Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PR ANES XTRPRTL LWR ABD W/URIN TRACT CSTOLITHOTOMY

Professional

Both

$5.00

Service Code	HCPCS 00870
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 XTRPRTL LWR ABD W/URIN TRACT RENAL TRANSPL

Professional

Both

$10.00

Service Code	HCPCS 00868
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 ANKLE CONTROL ORTHO PRE OTS

Professional

Both

$93.00

Service Code	HCPCS L4350
Min. Negotiated Rate	$37.20
Max. Negotiated Rate	$65.10
Rate for Payer: Aetna Commercial	$58.28
Rate for Payer: BCBS Complete	$37.20
Rate for Payer: Cash Price	$74.40
Rate for Payer: Cash Price	$74.40
Rate for Payer: Priority Health Cigna Priority Health	$65.10

PR ANKLE DISARTICULATION

Professional

Both

$1,310.00

Service Code	HCPCS 27889
Min. Negotiated Rate	$408.53
Max. Negotiated Rate	$1,940.55
Rate for Payer: Aetna Commercial	$853.82
Rate for Payer: BCBS Complete	$428.96
Rate for Payer: BCBS Trust/PPO	$1,940.55
Rate for Payer: Cash Price	$1,048.00
Rate for Payer: Cash Price	$1,048.00
Rate for Payer: Mclaren Medicaid	$408.53
Rate for Payer: Meridian Medicaid	$428.96
Rate for Payer: Priority Health Choice Medicaid	$408.53
Rate for Payer: Priority Health Cigna Priority Health	$917.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$966.16
Rate for Payer: Priority Health Narrow Network	$966.16
Rate for Payer: Priority Health SBD	$966.16

PR ANN BREAST EXAM

Professional

Both

$20.00

Service Code	HCPCS S0613
Min. Negotiated Rate	$8.00
Max. Negotiated Rate	$79.25
Rate for Payer: Aetna Commercial	$25.00
Rate for Payer: BCBS Complete	$8.00
Rate for Payer: BCBS Trust/PPO	$79.25
Rate for Payer: Cash Price	$16.00
Rate for Payer: Cash Price	$16.00
Rate for Payer: Priority Health Cigna Priority Health	$14.00

PR ANNUAL GYNECOLOGICAL EXAMINA

Professional

Both

$79.00

Service Code	HCPCS S0612
Min. Negotiated Rate	$31.60
Max. Negotiated Rate	$176.98
Rate for Payer: Aetna Commercial	$55.00
Rate for Payer: BCBS Complete	$31.60
Rate for Payer: BCBS Trust/PPO	$176.98
Rate for Payer: Cash Price	$63.20
Rate for Payer: Cash Price	$63.20
Rate for Payer: Priority Health Cigna Priority Health	$55.30

PR ANOGENITAL XM MAGNIFY CHILD/SUSPECT TRAUMA W IMG

Professional

Both

$263.00

Service Code	HCPCS 99170
Min. Negotiated Rate	$53.46
Max. Negotiated Rate	$820.45
Rate for Payer: Aetna Commercial	$95.44
Rate for Payer: BCBS Complete	$56.13
Rate for Payer: BCBS Trust/PPO	$820.45
Rate for Payer: Cash Price	$210.40
Rate for Payer: Cash Price	$210.40
Rate for Payer: Mclaren Medicaid	$53.46
Rate for Payer: Meridian Medicaid	$56.13
Rate for Payer: Priority Health Choice Medicaid	$53.46
Rate for Payer: Priority Health Cigna Priority Health	$184.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$112.74
Rate for Payer: Priority Health Narrow Network	$112.74
Rate for Payer: Priority Health SBD	$112.74

PR ANOPLASTY PLASTIC OPERATION STRICTURE ADULT

Professional

Both

$1,323.00

Service Code	HCPCS 46700
Min. Negotiated Rate	$272.07
Max. Negotiated Rate	$1,153.61
Rate for Payer: Aetna Commercial	$877.26
Rate for Payer: BCBS Complete	$439.70
Rate for Payer: BCBS Trust/PPO	$272.07
Rate for Payer: Cash Price	$1,058.40
Rate for Payer: Cash Price	$1,058.40
Rate for Payer: Mclaren Medicaid	$418.76
Rate for Payer: Meridian Medicaid	$439.70
Rate for Payer: Priority Health Choice Medicaid	$418.76
Rate for Payer: Priority Health Cigna Priority Health	$926.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,153.61
Rate for Payer: Priority Health Narrow Network	$1,153.61
Rate for Payer: Priority Health SBD	$1,153.61

PR ANOPLASTY PLASTIC OPERATION STRICTURE INFANT

Professional

Both

$1,397.00

Service Code	HCPCS 46705
Min. Negotiated Rate	$137.36
Max. Negotiated Rate	$1,012.49
Rate for Payer: Aetna Commercial	$764.79
Rate for Payer: BCBS Complete	$386.69
Rate for Payer: BCBS Trust/PPO	$137.36
Rate for Payer: Cash Price	$1,117.60
Rate for Payer: Cash Price	$1,117.60
Rate for Payer: Mclaren Medicaid	$368.28
Rate for Payer: Meridian Medicaid	$386.69
Rate for Payer: Priority Health Choice Medicaid	$368.28
Rate for Payer: Priority Health Cigna Priority Health	$977.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,012.49
Rate for Payer: Priority Health Narrow Network	$1,012.49
Rate for Payer: Priority Health SBD	$1,012.49

PR ANORECTAL MANOMETRY

Professional

Both

$385.00

Service Code	HCPCS 91122
Min. Negotiated Rate	$115.88
Max. Negotiated Rate	$1,146.94
Rate for Payer: Aetna Commercial	$290.91
Rate for Payer: BCBS Complete	$154.00
Rate for Payer: BCBS Trust/PPO	$1,146.94
Rate for Payer: Cash Price	$308.00
Rate for Payer: Cash Price	$308.00
Rate for Payer: Priority Health Cigna Priority Health	$269.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$115.88
Rate for Payer: Priority Health Narrow Network	$115.88
Rate for Payer: Priority Health SBD	$369.19

PR ANORECTAL MYOMECTOMY

Professional

Both

$1,632.00

Service Code	HCPCS 45108
Min. Negotiated Rate	$241.97
Max. Negotiated Rate	$1,142.40
Rate for Payer: Aetna Commercial	$499.66
Rate for Payer: BCBS Complete	$254.07
Rate for Payer: BCBS Trust/PPO	$359.24
Rate for Payer: Cash Price	$1,305.60
Rate for Payer: Cash Price	$1,305.60
Rate for Payer: Mclaren Medicaid	$241.97
Rate for Payer: Meridian Medicaid	$254.07
Rate for Payer: Priority Health Choice Medicaid	$241.97
Rate for Payer: Priority Health Cigna Priority Health	$1,142.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$660.88
Rate for Payer: Priority Health Narrow Network	$660.88
Rate for Payer: Priority Health SBD	$660.88

PR ANOSCOPY ABLATION LESION

Professional

Both

$657.00

Service Code	HCPCS 46615
Min. Negotiated Rate	$57.72
Max. Negotiated Rate	$459.90
Rate for Payer: Aetna Commercial	$121.05
Rate for Payer: BCBS Complete	$60.61
Rate for Payer: BCBS Trust/PPO	$245.13
Rate for Payer: Cash Price	$525.60
Rate for Payer: Cash Price	$525.60
Rate for Payer: Mclaren Medicaid	$57.72
Rate for Payer: Meridian Medicaid	$60.61
Rate for Payer: Priority Health Choice Medicaid	$57.72
Rate for Payer: Priority Health Cigna Priority Health	$459.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$156.99
Rate for Payer: Priority Health Narrow Network	$156.99
Rate for Payer: Priority Health SBD	$156.99

PR ANOSCOPY CONTROL BLEEDING

Professional

Both

$626.00

Service Code	HCPCS 46614
Min. Negotiated Rate	$41.11
Max. Negotiated Rate	$438.20
Rate for Payer: Aetna Commercial	$84.49
Rate for Payer: BCBS Complete	$43.17
Rate for Payer: BCBS Trust/PPO	$241.96
Rate for Payer: Cash Price	$500.80
Rate for Payer: Cash Price	$500.80
Rate for Payer: Mclaren Medicaid	$41.11
Rate for Payer: Meridian Medicaid	$43.17
Rate for Payer: Priority Health Choice Medicaid	$41.11
Rate for Payer: Priority Health Cigna Priority Health	$438.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$112.88
Rate for Payer: Priority Health Narrow Network	$112.88
Rate for Payer: Priority Health SBD	$112.88

PR ANOSCOPY DX W/COLLJ SPEC BR/WA SPX WHEN PRFRMD

Professional

Both

$181.00

Service Code	HCPCS 46600
Min. Negotiated Rate	$26.41
Max. Negotiated Rate	$2,291.24
Rate for Payer: Aetna Commercial	$53.23
Rate for Payer: BCBS Complete	$27.73
Rate for Payer: BCBS Trust/PPO	$2,291.24
Rate for Payer: Cash Price	$144.80
Rate for Payer: Cash Price	$144.80
Rate for Payer: Mclaren Medicaid	$26.41
Rate for Payer: Meridian Medicaid	$27.73
Rate for Payer: Priority Health Choice Medicaid	$26.41
Rate for Payer: Priority Health Cigna Priority Health	$126.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$72.32
Rate for Payer: Priority Health Narrow Network	$72.32
Rate for Payer: Priority Health SBD	$72.32

PR ANOSCOPY DX W/HRA &CHEM AGNTS ENHANCEMENT

Professional

Both

$267.00

Service Code	HCPCS 46601
Min. Negotiated Rate	$59.64
Max. Negotiated Rate	$375.62
Rate for Payer: Aetna Commercial	$126.71
Rate for Payer: BCBS Complete	$62.62
Rate for Payer: BCBS Trust/PPO	$375.62
Rate for Payer: Cash Price	$213.60
Rate for Payer: Cash Price	$213.60
Rate for Payer: Mclaren Medicaid	$59.64
Rate for Payer: Meridian Medicaid	$62.62
Rate for Payer: Priority Health Choice Medicaid	$59.64
Rate for Payer: Priority Health Cigna Priority Health	$186.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$162.28
Rate for Payer: Priority Health Narrow Network	$162.28
Rate for Payer: Priority Health SBD	$162.28

PR ANOSCOPY DX W/HRA &CHEM AGNTS ENHANCEMENT W/BX

Professional

Both

$282.00

Service Code	HCPCS 46607
Min. Negotiated Rate	$79.24
Max. Negotiated Rate	$1,451.24
Rate for Payer: Aetna Commercial	$170.74
Rate for Payer: BCBS Complete	$83.20
Rate for Payer: BCBS Trust/PPO	$1,451.24
Rate for Payer: Cash Price	$225.60
Rate for Payer: Cash Price	$225.60
Rate for Payer: Mclaren Medicaid	$79.24
Rate for Payer: Meridian Medicaid	$83.20
Rate for Payer: Priority Health Choice Medicaid	$79.24
Rate for Payer: Priority Health Cigna Priority Health	$197.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$216.37
Rate for Payer: Priority Health Narrow Network	$216.37
Rate for Payer: Priority Health SBD	$216.37

PR ANOSCOPY W/BX SINGLE/MULTIPLE

Professional

Both

$360.00

Service Code	HCPCS 46606
Min. Negotiated Rate	$48.14
Max. Negotiated Rate	$3,172.97
Rate for Payer: Aetna Commercial	$100.54
Rate for Payer: BCBS Complete	$50.55
Rate for Payer: BCBS Trust/PPO	$3,172.97
Rate for Payer: Cash Price	$288.00
Rate for Payer: Cash Price	$288.00
Rate for Payer: Mclaren Medicaid	$48.14
Rate for Payer: Meridian Medicaid	$50.55
Rate for Payer: Priority Health Choice Medicaid	$48.14
Rate for Payer: Priority Health Cigna Priority Health	$252.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$131.12
Rate for Payer: Priority Health Narrow Network	$131.12
Rate for Payer: Priority Health SBD	$131.12

PR ANOSCOPY W/DILATION

Professional

Both

$986.00

Service Code	HCPCS 46604
Min. Negotiated Rate	$42.17
Max. Negotiated Rate	$2,787.84
Rate for Payer: Aetna Commercial	$86.80
Rate for Payer: BCBS Complete	$44.28
Rate for Payer: BCBS Trust/PPO	$2,787.84
Rate for Payer: Cash Price	$788.80
Rate for Payer: Cash Price	$788.80
Rate for Payer: Mclaren Medicaid	$42.17
Rate for Payer: Meridian Medicaid	$44.28
Rate for Payer: Priority Health Choice Medicaid	$42.17
Rate for Payer: Priority Health Cigna Priority Health	$690.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$115.24
Rate for Payer: Priority Health Narrow Network	$115.24
Rate for Payer: Priority Health SBD	$115.24

PR ANOSCOPY W/RMVL FOREIGN BODY

Professional

Both

$349.00

Service Code	HCPCS 46608
Min. Negotiated Rate	$54.10
Max. Negotiated Rate	$244.30
Rate for Payer: Aetna Commercial	$112.47
Rate for Payer: BCBS Complete	$56.80
Rate for Payer: BCBS Trust/PPO	$241.96
Rate for Payer: Cash Price	$279.20
Rate for Payer: Cash Price	$279.20
Rate for Payer: Mclaren Medicaid	$54.10
Rate for Payer: Meridian Medicaid	$56.80
Rate for Payer: Priority Health Choice Medicaid	$54.10
Rate for Payer: Priority Health Cigna Priority Health	$244.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$148.18
Rate for Payer: Priority Health Narrow Network	$148.18
Rate for Payer: Priority Health SBD	$148.18

PR ANOSCOPY W/RMVL LESION CAUTERY

Professional

Both

$563.00

Service Code	HCPCS 46610
Min. Negotiated Rate	$51.12
Max. Negotiated Rate	$394.10
Rate for Payer: Aetna Commercial	$106.52
Rate for Payer: BCBS Complete	$53.68
Rate for Payer: BCBS Trust/PPO	$241.96
Rate for Payer: Cash Price	$450.40
Rate for Payer: Cash Price	$450.40
Rate for Payer: Mclaren Medicaid	$51.12
Rate for Payer: Meridian Medicaid	$53.68
Rate for Payer: Priority Health Choice Medicaid	$51.12
Rate for Payer: Priority Health Cigna Priority Health	$394.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$140.52
Rate for Payer: Priority Health Narrow Network	$140.52
Rate for Payer: Priority Health SBD	$140.52

PR ANOSC RMVL 1 TUM POLYP/OTH LES SNARE TQ

Professional

Both

$563.00

Service Code	HCPCS 46611
Min. Negotiated Rate	$51.33
Max. Negotiated Rate	$2,682.71
Rate for Payer: Aetna Commercial	$106.48
Rate for Payer: BCBS Complete	$53.90
Rate for Payer: BCBS Trust/PPO	$2,682.71
Rate for Payer: Cash Price	$450.40
Rate for Payer: Cash Price	$450.40
Rate for Payer: Mclaren Medicaid	$51.33
Rate for Payer: Meridian Medicaid	$53.90
Rate for Payer: Priority Health Choice Medicaid	$51.33
Rate for Payer: Priority Health Cigna Priority Health	$394.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$139.93
Rate for Payer: Priority Health Narrow Network	$139.93
Rate for Payer: Priority Health SBD	$139.93

PR ANOSC RMVL MULT TUMORS CAUTERY/SNARE

Professional

Both

$657.00

Service Code	HCPCS 46612
Min. Negotiated Rate	$60.92
Max. Negotiated Rate	$459.90
Rate for Payer: Aetna Commercial	$127.63
Rate for Payer: BCBS Complete	$63.97
Rate for Payer: BCBS Trust/PPO	$316.98
Rate for Payer: Cash Price	$525.60
Rate for Payer: Cash Price	$525.60
Rate for Payer: Mclaren Medicaid	$60.92
Rate for Payer: Meridian Medicaid	$63.97
Rate for Payer: Priority Health Choice Medicaid	$60.92
Rate for Payer: Priority Health Cigna Priority Health	$459.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$165.81
Rate for Payer: Priority Health Narrow Network	$165.81
Rate for Payer: Priority Health SBD	$165.81

PR ANRCT XM SURG REQ ANES GENERAL SPI/EDRL DX

Facility

$316.00

Service Code	CPT 45990
Hospital Charge Code	45990
Min. Negotiated Rate	$103.47
Max. Negotiated Rate	$3,122.94
Rate for Payer: Aetna Commercial	$268.60
Rate for Payer: Aetna Medicare	$2,598.28
Rate for Payer: Aetna New Business (MI Preferred)	$205.40
Rate for Payer: Allen County Amish Medical Aid Commercial	$3,122.94
Rate for Payer: Amish Plain Church Group Commercial	$3,122.94
Rate for Payer: BCBS Complete	$1,435.05
Rate for Payer: BCBS MAPPO	$2,498.35
Rate for Payer: BCBS Trust/PPO	$1,587.43
Rate for Payer: BCN Medicare Advantage	$2,498.35
Rate for Payer: Cash Price	$252.80
Rate for Payer: Cash Price	$252.80
Rate for Payer: Cofinity Commercial	$221.20
Rate for Payer: Cofinity Commercial	$271.76
Rate for Payer: Health Alliance Plan Medicare Advantage	$2,498.35
Rate for Payer: Healthscope Commercial	$284.40
Rate for Payer: Mclaren Medicaid	$1,366.60
Rate for Payer: Mclaren Medicare	$2,498.35
Rate for Payer: Meridian Medicaid	$1,435.05
Rate for Payer: Meridian Wellcare - Medicare Advantage	$2,623.27
Rate for Payer: MI Amish Medical Board Commercial	$2,873.10
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$268.60
Rate for Payer: PACE Medicare	$2,373.43
Rate for Payer: PACE SWMI	$2,498.35
Rate for Payer: PHP Commercial	$268.60
Rate for Payer: PHP Medicare Advantage	$2,498.35
Rate for Payer: Priority Health Choice Medicaid	$1,366.60
Rate for Payer: Priority Health Cigna Priority Health	$221.20
Rate for Payer: Priority Health Medicare	$2,498.35
Rate for Payer: Priority Health SBD	$199.08
Rate for Payer: Railroad Medicare Medicare	$2,498.35
Rate for Payer: UHC All Payor (Choice/PPO)	$113.82
Rate for Payer: UHC Dual Complete DSNP	$2,498.35
Rate for Payer: UHC Exchange	$103.47
Rate for Payer: UHC Medicare Advantage	$2,573.30
Rate for Payer: VA VA	$2,498.35

PR ANRCT XM SURG REQ ANES GENERAL SPI/EDRL DX

Professional

Both

$316.00

Service Code	HCPCS 45990
Min. Negotiated Rate	$67.31
Max. Negotiated Rate	$1,244.67
Rate for Payer: Aetna Commercial	$140.68
Rate for Payer: BCBS Complete	$70.68
Rate for Payer: BCBS Trust/PPO	$1,244.67
Rate for Payer: Cash Price	$252.80
Rate for Payer: Cash Price	$252.80
Rate for Payer: Mclaren Medicaid	$67.31
Rate for Payer: Meridian Medicaid	$70.68
Rate for Payer: Priority Health Choice Medicaid	$67.31
Rate for Payer: Priority Health Cigna Priority Health	$221.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$182.86
Rate for Payer: Priority Health Narrow Network	$182.86
Rate for Payer: Priority Health SBD	$182.86

PR ANRCT XM SURG REQ ANES GENERAL SPI/EDRL DX

Professional

Both

$316.00

Service Code	HCPCS 45990
Hospital Charge Code	45990
Min. Negotiated Rate	$67.31
Max. Negotiated Rate	$1,244.67
Rate for Payer: Aetna Commercial	$140.68
Rate for Payer: BCBS Complete	$70.68
Rate for Payer: BCBS Trust/PPO	$1,244.67
Rate for Payer: Cash Price	$252.80
Rate for Payer: Cash Price	$252.80
Rate for Payer: Mclaren Medicaid	$67.31
Rate for Payer: Meridian Medicaid	$70.68
Rate for Payer: Priority Health Choice Medicaid	$67.31
Rate for Payer: Priority Health Cigna Priority Health	$221.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$182.86
Rate for Payer: Priority Health Narrow Network	$182.86
Rate for Payer: Priority Health SBD	$182.86

Know your out-of-pocket cost for care.

All Charges