Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PRAVASTATIN 40 MG TABLET

Facility

$2.68

Service Code	NDC 50268-667-11
Hospital Charge Code	11112
Hospital Revenue Code	637
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$2.41
Rate for Payer: Aetna Commercial	$2.28
Rate for Payer: Aetna New Business (MI Preferred)	$1.74
Rate for Payer: Cash Price	$2.14
Rate for Payer: Cofinity Commercial	$1.88
Rate for Payer: Cofinity Commercial	$2.30
Rate for Payer: Healthscope Commercial	$2.41
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2.28
Rate for Payer: PHP Commercial	$2.28
Rate for Payer: Priority Health Cigna Priority Health	$1.88
Rate for Payer: Priority Health SBD	$1.69

PRAVASTATIN 40 MG TABLET

Facility

$276.96

Service Code	NDC 0904-5893-61
Hospital Charge Code	11112
Hospital Revenue Code	637
Min. Negotiated Rate	$174.48
Max. Negotiated Rate	$249.26
Rate for Payer: Aetna Commercial	$235.42
Rate for Payer: Aetna New Business (MI Preferred)	$180.02
Rate for Payer: Cash Price	$221.57
Rate for Payer: Cofinity Commercial	$193.87
Rate for Payer: Cofinity Commercial	$238.19
Rate for Payer: Healthscope Commercial	$249.26
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$235.42
Rate for Payer: PHP Commercial	$235.42
Rate for Payer: Priority Health Cigna Priority Health	$193.87
Rate for Payer: Priority Health SBD	$174.48

PRAVASTATIN 40 MG TABLET

Facility

$133.92

Service Code	NDC 50268-667-15
Hospital Charge Code	11112
Hospital Revenue Code	637
Min. Negotiated Rate	$84.37
Max. Negotiated Rate	$120.53
Rate for Payer: Aetna Commercial	$113.83
Rate for Payer: Aetna New Business (MI Preferred)	$87.05
Rate for Payer: Cash Price	$107.14
Rate for Payer: Cofinity Commercial	$115.17
Rate for Payer: Cofinity Commercial	$93.74
Rate for Payer: Healthscope Commercial	$120.53
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$113.83
Rate for Payer: PHP Commercial	$113.83
Rate for Payer: Priority Health Cigna Priority Health	$93.74
Rate for Payer: Priority Health SBD	$84.37

PR AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1

Professional

Both

$157.00

Service Code	HCPCS 11730
Min. Negotiated Rate	$33.96
Max. Negotiated Rate	$109.90
Rate for Payer: Aetna Commercial	$56.05
Rate for Payer: BCBS Complete	$35.78
Rate for Payer: BCBS Trust/PPO	$33.96
Rate for Payer: Cash Price	$125.60
Rate for Payer: Cash Price	$125.60
Rate for Payer: Mclaren Medicaid	$34.08
Rate for Payer: Meridian Medicaid	$35.78
Rate for Payer: Priority Health Choice Medicaid	$34.08
Rate for Payer: Priority Health Cigna Priority Health	$109.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$65.35
Rate for Payer: Priority Health Narrow Network	$65.35
Rate for Payer: Priority Health SBD	$65.35

PR AVULSION NAIL PLATE PARTIAL/COMP SIMPLE EA ADDL

Professional

Both

$73.00

Service Code	HCPCS 11732
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$106.97
Rate for Payer: Aetna Commercial	$18.36
Rate for Payer: BCBS Complete	$11.18
Rate for Payer: BCBS Trust/PPO	$106.97
Rate for Payer: Cash Price	$58.40
Rate for Payer: Cash Price	$58.40
Rate for Payer: Mclaren Medicaid	$10.65
Rate for Payer: Meridian Medicaid	$11.18
Rate for Payer: Priority Health Choice Medicaid	$10.65
Rate for Payer: Priority Health Cigna Priority Health	$51.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$20.96
Rate for Payer: Priority Health Narrow Network	$20.96
Rate for Payer: Priority Health SBD	$20.96

PR AXILLARY LYMPHADENECTOMY COMPLETE

Professional

Both

$1,533.00

Service Code	HCPCS 38745
Min. Negotiated Rate	$567.01
Max. Negotiated Rate	$1,911.53
Rate for Payer: Aetna Commercial	$1,096.73
Rate for Payer: BCBS Complete	$595.36
Rate for Payer: BCBS Trust/PPO	$664.07
Rate for Payer: Cash Price	$1,226.40
Rate for Payer: Cash Price	$1,226.40
Rate for Payer: Mclaren Medicaid	$567.01
Rate for Payer: Meridian Medicaid	$595.36
Rate for Payer: Priority Health Choice Medicaid	$567.01
Rate for Payer: Priority Health Cigna Priority Health	$1,073.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,911.53
Rate for Payer: Priority Health Narrow Network	$1,911.53
Rate for Payer: Priority Health SBD	$1,911.53

PR AXILLARY LYMPHADENECTOMY COMPLETE

Facility

$1,533.00

Service Code	CPT 38745
Hospital Charge Code	38745
Min. Negotiated Rate	$871.65
Max. Negotiated Rate	$15,754.72
Rate for Payer: Aetna Commercial	$1,303.05
Rate for Payer: Aetna Medicare	$5,339.45
Rate for Payer: Aetna New Business (MI Preferred)	$996.45
Rate for Payer: Allen County Amish Medical Aid Commercial	$6,417.61
Rate for Payer: Amish Plain Church Group Commercial	$6,417.61
Rate for Payer: BCBS Complete	$2,949.02
Rate for Payer: BCBS MAPPO	$5,134.09
Rate for Payer: BCBS Trust/PPO	$2,064.84
Rate for Payer: BCN Medicare Advantage	$5,134.09
Rate for Payer: Cash Price	$1,226.40
Rate for Payer: Cash Price	$1,226.40
Rate for Payer: Cofinity Commercial	$1,073.10
Rate for Payer: Cofinity Commercial	$1,318.38
Rate for Payer: Health Alliance Plan Medicare Advantage	$5,134.09
Rate for Payer: Healthscope Commercial	$1,379.70
Rate for Payer: Mclaren Medicaid	$2,808.35
Rate for Payer: Mclaren Medicare	$5,134.09
Rate for Payer: Meridian Medicaid	$2,949.02
Rate for Payer: Meridian Wellcare - Medicare Advantage	$5,390.79
Rate for Payer: MI Amish Medical Board Commercial	$5,904.20
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,303.05
Rate for Payer: PACE Medicare	$4,877.39
Rate for Payer: PACE SWMI	$5,134.09
Rate for Payer: PHP Commercial	$1,303.05
Rate for Payer: PHP Medicare Advantage	$5,134.09
Rate for Payer: Priority Health Choice Medicaid	$2,808.35
Rate for Payer: Priority Health Cigna Priority Health	$1,073.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$15,754.72
Rate for Payer: Priority Health Medicare	$5,134.09
Rate for Payer: Priority Health Narrow Network	$12,603.78
Rate for Payer: Priority Health SBD	$965.79
Rate for Payer: Railroad Medicare Medicare	$5,134.09
Rate for Payer: UHC All Payor (Choice/PPO)	$958.82
Rate for Payer: UHC Dual Complete DSNP	$5,134.09
Rate for Payer: UHC Exchange	$871.65
Rate for Payer: UHC Medicare Advantage	$5,288.11
Rate for Payer: VA VA	$5,134.09

PR AXILLARY LYMPHADENECTOMY COMPLETE

Facility

$1,533.00

Service Code	CPT 38745
Hospital Charge Code	38745
Min. Negotiated Rate	$965.79
Max. Negotiated Rate	$1,379.70
Rate for Payer: Aetna Commercial	$1,303.05
Rate for Payer: Aetna New Business (MI Preferred)	$996.45
Rate for Payer: Cash Price	$1,226.40
Rate for Payer: Cofinity Commercial	$1,073.10
Rate for Payer: Cofinity Commercial	$1,318.38
Rate for Payer: Healthscope Commercial	$1,379.70
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,303.05
Rate for Payer: PHP Commercial	$1,303.05
Rate for Payer: Priority Health Cigna Priority Health	$1,073.10
Rate for Payer: Priority Health SBD	$965.79

PR AXILLARY LYMPHADENECTOMY COMPLETE

Professional

Both

$1,533.00

Service Code	HCPCS 38745
Hospital Charge Code	38745
Min. Negotiated Rate	$567.01
Max. Negotiated Rate	$1,911.53
Rate for Payer: Aetna Commercial	$1,096.73
Rate for Payer: BCBS Complete	$595.36
Rate for Payer: BCBS Trust/PPO	$664.07
Rate for Payer: Cash Price	$1,226.40
Rate for Payer: Cash Price	$1,226.40
Rate for Payer: Mclaren Medicaid	$567.01
Rate for Payer: Meridian Medicaid	$595.36
Rate for Payer: Priority Health Choice Medicaid	$567.01
Rate for Payer: Priority Health Cigna Priority Health	$1,073.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,911.53
Rate for Payer: Priority Health Narrow Network	$1,911.53
Rate for Payer: Priority Health SBD	$1,911.53

PR AXILLARY LYMPHADENECTOMY SUPERFICIAL

Professional

Both

$2,062.00

Service Code	HCPCS 38740
Min. Negotiated Rate	$451.56
Max. Negotiated Rate	$1,522.57
Rate for Payer: Aetna Commercial	$870.38
Rate for Payer: BCBS Complete	$474.14
Rate for Payer: BCBS Trust/PPO	$931.39
Rate for Payer: Cash Price	$1,649.60
Rate for Payer: Cash Price	$1,649.60
Rate for Payer: Mclaren Medicaid	$451.56
Rate for Payer: Meridian Medicaid	$474.14
Rate for Payer: Priority Health Choice Medicaid	$451.56
Rate for Payer: Priority Health Cigna Priority Health	$1,443.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,522.57
Rate for Payer: Priority Health Narrow Network	$1,522.57
Rate for Payer: Priority Health SBD	$1,522.57

PRAZOSIN 1 MG CAPSULE

Facility

$244.80

Service Code	NDC 0093-4067-01
Hospital Charge Code	6468
Hospital Revenue Code	637
Min. Negotiated Rate	$154.22
Max. Negotiated Rate	$220.32
Rate for Payer: Aetna Commercial	$208.08
Rate for Payer: Aetna New Business (MI Preferred)	$159.12
Rate for Payer: Cash Price	$195.84
Rate for Payer: Cofinity Commercial	$171.36
Rate for Payer: Cofinity Commercial	$210.53
Rate for Payer: Healthscope Commercial	$220.32
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$208.08
Rate for Payer: PHP Commercial	$208.08
Rate for Payer: Priority Health Cigna Priority Health	$171.36
Rate for Payer: Priority Health SBD	$154.22

PRAZOSIN 1 MG CAPSULE

Facility

$685.92

Service Code	NDC 51079-630-20
Hospital Charge Code	6468
Hospital Revenue Code	637
Min. Negotiated Rate	$432.13
Max. Negotiated Rate	$617.33
Rate for Payer: Aetna Commercial	$583.03
Rate for Payer: Aetna New Business (MI Preferred)	$445.85
Rate for Payer: Cash Price	$548.74
Rate for Payer: Cofinity Commercial	$480.14
Rate for Payer: Cofinity Commercial	$589.89
Rate for Payer: Healthscope Commercial	$617.33
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$583.03
Rate for Payer: PHP Commercial	$583.03
Rate for Payer: Priority Health Cigna Priority Health	$480.14
Rate for Payer: Priority Health SBD	$432.13

PRAZOSIN 1 MG CAPSULE

Facility

$4.76

Service Code	NDC 68084-996-11
Hospital Charge Code	6468
Hospital Revenue Code	637
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$4.28
Rate for Payer: Aetna Commercial	$4.05
Rate for Payer: Aetna New Business (MI Preferred)	$3.09
Rate for Payer: Cash Price	$3.81
Rate for Payer: Cofinity Commercial	$3.33
Rate for Payer: Cofinity Commercial	$4.09
Rate for Payer: Healthscope Commercial	$4.28
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$4.05
Rate for Payer: PHP Commercial	$4.05
Rate for Payer: Priority Health Cigna Priority Health	$3.33
Rate for Payer: Priority Health SBD	$3.00

PRAZOSIN 1 MG CAPSULE

Facility

$475.20

Service Code	NDC 68084-996-01
Hospital Charge Code	6468
Hospital Revenue Code	637
Min. Negotiated Rate	$299.38
Max. Negotiated Rate	$427.68
Rate for Payer: Aetna Commercial	$403.92
Rate for Payer: Aetna New Business (MI Preferred)	$308.88
Rate for Payer: Cash Price	$380.16
Rate for Payer: Cofinity Commercial	$332.64
Rate for Payer: Cofinity Commercial	$408.67
Rate for Payer: Healthscope Commercial	$427.68
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$403.92
Rate for Payer: PHP Commercial	$403.92
Rate for Payer: Priority Health Cigna Priority Health	$332.64
Rate for Payer: Priority Health SBD	$299.38

PRAZOSIN 1 MG CAPSULE

Facility

$6.86

Service Code	NDC 51079-630-01
Hospital Charge Code	6468
Hospital Revenue Code	637
Min. Negotiated Rate	$4.32
Max. Negotiated Rate	$6.17
Rate for Payer: Aetna Commercial	$5.83
Rate for Payer: Aetna New Business (MI Preferred)	$4.46
Rate for Payer: Cash Price	$5.49
Rate for Payer: Cofinity Commercial	$4.80
Rate for Payer: Cofinity Commercial	$5.90
Rate for Payer: Healthscope Commercial	$6.17
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$5.83
Rate for Payer: PHP Commercial	$5.83
Rate for Payer: Priority Health Cigna Priority Health	$4.80
Rate for Payer: Priority Health SBD	$4.32

PRAZOSIN 2 MG CAPSULE

Facility

$7.79

Service Code	NDC 51079-631-01
Hospital Charge Code	6469
Hospital Revenue Code	637
Min. Negotiated Rate	$4.91
Max. Negotiated Rate	$7.01
Rate for Payer: Aetna Commercial	$6.62
Rate for Payer: Aetna New Business (MI Preferred)	$5.06
Rate for Payer: Cash Price	$6.23
Rate for Payer: Cofinity Commercial	$5.45
Rate for Payer: Cofinity Commercial	$6.70
Rate for Payer: Healthscope Commercial	$7.01
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$6.62
Rate for Payer: PHP Commercial	$6.62
Rate for Payer: Priority Health Cigna Priority Health	$5.45
Rate for Payer: Priority Health SBD	$4.91

PRAZOSIN 2 MG CAPSULE

Facility

$778.11

Service Code	NDC 51079-631-20
Hospital Charge Code	6469
Hospital Revenue Code	637
Min. Negotiated Rate	$490.21
Max. Negotiated Rate	$700.30
Rate for Payer: Aetna Commercial	$661.39
Rate for Payer: Aetna New Business (MI Preferred)	$505.77
Rate for Payer: Cash Price	$622.49
Rate for Payer: Cofinity Commercial	$544.68
Rate for Payer: Cofinity Commercial	$669.17
Rate for Payer: Healthscope Commercial	$700.30
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$661.39
Rate for Payer: PHP Commercial	$661.39
Rate for Payer: Priority Health Cigna Priority Health	$544.68
Rate for Payer: Priority Health SBD	$490.21

PRAZOSIN 2 MG CAPSULE

Facility

$630.24

Service Code	NDC 0904-7021-61
Hospital Charge Code	6469
Hospital Revenue Code	637
Min. Negotiated Rate	$397.05
Max. Negotiated Rate	$567.22
Rate for Payer: Aetna Commercial	$535.70
Rate for Payer: Aetna New Business (MI Preferred)	$409.66
Rate for Payer: Cash Price	$504.19
Rate for Payer: Cofinity Commercial	$441.17
Rate for Payer: Cofinity Commercial	$542.01
Rate for Payer: Healthscope Commercial	$567.22
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$535.70
Rate for Payer: PHP Commercial	$535.70
Rate for Payer: Priority Health Cigna Priority Health	$441.17
Rate for Payer: Priority Health SBD	$397.05

PRAZOSIN 5 MG CAPSULE

Facility

$1,171.05

Service Code	NDC 0904-7022-61
Hospital Charge Code	6470
Hospital Revenue Code	637
Min. Negotiated Rate	$737.76
Max. Negotiated Rate	$1,053.94
Rate for Payer: Aetna Commercial	$995.39
Rate for Payer: Aetna New Business (MI Preferred)	$761.18
Rate for Payer: Cash Price	$936.84
Rate for Payer: Cofinity Commercial	$1,007.10
Rate for Payer: Cofinity Commercial	$819.74
Rate for Payer: Healthscope Commercial	$1,053.94
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$995.39
Rate for Payer: PHP Commercial	$995.39
Rate for Payer: Priority Health Cigna Priority Health	$819.74
Rate for Payer: Priority Health SBD	$737.76

PRAZOSIN 5 MG CAPSULE

Facility

$1,268.36

Service Code	NDC 51079-632-20
Hospital Charge Code	6470
Hospital Revenue Code	637
Min. Negotiated Rate	$799.07
Max. Negotiated Rate	$1,141.52
Rate for Payer: Aetna Commercial	$1,078.11
Rate for Payer: Aetna New Business (MI Preferred)	$824.43
Rate for Payer: Cash Price	$1,014.69
Rate for Payer: Cofinity Commercial	$1,090.79
Rate for Payer: Cofinity Commercial	$887.85
Rate for Payer: Healthscope Commercial	$1,141.52
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,078.11
Rate for Payer: PHP Commercial	$1,078.11
Rate for Payer: Priority Health Cigna Priority Health	$887.85
Rate for Payer: Priority Health SBD	$799.07

PRAZOSIN 5 MG CAPSULE

Facility

$12.69

Service Code	NDC 51079-632-01
Hospital Charge Code	6470
Hospital Revenue Code	637
Min. Negotiated Rate	$7.99
Max. Negotiated Rate	$11.42
Rate for Payer: Aetna Commercial	$10.79
Rate for Payer: Aetna New Business (MI Preferred)	$8.25
Rate for Payer: Cash Price	$10.15
Rate for Payer: Cofinity Commercial	$10.91
Rate for Payer: Cofinity Commercial	$8.88
Rate for Payer: Healthscope Commercial	$11.42
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$10.79
Rate for Payer: PHP Commercial	$10.79
Rate for Payer: Priority Health Cigna Priority Health	$8.88
Rate for Payer: Priority Health SBD	$7.99

PRAZOSIN 5 MG CAPSULE

Facility

$326.61

Service Code	NDC 59762-5350-1
Hospital Charge Code	6470
Hospital Revenue Code	637
Min. Negotiated Rate	$205.76
Max. Negotiated Rate	$293.95
Rate for Payer: Aetna Commercial	$277.62
Rate for Payer: Aetna New Business (MI Preferred)	$212.30
Rate for Payer: Cash Price	$261.29
Rate for Payer: Cofinity Commercial	$228.63
Rate for Payer: Cofinity Commercial	$280.88
Rate for Payer: Healthscope Commercial	$293.95
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$277.62
Rate for Payer: PHP Commercial	$277.62
Rate for Payer: Priority Health Cigna Priority Health	$228.63
Rate for Payer: Priority Health SBD	$205.76

PR B1 GRF FEM H/N INTERTRCHNTRIC/SUBTRCHNTRIC AREA

Professional

Both

$2,131.00

Service Code	HCPCS 27170
Min. Negotiated Rate	$750.40
Max. Negotiated Rate	$1,814.18
Rate for Payer: Aetna Commercial	$1,567.73
Rate for Payer: BCBS Complete	$787.92
Rate for Payer: BCBS Trust/PPO	$1,814.18
Rate for Payer: Cash Price	$1,704.80
Rate for Payer: Cash Price	$1,704.80
Rate for Payer: Mclaren Medicaid	$750.40
Rate for Payer: Meridian Medicaid	$787.92
Rate for Payer: Priority Health Choice Medicaid	$750.40
Rate for Payer: Priority Health Cigna Priority Health	$1,491.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,790.84
Rate for Payer: Priority Health Narrow Network	$1,790.84
Rate for Payer: Priority Health SBD	$1,790.84

PR BACILLUS CALMETTE-GUERIN VACCINE INTRAVESICAL

Professional

Both

$268.00

Service Code	HCPCS 90586
Min. Negotiated Rate	$107.20
Max. Negotiated Rate	$187.60
Rate for Payer: Aetna Commercial	$144.50
Rate for Payer: BCBS Complete	$107.20
Rate for Payer: BCBS Trust/PPO	$147.22
Rate for Payer: Cash Price	$214.40
Rate for Payer: Cash Price	$214.40
Rate for Payer: Priority Health Cigna Priority Health	$187.60

PR BALLN ANGIOPLASTY OPEN,BRACHCEPH

Professional

Both

$939.00

Service Code	HCPCS 35458
Min. Negotiated Rate	$375.60
Max. Negotiated Rate	$657.30
Rate for Payer: BCBS Complete	$375.60
Rate for Payer: Cash Price	$751.20
Rate for Payer: Priority Health Cigna Priority Health	$657.30

Know your out-of-pocket cost for care.

All Charges