Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PR CLTX TRIMALLEOLAR ANKLE FX W/MANIPULATION

Professional

Both

$1,663.00

Service Code	HCPCS 27818
Min. Negotiated Rate	$290.32
Max. Negotiated Rate	$3,352.06
Rate for Payer: Aetna Commercial	$582.68
Rate for Payer: BCBS Complete	$304.84
Rate for Payer: BCBS Trust/PPO	$3,352.06
Rate for Payer: Cash Price	$1,330.40
Rate for Payer: Cash Price	$1,330.40
Rate for Payer: Mclaren Medicaid	$290.32
Rate for Payer: Meridian Medicaid	$304.84
Rate for Payer: Priority Health Choice Medicaid	$290.32
Rate for Payer: Priority Health Cigna Priority Health	$1,164.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$685.81
Rate for Payer: Priority Health Narrow Network	$685.81
Rate for Payer: Priority Health SBD	$685.81

PR CLTX TRIMALLEOLAR ANKLE FX W/O MANIPULATION

Professional

Both

$573.00

Service Code	HCPCS 27816
Min. Negotiated Rate	$196.17
Max. Negotiated Rate	$2,170.78
Rate for Payer: Aetna Commercial	$388.50
Rate for Payer: BCBS Complete	$205.98
Rate for Payer: BCBS Trust/PPO	$2,170.78
Rate for Payer: Cash Price	$458.40
Rate for Payer: Cash Price	$458.40
Rate for Payer: Mclaren Medicaid	$196.17
Rate for Payer: Meridian Medicaid	$205.98
Rate for Payer: Priority Health Choice Medicaid	$196.17
Rate for Payer: Priority Health Cigna Priority Health	$401.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$460.60
Rate for Payer: Priority Health Narrow Network	$460.60
Rate for Payer: Priority Health SBD	$460.60

PR CLTX VRT BDY FX W/O MANJ REQ&W/CSTING/BRACING

Professional

Both

$877.00

Service Code	HCPCS 22310
Min. Negotiated Rate	$193.83
Max. Negotiated Rate	$613.90
Rate for Payer: Aetna Commercial	$391.04
Rate for Payer: BCBS Complete	$203.52
Rate for Payer: BCBS Trust/PPO	$368.43
Rate for Payer: Cash Price	$701.60
Rate for Payer: Cash Price	$701.60
Rate for Payer: Mclaren Medicaid	$193.83
Rate for Payer: Meridian Medicaid	$203.52
Rate for Payer: Priority Health Choice Medicaid	$193.83
Rate for Payer: Priority Health Cigna Priority Health	$613.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$459.08
Rate for Payer: Priority Health Narrow Network	$459.08
Rate for Payer: Priority Health SBD	$459.08

PR CLTX VRT FX&/DISLC CSTING/BRACING MANJ/TRCJ

Professional

Both

$1,276.00

Service Code	HCPCS 22315
Min. Negotiated Rate	$368.43
Max. Negotiated Rate	$1,187.78
Rate for Payer: Aetna Commercial	$1,027.22
Rate for Payer: BCBS Complete	$530.05
Rate for Payer: BCBS Trust/PPO	$368.43
Rate for Payer: Cash Price	$1,020.80
Rate for Payer: Cash Price	$1,020.80
Rate for Payer: Mclaren Medicaid	$504.81
Rate for Payer: Meridian Medicaid	$530.05
Rate for Payer: Priority Health Choice Medicaid	$504.81
Rate for Payer: Priority Health Cigna Priority Health	$893.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,187.78
Rate for Payer: Priority Health Narrow Network	$1,187.78
Rate for Payer: Priority Health SBD	$1,187.78

PR CMBND ANTERPOST COLPORRAPHY W/CYSTO

Professional

Both

$1,989.00

Service Code	HCPCS 57260
Min. Negotiated Rate	$499.91
Max. Negotiated Rate	$1,612.37
Rate for Payer: Aetna Commercial	$929.36
Rate for Payer: BCBS Complete	$524.91
Rate for Payer: BCBS Trust/PPO	$1,612.37
Rate for Payer: Cash Price	$1,591.20
Rate for Payer: Cash Price	$1,591.20
Rate for Payer: Mclaren Medicaid	$499.91
Rate for Payer: Meridian Medicaid	$524.91
Rate for Payer: Priority Health Choice Medicaid	$499.91
Rate for Payer: Priority Health Cigna Priority Health	$1,392.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,105.91
Rate for Payer: Priority Health Narrow Network	$1,105.91
Rate for Payer: Priority Health SBD	$1,105.91

PR CMBND ANTERPOST COLPORRAPHY W/CYSTO W/NTRCL RPR

Professional

Both

$2,561.00

Service Code	HCPCS 57265
Min. Negotiated Rate	$558.91
Max. Negotiated Rate	$1,792.70
Rate for Payer: Aetna Commercial	$1,042.83
Rate for Payer: BCBS Complete	$586.86
Rate for Payer: BCBS Trust/PPO	$1,697.43
Rate for Payer: Cash Price	$2,048.80
Rate for Payer: Cash Price	$2,048.80
Rate for Payer: Mclaren Medicaid	$558.91
Rate for Payer: Meridian Medicaid	$586.86
Rate for Payer: Priority Health Choice Medicaid	$558.91
Rate for Payer: Priority Health Cigna Priority Health	$1,792.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,238.00
Rate for Payer: Priority Health Narrow Network	$1,238.00
Rate for Payer: Priority Health SBD	$1,238.00

PR CNTRST NJX RAD EVAL CTR VAD FLUOR IMG&REPRT

Professional

Both

$387.00

Service Code	HCPCS 36598
Min. Negotiated Rate	$22.15
Max. Negotiated Rate	$669.36
Rate for Payer: Aetna Commercial	$47.92
Rate for Payer: BCBS Complete	$23.26
Rate for Payer: BCBS Trust/PPO	$669.36
Rate for Payer: Cash Price	$309.60
Rate for Payer: Cash Price	$309.60
Rate for Payer: Mclaren Medicaid	$22.15
Rate for Payer: Meridian Medicaid	$23.26
Rate for Payer: Priority Health Choice Medicaid	$22.15
Rate for Payer: Priority Health Cigna Priority Health	$270.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$55.85
Rate for Payer: Priority Health Narrow Network	$55.85
Rate for Payer: Priority Health SBD	$55.85

PR COCCYGECTOMY PRIMARY

Professional

Both

$1,913.00

Service Code	HCPCS 27080
Min. Negotiated Rate	$329.72
Max. Negotiated Rate	$1,339.10
Rate for Payer: Aetna Commercial	$681.94
Rate for Payer: BCBS Complete	$346.21
Rate for Payer: BCBS Trust/PPO	$530.94
Rate for Payer: Cash Price	$1,530.40
Rate for Payer: Cash Price	$1,530.40
Rate for Payer: Mclaren Medicaid	$329.72
Rate for Payer: Meridian Medicaid	$346.21
Rate for Payer: Priority Health Choice Medicaid	$329.72
Rate for Payer: Priority Health Cigna Priority Health	$1,339.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$787.93
Rate for Payer: Priority Health Narrow Network	$787.93
Rate for Payer: Priority Health SBD	$787.93

PR COCHLEAR DEVICE/SOFT BAND FITTING FEE

Professional

Both

$500.00

Service Code	HCPCS 00593
Hospital Revenue Code	990
Min. Negotiated Rate	$200.00
Max. Negotiated Rate	$350.00
Rate for Payer: BCBS Complete	$200.00
Rate for Payer: Cash Price	$400.00
Rate for Payer: Priority Health Cigna Priority Health	$350.00

PR COCM BY RHC/FQHC 60 MIN MO

Professional

Both

$347.00

Service Code	HCPCS G0512
Min. Negotiated Rate	$138.80
Max. Negotiated Rate	$536.22
Rate for Payer: Aetna Commercial	$148.37
Rate for Payer: BCBS Complete	$138.80
Rate for Payer: BCBS Trust/PPO	$536.22
Rate for Payer: Cash Price	$277.60
Rate for Payer: Cash Price	$277.60
Rate for Payer: Priority Health Cigna Priority Health	$242.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$270.00
Rate for Payer: Priority Health Narrow Network	$270.00
Rate for Payer: Priority Health SBD	$270.00

PR CO DIFFUSING CAPACITY

Professional

Both

$153.00

Service Code	HCPCS 94729
Min. Negotiated Rate	$11.68
Max. Negotiated Rate	$280.00
Rate for Payer: Aetna Commercial	$62.31
Rate for Payer: Aetna Commercial	$62.31
Rate for Payer: BCBS Complete	$61.20
Rate for Payer: BCBS Complete	$6.80
Rate for Payer: BCBS Trust/PPO	$280.00
Rate for Payer: BCBS Trust/PPO	$280.00
Rate for Payer: Cash Price	$13.60
Rate for Payer: Cash Price	$122.40
Rate for Payer: Cash Price	$122.40
Rate for Payer: Cash Price	$13.60
Rate for Payer: Priority Health Cigna Priority Health	$11.90
Rate for Payer: Priority Health Cigna Priority Health	$107.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$11.68
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$11.68
Rate for Payer: Priority Health Narrow Network	$11.68
Rate for Payer: Priority Health Narrow Network	$11.68
Rate for Payer: Priority Health SBD	$75.91
Rate for Payer: Priority Health SBD	$75.91

PR COLCT TOT ABDL W/O PRCTECT W/CONTINENT ILEOST

Professional

Both

$3,765.00

Service Code	HCPCS 44151
Min. Negotiated Rate	$1,369.38
Max. Negotiated Rate	$3,767.73
Rate for Payer: Aetna Commercial	$2,916.77
Rate for Payer: BCBS Complete	$1,437.85
Rate for Payer: BCBS Trust/PPO	$1,395.77
Rate for Payer: Cash Price	$3,012.00
Rate for Payer: Cash Price	$3,012.00
Rate for Payer: Mclaren Medicaid	$1,369.38
Rate for Payer: Meridian Medicaid	$1,437.85
Rate for Payer: Priority Health Choice Medicaid	$1,369.38
Rate for Payer: Priority Health Cigna Priority Health	$2,635.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$3,767.73
Rate for Payer: Priority Health Narrow Network	$3,767.73
Rate for Payer: Priority Health SBD	$3,767.73

PR COLCT TOT ABDL W/O PRCTECT W/ILEOST/ILEOPXTS

Professional

Both

$4,521.00

Service Code	HCPCS 44150
Min. Negotiated Rate	$965.20
Max. Negotiated Rate	$3,240.31
Rate for Payer: Aetna Commercial	$2,499.17
Rate for Payer: BCBS Complete	$1,236.33
Rate for Payer: BCBS Trust/PPO	$965.20
Rate for Payer: Cash Price	$3,616.80
Rate for Payer: Cash Price	$3,616.80
Rate for Payer: Mclaren Medicaid	$1,177.46
Rate for Payer: Meridian Medicaid	$1,236.33
Rate for Payer: Priority Health Choice Medicaid	$1,177.46
Rate for Payer: Priority Health Cigna Priority Health	$3,164.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$3,240.31
Rate for Payer: Priority Health Narrow Network	$3,240.31
Rate for Payer: Priority Health SBD	$3,240.31

PR COLCT TTL ABD W/PRCTECT ILEOANAL ANAST & RSVR

Professional

Both

$4,607.00

Service Code	HCPCS 44158
Min. Negotiated Rate	$565.81
Max. Negotiated Rate	$3,924.13
Rate for Payer: Aetna Commercial	$3,035.01
Rate for Payer: BCBS Complete	$1,498.00
Rate for Payer: BCBS Trust/PPO	$565.81
Rate for Payer: Cash Price	$3,685.60
Rate for Payer: Cash Price	$3,685.60
Rate for Payer: Mclaren Medicaid	$1,426.67
Rate for Payer: Meridian Medicaid	$1,498.00
Rate for Payer: Priority Health Choice Medicaid	$1,426.67
Rate for Payer: Priority Health Cigna Priority Health	$3,224.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$3,924.13
Rate for Payer: Priority Health Narrow Network	$3,924.13
Rate for Payer: Priority Health SBD	$3,924.13

PR COLECTOMY PARTIAL W/ANASTOMOSIS

Facility

$3,798.00

Service Code	CPT 44140
Hospital Charge Code	44140
Hospital Revenue Code	960
Min. Negotiated Rate	$1,315.66
Max. Negotiated Rate	$3,418.20
Rate for Payer: Aetna Commercial	$3,228.30
Rate for Payer: Aetna New Business (MI Preferred)	$2,468.70
Rate for Payer: BCBS Complete	$1,519.20
Rate for Payer: BCBS Trust/PPO	$2,737.82
Rate for Payer: Cash Price	$3,038.40
Rate for Payer: Cash Price	$3,038.40
Rate for Payer: Cofinity Commercial	$3,266.28
Rate for Payer: Cofinity Commercial	$2,658.60
Rate for Payer: Healthscope Commercial	$3,418.20
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3,228.30
Rate for Payer: PHP Commercial	$3,228.30
Rate for Payer: Priority Health Cigna Priority Health	$2,658.60
Rate for Payer: Priority Health SBD	$2,392.74
Rate for Payer: UHC All Payor (Choice/PPO)	$1,447.23
Rate for Payer: UHC Exchange	$1,315.66

PR COLECTOMY PARTIAL W/ANASTOMOSIS

Professional

Both

$3,798.00

Service Code	HCPCS 44140
Min. Negotiated Rate	$855.83
Max. Negotiated Rate	$2,658.60
Rate for Payer: Aetna Commercial	$1,809.58
Rate for Payer: BCBS Complete	$898.62
Rate for Payer: BCBS Trust/PPO	$1,076.15
Rate for Payer: Cash Price	$3,038.40
Rate for Payer: Cash Price	$3,038.40
Rate for Payer: Mclaren Medicaid	$855.83
Rate for Payer: Meridian Medicaid	$898.62
Rate for Payer: Priority Health Choice Medicaid	$855.83
Rate for Payer: Priority Health Cigna Priority Health	$2,658.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,349.54
Rate for Payer: Priority Health Narrow Network	$2,349.54
Rate for Payer: Priority Health SBD	$2,349.54

PR COLECTOMY PARTIAL W/ANASTOMOSIS

Professional

Both

$3,798.00

Service Code	HCPCS 44140
Hospital Charge Code	44140
Min. Negotiated Rate	$855.83
Max. Negotiated Rate	$2,658.60
Rate for Payer: Aetna Commercial	$1,809.58
Rate for Payer: BCBS Complete	$898.62
Rate for Payer: BCBS Trust/PPO	$1,076.15
Rate for Payer: Cash Price	$3,038.40
Rate for Payer: Cash Price	$3,038.40
Rate for Payer: Mclaren Medicaid	$855.83
Rate for Payer: Meridian Medicaid	$898.62
Rate for Payer: Priority Health Choice Medicaid	$855.83
Rate for Payer: Priority Health Cigna Priority Health	$2,658.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,349.54
Rate for Payer: Priority Health Narrow Network	$2,349.54
Rate for Payer: Priority Health SBD	$2,349.54

PR COLECTOMY PARTIAL W/ANASTOMOSIS

Facility

$3,798.00

Service Code	CPT 44140
Hospital Charge Code	44140
Hospital Revenue Code	960
Min. Negotiated Rate	$2,392.74
Max. Negotiated Rate	$3,418.20
Rate for Payer: Aetna Commercial	$3,228.30
Rate for Payer: Aetna New Business (MI Preferred)	$2,468.70
Rate for Payer: Cash Price	$3,038.40
Rate for Payer: Cofinity Commercial	$2,658.60
Rate for Payer: Cofinity Commercial	$3,266.28
Rate for Payer: Healthscope Commercial	$3,418.20
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3,228.30
Rate for Payer: PHP Commercial	$3,228.30
Rate for Payer: Priority Health Cigna Priority Health	$2,658.60
Rate for Payer: Priority Health SBD	$2,392.74

PR COLECTOMY PRTL ABDOMINAL & TRANSANAL APPROACH

Professional

Both

$2,698.00

Service Code	HCPCS 44147
Min. Negotiated Rate	$209.74
Max. Negotiated Rate	$3,370.25
Rate for Payer: Aetna Commercial	$2,607.12
Rate for Payer: BCBS Complete	$1,289.12
Rate for Payer: BCBS Trust/PPO	$209.74
Rate for Payer: Cash Price	$2,158.40
Rate for Payer: Cash Price	$2,158.40
Rate for Payer: Mclaren Medicaid	$1,227.73
Rate for Payer: Meridian Medicaid	$1,289.12
Rate for Payer: Priority Health Choice Medicaid	$1,227.73
Rate for Payer: Priority Health Cigna Priority Health	$1,888.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$3,370.25
Rate for Payer: Priority Health Narrow Network	$3,370.25
Rate for Payer: Priority Health SBD	$3,370.25

PR COLECTOMY PRTL W/COLOPROCTOSTOMY

Professional

Both

$3,352.00

Service Code	HCPCS 44145
Min. Negotiated Rate	$122.04
Max. Negotiated Rate	$2,881.06
Rate for Payer: Aetna Commercial	$2,219.92
Rate for Payer: BCBS Complete	$1,100.81
Rate for Payer: BCBS Trust/PPO	$122.04
Rate for Payer: Cash Price	$2,681.60
Rate for Payer: Cash Price	$2,681.60
Rate for Payer: Mclaren Medicaid	$1,048.39
Rate for Payer: Meridian Medicaid	$1,100.81
Rate for Payer: Priority Health Choice Medicaid	$1,048.39
Rate for Payer: Priority Health Cigna Priority Health	$2,346.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,881.06
Rate for Payer: Priority Health Narrow Network	$2,881.06
Rate for Payer: Priority Health SBD	$2,881.06

PR COLECTOMY PRTL W/COLOPROCTOSTOMY & COLOSTOMY

Professional

Both

$5,044.00

Service Code	HCPCS 44146
Min. Negotiated Rate	$166.94
Max. Negotiated Rate	$3,661.89
Rate for Payer: Aetna Commercial	$2,830.09
Rate for Payer: BCBS Complete	$1,399.38
Rate for Payer: BCBS Trust/PPO	$166.94
Rate for Payer: Cash Price	$4,035.20
Rate for Payer: Cash Price	$4,035.20
Rate for Payer: Mclaren Medicaid	$1,332.74
Rate for Payer: Meridian Medicaid	$1,399.38
Rate for Payer: Priority Health Choice Medicaid	$1,332.74
Rate for Payer: Priority Health Cigna Priority Health	$3,530.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$3,661.89
Rate for Payer: Priority Health Narrow Network	$3,661.89
Rate for Payer: Priority Health SBD	$3,661.89

PR COLECTOMY PRTL W/COLOST/ILEOST & MUCOFISTULA

Professional

Both

$3,905.00

Service Code	HCPCS 44144
Min. Negotiated Rate	$89.28
Max. Negotiated Rate	$3,086.86
Rate for Payer: Aetna Commercial	$2,380.76
Rate for Payer: BCBS Complete	$1,177.74
Rate for Payer: BCBS Trust/PPO	$89.28
Rate for Payer: Cash Price	$3,124.00
Rate for Payer: Cash Price	$3,124.00
Rate for Payer: Mclaren Medicaid	$1,121.66
Rate for Payer: Meridian Medicaid	$1,177.74
Rate for Payer: Priority Health Choice Medicaid	$1,121.66
Rate for Payer: Priority Health Cigna Priority Health	$2,733.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$3,086.86
Rate for Payer: Priority Health Narrow Network	$3,086.86
Rate for Payer: Priority Health SBD	$3,086.86

PR COLECTOMY PRTL W/END COLOSTOMY & CLSR DSTL SGMT

Professional

Both

$4,118.00

Service Code	HCPCS 44143
Min. Negotiated Rate	$324.38
Max. Negotiated Rate	$2,893.42
Rate for Payer: Aetna Commercial	$2,239.80
Rate for Payer: BCBS Complete	$1,103.49
Rate for Payer: BCBS Trust/PPO	$324.38
Rate for Payer: Cash Price	$3,294.40
Rate for Payer: Cash Price	$3,294.40
Rate for Payer: Mclaren Medicaid	$1,050.94
Rate for Payer: Meridian Medicaid	$1,103.49
Rate for Payer: Priority Health Choice Medicaid	$1,050.94
Rate for Payer: Priority Health Cigna Priority Health	$2,882.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,893.42
Rate for Payer: Priority Health Narrow Network	$2,893.42
Rate for Payer: Priority Health SBD	$2,893.42

PR COLECTOMY PRTL W/RMVL TERMINAL ILEUM & ILEOCOLOS

Professional

Both

$3,887.00

Service Code	HCPCS 44160
Min. Negotiated Rate	$791.72
Max. Negotiated Rate	$2,720.90
Rate for Payer: Aetna Commercial	$1,670.76
Rate for Payer: BCBS Complete	$831.31
Rate for Payer: BCBS Trust/PPO	$813.05
Rate for Payer: Cash Price	$3,109.60
Rate for Payer: Cash Price	$3,109.60
Rate for Payer: Mclaren Medicaid	$791.72
Rate for Payer: Meridian Medicaid	$831.31
Rate for Payer: Priority Health Choice Medicaid	$791.72
Rate for Payer: Priority Health Cigna Priority Health	$2,720.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,174.33
Rate for Payer: Priority Health Narrow Network	$2,174.33
Rate for Payer: Priority Health SBD	$2,174.33

PR COLECTOMY PRTL W/SKIN LEVEL CECOST/COLOSTOMY

Professional

Both

$3,760.00

Service Code	HCPCS 44141
Min. Negotiated Rate	$244.07
Max. Negotiated Rate	$3,172.11
Rate for Payer: Aetna Commercial	$2,453.21
Rate for Payer: BCBS Complete	$1,211.51
Rate for Payer: BCBS Trust/PPO	$244.07
Rate for Payer: Cash Price	$3,008.00
Rate for Payer: Cash Price	$3,008.00
Rate for Payer: Mclaren Medicaid	$1,153.82
Rate for Payer: Meridian Medicaid	$1,211.51
Rate for Payer: Priority Health Choice Medicaid	$1,153.82
Rate for Payer: Priority Health Cigna Priority Health	$2,632.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$3,172.11
Rate for Payer: Priority Health Narrow Network	$3,172.11
Rate for Payer: Priority Health SBD	$3,172.11

Know your out-of-pocket cost for care.

All Charges