Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PR DEBRIDEMENT SUBCUTANEOUS TISSUE EA ADDL 20 SQ CM

Facility

$69.00

Service Code	CPT 11045
Hospital Charge Code	11045
Min. Negotiated Rate	$24.56
Max. Negotiated Rate	$81.69
Rate for Payer: Aetna Commercial	$58.65
Rate for Payer: Aetna New Business (MI Preferred)	$44.85
Rate for Payer: BCBS Complete	$27.60
Rate for Payer: BCBS Trust/PPO	$81.69
Rate for Payer: Cash Price	$55.20
Rate for Payer: Cash Price	$55.20
Rate for Payer: Cofinity Commercial	$48.30
Rate for Payer: Cofinity Commercial	$59.34
Rate for Payer: Healthscope Commercial	$62.10
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$58.65
Rate for Payer: PHP Commercial	$58.65
Rate for Payer: Priority Health Cigna Priority Health	$48.30
Rate for Payer: Priority Health SBD	$43.47
Rate for Payer: UHC All Payor (Choice/PPO)	$27.02
Rate for Payer: UHC Exchange	$24.56

PR DECLOT BY THROMBOLYTIC AGENT IMPLANT DEVICE/CATH

Professional

Both

$59.00

Service Code	HCPCS 36593
Min. Negotiated Rate	$23.60
Max. Negotiated Rate	$549.96
Rate for Payer: Aetna Commercial	$41.26
Rate for Payer: BCBS Complete	$23.60
Rate for Payer: BCBS Trust/PPO	$549.96
Rate for Payer: Cash Price	$47.20
Rate for Payer: Cash Price	$47.20
Rate for Payer: Priority Health Cigna Priority Health	$41.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$52.67
Rate for Payer: Priority Health Narrow Network	$52.67
Rate for Payer: Priority Health SBD	$52.67

PR DECOMPRESSION FASCIOTOMY PELVIC COMPARTMENT UNI

Professional

Both

$1,798.00

Service Code	HCPCS 27027
Min. Negotiated Rate	$570.41
Max. Negotiated Rate	$1,369.56
Rate for Payer: Aetna Commercial	$1,179.09
Rate for Payer: BCBS Complete	$598.93
Rate for Payer: BCBS Trust/PPO	$1,182.34
Rate for Payer: Cash Price	$1,438.40
Rate for Payer: Cash Price	$1,438.40
Rate for Payer: Mclaren Medicaid	$570.41
Rate for Payer: Meridian Medicaid	$598.93
Rate for Payer: Priority Health Choice Medicaid	$570.41
Rate for Payer: Priority Health Cigna Priority Health	$1,258.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,369.56
Rate for Payer: Priority Health Narrow Network	$1,369.56
Rate for Payer: Priority Health SBD	$1,369.56

PR DECOMPRESSION FASCIOTOMY THIGH&/KNEE 1 COMPONENT

Professional

Both

$929.00

Service Code	HCPCS 27496
Min. Negotiated Rate	$358.27
Max. Negotiated Rate	$1,098.34
Rate for Payer: Aetna Commercial	$728.83
Rate for Payer: BCBS Complete	$376.18
Rate for Payer: BCBS Trust/PPO	$1,098.34
Rate for Payer: Cash Price	$743.20
Rate for Payer: Cash Price	$743.20
Rate for Payer: Mclaren Medicaid	$358.27
Rate for Payer: Meridian Medicaid	$376.18
Rate for Payer: Priority Health Choice Medicaid	$358.27
Rate for Payer: Priority Health Cigna Priority Health	$650.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$847.68
Rate for Payer: Priority Health Narrow Network	$847.68
Rate for Payer: Priority Health SBD	$847.68

PR DECOMPRESSION FASCT F/ARM W/BRACH ART EXPL

Professional

Both

$1,659.00

Service Code	HCPCS 24495
Min. Negotiated Rate	$501.36
Max. Negotiated Rate	$1,430.84
Rate for Payer: Aetna Commercial	$1,009.58
Rate for Payer: BCBS Complete	$623.76
Rate for Payer: BCBS Trust/PPO	$501.36
Rate for Payer: Cash Price	$1,327.20
Rate for Payer: Cash Price	$1,327.20
Rate for Payer: Mclaren Medicaid	$594.06
Rate for Payer: Meridian Medicaid	$623.76
Rate for Payer: Priority Health Choice Medicaid	$594.06
Rate for Payer: Priority Health Cigna Priority Health	$1,161.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,430.84
Rate for Payer: Priority Health Narrow Network	$1,430.84
Rate for Payer: Priority Health SBD	$1,430.84

PR DECOMPRESSION FINGERS&/HAND INJECTION INJURY

Professional

Both

$2,143.00

Service Code	HCPCS 26035
Min. Negotiated Rate	$89.15
Max. Negotiated Rate	$1,500.10
Rate for Payer: Aetna Commercial	$1,146.22
Rate for Payer: BCBS Complete	$585.96
Rate for Payer: BCBS Trust/PPO	$89.15
Rate for Payer: Cash Price	$1,714.40
Rate for Payer: Cash Price	$1,714.40
Rate for Payer: Mclaren Medicaid	$558.06
Rate for Payer: Meridian Medicaid	$585.96
Rate for Payer: Priority Health Choice Medicaid	$558.06
Rate for Payer: Priority Health Cigna Priority Health	$1,500.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,325.13
Rate for Payer: Priority Health Narrow Network	$1,325.13
Rate for Payer: Priority Health SBD	$1,325.13

PR DECOMPRESSION ORBIT ONLY TRANSCRANIAL APPROACH

Professional

Both

$5,633.00

Service Code	HCPCS 61330
Min. Negotiated Rate	$322.79
Max. Negotiated Rate	$3,943.10
Rate for Payer: Aetna Commercial	$2,316.66
Rate for Payer: BCBS Complete	$1,223.82
Rate for Payer: BCBS Trust/PPO	$322.79
Rate for Payer: Cash Price	$4,506.40
Rate for Payer: Cash Price	$4,506.40
Rate for Payer: Mclaren Medicaid	$1,165.54
Rate for Payer: Meridian Medicaid	$1,223.82
Rate for Payer: Priority Health Choice Medicaid	$1,165.54
Rate for Payer: Priority Health Cigna Priority Health	$3,943.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$3,068.94
Rate for Payer: Priority Health Narrow Network	$3,068.94
Rate for Payer: Priority Health SBD	$3,068.94

PR DECOMPRESSION PLANTAR DIGITAL NERVE

Professional

Both

$1,542.00

Service Code	HCPCS 64726
Min. Negotiated Rate	$173.17
Max. Negotiated Rate	$1,254.71
Rate for Payer: Aetna Commercial	$341.98
Rate for Payer: BCBS Complete	$181.83
Rate for Payer: BCBS Trust/PPO	$1,254.71
Rate for Payer: Cash Price	$1,233.60
Rate for Payer: Cash Price	$1,233.60
Rate for Payer: Mclaren Medicaid	$173.17
Rate for Payer: Meridian Medicaid	$181.83
Rate for Payer: Priority Health Choice Medicaid	$173.17
Rate for Payer: Priority Health Cigna Priority Health	$1,079.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$456.37
Rate for Payer: Priority Health Narrow Network	$456.37
Rate for Payer: Priority Health SBD	$456.37

PR DECOMPRESSION UNSPECIFIED NERVE

Professional

Both

$1,748.00

Service Code	HCPCS 64722
Min. Negotiated Rate	$240.69
Max. Negotiated Rate	$5,909.56
Rate for Payer: Aetna Commercial	$455.08
Rate for Payer: BCBS Complete	$252.72
Rate for Payer: BCBS Trust/PPO	$5,909.56
Rate for Payer: Cash Price	$1,398.40
Rate for Payer: Cash Price	$1,398.40
Rate for Payer: Mclaren Medicaid	$240.69
Rate for Payer: Meridian Medicaid	$252.72
Rate for Payer: Priority Health Choice Medicaid	$240.69
Rate for Payer: Priority Health Cigna Priority Health	$1,223.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$622.85
Rate for Payer: Priority Health Narrow Network	$622.85
Rate for Payer: Priority Health SBD	$622.85

PR DECOMPRESSIVE FASCIOTOMY HAND

Professional

Both

$1,336.00

Service Code	HCPCS 26037
Min. Negotiated Rate	$109.10
Max. Negotiated Rate	$935.20
Rate for Payer: Aetna Commercial	$751.25
Rate for Payer: BCBS Complete	$383.11
Rate for Payer: BCBS Trust/PPO	$109.10
Rate for Payer: Cash Price	$1,068.80
Rate for Payer: Cash Price	$1,068.80
Rate for Payer: Mclaren Medicaid	$364.87
Rate for Payer: Meridian Medicaid	$383.11
Rate for Payer: Priority Health Choice Medicaid	$364.87
Rate for Payer: Priority Health Cigna Priority Health	$935.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$867.08
Rate for Payer: Priority Health Narrow Network	$867.08
Rate for Payer: Priority Health SBD	$867.08

PR DECORTICATION & PARIETAL PLEURECTOMY

Professional

Both

$3,934.00

Service Code	HCPCS 32320
Min. Negotiated Rate	$518.79
Max. Negotiated Rate	$2,753.80
Rate for Payer: Aetna Commercial	$2,067.00
Rate for Payer: BCBS Complete	$1,063.68
Rate for Payer: BCBS Trust/PPO	$518.79
Rate for Payer: Cash Price	$3,147.20
Rate for Payer: Cash Price	$3,147.20
Rate for Payer: Mclaren Medicaid	$1,013.03
Rate for Payer: Meridian Medicaid	$1,063.68
Rate for Payer: Priority Health Choice Medicaid	$1,013.03
Rate for Payer: Priority Health Cigna Priority Health	$2,753.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,192.52
Rate for Payer: Priority Health Narrow Network	$2,192.52
Rate for Payer: Priority Health SBD	$2,192.52

PR DECORTICATION PULMONARY PARTIAL SEPARATE PROC

Professional

Both

$2,022.00

Service Code	HCPCS 32225
Min. Negotiated Rate	$468.07
Max. Negotiated Rate	$1,415.40
Rate for Payer: Aetna Commercial	$1,281.01
Rate for Payer: BCBS Complete	$660.22
Rate for Payer: BCBS Trust/PPO	$468.07
Rate for Payer: Cash Price	$1,617.60
Rate for Payer: Cash Price	$1,617.60
Rate for Payer: Mclaren Medicaid	$628.78
Rate for Payer: Meridian Medicaid	$660.22
Rate for Payer: Priority Health Choice Medicaid	$628.78
Rate for Payer: Priority Health Cigna Priority Health	$1,415.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,362.28
Rate for Payer: Priority Health Narrow Network	$1,362.28
Rate for Payer: Priority Health SBD	$1,362.28

PR DECORTICATION PULMONARY TOTAL SEPARATE PROCEDURE

Professional

Both

$2,905.00

Service Code	HCPCS 32220
Min. Negotiated Rate	$758.11
Max. Negotiated Rate	$2,181.86
Rate for Payer: Aetna Commercial	$2,051.72
Rate for Payer: BCBS Complete	$1,060.55
Rate for Payer: BCBS Trust/PPO	$758.11
Rate for Payer: Cash Price	$2,324.00
Rate for Payer: Cash Price	$2,324.00
Rate for Payer: Mclaren Medicaid	$1,010.05
Rate for Payer: Meridian Medicaid	$1,060.55
Rate for Payer: Priority Health Choice Medicaid	$1,010.05
Rate for Payer: Priority Health Cigna Priority Health	$2,033.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,181.86
Rate for Payer: Priority Health Narrow Network	$2,181.86
Rate for Payer: Priority Health SBD	$2,181.86

PR DEGARELIX INJECTION

Professional

Both

$6.00

Service Code	HCPCS J9155
Min. Negotiated Rate	$2.40
Max. Negotiated Rate	$4.31
Rate for Payer: Aetna Commercial	$4.31
Rate for Payer: BCBS Complete	$2.40
Rate for Payer: BCBS Trust/PPO	$4.18
Rate for Payer: Cash Price	$4.80
Rate for Payer: Cash Price	$4.80
Rate for Payer: Priority Health Cigna Priority Health	$4.20

PR DELAYED CREATION EXIT SITE EMBEDDED CATHETER

Professional

Both

$1,265.00

Service Code	HCPCS 49436
Min. Negotiated Rate	$119.49
Max. Negotiated Rate	$2,493.58
Rate for Payer: Aetna Commercial	$252.08
Rate for Payer: BCBS Complete	$125.46
Rate for Payer: BCBS Trust/PPO	$2,493.58
Rate for Payer: Cash Price	$1,012.00
Rate for Payer: Cash Price	$1,012.00
Rate for Payer: Mclaren Medicaid	$119.49
Rate for Payer: Meridian Medicaid	$125.46
Rate for Payer: Priority Health Choice Medicaid	$119.49
Rate for Payer: Priority Health Cigna Priority Health	$885.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$326.91
Rate for Payer: Priority Health Narrow Network	$326.91
Rate for Payer: Priority Health SBD	$326.91

PR DELAY FLAP/SCTJ FLAP EYELIDS NOSE EARS/LIPS

Professional

Both

$888.00

Service Code	HCPCS 15630
Min. Negotiated Rate	$221.09
Max. Negotiated Rate	$3,918.45
Rate for Payer: Aetna Commercial	$362.89
Rate for Payer: BCBS Complete	$232.14
Rate for Payer: BCBS Trust/PPO	$3,918.45
Rate for Payer: Cash Price	$710.40
Rate for Payer: Cash Price	$710.40
Rate for Payer: Mclaren Medicaid	$221.09
Rate for Payer: Meridian Medicaid	$232.14
Rate for Payer: Priority Health Choice Medicaid	$221.09
Rate for Payer: Priority Health Cigna Priority Health	$621.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$421.72
Rate for Payer: Priority Health Narrow Network	$421.72
Rate for Payer: Priority Health SBD	$421.72

PR DELAY FLAP/SECTIONING FLAP F/C/C/N/AX/G/H/F

Professional

Both

$710.00

Service Code	HCPCS 15620
Min. Negotiated Rate	$75.69
Max. Negotiated Rate	$497.00
Rate for Payer: Aetna Commercial	$345.81
Rate for Payer: BCBS Complete	$220.74
Rate for Payer: BCBS Trust/PPO	$75.69
Rate for Payer: Cash Price	$568.00
Rate for Payer: Cash Price	$568.00
Rate for Payer: Mclaren Medicaid	$210.23
Rate for Payer: Meridian Medicaid	$220.74
Rate for Payer: Priority Health Choice Medicaid	$210.23
Rate for Payer: Priority Health Cigna Priority Health	$497.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$401.59
Rate for Payer: Priority Health Narrow Network	$401.59
Rate for Payer: Priority Health SBD	$401.59

PR DELAY FLAP/SECTIONING FLAP SCALP ARMS/LEGS

Professional

Both

$600.00

Service Code	HCPCS 15610
Min. Negotiated Rate	$157.62
Max. Negotiated Rate	$2,032.46
Rate for Payer: Aetna Commercial	$257.64
Rate for Payer: BCBS Complete	$165.50
Rate for Payer: BCBS Trust/PPO	$2,032.46
Rate for Payer: Cash Price	$480.00
Rate for Payer: Cash Price	$480.00
Rate for Payer: Mclaren Medicaid	$157.62
Rate for Payer: Meridian Medicaid	$165.50
Rate for Payer: Priority Health Choice Medicaid	$157.62
Rate for Payer: Priority Health Cigna Priority Health	$420.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$300.88
Rate for Payer: Priority Health Narrow Network	$300.88
Rate for Payer: Priority Health SBD	$300.88

PR DELAY FLAP/SECTIONING FLAP TRUNK

Professional

Both

$519.00

Service Code	HCPCS 15600
Min. Negotiated Rate	$136.96
Max. Negotiated Rate	$852.18
Rate for Payer: Aetna Commercial	$222.85
Rate for Payer: BCBS Complete	$143.81
Rate for Payer: BCBS Trust/PPO	$852.18
Rate for Payer: Cash Price	$415.20
Rate for Payer: Cash Price	$415.20
Rate for Payer: Mclaren Medicaid	$136.96
Rate for Payer: Meridian Medicaid	$143.81
Rate for Payer: Priority Health Choice Medicaid	$136.96
Rate for Payer: Priority Health Cigna Priority Health	$363.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$260.59
Rate for Payer: Priority Health Narrow Network	$260.59
Rate for Payer: Priority Health SBD	$260.59

PR DELIVERY/BIRTHING ROOM RESUSCITATION

Professional

Both

$456.00

Service Code	HCPCS 99465
Min. Negotiated Rate	$89.67
Max. Negotiated Rate	$319.20
Rate for Payer: Aetna Commercial	$143.87
Rate for Payer: BCBS Complete	$94.15
Rate for Payer: BCBS Trust/PPO	$115.04
Rate for Payer: Cash Price	$364.80
Rate for Payer: Cash Price	$364.80
Rate for Payer: Mclaren Medicaid	$89.67
Rate for Payer: Meridian Medicaid	$94.15
Rate for Payer: Priority Health Choice Medicaid	$89.67
Rate for Payer: Priority Health Cigna Priority Health	$319.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$179.04
Rate for Payer: Priority Health Narrow Network	$179.04
Rate for Payer: Priority Health SBD	$179.04

PR DELIVERY PLACENTA SEPARATE PROCEDURE

Professional

Both

$254.00

Service Code	HCPCS 59414
Min. Negotiated Rate	$68.68
Max. Negotiated Rate	$177.80
Rate for Payer: Aetna Commercial	$100.38
Rate for Payer: BCBS Complete	$88.49
Rate for Payer: BCBS Trust/PPO	$68.68
Rate for Payer: Cash Price	$203.20
Rate for Payer: Cash Price	$203.20
Rate for Payer: Mclaren Medicaid	$84.28
Rate for Payer: Meridian Medicaid	$88.49
Rate for Payer: Priority Health Choice Medicaid	$84.28
Rate for Payer: Priority Health Cigna Priority Health	$177.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$127.95
Rate for Payer: Priority Health Narrow Network	$127.95
Rate for Payer: Priority Health SBD	$127.95

PR DEMO&/EVAL OF PT UTILIZ AERSL GEN/NEB/INHLR/IP

Professional

Both

$55.00

Service Code	HCPCS 94664
Min. Negotiated Rate	$17.47
Max. Negotiated Rate	$379.32
Rate for Payer: Aetna Commercial	$17.47
Rate for Payer: BCBS Complete	$22.00
Rate for Payer: BCBS Trust/PPO	$379.32
Rate for Payer: Cash Price	$44.00
Rate for Payer: Cash Price	$44.00
Rate for Payer: Priority Health Cigna Priority Health	$38.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$22.90
Rate for Payer: Priority Health Narrow Network	$22.90
Rate for Payer: Priority Health SBD	$22.90

PR DENOSUMAB INJECTION

Professional

Both

$25.00

Service Code	HCPCS J0897
Min. Negotiated Rate	$10.00
Max. Negotiated Rate	$25.95
Rate for Payer: Aetna Commercial	$25.95
Rate for Payer: BCBS Complete	$10.00
Rate for Payer: BCBS Trust/PPO	$24.59
Rate for Payer: Cash Price	$20.00
Rate for Payer: Cash Price	$20.00
Rate for Payer: Priority Health Cigna Priority Health	$17.50

PR DEPO-ESTRADIOL CYPIONATE INJ

Professional

Both

$17.00

Service Code	HCPCS J1000
Min. Negotiated Rate	$6.80
Max. Negotiated Rate	$36.83
Rate for Payer: Aetna Commercial	$36.83
Rate for Payer: BCBS Complete	$6.80
Rate for Payer: BCBS Trust/PPO	$36.42
Rate for Payer: Cash Price	$13.60
Rate for Payer: Cash Price	$13.60
Rate for Payer: Priority Health Cigna Priority Health	$11.90

PR DEPRESSION SCREEN ANNUAL

Professional

Both

$31.00

Service Code	HCPCS G0444
Min. Negotiated Rate	$9.26
Max. Negotiated Rate	$1,280.07
Rate for Payer: Aetna Commercial	$9.26
Rate for Payer: BCBS Complete	$12.40
Rate for Payer: BCBS Trust/PPO	$1,280.07
Rate for Payer: Cash Price	$24.80
Rate for Payer: Cash Price	$24.80
Rate for Payer: Priority Health Cigna Priority Health	$21.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$10.80
Rate for Payer: Priority Health Narrow Network	$10.80
Rate for Payer: Priority Health SBD	$10.80

Know your out-of-pocket cost for care.

All Charges