Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PR BILIARY NDSC INTRAOPERATIVE

Professional

Both

$520.00

Service Code	HCPCS 47550
Min. Negotiated Rate	$103.31
Max. Negotiated Rate	$5,071.68
Rate for Payer: Aetna Commercial	$223.49
Rate for Payer: BCBS Complete	$108.48
Rate for Payer: BCBS Trust/PPO	$5,071.68
Rate for Payer: Cash Price	$416.00
Rate for Payer: Cash Price	$416.00
Rate for Payer: Mclaren Medicaid	$103.31
Rate for Payer: Meridian Medicaid	$108.48
Rate for Payer: Priority Health Choice Medicaid	$103.31
Rate for Payer: Priority Health Cigna Priority Health	$364.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$285.75
Rate for Payer: Priority Health Narrow Network	$285.75
Rate for Payer: Priority Health SBD	$285.75

PR BINOCULAR MICROSCOPY SEPARATE DX PROCEDURE

Professional

Both

$100.00

Service Code	HCPCS 92504
Min. Negotiated Rate	$10.27
Max. Negotiated Rate	$2,190.33
Rate for Payer: Aetna Commercial	$10.27
Rate for Payer: BCBS Complete	$40.00
Rate for Payer: BCBS Trust/PPO	$2,190.33
Rate for Payer: Cash Price	$80.00
Rate for Payer: Cash Price	$80.00
Rate for Payer: Priority Health Cigna Priority Health	$70.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$12.58
Rate for Payer: Priority Health Narrow Network	$12.58
Rate for Payer: Priority Health SBD	$12.58

PR BIOFEEDBACK PERI/URO/RECTAL

Professional

Both

$184.00

Service Code	HCPCS 90911
Min. Negotiated Rate	$73.60
Max. Negotiated Rate	$128.80
Rate for Payer: BCBS Complete	$73.60
Rate for Payer: Cash Price	$147.20
Rate for Payer: Priority Health Cigna Priority Health	$128.80

PR BIOFEEDBACK TRAINING ANY MODALITY

Professional

Both

$125.00

Service Code	HCPCS 90901
Min. Negotiated Rate	$50.00
Max. Negotiated Rate	$724.83
Rate for Payer: Aetna Commercial	$87.36
Rate for Payer: BCBS Complete	$50.00
Rate for Payer: BCBS Trust/PPO	$724.83
Rate for Payer: Cash Price	$100.00
Rate for Payer: Cash Price	$100.00
Rate for Payer: Priority Health Cigna Priority Health	$87.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$61.18
Rate for Payer: Priority Health Narrow Network	$61.18
Rate for Payer: Priority Health SBD	$61.18

PR BIOPSY BONE OPEN DEEP

Professional

Both

$1,239.00

Service Code	HCPCS 20245
Min. Negotiated Rate	$106.88
Max. Negotiated Rate	$867.30
Rate for Payer: Aetna Commercial	$465.71
Rate for Payer: BCBS Complete	$229.25
Rate for Payer: BCBS Trust/PPO	$106.88
Rate for Payer: Cash Price	$991.20
Rate for Payer: Cash Price	$991.20
Rate for Payer: Mclaren Medicaid	$218.33
Rate for Payer: Meridian Medicaid	$229.25
Rate for Payer: Priority Health Choice Medicaid	$218.33
Rate for Payer: Priority Health Cigna Priority Health	$867.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$522.40
Rate for Payer: Priority Health Narrow Network	$522.40
Rate for Payer: Priority Health SBD	$522.40

PR BIOPSY BONE OPEN SUPERFICIAL

Professional

Both

$535.00

Service Code	HCPCS 20240
Min. Negotiated Rate	$89.03
Max. Negotiated Rate	$1,002.07
Rate for Payer: Aetna Commercial	$190.88
Rate for Payer: BCBS Complete	$93.48
Rate for Payer: BCBS Trust/PPO	$1,002.07
Rate for Payer: Cash Price	$428.00
Rate for Payer: Cash Price	$428.00
Rate for Payer: Mclaren Medicaid	$89.03
Rate for Payer: Meridian Medicaid	$93.48
Rate for Payer: Priority Health Choice Medicaid	$89.03
Rate for Payer: Priority Health Cigna Priority Health	$374.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$211.40
Rate for Payer: Priority Health Narrow Network	$211.40
Rate for Payer: Priority Health SBD	$211.40

PR BIOPSY BONE TROCAR/NEEDLE DEEP

Professional

Both

$1,880.00

Service Code	HCPCS 20225
Min. Negotiated Rate	$57.48
Max. Negotiated Rate	$1,316.00
Rate for Payer: Aetna Commercial	$173.19
Rate for Payer: BCBS Complete	$85.21
Rate for Payer: BCBS Trust/PPO	$57.48
Rate for Payer: Cash Price	$1,504.00
Rate for Payer: Cash Price	$1,504.00
Rate for Payer: Mclaren Medicaid	$81.15
Rate for Payer: Meridian Medicaid	$85.21
Rate for Payer: Priority Health Choice Medicaid	$81.15
Rate for Payer: Priority Health Cigna Priority Health	$1,316.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$194.56
Rate for Payer: Priority Health Narrow Network	$194.56
Rate for Payer: Priority Health SBD	$194.56

PR BIOPSY BONE TROCAR/NEEDLE SUPERFICIAL

Professional

Both

$341.00

Service Code	HCPCS 20220
Min. Negotiated Rate	$54.74
Max. Negotiated Rate	$1,002.07
Rate for Payer: Aetna Commercial	$116.83
Rate for Payer: BCBS Complete	$57.48
Rate for Payer: BCBS Trust/PPO	$1,002.07
Rate for Payer: Cash Price	$272.80
Rate for Payer: Cash Price	$272.80
Rate for Payer: Mclaren Medicaid	$54.74
Rate for Payer: Meridian Medicaid	$57.48
Rate for Payer: Priority Health Choice Medicaid	$54.74
Rate for Payer: Priority Health Cigna Priority Health	$238.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$132.26
Rate for Payer: Priority Health Narrow Network	$132.26
Rate for Payer: Priority Health SBD	$132.26

PR BIOPSY BREAST OPEN INCISIONAL

Professional

Both

$559.00

Service Code	HCPCS 19101
Min. Negotiated Rate	$8.65
Max. Negotiated Rate	$391.30
Rate for Payer: Aetna Commercial	$243.74
Rate for Payer: BCBS Complete	$150.74
Rate for Payer: BCBS Trust/PPO	$8.65
Rate for Payer: Cash Price	$447.20
Rate for Payer: Cash Price	$447.20
Rate for Payer: Mclaren Medicaid	$143.56
Rate for Payer: Meridian Medicaid	$150.74
Rate for Payer: Priority Health Choice Medicaid	$143.56
Rate for Payer: Priority Health Cigna Priority Health	$391.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$275.80
Rate for Payer: Priority Health Narrow Network	$275.80
Rate for Payer: Priority Health SBD	$275.80

PR BIOPSY CERVIX SINGLE/MULT/EXCISION OF LESION SPX

Professional

Both

$253.00

Service Code	HCPCS 57500
Min. Negotiated Rate	$48.14
Max. Negotiated Rate	$225.58
Rate for Payer: Aetna Commercial	$88.96
Rate for Payer: BCBS Complete	$50.55
Rate for Payer: BCBS Trust/PPO	$225.58
Rate for Payer: Cash Price	$202.40
Rate for Payer: Cash Price	$202.40
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	$177.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$105.58
Rate for Payer: Priority Health Narrow Network	$105.58
Rate for Payer: Priority Health SBD	$105.58

PR BIOPSY, EACH ADDED LESION

Professional

Both

$67.00

Service Code	HCPCS 11101
Min. Negotiated Rate	$26.80
Max. Negotiated Rate	$46.90
Rate for Payer: BCBS Complete	$26.80
Rate for Payer: Cash Price	$53.60
Rate for Payer: Priority Health Cigna Priority Health	$46.90

PR BIOPSY EXTERNAL AUDITORY CANAL

Professional

Both

$234.00

Service Code	HCPCS 69105
Min. Negotiated Rate	$40.90
Max. Negotiated Rate	$2,308.67
Rate for Payer: Aetna Commercial	$69.92
Rate for Payer: BCBS Complete	$42.94
Rate for Payer: BCBS Trust/PPO	$2,308.67
Rate for Payer: Cash Price	$187.20
Rate for Payer: Cash Price	$187.20
Rate for Payer: Mclaren Medicaid	$40.90
Rate for Payer: Meridian Medicaid	$42.94
Rate for Payer: Priority Health Choice Medicaid	$40.90
Rate for Payer: Priority Health Cigna Priority Health	$163.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$89.58
Rate for Payer: Priority Health Narrow Network	$89.58
Rate for Payer: Priority Health SBD	$89.58

PR BIOPSY EXTERNAL EAR

Professional

Both

$171.00

Service Code	HCPCS 69100
Min. Negotiated Rate	$29.39
Max. Negotiated Rate	$1,733.35
Rate for Payer: Aetna Commercial	$52.85
Rate for Payer: BCBS Complete	$30.86
Rate for Payer: BCBS Trust/PPO	$1,733.35
Rate for Payer: Cash Price	$136.80
Rate for Payer: Cash Price	$136.80
Rate for Payer: Mclaren Medicaid	$29.39
Rate for Payer: Meridian Medicaid	$30.86
Rate for Payer: Priority Health Choice Medicaid	$29.39
Rate for Payer: Priority Health Cigna Priority Health	$119.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$65.53
Rate for Payer: Priority Health Narrow Network	$65.53
Rate for Payer: Priority Health SBD	$65.53

PR BIOPSY FLOOR MOUTH

Professional

Both

$235.00

Service Code	HCPCS 41108
Min. Negotiated Rate	$58.79
Max. Negotiated Rate	$1,421.66
Rate for Payer: Aetna Commercial	$119.24
Rate for Payer: BCBS Complete	$61.73
Rate for Payer: BCBS Trust/PPO	$1,421.66
Rate for Payer: Cash Price	$188.00
Rate for Payer: Cash Price	$188.00
Rate for Payer: Mclaren Medicaid	$58.79
Rate for Payer: Meridian Medicaid	$61.73
Rate for Payer: Priority Health Choice Medicaid	$58.79
Rate for Payer: Priority Health Cigna Priority Health	$164.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$161.69
Rate for Payer: Priority Health Narrow Network	$161.69
Rate for Payer: Priority Health SBD	$161.69

PR BIOPSY HYPOPHARYNX

Professional

Both

$432.00

Service Code	HCPCS 42802
Min. Negotiated Rate	$172.80
Max. Negotiated Rate	$302.40
Rate for Payer: BCBS Complete	$172.80
Rate for Payer: Cash Price	$345.60
Rate for Payer: Priority Health Cigna Priority Health	$302.40

PR BIOPSY INTRANASAL

Professional

Both

$224.00

Service Code	HCPCS 30100
Min. Negotiated Rate	$43.88
Max. Negotiated Rate	$591.70
Rate for Payer: Aetna Commercial	$84.78
Rate for Payer: BCBS Complete	$46.07
Rate for Payer: BCBS Trust/PPO	$591.70
Rate for Payer: Cash Price	$179.20
Rate for Payer: Cash Price	$179.20
Rate for Payer: Mclaren Medicaid	$43.88
Rate for Payer: Meridian Medicaid	$46.07
Rate for Payer: Priority Health Choice Medicaid	$43.88
Rate for Payer: Priority Health Cigna Priority Health	$156.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$93.53
Rate for Payer: Priority Health Narrow Network	$93.53
Rate for Payer: Priority Health SBD	$93.53

PR BIOPSY LIVER NEEDLE PERCUTANEOUS

Professional

Both

$581.00

Service Code	HCPCS 47000
Min. Negotiated Rate	$54.95
Max. Negotiated Rate	$1,914.56
Rate for Payer: Aetna Commercial	$117.26
Rate for Payer: BCBS Complete	$57.70
Rate for Payer: BCBS Trust/PPO	$1,914.56
Rate for Payer: Cash Price	$464.80
Rate for Payer: Cash Price	$464.80
Rate for Payer: Mclaren Medicaid	$54.95
Rate for Payer: Meridian Medicaid	$57.70
Rate for Payer: Priority Health Choice Medicaid	$54.95
Rate for Payer: Priority Health Cigna Priority Health	$406.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$152.29
Rate for Payer: Priority Health Narrow Network	$152.29
Rate for Payer: Priority Health SBD	$152.29

PR BIOPSY LIVER WEDGE

Professional

Both

$1,754.00

Service Code	HCPCS 47100
Min. Negotiated Rate	$545.07
Max. Negotiated Rate	$2,085.20
Rate for Payer: Aetna Commercial	$1,144.02
Rate for Payer: BCBS Complete	$572.32
Rate for Payer: BCBS Trust/PPO	$2,085.20
Rate for Payer: Cash Price	$1,403.20
Rate for Payer: Cash Price	$1,403.20
Rate for Payer: Mclaren Medicaid	$545.07
Rate for Payer: Meridian Medicaid	$572.32
Rate for Payer: Priority Health Choice Medicaid	$545.07
Rate for Payer: Priority Health Cigna Priority Health	$1,227.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,494.03
Rate for Payer: Priority Health Narrow Network	$1,494.03
Rate for Payer: Priority Health SBD	$1,494.03

PR BIOPSY LUNG/MEDIASTINUM PERCUTANEOUS NEEDLE

Professional

Both

$747.00

Service Code	HCPCS 32405
Min. Negotiated Rate	$298.80
Max. Negotiated Rate	$522.90
Rate for Payer: BCBS Complete	$298.80
Rate for Payer: Cash Price	$597.60
Rate for Payer: Priority Health Cigna Priority Health	$522.90

PR BIOPSY MUSCLE DEEP

Professional

Both

$579.00

Service Code	HCPCS 20205
Min. Negotiated Rate	$99.26
Max. Negotiated Rate	$570.00
Rate for Payer: Aetna Commercial	$206.66
Rate for Payer: BCBS Complete	$104.22
Rate for Payer: BCBS Trust/PPO	$570.00
Rate for Payer: Cash Price	$463.20
Rate for Payer: Cash Price	$463.20
Rate for Payer: Mclaren Medicaid	$99.26
Rate for Payer: Meridian Medicaid	$104.22
Rate for Payer: Priority Health Choice Medicaid	$99.26
Rate for Payer: Priority Health Cigna Priority Health	$405.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$235.41
Rate for Payer: Priority Health Narrow Network	$235.41
Rate for Payer: Priority Health SBD	$235.41

PR BIOPSY MUSCLE PERCUTANEOUS NEEDLE

Professional

Both

$406.00

Service Code	HCPCS 20206
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$2,284.30
Rate for Payer: Aetna Commercial	$75.67
Rate for Payer: BCBS Complete	$37.80
Rate for Payer: BCBS Trust/PPO	$2,284.30
Rate for Payer: Cash Price	$324.80
Rate for Payer: Cash Price	$324.80
Rate for Payer: Mclaren Medicaid	$36.00
Rate for Payer: Meridian Medicaid	$37.80
Rate for Payer: Priority Health Choice Medicaid	$36.00
Rate for Payer: Priority Health Cigna Priority Health	$284.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$86.30
Rate for Payer: Priority Health Narrow Network	$86.30
Rate for Payer: Priority Health SBD	$86.30

PR BIOPSY MUSCLE SUPERFICIAL

Facility

$352.00

Service Code	CPT 20200
Hospital Charge Code	20200
Min. Negotiated Rate	$221.76
Max. Negotiated Rate	$316.80
Rate for Payer: Aetna Commercial	$299.20
Rate for Payer: Aetna New Business (MI Preferred)	$228.80
Rate for Payer: Cash Price	$281.60
Rate for Payer: Cofinity Commercial	$246.40
Rate for Payer: Cofinity Commercial	$302.72
Rate for Payer: Healthscope Commercial	$316.80
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$299.20
Rate for Payer: PHP Commercial	$299.20
Rate for Payer: Priority Health Cigna Priority Health	$246.40
Rate for Payer: Priority Health SBD	$221.76

PR BIOPSY MUSCLE SUPERFICIAL

Professional

Both

$352.00

Service Code	HCPCS 20200
Hospital Charge Code	20200
Min. Negotiated Rate	$60.92
Max. Negotiated Rate	$672.75
Rate for Payer: Aetna Commercial	$125.65
Rate for Payer: BCBS Complete	$63.97
Rate for Payer: BCBS Trust/PPO	$672.75
Rate for Payer: Cash Price	$281.60
Rate for Payer: Cash Price	$281.60
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	$246.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$144.51
Rate for Payer: Priority Health Narrow Network	$144.51
Rate for Payer: Priority Health SBD	$144.51

PR BIOPSY MUSCLE SUPERFICIAL

Professional

Both

$352.00

Service Code	HCPCS 20200
Min. Negotiated Rate	$60.92
Max. Negotiated Rate	$672.75
Rate for Payer: Aetna Commercial	$125.65
Rate for Payer: BCBS Complete	$63.97
Rate for Payer: BCBS Trust/PPO	$672.75
Rate for Payer: Cash Price	$281.60
Rate for Payer: Cash Price	$281.60
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	$246.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$144.51
Rate for Payer: Priority Health Narrow Network	$144.51
Rate for Payer: Priority Health SBD	$144.51

PR BIOPSY MUSCLE SUPERFICIAL

Facility

$352.00

Service Code	CPT 20200
Hospital Charge Code	20200
Min. Negotiated Rate	$93.65
Max. Negotiated Rate	$4,496.47
Rate for Payer: Aetna Commercial	$299.20
Rate for Payer: Aetna Medicare	$1,500.31
Rate for Payer: Aetna New Business (MI Preferred)	$228.80
Rate for Payer: Allen County Amish Medical Aid Commercial	$1,803.26
Rate for Payer: Amish Plain Church Group Commercial	$1,803.26
Rate for Payer: BCBS Complete	$828.64
Rate for Payer: BCBS MAPPO	$1,442.61
Rate for Payer: BCBS Trust/PPO	$617.50
Rate for Payer: BCN Medicare Advantage	$1,442.61
Rate for Payer: Cash Price	$281.60
Rate for Payer: Cash Price	$281.60
Rate for Payer: Cofinity Commercial	$246.40
Rate for Payer: Cofinity Commercial	$302.72
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,442.61
Rate for Payer: Healthscope Commercial	$316.80
Rate for Payer: Mclaren Medicaid	$789.11
Rate for Payer: Mclaren Medicare	$1,442.61
Rate for Payer: Meridian Medicaid	$828.64
Rate for Payer: Meridian Wellcare - Medicare Advantage	$1,514.74
Rate for Payer: MI Amish Medical Board Commercial	$1,659.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$299.20
Rate for Payer: PACE Medicare	$1,370.48
Rate for Payer: PACE SWMI	$1,442.61
Rate for Payer: PHP Commercial	$299.20
Rate for Payer: PHP Medicare Advantage	$1,442.61
Rate for Payer: Priority Health Choice Medicaid	$789.11
Rate for Payer: Priority Health Cigna Priority Health	$246.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$4,496.47
Rate for Payer: Priority Health Medicare	$1,442.61
Rate for Payer: Priority Health Narrow Network	$3,597.18
Rate for Payer: Priority Health SBD	$221.76
Rate for Payer: Railroad Medicare Medicare	$1,442.61
Rate for Payer: UHC All Payor (Choice/PPO)	$103.02
Rate for Payer: UHC Dual Complete DSNP	$1,442.61
Rate for Payer: UHC Exchange	$93.65
Rate for Payer: UHC Medicare Advantage	$1,485.89
Rate for Payer: VA VA	$1,442.61

Know your out-of-pocket cost for care.

All Charges