Bronson South Haven Hospital

All Charges

Charge

Type

Setting

Price

PR CPLX INTRACRANIAL ARYSM VERTEBROBASILAR CRCJ

Professional

Both

$10,302.00

Service Code	HCPCS 61698
Min. Negotiated Rate	$4,120.80
Max. Negotiated Rate	$6,696.30
Rate for Payer: Aetna Commercial	$6,138.85
Rate for Payer: Aetna Medicare	$4,581.23
Rate for Payer: BCBS Complete	$4,120.80
Rate for Payer: BCBS MAPPO	$4,581.23
Rate for Payer: BCN Medicare Advantage	$4,581.23
Rate for Payer: Cash Price	$8,241.60
Rate for Payer: Cash Price	$8,241.60
Rate for Payer: Cofinity Commercial	$6,596.97
Rate for Payer: Cofinity Commercial	$6,138.85
Rate for Payer: Health Alliance Plan Medicare Advantage	$4,581.23
Rate for Payer: Healthscope Commercial	$5,497.48
Rate for Payer: Healthscope Whirlpool	$5,497.48
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$4,810.29
Rate for Payer: Nomi Health Commercial	$5,497.48
Rate for Payer: PACE SWMI	$4,581.23
Rate for Payer: PHP Medicare Advantage	$4,581.23
Rate for Payer: Priority Health Cigna Priority Health	$6,696.30
Rate for Payer: Priority Health Medicare	$4,581.23
Rate for Payer: UHC Dual Complete DSNP	$4,581.23
Rate for Payer: UHC Medicare Advantage	$4,581.23
Rate for Payer: UHCCP DNSP	$4,581.23

PR CPTR-ASST MUSCSKEL NAVIGJ ORTHO CT/MRI

Professional

Both

$510.00

Service Code	HCPCS 0055T
Min. Negotiated Rate	$204.00
Max. Negotiated Rate	$331.50
Rate for Payer: Aetna Medicare	$255.00
Rate for Payer: BCBS Complete	$204.00
Rate for Payer: Cash Price	$408.00
Rate for Payer: Priority Health Cigna Priority Health	$331.50

PR CPTR-ASST MUSCSKEL NAVIGJ ORTHO FLUOR IMAGES

Professional

Both

$267.00

Service Code	HCPCS 0054T
Min. Negotiated Rate	$106.80
Max. Negotiated Rate	$173.55
Rate for Payer: Aetna Medicare	$133.50
Rate for Payer: BCBS Complete	$106.80
Rate for Payer: Cash Price	$213.60
Rate for Payer: Priority Health Cigna Priority Health	$173.55

PR CPTR-ASST SURGICAL NAVIGATION IMAGE-LESS

Facility

$283.00

Service Code	CPT 20985
Hospital Charge Code	20985
Min. Negotiated Rate	$183.95
Max. Negotiated Rate	$283.00
Rate for Payer: Aetna Commercial	$254.70
Rate for Payer: ASR ASR	$274.51
Rate for Payer: ASR Commercial	$274.51
Rate for Payer: BCBS Trust/PPO	$230.62
Rate for Payer: BCN Commercial	$219.41
Rate for Payer: Cash Price	$226.40
Rate for Payer: Cofinity Commercial	$266.02
Rate for Payer: Encore Health Key Benefits Commercial	$226.40
Rate for Payer: Healthscope Commercial	$283.00
Rate for Payer: Healthscope Whirlpool	$274.51
Rate for Payer: Mclaren Commercial	$254.70
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$240.55
Rate for Payer: Nomi Health Commercial	$232.06
Rate for Payer: Priority Health Cigna Priority Health	$183.95
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$249.04

PR CPTR-ASST SURGICAL NAVIGATION IMAGE-LESS

Professional

Both

$283.00

Service Code	HCPCS 20985
Min. Negotiated Rate	$113.20
Max. Negotiated Rate	$200.32
Rate for Payer: Aetna Commercial	$186.41
Rate for Payer: Aetna Medicare	$139.11
Rate for Payer: BCBS Complete	$113.20
Rate for Payer: BCBS MAPPO	$139.11
Rate for Payer: BCN Medicare Advantage	$139.11
Rate for Payer: Cash Price	$226.40
Rate for Payer: Cash Price	$226.40
Rate for Payer: Cofinity Commercial	$200.32
Rate for Payer: Cofinity Commercial	$186.41
Rate for Payer: Health Alliance Plan Medicare Advantage	$139.11
Rate for Payer: Healthscope Commercial	$166.93
Rate for Payer: Healthscope Whirlpool	$166.93
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$146.07
Rate for Payer: Nomi Health Commercial	$166.93
Rate for Payer: PACE SWMI	$139.11
Rate for Payer: PHP Medicare Advantage	$139.11
Rate for Payer: Priority Health Cigna Priority Health	$183.95
Rate for Payer: Priority Health Medicare	$139.11
Rate for Payer: UHC Dual Complete DSNP	$139.11
Rate for Payer: UHC Medicare Advantage	$139.11
Rate for Payer: UHCCP DNSP	$139.11

PR CPTR-ASST SURGICAL NAVIGATION IMAGE-LESS

Professional

Both

$283.00

Service Code	HCPCS 20985
Hospital Charge Code	20985
Min. Negotiated Rate	$113.20
Max. Negotiated Rate	$200.32
Rate for Payer: Aetna Commercial	$186.41
Rate for Payer: Aetna Medicare	$139.11
Rate for Payer: BCBS Complete	$113.20
Rate for Payer: BCBS MAPPO	$139.11
Rate for Payer: BCN Medicare Advantage	$139.11
Rate for Payer: Cash Price	$226.40
Rate for Payer: Cash Price	$226.40
Rate for Payer: Cofinity Commercial	$200.32
Rate for Payer: Cofinity Commercial	$186.41
Rate for Payer: Health Alliance Plan Medicare Advantage	$139.11
Rate for Payer: Healthscope Commercial	$166.93
Rate for Payer: Healthscope Whirlpool	$166.93
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$146.07
Rate for Payer: Nomi Health Commercial	$166.93
Rate for Payer: PACE SWMI	$139.11
Rate for Payer: PHP Medicare Advantage	$139.11
Rate for Payer: Priority Health Cigna Priority Health	$183.95
Rate for Payer: Priority Health Medicare	$139.11
Rate for Payer: UHC Dual Complete DSNP	$139.11
Rate for Payer: UHC Medicare Advantage	$139.11
Rate for Payer: UHCCP DNSP	$139.11

PR CPTR-ASST SURGICAL NAVIGATION IMAGE-LESS

Facility

$283.00

Service Code	CPT 20985
Hospital Charge Code	20985
Min. Negotiated Rate	$113.20
Max. Negotiated Rate	$283.00
Rate for Payer: Aetna Commercial	$254.70
Rate for Payer: Aetna Medicare	$141.50
Rate for Payer: ASR ASR	$274.51
Rate for Payer: ASR Commercial	$274.51
Rate for Payer: BCBS Complete	$113.20
Rate for Payer: BCBS Trust/PPO	$231.75
Rate for Payer: BCN Commercial	$219.41
Rate for Payer: Cash Price	$226.40
Rate for Payer: Cofinity Commercial	$266.02
Rate for Payer: Encore Health Key Benefits Commercial	$226.40
Rate for Payer: Healthscope Commercial	$283.00
Rate for Payer: Healthscope Whirlpool	$274.51
Rate for Payer: Mclaren Commercial	$254.70
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$240.55
Rate for Payer: Nomi Health Commercial	$232.06
Rate for Payer: Priority Health Cigna Priority Health	$183.95
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$247.96
Rate for Payer: Priority Health Narrow Network	$198.38
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$249.04

PR CRANFCL ANT CRANIAL FOSSA UNI/BI CRANIOT/OSTEOT

Professional

Both

$7,294.00

Service Code	HCPCS 61582
Min. Negotiated Rate	$2,917.60
Max. Negotiated Rate	$4,741.10
Rate for Payer: Aetna Commercial	$3,925.76
Rate for Payer: Aetna Medicare	$2,929.67
Rate for Payer: BCBS Complete	$2,917.60
Rate for Payer: BCBS MAPPO	$2,929.67
Rate for Payer: BCN Medicare Advantage	$2,929.67
Rate for Payer: Cash Price	$5,835.20
Rate for Payer: Cash Price	$5,835.20
Rate for Payer: Cofinity Commercial	$4,218.72
Rate for Payer: Cofinity Commercial	$3,925.76
Rate for Payer: Health Alliance Plan Medicare Advantage	$2,929.67
Rate for Payer: Healthscope Commercial	$3,515.60
Rate for Payer: Healthscope Whirlpool	$3,515.60
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$3,076.15
Rate for Payer: Nomi Health Commercial	$3,515.60
Rate for Payer: PACE SWMI	$2,929.67
Rate for Payer: PHP Medicare Advantage	$2,929.67
Rate for Payer: Priority Health Cigna Priority Health	$4,741.10
Rate for Payer: Priority Health Medicare	$2,929.67
Rate for Payer: UHC Dual Complete DSNP	$2,929.67
Rate for Payer: UHC Medicare Advantage	$2,929.67
Rate for Payer: UHCCP DNSP	$2,929.67

PR CRANFCL ANT CRANIAL FOSSA UNI/BIFRNTL ELEV LOBE

Professional

Both

$7,968.00

Service Code	HCPCS 61583
Min. Negotiated Rate	$2,860.79
Max. Negotiated Rate	$5,179.20
Rate for Payer: Aetna Commercial	$3,833.46
Rate for Payer: Aetna Medicare	$2,860.79
Rate for Payer: BCBS Complete	$3,187.20
Rate for Payer: BCBS MAPPO	$2,860.79
Rate for Payer: BCN Medicare Advantage	$2,860.79
Rate for Payer: Cash Price	$6,374.40
Rate for Payer: Cash Price	$6,374.40
Rate for Payer: Cofinity Commercial	$4,119.54
Rate for Payer: Cofinity Commercial	$3,833.46
Rate for Payer: Health Alliance Plan Medicare Advantage	$2,860.79
Rate for Payer: Healthscope Commercial	$3,432.95
Rate for Payer: Healthscope Whirlpool	$3,432.95
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$3,003.83
Rate for Payer: Nomi Health Commercial	$3,432.95
Rate for Payer: PACE SWMI	$2,860.79
Rate for Payer: PHP Medicare Advantage	$2,860.79
Rate for Payer: Priority Health Cigna Priority Health	$5,179.20
Rate for Payer: Priority Health Medicare	$2,860.79
Rate for Payer: UHC Dual Complete DSNP	$2,860.79
Rate for Payer: UHC Medicare Advantage	$2,860.79
Rate for Payer: UHCCP DNSP	$2,860.79

PR CRANIECTOMY CRANIOSYNOSTOSIS BIFRONTAL BONE FLAP

Professional

Both

$3,387.00

Service Code	HCPCS 61557
Min. Negotiated Rate	$1,354.80
Max. Negotiated Rate	$2,411.16
Rate for Payer: Aetna Commercial	$2,243.72
Rate for Payer: Aetna Medicare	$1,674.42
Rate for Payer: BCBS Complete	$1,354.80
Rate for Payer: BCBS MAPPO	$1,674.42
Rate for Payer: BCN Medicare Advantage	$1,674.42
Rate for Payer: Cash Price	$2,709.60
Rate for Payer: Cash Price	$2,709.60
Rate for Payer: Cofinity Commercial	$2,411.16
Rate for Payer: Cofinity Commercial	$2,243.72
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,674.42
Rate for Payer: Healthscope Commercial	$2,009.30
Rate for Payer: Healthscope Whirlpool	$2,009.30
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$1,758.14
Rate for Payer: Nomi Health Commercial	$2,009.30
Rate for Payer: PACE SWMI	$1,674.42
Rate for Payer: PHP Medicare Advantage	$1,674.42
Rate for Payer: Priority Health Cigna Priority Health	$2,201.55
Rate for Payer: Priority Health Medicare	$1,674.42
Rate for Payer: UHC Dual Complete DSNP	$1,674.42
Rate for Payer: UHC Medicare Advantage	$1,674.42
Rate for Payer: UHCCP DNSP	$1,674.42

PR CRANIECTOMY/CRANIOTOMY EXC FOREIGN BODY BRAIN

Professional

Both

$9,394.00

Service Code	HCPCS 61570
Min. Negotiated Rate	$1,857.11
Max. Negotiated Rate	$6,106.10
Rate for Payer: Aetna Commercial	$2,488.53
Rate for Payer: Aetna Medicare	$1,857.11
Rate for Payer: BCBS Complete	$3,757.60
Rate for Payer: BCBS MAPPO	$1,857.11
Rate for Payer: BCN Medicare Advantage	$1,857.11
Rate for Payer: Cash Price	$7,515.20
Rate for Payer: Cash Price	$7,515.20
Rate for Payer: Cofinity Commercial	$2,674.24
Rate for Payer: Cofinity Commercial	$2,488.53
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,857.11
Rate for Payer: Healthscope Commercial	$2,228.53
Rate for Payer: Healthscope Whirlpool	$2,228.53
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$1,949.97
Rate for Payer: Nomi Health Commercial	$2,228.53
Rate for Payer: PACE SWMI	$1,857.11
Rate for Payer: PHP Medicare Advantage	$1,857.11
Rate for Payer: Priority Health Cigna Priority Health	$6,106.10
Rate for Payer: Priority Health Medicare	$1,857.11
Rate for Payer: UHC Dual Complete DSNP	$1,857.11
Rate for Payer: UHC Medicare Advantage	$1,857.11
Rate for Payer: UHCCP DNSP	$1,857.11

PR CRANIECTOMY/CRANIOTOMY EXPL INFRATENTORIAL

Professional

Both

$4,188.00

Service Code	HCPCS 61305
Min. Negotiated Rate	$1,675.20
Max. Negotiated Rate	$2,866.20
Rate for Payer: Aetna Commercial	$2,667.16
Rate for Payer: Aetna Medicare	$1,990.42
Rate for Payer: BCBS Complete	$1,675.20
Rate for Payer: BCBS MAPPO	$1,990.42
Rate for Payer: BCN Medicare Advantage	$1,990.42
Rate for Payer: Cash Price	$3,350.40
Rate for Payer: Cash Price	$3,350.40
Rate for Payer: Cofinity Commercial	$2,866.20
Rate for Payer: Cofinity Commercial	$2,667.16
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,990.42
Rate for Payer: Healthscope Commercial	$2,388.50
Rate for Payer: Healthscope Whirlpool	$2,388.50
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$2,089.94
Rate for Payer: Nomi Health Commercial	$2,388.50
Rate for Payer: PACE SWMI	$1,990.42
Rate for Payer: PHP Medicare Advantage	$1,990.42
Rate for Payer: Priority Health Cigna Priority Health	$2,722.20
Rate for Payer: Priority Health Medicare	$1,990.42
Rate for Payer: UHC Dual Complete DSNP	$1,990.42
Rate for Payer: UHC Medicare Advantage	$1,990.42
Rate for Payer: UHCCP DNSP	$1,990.42

PR CRANIECTOMY/CRANIOTOMY EXPL SUPRATENTORIAL

Professional

Both

$5,463.00

Service Code	HCPCS 61304
Min. Negotiated Rate	$1,626.97
Max. Negotiated Rate	$3,550.95
Rate for Payer: Aetna Commercial	$2,180.14
Rate for Payer: Aetna Medicare	$1,626.97
Rate for Payer: BCBS Complete	$2,185.20
Rate for Payer: BCBS MAPPO	$1,626.97
Rate for Payer: BCN Medicare Advantage	$1,626.97
Rate for Payer: Cash Price	$4,370.40
Rate for Payer: Cash Price	$4,370.40
Rate for Payer: Cofinity Commercial	$2,342.84
Rate for Payer: Cofinity Commercial	$2,180.14
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,626.97
Rate for Payer: Healthscope Commercial	$1,952.36
Rate for Payer: Healthscope Whirlpool	$1,952.36
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$1,708.32
Rate for Payer: Nomi Health Commercial	$1,952.36
Rate for Payer: PACE SWMI	$1,626.97
Rate for Payer: PHP Medicare Advantage	$1,626.97
Rate for Payer: Priority Health Cigna Priority Health	$3,550.95
Rate for Payer: Priority Health Medicare	$1,626.97
Rate for Payer: UHC Dual Complete DSNP	$1,626.97
Rate for Payer: UHC Medicare Advantage	$1,626.97
Rate for Payer: UHCCP DNSP	$1,626.97

PR CRANIECTOMY/CRANIOTOMY TX PENETRATNG WOUND BRAIN

Professional

Both

$8,983.00

Service Code	HCPCS 61571
Min. Negotiated Rate	$1,976.86
Max. Negotiated Rate	$5,838.95
Rate for Payer: Aetna Commercial	$2,648.99
Rate for Payer: Aetna Medicare	$1,976.86
Rate for Payer: BCBS Complete	$3,593.20
Rate for Payer: BCBS MAPPO	$1,976.86
Rate for Payer: BCN Medicare Advantage	$1,976.86
Rate for Payer: Cash Price	$7,186.40
Rate for Payer: Cash Price	$7,186.40
Rate for Payer: Cofinity Commercial	$2,846.68
Rate for Payer: Cofinity Commercial	$2,648.99
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,976.86
Rate for Payer: Healthscope Commercial	$2,372.23
Rate for Payer: Healthscope Whirlpool	$2,372.23
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$2,075.70
Rate for Payer: Nomi Health Commercial	$2,372.23
Rate for Payer: PACE SWMI	$1,976.86
Rate for Payer: PHP Medicare Advantage	$1,976.86
Rate for Payer: Priority Health Cigna Priority Health	$5,838.95
Rate for Payer: Priority Health Medicare	$1,976.86
Rate for Payer: UHC Dual Complete DSNP	$1,976.86
Rate for Payer: UHC Medicare Advantage	$1,976.86
Rate for Payer: UHCCP DNSP	$1,976.86

PR CRANIECTOMY FOR OSTEOMYELITIS

Professional

Both

$5,360.00

Service Code	HCPCS 61501
Min. Negotiated Rate	$1,103.87
Max. Negotiated Rate	$3,484.00
Rate for Payer: Aetna Commercial	$1,479.19
Rate for Payer: Aetna Medicare	$1,103.87
Rate for Payer: BCBS Complete	$2,144.00
Rate for Payer: BCBS MAPPO	$1,103.87
Rate for Payer: BCN Medicare Advantage	$1,103.87
Rate for Payer: Cash Price	$4,288.00
Rate for Payer: Cash Price	$4,288.00
Rate for Payer: Cofinity Commercial	$1,589.57
Rate for Payer: Cofinity Commercial	$1,479.19
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,103.87
Rate for Payer: Healthscope Commercial	$1,324.64
Rate for Payer: Healthscope Whirlpool	$1,324.64
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$1,159.06
Rate for Payer: Nomi Health Commercial	$1,324.64
Rate for Payer: PACE SWMI	$1,103.87
Rate for Payer: PHP Medicare Advantage	$1,103.87
Rate for Payer: Priority Health Cigna Priority Health	$3,484.00
Rate for Payer: Priority Health Medicare	$1,103.87
Rate for Payer: UHC Dual Complete DSNP	$1,103.87
Rate for Payer: UHC Medicare Advantage	$1,103.87
Rate for Payer: UHCCP DNSP	$1,103.87

PR CRANIECTOMY SUBOCCIPITAL SECTION 1/> CRANIAL NRV

Professional

Both

$6,301.00

Service Code	HCPCS 61460
Min. Negotiated Rate	$2,090.12
Max. Negotiated Rate	$4,095.65
Rate for Payer: Aetna Commercial	$2,800.76
Rate for Payer: Aetna Medicare	$2,090.12
Rate for Payer: BCBS Complete	$2,520.40
Rate for Payer: BCBS MAPPO	$2,090.12
Rate for Payer: BCN Medicare Advantage	$2,090.12
Rate for Payer: Cash Price	$5,040.80
Rate for Payer: Cash Price	$5,040.80
Rate for Payer: Cofinity Commercial	$3,009.77
Rate for Payer: Cofinity Commercial	$2,800.76
Rate for Payer: Health Alliance Plan Medicare Advantage	$2,090.12
Rate for Payer: Healthscope Commercial	$2,508.14
Rate for Payer: Healthscope Whirlpool	$2,508.14
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$2,194.63
Rate for Payer: Nomi Health Commercial	$2,508.14
Rate for Payer: PACE SWMI	$2,090.12
Rate for Payer: PHP Medicare Advantage	$2,090.12
Rate for Payer: Priority Health Cigna Priority Health	$4,095.65
Rate for Payer: Priority Health Medicare	$2,090.12
Rate for Payer: UHC Dual Complete DSNP	$2,090.12
Rate for Payer: UHC Medicare Advantage	$2,090.12
Rate for Payer: UHCCP DNSP	$2,090.12

PR CRANIECTOMY W/EXCISION TUMOR/OTH BONE LESION SKL

Professional

Both

$2,739.00

Service Code	HCPCS 61500
Min. Negotiated Rate	$1,095.60
Max. Negotiated Rate	$1,822.52
Rate for Payer: Aetna Commercial	$1,695.96
Rate for Payer: Aetna Medicare	$1,265.64
Rate for Payer: BCBS Complete	$1,095.60
Rate for Payer: BCBS MAPPO	$1,265.64
Rate for Payer: BCN Medicare Advantage	$1,265.64
Rate for Payer: Cash Price	$2,191.20
Rate for Payer: Cash Price	$2,191.20
Rate for Payer: Cofinity Commercial	$1,822.52
Rate for Payer: Cofinity Commercial	$1,695.96
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,265.64
Rate for Payer: Healthscope Commercial	$1,518.77
Rate for Payer: Healthscope Whirlpool	$1,518.77
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$1,328.92
Rate for Payer: Nomi Health Commercial	$1,518.77
Rate for Payer: PACE SWMI	$1,265.64
Rate for Payer: PHP Medicare Advantage	$1,265.64
Rate for Payer: Priority Health Cigna Priority Health	$1,780.35
Rate for Payer: Priority Health Medicare	$1,265.64
Rate for Payer: UHC Dual Complete DSNP	$1,265.64
Rate for Payer: UHC Medicare Advantage	$1,265.64
Rate for Payer: UHCCP DNSP	$1,265.64

PR CRANIOFACIAL ANT CRANIAL FOSSA W/O ORBITAL EXNTJ

Professional

Both

$5,312.00

Service Code	HCPCS 61580
Min. Negotiated Rate	$2,124.80
Max. Negotiated Rate	$3,452.80
Rate for Payer: Aetna Commercial	$3,174.67
Rate for Payer: Aetna Medicare	$2,369.16
Rate for Payer: BCBS Complete	$2,124.80
Rate for Payer: BCBS MAPPO	$2,369.16
Rate for Payer: BCN Medicare Advantage	$2,369.16
Rate for Payer: Cash Price	$4,249.60
Rate for Payer: Cash Price	$4,249.60
Rate for Payer: Cofinity Commercial	$3,411.59
Rate for Payer: Cofinity Commercial	$3,174.67
Rate for Payer: Health Alliance Plan Medicare Advantage	$2,369.16
Rate for Payer: Healthscope Commercial	$2,842.99
Rate for Payer: Healthscope Whirlpool	$2,842.99
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$2,487.62
Rate for Payer: Nomi Health Commercial	$2,842.99
Rate for Payer: PACE SWMI	$2,369.16
Rate for Payer: PHP Medicare Advantage	$2,369.16
Rate for Payer: Priority Health Cigna Priority Health	$3,452.80
Rate for Payer: Priority Health Medicare	$2,369.16
Rate for Payer: UHC Dual Complete DSNP	$2,369.16
Rate for Payer: UHC Medicare Advantage	$2,369.16
Rate for Payer: UHCCP DNSP	$2,369.16

PR CRANIOPLASTY SKULL DEFECT <5 CM DIAMETER

Professional

Both

$5,342.00

Service Code	HCPCS 62140
Min. Negotiated Rate	$1,006.89
Max. Negotiated Rate	$3,472.30
Rate for Payer: Aetna Commercial	$1,349.23
Rate for Payer: Aetna Medicare	$1,006.89
Rate for Payer: BCBS Complete	$2,136.80
Rate for Payer: BCBS MAPPO	$1,006.89
Rate for Payer: BCN Medicare Advantage	$1,006.89
Rate for Payer: Cash Price	$4,273.60
Rate for Payer: Cash Price	$4,273.60
Rate for Payer: Cofinity Commercial	$1,449.92
Rate for Payer: Cofinity Commercial	$1,349.23
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,006.89
Rate for Payer: Healthscope Commercial	$1,208.27
Rate for Payer: Healthscope Whirlpool	$1,208.27
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$1,057.23
Rate for Payer: Nomi Health Commercial	$1,208.27
Rate for Payer: PACE SWMI	$1,006.89
Rate for Payer: PHP Medicare Advantage	$1,006.89
Rate for Payer: Priority Health Cigna Priority Health	$3,472.30
Rate for Payer: Priority Health Medicare	$1,006.89
Rate for Payer: UHC Dual Complete DSNP	$1,006.89
Rate for Payer: UHC Medicare Advantage	$1,006.89
Rate for Payer: UHCCP DNSP	$1,006.89

PR CRANIOPLASTY SKULL DEFECT >5 CM DIAMETER

Professional

Both

$6,362.00

Service Code	HCPCS 62141
Min. Negotiated Rate	$1,131.89
Max. Negotiated Rate	$4,135.30
Rate for Payer: Aetna Commercial	$1,516.73
Rate for Payer: Aetna Medicare	$1,131.89
Rate for Payer: BCBS Complete	$2,544.80
Rate for Payer: BCBS MAPPO	$1,131.89
Rate for Payer: BCN Medicare Advantage	$1,131.89
Rate for Payer: Cash Price	$5,089.60
Rate for Payer: Cash Price	$5,089.60
Rate for Payer: Cofinity Commercial	$1,629.92
Rate for Payer: Cofinity Commercial	$1,516.73
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,131.89
Rate for Payer: Healthscope Commercial	$1,358.27
Rate for Payer: Healthscope Whirlpool	$1,358.27
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$1,188.48
Rate for Payer: Nomi Health Commercial	$1,358.27
Rate for Payer: PACE SWMI	$1,131.89
Rate for Payer: PHP Medicare Advantage	$1,131.89
Rate for Payer: Priority Health Cigna Priority Health	$4,135.30
Rate for Payer: Priority Health Medicare	$1,131.89
Rate for Payer: UHC Dual Complete DSNP	$1,131.89
Rate for Payer: UHC Medicare Advantage	$1,131.89
Rate for Payer: UHCCP DNSP	$1,131.89

PR CRANIOPLASTY SKULL DEFECT REPARATIVE BRAIN SURG

Professional

Both

$5,986.00

Service Code	HCPCS 62145
Min. Negotiated Rate	$1,388.99
Max. Negotiated Rate	$3,890.90
Rate for Payer: Aetna Commercial	$1,861.25
Rate for Payer: Aetna Medicare	$1,388.99
Rate for Payer: BCBS Complete	$2,394.40
Rate for Payer: BCBS MAPPO	$1,388.99
Rate for Payer: BCN Medicare Advantage	$1,388.99
Rate for Payer: Cash Price	$4,788.80
Rate for Payer: Cash Price	$4,788.80
Rate for Payer: Cofinity Commercial	$2,000.15
Rate for Payer: Cofinity Commercial	$1,861.25
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,388.99
Rate for Payer: Healthscope Commercial	$1,666.79
Rate for Payer: Healthscope Whirlpool	$1,666.79
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$1,458.44
Rate for Payer: Nomi Health Commercial	$1,666.79
Rate for Payer: PACE SWMI	$1,388.99
Rate for Payer: PHP Medicare Advantage	$1,388.99
Rate for Payer: Priority Health Cigna Priority Health	$3,890.90
Rate for Payer: Priority Health Medicare	$1,388.99
Rate for Payer: UHC Dual Complete DSNP	$1,388.99
Rate for Payer: UHC Medicare Advantage	$1,388.99
Rate for Payer: UHCCP DNSP	$1,388.99

PR CRANIOPLASTY W/AUTOGRAFT <5 CM DIAMETER

Professional

Both

$6,377.00

Service Code	HCPCS 62146
Min. Negotiated Rate	$1,242.36
Max. Negotiated Rate	$4,145.05
Rate for Payer: Aetna Commercial	$1,664.76
Rate for Payer: Aetna Medicare	$1,242.36
Rate for Payer: BCBS Complete	$2,550.80
Rate for Payer: BCBS MAPPO	$1,242.36
Rate for Payer: BCN Medicare Advantage	$1,242.36
Rate for Payer: Cash Price	$5,101.60
Rate for Payer: Cash Price	$5,101.60
Rate for Payer: Cofinity Commercial	$1,789.00
Rate for Payer: Cofinity Commercial	$1,664.76
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,242.36
Rate for Payer: Healthscope Commercial	$1,490.83
Rate for Payer: Healthscope Whirlpool	$1,490.83
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$1,304.48
Rate for Payer: Nomi Health Commercial	$1,490.83
Rate for Payer: PACE SWMI	$1,242.36
Rate for Payer: PHP Medicare Advantage	$1,242.36
Rate for Payer: Priority Health Cigna Priority Health	$4,145.05
Rate for Payer: Priority Health Medicare	$1,242.36
Rate for Payer: UHC Dual Complete DSNP	$1,242.36
Rate for Payer: UHC Medicare Advantage	$1,242.36
Rate for Payer: UHCCP DNSP	$1,242.36

PR CRANIOPLASTY W/AUTOGRAFT > 5 CM DIAMETER

Professional

Both

$7,296.00

Service Code	HCPCS 62147
Min. Negotiated Rate	$1,414.70
Max. Negotiated Rate	$4,742.40
Rate for Payer: Aetna Commercial	$1,895.70
Rate for Payer: Aetna Medicare	$1,414.70
Rate for Payer: BCBS Complete	$2,918.40
Rate for Payer: BCBS MAPPO	$1,414.70
Rate for Payer: BCN Medicare Advantage	$1,414.70
Rate for Payer: Cash Price	$5,836.80
Rate for Payer: Cash Price	$5,836.80
Rate for Payer: Cofinity Commercial	$2,037.17
Rate for Payer: Cofinity Commercial	$1,895.70
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,414.70
Rate for Payer: Healthscope Commercial	$1,697.64
Rate for Payer: Healthscope Whirlpool	$1,697.64
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$1,485.43
Rate for Payer: Nomi Health Commercial	$1,697.64
Rate for Payer: PACE SWMI	$1,414.70
Rate for Payer: PHP Medicare Advantage	$1,414.70
Rate for Payer: Priority Health Cigna Priority Health	$4,742.40
Rate for Payer: Priority Health Medicare	$1,414.70
Rate for Payer: UHC Dual Complete DSNP	$1,414.70
Rate for Payer: UHC Medicare Advantage	$1,414.70
Rate for Payer: UHCCP DNSP	$1,414.70

PR CRANIOT LOBECTOMY OTH/THN TEMPORAL LOBE W/O ECOG

Professional

Both

$7,866.00

Service Code	HCPCS 61540
Min. Negotiated Rate	$2,159.58
Max. Negotiated Rate	$5,112.90
Rate for Payer: Aetna Commercial	$2,893.84
Rate for Payer: Aetna Medicare	$2,159.58
Rate for Payer: BCBS Complete	$3,146.40
Rate for Payer: BCBS MAPPO	$2,159.58
Rate for Payer: BCN Medicare Advantage	$2,159.58
Rate for Payer: Cash Price	$6,292.80
Rate for Payer: Cash Price	$6,292.80
Rate for Payer: Cofinity Commercial	$3,109.80
Rate for Payer: Cofinity Commercial	$2,893.84
Rate for Payer: Health Alliance Plan Medicare Advantage	$2,159.58
Rate for Payer: Healthscope Commercial	$2,591.50
Rate for Payer: Healthscope Whirlpool	$2,591.50
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$2,267.56
Rate for Payer: Nomi Health Commercial	$2,591.50
Rate for Payer: PACE SWMI	$2,159.58
Rate for Payer: PHP Medicare Advantage	$2,159.58
Rate for Payer: Priority Health Cigna Priority Health	$5,112.90
Rate for Payer: Priority Health Medicare	$2,159.58
Rate for Payer: UHC Dual Complete DSNP	$2,159.58
Rate for Payer: UHC Medicare Advantage	$2,159.58
Rate for Payer: UHCCP DNSP	$2,159.58

PR CRANIOTOMY EXCISION CRANIOPHARYNGIOMA

Professional

Both

$6,696.00

Service Code	HCPCS 61545
Min. Negotiated Rate	$2,678.40
Max. Negotiated Rate	$4,550.52
Rate for Payer: Aetna Commercial	$4,234.51
Rate for Payer: Aetna Medicare	$3,160.08
Rate for Payer: BCBS Complete	$2,678.40
Rate for Payer: BCBS MAPPO	$3,160.08
Rate for Payer: BCN Medicare Advantage	$3,160.08
Rate for Payer: Cash Price	$5,356.80
Rate for Payer: Cash Price	$5,356.80
Rate for Payer: Cofinity Commercial	$4,550.52
Rate for Payer: Cofinity Commercial	$4,234.51
Rate for Payer: Health Alliance Plan Medicare Advantage	$3,160.08
Rate for Payer: Healthscope Commercial	$3,792.10
Rate for Payer: Healthscope Whirlpool	$3,792.10
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$3,318.08
Rate for Payer: Nomi Health Commercial	$3,792.10
Rate for Payer: PACE SWMI	$3,160.08
Rate for Payer: PHP Medicare Advantage	$3,160.08
Rate for Payer: Priority Health Cigna Priority Health	$4,352.40
Rate for Payer: Priority Health Medicare	$3,160.08
Rate for Payer: UHC Dual Complete DSNP	$3,160.08
Rate for Payer: UHC Medicare Advantage	$3,160.08
Rate for Payer: UHCCP DNSP	$3,160.08

Know your out-of-pocket cost for care.

All Charges