Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PR CLTX METATARSOPHLNGL JT DISLC W/O ANES

Professional

Both

$312.00

Service Code	HCPCS 28630
Min. Negotiated Rate	$71.78
Max. Negotiated Rate	$753.88
Rate for Payer: Aetna Commercial	$146.75
Rate for Payer: BCBS Complete	$75.37
Rate for Payer: BCBS Trust/PPO	$753.88
Rate for Payer: Cash Price	$249.60
Rate for Payer: Cash Price	$249.60
Rate for Payer: Mclaren Medicaid	$71.78
Rate for Payer: Meridian Medicaid	$75.37
Rate for Payer: Priority Health Choice Medicaid	$71.78
Rate for Payer: Priority Health Cigna Priority Health	$218.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$169.54
Rate for Payer: Priority Health Narrow Network	$169.54
Rate for Payer: Priority Health SBD	$169.54

PR CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/MANJ EA

Professional

Both

$701.00

Service Code	HCPCS 26725
Min. Negotiated Rate	$202.99
Max. Negotiated Rate	$830.49
Rate for Payer: Aetna Commercial	$403.72
Rate for Payer: BCBS Complete	$213.14
Rate for Payer: BCBS Trust/PPO	$830.49
Rate for Payer: Cash Price	$560.80
Rate for Payer: Cash Price	$560.80
Rate for Payer: Mclaren Medicaid	$202.99
Rate for Payer: Meridian Medicaid	$213.14
Rate for Payer: Priority Health Choice Medicaid	$202.99
Rate for Payer: Priority Health Cigna Priority Health	$490.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$478.47
Rate for Payer: Priority Health Narrow Network	$478.47
Rate for Payer: Priority Health SBD	$478.47

PR CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/O MANJ EA

Professional

Both

$404.00

Service Code	HCPCS 26720
Min. Negotiated Rate	$127.16
Max. Negotiated Rate	$909.78
Rate for Payer: Aetna Commercial	$246.60
Rate for Payer: BCBS Complete	$133.52
Rate for Payer: BCBS Trust/PPO	$909.78
Rate for Payer: Cash Price	$323.20
Rate for Payer: Cash Price	$323.20
Rate for Payer: Mclaren Medicaid	$127.16
Rate for Payer: Meridian Medicaid	$133.52
Rate for Payer: Priority Health Choice Medicaid	$127.16
Rate for Payer: Priority Health Cigna Priority Health	$282.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$297.71
Rate for Payer: Priority Health Narrow Network	$297.71
Rate for Payer: Priority Health SBD	$297.71

PR CLTX POST HIP ARTHRP DISLC REQ ANES

Professional

Both

$1,500.00

Service Code	HCPCS 27266
Min. Negotiated Rate	$378.93
Max. Negotiated Rate	$3,076.82
Rate for Payer: Aetna Commercial	$779.49
Rate for Payer: BCBS Complete	$397.88
Rate for Payer: BCBS Trust/PPO	$3,076.82
Rate for Payer: Cash Price	$1,200.00
Rate for Payer: Cash Price	$1,200.00
Rate for Payer: Mclaren Medicaid	$378.93
Rate for Payer: Meridian Medicaid	$397.88
Rate for Payer: Priority Health Choice Medicaid	$378.93
Rate for Payer: Priority Health Cigna Priority Health	$1,050.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$902.32
Rate for Payer: Priority Health Narrow Network	$902.32
Rate for Payer: Priority Health SBD	$902.32

PR CLTX POST HIP ARTHRP DISLC W/O ANES

Professional

Both

$727.00

Service Code	HCPCS 27265
Min. Negotiated Rate	$274.77
Max. Negotiated Rate	$2,859.69
Rate for Payer: Aetna Commercial	$541.09
Rate for Payer: BCBS Complete	$288.51
Rate for Payer: BCBS Trust/PPO	$2,859.69
Rate for Payer: Cash Price	$581.60
Rate for Payer: Cash Price	$581.60
Rate for Payer: Mclaren Medicaid	$274.77
Rate for Payer: Meridian Medicaid	$288.51
Rate for Payer: Priority Health Choice Medicaid	$274.77
Rate for Payer: Priority Health Cigna Priority Health	$508.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$646.99
Rate for Payer: Priority Health Narrow Network	$646.99
Rate for Payer: Priority Health SBD	$646.99

PR CLTX PROX FIBULA/SHFT FX W/MANJ

Professional

Both

$1,188.00

Service Code	HCPCS 27781
Min. Negotiated Rate	$267.10
Max. Negotiated Rate	$2,284.34
Rate for Payer: Aetna Commercial	$530.55
Rate for Payer: BCBS Complete	$280.46
Rate for Payer: BCBS Trust/PPO	$2,284.34
Rate for Payer: Cash Price	$950.40
Rate for Payer: Cash Price	$950.40
Rate for Payer: Mclaren Medicaid	$267.10
Rate for Payer: Meridian Medicaid	$280.46
Rate for Payer: Priority Health Choice Medicaid	$267.10
Rate for Payer: Priority Health Cigna Priority Health	$831.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$630.66
Rate for Payer: Priority Health Narrow Network	$630.66
Rate for Payer: Priority Health SBD	$630.66

PR CLTX PROX FIBULA/SHFT FX W/O MANJ

Professional

Both

$653.00

Service Code	HCPCS 27780
Min. Negotiated Rate	$190.00
Max. Negotiated Rate	$2,660.11
Rate for Payer: Aetna Commercial	$375.75
Rate for Payer: BCBS Complete	$199.50
Rate for Payer: BCBS Trust/PPO	$2,660.11
Rate for Payer: Cash Price	$522.40
Rate for Payer: Cash Price	$522.40
Rate for Payer: Mclaren Medicaid	$190.00
Rate for Payer: Meridian Medicaid	$199.50
Rate for Payer: Priority Health Choice Medicaid	$190.00
Rate for Payer: Priority Health Cigna Priority Health	$457.10
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

PR CLTX PROX HUMRL FX W/MNPJ W/WO SKELETAL TRACJ

Professional

Both

$1,396.00

Service Code	HCPCS 23605
Min. Negotiated Rate	$282.44
Max. Negotiated Rate	$977.20
Rate for Payer: Aetna Commercial	$569.91
Rate for Payer: BCBS Complete	$296.56
Rate for Payer: BCBS Trust/PPO	$303.24
Rate for Payer: Cash Price	$1,116.80
Rate for Payer: Cash Price	$1,116.80
Rate for Payer: Mclaren Medicaid	$282.44
Rate for Payer: Meridian Medicaid	$296.56
Rate for Payer: Priority Health Choice Medicaid	$282.44
Rate for Payer: Priority Health Cigna Priority Health	$977.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$667.43
Rate for Payer: Priority Health Narrow Network	$667.43
Rate for Payer: Priority Health SBD	$667.43

PR CLTX PROXIMAL HUMERAL FRACTURE W/O MANIPULATION

Professional

Both

$770.00

Service Code	HCPCS 23600
Min. Negotiated Rate	$203.34
Max. Negotiated Rate	$539.00
Rate for Payer: Aetna Commercial	$415.71
Rate for Payer: BCBS Complete	$221.63
Rate for Payer: BCBS Trust/PPO	$203.34
Rate for Payer: Cash Price	$616.00
Rate for Payer: Cash Price	$616.00
Rate for Payer: Mclaren Medicaid	$211.08
Rate for Payer: Meridian Medicaid	$221.63
Rate for Payer: Priority Health Choice Medicaid	$211.08
Rate for Payer: Priority Health Cigna Priority Health	$539.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$496.86
Rate for Payer: Priority Health Narrow Network	$496.86
Rate for Payer: Priority Health SBD	$496.86

PR CLTX PROX TIBFIB JT DISLC REQ ANES

Professional

Both

$745.00

Service Code	HCPCS 27831
Min. Negotiated Rate	$133.15
Max. Negotiated Rate	$636.78
Rate for Payer: Aetna Commercial	$541.69
Rate for Payer: BCBS Complete	$282.92
Rate for Payer: BCBS Trust/PPO	$133.15
Rate for Payer: Cash Price	$596.00
Rate for Payer: Cash Price	$596.00
Rate for Payer: Mclaren Medicaid	$269.45
Rate for Payer: Meridian Medicaid	$282.92
Rate for Payer: Priority Health Choice Medicaid	$269.45
Rate for Payer: Priority Health Cigna Priority Health	$521.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$636.78
Rate for Payer: Priority Health Narrow Network	$636.78
Rate for Payer: Priority Health SBD	$636.78

PR CLTX RDCRPL/INTERCARPL DISLC 1/> BONES W/MANJ

Professional

Both

$704.00

Service Code	HCPCS 25660
Min. Negotiated Rate	$296.71
Max. Negotiated Rate	$1,828.45
Rate for Payer: Aetna Commercial	$593.54
Rate for Payer: BCBS Complete	$311.55
Rate for Payer: BCBS Trust/PPO	$1,828.45
Rate for Payer: Cash Price	$563.20
Rate for Payer: Cash Price	$563.20
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	$492.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$700.61
Rate for Payer: Priority Health Narrow Network	$700.61
Rate for Payer: Priority Health SBD	$700.61

PR CLTX RDL HEAD SUBLXTJ CHLD NURSEMAID ELBW W/MANJ

Professional

Both

$239.00

Service Code	HCPCS 24640
Min. Negotiated Rate	$51.55
Max. Negotiated Rate	$890.19
Rate for Payer: Aetna Commercial	$105.52
Rate for Payer: BCBS Complete	$54.13
Rate for Payer: BCBS Trust/PPO	$890.19
Rate for Payer: Cash Price	$191.20
Rate for Payer: Cash Price	$191.20
Rate for Payer: Mclaren Medicaid	$51.55
Rate for Payer: Meridian Medicaid	$54.13
Rate for Payer: Priority Health Choice Medicaid	$51.55
Rate for Payer: Priority Health Cigna Priority Health	$167.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$122.04
Rate for Payer: Priority Health Narrow Network	$122.04
Rate for Payer: Priority Health SBD	$122.04

PR CLTX RDL SHFT FX&CLTX DISLC DSTL RAD/ULN JT

Professional

Both

$1,474.00

Service Code	HCPCS 25520
Min. Negotiated Rate	$358.69
Max. Negotiated Rate	$1,412.15
Rate for Payer: Aetna Commercial	$724.04
Rate for Payer: BCBS Complete	$376.62
Rate for Payer: BCBS Trust/PPO	$1,412.15
Rate for Payer: Cash Price	$1,179.20
Rate for Payer: Cash Price	$1,179.20
Rate for Payer: Mclaren Medicaid	$358.69
Rate for Payer: Meridian Medicaid	$376.62
Rate for Payer: Priority Health Choice Medicaid	$358.69
Rate for Payer: Priority Health Cigna Priority Health	$1,031.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$848.20
Rate for Payer: Priority Health Narrow Network	$848.20
Rate for Payer: Priority Health SBD	$848.20

PR CLTX SCAPULAR FX W/MNPJ W/WO SKELETAL TRACTION

Professional

Both

$1,011.00

Service Code	HCPCS 23575
Min. Negotiated Rate	$192.30
Max. Negotiated Rate	$707.70
Rate for Payer: Aetna Commercial	$502.77
Rate for Payer: BCBS Complete	$264.36
Rate for Payer: BCBS Trust/PPO	$192.30
Rate for Payer: Cash Price	$808.80
Rate for Payer: Cash Price	$808.80
Rate for Payer: Mclaren Medicaid	$251.77
Rate for Payer: Meridian Medicaid	$264.36
Rate for Payer: Priority Health Choice Medicaid	$251.77
Rate for Payer: Priority Health Cigna Priority Health	$707.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$593.38
Rate for Payer: Priority Health Narrow Network	$593.38
Rate for Payer: Priority Health SBD	$593.38

PR CLTX SHOULDER DISLC W/FX HUMERAL TUBRST W/MNPJ

Professional

Both

$1,346.00

Service Code	HCPCS 23665
Min. Negotiated Rate	$159.61
Max. Negotiated Rate	$942.20
Rate for Payer: Aetna Commercial	$529.72
Rate for Payer: BCBS Complete	$278.67
Rate for Payer: BCBS Trust/PPO	$159.61
Rate for Payer: Cash Price	$1,076.80
Rate for Payer: Cash Price	$1,076.80
Rate for Payer: Mclaren Medicaid	$265.40
Rate for Payer: Meridian Medicaid	$278.67
Rate for Payer: Priority Health Choice Medicaid	$265.40
Rate for Payer: Priority Health Cigna Priority Health	$942.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$624.01
Rate for Payer: Priority Health Narrow Network	$624.01
Rate for Payer: Priority Health SBD	$624.01

PR CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/MANJ

Professional

Both

$1,608.00

Service Code	HCPCS 24535
Min. Negotiated Rate	$376.58
Max. Negotiated Rate	$1,125.60
Rate for Payer: Aetna Commercial	$761.70
Rate for Payer: BCBS Complete	$395.41
Rate for Payer: BCBS Trust/PPO	$605.96
Rate for Payer: Cash Price	$1,286.40
Rate for Payer: Cash Price	$1,286.40
Rate for Payer: Mclaren Medicaid	$376.58
Rate for Payer: Meridian Medicaid	$395.41
Rate for Payer: Priority Health Choice Medicaid	$376.58
Rate for Payer: Priority Health Cigna Priority Health	$1,125.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$887.00
Rate for Payer: Priority Health Narrow Network	$887.00
Rate for Payer: Priority Health SBD	$887.00

PR CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/WO MANJ

Professional

Both

$827.00

Service Code	HCPCS 24530
Min. Negotiated Rate	$234.09
Max. Negotiated Rate	$578.90
Rate for Payer: Aetna Commercial	$463.61
Rate for Payer: BCBS Complete	$245.79
Rate for Payer: BCBS Trust/PPO	$472.30
Rate for Payer: Cash Price	$661.60
Rate for Payer: Cash Price	$661.60
Rate for Payer: Mclaren Medicaid	$234.09
Rate for Payer: Meridian Medicaid	$245.79
Rate for Payer: Priority Health Choice Medicaid	$234.09
Rate for Payer: Priority Health Cigna Priority Health	$578.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$552.01
Rate for Payer: Priority Health Narrow Network	$552.01
Rate for Payer: Priority Health SBD	$552.01

PR CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/MANJ

Professional

Both

$2,156.00

Service Code	HCPCS 27503
Min. Negotiated Rate	$516.95
Max. Negotiated Rate	$1,509.20
Rate for Payer: Aetna Commercial	$1,072.39
Rate for Payer: BCBS Complete	$542.80
Rate for Payer: BCBS Trust/PPO	$1,009.58
Rate for Payer: Cash Price	$1,724.80
Rate for Payer: Cash Price	$1,724.80
Rate for Payer: Mclaren Medicaid	$516.95
Rate for Payer: Meridian Medicaid	$542.80
Rate for Payer: Priority Health Choice Medicaid	$516.95
Rate for Payer: Priority Health Cigna Priority Health	$1,509.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,233.23
Rate for Payer: Priority Health Narrow Network	$1,233.23
Rate for Payer: Priority Health SBD	$1,233.23

PR CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/O MANJ

Professional

Both

$1,545.00

Service Code	HCPCS 27501
Min. Negotiated Rate	$324.83
Max. Negotiated Rate	$3,213.12
Rate for Payer: Aetna Commercial	$663.19
Rate for Payer: BCBS Complete	$341.07
Rate for Payer: BCBS Trust/PPO	$3,213.12
Rate for Payer: Cash Price	$1,236.00
Rate for Payer: Cash Price	$1,236.00
Rate for Payer: Mclaren Medicaid	$324.83
Rate for Payer: Meridian Medicaid	$341.07
Rate for Payer: Priority Health Choice Medicaid	$324.83
Rate for Payer: Priority Health Cigna Priority Health	$1,081.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$771.09
Rate for Payer: Priority Health Narrow Network	$771.09
Rate for Payer: Priority Health SBD	$771.09

PR CLTX TARSAL DISLC OTH/THN TALOTARSAL W/ANES

Professional

Both

$696.00

Service Code	HCPCS 28545
Min. Negotiated Rate	$179.77
Max. Negotiated Rate	$656.68
Rate for Payer: Aetna Commercial	$354.16
Rate for Payer: BCBS Complete	$188.76
Rate for Payer: BCBS Trust/PPO	$656.68
Rate for Payer: Cash Price	$556.80
Rate for Payer: Cash Price	$556.80
Rate for Payer: Mclaren Medicaid	$179.77
Rate for Payer: Meridian Medicaid	$188.76
Rate for Payer: Priority Health Choice Medicaid	$179.77
Rate for Payer: Priority Health Cigna Priority Health	$487.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$423.32
Rate for Payer: Priority Health Narrow Network	$423.32
Rate for Payer: Priority Health SBD	$423.32

PR CLTX TIBIAL FX PROXIMAL W/O MANIPULATION

Professional

Both

$826.00

Service Code	HCPCS 27530
Min. Negotiated Rate	$192.98
Max. Negotiated Rate	$1,234.64
Rate for Payer: Aetna Commercial	$379.22
Rate for Payer: BCBS Complete	$202.63
Rate for Payer: BCBS Trust/PPO	$1,234.64
Rate for Payer: Cash Price	$660.80
Rate for Payer: Cash Price	$660.80
Rate for Payer: Mclaren Medicaid	$192.98
Rate for Payer: Meridian Medicaid	$202.63
Rate for Payer: Priority Health Choice Medicaid	$192.98
Rate for Payer: Priority Health Cigna Priority Health	$578.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$454.48
Rate for Payer: Priority Health Narrow Network	$454.48
Rate for Payer: Priority Health SBD	$454.48

PR CLTX TIBIAL FX PROXIMAL W/WO MANJ W/SKEL TRACJ

Professional

Both

$1,114.00

Service Code	HCPCS 27532
Min. Negotiated Rate	$378.71
Max. Negotiated Rate	$936.15
Rate for Payer: Aetna Commercial	$769.38
Rate for Payer: BCBS Complete	$397.65
Rate for Payer: BCBS Trust/PPO	$936.15
Rate for Payer: Cash Price	$891.20
Rate for Payer: Cash Price	$891.20
Rate for Payer: Mclaren Medicaid	$378.71
Rate for Payer: Meridian Medicaid	$397.65
Rate for Payer: Priority Health Choice Medicaid	$378.71
Rate for Payer: Priority Health Cigna Priority Health	$779.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$896.19
Rate for Payer: Priority Health Narrow Network	$896.19
Rate for Payer: Priority Health SBD	$896.19

PR CLTX TIBIAL SHAFT FX W/MANJ W/WO SKEL TRACJ

Professional

Both

$1,758.00

Service Code	HCPCS 27752
Min. Negotiated Rate	$321.63
Max. Negotiated Rate	$3,450.64
Rate for Payer: Aetna Commercial	$655.97
Rate for Payer: BCBS Complete	$337.71
Rate for Payer: BCBS Trust/PPO	$3,450.64
Rate for Payer: Cash Price	$1,406.40
Rate for Payer: Cash Price	$1,406.40
Rate for Payer: Mclaren Medicaid	$321.63
Rate for Payer: Meridian Medicaid	$337.71
Rate for Payer: Priority Health Choice Medicaid	$321.63
Rate for Payer: Priority Health Cigna Priority Health	$1,230.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$763.42
Rate for Payer: Priority Health Narrow Network	$763.42
Rate for Payer: Priority Health SBD	$763.42

PR CLTX TIBIAL SHAFT FX W/O MANIPULATION

Professional

Both

$903.00

Service Code	HCPCS 27750
Min. Negotiated Rate	$215.13
Max. Negotiated Rate	$632.10
Rate for Payer: Aetna Commercial	$426.43
Rate for Payer: BCBS Complete	$225.89
Rate for Payer: BCBS Trust/PPO	$565.81
Rate for Payer: Cash Price	$722.40
Rate for Payer: Cash Price	$722.40
Rate for Payer: Mclaren Medicaid	$215.13
Rate for Payer: Meridian Medicaid	$225.89
Rate for Payer: Priority Health Choice Medicaid	$215.13
Rate for Payer: Priority Health Cigna Priority Health	$632.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$506.56
Rate for Payer: Priority Health Narrow Network	$506.56
Rate for Payer: Priority Health SBD	$506.56

PR CLTX TRANS-SCAPHOPRILUNAR TYP FX DISLC W/MANJ

Professional

Both

$876.00

Service Code	HCPCS 25680
Min. Negotiated Rate	$348.68
Max. Negotiated Rate	$1,480.30
Rate for Payer: Aetna Commercial	$702.57
Rate for Payer: BCBS Complete	$366.11
Rate for Payer: BCBS Trust/PPO	$1,480.30
Rate for Payer: Cash Price	$700.80
Rate for Payer: Cash Price	$700.80
Rate for Payer: Mclaren Medicaid	$348.68
Rate for Payer: Meridian Medicaid	$366.11
Rate for Payer: Priority Health Choice Medicaid	$348.68
Rate for Payer: Priority Health Cigna Priority Health	$613.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$825.21
Rate for Payer: Priority Health Narrow Network	$825.21
Rate for Payer: Priority Health SBD	$825.21

Know your out-of-pocket cost for care.

All Charges