Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PR CLSR ENTEROVES FSTL W/INTESTINE&/BLADDER RESCJ

Professional

Both

$3,506.00

Service Code	HCPCS 44661
Min. Negotiated Rate	$246.19
Max. Negotiated Rate	$2,694.09
Rate for Payer: Aetna Commercial	$2,083.58
Rate for Payer: BCBS Complete	$1,027.00
Rate for Payer: BCBS Trust/PPO	$246.19
Rate for Payer: Cash Price	$2,804.80
Rate for Payer: Cash Price	$2,804.80
Rate for Payer: Mclaren Medicaid	$978.10
Rate for Payer: Meridian Medicaid	$1,027.00
Rate for Payer: Priority Health Choice Medicaid	$978.10
Rate for Payer: Priority Health Cigna Priority Health	$2,454.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,694.09
Rate for Payer: Priority Health Narrow Network	$2,694.09
Rate for Payer: Priority Health SBD	$2,694.09

PR CLSR ENTEROVES FSTL W/O INTSTINAL/BLADDER RESCJ

Professional

Both

$2,610.00

Service Code	HCPCS 44660
Min. Negotiated Rate	$250.41
Max. Negotiated Rate	$2,327.78
Rate for Payer: Aetna Commercial	$1,795.04
Rate for Payer: BCBS Complete	$895.05
Rate for Payer: BCBS Trust/PPO	$250.41
Rate for Payer: Cash Price	$2,088.00
Rate for Payer: Cash Price	$2,088.00
Rate for Payer: Mclaren Medicaid	$852.43
Rate for Payer: Meridian Medicaid	$895.05
Rate for Payer: Priority Health Choice Medicaid	$852.43
Rate for Payer: Priority Health Cigna Priority Health	$1,827.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,327.78
Rate for Payer: Priority Health Narrow Network	$2,327.78
Rate for Payer: Priority Health SBD	$2,327.78

PR CLSR ESOPHAGOSTOMY/FSTL CRV APPR

Professional

Both

$2,640.00

Service Code	HCPCS 43420
Min. Negotiated Rate	$652.21
Max. Negotiated Rate	$1,848.00
Rate for Payer: Aetna Commercial	$1,345.37
Rate for Payer: BCBS Complete	$684.82
Rate for Payer: BCBS Trust/PPO	$1,339.77
Rate for Payer: Cash Price	$2,112.00
Rate for Payer: Cash Price	$2,112.00
Rate for Payer: Mclaren Medicaid	$652.21
Rate for Payer: Meridian Medicaid	$684.82
Rate for Payer: Priority Health Choice Medicaid	$652.21
Rate for Payer: Priority Health Cigna Priority Health	$1,848.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,793.91
Rate for Payer: Priority Health Narrow Network	$1,793.91
Rate for Payer: Priority Health SBD	$1,793.91

PR CLSR ESOPHAGOSTOMY/FSTL TTHRC/TABDL APPR

Professional

Both

$4,095.00

Service Code	HCPCS 43425
Min. Negotiated Rate	$911.43
Max. Negotiated Rate	$2,866.50
Rate for Payer: Aetna Commercial	$1,937.74
Rate for Payer: BCBS Complete	$957.00
Rate for Payer: BCBS Trust/PPO	$986.34
Rate for Payer: Cash Price	$3,276.00
Rate for Payer: Cash Price	$3,276.00
Rate for Payer: Mclaren Medicaid	$911.43
Rate for Payer: Meridian Medicaid	$957.00
Rate for Payer: Priority Health Choice Medicaid	$911.43
Rate for Payer: Priority Health Cigna Priority Health	$2,866.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,503.00
Rate for Payer: Priority Health Narrow Network	$2,503.00
Rate for Payer: Priority Health SBD	$2,503.00

PR CLSR LACRIMAL PUNCTUM PLUG EACH

Professional

Both

$299.00

Service Code	HCPCS 68761
Min. Negotiated Rate	$74.34
Max. Negotiated Rate	$1,031.77
Rate for Payer: Aetna Commercial	$152.10
Rate for Payer: BCBS Complete	$78.06
Rate for Payer: BCBS Trust/PPO	$1,031.77
Rate for Payer: Cash Price	$239.20
Rate for Payer: Cash Price	$239.20
Rate for Payer: Mclaren Medicaid	$74.34
Rate for Payer: Meridian Medicaid	$78.06
Rate for Payer: Priority Health Choice Medicaid	$74.34
Rate for Payer: Priority Health Cigna Priority Health	$209.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$202.56
Rate for Payer: Priority Health Narrow Network	$202.56
Rate for Payer: Priority Health SBD	$202.56

PR CLSR NTRSTM LG/SM RESCJ & ANAST OTH/THN CLRCT

Professional

Both

$2,856.00

Service Code	HCPCS 44625
Min. Negotiated Rate	$203.40
Max. Negotiated Rate	$1,999.20
Rate for Payer: Aetna Commercial	$1,357.27
Rate for Payer: BCBS Complete	$674.97
Rate for Payer: BCBS Trust/PPO	$203.40
Rate for Payer: Cash Price	$2,284.80
Rate for Payer: Cash Price	$2,284.80
Rate for Payer: Mclaren Medicaid	$642.83
Rate for Payer: Meridian Medicaid	$674.97
Rate for Payer: Priority Health Choice Medicaid	$642.83
Rate for Payer: Priority Health Cigna Priority Health	$1,999.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,765.68
Rate for Payer: Priority Health Narrow Network	$1,765.68
Rate for Payer: Priority Health SBD	$1,765.68

PR CLSR NTRSTM LG/SM RESCJ & COLORECTAL ANASTOMOSIS

Professional

Both

$2,914.00

Service Code	HCPCS 44626
Min. Negotiated Rate	$205.51
Max. Negotiated Rate	$2,781.10
Rate for Payer: Aetna Commercial	$2,151.52
Rate for Payer: BCBS Complete	$1,060.10
Rate for Payer: BCBS Trust/PPO	$205.51
Rate for Payer: Cash Price	$2,331.20
Rate for Payer: Cash Price	$2,331.20
Rate for Payer: Mclaren Medicaid	$1,009.62
Rate for Payer: Meridian Medicaid	$1,060.10
Rate for Payer: Priority Health Choice Medicaid	$1,009.62
Rate for Payer: Priority Health Cigna Priority Health	$2,039.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,781.10
Rate for Payer: Priority Health Narrow Network	$2,781.10
Rate for Payer: Priority Health SBD	$2,781.10

PR CLSR RECTOVAG FSTL TPRNL PRNL BDY RCNSTJ

Professional

Both

$1,442.00

Service Code	HCPCS 57308
Min. Negotiated Rate	$426.21
Max. Negotiated Rate	$1,574.86
Rate for Payer: Aetna Commercial	$782.21
Rate for Payer: BCBS Complete	$447.52
Rate for Payer: BCBS Trust/PPO	$1,574.86
Rate for Payer: Cash Price	$1,153.60
Rate for Payer: Cash Price	$1,153.60
Rate for Payer: Mclaren Medicaid	$426.21
Rate for Payer: Meridian Medicaid	$447.52
Rate for Payer: Priority Health Choice Medicaid	$426.21
Rate for Payer: Priority Health Cigna Priority Health	$1,009.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$940.22
Rate for Payer: Priority Health Narrow Network	$940.22
Rate for Payer: Priority Health SBD	$940.22

PR CLSR RECTOVAGINAL FISTULA ABDOMINAL APPROACH

Professional

Both

$1,937.00

Service Code	HCPCS 57305
Min. Negotiated Rate	$627.50
Max. Negotiated Rate	$2,391.09
Rate for Payer: Aetna Commercial	$1,168.24
Rate for Payer: BCBS Complete	$658.88
Rate for Payer: BCBS Trust/PPO	$2,391.09
Rate for Payer: Cash Price	$1,549.60
Rate for Payer: Cash Price	$1,549.60
Rate for Payer: Mclaren Medicaid	$627.50
Rate for Payer: Meridian Medicaid	$658.88
Rate for Payer: Priority Health Choice Medicaid	$627.50
Rate for Payer: Priority Health Cigna Priority Health	$1,355.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,398.97
Rate for Payer: Priority Health Narrow Network	$1,398.97
Rate for Payer: Priority Health SBD	$1,398.97

PR CLSR RECTOVAGINAL FISTULA VAGINAL/TRANSANAL APPR

Professional

Both

$1,295.00

Service Code	HCPCS 57300
Min. Negotiated Rate	$395.12
Max. Negotiated Rate	$2,627.76
Rate for Payer: Aetna Commercial	$717.48
Rate for Payer: BCBS Complete	$414.88
Rate for Payer: BCBS Trust/PPO	$2,627.76
Rate for Payer: Cash Price	$1,036.00
Rate for Payer: Cash Price	$1,036.00
Rate for Payer: Mclaren Medicaid	$395.12
Rate for Payer: Meridian Medicaid	$414.88
Rate for Payer: Priority Health Choice Medicaid	$395.12
Rate for Payer: Priority Health Cigna Priority Health	$906.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$870.63
Rate for Payer: Priority Health Narrow Network	$870.63
Rate for Payer: Priority Health SBD	$870.63

PR CLSR URETHROSTOMY/URETHROQ FSTL MALE SPX

Professional

Both

$1,130.00

Service Code	HCPCS 53520
Min. Negotiated Rate	$256.23
Max. Negotiated Rate	$893.75
Rate for Payer: Aetna Commercial	$715.24
Rate for Payer: BCBS Complete	$375.51
Rate for Payer: BCBS Trust/PPO	$256.23
Rate for Payer: Cash Price	$904.00
Rate for Payer: Cash Price	$904.00
Rate for Payer: Mclaren Medicaid	$357.63
Rate for Payer: Meridian Medicaid	$375.51
Rate for Payer: Priority Health Choice Medicaid	$357.63
Rate for Payer: Priority Health Cigna Priority Health	$791.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$893.75
Rate for Payer: Priority Health Narrow Network	$893.75
Rate for Payer: Priority Health SBD	$893.75

PR CLSR URETHROVAG FSTL W/BULBOCAVERNOSUS TRNSPL

Professional

Both

$1,081.00

Service Code	HCPCS 57311
Min. Negotiated Rate	$356.78
Max. Negotiated Rate	$2,101.05
Rate for Payer: Aetna Commercial	$653.71
Rate for Payer: BCBS Complete	$374.62
Rate for Payer: BCBS Trust/PPO	$2,101.05
Rate for Payer: Cash Price	$864.80
Rate for Payer: Cash Price	$864.80
Rate for Payer: Mclaren Medicaid	$356.78
Rate for Payer: Meridian Medicaid	$374.62
Rate for Payer: Priority Health Choice Medicaid	$356.78
Rate for Payer: Priority Health Cigna Priority Health	$756.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$783.04
Rate for Payer: Priority Health Narrow Network	$783.04
Rate for Payer: Priority Health SBD	$783.04

PR CLSR VESICOVAGINAL FISTUL AABDL APPROACH

Professional

Both

$3,839.00

Service Code	HCPCS 51900
Min. Negotiated Rate	$524.19
Max. Negotiated Rate	$2,687.30
Rate for Payer: Aetna Commercial	$1,056.40
Rate for Payer: BCBS Complete	$550.40
Rate for Payer: BCBS Trust/PPO	$1,789.35
Rate for Payer: Cash Price	$3,071.20
Rate for Payer: Cash Price	$3,071.20
Rate for Payer: Mclaren Medicaid	$524.19
Rate for Payer: Meridian Medicaid	$550.40
Rate for Payer: Priority Health Choice Medicaid	$524.19
Rate for Payer: Priority Health Cigna Priority Health	$2,687.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,313.61
Rate for Payer: Priority Health Narrow Network	$1,313.61
Rate for Payer: Priority Health SBD	$1,313.61

PR CLTR SKIN AGRFT F/S/N/H/F/G/M/D GT 1ST 25CM/<

Professional

Both

$1,299.00

Service Code	HCPCS 15155
Min. Negotiated Rate	$206.12
Max. Negotiated Rate	$909.30
Rate for Payer: Aetna Commercial	$787.97
Rate for Payer: BCBS Complete	$488.90
Rate for Payer: BCBS Trust/PPO	$206.12
Rate for Payer: Cash Price	$1,039.20
Rate for Payer: Cash Price	$1,039.20
Rate for Payer: Mclaren Medicaid	$465.62
Rate for Payer: Meridian Medicaid	$488.90
Rate for Payer: Priority Health Choice Medicaid	$465.62
Rate for Payer: Priority Health Cigna Priority Health	$909.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$896.06
Rate for Payer: Priority Health Narrow Network	$896.06
Rate for Payer: Priority Health SBD	$896.06

PR CLTR SKIN AGRFT F/S/N/H/F/G/M/D GT ADDL 1-75CM

Professional

Both

$350.00

Service Code	HCPCS 15156
Min. Negotiated Rate	$95.21
Max. Negotiated Rate	$6,614.63
Rate for Payer: Aetna Commercial	$166.77
Rate for Payer: BCBS Complete	$99.97
Rate for Payer: BCBS Trust/PPO	$6,614.63
Rate for Payer: Cash Price	$280.00
Rate for Payer: Cash Price	$280.00
Rate for Payer: Mclaren Medicaid	$95.21
Rate for Payer: Meridian Medicaid	$99.97
Rate for Payer: Priority Health Choice Medicaid	$95.21
Rate for Payer: Priority Health Cigna Priority Health	$245.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$182.91
Rate for Payer: Priority Health Narrow Network	$182.91
Rate for Payer: Priority Health SBD	$182.91

PR CLTR SKIN AGRFT T/A/L ADDL 1 CM-75 CM

Professional

Both

$225.00

Service Code	HCPCS 15151
Min. Negotiated Rate	$69.01
Max. Negotiated Rate	$206.12
Rate for Payer: Aetna Commercial	$120.68
Rate for Payer: BCBS Complete	$72.46
Rate for Payer: BCBS Trust/PPO	$206.12
Rate for Payer: Cash Price	$180.00
Rate for Payer: Cash Price	$180.00
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	$157.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$133.58
Rate for Payer: Priority Health Narrow Network	$133.58
Rate for Payer: Priority Health SBD	$133.58

PR CLTR SKIN AGRFT T/A/L EA 100 CM/EA 1%BODY AREA

Professional

Both

$300.00

Service Code	HCPCS 15152
Min. Negotiated Rate	$87.97
Max. Negotiated Rate	$6,614.63
Rate for Payer: Aetna Commercial	$151.77
Rate for Payer: BCBS Complete	$92.37
Rate for Payer: BCBS Trust/PPO	$6,614.63
Rate for Payer: Cash Price	$240.00
Rate for Payer: Cash Price	$240.00
Rate for Payer: Mclaren Medicaid	$87.97
Rate for Payer: Meridian Medicaid	$92.37
Rate for Payer: Priority Health Choice Medicaid	$87.97
Rate for Payer: Priority Health Cigna Priority Health	$210.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$172.23
Rate for Payer: Priority Health Narrow Network	$172.23
Rate for Payer: Priority Health SBD	$172.23

PR CLTR SKIN AUTOGRAFT T/A/L 1ST 25 CM/<

Professional

Both

$1,181.00

Service Code	HCPCS 15150
Min. Negotiated Rate	$212.16
Max. Negotiated Rate	$826.70
Rate for Payer: Aetna Commercial	$698.22
Rate for Payer: BCBS Complete	$430.53
Rate for Payer: BCBS Trust/PPO	$212.16
Rate for Payer: Cash Price	$944.80
Rate for Payer: Cash Price	$944.80
Rate for Payer: Mclaren Medicaid	$410.03
Rate for Payer: Meridian Medicaid	$430.53
Rate for Payer: Priority Health Choice Medicaid	$410.03
Rate for Payer: Priority Health Cigna Priority Health	$826.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$786.31
Rate for Payer: Priority Health Narrow Network	$786.31
Rate for Payer: Priority Health SBD	$786.31

PR CLTX ACETABULM HIP/SOCKT FX MANJ W/WO SKEL TRACJ

Professional

Both

$2,229.00

Service Code	HCPCS 27222
Min. Negotiated Rate	$631.33
Max. Negotiated Rate	$2,011.24
Rate for Payer: Aetna Commercial	$1,306.47
Rate for Payer: BCBS Complete	$662.90
Rate for Payer: BCBS Trust/PPO	$2,011.24
Rate for Payer: Cash Price	$1,783.20
Rate for Payer: Cash Price	$1,783.20
Rate for Payer: Mclaren Medicaid	$631.33
Rate for Payer: Meridian Medicaid	$662.90
Rate for Payer: Priority Health Choice Medicaid	$631.33
Rate for Payer: Priority Health Cigna Priority Health	$1,560.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,512.03
Rate for Payer: Priority Health Narrow Network	$1,512.03
Rate for Payer: Priority Health SBD	$1,512.03

PR CLTX ACETABULUM HIP/SOCKT FX W/O MANJ

Professional

Both

$1,646.00

Service Code	HCPCS 27220
Min. Negotiated Rate	$269.02
Max. Negotiated Rate	$2,011.24
Rate for Payer: Aetna Commercial	$550.55
Rate for Payer: BCBS Complete	$282.47
Rate for Payer: BCBS Trust/PPO	$2,011.24
Rate for Payer: Cash Price	$1,316.80
Rate for Payer: Cash Price	$1,316.80
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	$1,152.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$638.31
Rate for Payer: Priority Health Narrow Network	$638.31
Rate for Payer: Priority Health SBD	$638.31

PR CLTX ANKLE DISLC REQ ANES W/WO PRQ SKEL FIXJ

Professional

Both

$1,386.00

Service Code	HCPCS 27842
Min. Negotiated Rate	$321.84
Max. Negotiated Rate	$1,704.38
Rate for Payer: Aetna Commercial	$660.07
Rate for Payer: BCBS Complete	$337.93
Rate for Payer: BCBS Trust/PPO	$1,704.38
Rate for Payer: Cash Price	$1,108.80
Rate for Payer: Cash Price	$1,108.80
Rate for Payer: Mclaren Medicaid	$321.84
Rate for Payer: Meridian Medicaid	$337.93
Rate for Payer: Priority Health Choice Medicaid	$321.84
Rate for Payer: Priority Health Cigna Priority Health	$970.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$760.36
Rate for Payer: Priority Health Narrow Network	$760.36
Rate for Payer: Priority Health SBD	$760.36

PR CLTX ARTCLR FX INVG MTCARPHLNGL/IPHAL JT W/MANJ

Professional

Both

$917.00

Service Code	HCPCS 26742
Min. Negotiated Rate	$183.81
Max. Negotiated Rate	$641.90
Rate for Payer: Aetna Commercial	$448.66
Rate for Payer: BCBS Complete	$233.49
Rate for Payer: BCBS Trust/PPO	$183.81
Rate for Payer: Cash Price	$733.60
Rate for Payer: Cash Price	$733.60
Rate for Payer: Mclaren Medicaid	$222.37
Rate for Payer: Meridian Medicaid	$233.49
Rate for Payer: Priority Health Choice Medicaid	$222.37
Rate for Payer: Priority Health Cigna Priority Health	$641.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$527.49
Rate for Payer: Priority Health Narrow Network	$527.49
Rate for Payer: Priority Health SBD	$527.49

PR CLTX ARTCLR FX INVG MTCRPHLNGL/IPHAL JT W/O MANJ

Professional

Both

$620.00

Service Code	HCPCS 26740
Min. Negotiated Rate	$147.82
Max. Negotiated Rate	$434.00
Rate for Payer: Aetna Commercial	$289.66
Rate for Payer: BCBS Complete	$155.21
Rate for Payer: BCBS Trust/PPO	$153.74
Rate for Payer: Cash Price	$496.00
Rate for Payer: Cash Price	$496.00
Rate for Payer: Mclaren Medicaid	$147.82
Rate for Payer: Meridian Medicaid	$155.21
Rate for Payer: Priority Health Choice Medicaid	$147.82
Rate for Payer: Priority Health Cigna Priority Health	$434.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$347.24
Rate for Payer: Priority Health Narrow Network	$347.24
Rate for Payer: Priority Health SBD	$347.24

PR CLTX CARPAL BONE FX W/MANJ EACH BONE

Professional

Both

$1,101.00

Service Code	HCPCS 25635
Min. Negotiated Rate	$280.73
Max. Negotiated Rate	$1,016.45
Rate for Payer: Aetna Commercial	$560.87
Rate for Payer: BCBS Complete	$294.77
Rate for Payer: BCBS Trust/PPO	$1,016.45
Rate for Payer: Cash Price	$880.80
Rate for Payer: Cash Price	$880.80
Rate for Payer: Mclaren Medicaid	$280.73
Rate for Payer: Meridian Medicaid	$294.77
Rate for Payer: Priority Health Choice Medicaid	$280.73
Rate for Payer: Priority Health Cigna Priority Health	$770.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$661.29
Rate for Payer: Priority Health Narrow Network	$661.29
Rate for Payer: Priority Health SBD	$661.29

PR CLTX CARPAL BONE FX W/O MANJ EACH BONE

Professional

Both

$700.00

Service Code	HCPCS 25630
Min. Negotiated Rate	$189.78
Max. Negotiated Rate	$962.74
Rate for Payer: Aetna Commercial	$376.68
Rate for Payer: BCBS Complete	$199.27
Rate for Payer: BCBS Trust/PPO	$962.74
Rate for Payer: Cash Price	$560.00
Rate for Payer: Cash Price	$560.00
Rate for Payer: Mclaren Medicaid	$189.78
Rate for Payer: Meridian Medicaid	$199.27
Rate for Payer: Priority Health Choice Medicaid	$189.78
Rate for Payer: Priority Health Cigna Priority Health	$490.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$447.84
Rate for Payer: Priority Health Narrow Network	$447.84
Rate for Payer: Priority Health SBD	$447.84

Know your out-of-pocket cost for care.

All Charges