Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PR CORPORA CAVERNOSA-SAPHENOUS VEIN SHUNT UNI/BI

Professional

Both

$1,322.00

Service Code	HCPCS 54420
Min. Negotiated Rate	$447.73
Max. Negotiated Rate	$2,612.13
Rate for Payer: Aetna Commercial	$903.25
Rate for Payer: BCBS Complete	$470.12
Rate for Payer: BCBS Trust/PPO	$2,612.13
Rate for Payer: Cash Price	$1,057.60
Rate for Payer: Cash Price	$1,057.60
Rate for Payer: Mclaren Medicaid	$447.73
Rate for Payer: Meridian Medicaid	$470.12
Rate for Payer: Priority Health Choice Medicaid	$447.73
Rate for Payer: Priority Health Cigna Priority Health	$925.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,121.24
Rate for Payer: Priority Health Narrow Network	$1,121.24
Rate for Payer: Priority Health SBD	$1,121.24

PR CORRECT BUNION,SIMPLE

Professional

Both

$1,357.00

Service Code	HCPCS 28290
Min. Negotiated Rate	$542.80
Max. Negotiated Rate	$949.90
Rate for Payer: BCBS Complete	$542.80
Rate for Payer: Cash Price	$1,085.60
Rate for Payer: Priority Health Cigna Priority Health	$949.90

PR CORRECTION COCK-UP 5TH TOE W/PLASTIC CLOSURE

Professional

Both

$920.00

Service Code	HCPCS 28286
Min. Negotiated Rate	$192.13
Max. Negotiated Rate	$2,002.26
Rate for Payer: Aetna Commercial	$390.83
Rate for Payer: BCBS Complete	$201.74
Rate for Payer: BCBS Trust/PPO	$2,002.26
Rate for Payer: Cash Price	$736.00
Rate for Payer: Cash Price	$736.00
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	$644.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$449.89
Rate for Payer: Priority Health Narrow Network	$449.89
Rate for Payer: Priority Health SBD	$449.89

PR CORRECTION HAMMERTOE

Professional

Both

$937.00

Service Code	HCPCS 28285
Min. Negotiated Rate	$249.85
Max. Negotiated Rate	$1,673.65
Rate for Payer: Aetna Commercial	$502.98
Rate for Payer: BCBS Complete	$262.34
Rate for Payer: BCBS Trust/PPO	$1,673.65
Rate for Payer: Cash Price	$749.60
Rate for Payer: Cash Price	$749.60
Rate for Payer: Mclaren Medicaid	$249.85
Rate for Payer: Meridian Medicaid	$262.34
Rate for Payer: Priority Health Choice Medicaid	$249.85
Rate for Payer: Priority Health Cigna Priority Health	$655.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$586.23
Rate for Payer: Priority Health Narrow Network	$586.23
Rate for Payer: Priority Health SBD	$586.23

PR CORRECTION INVERTED NIPPLES

Professional

Both

$1,623.00

Service Code	HCPCS 19355
Min. Negotiated Rate	$85.82
Max. Negotiated Rate	$1,136.10
Rate for Payer: Aetna Commercial	$666.64
Rate for Payer: BCBS Complete	$415.77
Rate for Payer: BCBS Trust/PPO	$85.82
Rate for Payer: Cash Price	$1,298.40
Rate for Payer: Cash Price	$1,298.40
Rate for Payer: Mclaren Medicaid	$395.97
Rate for Payer: Meridian Medicaid	$415.77
Rate for Payer: Priority Health Choice Medicaid	$395.97
Rate for Payer: Priority Health Cigna Priority Health	$1,136.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$760.42
Rate for Payer: Priority Health Narrow Network	$760.42
Rate for Payer: Priority Health SBD	$760.42

PR CORRECTION TRICHIASIS EPILATION FORCEPS ONLY

Professional

Both

$141.00

Service Code	HCPCS 67820
Min. Negotiated Rate	$14.06
Max. Negotiated Rate	$668.83
Rate for Payer: Aetna Commercial	$29.30
Rate for Payer: BCBS Complete	$14.76
Rate for Payer: BCBS Trust/PPO	$668.83
Rate for Payer: Cash Price	$112.80
Rate for Payer: Cash Price	$112.80
Rate for Payer: Mclaren Medicaid	$14.06
Rate for Payer: Meridian Medicaid	$14.76
Rate for Payer: Priority Health Choice Medicaid	$14.06
Rate for Payer: Priority Health Cigna Priority Health	$98.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$38.06
Rate for Payer: Priority Health Narrow Network	$38.06
Rate for Payer: Priority Health SBD	$38.06

PR CORRJ HALLUX VALGUS W/SESMDC W/1METAR MEDIAL CNF

Professional

Both

$1,939.00

Service Code	HCPCS 28297
Min. Negotiated Rate	$387.45
Max. Negotiated Rate	$1,357.30
Rate for Payer: Aetna Commercial	$799.03
Rate for Payer: BCBS Complete	$406.82
Rate for Payer: BCBS Trust/PPO	$1,304.37
Rate for Payer: Cash Price	$1,551.20
Rate for Payer: Cash Price	$1,551.20
Rate for Payer: Mclaren Medicaid	$387.45
Rate for Payer: Meridian Medicaid	$406.82
Rate for Payer: Priority Health Choice Medicaid	$387.45
Rate for Payer: Priority Health Cigna Priority Health	$1,357.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$918.15
Rate for Payer: Priority Health Narrow Network	$918.15
Rate for Payer: Priority Health SBD	$918.15

PR CORRJ HALLUX VALGUS W/SESMDC W/2 OSTEOT

Professional

Both

$2,359.00

Service Code	HCPCS 28299
Min. Negotiated Rate	$383.61
Max. Negotiated Rate	$1,651.30
Rate for Payer: Aetna Commercial	$775.94
Rate for Payer: BCBS Complete	$402.79
Rate for Payer: BCBS Trust/PPO	$1,113.66
Rate for Payer: Cash Price	$1,887.20
Rate for Payer: Cash Price	$1,887.20
Rate for Payer: Mclaren Medicaid	$383.61
Rate for Payer: Meridian Medicaid	$402.79
Rate for Payer: Priority Health Choice Medicaid	$383.61
Rate for Payer: Priority Health Cigna Priority Health	$1,651.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$900.27
Rate for Payer: Priority Health Narrow Network	$900.27
Rate for Payer: Priority Health SBD	$900.27

PR CORRJ HALLUX VALGUS W/SESMDC W/DIST METAR OSTEOT

Professional

Both

$2,197.00

Service Code	HCPCS 28296
Min. Negotiated Rate	$330.79
Max. Negotiated Rate	$1,537.90
Rate for Payer: Aetna Commercial	$677.65
Rate for Payer: BCBS Complete	$347.33
Rate for Payer: BCBS Trust/PPO	$1,186.56
Rate for Payer: Cash Price	$1,757.60
Rate for Payer: Cash Price	$1,757.60
Rate for Payer: Mclaren Medicaid	$330.79
Rate for Payer: Meridian Medicaid	$347.33
Rate for Payer: Priority Health Choice Medicaid	$330.79
Rate for Payer: Priority Health Cigna Priority Health	$1,537.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$778.74
Rate for Payer: Priority Health Narrow Network	$778.74
Rate for Payer: Priority Health SBD	$778.74

PR CORRJ HALLUX VALGUS W/SESMDC W/PROX METAR OSTEOT

Professional

Both

$1,612.00

Service Code	HCPCS 28295
Min. Negotiated Rate	$388.30
Max. Negotiated Rate	$1,128.40
Rate for Payer: Aetna Commercial	$819.40
Rate for Payer: BCBS Complete	$407.72
Rate for Payer: BCBS Trust/PPO	$982.11
Rate for Payer: Cash Price	$1,289.60
Rate for Payer: Cash Price	$1,289.60
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	$1,128.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$931.42
Rate for Payer: Priority Health Narrow Network	$931.42
Rate for Payer: Priority Health SBD	$931.42

PR CORRJ HALLUX VALGUS W/SESMDC W/PROX PHLNX OSTEOT

Professional

Both

$1,874.00

Service Code	HCPCS 28298
Min. Negotiated Rate	$327.59
Max. Negotiated Rate	$1,491.48
Rate for Payer: Aetna Commercial	$662.21
Rate for Payer: BCBS Complete	$343.97
Rate for Payer: BCBS Trust/PPO	$1,491.48
Rate for Payer: Cash Price	$1,499.20
Rate for Payer: Cash Price	$1,499.20
Rate for Payer: Mclaren Medicaid	$327.59
Rate for Payer: Meridian Medicaid	$343.97
Rate for Payer: Priority Health Choice Medicaid	$327.59
Rate for Payer: Priority Health Cigna Priority Health	$1,311.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$769.04
Rate for Payer: Priority Health Narrow Network	$769.04
Rate for Payer: Priority Health SBD	$769.04

PR CORRJ HALLUX VALGUS W/SESMDC W/RESCJ PROX PHAL

Professional

Both

$1,745.00

Service Code	HCPCS 28292
Min. Negotiated Rate	$313.54
Max. Negotiated Rate	$1,544.75
Rate for Payer: Aetna Commercial	$635.54
Rate for Payer: BCBS Complete	$329.22
Rate for Payer: BCBS Trust/PPO	$1,544.75
Rate for Payer: Cash Price	$1,396.00
Rate for Payer: Cash Price	$1,396.00
Rate for Payer: Mclaren Medicaid	$313.54
Rate for Payer: Meridian Medicaid	$329.22
Rate for Payer: Priority Health Choice Medicaid	$313.54
Rate for Payer: Priority Health Cigna Priority Health	$1,221.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$734.83
Rate for Payer: Priority Health Narrow Network	$734.83
Rate for Payer: Priority Health SBD	$734.83

PR CORRJ HLX VLGS BNCTY SESMDC JOINT ARTHRODESIS

Facility

$1,939.00

Service Code	CPT 28297
Hospital Charge Code	28297
Min. Negotiated Rate	$1,221.57
Max. Negotiated Rate	$1,745.10
Rate for Payer: Aetna Commercial	$1,648.15
Rate for Payer: Aetna New Business (MI Preferred)	$1,260.35
Rate for Payer: Cash Price	$1,551.20
Rate for Payer: Cofinity Commercial	$1,357.30
Rate for Payer: Cofinity Commercial	$1,667.54
Rate for Payer: Healthscope Commercial	$1,745.10
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,648.15
Rate for Payer: PHP Commercial	$1,648.15
Rate for Payer: Priority Health Cigna Priority Health	$1,357.30
Rate for Payer: Priority Health SBD	$1,221.57

PR CORRJ HLX VLGS BNCTY SESMDC JOINT ARTHRODESIS

Facility

$1,939.00

Service Code	CPT 28297
Hospital Charge Code	28297
Min. Negotiated Rate	$595.62
Max. Negotiated Rate	$7,957.04
Rate for Payer: Aetna Commercial	$1,648.15
Rate for Payer: Aetna Medicare	$6,620.26
Rate for Payer: Aetna New Business (MI Preferred)	$1,260.35
Rate for Payer: Allen County Amish Medical Aid Commercial	$7,957.04
Rate for Payer: Amish Plain Church Group Commercial	$7,957.04
Rate for Payer: BCBS Complete	$3,656.42
Rate for Payer: BCBS MAPPO	$6,365.63
Rate for Payer: BCBS Trust/PPO	$3,671.58
Rate for Payer: BCN Medicare Advantage	$6,365.63
Rate for Payer: Cash Price	$1,551.20
Rate for Payer: Cash Price	$1,551.20
Rate for Payer: Cofinity Commercial	$1,667.54
Rate for Payer: Cofinity Commercial	$1,357.30
Rate for Payer: Health Alliance Plan Medicare Advantage	$6,365.63
Rate for Payer: Healthscope Commercial	$1,745.10
Rate for Payer: Mclaren Medicaid	$3,482.00
Rate for Payer: Mclaren Medicare	$6,365.63
Rate for Payer: Meridian Medicaid	$3,656.42
Rate for Payer: Meridian Wellcare - Medicare Advantage	$6,683.91
Rate for Payer: MI Amish Medical Board Commercial	$7,320.47
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,648.15
Rate for Payer: PACE Medicare	$6,047.35
Rate for Payer: PACE SWMI	$6,365.63
Rate for Payer: PHP Commercial	$1,648.15
Rate for Payer: PHP Medicare Advantage	$6,365.63
Rate for Payer: Priority Health Choice Medicaid	$3,482.00
Rate for Payer: Priority Health Cigna Priority Health	$1,357.30
Rate for Payer: Priority Health Medicare	$6,365.63
Rate for Payer: Priority Health SBD	$1,221.57
Rate for Payer: Railroad Medicare Medicare	$6,365.63
Rate for Payer: UHC All Payor (Choice/PPO)	$655.18
Rate for Payer: UHC Dual Complete DSNP	$6,365.63
Rate for Payer: UHC Exchange	$595.62
Rate for Payer: UHC Medicare Advantage	$6,556.60
Rate for Payer: VA VA	$6,365.63

PR CORRJ MALROTATION BANDS&/RDCTJ VOLVULUS

Professional

Both

$3,110.00

Service Code	HCPCS 44055
Min. Negotiated Rate	$949.55
Max. Negotiated Rate	$2,603.55
Rate for Payer: Aetna Commercial	$2,013.07
Rate for Payer: BCBS Complete	$997.03
Rate for Payer: BCBS Trust/PPO	$1,321.81
Rate for Payer: Cash Price	$2,488.00
Rate for Payer: Cash Price	$2,488.00
Rate for Payer: Mclaren Medicaid	$949.55
Rate for Payer: Meridian Medicaid	$997.03
Rate for Payer: Priority Health Choice Medicaid	$949.55
Rate for Payer: Priority Health Cigna Priority Health	$2,177.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,603.55
Rate for Payer: Priority Health Narrow Network	$2,603.55
Rate for Payer: Priority Health SBD	$2,603.55

PR COSMETIC CORRECTION OF INVERTED NIPPLES

Professional

Both

$1,500.00

Service Code	HCPCS 00557
Hospital Revenue Code	990
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$1,050.00
Rate for Payer: BCBS Complete	$600.00
Rate for Payer: Cash Price	$1,200.00
Rate for Payer: Priority Health Cigna Priority Health	$1,050.00

PR COSMETIC SCLEROTHERAPY/LASER

Professional

Both

$250.00

Service Code	HCPCS 00122
Hospital Revenue Code	960
Min. Negotiated Rate	$100.00
Max. Negotiated Rate	$175.00
Rate for Payer: BCBS Complete	$100.00
Rate for Payer: Cash Price	$200.00
Rate for Payer: Priority Health Cigna Priority Health	$175.00

PR COSMETIC SCLEROTHERAPY/LASER/F/U TREATMENT

Professional

Both

$75.00

Service Code	HCPCS 00123
Hospital Revenue Code	960
Min. Negotiated Rate	$30.00
Max. Negotiated Rate	$52.50
Rate for Payer: BCBS Complete	$30.00
Rate for Payer: Cash Price	$60.00
Rate for Payer: Priority Health Cigna Priority Health	$52.50

PR COSTOVERTEBRAL DCMPRN SPINAL CORD THORACIC 1 SEG

Professional

Both

$6,133.00

Service Code	HCPCS 63064
Min. Negotiated Rate	$631.85
Max. Negotiated Rate	$4,293.10
Rate for Payer: Aetna Commercial	$2,309.28
Rate for Payer: BCBS Complete	$1,205.69
Rate for Payer: BCBS Trust/PPO	$631.85
Rate for Payer: Cash Price	$4,906.40
Rate for Payer: Cash Price	$4,906.40
Rate for Payer: Mclaren Medicaid	$1,148.28
Rate for Payer: Meridian Medicaid	$1,205.69
Rate for Payer: Priority Health Choice Medicaid	$1,148.28
Rate for Payer: Priority Health Cigna Priority Health	$4,293.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$3,038.93
Rate for Payer: Priority Health Narrow Network	$3,038.93
Rate for Payer: Priority Health SBD	$3,038.93

PR COSTOVERTEBRAL DCMPRN SPINE CORD THORACIC EA SEG

Professional

Both

$2,103.00

Service Code	HCPCS 63066
Min. Negotiated Rate	$131.42
Max. Negotiated Rate	$1,472.10
Rate for Payer: Aetna Commercial	$266.49
Rate for Payer: BCBS Complete	$137.99
Rate for Payer: BCBS Trust/PPO	$766.04
Rate for Payer: Cash Price	$1,682.40
Rate for Payer: Cash Price	$1,682.40
Rate for Payer: Mclaren Medicaid	$131.42
Rate for Payer: Meridian Medicaid	$137.99
Rate for Payer: Priority Health Choice Medicaid	$131.42
Rate for Payer: Priority Health Cigna Priority Health	$1,472.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$348.23
Rate for Payer: Priority Health Narrow Network	$348.23
Rate for Payer: Priority Health SBD	$348.23

PR COUDE TIP URINARY CATHETER

Professional

Both

$8.00

Service Code	HCPCS A4352
Min. Negotiated Rate	$3.20
Max. Negotiated Rate	$5.60
Rate for Payer: Aetna Commercial	$5.09
Rate for Payer: BCBS Complete	$3.20
Rate for Payer: Cash Price	$6.40
Rate for Payer: Cash Price	$6.40
Rate for Payer: Priority Health Cigna Priority Health	$5.60

PR COUNSEL IMMUNE <21 16-30 M

Professional

Both

$45.00

Service Code	HCPCS G0314
Min. Negotiated Rate	$18.00
Max. Negotiated Rate	$31.50
Rate for Payer: BCBS Complete	$18.00
Rate for Payer: Cash Price	$36.00
Rate for Payer: Priority Health Cigna Priority Health	$31.50

PR COUNSEL IMMUNE <21 5-15 M

Professional

Both

$30.00

Service Code	HCPCS G0315
Min. Negotiated Rate	$12.00
Max. Negotiated Rate	$21.00
Rate for Payer: BCBS Complete	$12.00
Rate for Payer: Cash Price	$24.00
Rate for Payer: Priority Health Cigna Priority Health	$21.00

PR COUNSEL LUNG SCRN LDCT

Professional

Both

$53.00

Service Code	HCPCS G0296
Min. Negotiated Rate	$21.20
Max. Negotiated Rate	$735.92
Rate for Payer: Aetna Commercial	$26.13
Rate for Payer: BCBS Complete	$21.20
Rate for Payer: BCBS Trust/PPO	$735.92
Rate for Payer: Cash Price	$42.40
Rate for Payer: Cash Price	$42.40
Rate for Payer: Priority Health Cigna Priority Health	$37.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$34.13
Rate for Payer: Priority Health Narrow Network	$34.13
Rate for Payer: Priority Health SBD	$34.13

PR CPAP VENTILATION CPAP INITIATION&MGMT

Professional

Both

$228.00

Service Code	HCPCS 94660
Min. Negotiated Rate	$23.43
Max. Negotiated Rate	$313.28
Rate for Payer: Aetna Commercial	$41.58
Rate for Payer: BCBS Complete	$24.60
Rate for Payer: BCBS Trust/PPO	$313.28
Rate for Payer: Cash Price	$182.40
Rate for Payer: Cash Price	$182.40
Rate for Payer: Mclaren Medicaid	$23.43
Rate for Payer: Meridian Medicaid	$24.60
Rate for Payer: Priority Health Choice Medicaid	$23.43
Rate for Payer: Priority Health Cigna Priority Health	$159.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$48.96
Rate for Payer: Priority Health Narrow Network	$48.96
Rate for Payer: Priority Health SBD	$48.96

Know your out-of-pocket cost for care.

All Charges