Does Beacon Allegan have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Beacon Allegan. In a medical emergency, call 911.

Where is Beacon Allegan?

555 Linn Street, Allegan, MI 49010, in Allegan County, Michigan.

What is the phone number of Beacon Allegan?

(269) 686-4101, as listed by Medicare (CMS).

What is the Medicare star rating of Beacon Allegan?

CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Beacon Allegan — Phone, Address, ER & Ratings

Quick answers

Does Beacon Allegan have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Beacon Allegan. In a medical emergency, call 911.
Where is Beacon Allegan?: 555 Linn Street, Allegan, MI 49010, in Allegan County, Michigan.
What is the phone number of Beacon Allegan?: (269) 686-4101, as listed by Medicare (CMS).
What is the Medicare star rating of Beacon Allegan?: CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Specialties and care areas^[4]

Treatments^[4]

Cardiac rehab
Inpatient rehabilitation
Wound and hyperbaric care

Procedures^[4]

Minimally invasive procedures
Imaging
Lab tests

Emergency care (hospital website)^[4]

Emergency room	Yes
Open 24/7	Yes

Doctors and clinicians (69)

69 doctors and other clinicians list Beacon Allegan as a hospital where they work, in Medicare's official clinician data (updated 2026-10-02). It is not a complete staff list.

Main specialties

And 45 more: the button below opens the full list.

Other emergency rooms nearby

Hospitals that list emergency services, by straight-line distance (not driving distance).

Southridge Behavioral Hospital21 mi · Byron Center, MI · Psychiatric Hospital
Bronson Lakeview Hospital21 mi · Paw Paw, MI · Critical Access Hospital
Kalamazoo Regional Psychiatric Hospital21 mi · Kalamazoo, MI · Psychiatric Hospital
Borgess Medical Center21 mi · Kalamazoo, MI · Acute Care Hospital
Bronson Methodist Hospital21 mi · Kalamazoo, MI · Acute Care Hospital

Find the closest emergency room to where you are → · Compare ER wait times

Other hospitals near Allegan

Beacon Plainwell12 mi · Plainwell, MI · Long-Term Acute Care Hospital

Hospitals in Allegan County · Hospitals near me

Nursing homes, hospice, home health and dialysis nearby

Medicare-certified providers within 25 miles, by straight-line distance. Hospice and home health care is given at home: their address is the office.

Nursing homes

Ely Manor0.7 mi · Allegan, MI · 1 of 5 stars
Allegan County Medical Care Facility1.0 mi · Allegan, MI · 5 of 5 stars
Alamo Cove Rehab and Nursing Center12 mi · Kalamazoo, MI · 1 of 5 stars

All nursing homes in the state →

Hospice providers

Wings of Hope Hospice1.2 mi · Allegan, MI · 3 of 5 stars
Centrica Care Navigators17 mi · Kalamazoo, MI · 4 of 5 stars
Interim Healthcare of West Michigan17 mi · Kalamazoo, MI

All hospice providers in the state →

Home health agencies

Atrio Home Health Lakeshore19 mi · Holland, MI · 3.5 of 5 stars
Holland Community Hospital19 mi · Holland, MI · 4.5 of 5 stars
Kalamazoo Home Health Care20 mi · Kalamazoo, MI

All home health agencies in the state →

Dialysis facilities

FMC - Allegan1.2 mi · Allegan, MI · 3 of 5 stars
FMC - Oshtemo17 mi · Kalamazoo, MI · 3 of 5 stars
FMC Hastings Ave - Holland19 mi · Holland, MI · 4 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

Medicare-certified ambulatory surgery centers within 25 miles, by straight-line distance.

Bronson Orthopedic Surgery Center17 mi · Kalamazoo, MI
Holland Eye Surgery & Laser Center19 mi · Holland, MI
Southwest Surgical Center21 mi · Byron Center, MI

All outpatient surgery centers in the state →

Community care nearby

Health centers, clinics, urgent care and pharmacies closest to this hospital, by straight-line distance, from official HRSA, Medicare and NPI Registry data. In a medical emergency, call 911.

Community health centers

InterCare Child & Adolescent Health Center Otsego9.1 mi · Otsego, MI · Community health center
Intercare Pullman12 mi · Pullman, MI · Community health center
Intercare Bangor19 mi · Bangor, MI · Community health center

Clinics and urgent care

Beacon Allegan1.2 mi · Allegan, MI · Rural health clinic
Beacon Allegan Gobles Clinic10 mi · Gobles, MI · Rural health clinic
Beacon Plainwell Family Medicine14 mi · Plainwell, MI · Rural health clinic

Pharmacies

Allegan Medical Center Pharmacy1.2 mi · Allegan, MI · Pharmacy
Allegan Pharmacy LLC1.2 mi · Allegan, MI · Community/retail pharmacy
Lakeshore Pharmacies, Inc.1.2 mi · Allegan, MI · Community/retail pharmacy

Assisted living nearby

Licensed homes from the official state license list, by straight-line distance.

Agnus Dei AFC Home II1.2 mi · Allegan, MI
Agnus Dei AFC Home III1.2 mi · Allegan, MI
Allegan Enrichment Center #11.2 mi · Allegan, MI
Allegan Enrichment Center II1.2 mi · Allegan, MI

About the Medicare star rating

CMS (the federal Medicare agency) gives many hospitals an overall rating from 1 to 5 stars, based on measures of mortality, safety, readmissions, patient experience and timely care. It is one piece of information: ask your doctor what matters for your care. See the full Medicare profile →

Medicare quality data

What Beacon Allegan reported to Medicare (CMS), the federal agency that publishes these results for hospitals nationwide. These are averages for many patients, not a prediction for any one person: ask your doctor what matters for your care. In a medical emergency, call 911.

What patients said (patient survey)

What this means: Patients who stayed overnight answered a national survey (HCAHPS) about their stay. More stars mean patients reported a better experience than at other hospitals. The percentages show how often patients gave the best answer, next to the national average.

Rated the hospital 9 or 10 out of 10	64%National average: 72%
Would definitely recommend the hospital	69%National average: 71%
Nurses “always” communicated well	80%National average: 80%
Doctors “always” communicated well	79%National average: 80%
“Always” got help as soon as they wanted	76%National average: 64%
Staff “always” explained medicines before giving them	67%National average: 62%
Were given information about recovery at home	89%National average: 86%
Room and bathroom “always” clean	84%National average: 73%
Not reported to Medicare	Summary star rating (all survey topics); Overall rating of the hospital; Would recommend the hospital; Nurses communicated well; Doctors communicated well; Patients got help quickly from staff; Staff explained medicines; Information about recovery at home; Room and bathroom kept clean; Restfulness of Environment; Care Coordination; Symptoms After Stay
Completed surveys	54Response rate: 28%

Source: Patient survey (HCAHPS) - Hospital — CMS, released October 19, 2026; patients discharged January 2025 to December 2025.

Return visits to the hospital (readmissions)

What this means: The share of patients who had to be admitted to a hospital again within 30 days after going home, adjusted for how sick they were. A lower percentage is better.

Returned to any hospital within 30 days (all patients)	15.7%
Readmitted within 30 days: pneumonia	16.6%
Readmitted within 30 days: COPD	19%
Not reported to Medicare	Readmitted within 30 days: coronary bypass surgery; Readmitted within 30 days: hip or knee replacement
Too few cases to report	Readmitted within 30 days: heart attack; Readmitted within 30 days: heart failure

Source: Unplanned Hospital Visits - Hospital — CMS, released October 20, 2026; data from July 2024 to June 2025.

Emergency room times and sepsis care

What this means: ER time is the middle (median) time from arriving at the emergency room to leaving it; busier ERs usually have longer times, so the ER volume is shown too. Leaving before being seen: a lower percentage is better. Sepsis is a life-threatening reaction to an infection; a higher percentage means more patients got every recommended early step.

Emergency room volume (patients per year)	Low (under 20,000)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	98 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	0%National average: 2%
Not reported to Medicare	Sepsis patients who got all the recommended early care (SEP-1)

Source: Timely and Effective Care - Hospital — CMS, released October 19, 2026; data from January 2024 to December 2024.

Not reported to Medicare: infections caught in the hospital, complications and deaths. For these topics Medicare shows no result for this hospital (not reported, or too few cases).

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

How this hospital compares with others in the area, ranked only by official Medicare (CMS) numbers.

ER wait times in Michigan Best hospitals in Michigan

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 85 common services exactly as Beacon Allegan lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

Hospital charge: The hospital’s list price (“gross charge”) before any discount or insurance. Few people pay this amount.
Cash price: The price the hospital offers if you pay yourself, without insurance (“discounted cash price”).
Insurance rates: The lowest and highest amounts the hospital has agreed with any insurance plan for the service (“de-identified minimum and maximum”), and some of the rates it lists by insurer and plan. Your share depends on your deductible, copay and coinsurance.
Hospital and doctor fees: A service can have a hospital (facility) fee and a separate doctor (professional) fee; the total for your care can include both, plus other services.

How to use hospital prices: estimates, financial assistance and your rights →

Show the prices of 85 common services

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient In the file: OFFICE/OP VISIT NEW PATIENT LEVEL 3	$313	$153.37	$76.98 – $107.15
New patient office visit (about 30–44 minutes): rates for 5 insurance plans ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $85.64 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $85.64 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $85.64 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $85.64 MAGELLAN — 2050_BOMC, BPHC MAGELLAN 20210201: $76.98
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: OFFICE/OP VISIT NEW PATIENT LEVEL 3	$313	$153.37	$76.98 – $107.15
New patient office visit (about 30–44 minutes): rates for 5 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $85.64 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $83.66 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $85.64 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $83.66 MICHIGAN BCCCP — 2627_BOMC, BOLE, BPHC BCCCP 20210201: $107.15
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient In the file: NEW PATIENT LEVEL 3	$313	$153.37	$76.98 – $107.15
New patient office visit (about 30–44 minutes): rates for 5 insurance plans ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $85.64 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $85.64 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $85.64 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $85.64 MAGELLAN — 2050_BOMC, BPHC MAGELLAN 20210201: $76.98
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient In the file: OFFICE/OP VISIT NEW PATIENT LEVEL 4	$476.90	$233.68	$84.67 – $144.43
New patient office visit (about 45–59 minutes): rates for 5 insurance plans ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $144.43 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $144.43 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $144.43 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $144.43 MAGELLAN — 2050_BOMC, BPHC MAGELLAN 20210201: $84.67
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: OFFICE/OP VISIT NEW PATIENT LEVEL 4	$476.90	$233.68	$84.67 – $144.43
New patient office visit (about 45–59 minutes): rates for 5 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $144.43 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $143.08 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $144.43 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $143.08 MICHIGAN BCCCP — 2627_BOMC, BOLE, BPHC BCCCP 20210201: $107.15
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient In the file: NEW PATIENT LEVEL 4	$476.90	$233.68	$84.67 – $144.43
New patient office visit (about 45–59 minutes): rates for 5 insurance plans ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $144.43 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $144.43 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $144.43 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $144.43 MAGELLAN — 2050_BOMC, BPHC MAGELLAN 20210201: $84.67
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient In the file: OFFICE/OP VISIT NEW PATIENT LEVEL 5	$564.35	$276.53	$95.26 – $188.63
New patient office visit (about 60–74 minutes): rates for 5 insurance plans ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $188.63 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $188.63 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $188.63 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $188.63 MAGELLAN — 2050_BOMC, BPHC MAGELLAN 20210201: $95.26
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: OFFICE/OP VISIT NEW PATIENT LEVEL 5	$564.35	$276.53	$95.26 – $188.63
New patient office visit (about 60–74 minutes): rates for 5 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $188.63 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $186.83 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $188.63 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $186.83 MICHIGAN BCCCP — 2627_BOMC, BOLE, BPHC BCCCP 20210201: $107.15
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient In the file: NEW PATIENT LEVEL 5	$564.35	$276.53	$95.26 – $188.63
New patient office visit (about 60–74 minutes): rates for 5 insurance plans ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $188.63 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $188.63 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $188.63 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $188.63 MAGELLAN — 2050_BOMC, BPHC MAGELLAN 20210201: $95.26
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient In the file: OFFICE/OP VISIT EST PATIENT LEVEL 3	$297	$145.53	$56.68 – $72.85
Established patient office visit (about 20–29 minutes): rates for 5 insurance plans ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $57.18 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $57.18 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $57.18 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $57.18 MAGELLAN — 2050_BOMC, BPHC MAGELLAN 20210201: $71.28
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: OFFICE/OP VISIT EST PATIENT LEVEL 3	$297	$145.53	$56.68 – $72.85
Established patient office visit (about 20–29 minutes): rates for 5 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $57.18 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $56.68 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $57.18 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $56.68 MICHIGAN BCCCP — 2627_BOMC, BOLE, BPHC BCCCP 20210201: $72.85
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient In the file: EST. PATIENT LEVEL 3	$297	$145.53	$56.68 – $72.85
Established patient office visit (about 20–29 minutes): rates for 5 insurance plans ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $57.18 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $57.18 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $57.18 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $57.18 MAGELLAN — 2050_BOMC, BPHC MAGELLAN 20210201: $71.28
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient In the file: OFFICE/OP VISIT EST PATIENT LEVEL 4	$376	$184.24	$72.85 – $87.56
Established patient office visit (about 30–39 minutes): rates for 5 insurance plans ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $87.56 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $87.56 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $87.56 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $87.56 MAGELLAN — 2050_BOMC, BPHC MAGELLAN 20210201: $76.98
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: OFFICE/OP VISIT EST PATIENT LEVEL 4	$376	$184.24	$72.85 – $87.56
Established patient office visit (about 30–39 minutes): rates for 5 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $87.56 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $87.15 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $87.56 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $87.15 MICHIGAN BCCCP — 2627_BOMC, BOLE, BPHC BCCCP 20210201: $72.85
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient In the file: EST. PATIENT LEVEL 4	$376	$184.24	$72.85 – $87.56
Established patient office visit (about 30–39 minutes): rates for 5 insurance plans ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $87.56 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $87.56 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $87.56 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $87.56 MAGELLAN — 2050_BOMC, BPHC MAGELLAN 20210201: $76.98
Office consultation with a specialist (moderate) CPT 99243 · Inpatient or outpatient In the file: OFF/OP CNSLTJ NEW/EST LOW 30	Not listed in the file	Not listed in the file	$106.62 – $182.52
Office consultation with a specialist (moderate): rates for 5 insurance plans ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $106.62 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $106.62 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $106.62 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $106.62 MAGELLAN — 2050_BOMC, BPHC MAGELLAN 20210201: $182.52
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) In the file: OFF/OP CNSLTJ NEW/EST LOW 30	Not listed in the file	Not listed in the file	$106.62 – $182.52
Office consultation with a specialist (moderate): rates for 4 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $106.62 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $107.24 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $106.62 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $107.24
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient or outpatient In the file: OFF/OP CNSLTJ NEW/EST MOD 40	Not listed in the file	Not listed in the file	$171.39 – $182.52
Office consultation with a specialist (moderate to high): rates for 5 insurance plans ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $171.39 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $171.39 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $171.39 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $171.39 MAGELLAN — 2050_BOMC, BPHC MAGELLAN 20210201: $182.52
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) In the file: OFF/OP CNSLTJ NEW/EST MOD 40	Not listed in the file	Not listed in the file	$171.39 – $182.52
Office consultation with a specialist (moderate to high): rates for 4 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $171.39 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $172.62 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $171.39 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $172.62
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) In the file: PREV VISIT NEW AGE 18-39	Not listed in the file	Not listed in the file	$45 – $109.95
Preventive checkup, new patient, age 18–39: rates for 5 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $109.35 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $109.95 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $109.35 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $109.95 MICHIGAN BCCCP — 2627_BOMC, BOLE, BPHC BCCCP 20210201: $45
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient In the file: PREV VISIT NEW AGE 18-39	Not listed in the file	Not listed in the file	$45 – $109.95
Preventive checkup, new patient, age 18–39: rates for 4 insurance plans ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $109.35 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $109.35 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $109.35 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $109.35
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) In the file: PREV VISIT NEW AGE 40-64	Not listed in the file	Not listed in the file	$107.15 – $133.42
Preventive checkup, new patient, age 40–64: rates for 5 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $133.04 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $133.42 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $133.04 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $133.42 MICHIGAN BCCCP — 2627_BOMC, BOLE, BPHC BCCCP 20210201: $107.15
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient In the file: PREV VISIT NEW AGE 40-64	Not listed in the file	Not listed in the file	$107.15 – $133.42
Preventive checkup, new patient, age 40–64: rates for 4 insurance plans ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $133.04 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $133.04 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $133.04 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $133.04
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient In the file: ED LEV 3 FAC	$570.05	$279.32	$54 – $104.53
Emergency room visit (moderate): rates for 10 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $104.53 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $69.70 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $69.70 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $69.70 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $69.70 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $104.53 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $104.53 MAGELLAN — 2050_BOMC, BPHC MAGELLAN 20210201: $54 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $104.53 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $104.53
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient In the file: ED LEVEL 3 FAC	$570.05	$279.32	$54 – $104.53
Emergency room visit (moderate): rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $104.53 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $69.70 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $69.70 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $69.70 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $69.70 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $104.53 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $104.53 MAGELLAN — 2050_BOMC, BPHC MAGELLAN 20210201: $54 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $104.53
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: ED LEV 3 FAC	$570.05	$279.32	$54 – $104.53
Emergency room visit (moderate): rates for 4 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $69.70 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $72.57 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $69.70 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $72.57
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient In the file: ED LEV 4 FAC	$1,048.70	$513.86	$108 – $172.66
Emergency room visit (moderately high): rates for 10 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $172.66 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $132.30 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $132.30 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $132.30 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $132.30 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $172.66 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $172.66 MAGELLAN — 2050_BOMC, BPHC MAGELLAN 20210201: $108 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $172.66 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $172.66
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient In the file: ED LEVEL 4 FAC	$1,048.70	$513.86	$108 – $172.66
Emergency room visit (moderately high): rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $172.66 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $132.30 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $132.30 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $132.30 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $132.30 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $172.66 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $172.66 MAGELLAN — 2050_BOMC, BPHC MAGELLAN 20210201: $108 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $172.66
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: ED LEV 4 FAC	$1,048.70	$513.86	$108 – $172.66
Emergency room visit (moderately high): rates for 4 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $132.30 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $133.39 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $132.30 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $133.39
Emergency room visit (high) CPT 99285 · Inpatient or outpatient In the file: ED LEV 5 FAC	$1,573.10	$770.82	$108 – $253.86
Emergency room visit (high): rates for 10 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $253.86 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $194.96 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $194.96 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $194.96 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $194.96 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $253.86 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $253.86 MAGELLAN — 2050_BOMC, BPHC MAGELLAN 20210201: $108 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $253.86 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $253.86
Emergency room visit (high) CPT 99285 · Inpatient or outpatient In the file: ED LEVEL 5 FAC	$1,573.10	$770.82	$108 – $253.86
Emergency room visit (high): rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $253.86 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $194.96 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $194.96 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $194.96 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $194.96 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $253.86 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $253.86 MAGELLAN — 2050_BOMC, BPHC MAGELLAN 20210201: $108 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $253.86
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: ED LEV 5 FAC	$1,573.10	$770.82	$108 – $253.86
Emergency room visit (high): rates for 4 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $194.96 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $193.86 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $194.96 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $193.86

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient In the file: BASIC METABOLIC PANEL	$76.55	$37.51	$6 – $10.44
Basic metabolic panel (blood test): rates for 6 insurance plans AETNA — 3158_BOAH AETNA 20141201: $8.04 AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $6 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $6 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $6 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $6 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $6
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: BASIC METABOLIC PANEL	$76.55	$37.51	$6 – $10.44
Basic metabolic panel (blood test): rates for 5 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $10.44 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $8.46 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $10.44 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $8.46 SMARTHEALTH — 3501_SMARTHEALTH 20230101: $7.41
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient In the file: METABOLIC PANEL TOTAL CA	Not listed in the file	Not listed in the file	$6 – $65.07
Basic metabolic panel (blood test): rates for 6 insurance plans AETNA — 3158_BOAH AETNA 20141201: $8.04 AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $6 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $6 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $6 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $6 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $6
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient In the file: COMPREHENSIVE METABOLIC PANEL	$100.55	$49.27	$7.38 – $15.19
Comprehensive metabolic panel (blood test): rates for 6 insurance plans AETNA — 3158_BOAH AETNA 20141201: $10.03 AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $7.38 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $7.38 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $7.38 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $7.38 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $7.38
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: COMPREHENSIVE METABOLIC PANEL	$100.55	$49.27	$7.38 – $15.19
Comprehensive metabolic panel (blood test): rates for 4 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $13.04 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $10.56 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $13.04 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $10.56
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient (hospital stay) In the file: COMPREHENSIVE METABOLIC PANEL	$100.55	$49.27	$7.38 – $15.19
Comprehensive metabolic panel (blood test): rates for 1 insurance plan SMARTHEALTH — 3501_SMARTHEALTH 20230101: $15.19
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) In the file: PRENATAL PROFILE	$146.25	$71.66	$36.95 – $59.02
Obstetric blood test panel: rates for 5 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $59.02 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $47.81 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $59.02 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $47.81 SMARTHEALTH — 3501_SMARTHEALTH 20230101: $36.95
Obstetric blood test panel CPT 80055 · Inpatient or outpatient In the file: PRENATAL PROFILE	$146.25	$71.66	$36.95 – $59.02
Obstetric blood test panel: rates for 1 insurance plan AETNA — 3158_BOAH AETNA 20141201: $45.42
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) In the file: OBSTETRIC PANEL	Not listed in the file	Not listed in the file	$36.95 – $124.31
Obstetric blood test panel: rates for 5 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $59.02 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $47.81 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $59.02 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $47.81 SMARTHEALTH — 3501_SMARTHEALTH 20230101: $36.95
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient In the file: LIPID PROFILE	$131.40	$64.39	$9.07 – $16.53
Cholesterol panel (lipid panel): rates for 6 insurance plans AETNA — 3158_BOAH AETNA 20141201: $12.72 AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $9.07 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $9.07 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $9.07 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $9.07 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $9.07
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: LIPID PROFILE	$131.40	$64.39	$9.07 – $16.53
Cholesterol panel (lipid panel): rates for 5 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $16.53 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $13.39 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $16.53 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $13.39 SMARTHEALTH — 3501_SMARTHEALTH 20230101: $9.89
Cholesterol panel (lipid panel) CPT 80061 · Inpatient (hospital stay) In the file: LIPID PROFILE	$131.40	$64.39	$9.07 – $16.53
Cholesterol panel (lipid panel): rates for 1 insurance plan SMARTHEALTH — 3501_SMARTHEALTH 20230101: $11.58
Kidney function panel CPT 80069 · Inpatient or outpatient In the file: RENAL FUNCTION PANEL	$87.95	$43.10	$6.16 – $10.72
Kidney function panel: rates for 6 insurance plans AETNA — 3158_BOAH AETNA 20141201: $8.25 AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $6.16 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $6.16 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $6.16 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $6.16 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $6.16
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: RENAL FUNCTION PANEL	$87.95	$43.10	$6.16 – $10.72
Kidney function panel: rates for 5 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $10.72 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $8.68 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $10.72 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $8.68 SMARTHEALTH — 3501_SMARTHEALTH 20230101: $9.25
Kidney function panel CPT 80069 · Inpatient (hospital stay) In the file: RENAL FUNCTION PANEL	Not listed in the file	Not listed in the file	$6.16 – $74.76
Kidney function panel: rates for 1 insurance plan CIGNA ALLEGAN — 3180_BOAH CIGNA 20230701: $74.76
Liver function panel CPT 80076 · Inpatient or outpatient In the file: HEPATIC FUNCTION PANEL	$108.55	$53.19	$3.25 – $10.09
Liver function panel: rates for 6 insurance plans AETNA — 3158_BOAH AETNA 20141201: $7.76 AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $3.25 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $3.25 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $3.25 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $3.25 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $3.25
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: HEPATIC FUNCTION PANEL	$108.55	$53.19	$3.25 – $10.09
Liver function panel: rates for 5 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $10.09 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $8.17 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $10.09 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $8.17 SMARTHEALTH — 3501_SMARTHEALTH 20230101: $6.48
Liver function panel CPT 80076 · Inpatient (hospital stay) In the file: HEPATIC FUNCTION PANEL	Not listed in the file	Not listed in the file	$3.25 – $92.27
Liver function panel: rates for 2 insurance plans CIGNA ALLEGAN — 3180_BOAH CIGNA 20230701: $92.27 SMARTHEALTH — 3501_SMARTHEALTH 20230101: $7.59
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient In the file: URINALYSIS W/MICRO	$45.70	$22.39	$2.10 – $3.92
Urine test (automated, with microscope): rates for 6 insurance plans AETNA — 3158_BOAH AETNA 20141201: $3.01 AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $2.25 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $2.25 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $2.25 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $2.25 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $2.25
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: URINALYSIS W/MICRO	$45.70	$22.39	$2.10 – $3.92
Urine test (automated, with microscope): rates for 5 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $3.92 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $3.17 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $3.92 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $3.17 SMARTHEALTH — 3501_SMARTHEALTH 20230101: $2.10
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient In the file: URINALYSIS AUTO W/SCOPE	Not listed in the file	Not listed in the file	$2.25 – $38.84
Urine test (automated, with microscope): rates for 6 insurance plans AETNA — 3158_BOAH AETNA 20141201: $3.01 AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $2.25 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $2.25 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $2.25 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $2.25 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $2.25
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient In the file: URINALYSIS W/O MICRO NON AUTOMATED	$14.70	$7.20	$1.81 – $3.48
Urine test (manual, without microscope): rates for 6 insurance plans AETNA — 3158_BOAH AETNA 20141201: $3.31 AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $1.81 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $1.81 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $1.81 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $1.81 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $1.81
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: URINALYSIS W/O MICRO NON AUTOMATED	$14.70	$7.20	$1.81 – $3.48
Urine test (manual, without microscope): rates for 5 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $3.48 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $3.48 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $3.48 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $3.48 SMARTHEALTH — 3501_SMARTHEALTH 20230101: $2.08
Urine test (manual, without microscope) CPT 81002 · Inpatient (hospital stay) In the file: URINALYSIS W/O MICRO NON AUTOMATED	$14.70	$7.20	$1.81 – $3.48
Urine test (manual, without microscope): rates for 1 insurance plan SMARTHEALTH — 3501_SMARTHEALTH 20230101: $2.44
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: URINE CHEMICAL-DIP	$22.85	$11.20	$1.49 – $2.77
Urine test (automated, without microscope): rates for 6 insurance plans AETNA — 3158_BOAH AETNA 20141201: $2.14 AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $1.59 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $1.59 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $1.59 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $1.59 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $1.59
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: URINALYSIS	$22.85	$11.20	$1.49 – $2.77
Urine test (automated, without microscope): rates for 6 insurance plans AETNA — 3158_BOAH AETNA 20141201: $2.14 AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $1.59 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $1.59 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $1.59 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $1.59 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $1.59
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: URINE CHEMICAL-DIP	$22.85	$11.20	$1.49 – $2.77
Urine test (automated, without microscope): rates for 5 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $2.77 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $2.25 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $2.77 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $2.25 SMARTHEALTH — 3501_SMARTHEALTH 20230101: $1.49
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: PSA DIAGNOSTIC	$146.25	$71.66	$12.22 – $22.71
PSA (prostate specific antigen) blood test: rates for 6 insurance plans AETNA — 3158_BOAH AETNA 20141201: $17.47 AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $13.04 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $13.04 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $13.04 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $13.04 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $13.04
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: PSA REFERENCE	$130.20	$63.80	$13.04 – $22.71
PSA (prostate specific antigen) blood test: rates for 6 insurance plans AETNA — 3158_BOAH AETNA 20141201: $17.47 AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $13.04 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $13.04 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $13.04 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $13.04 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $13.04
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: PSA DIAGNOSTIC	$146.25	$71.66	$12.22 – $22.71
PSA (prostate specific antigen) blood test: rates for 5 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $22.71 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $18.39 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $22.71 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $18.39 SMARTHEALTH — 3501_SMARTHEALTH 20230101: $12.22
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient In the file: TSH	$131.40	$64.39	$11.92 – $20.75
Thyroid stimulating hormone (TSH) test: rates for 6 insurance plans AETNA — 3158_BOAH AETNA 20141201: $15.96 AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $11.92 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $11.92 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $11.92 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $11.92 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $11.92
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: TSH	$131.40	$64.39	$11.92 – $20.75
Thyroid stimulating hormone (TSH) test: rates for 4 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $20.75 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $16.80 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $20.75 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $16.80
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient (hospital stay) In the file: TSH	$131.40	$64.39	$11.92 – $20.75
Thyroid stimulating hormone (TSH) test: rates for 1 insurance plan SMARTHEALTH — 3501_SMARTHEALTH 20230101: $13.07
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient In the file: CBC/DIFF/PLATELETS	$76.55	$37.51	$5.51 – $9.59
Complete blood count (CBC) with differential: rates for 6 insurance plans AETNA — 3158_BOAH AETNA 20141201: $7.38 AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $5.51 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $5.51 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $5.51 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $5.51 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $5.51
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient In the file: CBC/TECH DIFF	$76.55	$37.51	$5.51 – $9.59
Complete blood count (CBC) with differential: rates for 6 insurance plans AETNA — 3158_BOAH AETNA 20141201: $7.38 AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $5.51 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $5.51 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $5.51 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $5.51 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $5.51
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) In the file: CBC/DIFF/PLATELETS	$76.55	$37.51	$5.51 – $9.59
Complete blood count (CBC) with differential: rates for 4 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $9.59 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $7.77 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $9.59 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $7.77
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient In the file: HEMOGRAM	$62.85	$30.80	$3.29 – $7.98
Complete blood count (CBC), automated: rates for 6 insurance plans AETNA — 3158_BOAH AETNA 20141201: $6.15 AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $3.29 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $3.29 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $3.29 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $3.29 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $3.29
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: HEMOGRAM	$62.85	$30.80	$3.29 – $7.98
Complete blood count (CBC), automated: rates for 4 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $7.98 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $6.47 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $7.98 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $6.47
Complete blood count (CBC), automated CPT 85027 · Inpatient (hospital stay) In the file: HEMOGRAM	$62.85	$30.80	$3.29 – $7.98
Complete blood count (CBC), automated: rates for 1 insurance plan SMARTHEALTH — 3501_SMARTHEALTH 20230101: $5.03
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: PROTIME REFERENCE	$40.95	$20.07	$2.61 – $4.85
Blood clotting time test (prothrombin time, PT): rates for 6 insurance plans AETNA — 3158_BOAH AETNA 20141201: $4.08 AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $2.79 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $2.79 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $2.79 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $2.79 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $2.79
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: PROTIME	$42.25	$20.70	$2.61 – $4.85
Blood clotting time test (prothrombin time, PT): rates for 6 insurance plans AETNA — 3158_BOAH AETNA 20141201: $4.08 AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $2.79 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $2.79 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $2.79 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $2.79 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $2.79
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: PROTIME REFERENCE	$40.95	$20.07	$2.61 – $4.85
Blood clotting time test (prothrombin time, PT): rates for 5 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $4.85 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $4.29 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $4.85 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $4.29 SMARTHEALTH — 3501_SMARTHEALTH 20230101: $2.61
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: PTT REFERENCE	$45.15	$22.12	$4.26 – $7.42
Blood clotting test (partial thromboplastin time, PTT): rates for 6 insurance plans AETNA — 3158_BOAH AETNA 20141201: $5.71 AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $4.26 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $4.26 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $4.26 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $4.26 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $4.26
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: PTT	$48	$23.52	$4.26 – $7.42
Blood clotting test (partial thromboplastin time, PTT): rates for 6 insurance plans AETNA — 3158_BOAH AETNA 20141201: $5.71 AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $4.26 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $4.26 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $4.26 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $4.26 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $4.26
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: PTT REFERENCE	$45.15	$22.12	$4.26 – $7.42
Blood clotting test (partial thromboplastin time, PTT): rates for 4 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $7.42 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $6.01 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $7.42 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $6.01

Imaging (X-ray, CT, MRI, ultrasound, mammogram)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient In the file: CT HEAD W/O CONTRAST	$1,198.40	$587.22	$47.36 – $58.56
CT scan of the head or brain, without contrast: rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $58.56 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $47.81 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $47.81 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $47.81 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $47.81 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $58.56 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $58.56 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $58.56 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $58.56
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) In the file: CT HEAD W/O CONTRAST	$1,198.40	$587.22	$47.36 – $58.56
CT scan of the head or brain, without contrast: rates for 4 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $47.81 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $47.36 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $47.81 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $47.36
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient In the file: CT HEAD/BRAIN W/O DYE	Not listed in the file	Not listed in the file	$47.36 – $1,078.56
CT scan of the head or brain, without contrast: rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $58.56 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $47.81 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $47.81 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $47.81 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $47.81 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $58.56 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $58.56 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $58.56 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $58.56
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient In the file: MRI BRAIN W/O & W CONTRAST	$4,228.55	$2,071.99	$127.15 – $221.54
MRI of the brain, before and after contrast: rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $221.54 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $128.42 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $128.42 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $128.42 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $128.42 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $221.54 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $221.54 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $221.54 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $221.54
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient In the file: MRI BRAIN&ACCOUSTICS W/WO CONT	$4,228.55	$2,071.99	$127.15 – $221.54
MRI of the brain, before and after contrast: rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $221.54 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $128.42 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $128.42 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $128.42 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $128.42 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $221.54 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $221.54 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $221.54 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $221.54
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient In the file: ACOUSTICS W & WO	$4,228.55	$2,071.99	$127.15 – $221.54
MRI of the brain, before and after contrast: rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $221.54 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $128.42 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $128.42 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $128.42 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $128.42 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $221.54 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $221.54 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $221.54 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $221.54
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: RADIOLOGIC EXAMINATION,CHEST,2VIEWS	$109.90	$53.85	$12.13 – $12.25
Chest X-ray, 2 views: rates for 4 insurance plans ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $12.25 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $12.25 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $12.25 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $12.25
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: RADIOLOGIC EXAMINATION,CHEST,2VIEWS	$109.90	$53.85	$12.13 – $12.25
Chest X-ray, 2 views: rates for 4 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $12.25 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $12.13 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $12.25 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $12.13
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: X-RAY EXAM CHEST 2 VIEWS	Not listed in the file	Not listed in the file	$12.13 – $12.25
Chest X-ray, 2 views: rates for 4 insurance plans ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $12.25 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $12.25 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $12.25 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $12.25
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient In the file: LUMBOSACRALCMPLW/OBLQ,MIN4VIEW	$129.05	$63.23	$14.46 – $58.56
X-ray of the lower spine, at least 4 views: rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $58.56 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $17.77 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $17.77 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $17.77 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $17.77 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $58.56 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $58.56 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $58.56 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $58.56
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: LUMBOSACRALCMPLW/OBLQ,MIN4VIEW	$129.05	$63.23	$14.46 – $58.56
X-ray of the lower spine, at least 4 views: rates for 4 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $17.77 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $14.46 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $17.77 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $14.46
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient In the file: X-RAY EXAM L-2 SPINE 4/>VWS	Not listed in the file	Not listed in the file	$14.46 – $58.56
X-ray of the lower spine, at least 4 views: rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $58.56 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $17.77 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $17.77 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $17.77 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $17.77 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $58.56 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $58.56 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $58.56 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $58.56
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient In the file: MRI LUMBAR SPINE W/O CONTRAST	$3,142.45	$1,539.80	$82.56 – $117.34
MRI of the lower back (lumbar spine), without contrast: rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $117.34 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $83.75 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $83.75 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $83.75 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $83.75 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $117.34 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $117.34 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $117.34 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $117.34
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) In the file: MRI LUMBAR SPINE W/O CONTRAST	$3,142.45	$1,539.80	$82.56 – $117.34
MRI of the lower back (lumbar spine), without contrast: rates for 4 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $83.75 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $82.56 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $83.75 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $82.56
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient In the file: MRI LUMBAR SPINE W/O DYE	Not listed in the file	Not listed in the file	$82.56 – $2,828.20
MRI of the lower back (lumbar spine), without contrast: rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $117.34 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $83.75 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $83.75 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $83.75 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $83.75 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $117.34 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $117.34 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $117.34 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $117.34
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient In the file: CT PELVIS WITH CONTRAST	$2,292.10	$1,123.13	$64.15 – $137.66
CT scan of the pelvis, with contrast: rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $137.66 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $65.58 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $65.58 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $65.58 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $65.58 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $137.66 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $137.66 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $137.66 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $137.66
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) In the file: CT PELVIS WITH CONTRAST	$2,292.10	$1,123.13	$64.15 – $137.66
CT scan of the pelvis, with contrast: rates for 4 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $65.58 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $64.15 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $65.58 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $64.15
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient In the file: CT PELVIS W/DYE	Not listed in the file	Not listed in the file	$64.15 – $2,062.89
CT scan of the pelvis, with contrast: rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $137.66 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $65.58 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $65.58 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $65.58 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $65.58 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $137.66 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $137.66 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $137.66 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $137.66
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient In the file: MRI LOWER EXTREMITY ANY JNT RT,W/O CONTR	$3,194.10	$1,565.11	$75.09 – $2,874.69
MRI of a leg joint (such as the knee), without contrast: rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $117.34 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $76.61 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $76.61 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $76.61 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $76.61 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $117.34 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $117.34 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $117.34 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $117.34
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient In the file: MRI LOWER EXTREMITY ANY JNT LT,W/O CONTR	$3,194.10	$1,565.11	$75.09 – $2,874.69
MRI of a leg joint (such as the knee), without contrast: rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $117.34 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $76.61 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $76.61 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $76.61 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $76.61 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $117.34 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $117.34 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $117.34 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $117.34
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) In the file: MRI LOWER EXTREMITY ANY JNT RT,W/O CONTR	$3,194.10	$1,565.11	$75.09 – $2,874.69
MRI of a leg joint (such as the knee), without contrast: rates for 5 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $76.61 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $75.09 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $76.61 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $75.09 CIGNA ALLEGAN — 3180_BOAH CIGNA 20230701: $2,874.69
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient In the file: CT ABDOMEN/PELVIS W/CONTRAST	$3,211.60	$1,573.68	$101.32 – $137.66
CT scan of the abdomen and pelvis, with contrast: rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $137.66 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $102.68 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $102.68 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $102.68 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $102.68 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $137.66 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $137.66 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $137.66 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $137.66
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: CT ABDOMEN/PELVIS W/CONTRAST	$3,211.60	$1,573.68	$101.32 – $137.66
CT scan of the abdomen and pelvis, with contrast: rates for 4 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $102.68 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $101.32 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $102.68 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $101.32
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient In the file: CT ABD & PELVIS W/CONTRAST	Not listed in the file	Not listed in the file	$101.32 – $2,890.44
CT scan of the abdomen and pelvis, with contrast: rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $137.66 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $102.68 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $102.68 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $102.68 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $102.68 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $137.66 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $137.66 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $137.66 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $137.66
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient In the file: ULTRA ABD COMP	$817.75	$400.70	$45.40 – $58.56
Ultrasound of the abdomen, complete: rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $58.56 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $45.42 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $45.42 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $45.42 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $45.42 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $58.56 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $58.56 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $58.56 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $58.56
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) In the file: ULTRA ABD COMP	$817.75	$400.70	$45.40 – $58.56
Ultrasound of the abdomen, complete: rates for 4 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $45.42 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $45.40 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $45.42 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $45.40
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient In the file: US EXAM ABDOM COMPLETE	Not listed in the file	Not listed in the file	$45.40 – $735.98
Ultrasound of the abdomen, complete: rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $58.56 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $45.42 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $45.42 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $45.42 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $45.42 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $58.56 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $58.56 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $58.56 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $58.56
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient In the file: ULTRA OB COMPLETE	$671.15	$328.86	$55.16 – $58.56
Pregnancy ultrasound (after the first trimester): rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $58.56 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $56.87 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $56.87 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $56.87 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $56.87 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $58.56 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $58.56 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $58.56 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $58.56
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient In the file: OB 2ND 3RD TRI	$671.15	$328.86	$55.16 – $58.56
Pregnancy ultrasound (after the first trimester): rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $58.56 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $56.87 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $56.87 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $56.87 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $56.87 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $58.56 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $58.56 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $58.56 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $58.56
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient In the file: US OB COMPLETE SURVEY MULT GESTATION	$671.15	$328.86	$55.16 – $58.56
Pregnancy ultrasound (after the first trimester): rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $58.56 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $56.87 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $56.87 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $56.87 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $56.87 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $58.56 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $58.56 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $58.56 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $58.56
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient In the file: TRANSVAGINAL	$735.85	$360.57	$38.33 – $58.56
Transvaginal ultrasound: rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $58.56 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $39.10 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $39.10 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $39.10 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $39.10 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $58.56 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $58.56 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $58.56 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $58.56
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: TRANSVAGINAL	$735.85	$360.57	$38.33 – $58.56
Transvaginal ultrasound: rates for 4 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $39.10 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $38.33 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $39.10 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $38.33
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient In the file: TRANSVAGINAL US NON-OB	Not listed in the file	Not listed in the file	$38.33 – $58.56
Transvaginal ultrasound: rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $58.56 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $39.10 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $39.10 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $39.10 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $39.10 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $58.56 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $58.56 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $58.56 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $58.56
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) In the file: MAMM UNI DIAG DIGITAL LT	$535.50	$262.40	$44.96 – $91.36
Diagnostic mammogram, one breast: rates for 5 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $87.52 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $86.55 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $87.52 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $86.55 MICHIGAN BCCCP — 2627_BOMC, BOLE, BPHC BCCCP 20210201: $91.36
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient In the file: MAMM UNI DIAG DIGITAL RT	$535.50	$262.40	$44.96 – $91.36
Diagnostic mammogram, one breast: rates for 5 insurance plans ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $44.96 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $87.52 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $44.96 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $44.96 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $44.96
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient In the file: UNI LAT ADD VIEWS RT 2D3D	$535.50	$262.40	$44.96 – $91.36
Diagnostic mammogram, one breast: rates for 5 insurance plans ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $44.96 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $87.52 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $44.96 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $44.96 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $44.96
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient In the file: MAMM BIL DIAG DIGITAL	$674.10	$330.31	$55.86 – $116.76
Diagnostic mammogram, both breasts: rates for 5 insurance plans ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $55.86 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $111.95 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $55.86 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $55.86 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $55.86
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: BILAT DIAGNOSTIC ADD VIEWS 2D3D	$674.10	$330.31	$55.86 – $116.76
Diagnostic mammogram, both breasts: rates for 5 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $111.95 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $110.32 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $111.95 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $110.32 MICHIGAN BCCCP — 2627_BOMC, BOLE, BPHC BCCCP 20210201: $116.76
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: MAMM BIL DIAG DIGITAL	$674.10	$330.31	$55.86 – $116.76
Diagnostic mammogram, both breasts: rates for 4 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $111.95 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $111.95 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $110.32 MICHIGAN BCCCP — 2627_BOMC, BOLE, BPHC BCCCP 20210201: $116.76
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: MAMM BIL SCREENING DIGITAL	$467.45	$229.05	$42.49 – $96.58
Screening mammogram, both breasts: rates for 5 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $92.47 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $91.50 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $92.47 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $91.50 MICHIGAN BCCCP — 2627_BOMC, BOLE, BPHC BCCCP 20210201: $96.58
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient In the file: MAMM UNI SCREENING DIGITAL RT	$467.45	$229.05	$42.49 – $96.58
Screening mammogram, both breasts: rates for 5 insurance plans ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $42.49 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $92.47 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $42.49 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $42.49 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $42.49
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient In the file: MAMM UNI SCREENING DIGITAL LT	$467.45	$229.05	$42.49 – $96.58
Screening mammogram, both breasts: rates for 5 insurance plans ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $42.49 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $92.47 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $42.49 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $42.49 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $42.49

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient or outpatient In the file: ELECTROCARDIOGRAM COMPLETE	Not listed in the file	Not listed in the file	$18.31 – $18.42
Electrocardiogram (ECG/EKG) with reading: rates for 4 insurance plans ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $18.42 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $18.42 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $18.42 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $18.42
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) In the file: ELECTROCARDIOGRAM COMPLETE	Not listed in the file	Not listed in the file	$18.31 – $18.42
Electrocardiogram (ECG/EKG) with reading: rates for 4 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $18.42 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $18.31 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $18.42 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $18.31
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient In the file: LEFT HRT CATH W/VENTRCLGRPHY	Not listed in the file	Not listed in the file	$268.94 – $1,471.80
Left heart catheterization (diagnostic): rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $1,471.80 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $274.50 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $274.50 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $274.50 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $274.50 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $1,471.80 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $1,471.80 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $1,471.80 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $1,471.80
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) In the file: LEFT HRT CATH W/VENTRCLGRPHY	Not listed in the file	Not listed in the file	$268.94 – $1,471.80
Left heart catheterization (diagnostic): rates for 6 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $274.50 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $268.94 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $274.50 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $268.94 AETNA — 2686_BOGI BOSU AETNA 20210701: 75% (a percentage in the contract, not a dollar amount) AETNA PPOM — 2681_BOGI BOSU AETNA PPOM 20210701: 75% (a percentage in the contract, not a dollar amount)
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient In the file: COMPREHENSIVE EP EVALUATION	Not listed in the file	Not listed in the file	$443.71 – $2,600.42
Heart rhythm study (electrophysiology evaluation): rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $2,600.42 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $450.07 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $450.07 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $450.07 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $450.07 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $2,600.42 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $2,600.42 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $2,600.42 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $2,600.42
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) In the file: COMPREHENSIVE EP EVALUATION	Not listed in the file	Not listed in the file	$443.71 – $2,600.42
Heart rhythm study (electrophysiology evaluation): rates for 6 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $450.07 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $443.71 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $450.07 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $443.71 AETNA — 2686_BOGI BOSU AETNA 20210701: 75% (a percentage in the contract, not a dollar amount) AETNA PPOM — 2681_BOGI BOSU AETNA PPOM 20210701: 75% (a percentage in the contract, not a dollar amount)
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient or outpatient In the file: COMPRE EP EVAL ABLTJ ATR FIB	Not listed in the file	Not listed in the file	$1,278.05 – $8,718.57
Heart rhythm study with ablation for atrial fibrillation: rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $8,718.57 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $1,293.56 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $1,293.56 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $1,293.56 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $1,293.56 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $8,718.57 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $8,718.57 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $8,718.57 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $8,718.57
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) In the file: COMPRE EP EVAL ABLTJ ATR FIB	Not listed in the file	Not listed in the file	$1,278.05 – $8,718.57
Heart rhythm study with ablation for atrial fibrillation: rates for 6 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $1,293.56 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $1,278.05 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $1,293.56 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $1,278.05 AETNA — 2686_BOGI BOSU AETNA 20210701: 75% (a percentage in the contract, not a dollar amount) AETNA PPOM — 2681_BOGI BOSU AETNA PPOM 20210701: 75% (a percentage in the contract, not a dollar amount)
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient In the file: POLYSOMNOGRAPHY 4+ 2/TECH	$5,162.85	$2,529.80	$135.08 – $449.06
Sleep study (overnight, in a sleep lab): rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $449.06 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $136.81 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $136.81 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $136.81 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $136.81 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $449.06 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $449.06 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $449.06 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $449.06
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) In the file: POLYSOMNOGRAPHY 4+ 2/TECH	$5,162.85	$2,529.80	$135.08 – $449.06
Sleep study (overnight, in a sleep lab): rates for 4 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $136.81 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $135.08 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $136.81 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $135.08
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient In the file: POLYSOM 6/> YRS 4/> PARAM	Not listed in the file	Not listed in the file	$135.08 – $449.06
Sleep study (overnight, in a sleep lab): rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $449.06 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $136.81 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $136.81 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $136.81 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $136.81 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $449.06 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $449.06 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $449.06 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $449.06

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient In the file: THERAPY EXERCISE PER 15 MINUTES	$190.80	$93.49	$16.40 – $33.79
Physical therapy: therapeutic exercise (each 15 minutes): rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $16.40 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $33.79 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $33.79 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $33.79 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $33.79 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $16.40 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $16.40 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $16.40 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $16.40
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) In the file: THERAPY EXERCISE PER 15 MINUTES	$190.80	$93.49	$16.40 – $33.79
Physical therapy: therapeutic exercise (each 15 minutes): rates for 4 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $33.79 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $33.54 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $33.79 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $33.54
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient In the file: THERAPEUTIC EXERCISES	Not listed in the file	Not listed in the file	$16.40 – $33.79
Physical therapy: therapeutic exercise (each 15 minutes): rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $16.40 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $33.79 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $33.79 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $33.79 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $33.79 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $16.40 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $16.40 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $16.40 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $16.40
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient In the file: PT EVAL LOW COMPLEXITY; 20 MINUTES	$323.30	$158.42	$40.82 – $93.49
Physical therapy evaluation (low complexity): rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $40.82 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $92.31 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $92.31 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $92.31 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $92.31 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $40.82 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $40.82 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $40.82 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $40.82
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) In the file: PT EVAL LOW COMPLEXITY; 20 MINUTES	$323.30	$158.42	$40.82 – $93.49
Physical therapy evaluation (low complexity): rates for 4 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $92.31 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $93.49 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $92.31 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $93.49
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient In the file: PT EVAL LOW COMPLEX 20 MIN	Not listed in the file	Not listed in the file	$40.82 – $93.49
Physical therapy evaluation (low complexity): rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $40.82 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $92.31 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $92.31 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $92.31 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $92.31 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $40.82 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $40.82 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $40.82 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $40.82
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient In the file: PT EVAL MEDIUM COMPLEXITY; 30 MINUTES	$323.30	$158.42	$40.82 – $93.49
Physical therapy evaluation (moderate complexity): rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $40.82 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $92.31 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $92.31 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $92.31 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $92.31 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $40.82 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $40.82 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $40.82 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $40.82
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) In the file: PT EVAL MEDIUM COMPLEXITY; 30 MINUTES	$323.30	$158.42	$40.82 – $93.49
Physical therapy evaluation (moderate complexity): rates for 4 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $92.31 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $93.49 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $92.31 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $93.49
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient In the file: PT EVAL MOD COMPLEX 30 MIN	Not listed in the file	Not listed in the file	$40.82 – $93.49
Physical therapy evaluation (moderate complexity): rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $40.82 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $92.31 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $92.31 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $92.31 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $92.31 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $40.82 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $40.82 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $40.82 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $40.82
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient In the file: PT EVAL HIGH COMPLEXITY; 45 MINUTES	$323.30	$158.42	$40.82 – $93.49
Physical therapy evaluation (high complexity): rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $40.82 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $92.31 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $92.31 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $92.31 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $92.31 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $40.82 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $40.82 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $40.82 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $40.82
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) In the file: PT EVAL HIGH COMPLEXITY; 45 MINUTES	$323.30	$158.42	$40.82 – $93.49
Physical therapy evaluation (high complexity): rates for 4 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $92.31 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $93.49 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $92.31 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $93.49
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient In the file: PT EVAL HIGH COMPLEX 45 MIN	Not listed in the file	Not listed in the file	$40.82 – $93.49
Physical therapy evaluation (high complexity): rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $40.82 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $92.31 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $92.31 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $92.31 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $92.31 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $40.82 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $40.82 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $40.82 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $40.82
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient In the file: PSYTX W PT 30 MINUTES	Not listed in the file	Not listed in the file	$36.50 – $78.84
Psychotherapy, 30 minutes: rates for 10 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $36.50 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $70.68 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $70.68 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $70.68 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $70.68 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $36.50 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $36.50 MAGELLAN — 2050_BOMC, BPHC MAGELLAN 20210201: $78.84 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $36.50 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $36.50
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) In the file: PSYTX W PT 30 MINUTES	Not listed in the file	Not listed in the file	$36.50 – $78.84
Psychotherapy, 30 minutes: rates for 4 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $70.68 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $69.97 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $70.68 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $69.97
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient In the file: PSYTX W PT 45 MINUTES	Not listed in the file	Not listed in the file	$65.45 – $94.26
Psychotherapy, 45 minutes: rates for 10 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $65.45 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $94.26 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $94.26 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $94.26 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $94.26 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $65.45 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $65.45 MAGELLAN — 2050_BOMC, BPHC MAGELLAN 20210201: $89.64 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $65.45 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $65.45
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) In the file: PSYTX W PT 45 MINUTES	Not listed in the file	Not listed in the file	$65.45 – $94.26
Psychotherapy, 45 minutes: rates for 4 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $94.26 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $93.30 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $94.26 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $93.30
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient In the file: PSYTX W PT 60 MINUTES	Not listed in the file	Not listed in the file	$65.45 – $141.78
Psychotherapy, 60 minutes: rates for 10 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $65.45 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $141.78 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $141.78 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $141.78 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $141.78 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $65.45 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $65.45 MAGELLAN — 2050_BOMC, BPHC MAGELLAN 20210201: $89.64 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $65.45 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $65.45
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) In the file: PSYTX W PT 60 MINUTES	Not listed in the file	Not listed in the file	$65.45 – $141.78
Psychotherapy, 60 minutes: rates for 4 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $141.78 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $139.54 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $141.78 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $139.54
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient In the file: FAMILY PSYTX W/O PT 50 MIN	Not listed in the file	Not listed in the file	$65.45 – $114.17
Family psychotherapy, without the patient: rates for 10 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $65.45 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $114.17 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $114.17 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $114.17 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $114.17 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $65.45 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $65.45 MAGELLAN — 2050_BOMC, BPHC MAGELLAN 20210201: $100.44 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $65.45 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $65.45
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) In the file: FAMILY PSYTX W/O PT 50 MIN	Not listed in the file	Not listed in the file	$65.45 – $114.17
Family psychotherapy, without the patient: rates for 4 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $114.17 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $112.60 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $114.17 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $112.60
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient In the file: FAMILY PSYTX W/PT 50 MIN	Not listed in the file	Not listed in the file	$65.45 – $118.94
Family psychotherapy, with the patient: rates for 10 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $65.45 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $118.94 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $118.94 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $118.94 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $118.94 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $65.45 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $65.45 MAGELLAN — 2050_BOMC, BPHC MAGELLAN 20210201: $100.44 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $65.45 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $65.45
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) In the file: FAMILY PSYTX W/PT 50 MIN	Not listed in the file	Not listed in the file	$65.45 – $118.94
Family psychotherapy, with the patient: rates for 4 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $118.94 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $116.95 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $118.94 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $116.95
Group psychotherapy CPT 90853 · Inpatient or outpatient In the file: GROUP PSYCHOTHERAPY	Not listed in the file	Not listed in the file	$27.65 – $45.36
Group psychotherapy: rates for 10 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $36.50 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $27.94 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $27.94 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $27.94 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $27.94 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $36.50 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $36.50 MAGELLAN — 2050_BOMC, BPHC MAGELLAN 20210201: $45.36 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $36.50 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $36.50
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) In the file: GROUP PSYCHOTHERAPY	Not listed in the file	Not listed in the file	$27.65 – $45.36
Group psychotherapy: rates for 4 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $27.94 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $27.65 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $27.94 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $27.65

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient In the file: REMOVAL OF BREAST LESION	Not listed in the file	Not listed in the file	$459.27 – $1,298.28
Removal of breast growth (open surgery): rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $1,298.28 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $465.82 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $465.82 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $465.82 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $465.82 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $1,298.28 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $1,298.28 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $1,298.28 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $1,298.28
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) In the file: REMOVAL OF BREAST LESION	Not listed in the file	Not listed in the file	$459.27 – $1,298.28
Removal of breast growth (open surgery): rates for 8 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $465.82 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $465.52 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $465.82 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $465.52 MICHIGAN BCCCP — 2627_BOMC, BOLE, BPHC BCCCP 20210201: $459.27 AETNA — 2686_BOGI BOSU AETNA 20210701: 75% (a percentage in the contract, not a dollar amount) AETNA PPOM — 2681_BOGI BOSU AETNA PPOM 20210701: 75% (a percentage in the contract, not a dollar amount) PHCS — 1971_BOGI, BOSU PHCS 20200101: 75% (a percentage in the contract, not a dollar amount)
Total hip replacement CPT 27130 · Outpatient (no overnight stay) In the file: TOTAL HIP ARTHROPLASTY	Not listed in the file	Not listed in the file	$1,523.58 – $1,534.66
Total hip replacement: rates for 7 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $1,534.66 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $1,523.58 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $1,534.66 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $1,523.58 AETNA — 2686_BOGI BOSU AETNA 20210701: 75% (a percentage in the contract, not a dollar amount) AETNA PPOM — 2681_BOGI BOSU AETNA PPOM 20210701: 75% (a percentage in the contract, not a dollar amount) PHCS — 1971_BOGI, BOSU PHCS 20200101: 75% (a percentage in the contract, not a dollar amount)
Total hip replacement CPT 27130 · Inpatient or outpatient In the file: TOTAL HIP ARTHROPLASTY	Not listed in the file	Not listed in the file	$1,523.58 – $1,534.66
Total hip replacement: rates for 4 insurance plans ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $1,534.66 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $1,534.66 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $1,534.66 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $1,534.66
Total knee replacement CPT 27447 · Outpatient (no overnight stay) In the file: TOTAL KNEE ARTHROPLASTY	Not listed in the file	Not listed in the file	$1,521.67 – $1,533.14
Total knee replacement: rates for 7 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $1,533.14 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $1,521.67 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $1,533.14 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $1,521.67 AETNA — 2686_BOGI BOSU AETNA 20210701: 75% (a percentage in the contract, not a dollar amount) AETNA PPOM — 2681_BOGI BOSU AETNA PPOM 20210701: 75% (a percentage in the contract, not a dollar amount) PHCS — 1971_BOGI, BOSU PHCS 20200101: 75% (a percentage in the contract, not a dollar amount)
Total knee replacement CPT 27447 · Inpatient or outpatient In the file: TOTAL KNEE ARTHROPLASTY	Not listed in the file	Not listed in the file	$1,521.67 – $1,533.14
Total knee replacement: rates for 4 insurance plans ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $1,533.14 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $1,533.14 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $1,533.14 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $1,533.14
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) In the file: SHO ARTHRS SRG DECOMPRESSION	Not listed in the file	Not listed in the file	$197.32 – $200.72
Shoulder arthroscopy: shaving of shoulder bone: rates for 7 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $200.72 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $197.32 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $200.72 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $197.32 AETNA — 2686_BOGI BOSU AETNA 20210701: 75% (a percentage in the contract, not a dollar amount) AETNA PPOM — 2681_BOGI BOSU AETNA PPOM 20210701: 75% (a percentage in the contract, not a dollar amount) PHCS — 1971_BOGI, BOSU PHCS 20200101: 75% (a percentage in the contract, not a dollar amount)
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient In the file: SHO ARTHRS SRG DECOMPRESSION	Not listed in the file	Not listed in the file	$197.32 – $200.72
Shoulder arthroscopy: shaving of shoulder bone: rates for 4 insurance plans ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $200.72 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $200.72 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $200.72 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $200.72
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient or outpatient In the file: KNEE ARTHROSCOPY/SURGERY	Not listed in the file	Not listed in the file	$601.75 – $1,266.52
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $1,266.52 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $606.46 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $606.46 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $606.46 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $606.46 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $1,266.52 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $1,266.52 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $1,266.52 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $1,266.52
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) In the file: KNEE ARTHROSCOPY/SURGERY	Not listed in the file	Not listed in the file	$601.75 – $1,266.52
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 7 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $606.46 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $601.75 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $606.46 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $601.75 AETNA — 2686_BOGI BOSU AETNA 20210701: 75% (a percentage in the contract, not a dollar amount) AETNA PPOM — 2681_BOGI BOSU AETNA PPOM 20210701: 75% (a percentage in the contract, not a dollar amount) PHCS — 1971_BOGI, BOSU PHCS 20200101: 75% (a percentage in the contract, not a dollar amount)
Removal of tonsils and adenoids (under age 12) CPT 42820 · Inpatient or outpatient In the file: REMOVE TONSILS AND ADENOIDS	Not listed in the file	Not listed in the file	$319.54 – $2,145.69
Removal of tonsils and adenoids (under age 12): rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $2,145.69 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $321.87 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $321.87 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $321.87 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $321.87 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $2,145.69 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $2,145.69 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $2,145.69 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $2,145.69
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) In the file: REMOVE TONSILS AND ADENOIDS	Not listed in the file	Not listed in the file	$319.54 – $2,145.69
Removal of tonsils and adenoids (under age 12): rates for 7 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $321.87 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $319.54 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $321.87 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $319.54 AETNA — 2686_BOGI BOSU AETNA 20210701: 75% (a percentage in the contract, not a dollar amount) AETNA PPOM — 2681_BOGI BOSU AETNA PPOM 20210701: 75% (a percentage in the contract, not a dollar amount) PHCS — 1971_BOGI, BOSU PHCS 20200101: 75% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient In the file: EGD	$2,493.75	$1,221.94	$137.81 – $1,870.31
Upper GI endoscopy (diagnostic): rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $363.49 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $141.75 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $141.75 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $141.75 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $141.75 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $363.49 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $363.49 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $363.49 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $363.49
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: EGD	$2,493.75	$1,221.94	$137.81 – $1,870.31
Upper GI endoscopy (diagnostic): rates for 7 insurance plans AETNA — 2686_BOGI BOSU AETNA 20210701: $1,870.31 AETNA PPOM — 2681_BOGI BOSU AETNA PPOM 20210701: $1,870.31 ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $141.75 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $137.81 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $141.75 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $137.81 PHCS — 1971_BOGI, BOSU PHCS 20200101: $1,870.31
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient In the file: EGD DIAGNOSTIC BRUSH WASH	Not listed in the file	Not listed in the file	$137.81 – $1,870.31
Upper GI endoscopy (diagnostic): rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $363.49 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $141.75 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $141.75 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $141.75 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $141.75 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $363.49 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $363.49 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $363.49 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $363.49
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient In the file: EGD W/ BIOPSY	$2,493.75	$1,221.94	$155.38 – $1,870.31
Upper GI endoscopy with biopsy: rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $363.49 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $159.48 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $159.48 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $159.48 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $159.48 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $363.49 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $363.49 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $363.49 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $363.49
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: EGD W/ BIOPSY	$2,493.75	$1,221.94	$155.38 – $1,870.31
Upper GI endoscopy with biopsy: rates for 7 insurance plans AETNA — 2686_BOGI BOSU AETNA 20210701: $1,870.31 AETNA PPOM — 2681_BOGI BOSU AETNA PPOM 20210701: $1,870.31 ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $159.48 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $155.38 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $159.48 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $155.38 PHCS — 1971_BOGI, BOSU PHCS 20200101: $1,870.31
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient In the file: EGD BIOPSY SINGLE/MULTIPLE	Not listed in the file	Not listed in the file	$155.38 – $1,870.31
Upper GI endoscopy with biopsy: rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $363.49 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $159.48 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $159.48 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $159.48 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $159.48 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $363.49 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $363.49 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $363.49 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $363.49
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient In the file: DIAGNOSTIC COLONOSCOPY IN SS	$2,493.75	$1,221.94	$208.62 – $1,870.31
Colonoscopy (diagnostic): rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $346.80 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $214.09 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $214.09 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $214.09 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $214.09 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $346.80 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $346.80 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $346.80 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $346.80
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient In the file: SCREENING COLONOSCOPY IN SS	$2,493.75	$1,221.94	$208.62 – $1,870.31
Colonoscopy (diagnostic): rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $346.80 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $214.09 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $214.09 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $214.09 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $214.09 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $346.80 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $346.80 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $346.80 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $346.80
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: DIAGNOSTIC COLONOSCOPY IN SS	$2,493.75	$1,221.94	$208.62 – $1,870.31
Colonoscopy (diagnostic): rates for 7 insurance plans AETNA — 2686_BOGI BOSU AETNA 20210701: $1,870.31 AETNA PPOM — 2681_BOGI BOSU AETNA PPOM 20210701: $1,870.31 ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $214.09 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $208.62 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $214.09 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $208.62 PHCS — 1971_BOGI, BOSU PHCS 20200101: $1,870.31
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient In the file: COLONOSCOPY W/ COLD BIOPSY	$1,552.95	$760.95	$225.75 – $1,164.71
Colonoscopy with biopsy: rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $455.84 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $232.53 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $232.53 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $232.53 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $232.53 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $455.84 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $455.84 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $455.84 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $455.84
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: COLONOSCOPY W/ COLD BIOPSY	$1,552.95	$760.95	$225.75 – $1,164.71
Colonoscopy with biopsy: rates for 7 insurance plans AETNA — 2686_BOGI BOSU AETNA 20210701: $1,164.71 AETNA PPOM — 2681_BOGI BOSU AETNA PPOM 20210701: $1,164.71 ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $232.53 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $225.75 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $232.53 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $225.75 PHCS — 1971_BOGI, BOSU PHCS 20200101: $1,164.71
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient In the file: COLONOSCOPY AND BIOPSY	Not listed in the file	Not listed in the file	$225.75 – $1,164.71
Colonoscopy with biopsy: rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $455.84 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $232.53 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $232.53 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $232.53 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $232.53 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $455.84 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $455.84 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $455.84 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $455.84
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient In the file: TOTAL COLON POLYPECTOMY W SNARE TECHNQ	$3,367.35	$1,650	$286.72 – $2,525.51
Colonoscopy with removal of polyps (snare): rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $455.84 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $294.52 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $294.52 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $294.52 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $294.52 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $455.84 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $455.84 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $455.84 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $455.84
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: TOTAL COLON POLYPECTOMY W SNARE TECHNQ	$3,367.35	$1,650	$286.72 – $2,525.51
Colonoscopy with removal of polyps (snare): rates for 7 insurance plans AETNA — 2686_BOGI BOSU AETNA 20210701: $2,525.51 AETNA PPOM — 2681_BOGI BOSU AETNA PPOM 20210701: $2,525.51 ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $294.52 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $286.72 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $294.52 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $286.72 PHCS — 1971_BOGI, BOSU PHCS 20200101: $2,525.51
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient In the file: COLONOSCOPY W/LESION REMOVAL	Not listed in the file	Not listed in the file	$286.72 – $2,525.51
Colonoscopy with removal of polyps (snare): rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $455.84 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $294.52 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $294.52 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $294.52 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $294.52 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $455.84 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $455.84 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $455.84 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $455.84
Ultrasound of the lower bowel by endoscope CPT 45391 · Inpatient or outpatient In the file: COLONOSCOPY W/ENDOSCOPE US	Not listed in the file	Not listed in the file	$289.78 – $455.84
Ultrasound of the lower bowel by endoscope: rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $455.84 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $298.38 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $298.38 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $298.38 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $298.38 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $455.84 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $455.84 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $455.84 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $455.84
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) In the file: COLONOSCOPY W/ENDOSCOPE US	Not listed in the file	Not listed in the file	$289.78 – $455.84
Ultrasound of the lower bowel by endoscope: rates for 7 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $298.38 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $289.78 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $298.38 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $289.78 AETNA — 2686_BOGI BOSU AETNA 20210701: 75% (a percentage in the contract, not a dollar amount) AETNA PPOM — 2681_BOGI BOSU AETNA PPOM 20210701: 75% (a percentage in the contract, not a dollar amount) PHCS — 1971_BOGI, BOSU PHCS 20200101: 75% (a percentage in the contract, not a dollar amount)
Gallbladder removal by laparoscope CPT 47562 · Inpatient or outpatient In the file: LAPAROSCOPIC CHOLECYSTECTOMY	Not listed in the file	Not listed in the file	$748.27 – $2,181.11
Gallbladder removal by laparoscope: rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $2,181.11 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $749.48 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $749.48 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $749.48 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $749.48 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $2,181.11 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $2,181.11 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $2,181.11 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $2,181.11
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: LAPAROSCOPIC CHOLECYSTECTOMY	Not listed in the file	Not listed in the file	$748.27 – $2,181.11
Gallbladder removal by laparoscope: rates for 7 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $749.48 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $748.27 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $749.48 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $748.27 AETNA — 2686_BOGI BOSU AETNA 20210701: 75% (a percentage in the contract, not a dollar amount) AETNA PPOM — 2681_BOGI BOSU AETNA PPOM 20210701: 75% (a percentage in the contract, not a dollar amount) PHCS — 1971_BOGI, BOSU PHCS 20200101: 75% (a percentage in the contract, not a dollar amount)
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient In the file: PRP I/HERN INIT REDUC >5 YR	Not listed in the file	Not listed in the file	$590.26 – $1,486.96
Groin (inguinal) hernia repair, age 5 or older: rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $1,486.96 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $590.26 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $590.26 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $590.26 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $590.26 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $1,486.96 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $1,486.96 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $1,486.96 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $1,486.96
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: PRP I/HERN INIT REDUC >5 YR	Not listed in the file	Not listed in the file	$590.26 – $1,486.96
Groin (inguinal) hernia repair, age 5 or older: rates for 7 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $590.26 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $590.32 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $590.26 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $590.32 AETNA — 2686_BOGI BOSU AETNA 20210701: 75% (a percentage in the contract, not a dollar amount) AETNA PPOM — 2681_BOGI BOSU AETNA PPOM 20210701: 75% (a percentage in the contract, not a dollar amount) PHCS — 1971_BOGI, BOSU PHCS 20200101: 75% (a percentage in the contract, not a dollar amount)
Prostate biopsy CPT 55700 · Inpatient or outpatient In the file: BIOPSY OF PROSTATE	Not listed in the file	Not listed in the file	$147.56 – $854.27
Prostate biopsy: rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $854.27 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $149.68 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $149.68 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $149.68 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $149.68 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $854.27 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $854.27 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $854.27 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $854.27
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) In the file: BIOPSY OF PROSTATE	Not listed in the file	Not listed in the file	$147.56 – $854.27
Prostate biopsy: rates for 7 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $149.68 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $147.56 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $149.68 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $147.56 AETNA — 2686_BOGI BOSU AETNA 20210701: 75% (a percentage in the contract, not a dollar amount) AETNA PPOM — 2681_BOGI BOSU AETNA PPOM 20210701: 75% (a percentage in the contract, not a dollar amount) PHCS — 1971_BOGI, BOSU PHCS 20200101: 75% (a percentage in the contract, not a dollar amount)
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) In the file: LAPS SURG PRST8ECT RPBIC RAD	Not listed in the file	Not listed in the file	$1,629.29 – $1,650.66
Prostate removal by laparoscope (radical prostatectomy): rates for 7 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $1,650.66 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $1,629.29 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $1,650.66 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $1,629.29 AETNA — 2686_BOGI BOSU AETNA 20210701: 75% (a percentage in the contract, not a dollar amount) AETNA PPOM — 2681_BOGI BOSU AETNA PPOM 20210701: 75% (a percentage in the contract, not a dollar amount) PHCS — 1971_BOGI, BOSU PHCS 20200101: 75% (a percentage in the contract, not a dollar amount)
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Inpatient or outpatient In the file: LAPS SURG PRST8ECT RPBIC RAD	Not listed in the file	Not listed in the file	$1,629.29 – $1,650.66
Prostate removal by laparoscope (radical prostatectomy): rates for 4 insurance plans ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $1,650.66 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $1,650.66 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $1,650.66 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $1,650.66
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient In the file: HYSTEROSCOPY BIOPSY	Not listed in the file	Not listed in the file	$262.80 – $1,083.23
Hysteroscopy with biopsy of the uterus lining: rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $1,083.23 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $262.80 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $262.80 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $262.80 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $262.80 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $1,083.23 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $1,083.23 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $1,083.23 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $1,083.23
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) In the file: HYSTEROSCOPY BIOPSY	Not listed in the file	Not listed in the file	$262.80 – $1,083.23
Hysteroscopy with biopsy of the uterus lining: rates for 7 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $262.80 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $263.42 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $262.80 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $263.42 AETNA — 2686_BOGI BOSU AETNA 20210701: 75% (a percentage in the contract, not a dollar amount) AETNA PPOM — 2681_BOGI BOSU AETNA PPOM 20210701: 75% (a percentage in the contract, not a dollar amount) PHCS — 1971_BOGI, BOSU PHCS 20200101: 75% (a percentage in the contract, not a dollar amount)
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient In the file: NJX INTERLAMINAR LMBR/SAC, W GUIDANCE	$1,702.05	$834	$111.55 – $1,276.54
Spinal injection, lower back (epidural), with imaging guidance: rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $263.44 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $112.12 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $112.12 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $112.12 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $112.12 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $263.44 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $263.44 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $263.44 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $263.44
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) In the file: NJX INTERLAMINAR LMBR/SAC, W GUIDANCE	$1,702.05	$834	$111.55 – $1,276.54
Spinal injection, lower back (epidural), with imaging guidance: rates for 5 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $112.12 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $111.55 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $112.12 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $111.55 PHCS — 1971_BOGI, BOSU PHCS 20200101: $1,276.54
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient In the file: NJX INTERLAMINAR LMBR/SAC	Not listed in the file	Not listed in the file	$111.55 – $1,276.54
Spinal injection, lower back (epidural), with imaging guidance: rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $263.44 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $112.12 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $112.12 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $112.12 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $112.12 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $263.44 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $263.44 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $263.44 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $263.44
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient In the file: XA FACET BLOCK LUMBAR	$2,207.10	$1,081.48	$124.78 – $1,655.33
Nerve root injection, lower back, with imaging guidance: rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $331.87 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $126.16 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $126.16 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $126.16 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $126.16 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $331.87 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $331.87 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $331.87 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $331.87
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient In the file: FORAMEN EPIDURAL INJ L/S	$2,207.10	$1,081.48	$124.78 – $1,655.33
Nerve root injection, lower back, with imaging guidance: rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $331.87 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $126.16 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $126.16 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $126.16 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $126.16 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $331.87 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $331.87 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $331.87 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $331.87
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) In the file: XA FACET BLOCK LUMBAR	$2,207.10	$1,081.48	$124.78 – $1,655.33
Nerve root injection, lower back, with imaging guidance: rates for 7 insurance plans AETNA — 2686_BOGI BOSU AETNA 20210701: $1,655.33 AETNA PPOM — 2681_BOGI BOSU AETNA PPOM 20210701: $1,655.33 ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $126.16 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $124.78 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $126.16 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $124.78 PHCS — 1971_BOGI, BOSU PHCS 20200101: $1,655.33
Carpal tunnel release CPT 64721 · Inpatient or outpatient In the file: CARPAL TUNNEL SURGERY	Not listed in the file	Not listed in the file	$474.83 – $812.07
Carpal tunnel release: rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $812.07 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $474.83 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $474.83 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $474.83 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $474.83 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $812.07 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $812.07 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $812.07 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $812.07
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) In the file: CARPAL TUNNEL SURGERY	Not listed in the file	Not listed in the file	$474.83 – $812.07
Carpal tunnel release: rates for 7 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $474.83 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $475.02 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $474.83 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $475.02 AETNA — 2686_BOGI BOSU AETNA 20210701: 75% (a percentage in the contract, not a dollar amount) AETNA PPOM — 2681_BOGI BOSU AETNA PPOM 20210701: 75% (a percentage in the contract, not a dollar amount) PHCS — 1971_BOGI, BOSU PHCS 20200101: 75% (a percentage in the contract, not a dollar amount)
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient In the file: AFTER CATARACT LASER SURGERY	Not listed in the file	Not listed in the file	$244.06 – $340.83
Laser treatment of clouding after cataract surgery: rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $244.06 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $340.83 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $340.83 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $340.83 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $340.83 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $244.06 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $244.06 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $244.06 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $244.06
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) In the file: AFTER CATARACT LASER SURGERY	Not listed in the file	Not listed in the file	$244.06 – $340.83
Laser treatment of clouding after cataract surgery: rates for 7 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $340.83 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $336.53 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $340.83 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $336.53 AETNA — 2686_BOGI BOSU AETNA 20210701: 75% (a percentage in the contract, not a dollar amount) AETNA PPOM — 2681_BOGI BOSU AETNA PPOM 20210701: 75% (a percentage in the contract, not a dollar amount) PHCS — 1971_BOGI, BOSU PHCS 20200101: 75% (a percentage in the contract, not a dollar amount)
Cataract removal with lens implant CPT 66984 · Inpatient or outpatient In the file: XCAPSL CTRC RMVL W/O ECP	Not listed in the file	Not listed in the file	$594.31 – $947.60
Cataract removal with lens implant: rates for 9 insurance plans AETNA MEDICAID — 3806_BOAH MEDICAID REPLACEMENT AETNA BETTER HEALTH OUTPATIEN: $947.60 ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $705.71 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $705.71 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $705.71 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $705.71 BLUE CAID — 3807_BOAH MEDICAID REPLACEMENT BLUE CROSS COMPLETE OUTPATIEN: $947.60 BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701 — 3808_BOAH MEDICAID REPLACEMENT MERIDIAN OUTPATIENT 20250701: $947.60 MOLINA MEDICAID — 3810_BOAH MOLINA MEDICAID OUTPATIENT 20250701: $947.60 UHC MCD — 3809_BOAH MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY : $947.60
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) In the file: XCAPSL CTRC RMVL W/O ECP	Not listed in the file	Not listed in the file	$594.31 – $947.60
Cataract removal with lens implant: rates for 7 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $705.71 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $594.31 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $705.71 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $594.31 AETNA — 2686_BOGI BOSU AETNA 20210701: 75% (a percentage in the contract, not a dollar amount) AETNA PPOM — 2681_BOGI BOSU AETNA PPOM 20210701: 75% (a percentage in the contract, not a dollar amount) PHCS — 1971_BOGI, BOSU PHCS 20200101: 75% (a percentage in the contract, not a dollar amount)

Pregnancy and childbirth

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) In the file: OBSTETRICAL CARE	Not listed in the file	Not listed in the file	$2,355.70 – $2,395.56
Vaginal delivery, with care before and after: rates for 7 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $2,355.70 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $2,395.56 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $2,355.70 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $2,395.56 AETNA — 2686_BOGI BOSU AETNA 20210701: 75% (a percentage in the contract, not a dollar amount) AETNA PPOM — 2681_BOGI BOSU AETNA PPOM 20210701: 75% (a percentage in the contract, not a dollar amount) PHCS — 1971_BOGI, BOSU PHCS 20200101: 75% (a percentage in the contract, not a dollar amount)
Vaginal delivery, with care before and after CPT 59400 · Inpatient or outpatient In the file: OBSTETRICAL CARE	Not listed in the file	Not listed in the file	$2,355.70 – $2,395.56
Vaginal delivery, with care before and after: rates for 4 insurance plans ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $2,355.70 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $2,355.70 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $2,355.70 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $2,355.70
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) In the file: CESAREAN DELIVERY	Not listed in the file	Not listed in the file	$2,614.87 – $2,659.18
Cesarean delivery (C-section), with care before and after: rates for 7 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $2,614.87 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $2,659.18 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $2,614.87 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $2,659.18 AETNA — 2686_BOGI BOSU AETNA 20210701: 75% (a percentage in the contract, not a dollar amount) AETNA PPOM — 2681_BOGI BOSU AETNA PPOM 20210701: 75% (a percentage in the contract, not a dollar amount) PHCS — 1971_BOGI, BOSU PHCS 20200101: 75% (a percentage in the contract, not a dollar amount)
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient or outpatient In the file: CESAREAN DELIVERY	Not listed in the file	Not listed in the file	$2,614.87 – $2,659.18
Cesarean delivery (C-section), with care before and after: rates for 4 insurance plans ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $2,614.87 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $2,614.87 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $2,614.87 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $2,614.87
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) In the file: VBAC DELIVERY	Not listed in the file	Not listed in the file	$2,482.33 – $2,523.37
Vaginal delivery after a previous C-section, with care before and after: rates for 7 insurance plans ALLEGAN HUMANA MCR — 3130_BOAH MEDICARE HUMANA OUTPATIENT 20231001: $2,482.33 ALLEGAN MEDICARE — 3127_BOAH MEDICARE OUTPATIENT 20231001: $2,523.37 ALLEGAN MOLINA MEDICARE — 3123_BOAH MEDICARE MOLINA OUTPATIENT 20230215: $2,482.33 AUTO MVA — 3452_BOAH AUTO MVA MEDICARE OUTPATIENT 20230215: $2,523.37 AETNA — 2686_BOGI BOSU AETNA 20210701: 75% (a percentage in the contract, not a dollar amount) AETNA PPOM — 2681_BOGI BOSU AETNA PPOM 20210701: 75% (a percentage in the contract, not a dollar amount) PHCS — 1971_BOGI, BOSU PHCS 20200101: 75% (a percentage in the contract, not a dollar amount)
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Inpatient or outpatient In the file: VBAC DELIVERY	Not listed in the file	Not listed in the file	$2,482.33 – $2,523.37
Vaginal delivery after a previous C-section, with care before and after: rates for 4 insurance plans ALLEGAN HUMANA MCR — 3129_BOAH MEDICARE HUMANA INPATIENT 20231001: $2,482.33 ALLEGAN MEDICARE — 3128_BOAH MEDICARE INPATIENT 20231001: $2,482.33 ALLEGAN MOLINA MEDICARE — 3124_BOAH MEDICARE MOLINA INPATIENT 20230215: $2,482.33 AUTO MVA — 3453_BOAH AUTO MVA MEDICARE INPATIENT 20230215: $2,482.33

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC	Not listed in the file	Not listed in the file	Not listed in the file
Heart valve or major heart-chest surgery with heart catheterization, with major complications: rates for 1 insurance plan CIGNA ALLEGAN — 3180_BOAH CIGNA 20230701: 78% (a percentage in the contract, not a dollar amount)
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC	Not listed in the file	Not listed in the file	Not listed in the file
Hip or knee replacement (major joint of the leg), without major complications: rates for 1 insurance plan CIGNA ALLEGAN — 3180_BOAH CIGNA 20230701: 78% (a percentage in the contract, not a dollar amount)
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC	Not listed in the file	Not listed in the file	Not listed in the file
Neck (cervical) spinal fusion, without complications: rates for 1 insurance plan CIGNA ALLEGAN — 3180_BOAH CIGNA 20230701: 78% (a percentage in the contract, not a dollar amount)
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC	Not listed in the file	Not listed in the file	Not listed in the file
Uterus and ovary surgery (not for cancer), without complications: rates for 1 insurance plan CIGNA ALLEGAN — 3180_BOAH CIGNA 20230701: 78% (a percentage in the contract, not a dollar amount)

Source: Beacon Allegan’s standard charges file (beaconhealthsystem.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on January 1, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

Found through the price transparency link on the hospital’s website (beaconhealthsystem.org), because the hospital has no cms-hpt.txt file; both are required by the federal hospital price transparency rule (CMS). We show a selection of common services; the file has every item and service.

Hospital information

Hospital type	Critical Access Hospital
Address	555 Linn Street, Allegan, MI 49010
County	Allegan County
State	Michigan
Phone	(269) 686‑4101
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	Not rated by CMS
CMS Certification Number	231328
Name in Medicare records	BEACON ALLEGAN
Profile level	Medicare data + hospital website
Main phone on the hospital’s website	(269) 673‑8424^[4]
Name on the hospital’s website	Beacon Allegan - Formerly Borgess Allegan Hospital
Official website	locations.beaconhealthsystem.org
Corrections	Report an error or suggest an update →

Sources

Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-10-26, retrieved 2026-11-13
Medicare Care Compare — official Medicare profile of this hospital
U.S. Census Bureau Geocoder — map position used for distances

From the hospital’s website

Numbers match the citations above. Checked 2026-10-30.

Beacon Allegan - Formerly Borgess Allegan Hospital — locations.beaconhealthsystem.org