Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PR CLTX FX W8 BRG ARTCLR PRTN DSTL TIB W/SKEL TRACJ

Professional

Both

$1,900.00

Service Code	HCPCS 27825
Min. Negotiated Rate	$322.27
Max. Negotiated Rate	$3,467.23
Rate for Payer: Aetna Commercial	$656.96
Rate for Payer: BCBS Complete	$338.38
Rate for Payer: BCBS Trust/PPO	$3,467.23
Rate for Payer: Cash Price	$1,520.00
Rate for Payer: Cash Price	$1,520.00
Rate for Payer: Mclaren Medicaid	$322.27
Rate for Payer: Meridian Medicaid	$338.38
Rate for Payer: Priority Health Choice Medicaid	$322.27
Rate for Payer: Priority Health Cigna Priority Health	$1,330.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$764.44
Rate for Payer: Priority Health Narrow Network	$764.44
Rate for Payer: Priority Health SBD	$764.44

PR CLTX GREATER HUMERAL TUBEROSITY FX W/O MNPJ

Professional

Both

$674.00

Service Code	HCPCS 23620
Min. Negotiated Rate	$173.60
Max. Negotiated Rate	$471.80
Rate for Payer: Aetna Commercial	$342.23
Rate for Payer: BCBS Complete	$182.28
Rate for Payer: BCBS Trust/PPO	$193.36
Rate for Payer: Cash Price	$539.20
Rate for Payer: Cash Price	$539.20
Rate for Payer: Mclaren Medicaid	$173.60
Rate for Payer: Meridian Medicaid	$182.28
Rate for Payer: Priority Health Choice Medicaid	$173.60
Rate for Payer: Priority Health Cigna Priority Health	$471.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$409.55
Rate for Payer: Priority Health Narrow Network	$409.55
Rate for Payer: Priority Health SBD	$409.55

PR CLTX GREATER HUMRL TUBEROSITY FX W/MANIPULATION

Professional

Both

$647.00

Service Code	HCPCS 23625
Min. Negotiated Rate	$234.51
Max. Negotiated Rate	$557.12
Rate for Payer: Aetna Commercial	$465.59
Rate for Payer: BCBS Complete	$246.24
Rate for Payer: BCBS Trust/PPO	$234.57
Rate for Payer: Cash Price	$517.60
Rate for Payer: Cash Price	$517.60
Rate for Payer: Mclaren Medicaid	$234.51
Rate for Payer: Meridian Medicaid	$246.24
Rate for Payer: Priority Health Choice Medicaid	$234.51
Rate for Payer: Priority Health Cigna Priority Health	$452.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$557.12
Rate for Payer: Priority Health Narrow Network	$557.12
Rate for Payer: Priority Health SBD	$557.12

PR CLTX GREATER TROCHANTERIC FX W/O MANJ

Professional

Both

$878.00

Service Code	HCPCS 27246
Min. Negotiated Rate	$253.90
Max. Negotiated Rate	$1,725.43
Rate for Payer: Aetna Commercial	$514.65
Rate for Payer: BCBS Complete	$266.60
Rate for Payer: BCBS Trust/PPO	$1,725.43
Rate for Payer: Cash Price	$702.40
Rate for Payer: Cash Price	$702.40
Rate for Payer: Mclaren Medicaid	$253.90
Rate for Payer: Meridian Medicaid	$266.60
Rate for Payer: Priority Health Choice Medicaid	$253.90
Rate for Payer: Priority Health Cigna Priority Health	$614.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$601.03
Rate for Payer: Priority Health Narrow Network	$601.03
Rate for Payer: Priority Health SBD	$601.03

PR CLTX HIP DISLOCATION TRAUMATIC REQ ANESTHESIA

Professional

Both

$1,920.00

Service Code	HCPCS 27252
Min. Negotiated Rate	$483.51
Max. Negotiated Rate	$2,221.50
Rate for Payer: Aetna Commercial	$1,012.43
Rate for Payer: BCBS Complete	$507.69
Rate for Payer: BCBS Trust/PPO	$2,221.50
Rate for Payer: Cash Price	$1,536.00
Rate for Payer: Cash Price	$1,536.00
Rate for Payer: Mclaren Medicaid	$483.51
Rate for Payer: Meridian Medicaid	$507.69
Rate for Payer: Priority Health Choice Medicaid	$483.51
Rate for Payer: Priority Health Cigna Priority Health	$1,344.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,157.64
Rate for Payer: Priority Health Narrow Network	$1,157.64
Rate for Payer: Priority Health SBD	$1,157.64

PR CLTX HIP DISLOCATION TRAUMATIC W/O ANESTHESIA

Professional

Both

$724.00

Service Code	HCPCS 27250
Min. Negotiated Rate	$114.38
Max. Negotiated Rate	$2,156.52
Rate for Payer: Aetna Commercial	$245.86
Rate for Payer: BCBS Complete	$120.10
Rate for Payer: BCBS Trust/PPO	$2,156.52
Rate for Payer: Cash Price	$579.20
Rate for Payer: Cash Price	$579.20
Rate for Payer: Mclaren Medicaid	$114.38
Rate for Payer: Meridian Medicaid	$120.10
Rate for Payer: Priority Health Choice Medicaid	$114.38
Rate for Payer: Priority Health Cigna Priority Health	$506.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$274.21
Rate for Payer: Priority Health Narrow Network	$274.21
Rate for Payer: Priority Health SBD	$274.21

PR CLTX HUMERAL CONDYLAR FX MEDIAL/LAT W/O MANJ

Professional

Both

$666.00

Service Code	HCPCS 24576
Min. Negotiated Rate	$129.43
Max. Negotiated Rate	$492.78
Rate for Payer: Aetna Commercial	$412.52
Rate for Payer: BCBS Complete	$220.30
Rate for Payer: BCBS Trust/PPO	$129.43
Rate for Payer: Cash Price	$532.80
Rate for Payer: Cash Price	$532.80
Rate for Payer: Mclaren Medicaid	$209.81
Rate for Payer: Meridian Medicaid	$220.30
Rate for Payer: Priority Health Choice Medicaid	$209.81
Rate for Payer: Priority Health Cigna Priority Health	$466.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$492.78
Rate for Payer: Priority Health Narrow Network	$492.78
Rate for Payer: Priority Health SBD	$492.78

PR CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/O MANJ

Professional

Both

$804.00

Service Code	HCPCS 24560
Min. Negotiated Rate	$112.00
Max. Negotiated Rate	$562.80
Rate for Payer: Aetna Commercial	$391.16
Rate for Payer: BCBS Complete	$206.65
Rate for Payer: BCBS Trust/PPO	$112.00
Rate for Payer: Cash Price	$643.20
Rate for Payer: Cash Price	$643.20
Rate for Payer: Mclaren Medicaid	$196.81
Rate for Payer: Meridian Medicaid	$206.65
Rate for Payer: Priority Health Choice Medicaid	$196.81
Rate for Payer: Priority Health Cigna Priority Health	$562.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$464.69
Rate for Payer: Priority Health Narrow Network	$464.69
Rate for Payer: Priority Health SBD	$464.69

PR CLTX HUMERAL SHFT FX W/MANJ W/WO SKELETAL TRACJ

Professional

Both

$1,263.00

Service Code	HCPCS 24505
Min. Negotiated Rate	$298.84
Max. Negotiated Rate	$884.10
Rate for Payer: Aetna Commercial	$601.92
Rate for Payer: BCBS Complete	$313.78
Rate for Payer: BCBS Trust/PPO	$313.28
Rate for Payer: Cash Price	$1,010.40
Rate for Payer: Cash Price	$1,010.40
Rate for Payer: Mclaren Medicaid	$298.84
Rate for Payer: Meridian Medicaid	$313.78
Rate for Payer: Priority Health Choice Medicaid	$298.84
Rate for Payer: Priority Health Cigna Priority Health	$884.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$706.23
Rate for Payer: Priority Health Narrow Network	$706.23
Rate for Payer: Priority Health SBD	$706.23

PR CLTX INTERCONDYLAR SPI&/TUBRST FX KNE W/WO MAN

Professional

Both

$934.00

Service Code	HCPCS 27538
Min. Negotiated Rate	$296.71
Max. Negotiated Rate	$716.37
Rate for Payer: Aetna Commercial	$595.65
Rate for Payer: BCBS Complete	$311.55
Rate for Payer: BCBS Trust/PPO	$716.37
Rate for Payer: Cash Price	$747.20
Rate for Payer: Cash Price	$747.20
Rate for Payer: Mclaren Medicaid	$296.71
Rate for Payer: Meridian Medicaid	$311.55
Rate for Payer: Priority Health Choice Medicaid	$296.71
Rate for Payer: Priority Health Cigna Priority Health	$653.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$702.15
Rate for Payer: Priority Health Narrow Network	$702.15
Rate for Payer: Priority Health SBD	$702.15

PR CLTX INTER/PERI/SUBTROCHANTERIC FEM FX W/O MANJ

Professional

Both

$933.00

Service Code	HCPCS 27238
Min. Negotiated Rate	$306.51
Max. Negotiated Rate	$1,049.20
Rate for Payer: Aetna Commercial	$620.82
Rate for Payer: BCBS Complete	$321.84
Rate for Payer: BCBS Trust/PPO	$1,049.20
Rate for Payer: Cash Price	$746.40
Rate for Payer: Cash Price	$746.40
Rate for Payer: Mclaren Medicaid	$306.51
Rate for Payer: Meridian Medicaid	$321.84
Rate for Payer: Priority Health Choice Medicaid	$306.51
Rate for Payer: Priority Health Cigna Priority Health	$653.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$725.13
Rate for Payer: Priority Health Narrow Network	$725.13
Rate for Payer: Priority Health SBD	$725.13

PR CLTX INTERPHALANGEAL JOINT DISLOCATION REQ ANES

Professional

Both

$267.00

Service Code	HCPCS 28665
Min. Negotiated Rate	$81.79
Max. Negotiated Rate	$1,135.32
Rate for Payer: Aetna Commercial	$166.79
Rate for Payer: BCBS Complete	$85.88
Rate for Payer: BCBS Trust/PPO	$1,135.32
Rate for Payer: Cash Price	$213.60
Rate for Payer: Cash Price	$213.60
Rate for Payer: Mclaren Medicaid	$81.79
Rate for Payer: Meridian Medicaid	$85.88
Rate for Payer: Priority Health Choice Medicaid	$81.79
Rate for Payer: Priority Health Cigna Priority Health	$186.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$189.96
Rate for Payer: Priority Health Narrow Network	$189.96
Rate for Payer: Priority Health SBD	$189.96

PR CLTX INTERPHALANGEAL JOINT DISLOCATION W/O ANES

Professional

Both

$229.00

Service Code	HCPCS 28660
Min. Negotiated Rate	$61.34
Max. Negotiated Rate	$766.04
Rate for Payer: Aetna Commercial	$122.37
Rate for Payer: BCBS Complete	$64.41
Rate for Payer: BCBS Trust/PPO	$766.04
Rate for Payer: Cash Price	$183.20
Rate for Payer: Cash Price	$183.20
Rate for Payer: Mclaren Medicaid	$61.34
Rate for Payer: Meridian Medicaid	$64.41
Rate for Payer: Priority Health Choice Medicaid	$61.34
Rate for Payer: Priority Health Cigna Priority Health	$160.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$142.98
Rate for Payer: Priority Health Narrow Network	$142.98
Rate for Payer: Priority Health SBD	$142.98

PR CLTX INTR/PERI/SBTRCHNTC FEMORAL FX W/MANJ

Professional

Both

$1,946.00

Service Code	HCPCS 27240
Min. Negotiated Rate	$613.87
Max. Negotiated Rate	$1,467.10
Rate for Payer: Aetna Commercial	$1,282.41
Rate for Payer: BCBS Complete	$644.56
Rate for Payer: BCBS Trust/PPO	$1,203.47
Rate for Payer: Cash Price	$1,556.80
Rate for Payer: Cash Price	$1,556.80
Rate for Payer: Mclaren Medicaid	$613.87
Rate for Payer: Meridian Medicaid	$644.56
Rate for Payer: Priority Health Choice Medicaid	$613.87
Rate for Payer: Priority Health Cigna Priority Health	$1,362.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,467.10
Rate for Payer: Priority Health Narrow Network	$1,467.10
Rate for Payer: Priority Health SBD	$1,467.10

PR CLTX IPHAL JT DISLC W/MANJ REQ ANES

Professional

Both

$809.00

Service Code	HCPCS 26775
Min. Negotiated Rate	$236.22
Max. Negotiated Rate	$2,900.37
Rate for Payer: Aetna Commercial	$466.21
Rate for Payer: BCBS Complete	$248.03
Rate for Payer: BCBS Trust/PPO	$2,900.37
Rate for Payer: Cash Price	$647.20
Rate for Payer: Cash Price	$647.20
Rate for Payer: Mclaren Medicaid	$236.22
Rate for Payer: Meridian Medicaid	$248.03
Rate for Payer: Priority Health Choice Medicaid	$236.22
Rate for Payer: Priority Health Cigna Priority Health	$566.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$557.12
Rate for Payer: Priority Health Narrow Network	$557.12
Rate for Payer: Priority Health SBD	$557.12

PR CLTX IPHAL JT DISLC W/MANJ W/O ANES

Professional

Both

$547.00

Service Code	HCPCS 26770
Min. Negotiated Rate	$175.73
Max. Negotiated Rate	$1,851.16
Rate for Payer: Aetna Commercial	$345.16
Rate for Payer: BCBS Complete	$184.52
Rate for Payer: BCBS Trust/PPO	$1,851.16
Rate for Payer: Cash Price	$437.60
Rate for Payer: Cash Price	$437.60
Rate for Payer: Mclaren Medicaid	$175.73
Rate for Payer: Meridian Medicaid	$184.52
Rate for Payer: Priority Health Choice Medicaid	$175.73
Rate for Payer: Priority Health Cigna Priority Health	$382.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$412.09
Rate for Payer: Priority Health Narrow Network	$412.09
Rate for Payer: Priority Health SBD	$412.09

PR CLTX MANDIBULAR/MAXILLARY ALVEOLAR RIDGE FX SPX

Professional

Both

$1,172.00

Service Code	HCPCS 21440
Min. Negotiated Rate	$388.30
Max. Negotiated Rate	$2,978.97
Rate for Payer: Aetna Commercial	$702.55
Rate for Payer: BCBS Complete	$407.72
Rate for Payer: BCBS Trust/PPO	$2,978.97
Rate for Payer: Cash Price	$937.60
Rate for Payer: Cash Price	$937.60
Rate for Payer: Mclaren Medicaid	$388.30
Rate for Payer: Meridian Medicaid	$407.72
Rate for Payer: Priority Health Choice Medicaid	$388.30
Rate for Payer: Priority Health Cigna Priority Health	$820.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$849.20
Rate for Payer: Priority Health Narrow Network	$849.20
Rate for Payer: Priority Health SBD	$849.20

PR CLTX MEDIAL MALLEOLUS FX W/O MANIPULATION

Professional

Both

$855.00

Service Code	HCPCS 27760
Min. Negotiated Rate	$204.91
Max. Negotiated Rate	$2,919.55
Rate for Payer: Aetna Commercial	$406.19
Rate for Payer: BCBS Complete	$215.16
Rate for Payer: BCBS Trust/PPO	$2,919.55
Rate for Payer: Cash Price	$684.00
Rate for Payer: Cash Price	$684.00
Rate for Payer: Mclaren Medicaid	$204.91
Rate for Payer: Meridian Medicaid	$215.16
Rate for Payer: Priority Health Choice Medicaid	$204.91
Rate for Payer: Priority Health Cigna Priority Health	$598.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$480.52
Rate for Payer: Priority Health Narrow Network	$480.52
Rate for Payer: Priority Health SBD	$480.52

PR CLTX METACARPAL FX W/MANIPULATION EACH BONE

Professional

Both

$701.00

Service Code	HCPCS 26605
Min. Negotiated Rate	$49.24
Max. Negotiated Rate	$490.70
Rate for Payer: Aetna Commercial	$392.63
Rate for Payer: BCBS Complete	$208.22
Rate for Payer: BCBS Trust/PPO	$49.24
Rate for Payer: Cash Price	$560.80
Rate for Payer: Cash Price	$560.80
Rate for Payer: Mclaren Medicaid	$198.30
Rate for Payer: Meridian Medicaid	$208.22
Rate for Payer: Priority Health Choice Medicaid	$198.30
Rate for Payer: Priority Health Cigna Priority Health	$490.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$468.27
Rate for Payer: Priority Health Narrow Network	$468.27
Rate for Payer: Priority Health SBD	$468.27

PR CLTX METACARPAL FX W/MANJ W/XTRNL FIXJ EA BONE

Professional

Both

$1,510.00

Service Code	HCPCS 26607
Min. Negotiated Rate	$49.24
Max. Negotiated Rate	$1,057.00
Rate for Payer: Aetna Commercial	$668.91
Rate for Payer: BCBS Complete	$348.44
Rate for Payer: BCBS Trust/PPO	$49.24
Rate for Payer: Cash Price	$1,208.00
Rate for Payer: Cash Price	$1,208.00
Rate for Payer: Mclaren Medicaid	$331.85
Rate for Payer: Meridian Medicaid	$348.44
Rate for Payer: Priority Health Choice Medicaid	$331.85
Rate for Payer: Priority Health Cigna Priority Health	$1,057.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$791.51
Rate for Payer: Priority Health Narrow Network	$791.51
Rate for Payer: Priority Health SBD	$791.51

PR CLTX METACARPAL FX W/O MANIPULATION EACH BONE

Professional

Both

$539.00

Service Code	HCPCS 26600
Min. Negotiated Rate	$103.55
Max. Negotiated Rate	$451.41
Rate for Payer: Aetna Commercial	$375.05
Rate for Payer: BCBS Complete	$201.74
Rate for Payer: BCBS Trust/PPO	$103.55
Rate for Payer: Cash Price	$431.20
Rate for Payer: Cash Price	$431.20
Rate for Payer: Mclaren Medicaid	$192.13
Rate for Payer: Meridian Medicaid	$201.74
Rate for Payer: Priority Health Choice Medicaid	$192.13
Rate for Payer: Priority Health Cigna Priority Health	$377.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$451.41
Rate for Payer: Priority Health Narrow Network	$451.41
Rate for Payer: Priority Health SBD	$451.41

PR CLTX METACARPOPHALANGEAL DISLC W/MANJ W/ANES

Professional

Both

$809.00

Service Code	HCPCS 26705
Min. Negotiated Rate	$254.64
Max. Negotiated Rate	$620.95
Rate for Payer: Aetna Commercial	$510.96
Rate for Payer: BCBS Complete	$276.21
Rate for Payer: BCBS Trust/PPO	$254.64
Rate for Payer: Cash Price	$647.20
Rate for Payer: Cash Price	$647.20
Rate for Payer: Mclaren Medicaid	$263.06
Rate for Payer: Meridian Medicaid	$276.21
Rate for Payer: Priority Health Choice Medicaid	$263.06
Rate for Payer: Priority Health Cigna Priority Health	$566.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$620.95
Rate for Payer: Priority Health Narrow Network	$620.95
Rate for Payer: Priority Health SBD	$620.95

PR CLTX METACARPOPHALANGEAL DISLC W/MANJ W/O ANES

Professional

Both

$539.00

Service Code	HCPCS 26700
Min. Negotiated Rate	$64.45
Max. Negotiated Rate	$492.26
Rate for Payer: Aetna Commercial	$412.37
Rate for Payer: BCBS Complete	$219.18
Rate for Payer: BCBS Trust/PPO	$64.45
Rate for Payer: Cash Price	$431.20
Rate for Payer: Cash Price	$431.20
Rate for Payer: Mclaren Medicaid	$208.74
Rate for Payer: Meridian Medicaid	$219.18
Rate for Payer: Priority Health Choice Medicaid	$208.74
Rate for Payer: Priority Health Cigna Priority Health	$377.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$492.26
Rate for Payer: Priority Health Narrow Network	$492.26
Rate for Payer: Priority Health SBD	$492.26

PR CLTX METAR FX W/MANJ

Professional

Both

$726.00

Service Code	HCPCS 28475
Min. Negotiated Rate	$150.80
Max. Negotiated Rate	$1,033.88
Rate for Payer: Aetna Commercial	$299.08
Rate for Payer: BCBS Complete	$158.34
Rate for Payer: BCBS Trust/PPO	$1,033.88
Rate for Payer: Cash Price	$580.80
Rate for Payer: Cash Price	$580.80
Rate for Payer: Mclaren Medicaid	$150.80
Rate for Payer: Meridian Medicaid	$158.34
Rate for Payer: Priority Health Choice Medicaid	$150.80
Rate for Payer: Priority Health Cigna Priority Health	$508.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$351.32
Rate for Payer: Priority Health Narrow Network	$351.32
Rate for Payer: Priority Health SBD	$351.32

PR CLTX METATARSOPHLNGL JT DISLC REQ ANES

Professional

Both

$310.00

Service Code	HCPCS 28635
Min. Negotiated Rate	$84.56
Max. Negotiated Rate	$342.34
Rate for Payer: Aetna Commercial	$178.03
Rate for Payer: BCBS Complete	$88.79
Rate for Payer: BCBS Trust/PPO	$342.34
Rate for Payer: Cash Price	$248.00
Rate for Payer: Cash Price	$248.00
Rate for Payer: Mclaren Medicaid	$84.56
Rate for Payer: Meridian Medicaid	$88.79
Rate for Payer: Priority Health Choice Medicaid	$84.56
Rate for Payer: Priority Health Cigna Priority Health	$217.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$205.29
Rate for Payer: Priority Health Narrow Network	$205.29
Rate for Payer: Priority Health SBD	$205.29

Know your out-of-pocket cost for care.

All Charges