Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PR CYSTO W/URTROSCOPY W/TX URTROPEL JUNCT STRIX

Professional

Both

$1,105.00

Service Code	HCPCS 52345
Min. Negotiated Rate	$247.51
Max. Negotiated Rate	$3,934.25
Rate for Payer: Aetna Commercial	$504.64
Rate for Payer: BCBS Complete	$259.89
Rate for Payer: BCBS Trust/PPO	$3,934.25
Rate for Payer: Cash Price	$884.00
Rate for Payer: Cash Price	$884.00
Rate for Payer: Mclaren Medicaid	$247.51
Rate for Payer: Meridian Medicaid	$259.89
Rate for Payer: Priority Health Choice Medicaid	$247.51
Rate for Payer: Priority Health Cigna Priority Health	$773.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$620.86
Rate for Payer: Priority Health Narrow Network	$620.86
Rate for Payer: Priority Health SBD	$620.86

PR DACRYOCSTORHINOSTOMY

Professional

Both

$1,541.00

Service Code	HCPCS 68720
Min. Negotiated Rate	$245.66
Max. Negotiated Rate	$1,405.01
Rate for Payer: Aetna Commercial	$1,040.24
Rate for Payer: BCBS Complete	$539.89
Rate for Payer: BCBS Trust/PPO	$245.66
Rate for Payer: Cash Price	$1,232.80
Rate for Payer: Cash Price	$1,232.80
Rate for Payer: Mclaren Medicaid	$514.18
Rate for Payer: Meridian Medicaid	$539.89
Rate for Payer: Priority Health Choice Medicaid	$514.18
Rate for Payer: Priority Health Cigna Priority Health	$1,078.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,405.01
Rate for Payer: Priority Health Narrow Network	$1,405.01
Rate for Payer: Priority Health SBD	$1,405.01

PR DAILY HOSP MGMT EDRL/SARACH CONT DRUG ADMN

Professional

Both

$3.00

Service Code	HCPCS 01996
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$133.50
Rate for Payer: BCBS Complete	$1.20
Rate for Payer: Cash Price	$2.40
Rate for Payer: Cash Price	$2.40
Rate for Payer: Priority Health Cigna Priority Health	$2.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$133.50
Rate for Payer: Priority Health Narrow Network	$133.50
Rate for Payer: Priority Health SBD	$133.50

PR DBRDMT EXTENSV ECZEMA/INFECT SKN UP 10% BDY SURF

Professional

Both

$88.00

Service Code	HCPCS 11000
Min. Negotiated Rate	$11.15
Max. Negotiated Rate	$61.60
Rate for Payer: Aetna Commercial	$30.50
Rate for Payer: BCBS Complete	$18.34
Rate for Payer: BCBS Trust/PPO	$11.15
Rate for Payer: Cash Price	$70.40
Rate for Payer: Cash Price	$70.40
Rate for Payer: Mclaren Medicaid	$17.47
Rate for Payer: Meridian Medicaid	$18.34
Rate for Payer: Priority Health Choice Medicaid	$17.47
Rate for Payer: Priority Health Cigna Priority Health	$61.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$32.88
Rate for Payer: Priority Health Narrow Network	$32.88
Rate for Payer: Priority Health SBD	$32.88

PR DBRDMT EXTNSVE ECZEMA/INFECT SKN EA 10% BDY SURF

Professional

Both

$47.00

Service Code	HCPCS 11001
Min. Negotiated Rate	$9.37
Max. Negotiated Rate	$2,904.75
Rate for Payer: Aetna Commercial	$15.82
Rate for Payer: BCBS Complete	$9.84
Rate for Payer: BCBS Trust/PPO	$2,904.75
Rate for Payer: Cash Price	$37.60
Rate for Payer: Cash Price	$37.60
Rate for Payer: Mclaren Medicaid	$9.37
Rate for Payer: Meridian Medicaid	$9.84
Rate for Payer: Priority Health Choice Medicaid	$9.37
Rate for Payer: Priority Health Cigna Priority Health	$32.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$18.09
Rate for Payer: Priority Health Narrow Network	$18.09
Rate for Payer: Priority Health SBD	$18.09

PR DBRDMT FX&/DISLC SUBQ T/M/F BONE

Professional

Both

$1,194.00

Service Code	HCPCS 11012
Min. Negotiated Rate	$25.40
Max. Negotiated Rate	$835.80
Rate for Payer: Aetna Commercial	$453.05
Rate for Payer: BCBS Complete	$277.33
Rate for Payer: BCBS Trust/PPO	$25.40
Rate for Payer: Cash Price	$955.20
Rate for Payer: Cash Price	$955.20
Rate for Payer: Mclaren Medicaid	$264.12
Rate for Payer: Meridian Medicaid	$277.33
Rate for Payer: Priority Health Choice Medicaid	$264.12
Rate for Payer: Priority Health Cigna Priority Health	$835.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$507.64
Rate for Payer: Priority Health Narrow Network	$507.64
Rate for Payer: Priority Health SBD	$507.64

PR DBRDMT SKN SUBQ T/M/F NECRO INFCTJ ABDL WALL

Facility

$1,395.00

Service Code	CPT 11005
Hospital Charge Code	11005
Min. Negotiated Rate	$558.00
Max. Negotiated Rate	$1,596.36
Rate for Payer: Aetna Commercial	$1,185.75
Rate for Payer: Aetna New Business (MI Preferred)	$906.75
Rate for Payer: BCBS Complete	$558.00
Rate for Payer: BCBS Trust/PPO	$1,596.36
Rate for Payer: Cash Price	$1,116.00
Rate for Payer: Cash Price	$1,116.00
Rate for Payer: Cofinity Commercial	$976.50
Rate for Payer: Cofinity Commercial	$1,199.70
Rate for Payer: Healthscope Commercial	$1,255.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,185.75
Rate for Payer: PHP Commercial	$1,185.75
Rate for Payer: Priority Health Cigna Priority Health	$976.50
Rate for Payer: Priority Health SBD	$878.85
Rate for Payer: UHC All Payor (Choice/PPO)	$826.63
Rate for Payer: UHC Exchange	$751.48

PR DBRDMT SKN SUBQ T/M/F NECRO INFCTJ ABDL WALL

Professional

Both

$1,395.00

Service Code	HCPCS 11005
Min. Negotiated Rate	$488.84
Max. Negotiated Rate	$2,189.70
Rate for Payer: Aetna Commercial	$855.76
Rate for Payer: BCBS Complete	$513.28
Rate for Payer: BCBS Trust/PPO	$2,189.70
Rate for Payer: Cash Price	$1,116.00
Rate for Payer: Cash Price	$1,116.00
Rate for Payer: Mclaren Medicaid	$488.84
Rate for Payer: Meridian Medicaid	$513.28
Rate for Payer: Priority Health Choice Medicaid	$488.84
Rate for Payer: Priority Health Cigna Priority Health	$976.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$940.87
Rate for Payer: Priority Health Narrow Network	$940.87
Rate for Payer: Priority Health SBD	$940.87

PR DBRDMT SKN SUBQ T/M/F NECRO INFCTJ ABDL WALL

Professional

Both

$1,395.00

Service Code	HCPCS 11005
Hospital Charge Code	11005
Min. Negotiated Rate	$488.84
Max. Negotiated Rate	$2,189.70
Rate for Payer: Aetna Commercial	$855.76
Rate for Payer: BCBS Complete	$513.28
Rate for Payer: BCBS Trust/PPO	$2,189.70
Rate for Payer: Cash Price	$1,116.00
Rate for Payer: Cash Price	$1,116.00
Rate for Payer: Mclaren Medicaid	$488.84
Rate for Payer: Meridian Medicaid	$513.28
Rate for Payer: Priority Health Choice Medicaid	$488.84
Rate for Payer: Priority Health Cigna Priority Health	$976.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$940.87
Rate for Payer: Priority Health Narrow Network	$940.87
Rate for Payer: Priority Health SBD	$940.87

PR DBRDMT SKN SUBQ T/M/F NECRO INFCTJ ABDL WALL

Facility

$1,395.00

Service Code	CPT 11005
Hospital Charge Code	11005
Min. Negotiated Rate	$878.85
Max. Negotiated Rate	$1,255.50
Rate for Payer: Aetna Commercial	$1,185.75
Rate for Payer: Aetna New Business (MI Preferred)	$906.75
Rate for Payer: Cash Price	$1,116.00
Rate for Payer: Cofinity Commercial	$1,199.70
Rate for Payer: Cofinity Commercial	$976.50
Rate for Payer: Healthscope Commercial	$1,255.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,185.75
Rate for Payer: PHP Commercial	$1,185.75
Rate for Payer: Priority Health Cigna Priority Health	$976.50
Rate for Payer: Priority Health SBD	$878.85

PR DBRDMT SKN SUBQ T/M/F NECRO INFCTJ GENT/ABDL

Professional

Both

$1,275.00

Service Code	HCPCS 11006
Min. Negotiated Rate	$442.19
Max. Negotiated Rate	$2,187.45
Rate for Payer: Aetna Commercial	$771.49
Rate for Payer: BCBS Complete	$464.30
Rate for Payer: BCBS Trust/PPO	$2,187.45
Rate for Payer: Cash Price	$1,020.00
Rate for Payer: Cash Price	$1,020.00
Rate for Payer: Mclaren Medicaid	$442.19
Rate for Payer: Meridian Medicaid	$464.30
Rate for Payer: Priority Health Choice Medicaid	$442.19
Rate for Payer: Priority Health Cigna Priority Health	$892.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$851.26
Rate for Payer: Priority Health Narrow Network	$851.26
Rate for Payer: Priority Health SBD	$851.26

PR DBRDMT SKN SUBQ T/M/F NECRO INFCTJ GENT&PR

Professional

Both

$1,046.00

Service Code	HCPCS 11004
Min. Negotiated Rate	$358.69
Max. Negotiated Rate	$2,904.75
Rate for Payer: Aetna Commercial	$627.05
Rate for Payer: BCBS Complete	$376.62
Rate for Payer: BCBS Trust/PPO	$2,904.75
Rate for Payer: Cash Price	$836.80
Rate for Payer: Cash Price	$836.80
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	$732.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$690.54
Rate for Payer: Priority Health Narrow Network	$690.54
Rate for Payer: Priority Health SBD	$690.54

PR DBRDMT SUBCUTANEOUS TISSUE EA ADDL 20 SQ CM

Professional

Both

$69.00

Service Code	HCPCS 11045
Min. Negotiated Rate	$15.98
Max. Negotiated Rate	$111.72
Rate for Payer: Aetna Commercial	$28.87
Rate for Payer: BCBS Complete	$16.78
Rate for Payer: BCBS Trust/PPO	$111.72
Rate for Payer: Cash Price	$55.20
Rate for Payer: Cash Price	$55.20
Rate for Payer: Mclaren Medicaid	$15.98
Rate for Payer: Meridian Medicaid	$16.78
Rate for Payer: Priority Health Choice Medicaid	$15.98
Rate for Payer: Priority Health Cigna Priority Health	$48.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$30.83
Rate for Payer: Priority Health Narrow Network	$30.83
Rate for Payer: Priority Health SBD	$30.83

PR DBRDMT W/RMVL FM FX&/DISLC SKIN&SUBQ TISSUS

Professional

Both

$803.00

Service Code	HCPCS 11010
Min. Negotiated Rate	$145.28
Max. Negotiated Rate	$562.10
Rate for Payer: Aetna Commercial	$296.95
Rate for Payer: BCBS Complete	$184.74
Rate for Payer: BCBS Trust/PPO	$145.28
Rate for Payer: Cash Price	$642.40
Rate for Payer: Cash Price	$642.40
Rate for Payer: Mclaren Medicaid	$175.94
Rate for Payer: Meridian Medicaid	$184.74
Rate for Payer: Priority Health Choice Medicaid	$175.94
Rate for Payer: Priority Health Cigna Priority Health	$562.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$338.28
Rate for Payer: Priority Health Narrow Network	$338.28
Rate for Payer: Priority Health SBD	$338.28

PR DBRDMT W/RMVL FM FX&/DISLC SKN SUBQ T/M/F MUSC

Professional

Both

$872.00

Service Code	HCPCS 11011
Min. Negotiated Rate	$28.95
Max. Negotiated Rate	$610.40
Rate for Payer: Aetna Commercial	$324.99
Rate for Payer: BCBS Complete	$198.60
Rate for Payer: BCBS Trust/PPO	$28.95
Rate for Payer: Cash Price	$697.60
Rate for Payer: Cash Price	$697.60
Rate for Payer: Mclaren Medicaid	$189.14
Rate for Payer: Meridian Medicaid	$198.60
Rate for Payer: Priority Health Choice Medicaid	$189.14
Rate for Payer: Priority Health Cigna Priority Health	$610.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$361.30
Rate for Payer: Priority Health Narrow Network	$361.30
Rate for Payer: Priority Health SBD	$361.30

PR DCMPRN FASCIOTOMY PELVIC CMPRT DBRDMT MUSCLE UNI

Professional

Both

$1,717.00

Service Code	HCPCS 27057
Min. Negotiated Rate	$647.95
Max. Negotiated Rate	$4,478.93
Rate for Payer: Aetna Commercial	$1,352.98
Rate for Payer: BCBS Complete	$680.35
Rate for Payer: BCBS Trust/PPO	$4,478.93
Rate for Payer: Cash Price	$1,373.60
Rate for Payer: Cash Price	$1,373.60
Rate for Payer: Mclaren Medicaid	$647.95
Rate for Payer: Meridian Medicaid	$680.35
Rate for Payer: Priority Health Choice Medicaid	$647.95
Rate for Payer: Priority Health Cigna Priority Health	$1,201.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,544.21
Rate for Payer: Priority Health Narrow Network	$1,544.21
Rate for Payer: Priority Health SBD	$1,544.21

PR DCMPRN FASCIOTOMY THIGH&/KNEE MLT COMPARTMENTS

Professional

Both

$1,314.00

Service Code	HCPCS 27498
Min. Negotiated Rate	$427.07
Max. Negotiated Rate	$1,135.85
Rate for Payer: Aetna Commercial	$875.65
Rate for Payer: BCBS Complete	$448.42
Rate for Payer: BCBS Trust/PPO	$1,135.85
Rate for Payer: Cash Price	$1,051.20
Rate for Payer: Cash Price	$1,051.20
Rate for Payer: Mclaren Medicaid	$427.07
Rate for Payer: Meridian Medicaid	$448.42
Rate for Payer: Priority Health Choice Medicaid	$427.07
Rate for Payer: Priority Health Cigna Priority Health	$919.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,013.64
Rate for Payer: Priority Health Narrow Network	$1,013.64
Rate for Payer: Priority Health SBD	$1,013.64

PR DCMPRN FASCT F/ARM&/WRST FLXR&XTNSR DBRDMT

Professional

Both

$2,138.00

Service Code	HCPCS 25025
Min. Negotiated Rate	$788.95
Max. Negotiated Rate	$1,877.66
Rate for Payer: Aetna Commercial	$1,589.91
Rate for Payer: BCBS Complete	$828.40
Rate for Payer: BCBS Trust/PPO	$1,086.18
Rate for Payer: Cash Price	$1,710.40
Rate for Payer: Cash Price	$1,710.40
Rate for Payer: Mclaren Medicaid	$788.95
Rate for Payer: Meridian Medicaid	$828.40
Rate for Payer: Priority Health Choice Medicaid	$788.95
Rate for Payer: Priority Health Cigna Priority Health	$1,496.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,877.66
Rate for Payer: Priority Health Narrow Network	$1,877.66
Rate for Payer: Priority Health SBD	$1,877.66

PR DCMPRN FASCT F/ARM&/WRST FLXR/XTNSR W/DBRDMT

Professional

Both

$1,930.00

Service Code	HCPCS 25023
Min. Negotiated Rate	$842.63
Max. Negotiated Rate	$2,015.03
Rate for Payer: Aetna Commercial	$1,702.85
Rate for Payer: BCBS Complete	$884.76
Rate for Payer: BCBS Trust/PPO	$1,085.13
Rate for Payer: Cash Price	$1,544.00
Rate for Payer: Cash Price	$1,544.00
Rate for Payer: Mclaren Medicaid	$842.63
Rate for Payer: Meridian Medicaid	$884.76
Rate for Payer: Priority Health Choice Medicaid	$842.63
Rate for Payer: Priority Health Cigna Priority Health	$1,351.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,015.03
Rate for Payer: Priority Health Narrow Network	$2,015.03
Rate for Payer: Priority Health SBD	$2,015.03

PR DCMPRN FASCT F/ARM&/WRST FLXR&XTNSR W/O DB

Professional

Both

$1,787.00

Service Code	HCPCS 25024
Min. Negotiated Rate	$218.72
Max. Negotiated Rate	$1,250.90
Rate for Payer: Aetna Commercial	$1,042.37
Rate for Payer: BCBS Complete	$529.83
Rate for Payer: BCBS Trust/PPO	$218.72
Rate for Payer: Cash Price	$1,429.60
Rate for Payer: Cash Price	$1,429.60
Rate for Payer: Mclaren Medicaid	$504.60
Rate for Payer: Meridian Medicaid	$529.83
Rate for Payer: Priority Health Choice Medicaid	$504.60
Rate for Payer: Priority Health Cigna Priority Health	$1,250.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,190.84
Rate for Payer: Priority Health Narrow Network	$1,190.84
Rate for Payer: Priority Health SBD	$1,190.84

PR DCMPRN FASCT F/ARM&WRST FLXR/XTNSR W/O DBRDMT

Professional

Both

$1,390.00

Service Code	HCPCS 25020
Min. Negotiated Rate	$160.07
Max. Negotiated Rate	$1,150.50
Rate for Payer: Aetna Commercial	$936.55
Rate for Payer: BCBS Complete	$501.20
Rate for Payer: BCBS Trust/PPO	$160.07
Rate for Payer: Cash Price	$1,112.00
Rate for Payer: Cash Price	$1,112.00
Rate for Payer: Mclaren Medicaid	$477.33
Rate for Payer: Meridian Medicaid	$501.20
Rate for Payer: Priority Health Choice Medicaid	$477.33
Rate for Payer: Priority Health Cigna Priority Health	$973.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,150.50
Rate for Payer: Priority Health Narrow Network	$1,150.50
Rate for Payer: Priority Health SBD	$1,150.50

PR DCMPRN FASCT LEG ANT&/LAT COMPARTMENTS ONLY

Professional

Both

$1,217.00

Service Code	HCPCS 27600
Min. Negotiated Rate	$256.88
Max. Negotiated Rate	$863.24
Rate for Payer: Aetna Commercial	$540.38
Rate for Payer: BCBS Complete	$269.72
Rate for Payer: BCBS Trust/PPO	$863.24
Rate for Payer: Cash Price	$973.60
Rate for Payer: Cash Price	$973.60
Rate for Payer: Mclaren Medicaid	$256.88
Rate for Payer: Meridian Medicaid	$269.72
Rate for Payer: Priority Health Choice Medicaid	$256.88
Rate for Payer: Priority Health Cigna Priority Health	$851.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$614.82
Rate for Payer: Priority Health Narrow Network	$614.82
Rate for Payer: Priority Health SBD	$614.82

PR DCMPRN FASCT LEG ANT&/LAT&PST CMPRT

Professional

Both

$1,734.00

Service Code	HCPCS 27602
Min. Negotiated Rate	$304.16
Max. Negotiated Rate	$1,903.46
Rate for Payer: Aetna Commercial	$647.06
Rate for Payer: BCBS Complete	$319.37
Rate for Payer: BCBS Trust/PPO	$1,903.46
Rate for Payer: Cash Price	$1,387.20
Rate for Payer: Cash Price	$1,387.20
Rate for Payer: Mclaren Medicaid	$304.16
Rate for Payer: Meridian Medicaid	$319.37
Rate for Payer: Priority Health Choice Medicaid	$304.16
Rate for Payer: Priority Health Cigna Priority Health	$1,213.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$726.65
Rate for Payer: Priority Health Narrow Network	$726.65
Rate for Payer: Priority Health SBD	$726.65

PR DCMPRN FASCT LEG ANT&/LAT&PST W/DBRDMT MUS

Professional

Both

$2,197.00

Service Code	HCPCS 27894
Min. Negotiated Rate	$522.06
Max. Negotiated Rate	$2,785.73
Rate for Payer: Aetna Commercial	$1,109.32
Rate for Payer: BCBS Complete	$548.16
Rate for Payer: BCBS Trust/PPO	$2,785.73
Rate for Payer: Cash Price	$1,757.60
Rate for Payer: Cash Price	$1,757.60
Rate for Payer: Mclaren Medicaid	$522.06
Rate for Payer: Meridian Medicaid	$548.16
Rate for Payer: Priority Health Choice Medicaid	$522.06
Rate for Payer: Priority Health Cigna Priority Health	$1,537.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,242.92
Rate for Payer: Priority Health Narrow Network	$1,242.92
Rate for Payer: Priority Health SBD	$1,242.92

PR DCMPRN FASCT LEG ANT&/LAT W/DBRDMT MUSC&/NERVE

Professional

Both

$1,613.00

Service Code	HCPCS 27892
Min. Negotiated Rate	$345.27
Max. Negotiated Rate	$2,576.52
Rate for Payer: Aetna Commercial	$716.58
Rate for Payer: BCBS Complete	$362.53
Rate for Payer: BCBS Trust/PPO	$2,576.52
Rate for Payer: Cash Price	$1,290.40
Rate for Payer: Cash Price	$1,290.40
Rate for Payer: Mclaren Medicaid	$345.27
Rate for Payer: Meridian Medicaid	$362.53
Rate for Payer: Priority Health Choice Medicaid	$345.27
Rate for Payer: Priority Health Cigna Priority Health	$1,129.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$820.11
Rate for Payer: Priority Health Narrow Network	$820.11
Rate for Payer: Priority Health SBD	$820.11

Know your out-of-pocket cost for care.

All Charges