Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

CHG X-RAY HIP UNILAT 1 VW

Professional

Both

$30.00

Service Code	HCPCS 73500
Min. Negotiated Rate	$12.00
Max. Negotiated Rate	$21.00
Rate for Payer: BCBS Complete	$12.00
Rate for Payer: BCBS Complete	$39.20
Rate for Payer: Cash Price	$78.40
Rate for Payer: Cash Price	$24.00
Rate for Payer: Priority Health Cigna Priority Health	$21.00
Rate for Payer: Priority Health Cigna Priority Health	$68.60

CHG X-RAY PELVIS/HIPS CHILD/INFANT

Professional

Both

$34.00

Service Code	HCPCS 73540
Min. Negotiated Rate	$13.60
Max. Negotiated Rate	$23.80
Rate for Payer: BCBS Complete	$13.60
Rate for Payer: BCBS Complete	$38.00
Rate for Payer: Cash Price	$76.00
Rate for Payer: Cash Price	$27.20
Rate for Payer: Priority Health Cigna Priority Health	$66.50
Rate for Payer: Priority Health Cigna Priority Health	$23.80

CHG X-RAY SPINE SURVEY

Professional

Both

$72.00

Service Code	HCPCS 72010
Min. Negotiated Rate	$28.80
Max. Negotiated Rate	$50.40
Rate for Payer: BCBS Complete	$28.80
Rate for Payer: Cash Price	$57.60
Rate for Payer: Priority Health Cigna Priority Health	$50.40

CHG X-RAY THOR-LUMB SP SCOLIOSIS

Professional

Both

$98.00

Service Code	HCPCS 72090
Min. Negotiated Rate	$39.20
Max. Negotiated Rate	$68.60
Rate for Payer: BCBS Complete	$39.20
Rate for Payer: BCBS Complete	$52.00
Rate for Payer: BCBS Complete	$28.00
Rate for Payer: Cash Price	$104.00
Rate for Payer: Cash Price	$78.40
Rate for Payer: Cash Price	$56.00
Rate for Payer: Priority Health Cigna Priority Health	$91.00
Rate for Payer: Priority Health Cigna Priority Health	$49.00
Rate for Payer: Priority Health Cigna Priority Health	$68.60

CHG X-RAY TRUNK SPINE SCOLIOSIS

Professional

Both

$44.00

Service Code	HCPCS 72069
Min. Negotiated Rate	$17.60
Max. Negotiated Rate	$30.80
Rate for Payer: BCBS Complete	$17.60
Rate for Payer: BCBS Complete	$23.60
Rate for Payer: Cash Price	$35.20
Rate for Payer: Cash Price	$47.20
Rate for Payer: Priority Health Cigna Priority Health	$41.30
Rate for Payer: Priority Health Cigna Priority Health	$30.80

CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES

Facility

$561,998.55

Service Code	MS-DRG 018
Min. Negotiated Rate	$148,708.54
Max. Negotiated Rate	$561,998.55
Rate for Payer: Aetna Medicare	$276,459.25
Rate for Payer: Allen County Amish Medical Aid Commercial	$332,282.75
Rate for Payer: Amish Plain Church Group Commercial	$332,282.75
Rate for Payer: BCBS MAPPO	$265,826.20
Rate for Payer: BCBS Trust/PPO	$148,708.54
Rate for Payer: BCN Medicare Advantage	$265,826.20
Rate for Payer: Health Alliance Plan Medicare Advantage	$265,826.20
Rate for Payer: Mclaren Medicare	$265,826.20
Rate for Payer: Meridian Wellcare - Medicare Advantage	$279,117.51
Rate for Payer: MI Amish Medical Board Commercial	$305,700.13
Rate for Payer: PACE Medicare	$252,534.89
Rate for Payer: PACE SWMI	$265,826.20
Rate for Payer: PHP Medicare Advantage	$265,826.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$528,689.80
Rate for Payer: Priority Health Medicare	$265,826.20
Rate for Payer: Priority Health Narrow Network	$422,951.84
Rate for Payer: Railroad Medicare Medicare	$265,826.20
Rate for Payer: UHC All Payor (Choice/PPO)	$561,998.55
Rate for Payer: UHC Core	$344,847.67
Rate for Payer: UHC Dual Complete DSNP	$265,826.20
Rate for Payer: UHC Exchange	$369,348.07
Rate for Payer: UHC Medicare Advantage	$273,800.99
Rate for Payer: VA VA	$265,826.20

CHLORDIAZEPOXIDE 10 MG CAPSULE

Facility

$282.00

Service Code	NDC 0555-0033-02
Hospital Charge Code	1622
Hospital Revenue Code	637
Min. Negotiated Rate	$177.66
Max. Negotiated Rate	$253.80
Rate for Payer: Aetna Commercial	$239.70
Rate for Payer: Aetna New Business (MI Preferred)	$183.30
Rate for Payer: Cash Price	$225.60
Rate for Payer: Cofinity Commercial	$197.40
Rate for Payer: Cofinity Commercial	$242.52
Rate for Payer: Healthscope Commercial	$253.80
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$239.70
Rate for Payer: PHP Commercial	$239.70
Rate for Payer: Priority Health Cigna Priority Health	$197.40
Rate for Payer: Priority Health SBD	$177.66

CHLORDIAZEPOXIDE 10 MG CAPSULE

Facility

$4.36

Service Code	NDC 51079-375-01
Hospital Charge Code	1622
Hospital Revenue Code	637
Min. Negotiated Rate	$2.75
Max. Negotiated Rate	$3.92
Rate for Payer: Aetna Commercial	$3.71
Rate for Payer: Aetna New Business (MI Preferred)	$2.83
Rate for Payer: Cash Price	$3.49
Rate for Payer: Cofinity Commercial	$3.05
Rate for Payer: Cofinity Commercial	$3.75
Rate for Payer: Healthscope Commercial	$3.92
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3.71
Rate for Payer: PHP Commercial	$3.71
Rate for Payer: Priority Health Cigna Priority Health	$3.05
Rate for Payer: Priority Health SBD	$2.75

CHLORDIAZEPOXIDE 10 MG CAPSULE

Facility

$435.10

Service Code	NDC 51079-375-20
Hospital Charge Code	1622
Hospital Revenue Code	637
Min. Negotiated Rate	$274.11
Max. Negotiated Rate	$391.59
Rate for Payer: Aetna Commercial	$369.84
Rate for Payer: Aetna New Business (MI Preferred)	$282.82
Rate for Payer: Cash Price	$348.08
Rate for Payer: Cofinity Commercial	$304.57
Rate for Payer: Cofinity Commercial	$374.19
Rate for Payer: Healthscope Commercial	$391.59
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$369.84
Rate for Payer: PHP Commercial	$369.84
Rate for Payer: Priority Health Cigna Priority Health	$304.57
Rate for Payer: Priority Health SBD	$274.11

CHLORDIAZEPOXIDE 25 MG CAPSULE

Facility

$1,527.50

Service Code	NDC 0555-0159-04
Hospital Charge Code	1623
Hospital Revenue Code	637
Min. Negotiated Rate	$962.32
Max. Negotiated Rate	$1,374.75
Rate for Payer: Aetna Commercial	$1,298.38
Rate for Payer: Aetna New Business (MI Preferred)	$992.88
Rate for Payer: Cash Price	$1,222.00
Rate for Payer: Cofinity Commercial	$1,069.25
Rate for Payer: Cofinity Commercial	$1,313.65
Rate for Payer: Healthscope Commercial	$1,374.75
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,298.38
Rate for Payer: PHP Commercial	$1,298.38
Rate for Payer: Priority Health Cigna Priority Health	$1,069.25
Rate for Payer: Priority Health SBD	$962.32

CHLORDIAZEPOXIDE 25 MG CAPSULE

Facility

$345.45

Service Code	NDC 0555-0159-02
Hospital Charge Code	1623
Hospital Revenue Code	637
Min. Negotiated Rate	$217.63
Max. Negotiated Rate	$310.90
Rate for Payer: Aetna Commercial	$293.63
Rate for Payer: Aetna New Business (MI Preferred)	$224.54
Rate for Payer: Cash Price	$276.36
Rate for Payer: Cofinity Commercial	$241.82
Rate for Payer: Cofinity Commercial	$297.09
Rate for Payer: Healthscope Commercial	$310.90
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$293.63
Rate for Payer: PHP Commercial	$293.63
Rate for Payer: Priority Health Cigna Priority Health	$241.82
Rate for Payer: Priority Health SBD	$217.63

CHLORDIAZEPOXIDE 25 MG CAPSULE

Facility

$469.30

Service Code	NDC 51079-141-20
Hospital Charge Code	1623
Hospital Revenue Code	637
Min. Negotiated Rate	$295.66
Max. Negotiated Rate	$422.37
Rate for Payer: Aetna Commercial	$398.90
Rate for Payer: Aetna New Business (MI Preferred)	$305.04
Rate for Payer: Cash Price	$375.44
Rate for Payer: Cofinity Commercial	$328.51
Rate for Payer: Cofinity Commercial	$403.60
Rate for Payer: Healthscope Commercial	$422.37
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$398.90
Rate for Payer: PHP Commercial	$398.90
Rate for Payer: Priority Health Cigna Priority Health	$328.51
Rate for Payer: Priority Health SBD	$295.66

CHLORDIAZEPOXIDE 25 MG CAPSULE

Facility

$4.70

Service Code	NDC 51079-141-01
Hospital Charge Code	1623
Hospital Revenue Code	637
Min. Negotiated Rate	$2.96
Max. Negotiated Rate	$4.23
Rate for Payer: Aetna Commercial	$4.00
Rate for Payer: Aetna New Business (MI Preferred)	$3.06
Rate for Payer: Cash Price	$3.76
Rate for Payer: Cofinity Commercial	$3.29
Rate for Payer: Cofinity Commercial	$4.04
Rate for Payer: Healthscope Commercial	$4.23
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$4.00
Rate for Payer: PHP Commercial	$4.00
Rate for Payer: Priority Health Cigna Priority Health	$3.29
Rate for Payer: Priority Health SBD	$2.96

CHLORDIAZEPOXIDE 5 MG CAPSULE

Facility

$2.88

Service Code	NDC 51079-374-01
Hospital Charge Code	1624
Hospital Revenue Code	637
Min. Negotiated Rate	$1.81
Max. Negotiated Rate	$2.59
Rate for Payer: Aetna Commercial	$2.45
Rate for Payer: Aetna New Business (MI Preferred)	$1.87
Rate for Payer: Cash Price	$2.30
Rate for Payer: Cofinity Commercial	$2.02
Rate for Payer: Cofinity Commercial	$2.48
Rate for Payer: Healthscope Commercial	$2.59
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2.45
Rate for Payer: PHP Commercial	$2.45
Rate for Payer: Priority Health Cigna Priority Health	$2.02
Rate for Payer: Priority Health SBD	$1.81

CHLORDIAZEPOXIDE 5 MG CAPSULE

Facility

$287.04

Service Code	NDC 51079-374-20
Hospital Charge Code	1624
Hospital Revenue Code	637
Min. Negotiated Rate	$180.84
Max. Negotiated Rate	$258.34
Rate for Payer: Aetna Commercial	$243.98
Rate for Payer: Aetna New Business (MI Preferred)	$186.58
Rate for Payer: Cash Price	$229.63
Rate for Payer: Cofinity Commercial	$200.93
Rate for Payer: Cofinity Commercial	$246.85
Rate for Payer: Healthscope Commercial	$258.34
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$243.98
Rate for Payer: PHP Commercial	$243.98
Rate for Payer: Priority Health Cigna Priority Health	$200.93
Rate for Payer: Priority Health SBD	$180.84

CHLORDIAZEPOXIDE 5 MG CAPSULE

Facility

$401.85

Service Code	NDC 0555-0158-02
Hospital Charge Code	1624
Hospital Revenue Code	637
Min. Negotiated Rate	$253.17
Max. Negotiated Rate	$361.66
Rate for Payer: Aetna Commercial	$341.57
Rate for Payer: Aetna New Business (MI Preferred)	$261.20
Rate for Payer: Cash Price	$321.48
Rate for Payer: Cofinity Commercial	$281.30
Rate for Payer: Cofinity Commercial	$345.59
Rate for Payer: Healthscope Commercial	$361.66
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$341.57
Rate for Payer: PHP Commercial	$341.57
Rate for Payer: Priority Health Cigna Priority Health	$281.30
Rate for Payer: Priority Health SBD	$253.17

CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH

Facility

$222.31

Service Code	NDC 48878-0620-1
Hospital Charge Code	9516
Hospital Revenue Code	637
Min. Negotiated Rate	$140.06
Max. Negotiated Rate	$200.08
Rate for Payer: Aetna Commercial	$188.96
Rate for Payer: Aetna New Business (MI Preferred)	$144.50
Rate for Payer: Cash Price	$177.85
Rate for Payer: Cofinity Commercial	$155.62
Rate for Payer: Cofinity Commercial	$191.19
Rate for Payer: Healthscope Commercial	$200.08
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$188.96
Rate for Payer: PHP Commercial	$188.96
Rate for Payer: Priority Health Cigna Priority Health	$155.62
Rate for Payer: Priority Health SBD	$140.06

CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH

Facility

$3.88

Service Code	NDC 9900-0000-23
Hospital Charge Code	9516
Hospital Revenue Code	637
Min. Negotiated Rate	$2.44
Max. Negotiated Rate	$3.49
Rate for Payer: Aetna Commercial	$3.30
Rate for Payer: Aetna New Business (MI Preferred)	$2.52
Rate for Payer: Cash Price	$3.10
Rate for Payer: Cofinity Commercial	$2.72
Rate for Payer: Cofinity Commercial	$3.34
Rate for Payer: Healthscope Commercial	$3.49
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3.30
Rate for Payer: PHP Commercial	$3.30
Rate for Payer: Priority Health Cigna Priority Health	$2.72
Rate for Payer: Priority Health SBD	$2.44

CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH

Facility

$35.61

Service Code	NDC 69339-138-17
Hospital Charge Code	9516
Hospital Revenue Code	637
Min. Negotiated Rate	$22.43
Max. Negotiated Rate	$32.05
Rate for Payer: Aetna Commercial	$30.27
Rate for Payer: Aetna New Business (MI Preferred)	$23.15
Rate for Payer: Cash Price	$28.49
Rate for Payer: Cofinity Commercial	$24.93
Rate for Payer: Cofinity Commercial	$30.62
Rate for Payer: Healthscope Commercial	$32.05
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$30.27
Rate for Payer: PHP Commercial	$30.27
Rate for Payer: Priority Health Cigna Priority Health	$24.93
Rate for Payer: Priority Health SBD	$22.43

CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH

Facility

$35.61

Service Code	NDC 69339-138-15
Hospital Charge Code	9516
Hospital Revenue Code	637
Min. Negotiated Rate	$22.43
Max. Negotiated Rate	$32.05
Rate for Payer: Aetna Commercial	$30.27
Rate for Payer: Aetna New Business (MI Preferred)	$23.15
Rate for Payer: Cash Price	$28.49
Rate for Payer: Cofinity Commercial	$24.93
Rate for Payer: Cofinity Commercial	$30.62
Rate for Payer: Healthscope Commercial	$32.05
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$30.27
Rate for Payer: PHP Commercial	$30.27
Rate for Payer: Priority Health Cigna Priority Health	$24.93
Rate for Payer: Priority Health SBD	$22.43

CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH

Facility

$44.47

Service Code	NDC 0116-2001-16
Hospital Charge Code	9516
Hospital Revenue Code	637
Min. Negotiated Rate	$28.02
Max. Negotiated Rate	$40.02
Rate for Payer: Aetna Commercial	$37.80
Rate for Payer: Aetna New Business (MI Preferred)	$28.91
Rate for Payer: Cash Price	$35.58
Rate for Payer: Cofinity Commercial	$31.13
Rate for Payer: Cofinity Commercial	$38.24
Rate for Payer: Healthscope Commercial	$40.02
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$37.80
Rate for Payer: PHP Commercial	$37.80
Rate for Payer: Priority Health Cigna Priority Health	$31.13
Rate for Payer: Priority Health SBD	$28.02

CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH

Facility

$28.20

Service Code	NDC 63739-052-69
Hospital Charge Code	9516
Hospital Revenue Code	637
Min. Negotiated Rate	$17.77
Max. Negotiated Rate	$25.38
Rate for Payer: Aetna Commercial	$23.97
Rate for Payer: Aetna New Business (MI Preferred)	$18.33
Rate for Payer: Cash Price	$22.56
Rate for Payer: Cofinity Commercial	$19.74
Rate for Payer: Cofinity Commercial	$24.25
Rate for Payer: Healthscope Commercial	$25.38
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$23.97
Rate for Payer: PHP Commercial	$23.97
Rate for Payer: Priority Health Cigna Priority Health	$19.74
Rate for Payer: Priority Health SBD	$17.77

CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH

Facility

$28.20

Service Code	NDC 63739-052-74
Hospital Charge Code	9516
Hospital Revenue Code	637
Min. Negotiated Rate	$17.77
Max. Negotiated Rate	$25.38
Rate for Payer: Aetna Commercial	$23.97
Rate for Payer: Aetna New Business (MI Preferred)	$18.33
Rate for Payer: Cash Price	$22.56
Rate for Payer: Cofinity Commercial	$19.74
Rate for Payer: Cofinity Commercial	$24.25
Rate for Payer: Healthscope Commercial	$25.38
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$23.97
Rate for Payer: PHP Commercial	$23.97
Rate for Payer: Priority Health Cigna Priority Health	$19.74
Rate for Payer: Priority Health SBD	$17.77

CHLOROPROCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION

Facility

$77.79

Service Code	HCPCS J2401
Hospital Charge Code	150549
Hospital Revenue Code	636
Min. Negotiated Rate	$49.01
Max. Negotiated Rate	$70.01
Rate for Payer: Aetna Commercial	$66.12
Rate for Payer: Aetna Commercial	$70.43
Rate for Payer: Aetna New Business (MI Preferred)	$53.86
Rate for Payer: Aetna New Business (MI Preferred)	$50.56
Rate for Payer: Cash Price	$62.23
Rate for Payer: Cash Price	$66.29
Rate for Payer: Cofinity Commercial	$54.45
Rate for Payer: Cofinity Commercial	$66.90
Rate for Payer: Cofinity Commercial	$58.00
Rate for Payer: Cofinity Commercial	$71.26
Rate for Payer: Healthscope Commercial	$70.01
Rate for Payer: Healthscope Commercial	$74.57
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$70.43
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$66.12
Rate for Payer: PHP Commercial	$66.12
Rate for Payer: PHP Commercial	$70.43
Rate for Payer: Priority Health Cigna Priority Health	$58.00
Rate for Payer: Priority Health Cigna Priority Health	$54.45
Rate for Payer: Priority Health SBD	$49.01
Rate for Payer: Priority Health SBD	$52.20

CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION

Facility

$81.71

Service Code	HCPCS J2401
Hospital Charge Code	1635
Hospital Revenue Code	636
Min. Negotiated Rate	$51.48
Max. Negotiated Rate	$73.54
Rate for Payer: Aetna Commercial	$69.45
Rate for Payer: Aetna Commercial	$73.99
Rate for Payer: Aetna New Business (MI Preferred)	$56.58
Rate for Payer: Aetna New Business (MI Preferred)	$53.11
Rate for Payer: Cash Price	$65.37
Rate for Payer: Cash Price	$69.64
Rate for Payer: Cofinity Commercial	$74.86
Rate for Payer: Cofinity Commercial	$57.20
Rate for Payer: Cofinity Commercial	$70.27
Rate for Payer: Cofinity Commercial	$60.94
Rate for Payer: Healthscope Commercial	$73.54
Rate for Payer: Healthscope Commercial	$78.34
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$69.45
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$73.99
Rate for Payer: PHP Commercial	$73.99
Rate for Payer: PHP Commercial	$69.45
Rate for Payer: Priority Health Cigna Priority Health	$57.20
Rate for Payer: Priority Health Cigna Priority Health	$60.94
Rate for Payer: Priority Health SBD	$51.48
Rate for Payer: Priority Health SBD	$54.84

Know your out-of-pocket cost for care.

All Charges