Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PR EXC ISCHIAL PR ULC W/PRIM SUTR W/OSTC ISCHIECT

Professional

Both

$1,584.00

Service Code	HCPCS 15941
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$1,154.61
Rate for Payer: Aetna Commercial	$1,001.30
Rate for Payer: BCBS Complete	$624.88
Rate for Payer: BCBS Trust/PPO	$562.50
Rate for Payer: Cash Price	$1,267.20
Rate for Payer: Cash Price	$1,267.20
Rate for Payer: Mclaren Medicaid	$595.12
Rate for Payer: Meridian Medicaid	$624.88
Rate for Payer: Priority Health Choice Medicaid	$595.12
Rate for Payer: Priority Health Cigna Priority Health	$1,108.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,154.61
Rate for Payer: Priority Health Narrow Network	$1,154.61
Rate for Payer: Priority Health SBD	$1,154.61

PR EXCISION 1ST &/CERVICAL RIB

Professional

Both

$1,178.00

Service Code	HCPCS 21615
Min. Negotiated Rate	$397.46
Max. Negotiated Rate	$3,350.93
Rate for Payer: Aetna Commercial	$825.88
Rate for Payer: BCBS Complete	$417.33
Rate for Payer: BCBS Trust/PPO	$3,350.93
Rate for Payer: Cash Price	$942.40
Rate for Payer: Cash Price	$942.40
Rate for Payer: Mclaren Medicaid	$397.46
Rate for Payer: Meridian Medicaid	$417.33
Rate for Payer: Priority Health Choice Medicaid	$397.46
Rate for Payer: Priority Health Cigna Priority Health	$824.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$945.21
Rate for Payer: Priority Health Narrow Network	$945.21
Rate for Payer: Priority Health SBD	$945.21

PR EXCISION AMPULLA VATER

Professional

Both

$1,811.00

Service Code	HCPCS 48148
Min. Negotiated Rate	$800.24
Max. Negotiated Rate	$2,199.61
Rate for Payer: Aetna Commercial	$1,692.66
Rate for Payer: BCBS Complete	$840.25
Rate for Payer: BCBS Trust/PPO	$1,258.41
Rate for Payer: Cash Price	$1,448.80
Rate for Payer: Cash Price	$1,448.80
Rate for Payer: Mclaren Medicaid	$800.24
Rate for Payer: Meridian Medicaid	$840.25
Rate for Payer: Priority Health Choice Medicaid	$800.24
Rate for Payer: Priority Health Cigna Priority Health	$1,267.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,199.61
Rate for Payer: Priority Health Narrow Network	$2,199.61
Rate for Payer: Priority Health SBD	$2,199.61

PR EXCISION AURAL POLYP

Professional

Both

$369.00

Service Code	HCPCS 69540
Min. Negotiated Rate	$84.14
Max. Negotiated Rate	$2,401.65
Rate for Payer: Aetna Commercial	$142.01
Rate for Payer: BCBS Complete	$88.35
Rate for Payer: BCBS Trust/PPO	$2,401.65
Rate for Payer: Cash Price	$295.20
Rate for Payer: Cash Price	$295.20
Rate for Payer: Mclaren Medicaid	$84.14
Rate for Payer: Meridian Medicaid	$88.35
Rate for Payer: Priority Health Choice Medicaid	$84.14
Rate for Payer: Priority Health Cigna Priority Health	$258.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$185.76
Rate for Payer: Priority Health Narrow Network	$185.76
Rate for Payer: Priority Health SBD	$185.76

PR EXCISION BENIGN TUMOR/CYST MANDIBLE ENCL & CURT

Professional

Both

$957.00

Service Code	HCPCS 21040
Min. Negotiated Rate	$231.74
Max. Negotiated Rate	$669.90
Rate for Payer: Aetna Commercial	$492.36
Rate for Payer: BCBS Complete	$243.33
Rate for Payer: BCBS Trust/PPO	$332.62
Rate for Payer: Cash Price	$765.60
Rate for Payer: Cash Price	$765.60
Rate for Payer: Mclaren Medicaid	$231.74
Rate for Payer: Meridian Medicaid	$243.33
Rate for Payer: Priority Health Choice Medicaid	$231.74
Rate for Payer: Priority Health Cigna Priority Health	$669.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$554.56
Rate for Payer: Priority Health Narrow Network	$554.56
Rate for Payer: Priority Health SBD	$554.56

PR EXCISION BONE CYST/BENIGN TUMOR DEEP

Professional

Both

$1,468.00

Service Code	HCPCS 27066
Min. Negotiated Rate	$80.30
Max. Negotiated Rate	$1,261.81
Rate for Payer: Aetna Commercial	$1,089.99
Rate for Payer: BCBS Complete	$553.76
Rate for Payer: BCBS Trust/PPO	$80.30
Rate for Payer: Cash Price	$1,174.40
Rate for Payer: Cash Price	$1,174.40
Rate for Payer: Mclaren Medicaid	$527.39
Rate for Payer: Meridian Medicaid	$553.76
Rate for Payer: Priority Health Choice Medicaid	$527.39
Rate for Payer: Priority Health Cigna Priority Health	$1,027.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,261.81
Rate for Payer: Priority Health Narrow Network	$1,261.81
Rate for Payer: Priority Health SBD	$1,261.81

PR EXCISION BONE CYST/BNIGN TUMOR SUPERFICIAL

Professional

Both

$887.00

Service Code	HCPCS 27065
Min. Negotiated Rate	$340.59
Max. Negotiated Rate	$4,717.19
Rate for Payer: Aetna Commercial	$699.39
Rate for Payer: BCBS Complete	$357.62
Rate for Payer: BCBS Trust/PPO	$4,717.19
Rate for Payer: Cash Price	$709.60
Rate for Payer: Cash Price	$709.60
Rate for Payer: Mclaren Medicaid	$340.59
Rate for Payer: Meridian Medicaid	$357.62
Rate for Payer: Priority Health Choice Medicaid	$340.59
Rate for Payer: Priority Health Cigna Priority Health	$620.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$815.51
Rate for Payer: Priority Health Narrow Network	$815.51
Rate for Payer: Priority Health SBD	$815.51

PR EXCISION BONE MANDIBLE

Professional

Both

$1,565.00

Service Code	HCPCS 21025
Min. Negotiated Rate	$103.02
Max. Negotiated Rate	$1,095.50
Rate for Payer: Aetna Commercial	$883.19
Rate for Payer: BCBS Complete	$444.84
Rate for Payer: BCBS Trust/PPO	$103.02
Rate for Payer: Cash Price	$1,252.00
Rate for Payer: Cash Price	$1,252.00
Rate for Payer: Mclaren Medicaid	$423.66
Rate for Payer: Meridian Medicaid	$444.84
Rate for Payer: Priority Health Choice Medicaid	$423.66
Rate for Payer: Priority Health Cigna Priority Health	$1,095.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,005.47
Rate for Payer: Priority Health Narrow Network	$1,005.47
Rate for Payer: Priority Health SBD	$1,005.47

PR EXCISION CHALAZION MULTIPLE SAME LID

Professional

Both

$285.00

Service Code	HCPCS 67801
Min. Negotiated Rate	$83.07
Max. Negotiated Rate	$552.60
Rate for Payer: Aetna Commercial	$171.99
Rate for Payer: BCBS Complete	$87.22
Rate for Payer: BCBS Trust/PPO	$552.60
Rate for Payer: Cash Price	$228.00
Rate for Payer: Cash Price	$228.00
Rate for Payer: Mclaren Medicaid	$83.07
Rate for Payer: Meridian Medicaid	$87.22
Rate for Payer: Priority Health Choice Medicaid	$83.07
Rate for Payer: Priority Health Cigna Priority Health	$199.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$227.73
Rate for Payer: Priority Health Narrow Network	$227.73
Rate for Payer: Priority Health SBD	$227.73

PR EXCISION CHALAZION SINGLE

Professional

Both

$193.00

Service Code	HCPCS 67800
Min. Negotiated Rate	$64.75
Max. Negotiated Rate	$552.07
Rate for Payer: Aetna Commercial	$133.72
Rate for Payer: BCBS Complete	$67.99
Rate for Payer: BCBS Trust/PPO	$552.07
Rate for Payer: Cash Price	$154.40
Rate for Payer: Cash Price	$154.40
Rate for Payer: Mclaren Medicaid	$64.75
Rate for Payer: Meridian Medicaid	$67.99
Rate for Payer: Priority Health Choice Medicaid	$64.75
Rate for Payer: Priority Health Cigna Priority Health	$135.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$176.21
Rate for Payer: Priority Health Narrow Network	$176.21
Rate for Payer: Priority Health SBD	$176.21

PR EXCISION CHEST WALL TUMOR INCLUDING RIBS

Professional

Both

$2,391.00

Service Code	HCPCS 21601
Min. Negotiated Rate	$267.70
Max. Negotiated Rate	$1,739.79
Rate for Payer: Aetna Commercial	$1,569.63
Rate for Payer: BCBS Complete	$770.70
Rate for Payer: BCBS Trust/PPO	$267.70
Rate for Payer: Cash Price	$1,912.80
Rate for Payer: Cash Price	$1,912.80
Rate for Payer: Mclaren Medicaid	$734.00
Rate for Payer: Meridian Medicaid	$770.70
Rate for Payer: Priority Health Choice Medicaid	$734.00
Rate for Payer: Priority Health Cigna Priority Health	$1,673.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,739.79
Rate for Payer: Priority Health Narrow Network	$1,739.79
Rate for Payer: Priority Health SBD	$1,739.79

PR EXCISION CHOLEDOCHAL CYST

Professional

Both

$2,262.00

Service Code	HCPCS 47715
Min. Negotiated Rate	$380.38
Max. Negotiated Rate	$2,339.54
Rate for Payer: Aetna Commercial	$1,802.67
Rate for Payer: BCBS Complete	$893.71
Rate for Payer: BCBS Trust/PPO	$380.38
Rate for Payer: Cash Price	$1,809.60
Rate for Payer: Cash Price	$1,809.60
Rate for Payer: Mclaren Medicaid	$851.15
Rate for Payer: Meridian Medicaid	$893.71
Rate for Payer: Priority Health Choice Medicaid	$851.15
Rate for Payer: Priority Health Cigna Priority Health	$1,583.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,339.54
Rate for Payer: Priority Health Narrow Network	$2,339.54
Rate for Payer: Priority Health SBD	$2,339.54

PR EXCISION CH WAL TUM W/RIB W/MEDSTNL LYMPHADEC

Professional

Both

$3,673.00

Service Code	HCPCS 21603
Min. Negotiated Rate	$1,071.39
Max. Negotiated Rate	$8,162.77
Rate for Payer: Aetna Commercial	$2,301.46
Rate for Payer: BCBS Complete	$1,124.96
Rate for Payer: BCBS Trust/PPO	$8,162.77
Rate for Payer: Cash Price	$2,938.40
Rate for Payer: Cash Price	$2,938.40
Rate for Payer: Mclaren Medicaid	$1,071.39
Rate for Payer: Meridian Medicaid	$1,124.96
Rate for Payer: Priority Health Choice Medicaid	$1,071.39
Rate for Payer: Priority Health Cigna Priority Health	$2,571.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,556.31
Rate for Payer: Priority Health Narrow Network	$2,556.31
Rate for Payer: Priority Health SBD	$2,556.31

PR EXCISION CH WAL TUM W/RIB W/O MEDSTNL LYMPHADEC

Professional

Both

$3,064.00

Service Code	HCPCS 21602
Min. Negotiated Rate	$977.46
Max. Negotiated Rate	$32,076.33
Rate for Payer: Aetna Commercial	$2,106.91
Rate for Payer: BCBS Complete	$1,026.33
Rate for Payer: BCBS Trust/PPO	$32,076.33
Rate for Payer: Cash Price	$2,451.20
Rate for Payer: Cash Price	$2,451.20
Rate for Payer: Mclaren Medicaid	$977.46
Rate for Payer: Meridian Medicaid	$1,026.33
Rate for Payer: Priority Health Choice Medicaid	$977.46
Rate for Payer: Priority Health Cigna Priority Health	$2,144.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,344.90
Rate for Payer: Priority Health Narrow Network	$2,344.90
Rate for Payer: Priority Health SBD	$2,344.90

PR EXCISION/CURETTAGE BONE CYST/TUMOR TIBIA/FIBULA

Professional

Both

$2,041.00

Service Code	HCPCS 27635
Min. Negotiated Rate	$375.09
Max. Negotiated Rate	$1,428.70
Rate for Payer: Aetna Commercial	$776.29
Rate for Payer: BCBS Complete	$393.84
Rate for Payer: BCBS Trust/PPO	$1,055.54
Rate for Payer: Cash Price	$1,632.80
Rate for Payer: Cash Price	$1,632.80
Rate for Payer: Mclaren Medicaid	$375.09
Rate for Payer: Meridian Medicaid	$393.84
Rate for Payer: Priority Health Choice Medicaid	$375.09
Rate for Payer: Priority Health Cigna Priority Health	$1,428.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$890.57
Rate for Payer: Priority Health Narrow Network	$890.57
Rate for Payer: Priority Health SBD	$890.57

PR EXCISION/CURETTAGE CYST/TUMOR CARPAL BONES

Professional

Both

$1,589.00

Service Code	HCPCS 25130
Min. Negotiated Rate	$295.43
Max. Negotiated Rate	$1,161.73
Rate for Payer: Aetna Commercial	$598.30
Rate for Payer: BCBS Complete	$310.20
Rate for Payer: BCBS Trust/PPO	$1,161.73
Rate for Payer: Cash Price	$1,271.20
Rate for Payer: Cash Price	$1,271.20
Rate for Payer: Mclaren Medicaid	$295.43
Rate for Payer: Meridian Medicaid	$310.20
Rate for Payer: Priority Health Choice Medicaid	$295.43
Rate for Payer: Priority Health Cigna Priority Health	$1,112.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$700.10
Rate for Payer: Priority Health Narrow Network	$700.10
Rate for Payer: Priority Health SBD	$700.10

PR EXCISION/CURETTAGE CYST/TUMOR FEMUR

Professional

Both

$2,242.00

Service Code	HCPCS 27355
Min. Negotiated Rate	$395.12
Max. Negotiated Rate	$2,489.35
Rate for Payer: Aetna Commercial	$808.43
Rate for Payer: BCBS Complete	$414.88
Rate for Payer: BCBS Trust/PPO	$2,489.35
Rate for Payer: Cash Price	$1,793.60
Rate for Payer: Cash Price	$1,793.60
Rate for Payer: Mclaren Medicaid	$395.12
Rate for Payer: Meridian Medicaid	$414.88
Rate for Payer: Priority Health Choice Medicaid	$395.12
Rate for Payer: Priority Health Cigna Priority Health	$1,569.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$939.09
Rate for Payer: Priority Health Narrow Network	$939.09
Rate for Payer: Priority Health SBD	$939.09

PR EXCISION/CURETTAGE CYST/TUMOR FEMUR INT FIXATION

Professional

Both

$1,049.00

Service Code	HCPCS 27358
Min. Negotiated Rate	$173.60
Max. Negotiated Rate	$2,110.56
Rate for Payer: Aetna Commercial	$370.47
Rate for Payer: BCBS Complete	$182.28
Rate for Payer: BCBS Trust/PPO	$2,110.56
Rate for Payer: Cash Price	$839.20
Rate for Payer: Cash Price	$839.20
Rate for Payer: Mclaren Medicaid	$173.60
Rate for Payer: Meridian Medicaid	$182.28
Rate for Payer: Priority Health Choice Medicaid	$173.60
Rate for Payer: Priority Health Cigna Priority Health	$734.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$415.67
Rate for Payer: Priority Health Narrow Network	$415.67
Rate for Payer: Priority Health SBD	$415.67

PR EXCISION/CURETTAGE CYST/TUMOR FEMUR W/ALLOGRAFT

Professional

Both

$2,172.00

Service Code	HCPCS 27356
Min. Negotiated Rate	$479.89
Max. Negotiated Rate	$1,520.40
Rate for Payer: Aetna Commercial	$987.19
Rate for Payer: BCBS Complete	$503.88
Rate for Payer: BCBS Trust/PPO	$1,244.15
Rate for Payer: Cash Price	$1,737.60
Rate for Payer: Cash Price	$1,737.60
Rate for Payer: Mclaren Medicaid	$479.89
Rate for Payer: Meridian Medicaid	$503.88
Rate for Payer: Priority Health Choice Medicaid	$479.89
Rate for Payer: Priority Health Cigna Priority Health	$1,520.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,140.28
Rate for Payer: Priority Health Narrow Network	$1,140.28
Rate for Payer: Priority Health SBD	$1,140.28

PR EXCISION/CURETTAGE CYST/TUMOR FEMUR W/AUTOGRAFT

Professional

Both

$1,978.00

Service Code	HCPCS 27357
Min. Negotiated Rate	$529.52
Max. Negotiated Rate	$1,740.22
Rate for Payer: Aetna Commercial	$1,090.68
Rate for Payer: BCBS Complete	$556.00
Rate for Payer: BCBS Trust/PPO	$1,740.22
Rate for Payer: Cash Price	$1,582.40
Rate for Payer: Cash Price	$1,582.40
Rate for Payer: Mclaren Medicaid	$529.52
Rate for Payer: Meridian Medicaid	$556.00
Rate for Payer: Priority Health Choice Medicaid	$529.52
Rate for Payer: Priority Health Cigna Priority Health	$1,384.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,260.29
Rate for Payer: Priority Health Narrow Network	$1,260.29
Rate for Payer: Priority Health SBD	$1,260.29

PR EXCISION/CURETTAGE CYST/TUMOR METACARPAL

Professional

Both

$1,269.00

Service Code	HCPCS 26200
Min. Negotiated Rate	$66.57
Max. Negotiated Rate	$888.30
Rate for Payer: Aetna Commercial	$599.88
Rate for Payer: BCBS Complete	$309.53
Rate for Payer: BCBS Trust/PPO	$66.57
Rate for Payer: Cash Price	$1,015.20
Rate for Payer: Cash Price	$1,015.20
Rate for Payer: Mclaren Medicaid	$294.79
Rate for Payer: Meridian Medicaid	$309.53
Rate for Payer: Priority Health Choice Medicaid	$294.79
Rate for Payer: Priority Health Cigna Priority Health	$888.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$700.10
Rate for Payer: Priority Health Narrow Network	$700.10
Rate for Payer: Priority Health SBD	$700.10

PR EXCISION/CURETTAGE CYST/TUMOR PHALANX FINGER

Professional

Both

$1,247.00

Service Code	HCPCS 26210
Min. Negotiated Rate	$293.51
Max. Negotiated Rate	$872.90
Rate for Payer: Aetna Commercial	$592.63
Rate for Payer: BCBS Complete	$308.19
Rate for Payer: BCBS Trust/PPO	$497.66
Rate for Payer: Cash Price	$997.60
Rate for Payer: Cash Price	$997.60
Rate for Payer: Mclaren Medicaid	$293.51
Rate for Payer: Meridian Medicaid	$308.19
Rate for Payer: Priority Health Choice Medicaid	$293.51
Rate for Payer: Priority Health Cigna Priority Health	$872.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$695.50
Rate for Payer: Priority Health Narrow Network	$695.50
Rate for Payer: Priority Health SBD	$695.50

PR EXCISION/CURETTAGE CYST/TUMOR RADIUS/ULNA

Professional

Both

$2,163.00

Service Code	HCPCS 25120
Min. Negotiated Rate	$327.81
Max. Negotiated Rate	$1,514.10
Rate for Payer: Aetna Commercial	$666.80
Rate for Payer: BCBS Complete	$344.20
Rate for Payer: BCBS Trust/PPO	$351.32
Rate for Payer: Cash Price	$1,730.40
Rate for Payer: Cash Price	$1,730.40
Rate for Payer: Mclaren Medicaid	$327.81
Rate for Payer: Meridian Medicaid	$344.20
Rate for Payer: Priority Health Choice Medicaid	$327.81
Rate for Payer: Priority Health Cigna Priority Health	$1,514.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$777.72
Rate for Payer: Priority Health Narrow Network	$777.72
Rate for Payer: Priority Health SBD	$777.72

PR EXCISION/CURETTAGE CYST/TUMOR TALUS/CALCANEUS

Professional

Both

$1,113.00

Service Code	HCPCS 28100
Min. Negotiated Rate	$269.87
Max. Negotiated Rate	$1,087.24
Rate for Payer: Aetna Commercial	$551.67
Rate for Payer: BCBS Complete	$283.36
Rate for Payer: BCBS Trust/PPO	$1,087.24
Rate for Payer: Cash Price	$890.40
Rate for Payer: Cash Price	$890.40
Rate for Payer: Mclaren Medicaid	$269.87
Rate for Payer: Meridian Medicaid	$283.36
Rate for Payer: Priority Health Choice Medicaid	$269.87
Rate for Payer: Priority Health Cigna Priority Health	$779.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$640.36
Rate for Payer: Priority Health Narrow Network	$640.36
Rate for Payer: Priority Health SBD	$640.36

PR EXCISION/CURTG BONE CYST/BENIGN TUMOR HUMERUS

Professional

Both

$1,172.00

Service Code	HCPCS 24110
Min. Negotiated Rate	$45.96
Max. Negotiated Rate	$913.55
Rate for Payer: Aetna Commercial	$774.56
Rate for Payer: BCBS Complete	$404.13
Rate for Payer: BCBS Trust/PPO	$45.96
Rate for Payer: Cash Price	$937.60
Rate for Payer: Cash Price	$937.60
Rate for Payer: Mclaren Medicaid	$384.89
Rate for Payer: Meridian Medicaid	$404.13
Rate for Payer: Priority Health Choice Medicaid	$384.89
Rate for Payer: Priority Health Cigna Priority Health	$820.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$913.55
Rate for Payer: Priority Health Narrow Network	$913.55
Rate for Payer: Priority Health SBD	$913.55

Know your out-of-pocket cost for care.

All Charges