Bronson Lakeview Hospital

All Charges

Charge

Type

Setting

Price

PR SHORTENING TENDON EXTENSOR HAND/FINGER EACH

Professional

Both

$1,244.00

Service Code	HCPCS 26477
Min. Negotiated Rate	$391.49
Max. Negotiated Rate	$1,014.08
Rate for Payer: Aetna Commercial	$822.68
Rate for Payer: Aetna Medicare	$622.00
Rate for Payer: BCBS Complete	$411.06
Rate for Payer: BCN Commercial	$948.65
Rate for Payer: Cash Price	$995.20
Rate for Payer: Cash Price	$995.20
Rate for Payer: Mclaren Medicaid	$391.49
Rate for Payer: Meridian Medicaid	$411.06
Rate for Payer: Opus (Opus Packaging Group) HMA	$933.00
Rate for Payer: Priority Health Choice Medicaid	$391.49
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,014.08
Rate for Payer: Priority Health Narrow/Tiered Network	$1,014.08
Rate for Payer: UHC Medicaid	$391.49
Rate for Payer: UHCCP Medicaid	$391.49

PR SHORT-LATENCY SOMATOSENS EP STD LWR LIMBS

Professional

Both

$327.00

Service Code	HCPCS 95926
Min. Negotiated Rate	$153.65
Max. Negotiated Rate	$245.25
Rate for Payer: Aetna Commercial	$153.65
Rate for Payer: Aetna Medicare	$163.50
Rate for Payer: BCN Commercial	$209.65
Rate for Payer: Cash Price	$261.60
Rate for Payer: Cash Price	$261.60
Rate for Payer: Opus (Opus Packaging Group) HMA	$245.25
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$193.34
Rate for Payer: Priority Health Narrow/Tiered Network	$193.34

PR SHORT-LATENCY SOMATOSENS EP STD TRNK/HEAD

Professional

Both

$297.00

Service Code	HCPCS 95927
Min. Negotiated Rate	$148.50
Max. Negotiated Rate	$263.44
Rate for Payer: Aetna Commercial	$150.85
Rate for Payer: Aetna Commercial	$150.85
Rate for Payer: Aetna Medicare	$148.50
Rate for Payer: Aetna Medicare	$103.50
Rate for Payer: BCN Commercial	$263.44
Rate for Payer: BCN Commercial	$263.44
Rate for Payer: Cash Price	$165.60
Rate for Payer: Cash Price	$165.60
Rate for Payer: Cash Price	$237.60
Rate for Payer: Cash Price	$237.60
Rate for Payer: Opus (Opus Packaging Group) HMA	$155.25
Rate for Payer: Opus (Opus Packaging Group) HMA	$222.75
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$242.94
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$242.94
Rate for Payer: Priority Health Narrow/Tiered Network	$242.94
Rate for Payer: Priority Health Narrow/Tiered Network	$242.94

PR SHORT-LATENCY SOMATOSENS EP STD UPR LIMBS

Professional

Both

$337.00

Service Code	HCPCS 95925
Min. Negotiated Rate	$166.52
Max. Negotiated Rate	$252.75
Rate for Payer: Aetna Commercial	$166.52
Rate for Payer: Aetna Medicare	$168.50
Rate for Payer: BCN Commercial	$229.08
Rate for Payer: Cash Price	$269.60
Rate for Payer: Cash Price	$269.60
Rate for Payer: Opus (Opus Packaging Group) HMA	$252.75
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$211.25
Rate for Payer: Priority Health Narrow/Tiered Network	$211.25

PR SHORT-LATENCY SOMATOSENS EP STD UPR & LOW LIMB

Professional

Both

$126.00

Service Code	HCPCS 95938
Min. Negotiated Rate	$63.00
Max. Negotiated Rate	$556.24
Rate for Payer: Aetna Commercial	$379.87
Rate for Payer: Aetna Medicare	$63.00
Rate for Payer: BCN Commercial	$556.24
Rate for Payer: Cash Price	$100.80
Rate for Payer: Cash Price	$100.80
Rate for Payer: Opus (Opus Packaging Group) HMA	$94.50
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$512.98
Rate for Payer: Priority Health Narrow/Tiered Network	$512.98

PR SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 0.6-1.0 CM

Professional

Both

$191.00

Service Code	HCPCS 11311
Min. Negotiated Rate	$32.38
Max. Negotiated Rate	$143.25
Rate for Payer: Aetna Commercial	$68.44
Rate for Payer: Aetna Medicare	$95.50
Rate for Payer: BCBS Complete	$34.00
Rate for Payer: BCN Commercial	$73.83
Rate for Payer: Cash Price	$152.80
Rate for Payer: Cash Price	$152.80
Rate for Payer: Mclaren Medicaid	$32.38
Rate for Payer: Meridian Medicaid	$34.00
Rate for Payer: Opus (Opus Packaging Group) HMA	$143.25
Rate for Payer: Priority Health Choice Medicaid	$32.38
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$85.68
Rate for Payer: Priority Health Narrow/Tiered Network	$85.68
Rate for Payer: UHC Medicaid	$32.38
Rate for Payer: UHCCP Medicaid	$32.38

PR SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 1.1-2.0 CM

Professional

Both

$274.00

Service Code	HCPCS 11312
Min. Negotiated Rate	$38.55
Max. Negotiated Rate	$205.50
Rate for Payer: Aetna Commercial	$80.68
Rate for Payer: Aetna Medicare	$137.00
Rate for Payer: BCBS Complete	$40.48
Rate for Payer: BCN Commercial	$87.57
Rate for Payer: Cash Price	$219.20
Rate for Payer: Cash Price	$219.20
Rate for Payer: Mclaren Medicaid	$38.55
Rate for Payer: Meridian Medicaid	$40.48
Rate for Payer: Opus (Opus Packaging Group) HMA	$205.50
Rate for Payer: Priority Health Choice Medicaid	$38.55
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$101.64
Rate for Payer: Priority Health Narrow/Tiered Network	$101.64
Rate for Payer: UHC Medicaid	$38.55
Rate for Payer: UHCCP Medicaid	$38.55

PR SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM

Professional

Both

$204.00

Service Code	HCPCS 11301
Hospital Charge Code	11301
Min. Negotiated Rate	$26.63
Max. Negotiated Rate	$153.00
Rate for Payer: Aetna Commercial	$55.41
Rate for Payer: Aetna Medicare	$102.00
Rate for Payer: BCBS Complete	$27.96
Rate for Payer: BCN Commercial	$60.48
Rate for Payer: Cash Price	$163.20
Rate for Payer: Cash Price	$163.20
Rate for Payer: Mclaren Medicaid	$26.63
Rate for Payer: Meridian Medicaid	$27.96
Rate for Payer: Opus (Opus Packaging Group) HMA	$153.00
Rate for Payer: Priority Health Choice Medicaid	$26.63
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$70.19
Rate for Payer: Priority Health Narrow/Tiered Network	$70.19
Rate for Payer: UHC Medicaid	$26.63
Rate for Payer: UHCCP Medicaid	$26.63

PR SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM

Facility

$204.00

Service Code	CPT 11301
Hospital Charge Code	11301
Hospital Revenue Code	521
Min. Negotiated Rate	$141.98
Max. Negotiated Rate	$183.60
Rate for Payer: Aetna Commercial	$173.40
Rate for Payer: BCBS Trust/PPO	$168.48
Rate for Payer: BCN Commercial	$168.48
Rate for Payer: Cash Price	$163.20
Rate for Payer: Cofinity Commercial	$175.44
Rate for Payer: Encore Health Key Benefits Commercial	$163.20
Rate for Payer: Healthscope Commercial	$183.60
Rate for Payer: Lakeland Regional Health Systems Commercial	$153.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$173.40
Rate for Payer: Nomi Health Commercial	$167.28
Rate for Payer: Opus (Opus Packaging Group) HMA	$153.00
Rate for Payer: PHP Commercial	$173.40
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$177.48
Rate for Payer: Priority Health Narrow/Tiered Network	$141.98
Rate for Payer: UHC Core	$170.34
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$153.00

PR SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM

Facility

$204.00

Service Code	CPT 11301
Hospital Charge Code	11301
Hospital Revenue Code	521
Min. Negotiated Rate	$35.97
Max. Negotiated Rate	$183.60
Rate for Payer: Aetna Commercial	$173.40
Rate for Payer: Aetna Medicare	$53.04
Rate for Payer: Allen County Amish Medical Aid Commercial	$63.75
Rate for Payer: Amish Plain Church Group Commercial	$63.75
Rate for Payer: BCBS Complete	$37.76
Rate for Payer: BCBS MAPPO	$51.00
Rate for Payer: BCBS Trust/PPO	$167.71
Rate for Payer: BCN Commercial	$167.71
Rate for Payer: BCN Medicare Advantage	$51.00
Rate for Payer: Cash Price	$163.20
Rate for Payer: Cofinity Commercial	$175.44
Rate for Payer: Encore Health Key Benefits Commercial	$163.20
Rate for Payer: Health Alliance Plan Medicare Advantage	$51.00
Rate for Payer: Healthscope Commercial	$183.60
Rate for Payer: Lakeland Regional Health Systems Commercial	$153.00
Rate for Payer: Mclaren Medicaid	$35.97
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$53.55
Rate for Payer: Meridian Medicaid	$37.76
Rate for Payer: MI Amish Medical Board Commercial	$58.65
Rate for Payer: Molina Medicare/Medicaid	$56.10
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$173.40
Rate for Payer: Nomi Health Commercial	$167.28
Rate for Payer: Opus (Opus Packaging Group) HMA	$153.00
Rate for Payer: PACE Senior Care Partners	$48.45
Rate for Payer: PACE SWMI	$51.00
Rate for Payer: PHP Commercial	$173.40
Rate for Payer: PHP Medicare Advantage	$51.00
Rate for Payer: Priority Health Choice Medicaid	$35.97
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$177.48
Rate for Payer: Priority Health Medicare	$51.51
Rate for Payer: Priority Health Narrow/Tiered Network	$141.98
Rate for Payer: Railroad Medicare Medicare	$51.00
Rate for Payer: UHC Core	$170.34
Rate for Payer: UHC Exchange	$51.00
Rate for Payer: UHC Medicaid	$35.97
Rate for Payer: UHC Medicare Advantage	$51.00
Rate for Payer: UHCCP Medicaid	$35.97
Rate for Payer: VA VA	$51.00
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$153.00

PR SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM

Professional

Both

$204.00

Service Code	HCPCS 11301
Min. Negotiated Rate	$26.63
Max. Negotiated Rate	$153.00
Rate for Payer: Aetna Commercial	$55.41
Rate for Payer: Aetna Medicare	$102.00
Rate for Payer: BCBS Complete	$27.96
Rate for Payer: BCN Commercial	$60.48
Rate for Payer: Cash Price	$163.20
Rate for Payer: Cash Price	$163.20
Rate for Payer: Mclaren Medicaid	$26.63
Rate for Payer: Meridian Medicaid	$27.96
Rate for Payer: Opus (Opus Packaging Group) HMA	$153.00
Rate for Payer: Priority Health Choice Medicaid	$26.63
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$70.19
Rate for Payer: Priority Health Narrow/Tiered Network	$70.19
Rate for Payer: UHC Medicaid	$26.63
Rate for Payer: UHCCP Medicaid	$26.63

PR SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM >2.0 CM

Professional

Both

$265.00

Service Code	HCPCS 11303
Min. Negotiated Rate	$36.85
Max. Negotiated Rate	$198.75
Rate for Payer: Aetna Commercial	$76.99
Rate for Payer: Aetna Medicare	$132.50
Rate for Payer: BCBS Complete	$38.69
Rate for Payer: BCN Commercial	$84.04
Rate for Payer: Cash Price	$212.00
Rate for Payer: Cash Price	$212.00
Rate for Payer: Mclaren Medicaid	$36.85
Rate for Payer: Meridian Medicaid	$38.69
Rate for Payer: Opus (Opus Packaging Group) HMA	$198.75
Rate for Payer: Priority Health Choice Medicaid	$36.85
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$97.54
Rate for Payer: Priority Health Narrow/Tiered Network	$97.54
Rate for Payer: UHC Medicaid	$36.85
Rate for Payer: UHCCP Medicaid	$36.85

PR SHVG SKN LESION 1 TRUNK/ARM/LEG DIAM 1.1-2.0 CM

Professional

Both

$241.00

Service Code	HCPCS 11302
Min. Negotiated Rate	$30.89
Max. Negotiated Rate	$180.75
Rate for Payer: Aetna Commercial	$65.07
Rate for Payer: Aetna Medicare	$120.50
Rate for Payer: BCBS Complete	$32.43
Rate for Payer: BCN Commercial	$70.29
Rate for Payer: Cash Price	$192.80
Rate for Payer: Cash Price	$192.80
Rate for Payer: Mclaren Medicaid	$30.89
Rate for Payer: Meridian Medicaid	$32.43
Rate for Payer: Opus (Opus Packaging Group) HMA	$180.75
Rate for Payer: Priority Health Choice Medicaid	$30.89
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$81.58
Rate for Payer: Priority Health Narrow/Tiered Network	$81.58
Rate for Payer: UHC Medicaid	$30.89
Rate for Payer: UHCCP Medicaid	$30.89

PR SIALOLITHOTOMY PRTD XTRORAL/COMP INTRAORAL

Professional

Both

$805.00

Service Code	HCPCS 42340
Min. Negotiated Rate	$197.03
Max. Negotiated Rate	$636.48
Rate for Payer: Aetna Commercial	$447.54
Rate for Payer: Aetna Medicare	$402.50
Rate for Payer: BCBS Complete	$206.88
Rate for Payer: BCN Commercial	$522.38
Rate for Payer: Cash Price	$644.00
Rate for Payer: Cash Price	$644.00
Rate for Payer: Mclaren Medicaid	$197.03
Rate for Payer: Meridian Medicaid	$206.88
Rate for Payer: Opus (Opus Packaging Group) HMA	$603.75
Rate for Payer: Priority Health Choice Medicaid	$197.03
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$636.48
Rate for Payer: Priority Health Narrow/Tiered Network	$636.48
Rate for Payer: UHC Medicaid	$197.03
Rate for Payer: UHCCP Medicaid	$197.03

PR SIALOLITHOTOMY SUBMNDBLR SUBMAX COMP INTRAORAL

Professional

Both

$1,052.00

Service Code	HCPCS 42335
Min. Negotiated Rate	$152.72
Max. Negotiated Rate	$789.00
Rate for Payer: Aetna Commercial	$339.73
Rate for Payer: Aetna Medicare	$526.00
Rate for Payer: BCBS Complete	$160.36
Rate for Payer: BCN Commercial	$400.87
Rate for Payer: Cash Price	$841.60
Rate for Payer: Cash Price	$841.60
Rate for Payer: Mclaren Medicaid	$152.72
Rate for Payer: Meridian Medicaid	$160.36
Rate for Payer: Opus (Opus Packaging Group) HMA	$789.00
Rate for Payer: Priority Health Choice Medicaid	$152.72
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$488.44
Rate for Payer: Priority Health Narrow/Tiered Network	$488.44
Rate for Payer: UHC Medicaid	$152.72
Rate for Payer: UHCCP Medicaid	$152.72

PR SIALOT SUBMNDBLR SUBLNGL/PRTD UNCOMP INTRAORAL

Professional

Both

$432.00

Service Code	HCPCS 42330
Min. Negotiated Rate	$95.85
Max. Negotiated Rate	$324.00
Rate for Payer: Aetna Commercial	$215.99
Rate for Payer: Aetna Medicare	$216.00
Rate for Payer: BCBS Complete	$100.64
Rate for Payer: BCN Commercial	$249.99
Rate for Payer: Cash Price	$345.60
Rate for Payer: Cash Price	$345.60
Rate for Payer: Mclaren Medicaid	$95.85
Rate for Payer: Meridian Medicaid	$100.64
Rate for Payer: Opus (Opus Packaging Group) HMA	$324.00
Rate for Payer: Priority Health Choice Medicaid	$95.85
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$304.59
Rate for Payer: Priority Health Narrow/Tiered Network	$304.59
Rate for Payer: UHC Medicaid	$95.85
Rate for Payer: UHCCP Medicaid	$95.85

PR SIGMOIDOSCOPY,ABLATE LESN

Professional

Both

$774.00

Service Code	HCPCS 45339
Min. Negotiated Rate	$309.60
Max. Negotiated Rate	$580.50
Rate for Payer: Aetna Medicare	$387.00
Rate for Payer: BCBS Complete	$309.60
Rate for Payer: Cash Price	$619.20
Rate for Payer: Opus (Opus Packaging Group) HMA	$580.50

PR SIGMOIDOSCOPY FLX ABLATION TUMOR POLYP/OTH LES

Professional

Both

$779.00

Service Code	HCPCS 45346
Min. Negotiated Rate	$91.38
Max. Negotiated Rate	$584.25
Rate for Payer: Aetna Commercial	$213.21
Rate for Payer: Aetna Medicare	$389.50
Rate for Payer: BCBS Complete	$95.95
Rate for Payer: BCN Commercial	$236.55
Rate for Payer: Cash Price	$623.20
Rate for Payer: Cash Price	$623.20
Rate for Payer: Mclaren Medicaid	$91.38
Rate for Payer: Meridian Medicaid	$95.95
Rate for Payer: Opus (Opus Packaging Group) HMA	$584.25
Rate for Payer: Priority Health Choice Medicaid	$91.38
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$288.22
Rate for Payer: Priority Health Narrow/Tiered Network	$288.22
Rate for Payer: UHC Medicaid	$91.38
Rate for Payer: UHCCP Medicaid	$91.38

PR SIGMOIDOSCOPY FLX CONTROL BLEEDING

Professional

Both

$687.00

Service Code	HCPCS 45334
Min. Negotiated Rate	$67.52
Max. Negotiated Rate	$515.25
Rate for Payer: Aetna Commercial	$155.42
Rate for Payer: Aetna Medicare	$343.50
Rate for Payer: BCBS Complete	$70.90
Rate for Payer: BCN Commercial	$173.80
Rate for Payer: Cash Price	$549.60
Rate for Payer: Cash Price	$549.60
Rate for Payer: Mclaren Medicaid	$67.52
Rate for Payer: Meridian Medicaid	$70.90
Rate for Payer: Opus (Opus Packaging Group) HMA	$515.25
Rate for Payer: Priority Health Choice Medicaid	$67.52
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$211.76
Rate for Payer: Priority Health Narrow/Tiered Network	$211.76
Rate for Payer: UHC Medicaid	$67.52
Rate for Payer: UHCCP Medicaid	$67.52

PR SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD

Professional

Both

$256.00

Service Code	HCPCS 45330
Hospital Charge Code	45330
Min. Negotiated Rate	$34.29
Max. Negotiated Rate	$192.00
Rate for Payer: Aetna Commercial	$73.39
Rate for Payer: Aetna Medicare	$128.00
Rate for Payer: BCBS Complete	$36.00
Rate for Payer: BCN Commercial	$67.15
Rate for Payer: Cash Price	$204.80
Rate for Payer: Cash Price	$204.80
Rate for Payer: Mclaren Medicaid	$34.29
Rate for Payer: Meridian Medicaid	$36.00
Rate for Payer: Opus (Opus Packaging Group) HMA	$192.00
Rate for Payer: Priority Health Choice Medicaid	$34.29
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$103.75
Rate for Payer: Priority Health Narrow/Tiered Network	$103.75
Rate for Payer: UHC Medicaid	$34.29
Rate for Payer: UHCCP Medicaid	$34.29

PR SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD

Professional

Both

$256.00

Service Code	HCPCS 45330
Min. Negotiated Rate	$34.29
Max. Negotiated Rate	$192.00
Rate for Payer: Aetna Commercial	$73.39
Rate for Payer: Aetna Medicare	$128.00
Rate for Payer: BCBS Complete	$36.00
Rate for Payer: BCN Commercial	$67.15
Rate for Payer: Cash Price	$204.80
Rate for Payer: Cash Price	$204.80
Rate for Payer: Mclaren Medicaid	$34.29
Rate for Payer: Meridian Medicaid	$36.00
Rate for Payer: Opus (Opus Packaging Group) HMA	$192.00
Rate for Payer: Priority Health Choice Medicaid	$34.29
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$103.75
Rate for Payer: Priority Health Narrow/Tiered Network	$103.75
Rate for Payer: UHC Medicaid	$34.29
Rate for Payer: UHCCP Medicaid	$34.29

PR SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD

Facility

$256.00

Service Code	CPT 45330
Hospital Charge Code	45330
Hospital Revenue Code	960
Min. Negotiated Rate	$178.18
Max. Negotiated Rate	$230.40
Rate for Payer: Aetna Commercial	$217.60
Rate for Payer: BCBS Trust/PPO	$211.43
Rate for Payer: BCN Commercial	$211.43
Rate for Payer: Cash Price	$204.80
Rate for Payer: Cofinity Commercial	$220.16
Rate for Payer: Encore Health Key Benefits Commercial	$204.80
Rate for Payer: Healthscope Commercial	$230.40
Rate for Payer: Lakeland Regional Health Systems Commercial	$192.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$217.60
Rate for Payer: Nomi Health Commercial	$209.92
Rate for Payer: Opus (Opus Packaging Group) HMA	$192.00
Rate for Payer: PHP Commercial	$217.60
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$222.72
Rate for Payer: Priority Health Narrow/Tiered Network	$178.18
Rate for Payer: UHC Core	$213.76
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$192.00

PR SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD

Facility

$256.00

Service Code	CPT 45330
Hospital Charge Code	45330
Hospital Revenue Code	960
Min. Negotiated Rate	$45.13
Max. Negotiated Rate	$230.40
Rate for Payer: Aetna Commercial	$217.60
Rate for Payer: Aetna Medicare	$66.56
Rate for Payer: Allen County Amish Medical Aid Commercial	$80.00
Rate for Payer: Amish Plain Church Group Commercial	$80.00
Rate for Payer: BCBS Complete	$47.39
Rate for Payer: BCBS MAPPO	$64.00
Rate for Payer: BCBS Trust/PPO	$210.46
Rate for Payer: BCN Commercial	$210.46
Rate for Payer: BCN Medicare Advantage	$64.00
Rate for Payer: Cash Price	$204.80
Rate for Payer: Cofinity Commercial	$220.16
Rate for Payer: Encore Health Key Benefits Commercial	$204.80
Rate for Payer: Health Alliance Plan Medicare Advantage	$64.00
Rate for Payer: Healthscope Commercial	$230.40
Rate for Payer: Lakeland Regional Health Systems Commercial	$192.00
Rate for Payer: Mclaren Medicaid	$45.13
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$67.20
Rate for Payer: Meridian Medicaid	$47.39
Rate for Payer: MI Amish Medical Board Commercial	$73.60
Rate for Payer: Molina Medicare/Medicaid	$70.40
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$217.60
Rate for Payer: Nomi Health Commercial	$209.92
Rate for Payer: Opus (Opus Packaging Group) HMA	$192.00
Rate for Payer: PACE Senior Care Partners	$60.80
Rate for Payer: PACE SWMI	$64.00
Rate for Payer: PHP Commercial	$217.60
Rate for Payer: PHP Medicare Advantage	$64.00
Rate for Payer: Priority Health Choice Medicaid	$45.13
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$222.72
Rate for Payer: Priority Health Medicare	$64.64
Rate for Payer: Priority Health Narrow/Tiered Network	$178.18
Rate for Payer: Railroad Medicare Medicare	$64.00
Rate for Payer: UHC Core	$213.76
Rate for Payer: UHC Exchange	$64.00
Rate for Payer: UHC Medicaid	$45.13
Rate for Payer: UHC Medicare Advantage	$64.00
Rate for Payer: UHCCP Medicaid	$45.13
Rate for Payer: VA VA	$64.00
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$192.00

PR SIGMOIDOSCOPY FLX NDSC US XM

Professional

Both

$306.00

Service Code	HCPCS 45341
Min. Negotiated Rate	$71.14
Max. Negotiated Rate	$229.50
Rate for Payer: Aetna Commercial	$164.11
Rate for Payer: Aetna Medicare	$153.00
Rate for Payer: BCBS Complete	$74.70
Rate for Payer: BCN Commercial	$183.26
Rate for Payer: Cash Price	$244.80
Rate for Payer: Cash Price	$244.80
Rate for Payer: Mclaren Medicaid	$71.14
Rate for Payer: Meridian Medicaid	$74.70
Rate for Payer: Opus (Opus Packaging Group) HMA	$229.50
Rate for Payer: Priority Health Choice Medicaid	$71.14
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$223.30
Rate for Payer: Priority Health Narrow/Tiered Network	$223.30
Rate for Payer: UHC Medicaid	$71.14
Rate for Payer: UHCCP Medicaid	$71.14

PR SIGMOIDOSCOPY FLX PLACEMENT OF ENDOSCOPIC STENT

Professional

Both

$382.00

Service Code	HCPCS 45347
Min. Negotiated Rate	$87.12
Max. Negotiated Rate	$286.50
Rate for Payer: Aetna Commercial	$205.04
Rate for Payer: Aetna Medicare	$191.00
Rate for Payer: BCBS Complete	$91.48
Rate for Payer: BCN Commercial	$227.08
Rate for Payer: Cash Price	$305.60
Rate for Payer: Cash Price	$305.60
Rate for Payer: Mclaren Medicaid	$87.12
Rate for Payer: Meridian Medicaid	$91.48
Rate for Payer: Opus (Opus Packaging Group) HMA	$286.50
Rate for Payer: Priority Health Choice Medicaid	$87.12
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$276.68
Rate for Payer: Priority Health Narrow/Tiered Network	$276.68
Rate for Payer: UHC Medicaid	$87.12
Rate for Payer: UHCCP Medicaid	$87.12

Know your out-of-pocket cost for care.

All Charges