Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PR BIOPSY NAIL UNIT SEPARATE PROCEDURE

Professional

Both

$217.00

Service Code	HCPCS 11755
Min. Negotiated Rate	$28.95
Max. Negotiated Rate	$151.90
Rate for Payer: Aetna Commercial	$63.74
Rate for Payer: BCBS Complete	$40.26
Rate for Payer: BCBS Trust/PPO	$28.95
Rate for Payer: Cash Price	$173.60
Rate for Payer: Cash Price	$173.60
Rate for Payer: Mclaren Medicaid	$38.34
Rate for Payer: Meridian Medicaid	$40.26
Rate for Payer: Priority Health Choice Medicaid	$38.34
Rate for Payer: Priority Health Cigna Priority Health	$151.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$73.58
Rate for Payer: Priority Health Narrow Network	$73.58
Rate for Payer: Priority Health SBD	$73.58

PR BIOPSY NASOPHARYNX VISIBLE LESION SIMPLE

Professional

Both

$822.00

Service Code	HCPCS 42804
Min. Negotiated Rate	$79.66
Max. Negotiated Rate	$575.40
Rate for Payer: Aetna Commercial	$153.57
Rate for Payer: BCBS Complete	$83.64
Rate for Payer: BCBS Trust/PPO	$212.38
Rate for Payer: Cash Price	$657.60
Rate for Payer: Cash Price	$657.60
Rate for Payer: Mclaren Medicaid	$79.66
Rate for Payer: Meridian Medicaid	$83.64
Rate for Payer: Priority Health Choice Medicaid	$79.66
Rate for Payer: Priority Health Cigna Priority Health	$575.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$217.55
Rate for Payer: Priority Health Narrow Network	$217.55
Rate for Payer: Priority Health SBD	$217.55

PR BIOPSY NERVE

Professional

Both

$708.00

Service Code	HCPCS 64795
Min. Negotiated Rate	$124.82
Max. Negotiated Rate	$495.60
Rate for Payer: Aetna Commercial	$245.85
Rate for Payer: BCBS Complete	$131.06
Rate for Payer: BCBS Trust/PPO	$218.19
Rate for Payer: Cash Price	$566.40
Rate for Payer: Cash Price	$566.40
Rate for Payer: Mclaren Medicaid	$124.82
Rate for Payer: Meridian Medicaid	$131.06
Rate for Payer: Priority Health Choice Medicaid	$124.82
Rate for Payer: Priority Health Cigna Priority Health	$495.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$327.28
Rate for Payer: Priority Health Narrow Network	$327.28
Rate for Payer: Priority Health SBD	$327.28

PR BIOPSY OF LIP

Professional

Both

$224.00

Service Code	HCPCS 40490
Min. Negotiated Rate	$43.88
Max. Negotiated Rate	$637.13
Rate for Payer: Aetna Commercial	$92.65
Rate for Payer: BCBS Complete	$46.07
Rate for Payer: BCBS Trust/PPO	$637.13
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	$120.54
Rate for Payer: Priority Health Narrow Network	$120.54
Rate for Payer: Priority Health SBD	$120.54

PR BIOPSY OF SKIN LESION

Professional

Both

$168.00

Service Code	HCPCS 11100
Min. Negotiated Rate	$67.20
Max. Negotiated Rate	$117.60
Rate for Payer: BCBS Complete	$67.20
Rate for Payer: Cash Price	$134.40
Rate for Payer: Priority Health Cigna Priority Health	$117.60

PR BIOPSY OROPHARYNX

Professional

Both

$253.00

Service Code	HCPCS 42800
Min. Negotiated Rate	$75.62
Max. Negotiated Rate	$205.80
Rate for Payer: Aetna Commercial	$149.58
Rate for Payer: BCBS Complete	$79.40
Rate for Payer: BCBS Trust/PPO	$175.40
Rate for Payer: Cash Price	$202.40
Rate for Payer: Cash Price	$202.40
Rate for Payer: Mclaren Medicaid	$75.62
Rate for Payer: Meridian Medicaid	$79.40
Rate for Payer: Priority Health Choice Medicaid	$75.62
Rate for Payer: Priority Health Cigna Priority Health	$177.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$205.80
Rate for Payer: Priority Health Narrow Network	$205.80
Rate for Payer: Priority Health SBD	$205.80

PR BIOPSY OVARY UNI/BI SEPARATE PROCEDURE

Professional

Both

$1,585.00

Service Code	HCPCS 58900
Min. Negotiated Rate	$170.11
Max. Negotiated Rate	$1,109.50
Rate for Payer: Aetna Commercial	$516.89
Rate for Payer: BCBS Complete	$296.34
Rate for Payer: BCBS Trust/PPO	$170.11
Rate for Payer: Cash Price	$1,268.00
Rate for Payer: Cash Price	$1,268.00
Rate for Payer: Mclaren Medicaid	$282.23
Rate for Payer: Meridian Medicaid	$296.34
Rate for Payer: Priority Health Choice Medicaid	$282.23
Rate for Payer: Priority Health Cigna Priority Health	$1,109.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$624.44
Rate for Payer: Priority Health Narrow Network	$624.44
Rate for Payer: Priority Health SBD	$624.44

PR BIOPSY PALATE UVULA

Professional

Both

$263.00

Service Code	HCPCS 42100
Min. Negotiated Rate	$70.93
Max. Negotiated Rate	$796.68
Rate for Payer: Aetna Commercial	$141.39
Rate for Payer: BCBS Complete	$74.48
Rate for Payer: BCBS Trust/PPO	$796.68
Rate for Payer: Cash Price	$210.40
Rate for Payer: Cash Price	$210.40
Rate for Payer: Mclaren Medicaid	$70.93
Rate for Payer: Meridian Medicaid	$74.48
Rate for Payer: Priority Health Choice Medicaid	$70.93
Rate for Payer: Priority Health Cigna Priority Health	$184.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$194.03
Rate for Payer: Priority Health Narrow Network	$194.03
Rate for Payer: Priority Health SBD	$194.03

PR BIOPSY PANCREAS OPEN

Professional

Both

$1,557.00

Service Code	HCPCS 48100
Min. Negotiated Rate	$571.48
Max. Negotiated Rate	$2,117.43
Rate for Payer: Aetna Commercial	$1,190.74
Rate for Payer: BCBS Complete	$600.05
Rate for Payer: BCBS Trust/PPO	$2,117.43
Rate for Payer: Cash Price	$1,245.60
Rate for Payer: Cash Price	$1,245.60
Rate for Payer: Mclaren Medicaid	$571.48
Rate for Payer: Meridian Medicaid	$600.05
Rate for Payer: Priority Health Choice Medicaid	$571.48
Rate for Payer: Priority Health Cigna Priority Health	$1,089.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,560.49
Rate for Payer: Priority Health Narrow Network	$1,560.49
Rate for Payer: Priority Health SBD	$1,560.49

PR BIOPSY PENIS DEEP STRUCTURES

Professional

Both

$552.00

Service Code	HCPCS 54105
Min. Negotiated Rate	$136.11
Max. Negotiated Rate	$1,906.11
Rate for Payer: Aetna Commercial	$272.65
Rate for Payer: BCBS Complete	$142.92
Rate for Payer: BCBS Trust/PPO	$1,906.11
Rate for Payer: Cash Price	$441.60
Rate for Payer: Cash Price	$441.60
Rate for Payer: Mclaren Medicaid	$136.11
Rate for Payer: Meridian Medicaid	$142.92
Rate for Payer: Priority Health Choice Medicaid	$136.11
Rate for Payer: Priority Health Cigna Priority Health	$386.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$339.88
Rate for Payer: Priority Health Narrow Network	$339.88
Rate for Payer: Priority Health SBD	$339.88

PR BIOPSY PENIS SEPARATE PROCEDURE

Professional

Both

$301.00

Service Code	HCPCS 54100
Min. Negotiated Rate	$77.32
Max. Negotiated Rate	$1,453.88
Rate for Payer: Aetna Commercial	$153.72
Rate for Payer: BCBS Complete	$81.19
Rate for Payer: BCBS Trust/PPO	$1,453.88
Rate for Payer: Cash Price	$240.80
Rate for Payer: Cash Price	$240.80
Rate for Payer: Mclaren Medicaid	$77.32
Rate for Payer: Meridian Medicaid	$81.19
Rate for Payer: Priority Health Choice Medicaid	$77.32
Rate for Payer: Priority Health Cigna Priority Health	$210.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$193.45
Rate for Payer: Priority Health Narrow Network	$193.45
Rate for Payer: Priority Health SBD	$193.45

PR BIOPSY PROSTATE INCISIONAL ANY APPROACH

Professional

Both

$468.00

Service Code	HCPCS 55705
Min. Negotiated Rate	$168.70
Max. Negotiated Rate	$1,436.98
Rate for Payer: Aetna Commercial	$340.09
Rate for Payer: BCBS Complete	$177.14
Rate for Payer: BCBS Trust/PPO	$1,436.98
Rate for Payer: Cash Price	$374.40
Rate for Payer: Cash Price	$374.40
Rate for Payer: Mclaren Medicaid	$168.70
Rate for Payer: Meridian Medicaid	$177.14
Rate for Payer: Priority Health Choice Medicaid	$168.70
Rate for Payer: Priority Health Cigna Priority Health	$327.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$423.11
Rate for Payer: Priority Health Narrow Network	$423.11
Rate for Payer: Priority Health SBD	$423.11

PR BIOPSY SALIVARY GLAND INCISIONAL

Professional

Both

$523.00

Service Code	HCPCS 42405
Min. Negotiated Rate	$146.12
Max. Negotiated Rate	$400.41
Rate for Payer: Aetna Commercial	$298.24
Rate for Payer: BCBS Complete	$153.43
Rate for Payer: BCBS Trust/PPO	$192.83
Rate for Payer: Cash Price	$418.40
Rate for Payer: Cash Price	$418.40
Rate for Payer: Mclaren Medicaid	$146.12
Rate for Payer: Meridian Medicaid	$153.43
Rate for Payer: Priority Health Choice Medicaid	$146.12
Rate for Payer: Priority Health Cigna Priority Health	$366.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$400.41
Rate for Payer: Priority Health Narrow Network	$400.41
Rate for Payer: Priority Health SBD	$400.41

PR BIOPSY SOFT TISSUE BACK/FLANK DEEP

Professional

Both

$902.00

Service Code	HCPCS 21925
Min. Negotiated Rate	$245.59
Max. Negotiated Rate	$631.40
Rate for Payer: Aetna Commercial	$488.62
Rate for Payer: BCBS Complete	$257.87
Rate for Payer: BCBS Trust/PPO	$280.06
Rate for Payer: Cash Price	$721.60
Rate for Payer: Cash Price	$721.60
Rate for Payer: Mclaren Medicaid	$245.59
Rate for Payer: Meridian Medicaid	$257.87
Rate for Payer: Priority Health Choice Medicaid	$245.59
Rate for Payer: Priority Health Cigna Priority Health	$631.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$580.10
Rate for Payer: Priority Health Narrow Network	$580.10
Rate for Payer: Priority Health SBD	$580.10

PR BIOPSY SOFT TISSUE BACK/FLANK SUPERFICIAL

Professional

Both

$498.00

Service Code	HCPCS 21920
Min. Negotiated Rate	$99.47
Max. Negotiated Rate	$625.34
Rate for Payer: Aetna Commercial	$205.43
Rate for Payer: BCBS Complete	$104.44
Rate for Payer: BCBS Trust/PPO	$625.34
Rate for Payer: Cash Price	$398.40
Rate for Payer: Cash Price	$398.40
Rate for Payer: Mclaren Medicaid	$99.47
Rate for Payer: Meridian Medicaid	$104.44
Rate for Payer: Priority Health Choice Medicaid	$99.47
Rate for Payer: Priority Health Cigna Priority Health	$348.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$236.43
Rate for Payer: Priority Health Narrow Network	$236.43
Rate for Payer: Priority Health SBD	$236.43

PR BIOPSY SOFT TISSUE FOREARM&/WRIST DEEP

Professional

Both

$822.00

Service Code	HCPCS 25066
Min. Negotiated Rate	$240.26
Max. Negotiated Rate	$1,010.64
Rate for Payer: Aetna Commercial	$479.14
Rate for Payer: BCBS Complete	$252.27
Rate for Payer: BCBS Trust/PPO	$1,010.64
Rate for Payer: Cash Price	$657.60
Rate for Payer: Cash Price	$657.60
Rate for Payer: Mclaren Medicaid	$240.26
Rate for Payer: Meridian Medicaid	$252.27
Rate for Payer: Priority Health Choice Medicaid	$240.26
Rate for Payer: Priority Health Cigna Priority Health	$575.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$569.37
Rate for Payer: Priority Health Narrow Network	$569.37
Rate for Payer: Priority Health SBD	$569.37

PR BIOPSY SOFT TISSUE FOREARM&/WRIST SUPERFICIAL

Professional

Both

$477.00

Service Code	HCPCS 25065
Min. Negotiated Rate	$101.81
Max. Negotiated Rate	$333.90
Rate for Payer: Aetna Commercial	$208.50
Rate for Payer: BCBS Complete	$106.90
Rate for Payer: BCBS Trust/PPO	$140.53
Rate for Payer: Cash Price	$381.60
Rate for Payer: Cash Price	$381.60
Rate for Payer: Mclaren Medicaid	$101.81
Rate for Payer: Meridian Medicaid	$106.90
Rate for Payer: Priority Health Choice Medicaid	$101.81
Rate for Payer: Priority Health Cigna Priority Health	$333.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$241.54
Rate for Payer: Priority Health Narrow Network	$241.54
Rate for Payer: Priority Health SBD	$241.54

PR BIOPSY SOFT TISSUE LEG/ANKLE AREA DEEP

Professional

Both

$925.00

Service Code	HCPCS 27614
Min. Negotiated Rate	$269.02
Max. Negotiated Rate	$1,061.35
Rate for Payer: Aetna Commercial	$544.43
Rate for Payer: BCBS Complete	$282.47
Rate for Payer: BCBS Trust/PPO	$1,061.35
Rate for Payer: Cash Price	$740.00
Rate for Payer: Cash Price	$740.00
Rate for Payer: Mclaren Medicaid	$269.02
Rate for Payer: Meridian Medicaid	$282.47
Rate for Payer: Priority Health Choice Medicaid	$269.02
Rate for Payer: Priority Health Cigna Priority Health	$647.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$638.82
Rate for Payer: Priority Health Narrow Network	$638.82
Rate for Payer: Priority Health SBD	$638.82

PR BIOPSY SOFT TISSUE LEG/ANKLE AREA SUPERFICIAL

Facility

$437.00

Service Code	CPT 27613
Hospital Charge Code	27613
Min. Negotiated Rate	$275.31
Max. Negotiated Rate	$393.30
Rate for Payer: Aetna Commercial	$371.45
Rate for Payer: Aetna New Business (MI Preferred)	$284.05
Rate for Payer: Cash Price	$349.60
Rate for Payer: Cofinity Commercial	$305.90
Rate for Payer: Cofinity Commercial	$375.82
Rate for Payer: Healthscope Commercial	$393.30
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$371.45
Rate for Payer: PHP Commercial	$371.45
Rate for Payer: Priority Health Cigna Priority Health	$305.90
Rate for Payer: Priority Health SBD	$275.31

PR BIOPSY SOFT TISSUE LEG/ANKLE AREA SUPERFICIAL

Professional

Both

$437.00

Service Code	HCPCS 27613
Min. Negotiated Rate	$104.16
Max. Negotiated Rate	$2,976.66
Rate for Payer: Aetna Commercial	$210.61
Rate for Payer: BCBS Complete	$109.37
Rate for Payer: BCBS Trust/PPO	$2,976.66
Rate for Payer: Cash Price	$349.60
Rate for Payer: Cash Price	$349.60
Rate for Payer: Mclaren Medicaid	$104.16
Rate for Payer: Meridian Medicaid	$109.37
Rate for Payer: Priority Health Choice Medicaid	$104.16
Rate for Payer: Priority Health Cigna Priority Health	$305.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$245.11
Rate for Payer: Priority Health Narrow Network	$245.11
Rate for Payer: Priority Health SBD	$245.11

PR BIOPSY SOFT TISSUE LEG/ANKLE AREA SUPERFICIAL

Facility

$437.00

Service Code	CPT 27613
Hospital Charge Code	27613
Min. Negotiated Rate	$124.13
Max. Negotiated Rate	$4,496.47
Rate for Payer: Aetna Commercial	$371.45
Rate for Payer: Aetna Medicare	$1,500.31
Rate for Payer: Aetna New Business (MI Preferred)	$284.05
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	$124.13
Rate for Payer: BCN Medicare Advantage	$1,442.61
Rate for Payer: Cash Price	$349.60
Rate for Payer: Cash Price	$349.60
Rate for Payer: Cofinity Commercial	$305.90
Rate for Payer: Cofinity Commercial	$375.82
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,442.61
Rate for Payer: Healthscope Commercial	$393.30
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	$371.45
Rate for Payer: PACE Medicare	$1,370.48
Rate for Payer: PACE SWMI	$1,442.61
Rate for Payer: PHP Commercial	$371.45
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	$305.90
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	$275.31
Rate for Payer: Railroad Medicare Medicare	$1,442.61
Rate for Payer: UHC All Payor (Choice/PPO)	$176.13
Rate for Payer: UHC Dual Complete DSNP	$1,442.61
Rate for Payer: UHC Exchange	$160.12
Rate for Payer: UHC Medicare Advantage	$1,485.89
Rate for Payer: VA VA	$1,442.61

PR BIOPSY SOFT TISSUE LEG/ANKLE AREA SUPERFICIAL

Professional

Both

$437.00

Service Code	HCPCS 27613
Hospital Charge Code	27613
Min. Negotiated Rate	$104.16
Max. Negotiated Rate	$2,976.66
Rate for Payer: Aetna Commercial	$210.61
Rate for Payer: BCBS Complete	$109.37
Rate for Payer: BCBS Trust/PPO	$2,976.66
Rate for Payer: Cash Price	$349.60
Rate for Payer: Cash Price	$349.60
Rate for Payer: Mclaren Medicaid	$104.16
Rate for Payer: Meridian Medicaid	$109.37
Rate for Payer: Priority Health Choice Medicaid	$104.16
Rate for Payer: Priority Health Cigna Priority Health	$305.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$245.11
Rate for Payer: Priority Health Narrow Network	$245.11
Rate for Payer: Priority Health SBD	$245.11

PR BIOPSY SOFT TISSUE NECK/THORAX

Professional

Both

$448.00

Service Code	HCPCS 21550
Min. Negotiated Rate	$62.73
Max. Negotiated Rate	$313.60
Rate for Payer: Aetna Commercial	$204.97
Rate for Payer: BCBS Complete	$105.12
Rate for Payer: BCBS Trust/PPO	$62.73
Rate for Payer: Cash Price	$358.40
Rate for Payer: Cash Price	$358.40
Rate for Payer: Mclaren Medicaid	$100.11
Rate for Payer: Meridian Medicaid	$105.12
Rate for Payer: Priority Health Choice Medicaid	$100.11
Rate for Payer: Priority Health Cigna Priority Health	$313.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$238.47
Rate for Payer: Priority Health Narrow Network	$238.47
Rate for Payer: Priority Health SBD	$238.47

PR BIOPSY SOFT TISSUE PELVIS&HIP AREA SUPERFICIAL

Professional

Both

$585.00

Service Code	HCPCS 27040
Min. Negotiated Rate	$127.59
Max. Negotiated Rate	$409.50
Rate for Payer: Aetna Commercial	$264.26
Rate for Payer: BCBS Complete	$133.97
Rate for Payer: BCBS Trust/PPO	$289.10
Rate for Payer: Cash Price	$468.00
Rate for Payer: Cash Price	$468.00
Rate for Payer: Mclaren Medicaid	$127.59
Rate for Payer: Meridian Medicaid	$133.97
Rate for Payer: Priority Health Choice Medicaid	$127.59
Rate for Payer: Priority Health Cigna Priority Health	$409.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$303.33
Rate for Payer: Priority Health Narrow Network	$303.33
Rate for Payer: Priority Health SBD	$303.33

PR BIOPSY SOFT TISSUE PELVIS&HIP DEEP/SUBFSCAL/IM

Professional

Both

$1,396.00

Service Code	HCPCS 27041
Min. Negotiated Rate	$316.44
Max. Negotiated Rate	$1,090.75
Rate for Payer: Aetna Commercial	$939.71
Rate for Payer: BCBS Complete	$479.96
Rate for Payer: BCBS Trust/PPO	$316.44
Rate for Payer: Cash Price	$1,116.80
Rate for Payer: Cash Price	$1,116.80
Rate for Payer: Mclaren Medicaid	$457.10
Rate for Payer: Meridian Medicaid	$479.96
Rate for Payer: Priority Health Choice Medicaid	$457.10
Rate for Payer: Priority Health Cigna Priority Health	$977.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,090.75
Rate for Payer: Priority Health Narrow Network	$1,090.75
Rate for Payer: Priority Health SBD	$1,090.75

Know your out-of-pocket cost for care.

All Charges