Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PR ANRCT XM SURG REQ ANES GENERAL SPI/EDRL DX

Facility

$316.00

Service Code	CPT 45990
Hospital Charge Code	45990
Min. Negotiated Rate	$199.08
Max. Negotiated Rate	$284.40
Rate for Payer: Aetna Commercial	$268.60
Rate for Payer: Aetna New Business (MI Preferred)	$205.40
Rate for Payer: Cash Price	$252.80
Rate for Payer: Cofinity Commercial	$221.20
Rate for Payer: Cofinity Commercial	$271.76
Rate for Payer: Healthscope Commercial	$284.40
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$268.60
Rate for Payer: PHP Commercial	$268.60
Rate for Payer: Priority Health Cigna Priority Health	$221.20
Rate for Payer: Priority Health SBD	$199.08

PR ANTEPARTUM CARE ONLY 4-6 VISITS

Professional

Both

$1,133.00

Service Code	HCPCS 59425
Min. Negotiated Rate	$94.57
Max. Negotiated Rate	$793.10
Rate for Payer: Aetna Commercial	$479.68
Rate for Payer: BCBS Complete	$422.12
Rate for Payer: BCBS Trust/PPO	$94.57
Rate for Payer: Cash Price	$906.40
Rate for Payer: Cash Price	$906.40
Rate for Payer: Mclaren Medicaid	$402.02
Rate for Payer: Meridian Medicaid	$422.12
Rate for Payer: Priority Health Choice Medicaid	$402.02
Rate for Payer: Priority Health Cigna Priority Health	$793.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$612.89
Rate for Payer: Priority Health Narrow Network	$612.89
Rate for Payer: Priority Health SBD	$612.89

PR ANTEPARTUM CARE ONLY 7/> VISITS

Professional

Both

$1,558.00

Service Code	HCPCS 59426
Min. Negotiated Rate	$55.47
Max. Negotiated Rate	$1,125.66
Rate for Payer: Aetna Commercial	$878.78
Rate for Payer: BCBS Complete	$775.40
Rate for Payer: BCBS Trust/PPO	$55.47
Rate for Payer: Cash Price	$1,246.40
Rate for Payer: Cash Price	$1,246.40
Rate for Payer: Mclaren Medicaid	$738.48
Rate for Payer: Meridian Medicaid	$775.40
Rate for Payer: Priority Health Choice Medicaid	$738.48
Rate for Payer: Priority Health Cigna Priority Health	$1,090.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,125.66
Rate for Payer: Priority Health Narrow Network	$1,125.66
Rate for Payer: Priority Health SBD	$1,125.66

PR ANTERIOR COLPORRAPHY RPR CYSTOCELE W/CYSTO

Professional

Both

$1,523.00

Service Code	HCPCS 57240
Min. Negotiated Rate	$394.26
Max. Negotiated Rate	$2,162.33
Rate for Payer: Aetna Commercial	$727.57
Rate for Payer: BCBS Complete	$413.97
Rate for Payer: BCBS Trust/PPO	$2,162.33
Rate for Payer: Cash Price	$1,218.40
Rate for Payer: Cash Price	$1,218.40
Rate for Payer: Mclaren Medicaid	$394.26
Rate for Payer: Meridian Medicaid	$413.97
Rate for Payer: Priority Health Choice Medicaid	$394.26
Rate for Payer: Priority Health Cigna Priority Health	$1,066.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$871.57
Rate for Payer: Priority Health Narrow Network	$871.57
Rate for Payer: Priority Health SBD	$871.57

PR ANTERIOR INSTRUMENTATION 2-3 VERTEBRAL SEGMENTS

Professional

Both

$3,805.00

Service Code	HCPCS 22845
Min. Negotiated Rate	$92.54
Max. Negotiated Rate	$2,663.50
Rate for Payer: Aetna Commercial	$979.87
Rate for Payer: BCBS Complete	$485.77
Rate for Payer: BCBS Trust/PPO	$92.54
Rate for Payer: Cash Price	$3,044.00
Rate for Payer: Cash Price	$3,044.00
Rate for Payer: Mclaren Medicaid	$462.64
Rate for Payer: Meridian Medicaid	$485.77
Rate for Payer: Priority Health Choice Medicaid	$462.64
Rate for Payer: Priority Health Cigna Priority Health	$2,663.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,105.05
Rate for Payer: Priority Health Narrow Network	$1,105.05
Rate for Payer: Priority Health SBD	$1,105.05

PR ANTERIOR INSTRUMENTATION 4-7 VERTEBRAL SEGMENTS

Professional

Both

$4,186.00

Service Code	HCPCS 22846
Min. Negotiated Rate	$62.83
Max. Negotiated Rate	$2,930.20
Rate for Payer: Aetna Commercial	$1,018.33
Rate for Payer: BCBS Complete	$505.67
Rate for Payer: BCBS Trust/PPO	$62.83
Rate for Payer: Cash Price	$3,348.80
Rate for Payer: Cash Price	$3,348.80
Rate for Payer: Mclaren Medicaid	$481.59
Rate for Payer: Meridian Medicaid	$505.67
Rate for Payer: Priority Health Choice Medicaid	$481.59
Rate for Payer: Priority Health Cigna Priority Health	$2,930.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,149.98
Rate for Payer: Priority Health Narrow Network	$1,149.98
Rate for Payer: Priority Health SBD	$1,149.98

PR ANTERIOR INSTRUMENTATION 8/> VERTEBRAL SEGMENTS

Professional

Both

$3,705.00

Service Code	HCPCS 22847
Min. Negotiated Rate	$111.22
Max. Negotiated Rate	$2,593.50
Rate for Payer: Aetna Commercial	$1,078.87
Rate for Payer: BCBS Complete	$530.72
Rate for Payer: BCBS Trust/PPO	$111.22
Rate for Payer: Cash Price	$2,964.00
Rate for Payer: Cash Price	$2,964.00
Rate for Payer: Mclaren Medicaid	$505.45
Rate for Payer: Meridian Medicaid	$530.72
Rate for Payer: Priority Health Choice Medicaid	$505.45
Rate for Payer: Priority Health Cigna Priority Health	$2,593.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,210.25
Rate for Payer: Priority Health Narrow Network	$1,210.25
Rate for Payer: Priority Health SBD	$1,210.25

PR ANTERIOR TIBIAL TUBERCLEPLASTY

Professional

Both

$2,526.00

Service Code	HCPCS 27418
Min. Negotiated Rate	$531.01
Max. Negotiated Rate	$1,768.20
Rate for Payer: Aetna Commercial	$1,109.69
Rate for Payer: BCBS Complete	$557.56
Rate for Payer: BCBS Trust/PPO	$1,136.90
Rate for Payer: Cash Price	$2,020.80
Rate for Payer: Cash Price	$2,020.80
Rate for Payer: Mclaren Medicaid	$531.01
Rate for Payer: Meridian Medicaid	$557.56
Rate for Payer: Priority Health Choice Medicaid	$531.01
Rate for Payer: Priority Health Cigna Priority Health	$1,768.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,275.09
Rate for Payer: Priority Health Narrow Network	$1,275.09
Rate for Payer: Priority Health SBD	$1,275.09

PR ANTICOAG MGMT, EACH SUBSEQ 90 DAYS

Professional

Both

$92.00

Service Code	HCPCS 99364
Min. Negotiated Rate	$36.80
Max. Negotiated Rate	$64.40
Rate for Payer: BCBS Complete	$36.80
Rate for Payer: Cash Price	$73.60
Rate for Payer: Priority Health Cigna Priority Health	$64.40

PR ANTICOAG MGMT, INITIAL 90 DAYS

Professional

Both

$203.00

Service Code	HCPCS 99363
Min. Negotiated Rate	$81.20
Max. Negotiated Rate	$142.10
Rate for Payer: BCBS Complete	$81.20
Rate for Payer: Cash Price	$162.40
Rate for Payer: Priority Health Cigna Priority Health	$142.10

PR ANTICOAGULANT MGMT FOR PT TAKING WARFARIN

Professional

Both

$24.00

Service Code	HCPCS 93793
Min. Negotiated Rate	$9.60
Max. Negotiated Rate	$39.09
Rate for Payer: Aetna Commercial	$12.40
Rate for Payer: BCBS Complete	$9.60
Rate for Payer: BCBS Trust/PPO	$39.09
Rate for Payer: Cash Price	$19.20
Rate for Payer: Cash Price	$19.20
Rate for Payer: Priority Health Cigna Priority Health	$16.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$16.08
Rate for Payer: Priority Health Narrow Network	$16.08
Rate for Payer: Priority Health SBD	$16.08

PR ANT VESICOURETHROPEXY/URETHROPEXY SMPL

Professional

Both

$2,411.00

Service Code	HCPCS 51840
Min. Negotiated Rate	$444.53
Max. Negotiated Rate	$5,391.30
Rate for Payer: Aetna Commercial	$888.00
Rate for Payer: BCBS Complete	$466.76
Rate for Payer: BCBS Trust/PPO	$5,391.30
Rate for Payer: Cash Price	$1,928.80
Rate for Payer: Cash Price	$1,928.80
Rate for Payer: Mclaren Medicaid	$444.53
Rate for Payer: Meridian Medicaid	$466.76
Rate for Payer: Priority Health Choice Medicaid	$444.53
Rate for Payer: Priority Health Cigna Priority Health	$1,687.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,117.46
Rate for Payer: Priority Health Narrow Network	$1,117.46
Rate for Payer: Priority Health SBD	$1,117.46

PR AORTIC HEMIARCH GRAFT W/ISOL & CTRL ARCH VESSELS

Professional

Both

$1,902.00

Service Code	HCPCS 33866
Min. Negotiated Rate	$572.54
Max. Negotiated Rate	$1,430.97
Rate for Payer: Aetna Commercial	$1,243.44
Rate for Payer: BCBS Complete	$601.17
Rate for Payer: BCBS Trust/PPO	$573.21
Rate for Payer: Cash Price	$1,521.60
Rate for Payer: Cash Price	$1,521.60
Rate for Payer: Mclaren Medicaid	$572.54
Rate for Payer: Meridian Medicaid	$601.17
Rate for Payer: Priority Health Choice Medicaid	$572.54
Rate for Payer: Priority Health Cigna Priority Health	$1,331.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,430.97
Rate for Payer: Priority Health Narrow Network	$1,430.97
Rate for Payer: Priority Health SBD	$1,430.97

PR AORTIC SUSPENSION TRACHEAL DECOMPRESSION SPX

Professional

Both

$1,827.00

Service Code	HCPCS 33800
Min. Negotiated Rate	$621.11
Max. Negotiated Rate	$1,542.68
Rate for Payer: Aetna Commercial	$1,324.10
Rate for Payer: BCBS Complete	$652.17
Rate for Payer: BCBS Trust/PPO	$1,416.90
Rate for Payer: Cash Price	$1,461.60
Rate for Payer: Cash Price	$1,461.60
Rate for Payer: Mclaren Medicaid	$621.11
Rate for Payer: Meridian Medicaid	$652.17
Rate for Payer: Priority Health Choice Medicaid	$621.11
Rate for Payer: Priority Health Cigna Priority Health	$1,278.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,542.68
Rate for Payer: Priority Health Narrow Network	$1,542.68
Rate for Payer: Priority Health SBD	$1,542.68

PR AORTOPLASTY SUPRAVALVULAR STENOSIS

Professional

Both

$9,194.00

Service Code	HCPCS 33417
Min. Negotiated Rate	$918.19
Max. Negotiated Rate	$6,435.80
Rate for Payer: Aetna Commercial	$2,236.97
Rate for Payer: BCBS Complete	$1,103.27
Rate for Payer: BCBS Trust/PPO	$918.19
Rate for Payer: Cash Price	$7,355.20
Rate for Payer: Cash Price	$7,355.20
Rate for Payer: Mclaren Medicaid	$1,050.73
Rate for Payer: Meridian Medicaid	$1,103.27
Rate for Payer: Priority Health Choice Medicaid	$1,050.73
Rate for Payer: Priority Health Cigna Priority Health	$6,435.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,609.79
Rate for Payer: Priority Health Narrow Network	$2,609.79
Rate for Payer: Priority Health SBD	$2,609.79

PR APNEALINK

Professional

Both

$10.00

Service Code	HCPCS 00020
Hospital Revenue Code	920
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 APPENDEC INDICATED PURPOSE OTH MAJOR PX NOT SPX

Facility

$848.00

Service Code	CPT 44955
Hospital Charge Code	44955
Min. Negotiated Rate	$534.24
Max. Negotiated Rate	$763.20
Rate for Payer: Aetna Commercial	$720.80
Rate for Payer: Aetna New Business (MI Preferred)	$551.20
Rate for Payer: Cash Price	$678.40
Rate for Payer: Cofinity Commercial	$593.60
Rate for Payer: Cofinity Commercial	$729.28
Rate for Payer: Healthscope Commercial	$763.20
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$720.80
Rate for Payer: PHP Commercial	$720.80
Rate for Payer: Priority Health Cigna Priority Health	$593.60
Rate for Payer: Priority Health SBD	$534.24

PR APPENDEC INDICATED PURPOSE OTH MAJOR PX NOT SPX

Professional

Both

$848.00

Service Code	HCPCS 44955
Min. Negotiated Rate	$52.82
Max. Negotiated Rate	$593.60
Rate for Payer: Aetna Commercial	$112.58
Rate for Payer: BCBS Complete	$55.46
Rate for Payer: BCBS Trust/PPO	$566.34
Rate for Payer: Cash Price	$678.40
Rate for Payer: Cash Price	$678.40
Rate for Payer: Mclaren Medicaid	$52.82
Rate for Payer: Meridian Medicaid	$55.46
Rate for Payer: Priority Health Choice Medicaid	$52.82
Rate for Payer: Priority Health Cigna Priority Health	$593.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$145.82
Rate for Payer: Priority Health Narrow Network	$145.82
Rate for Payer: Priority Health SBD	$145.82

PR APPENDEC INDICATED PURPOSE OTH MAJOR PX NOT SPX

Professional

Both

$848.00

Service Code	HCPCS 44955
Hospital Charge Code	44955
Min. Negotiated Rate	$52.82
Max. Negotiated Rate	$593.60
Rate for Payer: Aetna Commercial	$112.58
Rate for Payer: BCBS Complete	$55.46
Rate for Payer: BCBS Trust/PPO	$566.34
Rate for Payer: Cash Price	$678.40
Rate for Payer: Cash Price	$678.40
Rate for Payer: Mclaren Medicaid	$52.82
Rate for Payer: Meridian Medicaid	$55.46
Rate for Payer: Priority Health Choice Medicaid	$52.82
Rate for Payer: Priority Health Cigna Priority Health	$593.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$145.82
Rate for Payer: Priority Health Narrow Network	$145.82
Rate for Payer: Priority Health SBD	$145.82

PR APPENDEC INDICATED PURPOSE OTH MAJOR PX NOT SPX

Facility

$848.00

Service Code	CPT 44955
Hospital Charge Code	44955
Min. Negotiated Rate	$81.21
Max. Negotiated Rate	$763.20
Rate for Payer: Aetna Commercial	$720.80
Rate for Payer: Aetna New Business (MI Preferred)	$551.20
Rate for Payer: BCBS Complete	$339.20
Rate for Payer: BCBS Trust/PPO	$171.81
Rate for Payer: Cash Price	$678.40
Rate for Payer: Cash Price	$678.40
Rate for Payer: Cofinity Commercial	$593.60
Rate for Payer: Cofinity Commercial	$729.28
Rate for Payer: Healthscope Commercial	$763.20
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$720.80
Rate for Payer: PHP Commercial	$720.80
Rate for Payer: Priority Health Cigna Priority Health	$593.60
Rate for Payer: Priority Health SBD	$534.24
Rate for Payer: UHC All Payor (Choice/PPO)	$89.33
Rate for Payer: UHC Exchange	$81.21

PR APPENDEC RPTD APPENDIX ABSC/PRITONITIS

Professional

Both

$2,095.00

Service Code	HCPCS 44960
Min. Negotiated Rate	$561.26
Max. Negotiated Rate	$1,541.66
Rate for Payer: Aetna Commercial	$1,185.47
Rate for Payer: BCBS Complete	$589.32
Rate for Payer: BCBS Trust/PPO	$857.96
Rate for Payer: Cash Price	$1,676.00
Rate for Payer: Cash Price	$1,676.00
Rate for Payer: Mclaren Medicaid	$561.26
Rate for Payer: Meridian Medicaid	$589.32
Rate for Payer: Priority Health Choice Medicaid	$561.26
Rate for Payer: Priority Health Cigna Priority Health	$1,466.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,541.66
Rate for Payer: Priority Health Narrow Network	$1,541.66
Rate for Payer: Priority Health SBD	$1,541.66

PR APPENDECTOMY

Facility

$1,704.00

Service Code	CPT 44950
Hospital Charge Code	44950
Min. Negotiated Rate	$632.62
Max. Negotiated Rate	$9,906.28
Rate for Payer: Aetna Commercial	$1,448.40
Rate for Payer: Aetna Medicare	$7,001.06
Rate for Payer: Aetna New Business (MI Preferred)	$1,107.60
Rate for Payer: Allen County Amish Medical Aid Commercial	$8,414.74
Rate for Payer: Amish Plain Church Group Commercial	$8,414.74
Rate for Payer: BCBS Complete	$3,866.74
Rate for Payer: BCBS MAPPO	$6,731.79
Rate for Payer: BCBS Trust/PPO	$2,665.09
Rate for Payer: BCN Medicare Advantage	$6,731.79
Rate for Payer: Cash Price	$1,363.20
Rate for Payer: Cash Price	$1,363.20
Rate for Payer: Cofinity Commercial	$1,192.80
Rate for Payer: Cofinity Commercial	$1,465.44
Rate for Payer: Health Alliance Plan Medicare Advantage	$6,731.79
Rate for Payer: Healthscope Commercial	$1,533.60
Rate for Payer: Mclaren Medicaid	$3,682.29
Rate for Payer: Mclaren Medicare	$6,731.79
Rate for Payer: Meridian Medicaid	$3,866.74
Rate for Payer: Meridian Wellcare - Medicare Advantage	$7,068.38
Rate for Payer: MI Amish Medical Board Commercial	$7,741.56
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,448.40
Rate for Payer: PACE Medicare	$6,395.20
Rate for Payer: PACE SWMI	$6,731.79
Rate for Payer: PHP Commercial	$1,448.40
Rate for Payer: PHP Medicare Advantage	$6,731.79
Rate for Payer: Priority Health Choice Medicaid	$3,682.29
Rate for Payer: Priority Health Cigna Priority Health	$1,192.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$9,906.28
Rate for Payer: Priority Health Medicare	$6,731.79
Rate for Payer: Priority Health Narrow Network	$7,925.02
Rate for Payer: Priority Health SBD	$1,073.52
Rate for Payer: Railroad Medicare Medicare	$6,731.79
Rate for Payer: UHC All Payor (Choice/PPO)	$695.88
Rate for Payer: UHC Dual Complete DSNP	$6,731.79
Rate for Payer: UHC Exchange	$632.62
Rate for Payer: UHC Medicare Advantage	$6,933.74
Rate for Payer: VA VA	$6,731.79

PR APPENDECTOMY

Professional

Both

$1,704.00

Service Code	HCPCS 44950
Hospital Charge Code	44950
Min. Negotiated Rate	$411.52
Max. Negotiated Rate	$1,192.80
Rate for Payer: Aetna Commercial	$868.66
Rate for Payer: BCBS Complete	$432.10
Rate for Payer: BCBS Trust/PPO	$413.13
Rate for Payer: Cash Price	$1,363.20
Rate for Payer: Cash Price	$1,363.20
Rate for Payer: Mclaren Medicaid	$411.52
Rate for Payer: Meridian Medicaid	$432.10
Rate for Payer: Priority Health Choice Medicaid	$411.52
Rate for Payer: Priority Health Cigna Priority Health	$1,192.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,129.49
Rate for Payer: Priority Health Narrow Network	$1,129.49
Rate for Payer: Priority Health SBD	$1,129.49

PR APPENDECTOMY

Professional

Both

$1,704.00

Service Code	HCPCS 44950
Min. Negotiated Rate	$411.52
Max. Negotiated Rate	$1,192.80
Rate for Payer: Aetna Commercial	$868.66
Rate for Payer: BCBS Complete	$432.10
Rate for Payer: BCBS Trust/PPO	$413.13
Rate for Payer: Cash Price	$1,363.20
Rate for Payer: Cash Price	$1,363.20
Rate for Payer: Mclaren Medicaid	$411.52
Rate for Payer: Meridian Medicaid	$432.10
Rate for Payer: Priority Health Choice Medicaid	$411.52
Rate for Payer: Priority Health Cigna Priority Health	$1,192.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,129.49
Rate for Payer: Priority Health Narrow Network	$1,129.49
Rate for Payer: Priority Health SBD	$1,129.49

PR APPENDECTOMY

Facility

$1,704.00

Service Code	CPT 44950
Hospital Charge Code	44950
Min. Negotiated Rate	$1,073.52
Max. Negotiated Rate	$1,533.60
Rate for Payer: Aetna Commercial	$1,448.40
Rate for Payer: Aetna New Business (MI Preferred)	$1,107.60
Rate for Payer: Cash Price	$1,363.20
Rate for Payer: Cofinity Commercial	$1,192.80
Rate for Payer: Cofinity Commercial	$1,465.44
Rate for Payer: Healthscope Commercial	$1,533.60
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,448.40
Rate for Payer: PHP Commercial	$1,448.40
Rate for Payer: Priority Health Cigna Priority Health	$1,192.80
Rate for Payer: Priority Health SBD	$1,073.52

Know your out-of-pocket cost for care.

All Charges