Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PR ARTHROPLASTY W/PROSTHETIC RPLCMT DISTAL RADIUS

Professional

Both

$1,856.00

Service Code	HCPCS 25441
Min. Negotiated Rate	$605.56
Max. Negotiated Rate	$1,441.57
Rate for Payer: Aetna Commercial	$1,253.73
Rate for Payer: BCBS Complete	$635.84
Rate for Payer: BCBS Trust/PPO	$807.77
Rate for Payer: Cash Price	$1,484.80
Rate for Payer: Cash Price	$1,484.80
Rate for Payer: Mclaren Medicaid	$605.56
Rate for Payer: Meridian Medicaid	$635.84
Rate for Payer: Priority Health Choice Medicaid	$605.56
Rate for Payer: Priority Health Cigna Priority Health	$1,299.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,441.57
Rate for Payer: Priority Health Narrow Network	$1,441.57
Rate for Payer: Priority Health SBD	$1,441.57

PR ARTHROPLASTY W/PROSTHETIC RPLCMT DISTAL ULNA

Professional

Both

$1,596.00

Service Code	HCPCS 25442
Min. Negotiated Rate	$523.55
Max. Negotiated Rate	$1,245.99
Rate for Payer: Aetna Commercial	$1,076.84
Rate for Payer: BCBS Complete	$549.73
Rate for Payer: BCBS Trust/PPO	$863.24
Rate for Payer: Cash Price	$1,276.80
Rate for Payer: Cash Price	$1,276.80
Rate for Payer: Mclaren Medicaid	$523.55
Rate for Payer: Meridian Medicaid	$549.73
Rate for Payer: Priority Health Choice Medicaid	$523.55
Rate for Payer: Priority Health Cigna Priority Health	$1,117.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,245.99
Rate for Payer: Priority Health Narrow Network	$1,245.99
Rate for Payer: Priority Health SBD	$1,245.99

PR ARTHROPLASTY W/PROSTHETIC RPLCMT SCAPHOID CARPAL

Professional

Both

$1,566.00

Service Code	HCPCS 25443
Min. Negotiated Rate	$509.28
Max. Negotiated Rate	$1,209.73
Rate for Payer: Aetna Commercial	$1,047.50
Rate for Payer: BCBS Complete	$534.74
Rate for Payer: BCBS Trust/PPO	$628.15
Rate for Payer: Cash Price	$1,252.80
Rate for Payer: Cash Price	$1,252.80
Rate for Payer: Mclaren Medicaid	$509.28
Rate for Payer: Meridian Medicaid	$534.74
Rate for Payer: Priority Health Choice Medicaid	$509.28
Rate for Payer: Priority Health Cigna Priority Health	$1,096.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,209.73
Rate for Payer: Priority Health Narrow Network	$1,209.73
Rate for Payer: Priority Health SBD	$1,209.73

PR ARTHROSCOPY AID TX SPINE&/FX KNEE W/FIXJ

Professional

Both

$3,055.00

Service Code	HCPCS 29851
Min. Negotiated Rate	$599.38
Max. Negotiated Rate	$2,138.50
Rate for Payer: Aetna Commercial	$1,241.59
Rate for Payer: BCBS Complete	$629.35
Rate for Payer: BCBS Trust/PPO	$1,262.11
Rate for Payer: Cash Price	$2,444.00
Rate for Payer: Cash Price	$2,444.00
Rate for Payer: Mclaren Medicaid	$599.38
Rate for Payer: Meridian Medicaid	$629.35
Rate for Payer: Priority Health Choice Medicaid	$599.38
Rate for Payer: Priority Health Cigna Priority Health	$2,138.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,425.22
Rate for Payer: Priority Health Narrow Network	$1,425.22
Rate for Payer: Priority Health SBD	$1,425.22

PR ARTHROSCOPY AID TX SPINE&/FX KNEE W/O FIXJ

Professional

Both

$1,207.00

Service Code	HCPCS 29850
Min. Negotiated Rate	$405.34
Max. Negotiated Rate	$961.56
Rate for Payer: Aetna Commercial	$830.82
Rate for Payer: BCBS Complete	$425.61
Rate for Payer: BCBS Trust/PPO	$917.66
Rate for Payer: Cash Price	$965.60
Rate for Payer: Cash Price	$965.60
Rate for Payer: Mclaren Medicaid	$405.34
Rate for Payer: Meridian Medicaid	$425.61
Rate for Payer: Priority Health Choice Medicaid	$405.34
Rate for Payer: Priority Health Cigna Priority Health	$844.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$961.56
Rate for Payer: Priority Health Narrow Network	$961.56
Rate for Payer: Priority Health SBD	$961.56

PR ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT EXTENSIVE

Professional

Both

$2,158.00

Service Code	HCPCS 29898
Min. Negotiated Rate	$361.25
Max. Negotiated Rate	$1,510.60
Rate for Payer: Aetna Commercial	$747.21
Rate for Payer: BCBS Complete	$379.31
Rate for Payer: BCBS Trust/PPO	$1,477.13
Rate for Payer: Cash Price	$1,726.40
Rate for Payer: Cash Price	$1,726.40
Rate for Payer: Mclaren Medicaid	$361.25
Rate for Payer: Meridian Medicaid	$379.31
Rate for Payer: Priority Health Choice Medicaid	$361.25
Rate for Payer: Priority Health Cigna Priority Health	$1,510.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$859.42
Rate for Payer: Priority Health Narrow Network	$859.42
Rate for Payer: Priority Health SBD	$859.42

PR ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT LIMITED

Professional

Both

$1,904.00

Service Code	HCPCS 29897
Min. Negotiated Rate	$319.93
Max. Negotiated Rate	$1,332.80
Rate for Payer: Aetna Commercial	$661.76
Rate for Payer: BCBS Complete	$335.93
Rate for Payer: BCBS Trust/PPO	$1,230.41
Rate for Payer: Cash Price	$1,523.20
Rate for Payer: Cash Price	$1,523.20
Rate for Payer: Mclaren Medicaid	$319.93
Rate for Payer: Meridian Medicaid	$335.93
Rate for Payer: Priority Health Choice Medicaid	$319.93
Rate for Payer: Priority Health Cigna Priority Health	$1,332.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$763.93
Rate for Payer: Priority Health Narrow Network	$763.93
Rate for Payer: Priority Health SBD	$763.93

PR ARTHROSCOPY ANKLE SURGICAL SYNOVECTOMY PARTIAL

Professional

Both

$1,840.00

Service Code	HCPCS 29895
Min. Negotiated Rate	$298.84
Max. Negotiated Rate	$1,288.00
Rate for Payer: Aetna Commercial	$623.06
Rate for Payer: BCBS Complete	$313.78
Rate for Payer: BCBS Trust/PPO	$911.32
Rate for Payer: Cash Price	$1,472.00
Rate for Payer: Cash Price	$1,472.00
Rate for Payer: Mclaren Medicaid	$298.84
Rate for Payer: Meridian Medicaid	$313.78
Rate for Payer: Priority Health Choice Medicaid	$298.84
Rate for Payer: Priority Health Cigna Priority Health	$1,288.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$710.31
Rate for Payer: Priority Health Narrow Network	$710.31
Rate for Payer: Priority Health SBD	$710.31

PR ARTHROSCOPY ANKLE SURGICAL W/ANKLE ARTHRODESIS

Professional

Both

$3,028.00

Service Code	HCPCS 29899
Min. Negotiated Rate	$645.82
Max. Negotiated Rate	$2,119.60
Rate for Payer: Aetna Commercial	$1,366.39
Rate for Payer: BCBS Complete	$678.11
Rate for Payer: BCBS Trust/PPO	$1,942.03
Rate for Payer: Cash Price	$2,422.40
Rate for Payer: Cash Price	$2,422.40
Rate for Payer: Mclaren Medicaid	$645.82
Rate for Payer: Meridian Medicaid	$678.11
Rate for Payer: Priority Health Choice Medicaid	$645.82
Rate for Payer: Priority Health Cigna Priority Health	$2,119.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,538.07
Rate for Payer: Priority Health Narrow Network	$1,538.07
Rate for Payer: Priority Health SBD	$1,538.07

PR ARTHROSCOPY ANKLE W/REMOVAL LOOSE/FOREIGN BODY

Professional

Both

$1,904.00

Service Code	HCPCS 29894
Min. Negotiated Rate	$325.89
Max. Negotiated Rate	$1,332.80
Rate for Payer: Aetna Commercial	$663.97
Rate for Payer: BCBS Complete	$342.18
Rate for Payer: BCBS Trust/PPO	$1,168.07
Rate for Payer: Cash Price	$1,523.20
Rate for Payer: Cash Price	$1,523.20
Rate for Payer: Mclaren Medicaid	$325.89
Rate for Payer: Meridian Medicaid	$342.18
Rate for Payer: Priority Health Choice Medicaid	$325.89
Rate for Payer: Priority Health Cigna Priority Health	$1,332.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$760.87
Rate for Payer: Priority Health Narrow Network	$760.87
Rate for Payer: Priority Health SBD	$760.87

PR ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT EXTENSIVE

Professional

Both

$2,158.00

Service Code	HCPCS 29838
Min. Negotiated Rate	$386.17
Max. Negotiated Rate	$1,510.60
Rate for Payer: Aetna Commercial	$790.94
Rate for Payer: BCBS Complete	$405.48
Rate for Payer: BCBS Trust/PPO	$1,480.30
Rate for Payer: Cash Price	$1,726.40
Rate for Payer: Cash Price	$1,726.40
Rate for Payer: Mclaren Medicaid	$386.17
Rate for Payer: Meridian Medicaid	$405.48
Rate for Payer: Priority Health Choice Medicaid	$386.17
Rate for Payer: Priority Health Cigna Priority Health	$1,510.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$916.11
Rate for Payer: Priority Health Narrow Network	$916.11
Rate for Payer: Priority Health SBD	$916.11

PR ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT LIMITED

Professional

Both

$1,902.00

Service Code	HCPCS 29837
Min. Negotiated Rate	$340.80
Max. Negotiated Rate	$1,331.40
Rate for Payer: Aetna Commercial	$704.42
Rate for Payer: BCBS Complete	$357.84
Rate for Payer: BCBS Trust/PPO	$1,072.98
Rate for Payer: Cash Price	$1,521.60
Rate for Payer: Cash Price	$1,521.60
Rate for Payer: Mclaren Medicaid	$340.80
Rate for Payer: Meridian Medicaid	$357.84
Rate for Payer: Priority Health Choice Medicaid	$340.80
Rate for Payer: Priority Health Cigna Priority Health	$1,331.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$813.46
Rate for Payer: Priority Health Narrow Network	$813.46
Rate for Payer: Priority Health SBD	$813.46

PR ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY COMPLETE

Professional

Both

$1,020.00

Service Code	HCPCS 29836
Min. Negotiated Rate	$379.14
Max. Negotiated Rate	$1,712.22
Rate for Payer: Aetna Commercial	$777.30
Rate for Payer: BCBS Complete	$398.10
Rate for Payer: BCBS Trust/PPO	$1,712.22
Rate for Payer: Cash Price	$816.00
Rate for Payer: Cash Price	$816.00
Rate for Payer: Mclaren Medicaid	$379.14
Rate for Payer: Meridian Medicaid	$398.10
Rate for Payer: Priority Health Choice Medicaid	$379.14
Rate for Payer: Priority Health Cigna Priority Health	$714.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$902.32
Rate for Payer: Priority Health Narrow Network	$902.32
Rate for Payer: Priority Health SBD	$902.32

PR ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY PARTIAL

Professional

Both

$1,930.00

Service Code	HCPCS 29835
Min. Negotiated Rate	$331.43
Max. Negotiated Rate	$1,673.65
Rate for Payer: Aetna Commercial	$679.61
Rate for Payer: BCBS Complete	$348.00
Rate for Payer: BCBS Trust/PPO	$1,673.65
Rate for Payer: Cash Price	$1,544.00
Rate for Payer: Cash Price	$1,544.00
Rate for Payer: Mclaren Medicaid	$331.43
Rate for Payer: Meridian Medicaid	$348.00
Rate for Payer: Priority Health Choice Medicaid	$331.43
Rate for Payer: Priority Health Cigna Priority Health	$1,351.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$785.88
Rate for Payer: Priority Health Narrow Network	$785.88
Rate for Payer: Priority Health SBD	$785.88

PR ARTHROSCOPY ELBOW SURGICAL W/REMOVAL LOOSE/FB

Professional

Both

$1,809.00

Service Code	HCPCS 29834
Min. Negotiated Rate	$319.29
Max. Negotiated Rate	$1,694.79
Rate for Payer: Aetna Commercial	$657.85
Rate for Payer: BCBS Complete	$335.25
Rate for Payer: BCBS Trust/PPO	$1,694.79
Rate for Payer: Cash Price	$1,447.20
Rate for Payer: Cash Price	$1,447.20
Rate for Payer: Mclaren Medicaid	$319.29
Rate for Payer: Meridian Medicaid	$335.25
Rate for Payer: Priority Health Choice Medicaid	$319.29
Rate for Payer: Priority Health Cigna Priority Health	$1,266.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$759.84
Rate for Payer: Priority Health Narrow Network	$759.84
Rate for Payer: Priority Health SBD	$759.84

PR ARTHROSCOPY HIP SURGICAL W/REMOVAL LOOSE/FB

Professional

Both

$2,396.00

Service Code	HCPCS 29861
Min. Negotiated Rate	$461.36
Max. Negotiated Rate	$1,677.20
Rate for Payer: Aetna Commercial	$964.85
Rate for Payer: BCBS Complete	$484.43
Rate for Payer: BCBS Trust/PPO	$480.75
Rate for Payer: Cash Price	$1,916.80
Rate for Payer: Cash Price	$1,916.80
Rate for Payer: Mclaren Medicaid	$461.36
Rate for Payer: Meridian Medicaid	$484.43
Rate for Payer: Priority Health Choice Medicaid	$461.36
Rate for Payer: Priority Health Cigna Priority Health	$1,677.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,092.28
Rate for Payer: Priority Health Narrow Network	$1,092.28
Rate for Payer: Priority Health SBD	$1,092.28

PR ARTHROSCOPY HIP SURGICAL W/SYNOVECTOMY

Professional

Both

$1,615.00

Service Code	HCPCS 29863
Min. Negotiated Rate	$526.32
Max. Negotiated Rate	$1,244.96
Rate for Payer: Aetna Commercial	$1,082.78
Rate for Payer: BCBS Complete	$552.64
Rate for Payer: BCBS Trust/PPO	$1,151.17
Rate for Payer: Cash Price	$1,292.00
Rate for Payer: Cash Price	$1,292.00
Rate for Payer: Mclaren Medicaid	$526.32
Rate for Payer: Meridian Medicaid	$552.64
Rate for Payer: Priority Health Choice Medicaid	$526.32
Rate for Payer: Priority Health Cigna Priority Health	$1,130.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,244.96
Rate for Payer: Priority Health Narrow Network	$1,244.96
Rate for Payer: Priority Health SBD	$1,244.96

PR ARTHROSCOPY HIP W/ACETABULOPLASTY

Professional

Both

$3,195.00

Service Code	HCPCS 29915
Min. Negotiated Rate	$654.55
Max. Negotiated Rate	$2,236.50
Rate for Payer: Aetna Commercial	$1,365.58
Rate for Payer: BCBS Complete	$687.28
Rate for Payer: BCBS Trust/PPO	$1,190.26
Rate for Payer: Cash Price	$2,556.00
Rate for Payer: Cash Price	$2,556.00
Rate for Payer: Mclaren Medicaid	$654.55
Rate for Payer: Meridian Medicaid	$687.28
Rate for Payer: Priority Health Choice Medicaid	$654.55
Rate for Payer: Priority Health Cigna Priority Health	$2,236.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,556.97
Rate for Payer: Priority Health Narrow Network	$1,556.97
Rate for Payer: Priority Health SBD	$1,556.97

PR ARTHROSCOPY HIP W/FEMOROPLASTY

Professional

Both

$3,003.00

Service Code	HCPCS 29914
Min. Negotiated Rate	$556.83
Max. Negotiated Rate	$2,102.10
Rate for Payer: Aetna Commercial	$1,332.42
Rate for Payer: BCBS Complete	$670.50
Rate for Payer: BCBS Trust/PPO	$556.83
Rate for Payer: Cash Price	$2,402.40
Rate for Payer: Cash Price	$2,402.40
Rate for Payer: Mclaren Medicaid	$638.57
Rate for Payer: Meridian Medicaid	$670.50
Rate for Payer: Priority Health Choice Medicaid	$638.57
Rate for Payer: Priority Health Cigna Priority Health	$2,102.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,521.74
Rate for Payer: Priority Health Narrow Network	$1,521.74
Rate for Payer: Priority Health SBD	$1,521.74

PR ARTHROSCOPY HIP W/LABRAL REPAIR

Professional

Both

$3,210.00

Service Code	HCPCS 29916
Min. Negotiated Rate	$651.78
Max. Negotiated Rate	$2,247.00
Rate for Payer: Aetna Commercial	$1,365.49
Rate for Payer: BCBS Complete	$684.37
Rate for Payer: BCBS Trust/PPO	$2,084.67
Rate for Payer: Cash Price	$2,568.00
Rate for Payer: Cash Price	$2,568.00
Rate for Payer: Mclaren Medicaid	$651.78
Rate for Payer: Meridian Medicaid	$684.37
Rate for Payer: Priority Health Choice Medicaid	$651.78
Rate for Payer: Priority Health Cigna Priority Health	$2,247.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,558.51
Rate for Payer: Priority Health Narrow Network	$1,558.51
Rate for Payer: Priority Health SBD	$1,558.51

PR ARTHROSCOPY KNEE DIAGNOSTIC W/WO SYNOVIAL BX SPX

Professional

Both

$1,111.00

Service Code	HCPCS 29870
Min. Negotiated Rate	$267.10
Max. Negotiated Rate	$1,328.67
Rate for Payer: Aetna Commercial	$540.25
Rate for Payer: BCBS Complete	$280.46
Rate for Payer: BCBS Trust/PPO	$1,328.67
Rate for Payer: Cash Price	$888.80
Rate for Payer: Cash Price	$888.80
Rate for Payer: Mclaren Medicaid	$267.10
Rate for Payer: Meridian Medicaid	$280.46
Rate for Payer: Priority Health Choice Medicaid	$267.10
Rate for Payer: Priority Health Cigna Priority Health	$777.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$627.07
Rate for Payer: Priority Health Narrow Network	$627.07
Rate for Payer: Priority Health SBD	$627.07

PR ARTHROSCOPY KNEE INFECTION LAVAGE & DRAINAGE

Professional

Both

$1,586.00

Service Code	HCPCS 29871
Min. Negotiated Rate	$334.84
Max. Negotiated Rate	$1,303.32
Rate for Payer: Aetna Commercial	$684.95
Rate for Payer: BCBS Complete	$351.58
Rate for Payer: BCBS Trust/PPO	$1,303.32
Rate for Payer: Cash Price	$1,268.80
Rate for Payer: Cash Price	$1,268.80
Rate for Payer: Mclaren Medicaid	$334.84
Rate for Payer: Meridian Medicaid	$351.58
Rate for Payer: Priority Health Choice Medicaid	$334.84
Rate for Payer: Priority Health Cigna Priority Health	$1,110.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$795.08
Rate for Payer: Priority Health Narrow Network	$795.08
Rate for Payer: Priority Health SBD	$795.08

PR ARTHROSCOPY KNEE LATERAL RELEASE

Professional

Both

$1,935.00

Service Code	HCPCS 29873
Min. Negotiated Rate	$350.17
Max. Negotiated Rate	$1,722.26
Rate for Payer: Aetna Commercial	$709.91
Rate for Payer: BCBS Complete	$367.68
Rate for Payer: BCBS Trust/PPO	$1,722.26
Rate for Payer: Cash Price	$1,548.00
Rate for Payer: Cash Price	$1,548.00
Rate for Payer: Mclaren Medicaid	$350.17
Rate for Payer: Meridian Medicaid	$367.68
Rate for Payer: Priority Health Choice Medicaid	$350.17
Rate for Payer: Priority Health Cigna Priority Health	$1,354.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$827.76
Rate for Payer: Priority Health Narrow Network	$827.76
Rate for Payer: Priority Health SBD	$827.76

PR ARTHROSCOPY KNEE MENISCAL TRNSPLJ MED/LAT

Professional

Both

$2,944.00

Service Code	HCPCS 29868
Min. Negotiated Rate	$818.87
Max. Negotiated Rate	$2,547.12
Rate for Payer: Aetna Commercial	$2,231.26
Rate for Payer: BCBS Complete	$1,122.72
Rate for Payer: BCBS Trust/PPO	$818.87
Rate for Payer: Cash Price	$2,355.20
Rate for Payer: Cash Price	$2,355.20
Rate for Payer: Mclaren Medicaid	$1,069.26
Rate for Payer: Meridian Medicaid	$1,122.72
Rate for Payer: Priority Health Choice Medicaid	$1,069.26
Rate for Payer: Priority Health Cigna Priority Health	$2,060.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,547.12
Rate for Payer: Priority Health Narrow Network	$2,547.12
Rate for Payer: Priority Health SBD	$2,547.12

PR ARTHROSCOPY KNEE OSTEOCHONDRAL AGRFT MOSAICPLAST

Professional

Both

$3,036.00

Service Code	HCPCS 29866
Min. Negotiated Rate	$678.83
Max. Negotiated Rate	$2,125.20
Rate for Payer: Aetna Commercial	$1,401.56
Rate for Payer: BCBS Complete	$712.77
Rate for Payer: BCBS Trust/PPO	$1,167.54
Rate for Payer: Cash Price	$2,428.80
Rate for Payer: Cash Price	$2,428.80
Rate for Payer: Mclaren Medicaid	$678.83
Rate for Payer: Meridian Medicaid	$712.77
Rate for Payer: Priority Health Choice Medicaid	$678.83
Rate for Payer: Priority Health Cigna Priority Health	$2,125.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,613.15
Rate for Payer: Priority Health Narrow Network	$1,613.15
Rate for Payer: Priority Health SBD	$1,613.15

Know your out-of-pocket cost for care.

All Charges