With a PriorityEngage plan, you have access to a wide network of providers, but to get the most out of your plan and pay the best price for your care, you need to shop for and schedule PriorityEngage-eligible procedures or services at a fair-market priced facility.

What's fair-market price?

The reasonable amount you should expect to pay for a medical service based on the fees many high-quality providers in your plan’s network are contracted to accept as payment from Priority Health. If you’re outside of Michigan, this price is calculated from an independent nationwide database and customized to your area.

What do you need to do?

If you need one of the procedures or services listed below, complete these steps:

  1. Identify your procedure. Refer to the lists below to see if your procedure is PriorityEngage-eligible 
  2. Do your research. Call your dedicated concierge team at 833.734.0015 or log in to your online Priority Health member account and use Coverage Check to search for a procedure and find fair-price facilities near you. 
  3. Choose your facility. Select, schedule and receive care at one of the at or below market price facilities identified by your concierge team or Coverage Check. 

Be sure to involve your concierge team or shop using our Coverage Check tool for any PriorityEngage-eligible procedures. If you do not take these steps or do so but choose a facility above fair-market price, you’ll receive non-engaged health benefits and may pay more for your care. If you already have prior authorization for a scheduled service, your concierge team may reach out to you to help find fair-priced locations for that service. 

PriorityEngage-eligible procedures

Inpatient and outpatient facility services

  • Anterior cruciate ligament knee surgery (ACL)
  • Arthroscopic rotator cuff repair
  • Breast biopsy
  • Carpal Tunnel surgery
  • Cataract surgery
  • Cesarean delivery
  • Cholecystectomy (laparoscopic)
  • Colonoscopy
  • Cystoscopy
  • Ear tube placement
  • Exise lesions (laparoscopic)
  • Hysteroscopy with biopsy
  • Knee arthroscopy
  • Lithotripsy
  • Nasal septum repair
  • Nose plastic surgery
  • Removal of adenoids
  • Shoulder arthroscopy
  • Sleep study, in center
  • Tonsillectomy
  • Total hip replacement (inpatient)
  • Total knee replacement (inpatient)
  • Upper gastrointestinal endoscopy
  • Vaginal delivery
  • Vaginal hysterotomy 

Advanced diagnostic imaging services

  • Abdomen and pelvis CT
  • Abdominal CT
  • Abdominal MRI
  • Ankle, hip, knee MRI
  • Arm CT
  • Arm MRI
  • Bone length study CT
  • Brain CT
  • Brain MRI
  • Breast MRI
  • Chest CT
  • Chest MRI
  • CT angiography (chest)
  • CT angiography (head or neck)
  • Dopper exam of the heart
  • Elbow, shoulder, wrist MRI
  • Face and jaw CT
  • Face MRI
  • Heart CT
  • Heart echo imaging
  • Heart MRI
  • Heart perfusion imaging
  • Jaw MRI
  • Leg CT
  • Leg MRI
  • Neck CT
  • Pelvic CT
  • Pelvis MRI
  • Spine CT
  • Spine MRI

Call 833.734.0015 to reach your dedicated concierge team of plan experts. They’re here to help you with any PriorityEngage plan questions you might have. We also encourage you to save this number in your phone. Or you can log in  to your online member account to send us a secure message.