Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PR ANES INTEG EXTREMITIES ANT TRUNK & PERINEUM NOS

Professional

Both

$3.00

Service Code	HCPCS 00400
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$2.10
Rate for Payer: BCBS Complete	$1.20
Rate for Payer: Cash Price	$2.40
Rate for Payer: Priority Health Cigna Priority Health	$2.10

PR ANES INTEG MUSC & NRV HEAD NECK&POSTERIOR TRUNK

Professional

Both

$5.00

Service Code	HCPCS 00300
Min. Negotiated Rate	$2.00
Max. Negotiated Rate	$3.50
Rate for Payer: BCBS Complete	$2.00
Rate for Payer: Cash Price	$4.00
Rate for Payer: Priority Health Cigna Priority Health	$3.50

PR ANES INTEG SYS ELEC CONVERSION ARRHYTHMIAS

Professional

Both

$4.00

Service Code	HCPCS 00410
Min. Negotiated Rate	$1.60
Max. Negotiated Rate	$2.80
Rate for Payer: BCBS Complete	$1.60
Rate for Payer: Cash Price	$3.20
Rate for Payer: Priority Health Cigna Priority Health	$2.80

PR ANES INTRACRANIAL BURR HOLES W/VENTRICULOGRAPHY

Professional

Both

$9.00

Service Code	HCPCS 00214
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$6.30
Rate for Payer: BCBS Complete	$3.60
Rate for Payer: Cash Price	$7.20
Rate for Payer: Priority Health Cigna Priority Health	$6.30

PR ANES INTRACRANIAL CEREBROSPINAL FLUID SHUNTING

Professional

Both

$10.00

Service Code	HCPCS 00220
Min. Negotiated Rate	$4.00
Max. Negotiated Rate	$7.00
Rate for Payer: BCBS Complete	$4.00
Rate for Payer: Cash Price	$8.00
Rate for Payer: Priority Health Cigna Priority Health	$7.00

PR ANES INTRACRANIAL CRANIOTOMY/CRANIECTOMY HMTMA

Professional

Both

$10.00

Service Code	HCPCS 00211
Min. Negotiated Rate	$4.00
Max. Negotiated Rate	$7.00
Rate for Payer: BCBS Complete	$4.00
Rate for Payer: Cash Price	$8.00
Rate for Payer: Priority Health Cigna Priority Health	$7.00

PR ANES INTRACRANIAL ELECTROCOAGULATION ICRA NERVE

Professional

Both

$6.00

Service Code	HCPCS 00222
Min. Negotiated Rate	$2.40
Max. Negotiated Rate	$4.20
Rate for Payer: BCBS Complete	$2.40
Rate for Payer: Cash Price	$4.80
Rate for Payer: Priority Health Cigna Priority Health	$4.20

PR ANES INTRACRANIAL/ELEVATION DEPRSD SKULL FX XDRL

Professional

Both

$9.00

Service Code	HCPCS 00215
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$6.30
Rate for Payer: BCBS Complete	$3.60
Rate for Payer: Cash Price	$7.20
Rate for Payer: Priority Health Cigna Priority Health	$6.30

PR ANES INTRACRANIAL PROCEDURE IN SITTING POSITION

Professional

Both

$13.00

Service Code	HCPCS 00218
Min. Negotiated Rate	$5.20
Max. Negotiated Rate	$9.10
Rate for Payer: BCBS Complete	$5.20
Rate for Payer: Cash Price	$10.40
Rate for Payer: Priority Health Cigna Priority Health	$9.10

PR ANES INTRACRANIAL THER IVNTL RAD VENS/LYMPHTC

Professional

Both

$7.00

Service Code	HCPCS 01933
Min. Negotiated Rate	$2.80
Max. Negotiated Rate	$4.90
Rate for Payer: BCBS Complete	$2.80
Rate for Payer: Cash Price	$5.60
Rate for Payer: Priority Health Cigna Priority Health	$4.90

PR ANES INTRAORAL W/BIOPSY REPAIR CLEFT PALATE

Professional

Both

$6.00

Service Code	HCPCS 00172
Min. Negotiated Rate	$2.40
Max. Negotiated Rate	$4.20
Rate for Payer: BCBS Complete	$2.40
Rate for Payer: Cash Price	$4.80
Rate for Payer: Priority Health Cigna Priority Health	$4.20

PR ANES INTRAORAL W/BX EXC RETROPHARYNGEAL TUMOR

Professional

Both

$6.00

Service Code	HCPCS 00174
Min. Negotiated Rate	$2.40
Max. Negotiated Rate	$4.20
Rate for Payer: BCBS Complete	$2.40
Rate for Payer: Cash Price	$4.80
Rate for Payer: Priority Health Cigna Priority Health	$4.20

PR ANES INTRAPERITONEAL UPPER ABDOMEN W/LAPS NOS

Professional

Both

$7.00

Service Code	HCPCS 00790
Min. Negotiated Rate	$2.80
Max. Negotiated Rate	$4.90
Rate for Payer: BCBS Complete	$2.80
Rate for Payer: Cash Price	$5.60
Rate for Payer: Priority Health Cigna Priority Health	$4.90

PR ANES IPER LOWER ABDOMEN W/LAPS AMNIOCENTESIS

Professional

Both

$4.00

Service Code	HCPCS 00842
Min. Negotiated Rate	$1.60
Max. Negotiated Rate	$2.80
Rate for Payer: BCBS Complete	$1.60
Rate for Payer: Cash Price	$3.20
Rate for Payer: Priority Health Cigna Priority Health	$2.80

PR ANES IPER LOWER ABD W/LAPS ABDOMINOPRNL RESCJ

Professional

Both

$7.00

Service Code	HCPCS 00844
Min. Negotiated Rate	$2.80
Max. Negotiated Rate	$4.90
Rate for Payer: BCBS Complete	$2.80
Rate for Payer: Cash Price	$5.60
Rate for Payer: Priority Health Cigna Priority Health	$4.90

PR ANES IPER LOWER ABD W/LAPS PELVIC EXENTERATION

Professional

Both

$8.00

Service Code	HCPCS 00848
Min. Negotiated Rate	$3.20
Max. Negotiated Rate	$5.60
Rate for Payer: BCBS Complete	$3.20
Rate for Payer: Cash Price	$6.40
Rate for Payer: Priority Health Cigna Priority Health	$5.60

PR ANES IPER LOWER ABD W/LAPS RAD HYSTERECTOMY

Professional

Both

$8.00

Service Code	HCPCS 00846
Min. Negotiated Rate	$3.20
Max. Negotiated Rate	$5.60
Rate for Payer: BCBS Complete	$3.20
Rate for Payer: Cash Price	$6.40
Rate for Payer: Priority Health Cigna Priority Health	$5.60

PR ANES IPER LWR ABD W/LAPS TUBAL LIGATION/TRANSECT

Professional

Both

$6.00

Service Code	HCPCS 00851
Min. Negotiated Rate	$2.40
Max. Negotiated Rate	$4.20
Rate for Payer: BCBS Complete	$2.40
Rate for Payer: Cash Price	$4.80
Rate for Payer: Priority Health Cigna Priority Health	$4.20

PR ANES IPR UPPER ABDOMEN LAPS GASTRIC RSTCV MO

Professional

Both

$11.00

Service Code	HCPCS 00797
Min. Negotiated Rate	$4.40
Max. Negotiated Rate	$7.70
Rate for Payer: BCBS Complete	$4.40
Rate for Payer: Cash Price	$8.80
Rate for Payer: Priority Health Cigna Priority Health	$7.70

PR ANES KNEE & POPLITEAL ARTERY VEIN FISTULA NOS

Professional

Both

$6.00

Service Code	HCPCS 01432
Min. Negotiated Rate	$2.40
Max. Negotiated Rate	$4.20
Rate for Payer: BCBS Complete	$2.40
Rate for Payer: Cash Price	$4.80
Rate for Payer: Priority Health Cigna Priority Health	$4.20

PR ANES LAPAROSCOPIC LIVER TRANSPLANT

Professional

Both

$30.00

Service Code	HCPCS 00796
Min. Negotiated Rate	$12.00
Max. Negotiated Rate	$21.00
Rate for Payer: BCBS Complete	$12.00
Rate for Payer: Cash Price	$24.00
Rate for Payer: Priority Health Cigna Priority Health	$21.00

PR ANES LAPAROSCOPIC PARTIAL/TOTAL PANCREATECTOMY

Professional

Both

$8.00

Service Code	HCPCS 00794
Min. Negotiated Rate	$3.20
Max. Negotiated Rate	$5.60
Rate for Payer: BCBS Complete	$3.20
Rate for Payer: Cash Price	$6.40
Rate for Payer: Priority Health Cigna Priority Health	$5.60

PR ANES LAPS PARTIAL HEPATECTOMY W/MGMT LIVER HEMOR

Professional

Both

$13.00

Service Code	HCPCS 00792
Min. Negotiated Rate	$5.20
Max. Negotiated Rate	$9.10
Rate for Payer: BCBS Complete	$5.20
Rate for Payer: Cash Price	$10.40
Rate for Payer: Priority Health Cigna Priority Health	$9.10

PR ANES LITHOTRP XTRCORP SHOCK WAVE W/O WATER BATH

Professional

Both

$5.00

Service Code	HCPCS 00873
Min. Negotiated Rate	$2.00
Max. Negotiated Rate	$3.50
Rate for Payer: BCBS Complete	$2.00
Rate for Payer: Cash Price	$4.00
Rate for Payer: Priority Health Cigna Priority Health	$3.50

PR ANES LITHOTRP XTRCORP SHOCK WAVE W/WATER BATH

Professional

Both

$7.00

Service Code	HCPCS 00872
Min. Negotiated Rate	$2.80
Max. Negotiated Rate	$4.90
Rate for Payer: BCBS Complete	$2.80
Rate for Payer: Cash Price	$5.60
Rate for Payer: Priority Health Cigna Priority Health	$4.90

Know your out-of-pocket cost for care.

All Charges