Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PR ANESTHESIA ARTHROSCOPIC SHOULDER DISARTICULATION

Professional

Both

$9.00

Service Code	HCPCS 01634
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 ANESTHESIA ARTHRS/ENDOSCPIC TOTAL WRIST REPLCMT

Professional

Both

$6.00

Service Code	HCPCS 01832
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 ANESTHESIA AXILLARY-BRACHIAL ANEURYSM

Professional

Both

$10.00

Service Code	HCPCS 01652
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 ANESTHESIA AXILLARY-FEMORAL BYPASS GRAFT

Professional

Both

$10.00

Service Code	HCPCS 01656
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 ANESTHESIA BICEPS TENODESIS RUPTURE LONG TENDON

Professional

Both

$5.00

Service Code	HCPCS 01716
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 ANESTHESIA BODY CAST APPLICATION OR REVISION

Professional

Both

$3.00

Service Code	HCPCS 01130
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 ANESTHESIA CAROTID/CORONARY THER IVNTL RAD

Professional

Both

$7.00

Service Code	HCPCS 01925
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 ANESTHESIA CERVICAL CERCLAGE INCLUDING BIOPSY

Professional

Both

$4.00

Service Code	HCPCS 00948
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 ANESTHESIA CERVICAL SPINE & CORD NOS

Professional

Both

$10.00

Service Code	HCPCS 00600
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 ANESTHESIA CESAREAN DELIVERY ONLY

Professional

Both

$7.00

Service Code	HCPCS 01961
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 ANESTHESIA C HYST W/O ANY LABOR ANALG/ANES CARE

Professional

Both

$8.00

Service Code	HCPCS 01963
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 ANESTHESIA CLAVICLE AND SCAPULA NOS

Professional

Both

$5.00

Service Code	HCPCS 00450
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 ANESTHESIA CLAVICLE & SCAPULA BIOPSY CLAVICLE

Professional

Both

$3.00

Service Code	HCPCS 00454
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 ANESTHESIA CLEFT LIP INVOLVING PLASTIC REPAIR

Professional

Both

$6.00

Service Code	HCPCS 00102
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 ANESTHESIA CLOSED CHEST NEEDLE BIOPSY PLEURA

Professional

Both

$4.00

Service Code	HCPCS 00522
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 ANESTHESIA CLOSED CHEST PNEUMOCENTESIS

Professional

Both

$4.00

Service Code	HCPCS 00524
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 ANESTHESIA CLOSED CHEST W/BRONCHOSCOPY NOS

Professional

Both

$6.00

Service Code	HCPCS 00520
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 ANESTHESIA CLOSED HIP JOINT PROCEDURE

Professional

Both

$4.00

Service Code	HCPCS 01200
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 ANESTHESIA CLOSED PROCEDURES HUMERUS & ELBOW

Professional

Both

$3.00

Service Code	HCPCS 01730
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 ANESTHESIA CLOSED PROCEDURES KNEE JOINT

Professional

Both

$3.00

Service Code	HCPCS 01380
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 ANESTHESIA CLOSED PROCEDURES LOWER 1/3 FEMUR

Professional

Both

$4.00

Service Code	HCPCS 01340
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 ANESTHESIA CLOSED PROCEDURES UPPER 2/3 FEMUR

Professional

Both

$4.00

Service Code	HCPCS 01220
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 ANESTHESIA CLOSED PROC LOWER LEG ANKLE & FOOT

Professional

Both

$3.00

Service Code	HCPCS 01462
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 ANESTHESIA COMBINED UPPER&LOWER GI ENDOSCOPIC PX

Professional

Both

$1.00

Service Code	HCPCS 00813
Min. Negotiated Rate	$0.40
Max. Negotiated Rate	$0.70
Rate for Payer: BCBS Complete	$0.40
Rate for Payer: Cash Price	$0.80
Rate for Payer: Priority Health Cigna Priority Health	$0.70

PR ANESTHESIA CULDOSCOPY INCLUDING BIOPSY

Professional

Both

$5.00

Service Code	HCPCS 00950
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

Know your out-of-pocket cost for care.

All Charges