Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PR BIOPSY SOFT TISSUE SHOULDER DEEP

Professional

Both

$831.00

Service Code	HCPCS 23066
Min. Negotiated Rate	$240.26
Max. Negotiated Rate	$581.70
Rate for Payer: Aetna Commercial	$485.10
Rate for Payer: BCBS Complete	$252.27
Rate for Payer: BCBS Trust/PPO	$426.87
Rate for Payer: Cash Price	$664.80
Rate for Payer: Cash Price	$664.80
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	$581.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$563.75
Rate for Payer: Priority Health Narrow Network	$563.75
Rate for Payer: Priority Health SBD	$563.75

PR BIOPSY SOFT TISSUE THIGH/KNEE AREA DEEP

Professional

Both

$682.00

Service Code	HCPCS 27324
Min. Negotiated Rate	$267.32
Max. Negotiated Rate	$1,614.48
Rate for Payer: Aetna Commercial	$541.89
Rate for Payer: BCBS Complete	$280.69
Rate for Payer: BCBS Trust/PPO	$1,614.48
Rate for Payer: Cash Price	$545.60
Rate for Payer: Cash Price	$545.60
Rate for Payer: Mclaren Medicaid	$267.32
Rate for Payer: Meridian Medicaid	$280.69
Rate for Payer: Priority Health Choice Medicaid	$267.32
Rate for Payer: Priority Health Cigna Priority Health	$477.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$633.72
Rate for Payer: Priority Health Narrow Network	$633.72
Rate for Payer: Priority Health SBD	$633.72

PR BIOPSY SOFT TISSUE THIGH/KNEE AREA SUPERFICIAL

Professional

Both

$472.00

Service Code	HCPCS 27323
Min. Negotiated Rate	$112.68
Max. Negotiated Rate	$2,259.54
Rate for Payer: Aetna Commercial	$230.57
Rate for Payer: BCBS Complete	$118.31
Rate for Payer: BCBS Trust/PPO	$2,259.54
Rate for Payer: Cash Price	$377.60
Rate for Payer: Cash Price	$377.60
Rate for Payer: Mclaren Medicaid	$112.68
Rate for Payer: Meridian Medicaid	$118.31
Rate for Payer: Priority Health Choice Medicaid	$112.68
Rate for Payer: Priority Health Cigna Priority Health	$330.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$267.58
Rate for Payer: Priority Health Narrow Network	$267.58
Rate for Payer: Priority Health SBD	$267.58

PR BIOPSY SOFT TISSUE UPPER ARM/ELBOW AREA DEEP

Professional

Both

$1,052.00

Service Code	HCPCS 24066
Min. Negotiated Rate	$75.99
Max. Negotiated Rate	$736.40
Rate for Payer: Aetna Commercial	$557.74
Rate for Payer: BCBS Complete	$288.73
Rate for Payer: BCBS Trust/PPO	$75.99
Rate for Payer: Cash Price	$841.60
Rate for Payer: Cash Price	$841.60
Rate for Payer: Mclaren Medicaid	$274.98
Rate for Payer: Meridian Medicaid	$288.73
Rate for Payer: Priority Health Choice Medicaid	$274.98
Rate for Payer: Priority Health Cigna Priority Health	$736.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$649.04
Rate for Payer: Priority Health Narrow Network	$649.04
Rate for Payer: Priority Health SBD	$649.04

PR BIOPSY SOFT TISSUE UPPER ARM/ELBOW SUPERFICIAL

Professional

Both

$458.00

Service Code	HCPCS 24065
Min. Negotiated Rate	$105.01
Max. Negotiated Rate	$320.60
Rate for Payer: Aetna Commercial	$215.45
Rate for Payer: BCBS Complete	$110.26
Rate for Payer: BCBS Trust/PPO	$126.93
Rate for Payer: Cash Price	$366.40
Rate for Payer: Cash Price	$366.40
Rate for Payer: Mclaren Medicaid	$105.01
Rate for Payer: Meridian Medicaid	$110.26
Rate for Payer: Priority Health Choice Medicaid	$105.01
Rate for Payer: Priority Health Cigna Priority Health	$320.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$248.17
Rate for Payer: Priority Health Narrow Network	$248.17
Rate for Payer: Priority Health SBD	$248.17

PR BIOPSY SPINAL CORD PERCUTANEOUS NEEDLE

Professional

Both

$2,495.00

Service Code	HCPCS 62269
Min. Negotiated Rate	$162.95
Max. Negotiated Rate	$1,746.50
Rate for Payer: Aetna Commercial	$336.41
Rate for Payer: BCBS Complete	$171.10
Rate for Payer: BCBS Trust/PPO	$567.92
Rate for Payer: Cash Price	$1,996.00
Rate for Payer: Cash Price	$1,996.00
Rate for Payer: Mclaren Medicaid	$162.95
Rate for Payer: Meridian Medicaid	$171.10
Rate for Payer: Priority Health Choice Medicaid	$162.95
Rate for Payer: Priority Health Cigna Priority Health	$1,746.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$435.42
Rate for Payer: Priority Health Narrow Network	$435.42
Rate for Payer: Priority Health SBD	$435.42

PR BIOPSY TESTIS INCISIONAL SEPARATE PROCEDURE

Professional

Both

$668.00

Service Code	HCPCS 54505
Min. Negotiated Rate	$133.76
Max. Negotiated Rate	$1,963.16
Rate for Payer: Aetna Commercial	$269.15
Rate for Payer: BCBS Complete	$140.45
Rate for Payer: BCBS Trust/PPO	$1,963.16
Rate for Payer: Cash Price	$534.40
Rate for Payer: Cash Price	$534.40
Rate for Payer: Mclaren Medicaid	$133.76
Rate for Payer: Meridian Medicaid	$140.45
Rate for Payer: Priority Health Choice Medicaid	$133.76
Rate for Payer: Priority Health Cigna Priority Health	$467.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$335.56
Rate for Payer: Priority Health Narrow Network	$335.56
Rate for Payer: Priority Health SBD	$335.56

PR BIOPSY THYROID PERCUTANEOUS CORE NEEDLE

Professional

Both

$212.00

Service Code	HCPCS 60100
Min. Negotiated Rate	$48.14
Max. Negotiated Rate	$172.75
Rate for Payer: Aetna Commercial	$99.74
Rate for Payer: BCBS Complete	$50.55
Rate for Payer: BCBS Trust/PPO	$172.75
Rate for Payer: Cash Price	$169.60
Rate for Payer: Cash Price	$169.60
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	$148.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$107.87
Rate for Payer: Priority Health Narrow Network	$107.87
Rate for Payer: Priority Health SBD	$107.87

PR BIOPSY TONGUE ANTERIOR TWO-THIRDS

Professional

Both

$322.00

Service Code	HCPCS 41100
Min. Negotiated Rate	$69.01
Max. Negotiated Rate	$824.68
Rate for Payer: Aetna Commercial	$140.82
Rate for Payer: BCBS Complete	$72.46
Rate for Payer: BCBS Trust/PPO	$824.68
Rate for Payer: Cash Price	$257.60
Rate for Payer: Cash Price	$257.60
Rate for Payer: Mclaren Medicaid	$69.01
Rate for Payer: Meridian Medicaid	$72.46
Rate for Payer: Priority Health Choice Medicaid	$69.01
Rate for Payer: Priority Health Cigna Priority Health	$225.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$189.33
Rate for Payer: Priority Health Narrow Network	$189.33
Rate for Payer: Priority Health SBD	$189.33

PR BIOPSY TONGUE POSTERIOR ONE-THIRD

Professional

Both

$298.00

Service Code	HCPCS 41105
Min. Negotiated Rate	$70.93
Max. Negotiated Rate	$609.66
Rate for Payer: Aetna Commercial	$144.46
Rate for Payer: BCBS Complete	$74.48
Rate for Payer: BCBS Trust/PPO	$609.66
Rate for Payer: Cash Price	$238.40
Rate for Payer: Cash Price	$238.40
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	$208.60
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 URETHRA

Professional

Both

$378.00

Service Code	HCPCS 53200
Min. Negotiated Rate	$90.10
Max. Negotiated Rate	$364.00
Rate for Payer: Aetna Commercial	$181.70
Rate for Payer: BCBS Complete	$94.60
Rate for Payer: BCBS Trust/PPO	$364.00
Rate for Payer: Cash Price	$302.40
Rate for Payer: Cash Price	$302.40
Rate for Payer: Mclaren Medicaid	$90.10
Rate for Payer: Meridian Medicaid	$94.60
Rate for Payer: Priority Health Choice Medicaid	$90.10
Rate for Payer: Priority Health Cigna Priority Health	$264.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$225.33
Rate for Payer: Priority Health Narrow Network	$225.33
Rate for Payer: Priority Health SBD	$225.33

PR BIOPSY VAGINAL MUCOSA EXTENSIVE

Professional

Both

$310.00

Service Code	HCPCS 57105
Min. Negotiated Rate	$94.79
Max. Negotiated Rate	$3,594.02
Rate for Payer: Aetna Commercial	$167.82
Rate for Payer: BCBS Complete	$99.53
Rate for Payer: BCBS Trust/PPO	$3,594.02
Rate for Payer: Cash Price	$248.00
Rate for Payer: Cash Price	$248.00
Rate for Payer: Mclaren Medicaid	$94.79
Rate for Payer: Meridian Medicaid	$99.53
Rate for Payer: Priority Health Choice Medicaid	$94.79
Rate for Payer: Priority Health Cigna Priority Health	$217.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$208.78
Rate for Payer: Priority Health Narrow Network	$208.78
Rate for Payer: Priority Health SBD	$208.78

PR BIOPSY VAGINAL MUCOSA SIMPLE

Professional

Both

$166.00

Service Code	HCPCS 57100
Min. Negotiated Rate	$41.75
Max. Negotiated Rate	$3,206.78
Rate for Payer: Aetna Commercial	$78.63
Rate for Payer: BCBS Complete	$43.84
Rate for Payer: BCBS Trust/PPO	$3,206.78
Rate for Payer: Cash Price	$132.80
Rate for Payer: Cash Price	$132.80
Rate for Payer: Mclaren Medicaid	$41.75
Rate for Payer: Meridian Medicaid	$43.84
Rate for Payer: Priority Health Choice Medicaid	$41.75
Rate for Payer: Priority Health Cigna Priority Health	$116.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$91.84
Rate for Payer: Priority Health Narrow Network	$91.84
Rate for Payer: Priority Health SBD	$91.84

PR BIOPSY VERTEBRAL BODY OPEN LUMBAR/CERVICAL

Professional

Both

$1,301.00

Service Code	HCPCS 20251
Min. Negotiated Rate	$106.88
Max. Negotiated Rate	$910.70
Rate for Payer: Aetna Commercial	$569.56
Rate for Payer: BCBS Complete	$283.14
Rate for Payer: BCBS Trust/PPO	$106.88
Rate for Payer: Cash Price	$1,040.80
Rate for Payer: Cash Price	$1,040.80
Rate for Payer: Mclaren Medicaid	$269.66
Rate for Payer: Meridian Medicaid	$283.14
Rate for Payer: Priority Health Choice Medicaid	$269.66
Rate for Payer: Priority Health Cigna Priority Health	$910.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$646.48
Rate for Payer: Priority Health Narrow Network	$646.48
Rate for Payer: Priority Health SBD	$646.48

PR BIOPSY VERTEBRAL BODY OPEN THORACIC

Professional

Both

$787.00

Service Code	HCPCS 20250
Min. Negotiated Rate	$252.19
Max. Negotiated Rate	$595.41
Rate for Payer: Aetna Commercial	$521.70
Rate for Payer: BCBS Complete	$264.80
Rate for Payer: BCBS Trust/PPO	$556.70
Rate for Payer: Cash Price	$629.60
Rate for Payer: Cash Price	$629.60
Rate for Payer: Mclaren Medicaid	$252.19
Rate for Payer: Meridian Medicaid	$264.80
Rate for Payer: Priority Health Choice Medicaid	$252.19
Rate for Payer: Priority Health Cigna Priority Health	$550.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$595.41
Rate for Payer: Priority Health Narrow Network	$595.41
Rate for Payer: Priority Health SBD	$595.41

PR BIOPSY VESTIBULE MOUTH

Professional

Both

$299.00

Service Code	HCPCS 40808
Min. Negotiated Rate	$57.30
Max. Negotiated Rate	$547.85
Rate for Payer: Aetna Commercial	$113.82
Rate for Payer: BCBS Complete	$60.16
Rate for Payer: BCBS Trust/PPO	$547.85
Rate for Payer: Cash Price	$239.20
Rate for Payer: Cash Price	$239.20
Rate for Payer: Mclaren Medicaid	$57.30
Rate for Payer: Meridian Medicaid	$60.16
Rate for Payer: Priority Health Choice Medicaid	$57.30
Rate for Payer: Priority Health Cigna Priority Health	$209.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$155.81
Rate for Payer: Priority Health Narrow Network	$155.81
Rate for Payer: Priority Health SBD	$155.81

PR BIOPSY VULVA/PERINEUM 1 LESION SPX

Professional

Both

$299.00

Service Code	HCPCS 56605
Min. Negotiated Rate	$37.70
Max. Negotiated Rate	$2,173.43
Rate for Payer: Aetna Commercial	$70.93
Rate for Payer: BCBS Complete	$39.58
Rate for Payer: BCBS Trust/PPO	$2,173.43
Rate for Payer: Cash Price	$239.20
Rate for Payer: Cash Price	$239.20
Rate for Payer: Mclaren Medicaid	$37.70
Rate for Payer: Meridian Medicaid	$39.58
Rate for Payer: Priority Health Choice Medicaid	$37.70
Rate for Payer: Priority Health Cigna Priority Health	$209.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$83.80
Rate for Payer: Priority Health Narrow Network	$83.80
Rate for Payer: Priority Health SBD	$83.80

PR BIOPSY VULVA/PERINEUM EACH ADDL LESION

Professional

Both

$188.00

Service Code	HCPCS 56606
Min. Negotiated Rate	$18.53
Max. Negotiated Rate	$1,893.96
Rate for Payer: Aetna Commercial	$35.11
Rate for Payer: BCBS Complete	$19.46
Rate for Payer: BCBS Trust/PPO	$1,893.96
Rate for Payer: Cash Price	$150.40
Rate for Payer: Cash Price	$150.40
Rate for Payer: Mclaren Medicaid	$18.53
Rate for Payer: Meridian Medicaid	$19.46
Rate for Payer: Priority Health Choice Medicaid	$18.53
Rate for Payer: Priority Health Cigna Priority Health	$131.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$41.66
Rate for Payer: Priority Health Narrow Network	$41.66
Rate for Payer: Priority Health SBD	$41.66

PR BKBENCH PREPJ CADAVER DONOR HEART/LUNG ALLOGRAFT

Professional

Both

$661.00

Service Code	HCPCS 33933
Min. Negotiated Rate	$251.71
Max. Negotiated Rate	$1,305.43
Rate for Payer: Aetna Commercial	$536.72
Rate for Payer: BCBS Complete	$264.30
Rate for Payer: BCBS Trust/PPO	$1,305.43
Rate for Payer: Cash Price	$528.80
Rate for Payer: Cash Price	$528.80
Rate for Payer: Mclaren Medicaid	$251.71
Rate for Payer: Meridian Medicaid	$264.30
Rate for Payer: Priority Health Choice Medicaid	$251.71
Rate for Payer: Priority Health Cigna Priority Health	$462.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$635.15
Rate for Payer: Priority Health Narrow Network	$635.15
Rate for Payer: Priority Health SBD	$635.15

PR BLADDER INSTILLATION ANTICARCINOGENIC AGENT

Professional

Both

$267.00

Service Code	HCPCS 51720
Min. Negotiated Rate	$27.48
Max. Negotiated Rate	$2,209.35
Rate for Payer: Aetna Commercial	$56.30
Rate for Payer: BCBS Complete	$28.85
Rate for Payer: BCBS Trust/PPO	$2,209.35
Rate for Payer: Cash Price	$213.60
Rate for Payer: Cash Price	$213.60
Rate for Payer: Mclaren Medicaid	$27.48
Rate for Payer: Meridian Medicaid	$28.85
Rate for Payer: Priority Health Choice Medicaid	$27.48
Rate for Payer: Priority Health Cigna Priority Health	$186.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$69.70
Rate for Payer: Priority Health Narrow Network	$69.70
Rate for Payer: Priority Health SBD	$69.70

PR BLADDER PRESSURE MEASUREMENT DURING FILLING

Professional

Both

$686.00

Service Code	HCPCS 51726
Min. Negotiated Rate	$134.55
Max. Negotiated Rate	$3,274.93
Rate for Payer: Aetna Commercial	$380.17
Rate for Payer: BCBS Complete	$274.40
Rate for Payer: BCBS Trust/PPO	$3,274.93
Rate for Payer: Cash Price	$548.80
Rate for Payer: Cash Price	$548.80
Rate for Payer: Priority Health Cigna Priority Health	$480.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$134.55
Rate for Payer: Priority Health Narrow Network	$134.55
Rate for Payer: Priority Health SBD	$488.48

PR BLD-DRV HEMATOP PROGEN CELL HRVG TRNSPLJ AUTOL

Professional

Both

$452.00

Service Code	HCPCS 38206
Min. Negotiated Rate	$51.97
Max. Negotiated Rate	$1,117.35
Rate for Payer: Aetna Commercial	$104.26
Rate for Payer: BCBS Complete	$54.57
Rate for Payer: BCBS Trust/PPO	$1,117.35
Rate for Payer: Cash Price	$361.60
Rate for Payer: Cash Price	$361.60
Rate for Payer: Mclaren Medicaid	$51.97
Rate for Payer: Meridian Medicaid	$54.57
Rate for Payer: Priority Health Choice Medicaid	$51.97
Rate for Payer: Priority Health Cigna Priority Health	$316.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$178.18
Rate for Payer: Priority Health Narrow Network	$178.18
Rate for Payer: Priority Health SBD	$178.18

PR BLDR IRRIGATION SMPL LAVAGE &/INSTLJ

Professional

Both

$173.00

Service Code	HCPCS 51700
Min. Negotiated Rate	$18.96
Max. Negotiated Rate	$1,655.16
Rate for Payer: Aetna Commercial	$39.89
Rate for Payer: BCBS Complete	$19.91
Rate for Payer: BCBS Trust/PPO	$1,655.16
Rate for Payer: Cash Price	$138.40
Rate for Payer: Cash Price	$138.40
Rate for Payer: Mclaren Medicaid	$18.96
Rate for Payer: Meridian Medicaid	$19.91
Rate for Payer: Priority Health Choice Medicaid	$18.96
Rate for Payer: Priority Health Cigna Priority Health	$121.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$48.09
Rate for Payer: Priority Health Narrow Network	$48.09
Rate for Payer: Priority Health SBD	$48.09

PR BLEPHAROPLASTY LOWER EYELID HERNIATED FAT PAD

Professional

Both

$900.00

Service Code	HCPCS 15821
Min. Negotiated Rate	$312.59
Max. Negotiated Rate	$671.64
Rate for Payer: Aetna Commercial	$582.43
Rate for Payer: BCBS Complete	$369.24
Rate for Payer: BCBS Trust/PPO	$312.59
Rate for Payer: Cash Price	$720.00
Rate for Payer: Cash Price	$720.00
Rate for Payer: Mclaren Medicaid	$351.66
Rate for Payer: Meridian Medicaid	$369.24
Rate for Payer: Priority Health Choice Medicaid	$351.66
Rate for Payer: Priority Health Cigna Priority Health	$630.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$671.64
Rate for Payer: Priority Health Narrow Network	$671.64
Rate for Payer: Priority Health SBD	$671.64

PR BLEPHAROPLASTY UPPER EYELID

Professional

Both

$925.00

Service Code	HCPCS 15822
Min. Negotiated Rate	$31.71
Max. Negotiated Rate	$647.50
Rate for Payer: Aetna Commercial	$422.37
Rate for Payer: BCBS Complete	$268.16
Rate for Payer: BCBS Trust/PPO	$31.71
Rate for Payer: Cash Price	$740.00
Rate for Payer: Cash Price	$740.00
Rate for Payer: Mclaren Medicaid	$255.39
Rate for Payer: Meridian Medicaid	$268.16
Rate for Payer: Priority Health Choice Medicaid	$255.39
Rate for Payer: Priority Health Cigna Priority Health	$647.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$488.73
Rate for Payer: Priority Health Narrow Network	$488.73
Rate for Payer: Priority Health SBD	$488.73

Know your out-of-pocket cost for care.

All Charges