rate for Payer: UHCCP Medicaid	$590.01

PR REPAIR PECTUS EXCAVATM/CARINATM MINLY W/THRSC

Professional

Both

$4,265.00

Service Code	HCPCS 21743
Min. Negotiated Rate	$421.31
Max. Negotiated Rate	$3,198.75
Rate for Payer: Aetna Commercial	$2,118.84
Rate for Payer: Aetna Medicare	$2,132.50
Rate for Payer: BCBS Complete	$442.38
Rate for Payer: BCN Commercial	$3,033.71
Rate for Payer: Cash Price	$3,412.00
Rate for Payer: Cash Price	$3,412.00
Rate for Payer: Mclaren Medicaid	$421.31
Rate for Payer: Meridian Medicaid	$442.38
Rate for Payer: Opus (Opus Packaging Group) HMA	$3,198.75
Rate for Payer: Priority Health Choice Medicaid	$421.31
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$2,544.00
Rate for Payer: Priority Health Narrow/Tiered Network	$2,544.00
Rate for Payer: UHC Medicaid	$421.31
Rate for Payer: UHCCP Medicaid	$421.31

PR REPAIR PECTUS EXCAVATUM/CARINATUM OPEN

Professional

Both

$4,265.00

Service Code	HCPCS 21740
Min. Negotiated Rate	$631.12
Max. Negotiated Rate	$3,198.75
Rate for Payer: Aetna Commercial	$1,381.26
Rate for Payer: Aetna Medicare	$2,132.50
Rate for Payer: BCBS Complete	$662.68
Rate for Payer: BCN Commercial	$1,530.30
Rate for Payer: Cash Price	$3,412.00
Rate for Payer: Cash Price	$3,412.00
Rate for Payer: Mclaren Medicaid	$631.12
Rate for Payer: Meridian Medicaid	$662.68
Rate for Payer: Opus (Opus Packaging Group) HMA	$3,198.75
Rate for Payer: Priority Health Choice Medicaid	$631.12
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,635.85
Rate for Payer: Priority Health Narrow/Tiered Network	$1,635.85
Rate for Payer: UHC Medicaid	$631.12
Rate for Payer: UHCCP Medicaid	$631.12

PR REPAIR PRIMARY OPEN/PRQ RUPTURED ACHILLES TENDON

Professional

Both

$2,680.00

Service Code	HCPCS 27650
Min. Negotiated Rate	$398.10
Max. Negotiated Rate	$2,010.00
Rate for Payer: Aetna Commercial	$877.03
Rate for Payer: Aetna Medicare	$1,340.00
Rate for Payer: BCBS Complete	$418.00
Rate for Payer: BCN Commercial	$1,102.89
Rate for Payer: Cash Price	$2,144.00
Rate for Payer: Cash Price	$2,144.00
Rate for Payer: Mclaren Medicaid	$398.10
Rate for Payer: Meridian Medicaid	$418.00
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,010.00
Rate for Payer: Priority Health Choice Medicaid	$398.10
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,073.18
Rate for Payer: Priority Health Narrow/Tiered Network	$1,073.18
Rate for Payer: UHC Medicaid	$398.10
Rate for Payer: UHCCP Medicaid	$398.10

PR REPAIR PRIMARY TORN LIGM&/CAPSULE KNEE CRUCIAT

Professional

Both

$1,868.00

Service Code	HCPCS 27407
Min. Negotiated Rate	$477.12
Max. Negotiated Rate	$1,401.00
Rate for Payer: Aetna Commercial	$1,063.01
Rate for Payer: Aetna Medicare	$934.00
Rate for Payer: BCBS Complete	$500.98
Rate for Payer: BCN Commercial	$1,218.06
Rate for Payer: Cash Price	$1,494.40
Rate for Payer: Cash Price	$1,494.40
Rate for Payer: Mclaren Medicaid	$477.12
Rate for Payer: Meridian Medicaid	$500.98
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,401.00
Rate for Payer: Priority Health Choice Medicaid	$477.12
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,302.08
Rate for Payer: Priority Health Narrow/Tiered Network	$1,302.08
Rate for Payer: UHC Medicaid	$477.12
Rate for Payer: UHCCP Medicaid	$477.12

PR REPAIR RECTOCELE SEPARATE PROCEDURE

Professional

Both

$1,327.00

Service Code	HCPCS 45560
Min. Negotiated Rate	$404.06
Max. Negotiated Rate	$1,265.08
Rate for Payer: Aetna Commercial	$927.04
Rate for Payer: Aetna Medicare	$663.50
Rate for Payer: BCBS Complete	$424.26
Rate for Payer: BCN Commercial	$1,038.29
Rate for Payer: Cash Price	$1,061.60
Rate for Payer: Cash Price	$1,061.60
Rate for Payer: Mclaren Medicaid	$404.06
Rate for Payer: Meridian Medicaid	$424.26
Rate for Payer: Opus (Opus Packaging Group) HMA	$995.25
Rate for Payer: Priority Health Choice Medicaid	$404.06
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,265.08
Rate for Payer: Priority Health Narrow/Tiered Network	$1,265.08
Rate for Payer: UHC Medicaid	$404.06
Rate for Payer: UHCCP Medicaid	$404.06

PR REPAIR SECONDARY ACHILLES TENDON W/WO GRAFT

Professional

Both

$2,858.00

Service Code	HCPCS 27654
Min. Negotiated Rate	$431.11
Max. Negotiated Rate	$2,143.50
Rate for Payer: Aetna Commercial	$947.16
Rate for Payer: Aetna Medicare	$1,429.00
Rate for Payer: BCBS Complete	$452.67
Rate for Payer: BCN Commercial	$1,092.07
Rate for Payer: Cash Price	$2,286.40
Rate for Payer: Cash Price	$2,286.40
Rate for Payer: Mclaren Medicaid	$431.11
Rate for Payer: Meridian Medicaid	$452.67
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,143.50
Rate for Payer: Priority Health Choice Medicaid	$431.11
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,167.40
Rate for Payer: Priority Health Narrow/Tiered Network	$1,167.40
Rate for Payer: UHC Medicaid	$431.11
Rate for Payer: UHCCP Medicaid	$431.11

PR REPAIR SECONDARY DISRUPTED LIGAMENT ANKLE COLTRL

Professional

Both

$3,083.00

Service Code	HCPCS 27698
Min. Negotiated Rate	$380.63
Max. Negotiated Rate	$2,312.25
Rate for Payer: Aetna Commercial	$851.31
Rate for Payer: Aetna Medicare	$1,541.50
Rate for Payer: BCBS Complete	$399.66
Rate for Payer: BCN Commercial	$970.06
Rate for Payer: Cash Price	$2,466.40
Rate for Payer: Cash Price	$2,466.40
Rate for Payer: Mclaren Medicaid	$380.63
Rate for Payer: Meridian Medicaid	$399.66
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,312.25
Rate for Payer: Priority Health Choice Medicaid	$380.63
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,036.97
Rate for Payer: Priority Health Narrow/Tiered Network	$1,036.97
Rate for Payer: UHC Medicaid	$380.63
Rate for Payer: UHCCP Medicaid	$380.63

PR REPAIR SYNDACTYLY EACH SPACE COMPLEX

Professional

Both

$2,329.00

Service Code	HCPCS 26562
Min. Negotiated Rate	$835.17
Max. Negotiated Rate	$2,223.00
Rate for Payer: Aetna Commercial	$1,830.63
Rate for Payer: Aetna Medicare	$1,164.50
Rate for Payer: BCBS Complete	$876.93
Rate for Payer: BCN Commercial	$2,079.57
Rate for Payer: Cash Price	$1,863.20
Rate for Payer: Cash Price	$1,863.20
Rate for Payer: Mclaren Medicaid	$835.17
Rate for Payer: Meridian Medicaid	$876.93
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,746.75
Rate for Payer: Priority Health Choice Medicaid	$835.17
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$2,223.00
Rate for Payer: Priority Health Narrow/Tiered Network	$2,223.00
Rate for Payer: UHC Medicaid	$835.17
Rate for Payer: UHCCP Medicaid	$835.17

PR REPAIR SYNDACTYLY EACH SPACE W/SKIN FLAPS

Professional

Both

$2,042.00

Service Code	HCPCS 26560
Min. Negotiated Rate	$406.83
Max. Negotiated Rate	$1,531.50
Rate for Payer: Aetna Commercial	$838.58
Rate for Payer: Aetna Medicare	$1,021.00
Rate for Payer: BCBS Complete	$427.17
Rate for Payer: BCN Commercial	$959.61
Rate for Payer: Cash Price	$1,633.60
Rate for Payer: Cash Price	$1,633.60
Rate for Payer: Mclaren Medicaid	$406.83
Rate for Payer: Meridian Medicaid	$427.17
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,531.50
Rate for Payer: Priority Health Choice Medicaid	$406.83
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,025.80
Rate for Payer: Priority Health Narrow/Tiered Network	$1,025.80
Rate for Payer: UHC Medicaid	$406.83
Rate for Payer: UHCCP Medicaid	$406.83

PR REPAIR SYNDACTYLY EACH SPACE W/SKIN FLAPS&GRAFT

Professional

Both

$2,476.00

Service Code	HCPCS 26561
Min. Negotiated Rate	$603.43
Max. Negotiated Rate	$1,857.00
Rate for Payer: Aetna Commercial	$1,308.00
Rate for Payer: Aetna Medicare	$1,238.00
Rate for Payer: BCBS Complete	$633.60
Rate for Payer: BCN Commercial	$1,481.99
Rate for Payer: Cash Price	$1,980.80
Rate for Payer: Cash Price	$1,980.80
Rate for Payer: Mclaren Medicaid	$603.43
Rate for Payer: Meridian Medicaid	$633.60
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,857.00
Rate for Payer: Priority Health Choice Medicaid	$603.43
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,584.20
Rate for Payer: Priority Health Narrow/Tiered Network	$1,584.20
Rate for Payer: UHC Medicaid	$603.43
Rate for Payer: UHCCP Medicaid	$603.43

PR REPAIR TENDON EXTENSOR FOOT 1/2 EACH TENDON

Professional

Both

$784.00

Service Code	HCPCS 28208
Min. Negotiated Rate	$197.45
Max. Negotiated Rate	$588.00
Rate for Payer: Aetna Commercial	$419.67
Rate for Payer: Aetna Medicare	$392.00
Rate for Payer: BCBS Complete	$207.32
Rate for Payer: BCN Commercial	$488.02
Rate for Payer: Cash Price	$627.20
Rate for Payer: Cash Price	$627.20
Rate for Payer: Mclaren Medicaid	$197.45
Rate for Payer: Meridian Medicaid	$207.32
Rate for Payer: Opus (Opus Packaging Group) HMA	$588.00
Rate for Payer: Priority Health Choice Medicaid	$197.45
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$521.69
Rate for Payer: Priority Health Narrow/Tiered Network	$521.69
Rate for Payer: UHC Medicaid	$197.45
Rate for Payer: UHCCP Medicaid	$197.45

PR REPAIR TENDON/MUSCLE UPPER ARM/ELBOW EA TDN/MUSC

Professional

Both

$2,405.00

Service Code	HCPCS 24341
Min. Negotiated Rate	$451.56
Max. Negotiated Rate	$1,803.75
Rate for Payer: Aetna Commercial	$990.50
Rate for Payer: Aetna Medicare	$1,202.50
Rate for Payer: BCBS Complete	$474.14
Rate for Payer: BCN Commercial	$1,148.35
Rate for Payer: Cash Price	$1,924.00
Rate for Payer: Cash Price	$1,924.00
Rate for Payer: Mclaren Medicaid	$451.56
Rate for Payer: Meridian Medicaid	$474.14
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,803.75
Rate for Payer: Priority Health Choice Medicaid	$451.56
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,227.55
Rate for Payer: Priority Health Narrow/Tiered Network	$1,227.55
Rate for Payer: UHC Medicaid	$451.56
Rate for Payer: UHCCP Medicaid	$451.56

PR REPLACE AORTIC VALVE OPEN AXILLRY ARTRY APPROACH

Professional

Both

$2,651.00

Service Code	HCPCS 33363
Min. Negotiated Rate	$778.73
Max. Negotiated Rate	$2,149.03
Rate for Payer: Aetna Commercial	$1,838.76
Rate for Payer: Aetna Medicare	$1,325.50
Rate for Payer: BCBS Complete	$817.67
Rate for Payer: BCN Commercial	$1,998.39
Rate for Payer: Cash Price	$2,120.80
Rate for Payer: Cash Price	$2,120.80
Rate for Payer: Mclaren Medicaid	$778.73
Rate for Payer: Meridian Medicaid	$817.67
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,988.25
Rate for Payer: Priority Health Choice Medicaid	$778.73
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$2,149.03
Rate for Payer: Priority Health Narrow/Tiered Network	$2,149.03
Rate for Payer: UHC Medicaid	$778.73
Rate for Payer: UHCCP Medicaid	$778.73

Know your out-of-pocket cost for care.

All Charges