Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PR ASCENDING AORTA GRF VALVE SPARE ROOT REMODEL

Professional

Both

$5,125.00

Service Code	HCPCS 33864
Min. Negotiated Rate	$1,166.49
Max. Negotiated Rate	$5,000.94
Rate for Payer: Aetna Commercial	$4,324.43
Rate for Payer: BCBS Complete	$2,105.44
Rate for Payer: BCBS Trust/PPO	$1,166.49
Rate for Payer: Cash Price	$4,100.00
Rate for Payer: Cash Price	$4,100.00
Rate for Payer: Mclaren Medicaid	$2,005.18
Rate for Payer: Meridian Medicaid	$2,105.44
Rate for Payer: Priority Health Choice Medicaid	$2,005.18
Rate for Payer: Priority Health Cigna Priority Health	$3,587.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$5,000.94
Rate for Payer: Priority Health Narrow Network	$5,000.94
Rate for Payer: Priority Health SBD	$5,000.94

PR ASPIRATION AND/OR INJECTION THYROID CYST

Professional

Both

$159.00

Service Code	HCPCS 60300
Min. Negotiated Rate	$30.46
Max. Negotiated Rate	$3,338.86
Rate for Payer: Aetna Commercial	$63.32
Rate for Payer: BCBS Complete	$31.98
Rate for Payer: BCBS Trust/PPO	$3,338.86
Rate for Payer: Cash Price	$127.20
Rate for Payer: Cash Price	$127.20
Rate for Payer: Mclaren Medicaid	$30.46
Rate for Payer: Meridian Medicaid	$31.98
Rate for Payer: Priority Health Choice Medicaid	$30.46
Rate for Payer: Priority Health Cigna Priority Health	$111.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$67.66
Rate for Payer: Priority Health Narrow Network	$67.66
Rate for Payer: Priority Health SBD	$67.66

PR ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER

Professional

Both

$242.00

Service Code	HCPCS 51102
Min. Negotiated Rate	$89.89
Max. Negotiated Rate	$1,872.30
Rate for Payer: Aetna Commercial	$185.74
Rate for Payer: BCBS Complete	$94.38
Rate for Payer: BCBS Trust/PPO	$1,872.30
Rate for Payer: Cash Price	$193.60
Rate for Payer: Cash Price	$193.60
Rate for Payer: Mclaren Medicaid	$89.89
Rate for Payer: Meridian Medicaid	$94.38
Rate for Payer: Priority Health Choice Medicaid	$89.89
Rate for Payer: Priority Health Cigna Priority Health	$169.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$228.02
Rate for Payer: Priority Health Narrow Network	$228.02
Rate for Payer: Priority Health SBD	$228.02

PR ASPIRATION BLADDER NEEDLE

Professional

Both

$122.00

Service Code	HCPCS 51100
Min. Negotiated Rate	$24.71
Max. Negotiated Rate	$2,925.20
Rate for Payer: Aetna Commercial	$49.74
Rate for Payer: BCBS Complete	$25.95
Rate for Payer: BCBS Trust/PPO	$2,925.20
Rate for Payer: Cash Price	$97.60
Rate for Payer: Cash Price	$97.60
Rate for Payer: Mclaren Medicaid	$24.71
Rate for Payer: Meridian Medicaid	$25.95
Rate for Payer: Priority Health Choice Medicaid	$24.71
Rate for Payer: Priority Health Cigna Priority Health	$85.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$62.14
Rate for Payer: Priority Health Narrow Network	$62.14
Rate for Payer: Priority Health SBD	$62.14

PR ASPIRATION BLADDER TROCAR/INTRACATHETER

Professional

Both

$379.00

Service Code	HCPCS 51101
Min. Negotiated Rate	$32.16
Max. Negotiated Rate	$2,914.10
Rate for Payer: Aetna Commercial	$66.50
Rate for Payer: BCBS Complete	$33.77
Rate for Payer: BCBS Trust/PPO	$2,914.10
Rate for Payer: Cash Price	$303.20
Rate for Payer: Cash Price	$303.20
Rate for Payer: Mclaren Medicaid	$32.16
Rate for Payer: Meridian Medicaid	$33.77
Rate for Payer: Priority Health Choice Medicaid	$32.16
Rate for Payer: Priority Health Cigna Priority Health	$265.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$80.51
Rate for Payer: Priority Health Narrow Network	$80.51
Rate for Payer: Priority Health SBD	$80.51

PR ASPIRATION&/INJECTION GANGLION CYST ANY LOCATJ

Professional

Both

$132.00

Service Code	HCPCS 20612
Min. Negotiated Rate	$26.20
Max. Negotiated Rate	$2,114.22
Rate for Payer: Aetna Commercial	$55.18
Rate for Payer: BCBS Complete	$27.51
Rate for Payer: BCBS Trust/PPO	$2,114.22
Rate for Payer: Cash Price	$105.60
Rate for Payer: Cash Price	$105.60
Rate for Payer: Mclaren Medicaid	$26.20
Rate for Payer: Meridian Medicaid	$27.51
Rate for Payer: Priority Health Choice Medicaid	$26.20
Rate for Payer: Priority Health Cigna Priority Health	$92.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$62.30
Rate for Payer: Priority Health Narrow Network	$62.30
Rate for Payer: Priority Health SBD	$62.30

PR ASSESSMENT APHASIA W/INTERP & REPORT PER HOUR

Professional

Both

$199.00

Service Code	HCPCS 96105
Min. Negotiated Rate	$79.60
Max. Negotiated Rate	$332.30
Rate for Payer: Aetna Commercial	$109.95
Rate for Payer: BCBS Complete	$79.60
Rate for Payer: BCBS Trust/PPO	$332.30
Rate for Payer: Cash Price	$159.20
Rate for Payer: Cash Price	$159.20
Rate for Payer: Priority Health Cigna Priority Health	$139.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$130.25
Rate for Payer: Priority Health Narrow Network	$130.25
Rate for Payer: Priority Health SBD	$130.25

PR ASSESSMENT FOR HEARING AID

Professional

Both

$140.00

Service Code	HCPCS V5010
Min. Negotiated Rate	$47.05
Max. Negotiated Rate	$98.00
Rate for Payer: Aetna Commercial	$47.05
Rate for Payer: BCBS Complete	$56.00
Rate for Payer: Cash Price	$112.00
Rate for Payer: Cash Price	$112.00
Rate for Payer: Priority Health Cigna Priority Health	$98.00

PR ASSMT & CARE PLANNING PT W/COGNITIVE IMPAIRMENT

Professional

Both

$350.00

Service Code	HCPCS 99483
Min. Negotiated Rate	$122.26
Max. Negotiated Rate	$405.21
Rate for Payer: Aetna Commercial	$195.52
Rate for Payer: BCBS Complete	$128.37
Rate for Payer: BCBS Trust/PPO	$405.21
Rate for Payer: Cash Price	$280.00
Rate for Payer: Cash Price	$280.00
Rate for Payer: Mclaren Medicaid	$122.26
Rate for Payer: Meridian Medicaid	$128.37
Rate for Payer: Priority Health Choice Medicaid	$122.26
Rate for Payer: Priority Health Cigna Priority Health	$245.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$245.42
Rate for Payer: Priority Health Narrow Network	$245.42
Rate for Payer: Priority Health SBD	$245.42

PRASUGREL 10 MG TABLET

Facility

$52.83

Service Code	NDC 0002-5123-01
Hospital Charge Code	98373
Hospital Revenue Code	637
Min. Negotiated Rate	$33.28
Max. Negotiated Rate	$47.55
Rate for Payer: Aetna Commercial	$44.91
Rate for Payer: Aetna New Business (MI Preferred)	$34.34
Rate for Payer: Cash Price	$42.26
Rate for Payer: Cofinity Commercial	$36.98
Rate for Payer: Cofinity Commercial	$45.43
Rate for Payer: Healthscope Commercial	$47.55
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$44.91
Rate for Payer: PHP Commercial	$44.91
Rate for Payer: Priority Health Cigna Priority Health	$36.98
Rate for Payer: Priority Health SBD	$33.28

PRASUGREL 10 MG TABLET

Facility

$4,753.91

Service Code	NDC 0002-5123-77
Hospital Charge Code	98373
Hospital Revenue Code	637
Min. Negotiated Rate	$2,994.96
Max. Negotiated Rate	$4,278.52
Rate for Payer: Aetna Commercial	$4,040.82
Rate for Payer: Aetna New Business (MI Preferred)	$3,090.04
Rate for Payer: Cash Price	$3,803.13
Rate for Payer: Cofinity Commercial	$3,327.74
Rate for Payer: Cofinity Commercial	$4,088.36
Rate for Payer: Healthscope Commercial	$4,278.52
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$4,040.82
Rate for Payer: PHP Commercial	$4,040.82
Rate for Payer: Priority Health Cigna Priority Health	$3,327.74
Rate for Payer: Priority Health SBD	$2,994.96

PRASUGREL 10 MG TABLET

Facility

$94.34

Service Code	NDC 60505-4643-3
Hospital Charge Code	98373
Hospital Revenue Code	637
Min. Negotiated Rate	$59.43
Max. Negotiated Rate	$84.91
Rate for Payer: Aetna Commercial	$80.19
Rate for Payer: Aetna New Business (MI Preferred)	$61.32
Rate for Payer: Cash Price	$75.47
Rate for Payer: Cofinity Commercial	$66.04
Rate for Payer: Cofinity Commercial	$81.13
Rate for Payer: Healthscope Commercial	$84.91
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$80.19
Rate for Payer: PHP Commercial	$80.19
Rate for Payer: Priority Health Cigna Priority Health	$66.04
Rate for Payer: Priority Health SBD	$59.43

PR ATRIA ABLATE & RCNSTJ W/OTHER PROCEDURE LIMITE

Professional

Both

$1,495.00

Service Code	HCPCS 33257
Min. Negotiated Rate	$367.43
Max. Negotiated Rate	$2,631.46
Rate for Payer: Aetna Commercial	$778.27
Rate for Payer: BCBS Complete	$385.80
Rate for Payer: BCBS Trust/PPO	$2,631.46
Rate for Payer: Cash Price	$1,196.00
Rate for Payer: Cash Price	$1,196.00
Rate for Payer: Mclaren Medicaid	$367.43
Rate for Payer: Meridian Medicaid	$385.80
Rate for Payer: Priority Health Choice Medicaid	$367.43
Rate for Payer: Priority Health Cigna Priority Health	$1,046.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$912.83
Rate for Payer: Priority Health Narrow Network	$912.83
Rate for Payer: Priority Health SBD	$912.83

PR ATRIA ABLTJ & RCNSTJ W/OTHER PX EXTEN W/BYPASS

Professional

Both

$2,258.00

Service Code	HCPCS 33259
Min. Negotiated Rate	$533.78
Max. Negotiated Rate	$5,209.57
Rate for Payer: Aetna Commercial	$1,129.42
Rate for Payer: BCBS Complete	$560.47
Rate for Payer: BCBS Trust/PPO	$5,209.57
Rate for Payer: Cash Price	$1,806.40
Rate for Payer: Cash Price	$1,806.40
Rate for Payer: Mclaren Medicaid	$533.78
Rate for Payer: Meridian Medicaid	$560.47
Rate for Payer: Priority Health Choice Medicaid	$533.78
Rate for Payer: Priority Health Cigna Priority Health	$1,580.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,324.04
Rate for Payer: Priority Health Narrow Network	$1,324.04
Rate for Payer: Priority Health SBD	$1,324.04

PR ATTN AT DELIVERY 1ST STABILIZATION OF NEWBORN

Professional

Both

$402.00

Service Code	HCPCS 99464
Min. Negotiated Rate	$45.80
Max. Negotiated Rate	$1,378.86
Rate for Payer: Aetna Commercial	$73.65
Rate for Payer: BCBS Complete	$48.09
Rate for Payer: BCBS Trust/PPO	$1,378.86
Rate for Payer: Cash Price	$321.60
Rate for Payer: Cash Price	$321.60
Rate for Payer: Mclaren Medicaid	$45.80
Rate for Payer: Meridian Medicaid	$48.09
Rate for Payer: Priority Health Choice Medicaid	$45.80
Rate for Payer: Priority Health Cigna Priority Health	$281.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$92.09
Rate for Payer: Priority Health Narrow Network	$92.09
Rate for Payer: Priority Health SBD	$92.09

PR AUDIOMETRY FOR HEARING AID

Professional

Both

$77.00

Service Code	HCPCS S0618
Min. Negotiated Rate	$30.80
Max. Negotiated Rate	$53.90
Rate for Payer: Aetna Commercial	$43.02
Rate for Payer: BCBS Complete	$30.80
Rate for Payer: Cash Price	$61.60
Rate for Payer: Cash Price	$61.60
Rate for Payer: Priority Health Cigna Priority Health	$53.90

PR AUDITORY EVOKED POTENTIAL

Professional

Both

$334.00

Service Code	HCPCS 92585
Min. Negotiated Rate	$133.60
Max. Negotiated Rate	$233.80
Rate for Payer: BCBS Complete	$133.60
Rate for Payer: Cash Price	$267.20
Rate for Payer: Priority Health Cigna Priority Health	$233.80

PR AUDITORY EVOKED POTENTIAL, LIMITED

Professional

Both

$145.00

Service Code	HCPCS 92586
Min. Negotiated Rate	$58.00
Max. Negotiated Rate	$101.50
Rate for Payer: BCBS Complete	$58.00
Rate for Payer: Cash Price	$116.00
Rate for Payer: Priority Health Cigna Priority Health	$101.50

PR AUTOGRAFT SPINE SURGERY BICORT/TRICORT SEP INC

Professional

Both

$1,186.00

Service Code	HCPCS 20938
Min. Negotiated Rate	$116.94
Max. Negotiated Rate	$3,247.68
Rate for Payer: Aetna Commercial	$248.13
Rate for Payer: BCBS Complete	$122.79
Rate for Payer: BCBS Trust/PPO	$3,247.68
Rate for Payer: Cash Price	$948.80
Rate for Payer: Cash Price	$948.80
Rate for Payer: Mclaren Medicaid	$116.94
Rate for Payer: Meridian Medicaid	$122.79
Rate for Payer: Priority Health Choice Medicaid	$116.94
Rate for Payer: Priority Health Cigna Priority Health	$830.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$277.80
Rate for Payer: Priority Health Narrow Network	$277.80
Rate for Payer: Priority Health SBD	$277.80

PR AUTOGRAFT SPINE SURGERY LOCAL FROM SAME INCISION

Professional

Both

$729.00

Service Code	HCPCS 20936
Min. Negotiated Rate	$165.78
Max. Negotiated Rate	$3,247.68
Rate for Payer: Aetna Commercial	$165.78
Rate for Payer: BCBS Complete	$291.60
Rate for Payer: BCBS Trust/PPO	$3,247.68
Rate for Payer: Cash Price	$583.20
Rate for Payer: Cash Price	$583.20
Rate for Payer: Priority Health Cigna Priority Health	$510.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$190.47
Rate for Payer: Priority Health Narrow Network	$190.47
Rate for Payer: Priority Health SBD	$190.47

PR AUTOGRAFT SPINE SURGERY MORSELIZED SEP INCISION

Professional

Both

$952.00

Service Code	HCPCS 20937
Min. Negotiated Rate	$106.07
Max. Negotiated Rate	$3,247.68
Rate for Payer: Aetna Commercial	$224.25
Rate for Payer: BCBS Complete	$111.37
Rate for Payer: BCBS Trust/PPO	$3,247.68
Rate for Payer: Cash Price	$761.60
Rate for Payer: Cash Price	$761.60
Rate for Payer: Mclaren Medicaid	$106.07
Rate for Payer: Meridian Medicaid	$111.37
Rate for Payer: Priority Health Choice Medicaid	$106.07
Rate for Payer: Priority Health Cigna Priority Health	$666.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$253.79
Rate for Payer: Priority Health Narrow Network	$253.79
Rate for Payer: Priority Health SBD	$253.79

PR AUTOLOGOUS CHONDROCYTE IMPLANTATION KNEE

Professional

Both

$3,315.00

Service Code	HCPCS 27412
Min. Negotiated Rate	$149.51
Max. Negotiated Rate	$2,514.45
Rate for Payer: Aetna Commercial	$2,202.92
Rate for Payer: BCBS Complete	$1,108.63
Rate for Payer: BCBS Trust/PPO	$149.51
Rate for Payer: Cash Price	$2,652.00
Rate for Payer: Cash Price	$2,652.00
Rate for Payer: Mclaren Medicaid	$1,055.84
Rate for Payer: Meridian Medicaid	$1,108.63
Rate for Payer: Priority Health Choice Medicaid	$1,055.84
Rate for Payer: Priority Health Cigna Priority Health	$2,320.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,514.45
Rate for Payer: Priority Health Narrow Network	$2,514.45
Rate for Payer: Priority Health SBD	$2,514.45

PRAVASTATIN 10 MG TABLET

Facility

$314.45

Service Code	NDC 0904-5891-61
Hospital Charge Code	11110
Hospital Revenue Code	637
Min. Negotiated Rate	$198.10
Max. Negotiated Rate	$283.00
Rate for Payer: Aetna Commercial	$267.28
Rate for Payer: Aetna New Business (MI Preferred)	$204.39
Rate for Payer: Cash Price	$251.56
Rate for Payer: Cofinity Commercial	$220.12
Rate for Payer: Cofinity Commercial	$270.43
Rate for Payer: Healthscope Commercial	$283.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$267.28
Rate for Payer: PHP Commercial	$267.28
Rate for Payer: Priority Health Cigna Priority Health	$220.12
Rate for Payer: Priority Health SBD	$198.10

PRAVASTATIN 20 MG TABLET

Facility

$2.97

Service Code	NDC 51079-458-01
Hospital Charge Code	11111
Hospital Revenue Code	637
Min. Negotiated Rate	$1.87
Max. Negotiated Rate	$2.67
Rate for Payer: Aetna Commercial	$2.52
Rate for Payer: Aetna New Business (MI Preferred)	$1.93
Rate for Payer: Cash Price	$2.38
Rate for Payer: Cofinity Commercial	$2.08
Rate for Payer: Cofinity Commercial	$2.55
Rate for Payer: Healthscope Commercial	$2.67
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2.52
Rate for Payer: PHP Commercial	$2.52
Rate for Payer: Priority Health Cigna Priority Health	$2.08
Rate for Payer: Priority Health SBD	$1.87

PRAVASTATIN 20 MG TABLET

Facility

$296.16

Service Code	NDC 51079-458-20
Hospital Charge Code	11111
Hospital Revenue Code	637
Min. Negotiated Rate	$186.58
Max. Negotiated Rate	$266.54
Rate for Payer: Aetna Commercial	$251.74
Rate for Payer: Aetna New Business (MI Preferred)	$192.50
Rate for Payer: Cash Price	$236.93
Rate for Payer: Cofinity Commercial	$207.31
Rate for Payer: Cofinity Commercial	$254.70
Rate for Payer: Healthscope Commercial	$266.54
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$251.74
Rate for Payer: PHP Commercial	$251.74
Rate for Payer: Priority Health Cigna Priority Health	$207.31
Rate for Payer: Priority Health SBD	$186.58

Know your out-of-pocket cost for care.

All Charges