Bronson Lakeview Hospital

All Charges

Charge

Type

Setting

Price

PR SURG TX ANAL FISTULA SUBQ

Professional

Both

$888.00

Service Code	HCPCS 46270
Min. Negotiated Rate	$260.29
Max. Negotiated Rate	$746.31
Rate for Payer: Aetna Commercial	$530.44
Rate for Payer: Aetna Medicare	$444.00
Rate for Payer: BCBS Complete	$273.30
Rate for Payer: BCN Commercial	$612.52
Rate for Payer: Cash Price	$710.40
Rate for Payer: Cash Price	$710.40
Rate for Payer: Mclaren Medicaid	$260.29
Rate for Payer: Meridian Medicaid	$273.30
Rate for Payer: Opus (Opus Packaging Group) HMA	$666.00
Rate for Payer: Priority Health Choice Medicaid	$260.29
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$746.31
Rate for Payer: Priority Health Narrow/Tiered Network	$746.31
Rate for Payer: UHC Medicaid	$260.29
Rate for Payer: UHCCP Medicaid	$260.29

PR SURG VENTRICULAR RSTRJ PX W/PROSTC PATCH PFRMD

Professional

Both

$11,674.00

Service Code	HCPCS 33548
Min. Negotiated Rate	$1,770.03
Max. Negotiated Rate	$8,755.50
Rate for Payer: Aetna Commercial	$3,982.60
Rate for Payer: Aetna Medicare	$5,837.00
Rate for Payer: BCBS Complete	$1,858.53
Rate for Payer: BCN Commercial	$4,318.99
Rate for Payer: Cash Price	$9,339.20
Rate for Payer: Cash Price	$9,339.20
Rate for Payer: Mclaren Medicaid	$1,770.03
Rate for Payer: Meridian Medicaid	$1,858.53
Rate for Payer: Opus (Opus Packaging Group) HMA	$8,755.50
Rate for Payer: Priority Health Choice Medicaid	$1,770.03
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$4,644.52
Rate for Payer: Priority Health Narrow/Tiered Network	$4,644.52
Rate for Payer: UHC Medicaid	$1,770.03
Rate for Payer: UHCCP Medicaid	$1,770.03

PR SUTR DIGITAL NRV HAND/FOOT EA DGTAL NRV

Professional

Both

$1,363.00

Service Code	HCPCS 64832
Min. Negotiated Rate	$179.56
Max. Negotiated Rate	$1,022.25
Rate for Payer: Aetna Commercial	$430.52
Rate for Payer: Aetna Medicare	$681.50
Rate for Payer: BCBS Complete	$188.54
Rate for Payer: BCN Commercial	$493.00
Rate for Payer: Cash Price	$1,090.40
Rate for Payer: Cash Price	$1,090.40
Rate for Payer: Mclaren Medicaid	$179.56
Rate for Payer: Meridian Medicaid	$188.54
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,022.25
Rate for Payer: Priority Health Choice Medicaid	$179.56
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$572.61
Rate for Payer: Priority Health Narrow/Tiered Network	$572.61
Rate for Payer: UHC Medicaid	$179.56
Rate for Payer: UHCCP Medicaid	$179.56

PR SUTR ESOPHGL WND/INJ CRV APPR

Professional

Both

$2,941.00

Service Code	HCPCS 43410
Min. Negotiated Rate	$575.31
Max. Negotiated Rate	$2,205.75
Rate for Payer: Aetna Commercial	$1,357.86
Rate for Payer: Aetna Medicare	$1,470.50
Rate for Payer: BCBS Complete	$604.08
Rate for Payer: BCN Commercial	$1,558.68
Rate for Payer: Cash Price	$2,352.80
Rate for Payer: Cash Price	$2,352.80
Rate for Payer: Mclaren Medicaid	$575.31
Rate for Payer: Meridian Medicaid	$604.08
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,205.75
Rate for Payer: Priority Health Choice Medicaid	$575.31
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,899.16
Rate for Payer: Priority Health Narrow/Tiered Network	$1,899.16
Rate for Payer: UHC Medicaid	$575.31
Rate for Payer: UHCCP Medicaid	$575.31

PR SUTR ESOPHGL WND/INJ TTHRC/TABDL APPR

Professional

Both

$4,198.00

Service Code	HCPCS 43415
Min. Negotiated Rate	$1,539.78
Max. Negotiated Rate	$4,639.88
Rate for Payer: Aetna Commercial	$3,436.27
Rate for Payer: Aetna Medicare	$2,099.00
Rate for Payer: BCBS Complete	$1,616.77
Rate for Payer: BCN Commercial	$3,808.06
Rate for Payer: Cash Price	$3,358.40
Rate for Payer: Cash Price	$3,358.40
Rate for Payer: Mclaren Medicaid	$1,539.78
Rate for Payer: Meridian Medicaid	$1,616.77
Rate for Payer: Opus (Opus Packaging Group) HMA	$3,148.50
Rate for Payer: Priority Health Choice Medicaid	$1,539.78
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$4,639.88
Rate for Payer: Priority Health Narrow/Tiered Network	$4,639.88
Rate for Payer: UHC Medicaid	$1,539.78
Rate for Payer: UHCCP Medicaid	$1,539.78

PR SUTR INFRAPATELLAR TDN 2 RCNSTJ W/FSCAL/TDN GRF

Professional

Both

$1,634.00

Service Code	HCPCS 27381
Min. Negotiated Rate	$494.37
Max. Negotiated Rate	$1,334.01
Rate for Payer: Aetna Commercial	$1,093.37
Rate for Payer: Aetna Medicare	$817.00
Rate for Payer: BCBS Complete	$519.09
Rate for Payer: BCN Commercial	$1,247.94
Rate for Payer: Cash Price	$1,307.20
Rate for Payer: Cash Price	$1,307.20
Rate for Payer: Mclaren Medicaid	$494.37
Rate for Payer: Meridian Medicaid	$519.09
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,225.50
Rate for Payer: Priority Health Choice Medicaid	$494.37
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,334.01
Rate for Payer: Priority Health Narrow/Tiered Network	$1,334.01
Rate for Payer: UHC Medicaid	$494.37
Rate for Payer: UHCCP Medicaid	$494.37

PR SUTR LG INTESTINE 1/MULT PERFORAT W/COLOSTOMY

Professional

Both

$3,026.00

Service Code	HCPCS 44605
Min. Negotiated Rate	$776.60
Max. Negotiated Rate	$2,348.75
Rate for Payer: Aetna Commercial	$1,748.55
Rate for Payer: Aetna Medicare	$1,513.00
Rate for Payer: BCBS Complete	$815.43
Rate for Payer: BCN Commercial	$1,927.68
Rate for Payer: Cash Price	$2,420.80
Rate for Payer: Cash Price	$2,420.80
Rate for Payer: Mclaren Medicaid	$776.60
Rate for Payer: Meridian Medicaid	$815.43
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,269.50
Rate for Payer: Priority Health Choice Medicaid	$776.60
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$2,348.75
Rate for Payer: Priority Health Narrow/Tiered Network	$2,348.75
Rate for Payer: UHC Medicaid	$776.60
Rate for Payer: UHCCP Medicaid	$776.60

PR SUTR LG INTESTINE 1/MULT PERFORAT W/O COLOSTOMY

Professional

Both

$3,173.00

Service Code	HCPCS 44604
Min. Negotiated Rate	$621.53
Max. Negotiated Rate	$2,379.75
Rate for Payer: Aetna Commercial	$1,425.76
Rate for Payer: Aetna Medicare	$1,586.50
Rate for Payer: BCBS Complete	$652.61
Rate for Payer: BCN Commercial	$1,577.10
Rate for Payer: Cash Price	$2,538.40
Rate for Payer: Cash Price	$2,538.40
Rate for Payer: Mclaren Medicaid	$621.53
Rate for Payer: Meridian Medicaid	$652.61
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,379.75
Rate for Payer: Priority Health Choice Medicaid	$621.53
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,921.59
Rate for Payer: Priority Health Narrow/Tiered Network	$1,921.59
Rate for Payer: UHC Medicaid	$621.53
Rate for Payer: UHCCP Medicaid	$621.53

PR SUTR&/LIG THORACIC DUCT CERVICAL APPROACH

Professional

Both

$1,256.00

Service Code	HCPCS 38380
Min. Negotiated Rate	$330.58
Max. Negotiated Rate	$1,166.19
Rate for Payer: Aetna Commercial	$699.25
Rate for Payer: Aetna Medicare	$628.00
Rate for Payer: BCBS Complete	$347.11
Rate for Payer: BCN Commercial	$876.45
Rate for Payer: Cash Price	$1,004.80
Rate for Payer: Cash Price	$1,004.80
Rate for Payer: Mclaren Medicaid	$330.58
Rate for Payer: Meridian Medicaid	$347.11
Rate for Payer: Opus (Opus Packaging Group) HMA	$942.00
Rate for Payer: Priority Health Choice Medicaid	$330.58
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,166.19
Rate for Payer: Priority Health Narrow/Tiered Network	$1,166.19
Rate for Payer: UHC Medicaid	$330.58
Rate for Payer: UHCCP Medicaid	$330.58

PR SUTR&/LIG THORACIC DUCT THORACIC APPROACH

Professional

Both

$6,105.00

Service Code	HCPCS 38381
Min. Negotiated Rate	$492.03
Max. Negotiated Rate	$4,578.75
Rate for Payer: Aetna Commercial	$994.35
Rate for Payer: Aetna Medicare	$3,052.50
Rate for Payer: BCBS Complete	$516.63
Rate for Payer: BCN Commercial	$1,207.61
Rate for Payer: Cash Price	$4,884.00
Rate for Payer: Cash Price	$4,884.00
Rate for Payer: Mclaren Medicaid	$492.03
Rate for Payer: Meridian Medicaid	$516.63
Rate for Payer: Opus (Opus Packaging Group) HMA	$4,578.75
Rate for Payer: Priority Health Choice Medicaid	$492.03
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,606.81
Rate for Payer: Priority Health Narrow/Tiered Network	$1,606.81
Rate for Payer: UHC Medicaid	$492.03
Rate for Payer: UHCCP Medicaid	$492.03

PR SUTR NRV ITPRL W/WO GRF/DCMPRN LAT GENICULATE

Professional

Both

$2,117.00

Service Code	HCPCS 69740
Min. Negotiated Rate	$649.86
Max. Negotiated Rate	$1,731.98
Rate for Payer: Aetna Commercial	$1,318.76
Rate for Payer: Aetna Medicare	$1,058.50
Rate for Payer: BCBS Complete	$682.35
Rate for Payer: BCN Commercial	$1,731.98
Rate for Payer: Cash Price	$1,693.60
Rate for Payer: Cash Price	$1,693.60
Rate for Payer: Mclaren Medicaid	$649.86
Rate for Payer: Meridian Medicaid	$682.35
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,587.75
Rate for Payer: Priority Health Choice Medicaid	$649.86
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,711.36
Rate for Payer: Priority Health Narrow/Tiered Network	$1,711.36
Rate for Payer: UHC Medicaid	$649.86
Rate for Payer: UHCCP Medicaid	$649.86

PR SUTR PRPH NRV ARM/LEG XCP SCIATIC W/O TRPOS

Professional

Both

$3,270.00

Service Code	HCPCS 64857
Min. Negotiated Rate	$602.58
Max. Negotiated Rate	$2,452.50
Rate for Payer: Aetna Commercial	$1,356.55
Rate for Payer: Aetna Medicare	$1,635.00
Rate for Payer: BCBS Complete	$632.71
Rate for Payer: BCN Commercial	$1,582.09
Rate for Payer: Cash Price	$2,616.00
Rate for Payer: Cash Price	$2,616.00
Rate for Payer: Mclaren Medicaid	$602.58
Rate for Payer: Meridian Medicaid	$632.71
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,452.50
Rate for Payer: Priority Health Choice Medicaid	$602.58
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,837.57
Rate for Payer: Priority Health Narrow/Tiered Network	$1,837.57
Rate for Payer: UHC Medicaid	$602.58
Rate for Payer: UHCCP Medicaid	$602.58

PR SUTR PRPH NRV ARM/LEG XCP SCIATIC W/TRPOS

Professional

Both

$4,072.00

Service Code	HCPCS 64856
Min. Negotiated Rate	$586.39
Max. Negotiated Rate	$3,054.00
Rate for Payer: Aetna Commercial	$1,297.52
Rate for Payer: Aetna Medicare	$2,036.00
Rate for Payer: BCBS Complete	$615.71
Rate for Payer: BCN Commercial	$1,526.31
Rate for Payer: Cash Price	$3,257.60
Rate for Payer: Cash Price	$3,257.60
Rate for Payer: Mclaren Medicaid	$586.39
Rate for Payer: Meridian Medicaid	$615.71
Rate for Payer: Opus (Opus Packaging Group) HMA	$3,054.00
Rate for Payer: Priority Health Choice Medicaid	$586.39
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,772.78
Rate for Payer: Priority Health Narrow/Tiered Network	$1,772.78
Rate for Payer: UHC Medicaid	$586.39
Rate for Payer: UHCCP Medicaid	$586.39

PR SUTR QUADRICEPS/HAMSTRING MUSC RPT RCNSTJ

Professional

Both

$2,412.00

Service Code	HCPCS 27386
Min. Negotiated Rate	$514.82
Max. Negotiated Rate	$1,809.00
Rate for Payer: Aetna Commercial	$1,142.85
Rate for Payer: Aetna Medicare	$1,206.00
Rate for Payer: BCBS Complete	$540.56
Rate for Payer: BCN Commercial	$1,302.22
Rate for Payer: Cash Price	$1,929.60
Rate for Payer: Cash Price	$1,929.60
Rate for Payer: Mclaren Medicaid	$514.82
Rate for Payer: Meridian Medicaid	$540.56
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,809.00
Rate for Payer: Priority Health Choice Medicaid	$514.82
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,392.04
Rate for Payer: Priority Health Narrow/Tiered Network	$1,392.04
Rate for Payer: UHC Medicaid	$514.82
Rate for Payer: UHCCP Medicaid	$514.82

PR SUTR RPR AORTA/GRT VSL W/O SHUNT/CARD BYP

Professional

Both

$2,269.00

Service Code	HCPCS 33320
Min. Negotiated Rate	$648.80
Max. Negotiated Rate	$1,701.75
Rate for Payer: Aetna Commercial	$1,417.73
Rate for Payer: Aetna Medicare	$1,134.50
Rate for Payer: BCBS Complete	$681.24
Rate for Payer: BCN Commercial	$1,581.09
Rate for Payer: Cash Price	$1,815.20
Rate for Payer: Cash Price	$1,815.20
Rate for Payer: Mclaren Medicaid	$648.80
Rate for Payer: Meridian Medicaid	$681.24
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,701.75
Rate for Payer: Priority Health Choice Medicaid	$648.80
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,700.26
Rate for Payer: Priority Health Narrow/Tiered Network	$1,700.26
Rate for Payer: UHC Medicaid	$648.80
Rate for Payer: UHCCP Medicaid	$648.80

PR SUTR WND EYELID/MARGIN/TARSUS/CONJUNC FULL THICK

Professional

Both

$1,186.00

Service Code	HCPCS 67935
Min. Negotiated Rate	$234.94
Max. Negotiated Rate	$889.50
Rate for Payer: Aetna Commercial	$573.82
Rate for Payer: Aetna Medicare	$593.00
Rate for Payer: BCBS Complete	$246.69
Rate for Payer: BCN Commercial	$648.38
Rate for Payer: Cash Price	$948.80
Rate for Payer: Cash Price	$948.80
Rate for Payer: Mclaren Medicaid	$234.94
Rate for Payer: Meridian Medicaid	$246.69
Rate for Payer: Opus (Opus Packaging Group) HMA	$889.50
Rate for Payer: Priority Health Choice Medicaid	$234.94
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$759.46
Rate for Payer: Priority Health Narrow/Tiered Network	$759.46
Rate for Payer: UHC Medicaid	$234.94
Rate for Payer: UHCCP Medicaid	$234.94

PR SUTR WND EYELID/MARGIN/TARSUS/CONJUNC PRTL THICK

Professional

Both

$788.00

Service Code	HCPCS 67930
Min. Negotiated Rate	$125.46
Max. Negotiated Rate	$591.00
Rate for Payer: Aetna Commercial	$309.73
Rate for Payer: Aetna Medicare	$394.00
Rate for Payer: BCBS Complete	$131.73
Rate for Payer: BCN Commercial	$348.59
Rate for Payer: Cash Price	$630.40
Rate for Payer: Cash Price	$630.40
Rate for Payer: Mclaren Medicaid	$125.46
Rate for Payer: Meridian Medicaid	$131.73
Rate for Payer: Opus (Opus Packaging Group) HMA	$591.00
Rate for Payer: Priority Health Choice Medicaid	$125.46
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$408.32
Rate for Payer: Priority Health Narrow/Tiered Network	$408.32
Rate for Payer: UHC Medicaid	$125.46
Rate for Payer: UHCCP Medicaid	$125.46

PR SUTURE 1 NERVE HAND/FOOT COMMON SENSORY NERVE

Professional

Both

$2,215.00

Service Code	HCPCS 64834
Min. Negotiated Rate	$421.31
Max. Negotiated Rate	$1,661.25
Rate for Payer: Aetna Commercial	$952.43
Rate for Payer: Aetna Medicare	$1,107.50
Rate for Payer: BCBS Complete	$442.38
Rate for Payer: BCN Commercial	$1,133.90
Rate for Payer: Cash Price	$1,772.00
Rate for Payer: Cash Price	$1,772.00
Rate for Payer: Mclaren Medicaid	$421.31
Rate for Payer: Meridian Medicaid	$442.38
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,661.25
Rate for Payer: Priority Health Choice Medicaid	$421.31
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,317.01
Rate for Payer: Priority Health Narrow/Tiered Network	$1,317.01
Rate for Payer: UHC Medicaid	$421.31
Rate for Payer: UHCCP Medicaid	$421.31

PR SUTURE 1 NERVE MEDIAN MOTOR THENAR

Professional

Both

$2,356.00

Service Code	HCPCS 64835
Min. Negotiated Rate	$481.59
Max. Negotiated Rate	$1,767.00
Rate for Payer: Aetna Commercial	$1,049.59
Rate for Payer: Aetna Medicare	$1,178.00
Rate for Payer: BCBS Complete	$505.67
Rate for Payer: BCN Commercial	$1,239.47
Rate for Payer: Cash Price	$1,884.80
Rate for Payer: Cash Price	$1,884.80
Rate for Payer: Mclaren Medicaid	$481.59
Rate for Payer: Meridian Medicaid	$505.67
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,767.00
Rate for Payer: Priority Health Choice Medicaid	$481.59
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,439.62
Rate for Payer: Priority Health Narrow/Tiered Network	$1,439.62
Rate for Payer: UHC Medicaid	$481.59
Rate for Payer: UHCCP Medicaid	$481.59

PR SUTURE 1 NERVE ULNAR MOTOR

Professional

Both

$1,859.00

Service Code	HCPCS 64836
Min. Negotiated Rate	$481.59
Max. Negotiated Rate	$1,439.62
Rate for Payer: Aetna Commercial	$1,049.59
Rate for Payer: Aetna Medicare	$929.50
Rate for Payer: BCBS Complete	$505.67
Rate for Payer: BCN Commercial	$1,239.47
Rate for Payer: Cash Price	$1,487.20
Rate for Payer: Cash Price	$1,487.20
Rate for Payer: Mclaren Medicaid	$481.59
Rate for Payer: Meridian Medicaid	$505.67
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,394.25
Rate for Payer: Priority Health Choice Medicaid	$481.59
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,439.62
Rate for Payer: Priority Health Narrow/Tiered Network	$1,439.62
Rate for Payer: UHC Medicaid	$481.59
Rate for Payer: UHCCP Medicaid	$481.59

PR SUTURE BRACHIAL PLEXUS

Professional

Both

$3,816.00

Service Code	HCPCS 64861
Min. Negotiated Rate	$964.25
Max. Negotiated Rate	$2,862.00
Rate for Payer: Aetna Commercial	$1,962.06
Rate for Payer: Aetna Medicare	$1,908.00
Rate for Payer: BCBS Complete	$1,012.46
Rate for Payer: BCN Commercial	$2,327.56
Rate for Payer: Cash Price	$3,052.80
Rate for Payer: Cash Price	$3,052.80
Rate for Payer: Mclaren Medicaid	$964.25
Rate for Payer: Meridian Medicaid	$1,012.46
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,862.00
Rate for Payer: Priority Health Choice Medicaid	$964.25
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$2,703.43
Rate for Payer: Priority Health Narrow/Tiered Network	$2,703.43
Rate for Payer: UHC Medicaid	$964.25
Rate for Payer: UHCCP Medicaid	$964.25

PR SUTURE DIGITAL NERVE HAND/FOOT 1 NERVE

Professional

Both

$2,045.00

Service Code	HCPCS 64831
Min. Negotiated Rate	$410.45
Max. Negotiated Rate	$1,533.75
Rate for Payer: Aetna Commercial	$883.33
Rate for Payer: Aetna Medicare	$1,022.50
Rate for Payer: BCBS Complete	$430.97
Rate for Payer: BCN Commercial	$1,060.21
Rate for Payer: Cash Price	$1,636.00
Rate for Payer: Cash Price	$1,636.00
Rate for Payer: Mclaren Medicaid	$410.45
Rate for Payer: Meridian Medicaid	$430.97
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,533.75
Rate for Payer: Priority Health Choice Medicaid	$410.45
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$1,231.41
Rate for Payer: Priority Health Narrow/Tiered Network	$1,231.41
Rate for Payer: UHC Medicaid	$410.45
Rate for Payer: UHCCP Medicaid	$410.45

PR SUTURE EACH ADDITIONAL NERVE HAND/FOOT

Professional

Both

$1,350.00

Service Code	HCPCS 64837
Min. Negotiated Rate	$198.73
Max. Negotiated Rate	$1,012.50
Rate for Payer: Aetna Commercial	$471.67
Rate for Payer: Aetna Medicare	$675.00
Rate for Payer: BCBS Complete	$208.67
Rate for Payer: BCN Commercial	$539.81
Rate for Payer: Cash Price	$1,080.00
Rate for Payer: Cash Price	$1,080.00
Rate for Payer: Mclaren Medicaid	$198.73
Rate for Payer: Meridian Medicaid	$208.67
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,012.50
Rate for Payer: Priority Health Choice Medicaid	$198.73
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$626.99
Rate for Payer: Priority Health Narrow/Tiered Network	$626.99
Rate for Payer: UHC Medicaid	$198.73
Rate for Payer: UHCCP Medicaid	$198.73

PR SUTURE EACH ADDITIONAL PERIPHERAL NERVE

Professional

Both

$1,682.00

Service Code	HCPCS 64859
Min. Negotiated Rate	$135.26
Max. Negotiated Rate	$1,261.50
Rate for Payer: Aetna Commercial	$320.62
Rate for Payer: Aetna Medicare	$841.00
Rate for Payer: BCBS Complete	$142.02
Rate for Payer: BCN Commercial	$366.51
Rate for Payer: Cash Price	$1,345.60
Rate for Payer: Cash Price	$1,345.60
Rate for Payer: Mclaren Medicaid	$135.26
Rate for Payer: Meridian Medicaid	$142.02
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,261.50
Rate for Payer: Priority Health Choice Medicaid	$135.26
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$425.70
Rate for Payer: Priority Health Narrow/Tiered Network	$425.70
Rate for Payer: UHC Medicaid	$135.26
Rate for Payer: UHCCP Medicaid	$135.26

PR SUTURE EXTRAHEPATIC BILE DUCT PRE-EXIST INJURY

Professional

Both

$3,139.00

Service Code	HCPCS 47900
Min. Negotiated Rate	$827.72
Max. Negotiated Rate	$2,524.10
Rate for Payer: Aetna Commercial	$1,836.31
Rate for Payer: Aetna Medicare	$1,569.50
Rate for Payer: BCBS Complete	$869.11
Rate for Payer: BCN Commercial	$2,071.60
Rate for Payer: Cash Price	$2,511.20
Rate for Payer: Cash Price	$2,511.20
Rate for Payer: Mclaren Medicaid	$827.72
Rate for Payer: Meridian Medicaid	$869.11
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,354.25
Rate for Payer: Priority Health Choice Medicaid	$827.72
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$2,524.10
Rate for Payer: Priority Health Narrow/Tiered Network	$2,524.10
Rate for Payer: UHC Medicaid	$827.72
Rate for Payer: UHCCP Medicaid	$827.72

Know your out-of-pocket cost for care.

All Charges