Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PR FASCIOTOMY PALMAR OPEN PARTIAL

Professional

Both

$1,341.00

Service Code	HCPCS 26045
Min. Negotiated Rate	$153.67
Max. Negotiated Rate	$938.70
Rate for Payer: Aetna Commercial	$627.38
Rate for Payer: BCBS Complete	$324.51
Rate for Payer: BCBS Trust/PPO	$153.67
Rate for Payer: Cash Price	$1,072.80
Rate for Payer: Cash Price	$1,072.80
Rate for Payer: Mclaren Medicaid	$309.06
Rate for Payer: Meridian Medicaid	$324.51
Rate for Payer: Priority Health Choice Medicaid	$309.06
Rate for Payer: Priority Health Cigna Priority Health	$938.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$732.78
Rate for Payer: Priority Health Narrow Network	$732.78
Rate for Payer: Priority Health SBD	$732.78

PR FASCIOTOMY PALMAR PERCUTANEOUS

Professional

Both

$912.00

Service Code	HCPCS 26040
Min. Negotiated Rate	$139.24
Max. Negotiated Rate	$638.40
Rate for Payer: Aetna Commercial	$417.73
Rate for Payer: BCBS Complete	$218.28
Rate for Payer: BCBS Trust/PPO	$139.24
Rate for Payer: Cash Price	$729.60
Rate for Payer: Cash Price	$729.60
Rate for Payer: Mclaren Medicaid	$207.89
Rate for Payer: Meridian Medicaid	$218.28
Rate for Payer: Priority Health Choice Medicaid	$207.89
Rate for Payer: Priority Health Cigna Priority Health	$638.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$492.26
Rate for Payer: Priority Health Narrow Network	$492.26
Rate for Payer: Priority Health SBD	$492.26

PR FASCT PALM W/WO Z-PLASTY TISSUE REARGMT/SKN GRFT

Professional

Both

$2,315.00

Service Code	HCPCS 26121
Min. Negotiated Rate	$250.03
Max. Negotiated Rate	$1,620.50
Rate for Payer: Aetna Commercial	$797.78
Rate for Payer: BCBS Complete	$409.95
Rate for Payer: BCBS Trust/PPO	$250.03
Rate for Payer: Cash Price	$1,852.00
Rate for Payer: Cash Price	$1,852.00
Rate for Payer: Mclaren Medicaid	$390.43
Rate for Payer: Meridian Medicaid	$409.95
Rate for Payer: Priority Health Choice Medicaid	$390.43
Rate for Payer: Priority Health Cigna Priority Health	$1,620.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$927.34
Rate for Payer: Priority Health Narrow Network	$927.34
Rate for Payer: Priority Health SBD	$927.34

PR FASCT PRTL PALMAR 1 DGT PROX IPHAL JT W/WO RPR

Professional

Both

$2,894.00

Service Code	HCPCS 26123
Min. Negotiated Rate	$337.48
Max. Negotiated Rate	$2,025.80
Rate for Payer: Aetna Commercial	$1,109.61
Rate for Payer: BCBS Complete	$571.20
Rate for Payer: BCBS Trust/PPO	$337.48
Rate for Payer: Cash Price	$2,315.20
Rate for Payer: Cash Price	$2,315.20
Rate for Payer: Mclaren Medicaid	$544.00
Rate for Payer: Meridian Medicaid	$571.20
Rate for Payer: Priority Health Choice Medicaid	$544.00
Rate for Payer: Priority Health Cigna Priority Health	$2,025.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,291.44
Rate for Payer: Priority Health Narrow Network	$1,291.44
Rate for Payer: Priority Health SBD	$1,291.44

PR FASCT PRTL PALMR ADDL DGT PROX IPHAL JT W/WO RPR

Professional

Both

$868.00

Service Code	HCPCS 26125
Min. Negotiated Rate	$170.40
Max. Negotiated Rate	$607.60
Rate for Payer: Aetna Commercial	$361.78
Rate for Payer: BCBS Complete	$178.92
Rate for Payer: BCBS Trust/PPO	$555.24
Rate for Payer: Cash Price	$694.40
Rate for Payer: Cash Price	$694.40
Rate for Payer: Mclaren Medicaid	$170.40
Rate for Payer: Meridian Medicaid	$178.92
Rate for Payer: Priority Health Choice Medicaid	$170.40
Rate for Payer: Priority Health Cigna Priority Health	$607.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$407.50
Rate for Payer: Priority Health Narrow Network	$407.50
Rate for Payer: Priority Health SBD	$407.50

PR FECAL BLOOD SCRN IMMUNOASSAY

Professional

Both

$37.00

Service Code	HCPCS G0328
Min. Negotiated Rate	$14.80
Max. Negotiated Rate	$1,270.03
Rate for Payer: Aetna Commercial	$17.15
Rate for Payer: BCBS Complete	$14.80
Rate for Payer: BCBS Trust/PPO	$1,270.03
Rate for Payer: Cash Price	$29.60
Rate for Payer: Cash Price	$29.60
Rate for Payer: Priority Health Cigna Priority Health	$25.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$18.63
Rate for Payer: Priority Health Narrow Network	$18.63
Rate for Payer: Priority Health SBD	$18.63

PR FECAL MICROBIOTA PREP INSTIL

Professional

Both

$200.00

Service Code	HCPCS G0455
Min. Negotiated Rate	$44.52
Max. Negotiated Rate	$1,923.54
Rate for Payer: Aetna Commercial	$71.32
Rate for Payer: BCBS Complete	$46.75
Rate for Payer: BCBS Trust/PPO	$1,923.54
Rate for Payer: Cash Price	$160.00
Rate for Payer: Cash Price	$160.00
Rate for Payer: Mclaren Medicaid	$44.52
Rate for Payer: Meridian Medicaid	$46.75
Rate for Payer: Priority Health Choice Medicaid	$44.52
Rate for Payer: Priority Health Cigna Priority Health	$140.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$124.06
Rate for Payer: Priority Health Narrow Network	$124.06
Rate for Payer: Priority Health SBD	$124.06

PR FERN TEST

Professional

Both

$6.00

Service Code	HCPCS Q0114
Min. Negotiated Rate	$2.40
Max. Negotiated Rate	$126.79
Rate for Payer: Aetna Commercial	$9.25
Rate for Payer: BCBS Complete	$2.40
Rate for Payer: BCBS Trust/PPO	$126.79
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 FETAL CONTRACTION STRESS TEST

Professional

Both

$161.00

Service Code	HCPCS 59020
Min. Negotiated Rate	$47.69
Max. Negotiated Rate	$145.28
Rate for Payer: Aetna Commercial	$74.73
Rate for Payer: BCBS Complete	$64.40
Rate for Payer: BCBS Trust/PPO	$145.28
Rate for Payer: Cash Price	$128.80
Rate for Payer: Cash Price	$128.80
Rate for Payer: Priority Health Cigna Priority Health	$112.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$47.69
Rate for Payer: Priority Health Narrow Network	$47.69
Rate for Payer: Priority Health SBD	$99.63

PR FETAL FLUID DRAINAGE W/ULTRASOUND GUIDANCE

Professional

Both

$825.00

Service Code	HCPCS 59074
Min. Negotiated Rate	$197.24
Max. Negotiated Rate	$577.50
Rate for Payer: Aetna Commercial	$338.16
Rate for Payer: BCBS Complete	$207.10
Rate for Payer: BCBS Trust/PPO	$488.15
Rate for Payer: Cash Price	$660.00
Rate for Payer: Cash Price	$660.00
Rate for Payer: Mclaren Medicaid	$197.24
Rate for Payer: Meridian Medicaid	$207.10
Rate for Payer: Priority Health Choice Medicaid	$197.24
Rate for Payer: Priority Health Cigna Priority Health	$577.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$434.87
Rate for Payer: Priority Health Narrow Network	$434.87
Rate for Payer: Priority Health SBD	$434.87

PR FETAL NONSTRESS TEST

Professional

Both

$100.00

Service Code	HCPCS 59025
Min. Negotiated Rate	$28.33
Max. Negotiated Rate	$522.49
Rate for Payer: Aetna Commercial	$52.53
Rate for Payer: BCBS Complete	$40.00
Rate for Payer: BCBS Trust/PPO	$522.49
Rate for Payer: Cash Price	$80.00
Rate for Payer: Cash Price	$80.00
Rate for Payer: Priority Health Cigna Priority Health	$70.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$28.33
Rate for Payer: Priority Health Narrow Network	$28.33
Rate for Payer: Priority Health SBD	$68.94

PR FETAL SHUNT PLACEMENT W/ULTRASOUND GUIDANCE

Professional

Both

$1,045.00

Service Code	HCPCS 59076
Min. Negotiated Rate	$125.74
Max. Negotiated Rate	$733.76
Rate for Payer: Aetna Commercial	$572.27
Rate for Payer: BCBS Complete	$349.11
Rate for Payer: BCBS Trust/PPO	$125.74
Rate for Payer: Cash Price	$836.00
Rate for Payer: Cash Price	$836.00
Rate for Payer: Mclaren Medicaid	$332.49
Rate for Payer: Meridian Medicaid	$349.11
Rate for Payer: Priority Health Choice Medicaid	$332.49
Rate for Payer: Priority Health Cigna Priority Health	$731.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$733.76
Rate for Payer: Priority Health Narrow Network	$733.76
Rate for Payer: Priority Health SBD	$733.76

PR FILLETED FINGER/TOE FLAP W/PREPJ RECIPIENT SITE

Professional

Both

$1,268.00

Service Code	HCPCS 14350
Min. Negotiated Rate	$432.18
Max. Negotiated Rate	$5,240.72
Rate for Payer: Aetna Commercial	$734.78
Rate for Payer: BCBS Complete	$453.79
Rate for Payer: BCBS Trust/PPO	$5,240.72
Rate for Payer: Cash Price	$1,014.40
Rate for Payer: Cash Price	$1,014.40
Rate for Payer: Mclaren Medicaid	$432.18
Rate for Payer: Meridian Medicaid	$453.79
Rate for Payer: Priority Health Choice Medicaid	$432.18
Rate for Payer: Priority Health Cigna Priority Health	$887.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$826.18
Rate for Payer: Priority Health Narrow Network	$826.18
Rate for Payer: Priority Health SBD	$826.18

PR FINE NEEDLE ASPIRATION BX W/CT GDN 1ST LESION

Professional

Both

$722.00

Service Code	HCPCS 10009
Min. Negotiated Rate	$68.16
Max. Negotiated Rate	$505.40
Rate for Payer: Aetna Commercial	$121.91
Rate for Payer: BCBS Complete	$71.57
Rate for Payer: BCBS Trust/PPO	$405.74
Rate for Payer: Cash Price	$577.60
Rate for Payer: Cash Price	$577.60
Rate for Payer: Mclaren Medicaid	$68.16
Rate for Payer: Meridian Medicaid	$71.57
Rate for Payer: Priority Health Choice Medicaid	$68.16
Rate for Payer: Priority Health Cigna Priority Health	$505.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$132.36
Rate for Payer: Priority Health Narrow Network	$132.36
Rate for Payer: Priority Health SBD	$132.36

PR FINE NEEDLE ASPIRATION BX W/O IMG GDN 1ST LESION

Professional

Both

$233.00

Service Code	HCPCS 10021
Min. Negotiated Rate	$34.72
Max. Negotiated Rate	$3,585.00
Rate for Payer: Aetna Commercial	$60.18
Rate for Payer: BCBS Complete	$36.46
Rate for Payer: BCBS Trust/PPO	$3,585.00
Rate for Payer: Cash Price	$186.40
Rate for Payer: Cash Price	$186.40
Rate for Payer: Mclaren Medicaid	$34.72
Rate for Payer: Meridian Medicaid	$36.46
Rate for Payer: Priority Health Choice Medicaid	$34.72
Rate for Payer: Priority Health Cigna Priority Health	$163.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$67.00
Rate for Payer: Priority Health Narrow Network	$67.00
Rate for Payer: Priority Health SBD	$67.00

PR FINE NEEDLE ASPIRATION BX W/US GDN 1ST LESION

Professional

Both

$247.00

Service Code	HCPCS 10005
Min. Negotiated Rate	$28.95
Max. Negotiated Rate	$172.90
Rate for Payer: Aetna Commercial	$79.16
Rate for Payer: BCBS Complete	$48.31
Rate for Payer: BCBS Trust/PPO	$28.95
Rate for Payer: Cash Price	$197.60
Rate for Payer: Cash Price	$197.60
Rate for Payer: Mclaren Medicaid	$46.01
Rate for Payer: Meridian Medicaid	$48.31
Rate for Payer: Priority Health Choice Medicaid	$46.01
Rate for Payer: Priority Health Cigna Priority Health	$172.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$89.60
Rate for Payer: Priority Health Narrow Network	$89.60
Rate for Payer: Priority Health SBD	$89.60

PR FINE NEEDLE ASPIRATION BX W/US GDN EA ADDL

Professional

Both

$120.00

Service Code	HCPCS 10006
Min. Negotiated Rate	$31.52
Max. Negotiated Rate	$349.63
Rate for Payer: Aetna Commercial	$55.08
Rate for Payer: BCBS Complete	$33.10
Rate for Payer: BCBS Trust/PPO	$349.63
Rate for Payer: Cash Price	$96.00
Rate for Payer: Cash Price	$96.00
Rate for Payer: Mclaren Medicaid	$31.52
Rate for Payer: Meridian Medicaid	$33.10
Rate for Payer: Priority Health Choice Medicaid	$31.52
Rate for Payer: Priority Health Cigna Priority Health	$84.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$60.83
Rate for Payer: Priority Health Narrow Network	$60.83
Rate for Payer: Priority Health SBD	$60.83

PR FINE NEEDLE ASP;W/IMAGING GUIDANCE

Professional

Both

$264.00

Service Code	HCPCS 10022
Min. Negotiated Rate	$105.60
Max. Negotiated Rate	$184.80
Rate for Payer: BCBS Complete	$105.60
Rate for Payer: Cash Price	$211.20
Rate for Payer: Priority Health Cigna Priority Health	$184.80

PR FINGER SPLINT, STATIC

Professional

Both

$5.00

Service Code	HCPCS Q4049
Min. Negotiated Rate	$1.77
Max. Negotiated Rate	$3.50
Rate for Payer: Aetna Commercial	$1.77
Rate for Payer: BCBS Complete	$2.00
Rate for Payer: Cash Price	$4.00
Rate for Payer: Cash Price	$4.00
Rate for Payer: Priority Health Cigna Priority Health	$3.50

PR FISSURECTOMY INCL SPHINCTEROTOMY WHEN PERFORMED

Professional

Both

$943.00

Service Code	HCPCS 46200
Min. Negotiated Rate	$218.54
Max. Negotiated Rate	$1,577.50
Rate for Payer: Aetna Commercial	$443.17
Rate for Payer: BCBS Complete	$229.47
Rate for Payer: BCBS Trust/PPO	$1,577.50
Rate for Payer: Cash Price	$754.40
Rate for Payer: Cash Price	$754.40
Rate for Payer: Mclaren Medicaid	$218.54
Rate for Payer: Meridian Medicaid	$229.47
Rate for Payer: Priority Health Choice Medicaid	$218.54
Rate for Payer: Priority Health Cigna Priority Health	$660.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$596.80
Rate for Payer: Priority Health Narrow Network	$596.80
Rate for Payer: Priority Health SBD	$596.80

PR FIT CONTACT LENS TX OCULAR SURFACE DISEASE

Professional

Both

$66.00

Service Code	HCPCS 92071
Min. Negotiated Rate	$20.24
Max. Negotiated Rate	$664.07
Rate for Payer: Aetna Commercial	$35.00
Rate for Payer: BCBS Complete	$21.25
Rate for Payer: BCBS Trust/PPO	$664.07
Rate for Payer: Cash Price	$52.80
Rate for Payer: Cash Price	$52.80
Rate for Payer: Mclaren Medicaid	$20.24
Rate for Payer: Meridian Medicaid	$21.25
Rate for Payer: Priority Health Choice Medicaid	$20.24
Rate for Payer: Priority Health Cigna Priority Health	$46.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$38.14
Rate for Payer: Priority Health Narrow Network	$38.14
Rate for Payer: Priority Health SBD	$38.14

PR FIT&INSJ PESSARY/OTH INTRAVAGINAL SUPPORT DEVI

Professional

Both

$125.00

Service Code	HCPCS 57160
Min. Negotiated Rate	$29.18
Max. Negotiated Rate	$2,269.05
Rate for Payer: Aetna Commercial	$55.97
Rate for Payer: BCBS Complete	$30.64
Rate for Payer: BCBS Trust/PPO	$2,269.05
Rate for Payer: Cash Price	$100.00
Rate for Payer: Cash Price	$100.00
Rate for Payer: Mclaren Medicaid	$29.18
Rate for Payer: Meridian Medicaid	$30.64
Rate for Payer: Priority Health Choice Medicaid	$29.18
Rate for Payer: Priority Health Cigna Priority Health	$87.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$64.87
Rate for Payer: Priority Health Narrow Network	$64.87
Rate for Payer: Priority Health SBD	$64.87

PR FITTING CONTACT LENS FOR MNGT OF KERATOCONUS

Professional

Both

$217.00

Service Code	HCPCS 92072
Min. Negotiated Rate	$58.58
Max. Negotiated Rate	$900.75
Rate for Payer: Aetna Commercial	$104.39
Rate for Payer: BCBS Complete	$61.51
Rate for Payer: BCBS Trust/PPO	$900.75
Rate for Payer: Cash Price	$173.60
Rate for Payer: Cash Price	$173.60
Rate for Payer: Mclaren Medicaid	$58.58
Rate for Payer: Meridian Medicaid	$61.51
Rate for Payer: Priority Health Choice Medicaid	$58.58
Rate for Payer: Priority Health Cigna Priority Health	$151.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$111.61
Rate for Payer: Priority Health Narrow Network	$111.61
Rate for Payer: Priority Health SBD	$111.61

PR FIXATION CONTRALATERAL TESTIS SEPARATE PROCEDURE

Professional

Both

$563.00

Service Code	HCPCS 54620
Min. Negotiated Rate	$190.21
Max. Negotiated Rate	$3,422.86
Rate for Payer: Aetna Commercial	$383.67
Rate for Payer: BCBS Complete	$199.72
Rate for Payer: BCBS Trust/PPO	$3,422.86
Rate for Payer: Cash Price	$450.40
Rate for Payer: Cash Price	$450.40
Rate for Payer: Mclaren Medicaid	$190.21
Rate for Payer: Meridian Medicaid	$199.72
Rate for Payer: Priority Health Choice Medicaid	$190.21
Rate for Payer: Priority Health Cigna Priority Health	$394.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$477.13
Rate for Payer: Priority Health Narrow Network	$477.13
Rate for Payer: Priority Health SBD	$477.13

PR FLAP ISLAND PEDICLE ANATOMIC NAMED AXIAL ARTERY

Professional

Both

$1,699.00

Service Code	HCPCS 15740
Min. Negotiated Rate	$538.89
Max. Negotiated Rate	$1,709.25
Rate for Payer: Aetna Commercial	$895.75
Rate for Payer: BCBS Complete	$565.83
Rate for Payer: BCBS Trust/PPO	$1,709.25
Rate for Payer: Cash Price	$1,359.20
Rate for Payer: Cash Price	$1,359.20
Rate for Payer: Mclaren Medicaid	$538.89
Rate for Payer: Meridian Medicaid	$565.83
Rate for Payer: Priority Health Choice Medicaid	$538.89
Rate for Payer: Priority Health Cigna Priority Health	$1,189.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,030.47
Rate for Payer: Priority Health Narrow Network	$1,030.47
Rate for Payer: Priority Health SBD	$1,030.47

Know your out-of-pocket cost for care.

All Charges