Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PR CRANIECTOMY W/EXCISION TUMOR/LESION SKULL

Professional

Both

$2,685.32

Service Code	HCPCS 61500
Min. Negotiated Rate	$534.64
Max. Negotiated Rate	$2,220.74
Rate for Payer: Aetna Commercial	$1,684.10
Rate for Payer: BCBS Complete	$882.07
Rate for Payer: BCBS Trust/PPO	$534.64
Rate for Payer: Cash Price	$2,148.26
Rate for Payer: Cash Price	$2,148.26
Rate for Payer: Mclaren Medicaid	$840.07
Rate for Payer: Meridian Medicaid	$882.07
Rate for Payer: Priority Health Choice Medicaid	$840.07
Rate for Payer: Priority Health Cigna Priority Health	$1,879.72
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,220.74
Rate for Payer: Priority Health Narrow Network	$2,220.74
Rate for Payer: Priority Health SBD	$2,220.74

PR CRANIEC TREPHINE BONE FLP BRAIN TUMOR SUPRTENTOR

Professional

Both

$4,513.72

Service Code	HCPCS 61510
Min. Negotiated Rate	$455.92
Max. Negotiated Rate	$3,763.68
Rate for Payer: Aetna Commercial	$2,837.36
Rate for Payer: BCBS Complete	$1,500.91
Rate for Payer: BCBS Trust/PPO	$455.92
Rate for Payer: Cash Price	$3,610.98
Rate for Payer: Cash Price	$3,610.98
Rate for Payer: Mclaren Medicaid	$1,429.44
Rate for Payer: Meridian Medicaid	$1,500.91
Rate for Payer: Priority Health Choice Medicaid	$1,429.44
Rate for Payer: Priority Health Cigna Priority Health	$3,159.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$3,763.68
Rate for Payer: Priority Health Narrow Network	$3,763.68
Rate for Payer: Priority Health SBD	$3,763.68

PR CRANIOFACIAL ANT CRANIAL FOSSA W/O ORBITAL EXNTJ

Professional

Both

$5,208.00

Service Code	HCPCS 61580
Min. Negotiated Rate	$901.81
Max. Negotiated Rate	$4,233.66
Rate for Payer: Aetna Commercial	$3,215.20
Rate for Payer: BCBS Complete	$1,673.12
Rate for Payer: BCBS Trust/PPO	$901.81
Rate for Payer: Cash Price	$4,166.40
Rate for Payer: Cash Price	$4,166.40
Rate for Payer: Mclaren Medicaid	$1,593.45
Rate for Payer: Meridian Medicaid	$1,673.12
Rate for Payer: Priority Health Choice Medicaid	$1,593.45
Rate for Payer: Priority Health Cigna Priority Health	$3,645.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$4,233.66
Rate for Payer: Priority Health Narrow Network	$4,233.66
Rate for Payer: Priority Health SBD	$4,233.66

PR CRANIOPLASTY SKULL DEFECT </5 CM DIAMETER

Professional

Both

$5,237.00

Service Code	HCPCS 62140
Min. Negotiated Rate	$330.72
Max. Negotiated Rate	$3,665.90
Rate for Payer: Aetna Commercial	$1,313.67
Rate for Payer: BCBS Complete	$696.68
Rate for Payer: BCBS Trust/PPO	$330.72
Rate for Payer: Cash Price	$4,189.60
Rate for Payer: Cash Price	$4,189.60
Rate for Payer: Mclaren Medicaid	$663.50
Rate for Payer: Meridian Medicaid	$696.68
Rate for Payer: Priority Health Choice Medicaid	$663.50
Rate for Payer: Priority Health Cigna Priority Health	$3,665.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,747.37
Rate for Payer: Priority Health Narrow Network	$1,747.37
Rate for Payer: Priority Health SBD	$1,747.37

PR CRANIOPLASTY SKULL DEFECT >5 CM DIAMETER

Professional

Both

$6,237.00

Service Code	HCPCS 62141
Min. Negotiated Rate	$415.77
Max. Negotiated Rate	$4,365.90
Rate for Payer: Aetna Commercial	$1,476.78
Rate for Payer: BCBS Complete	$780.09
Rate for Payer: BCBS Trust/PPO	$415.77
Rate for Payer: Cash Price	$4,989.60
Rate for Payer: Cash Price	$4,989.60
Rate for Payer: Mclaren Medicaid	$742.94
Rate for Payer: Meridian Medicaid	$780.09
Rate for Payer: Priority Health Choice Medicaid	$742.94
Rate for Payer: Priority Health Cigna Priority Health	$4,365.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,954.04
Rate for Payer: Priority Health Narrow Network	$1,954.04
Rate for Payer: Priority Health SBD	$1,954.04

PR CRANIOPLASTY SKULL DEFECT REPARATIVE BRAIN SURG

Professional

Both

$5,869.00

Service Code	HCPCS 62145
Min. Negotiated Rate	$923.57
Max. Negotiated Rate	$4,108.30
Rate for Payer: Aetna Commercial	$1,818.24
Rate for Payer: BCBS Complete	$969.75
Rate for Payer: BCBS Trust/PPO	$1,261.58
Rate for Payer: Cash Price	$4,695.20
Rate for Payer: Cash Price	$4,695.20
Rate for Payer: Mclaren Medicaid	$923.57
Rate for Payer: Meridian Medicaid	$969.75
Rate for Payer: Priority Health Choice Medicaid	$923.57
Rate for Payer: Priority Health Cigna Priority Health	$4,108.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,424.00
Rate for Payer: Priority Health Narrow Network	$2,424.00
Rate for Payer: Priority Health SBD	$2,424.00

PR CRANIOPLASTY W/AUTOGRAFT </ 5 CM DIAMETER

Professional

Both

$6,252.00

Service Code	HCPCS 62146
Min. Negotiated Rate	$814.51
Max. Negotiated Rate	$4,376.40
Rate for Payer: Aetna Commercial	$1,615.24
Rate for Payer: BCBS Complete	$855.24
Rate for Payer: BCBS Trust/PPO	$1,636.15
Rate for Payer: Cash Price	$5,001.60
Rate for Payer: Cash Price	$5,001.60
Rate for Payer: Mclaren Medicaid	$814.51
Rate for Payer: Meridian Medicaid	$855.24
Rate for Payer: Priority Health Choice Medicaid	$814.51
Rate for Payer: Priority Health Cigna Priority Health	$4,376.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,144.29
Rate for Payer: Priority Health Narrow Network	$2,144.29
Rate for Payer: Priority Health SBD	$2,144.29

PR CRANIOPLASTY W/AUTOGRAFT > 5 CM DIAMETER

Professional

Both

$7,153.00

Service Code	HCPCS 62147
Min. Negotiated Rate	$128.38
Max. Negotiated Rate	$5,007.10
Rate for Payer: Aetna Commercial	$1,834.50
Rate for Payer: BCBS Complete	$964.82
Rate for Payer: BCBS Trust/PPO	$128.38
Rate for Payer: Cash Price	$5,722.40
Rate for Payer: Cash Price	$5,722.40
Rate for Payer: Mclaren Medicaid	$918.88
Rate for Payer: Meridian Medicaid	$964.82
Rate for Payer: Priority Health Choice Medicaid	$918.88
Rate for Payer: Priority Health Cigna Priority Health	$5,007.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,421.18
Rate for Payer: Priority Health Narrow Network	$2,421.18
Rate for Payer: Priority Health SBD	$2,421.18

PR CRANIOT LOBECTOMY OTH/THN TEMPORAL LOBE W/O ECOG

Professional

Both

$7,712.00

Service Code	HCPCS 61540
Min. Negotiated Rate	$611.24
Max. Negotiated Rate	$5,398.40
Rate for Payer: Aetna Commercial	$2,815.85
Rate for Payer: BCBS Complete	$1,481.69
Rate for Payer: BCBS Trust/PPO	$611.24
Rate for Payer: Cash Price	$6,169.60
Rate for Payer: Cash Price	$6,169.60
Rate for Payer: Mclaren Medicaid	$1,411.13
Rate for Payer: Meridian Medicaid	$1,481.69
Rate for Payer: Priority Health Choice Medicaid	$1,411.13
Rate for Payer: Priority Health Cigna Priority Health	$5,398.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$3,718.95
Rate for Payer: Priority Health Narrow Network	$3,718.95
Rate for Payer: Priority Health SBD	$3,718.95

PR CRANIOTOMY EXCISION CRANIOPHARYNGIOMA

Professional

Both

$6,564.86

Service Code	HCPCS 61545
Min. Negotiated Rate	$2,062.05
Max. Negotiated Rate	$5,437.45
Rate for Payer: Aetna Commercial	$4,116.77
Rate for Payer: BCBS Complete	$2,165.15
Rate for Payer: BCBS Trust/PPO	$2,713.35
Rate for Payer: Cash Price	$5,251.89
Rate for Payer: Cash Price	$5,251.89
Rate for Payer: Mclaren Medicaid	$2,062.05
Rate for Payer: Meridian Medicaid	$2,165.15
Rate for Payer: Priority Health Choice Medicaid	$2,062.05
Rate for Payer: Priority Health Cigna Priority Health	$4,595.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$5,437.45
Rate for Payer: Priority Health Narrow Network	$5,437.45
Rate for Payer: Priority Health SBD	$5,437.45

PR CRANIOTOMY FOR ENCEPHALOCELE REPAIR SKULL BASE

Professional

Both

$5,502.00

Service Code	HCPCS 62121
Min. Negotiated Rate	$1,003.23
Max. Negotiated Rate	$3,851.40
Rate for Payer: Aetna Commercial	$2,019.44
Rate for Payer: BCBS Complete	$1,053.39
Rate for Payer: BCBS Trust/PPO	$1,394.18
Rate for Payer: Cash Price	$4,401.60
Rate for Payer: Cash Price	$4,401.60
Rate for Payer: Mclaren Medicaid	$1,003.23
Rate for Payer: Meridian Medicaid	$1,053.39
Rate for Payer: Priority Health Choice Medicaid	$1,003.23
Rate for Payer: Priority Health Cigna Priority Health	$3,851.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,659.55
Rate for Payer: Priority Health Narrow Network	$2,659.55
Rate for Payer: Priority Health SBD	$2,659.55

PR CRANIOT TEMPORAL LOBE W/O ELECTROCORTICOGRAPHY

Professional

Both

$6,928.00

Service Code	HCPCS 61537
Min. Negotiated Rate	$1,588.98
Max. Negotiated Rate	$4,849.60
Rate for Payer: Aetna Commercial	$3,184.49
Rate for Payer: BCBS Complete	$1,668.43
Rate for Payer: BCBS Trust/PPO	$2,057.20
Rate for Payer: Cash Price	$5,542.40
Rate for Payer: Cash Price	$5,542.40
Rate for Payer: Mclaren Medicaid	$1,588.98
Rate for Payer: Meridian Medicaid	$1,668.43
Rate for Payer: Priority Health Choice Medicaid	$1,588.98
Rate for Payer: Priority Health Cigna Priority Health	$4,849.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$4,192.89
Rate for Payer: Priority Health Narrow Network	$4,192.89
Rate for Payer: Priority Health SBD	$4,192.89

PR CRICOPHARYNGEAL MYOTOMY

Professional

Both

$2,239.00

Service Code	HCPCS 43030
Min. Negotiated Rate	$226.11
Max. Negotiated Rate	$1,567.30
Rate for Payer: Aetna Commercial	$688.64
Rate for Payer: BCBS Complete	$354.49
Rate for Payer: BCBS Trust/PPO	$226.11
Rate for Payer: Cash Price	$1,791.20
Rate for Payer: Cash Price	$1,791.20
Rate for Payer: Mclaren Medicaid	$337.61
Rate for Payer: Meridian Medicaid	$354.49
Rate for Payer: Priority Health Choice Medicaid	$337.61
Rate for Payer: Priority Health Cigna Priority Health	$1,567.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$924.89
Rate for Payer: Priority Health Narrow Network	$924.89
Rate for Payer: Priority Health SBD	$924.89

PR CRITICAL CARE ILL/INJURED PATIENT ADDL 30 MIN

Professional

Both

$212.00

Service Code	HCPCS 99292
Min. Negotiated Rate	$67.73
Max. Negotiated Rate	$1,875.47
Rate for Payer: Aetna Commercial	$109.66
Rate for Payer: BCBS Complete	$71.12
Rate for Payer: BCBS Trust/PPO	$1,875.47
Rate for Payer: Cash Price	$169.60
Rate for Payer: Cash Price	$169.60
Rate for Payer: Mclaren Medicaid	$67.73
Rate for Payer: Meridian Medicaid	$71.12
Rate for Payer: Priority Health Choice Medicaid	$67.73
Rate for Payer: Priority Health Cigna Priority Health	$148.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$135.77
Rate for Payer: Priority Health Narrow Network	$135.77
Rate for Payer: Priority Health SBD	$135.77

PR CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN

Professional

Both

$467.00

Service Code	HCPCS 99291
Min. Negotiated Rate	$134.40
Max. Negotiated Rate	$1,522.56
Rate for Payer: Aetna Commercial	$218.32
Rate for Payer: BCBS Complete	$141.12
Rate for Payer: BCBS Trust/PPO	$1,522.56
Rate for Payer: Cash Price	$373.60
Rate for Payer: Cash Price	$373.60
Rate for Payer: Mclaren Medicaid	$134.40
Rate for Payer: Meridian Medicaid	$141.12
Rate for Payer: Priority Health Choice Medicaid	$134.40
Rate for Payer: Priority Health Cigna Priority Health	$326.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$395.09
Rate for Payer: Priority Health Narrow Network	$395.09
Rate for Payer: Priority Health SBD	$395.09

PR CRITICAL CARE INTERFACILITY TRANSPORT 30-74 MIN

Professional

Both

$571.00

Service Code	HCPCS 99466
Min. Negotiated Rate	$168.10
Max. Negotiated Rate	$399.70
Rate for Payer: Aetna Commercial	$234.41
Rate for Payer: BCBS Complete	$228.40
Rate for Payer: BCBS Trust/PPO	$168.10
Rate for Payer: Cash Price	$456.80
Rate for Payer: Cash Price	$456.80
Rate for Payer: Priority Health Cigna Priority Health	$399.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$292.97
Rate for Payer: Priority Health Narrow Network	$292.97
Rate for Payer: Priority Health SBD	$292.97

PR CRITICAL CARE INTERFACILITY TRANSPORT EA 30 MIN

Professional

Both

$238.00

Service Code	HCPCS 99467
Min. Negotiated Rate	$95.20
Max. Negotiated Rate	$166.60
Rate for Payer: Aetna Commercial	$117.37
Rate for Payer: BCBS Complete	$95.20
Rate for Payer: BCBS Trust/PPO	$137.11
Rate for Payer: Cash Price	$190.40
Rate for Payer: Cash Price	$190.40
Rate for Payer: Priority Health Cigna Priority Health	$166.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$148.20
Rate for Payer: Priority Health Narrow Network	$148.20
Rate for Payer: Priority Health SBD	$148.20

PR CRNEC EXC BRAIN TUMOR INFRATENTORIAL/POST FOSSA

Professional

Both

$8,254.00

Service Code	HCPCS 61518
Min. Negotiated Rate	$1,142.71
Max. Negotiated Rate	$5,777.80
Rate for Payer: Aetna Commercial	$3,575.97
Rate for Payer: BCBS Complete	$1,884.70
Rate for Payer: BCBS Trust/PPO	$1,142.71
Rate for Payer: Cash Price	$6,603.20
Rate for Payer: Cash Price	$6,603.20
Rate for Payer: Mclaren Medicaid	$1,794.95
Rate for Payer: Meridian Medicaid	$1,884.70
Rate for Payer: Priority Health Choice Medicaid	$1,794.95
Rate for Payer: Priority Health Cigna Priority Health	$5,777.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$4,727.40
Rate for Payer: Priority Health Narrow Network	$4,727.40
Rate for Payer: Priority Health SBD	$4,727.40

PR CRNEC EXC CEREBELLOPNTIN ANGLE TUM MID/POSTFOSSA

Professional

Both

$7,704.00

Service Code	HCPCS 61530
Min. Negotiated Rate	$1,728.07
Max. Negotiated Rate	$5,392.80
Rate for Payer: Aetna Commercial	$3,972.92
Rate for Payer: BCBS Complete	$2,084.42
Rate for Payer: BCBS Trust/PPO	$1,728.07
Rate for Payer: Cash Price	$6,163.20
Rate for Payer: Cash Price	$6,163.20
Rate for Payer: Mclaren Medicaid	$1,985.16
Rate for Payer: Meridian Medicaid	$2,084.42
Rate for Payer: Priority Health Choice Medicaid	$1,985.16
Rate for Payer: Priority Health Cigna Priority Health	$5,392.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$5,238.13
Rate for Payer: Priority Health Narrow Network	$5,238.13
Rate for Payer: Priority Health SBD	$5,238.13

PR CRNEC EXC TUM INFRATENTOR/POST FOSSA MENINGIOMA

Professional

Both

$8,547.00

Service Code	HCPCS 61519
Min. Negotiated Rate	$1,169.66
Max. Negotiated Rate	$5,982.90
Rate for Payer: Aetna Commercial	$3,807.82
Rate for Payer: BCBS Complete	$1,997.42
Rate for Payer: BCBS Trust/PPO	$1,169.66
Rate for Payer: Cash Price	$6,837.60
Rate for Payer: Cash Price	$6,837.60
Rate for Payer: Mclaren Medicaid	$1,902.30
Rate for Payer: Meridian Medicaid	$1,997.42
Rate for Payer: Priority Health Choice Medicaid	$1,902.30
Rate for Payer: Priority Health Cigna Priority Health	$5,982.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$5,028.63
Rate for Payer: Priority Health Narrow Network	$5,028.63
Rate for Payer: Priority Health SBD	$5,028.63

PR CRNEC INFRATNTORIAL/POST FOSSA EXC BRAIN ABSCESS

Professional

Both

$6,105.00

Service Code	HCPCS 61522
Min. Negotiated Rate	$581.66
Max. Negotiated Rate	$4,273.50
Rate for Payer: Aetna Commercial	$2,828.40
Rate for Payer: BCBS Complete	$1,489.51
Rate for Payer: BCBS Trust/PPO	$581.66
Rate for Payer: Cash Price	$4,884.00
Rate for Payer: Cash Price	$4,884.00
Rate for Payer: Mclaren Medicaid	$1,418.58
Rate for Payer: Meridian Medicaid	$1,489.51
Rate for Payer: Priority Health Choice Medicaid	$1,418.58
Rate for Payer: Priority Health Cigna Priority Health	$4,273.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$3,738.20
Rate for Payer: Priority Health Narrow Network	$3,738.20
Rate for Payer: Priority Health SBD	$3,738.20

PR CRNEC INFRATNTOR/POSTFOSSA EXC/FENESTRATION CYST

Professional

Both

$6,970.00

Service Code	HCPCS 61524
Min. Negotiated Rate	$322.26
Max. Negotiated Rate	$4,879.00
Rate for Payer: Aetna Commercial	$2,693.85
Rate for Payer: BCBS Complete	$1,419.73
Rate for Payer: BCBS Trust/PPO	$322.26
Rate for Payer: Cash Price	$5,576.00
Rate for Payer: Cash Price	$5,576.00
Rate for Payer: Mclaren Medicaid	$1,352.12
Rate for Payer: Meridian Medicaid	$1,419.73
Rate for Payer: Priority Health Choice Medicaid	$1,352.12
Rate for Payer: Priority Health Cigna Priority Health	$4,879.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$3,563.81
Rate for Payer: Priority Health Narrow Network	$3,563.81
Rate for Payer: Priority Health SBD	$3,563.81

PR CRNEC SOPL EXPL/DCMPRN CRNL NRV

Professional

Both

$7,690.00

Service Code	HCPCS 61458
Min. Negotiated Rate	$861.66
Max. Negotiated Rate	$5,383.00
Rate for Payer: Aetna Commercial	$2,603.51
Rate for Payer: BCBS Complete	$1,369.63
Rate for Payer: BCBS Trust/PPO	$861.66
Rate for Payer: Cash Price	$6,152.00
Rate for Payer: Cash Price	$6,152.00
Rate for Payer: Mclaren Medicaid	$1,304.41
Rate for Payer: Meridian Medicaid	$1,369.63
Rate for Payer: Priority Health Choice Medicaid	$1,304.41
Rate for Payer: Priority Health Cigna Priority Health	$5,383.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$3,447.73
Rate for Payer: Priority Health Narrow Network	$3,447.73
Rate for Payer: Priority Health SBD	$3,447.73

PR CRNEC STPL SCTJ COMPRESSION/DCMPRN GANGLION

Professional

Both

$6,581.00

Service Code	HCPCS 61450
Min. Negotiated Rate	$732.75
Max. Negotiated Rate	$4,606.70
Rate for Payer: Aetna Commercial	$2,481.54
Rate for Payer: BCBS Complete	$1,307.68
Rate for Payer: BCBS Trust/PPO	$732.75
Rate for Payer: Cash Price	$5,264.80
Rate for Payer: Cash Price	$5,264.80
Rate for Payer: Mclaren Medicaid	$1,245.41
Rate for Payer: Meridian Medicaid	$1,307.68
Rate for Payer: Priority Health Choice Medicaid	$1,245.41
Rate for Payer: Priority Health Cigna Priority Health	$4,606.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$3,280.69
Rate for Payer: Priority Health Narrow Network	$3,280.69
Rate for Payer: Priority Health SBD	$3,280.69

PR CRNEC SUBOCCIPITAL CRV LAM DCMPRN MEDULLA & CORD

Professional

Both

$4,519.40

Service Code	HCPCS 61343
Min. Negotiated Rate	$230.87
Max. Negotiated Rate	$3,751.80
Rate for Payer: Aetna Commercial	$2,837.46
Rate for Payer: BCBS Complete	$1,491.52
Rate for Payer: BCBS Trust/PPO	$230.87
Rate for Payer: Cash Price	$3,615.52
Rate for Payer: Cash Price	$3,615.52
Rate for Payer: Mclaren Medicaid	$1,420.50
Rate for Payer: Meridian Medicaid	$1,491.52
Rate for Payer: Priority Health Choice Medicaid	$1,420.50
Rate for Payer: Priority Health Cigna Priority Health	$3,163.58
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$3,751.80
Rate for Payer: Priority Health Narrow Network	$3,751.80
Rate for Payer: Priority Health SBD	$3,751.80

Know your out-of-pocket cost for care.

All Charges