Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PR ANES LITHOTRP XTRCORP SHOCK WAVE W/O WATER BATH

Professional

Both

$5.00

Service Code	HCPCS 00873
Min. Negotiated Rate	$2.00
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Medicare	$2.50
Rate for Payer: BCBS Complete	$2.00
Rate for Payer: Cash Price	$4.00
Rate for Payer: Cash Price	$4.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$50.00
Rate for Payer: Opus (Opus Packaging Group) HMA	$3.75

PR ANES LITHOTRP XTRCORP SHOCK WAVE W/WATER BATH

Professional

Both

$7.00

Service Code	HCPCS 00872
Min. Negotiated Rate	$2.80
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Medicare	$3.50
Rate for Payer: BCBS Complete	$2.80
Rate for Payer: Cash Price	$5.60
Rate for Payer: Cash Price	$5.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$50.00
Rate for Payer: Opus (Opus Packaging Group) HMA	$5.25

PR ANES LOWER LEG CAST APPLICATION REMOVAL/REPAIR

Professional

Both

$3.00

Service Code	HCPCS 01490
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Medicare	$1.50
Rate for Payer: BCBS Complete	$1.20
Rate for Payer: Cash Price	$2.40
Rate for Payer: Cash Price	$2.40
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$50.00
Rate for Payer: Opus (Opus Packaging Group) HMA	$2.25

PR ANES MALE GENT RAD AMP PENIS BI INGUN LYMPHADEC

Professional

Both

$6.00

Service Code	HCPCS 00934
Min. Negotiated Rate	$2.40
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Medicare	$3.00
Rate for Payer: BCBS Complete	$2.40
Rate for Payer: Cash Price	$4.80
Rate for Payer: Cash Price	$4.80
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$50.00
Rate for Payer: Opus (Opus Packaging Group) HMA	$4.50

PR ANES MNPJ SPINE/CLSD PX CRV THRC/LUMBAR SPINE

Professional

Both

$3.00

Service Code	HCPCS 00640
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Medicare	$1.50
Rate for Payer: BCBS Complete	$1.20
Rate for Payer: Cash Price	$2.40
Rate for Payer: Cash Price	$2.40
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$50.00
Rate for Payer: Opus (Opus Packaging Group) HMA	$2.25

PR ANES NON-INVASIVE IMAGING/RADIATION THERAPY

Professional

Both

$7.00

Service Code	HCPCS 01922
Min. Negotiated Rate	$2.80
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Medicare	$3.50
Rate for Payer: BCBS Complete	$2.80
Rate for Payer: Cash Price	$5.60
Rate for Payer: Cash Price	$5.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$50.00
Rate for Payer: Opus (Opus Packaging Group) HMA	$5.25

PR ANES NRV MUSC TDN FSCA&BRS UPR A&E TENODESIS

Professional

Both

$5.00

Service Code	HCPCS 01716
Min. Negotiated Rate	$2.00
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Medicare	$2.50
Rate for Payer: BCBS Complete	$2.00
Rate for Payer: Cash Price	$4.00
Rate for Payer: Cash Price	$4.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$50.00
Rate for Payer: Opus (Opus Packaging Group) HMA	$3.75

PR ANES NRV MUSC TDN FSCA&BRS UPR A&E TENOPLASTY

Professional

Both

$5.00

Service Code	HCPCS 01714
Min. Negotiated Rate	$2.00
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Medicare	$2.50
Rate for Payer: BCBS Complete	$2.00
Rate for Payer: Cash Price	$4.00
Rate for Payer: Cash Price	$4.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$50.00
Rate for Payer: Opus (Opus Packaging Group) HMA	$3.75

PR ANES NRV MUSC TDN FSCA&BRS UPR ARM&ELBOW NOS

Professional

Both

$3.00

Service Code	HCPCS 01710
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Medicare	$1.50
Rate for Payer: BCBS Complete	$1.20
Rate for Payer: Cash Price	$2.40
Rate for Payer: Cash Price	$2.40
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$50.00
Rate for Payer: Opus (Opus Packaging Group) HMA	$2.25

PR ANES OPEN/ARTHROSCOPIC SHOULDER DISARTICULATION

Professional

Both

$9.00

Service Code	HCPCS 01634
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Medicare	$4.50
Rate for Payer: BCBS Complete	$3.60
Rate for Payer: Cash Price	$7.20
Rate for Payer: Cash Price	$7.20
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$50.00
Rate for Payer: Opus (Opus Packaging Group) HMA	$6.75

PR ANES OPEN/ARTHRS INTERTHORACOSCAPULAR AMPUTATION

Professional

Both

$15.00

Service Code	HCPCS 01636
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Medicare	$7.50
Rate for Payer: BCBS Complete	$6.00
Rate for Payer: Cash Price	$12.00
Rate for Payer: Cash Price	$12.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$50.00
Rate for Payer: Opus (Opus Packaging Group) HMA	$11.25

PR ANES OPEN PX B1 LWR L/A/F OSTEOT/OSTPL TIB&/FIB

Professional

Both

$4.00

Service Code	HCPCS 01484
Min. Negotiated Rate	$1.60
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Medicare	$2.00
Rate for Payer: BCBS Complete	$1.60
Rate for Payer: Cash Price	$3.20
Rate for Payer: Cash Price	$3.20
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$50.00
Rate for Payer: Opus (Opus Packaging Group) HMA	$3.00

PR ANES OPEN PX B1 LWR L/A/F RADICAL RESECTION

Professional

Both

$4.00

Service Code	HCPCS 01482
Min. Negotiated Rate	$1.60
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Medicare	$2.00
Rate for Payer: BCBS Complete	$1.60
Rate for Payer: Cash Price	$3.20
Rate for Payer: Cash Price	$3.20
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$50.00
Rate for Payer: Opus (Opus Packaging Group) HMA	$3.00

PR ANES OPEN PX BONES LOWER LEG ANKLE&FOOT NOS

Professional

Both

$3.00

Service Code	HCPCS 01480
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Medicare	$1.50
Rate for Payer: BCBS Complete	$1.20
Rate for Payer: Cash Price	$2.40
Rate for Payer: Cash Price	$2.40
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$50.00
Rate for Payer: Opus (Opus Packaging Group) HMA	$2.25

PR ANES OPEN PX SYMPHYSIS PUBIS/SACROILIAC JOINT

Professional

Both

$8.00

Service Code	HCPCS 01170
Min. Negotiated Rate	$3.20
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Medicare	$4.00
Rate for Payer: BCBS Complete	$3.20
Rate for Payer: Cash Price	$6.40
Rate for Payer: Cash Price	$6.40
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$50.00
Rate for Payer: Opus (Opus Packaging Group) HMA	$6.00

PR ANES OPEN PX UPPER 2/3 FEMUR RADICAL RESCECTION

Professional

Both

$8.00

Service Code	HCPCS 01234
Min. Negotiated Rate	$3.20
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Medicare	$4.00
Rate for Payer: BCBS Complete	$3.20
Rate for Payer: Cash Price	$6.40
Rate for Payer: Cash Price	$6.40
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$50.00
Rate for Payer: Opus (Opus Packaging Group) HMA	$6.00

PR ANES OPEN/SURG ARTHROSCOPIC PX KNEE JOINT NOS

Professional

Both

$4.00

Service Code	HCPCS 01400
Min. Negotiated Rate	$1.60
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Medicare	$2.00
Rate for Payer: BCBS Complete	$1.60
Rate for Payer: Cash Price	$3.20
Rate for Payer: Cash Price	$3.20
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$50.00
Rate for Payer: Opus (Opus Packaging Group) HMA	$3.00

PR ANES OPEN/SURG ARTHRS DISARTICULATION AT KNEE

Professional

Both

$5.00

Service Code	HCPCS 01404
Min. Negotiated Rate	$2.00
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Medicare	$2.50
Rate for Payer: BCBS Complete	$2.00
Rate for Payer: Cash Price	$4.00
Rate for Payer: Cash Price	$4.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$50.00
Rate for Payer: Opus (Opus Packaging Group) HMA	$3.75

PR ANES OPEN/SURG ARTHRS PX ELBW TOTAL ELBOW RPLCMT

Professional

Both

$7.00

Service Code	HCPCS 01760
Min. Negotiated Rate	$2.80
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Medicare	$3.50
Rate for Payer: BCBS Complete	$2.80
Rate for Payer: Cash Price	$5.60
Rate for Payer: Cash Price	$5.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$50.00
Rate for Payer: Opus (Opus Packaging Group) HMA	$5.25

PR ANES OPEN/SURG ARTHRS TOTAL KNEE ARTHROPLASTY

Professional

Both

$7.00

Service Code	HCPCS 01402
Min. Negotiated Rate	$2.80
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Medicare	$3.50
Rate for Payer: BCBS Complete	$2.80
Rate for Payer: Cash Price	$5.60
Rate for Payer: Cash Price	$5.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$50.00
Rate for Payer: Opus (Opus Packaging Group) HMA	$5.25

PR ANES OPN/ARTHR HUMRL H/N STRNCLV ACRMCLV&SHO NOS

Professional

Both

$5.00

Service Code	HCPCS 01630
Min. Negotiated Rate	$2.00
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Medicare	$2.50
Rate for Payer: BCBS Complete	$2.00
Rate for Payer: Cash Price	$4.00
Rate for Payer: Cash Price	$4.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$50.00
Rate for Payer: Opus (Opus Packaging Group) HMA	$3.75

PR ANES OPN/ARTHROSCOPIC TOTAL SHOULDER REPLACEMENT

Professional

Both

$10.00

Service Code	HCPCS 01638
Min. Negotiated Rate	$4.00
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Medicare	$5.00
Rate for Payer: BCBS Complete	$4.00
Rate for Payer: Cash Price	$8.00
Rate for Payer: Cash Price	$8.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$50.00
Rate for Payer: Opus (Opus Packaging Group) HMA	$7.50

PR ANES OPN RPR FX DISRPJ PLVS/COLUMN FX ACETABULUM

Professional

Both

$12.00

Service Code	HCPCS 01173
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Medicare	$6.00
Rate for Payer: BCBS Complete	$4.80
Rate for Payer: Cash Price	$9.60
Rate for Payer: Cash Price	$9.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$50.00
Rate for Payer: Opus (Opus Packaging Group) HMA	$9.00

PR ANES OPN/SURG ARTHRS PX ELBW EXC CST/TUM HUMERUS

Professional

Both

$5.00

Service Code	HCPCS 01758
Min. Negotiated Rate	$2.00
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Medicare	$2.50
Rate for Payer: BCBS Complete	$2.00
Rate for Payer: Cash Price	$4.00
Rate for Payer: Cash Price	$4.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$50.00
Rate for Payer: Opus (Opus Packaging Group) HMA	$3.75

PR ANES OPN/SURG ARTHRS PX ELBW RPR NON/MALUN HUM

Professional

Both

$5.00

Service Code	HCPCS 01744
Min. Negotiated Rate	$2.00
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Medicare	$2.50
Rate for Payer: BCBS Complete	$2.00
Rate for Payer: Cash Price	$4.00
Rate for Payer: Cash Price	$4.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$50.00
Rate for Payer: Opus (Opus Packaging Group) HMA	$3.75

Know your out-of-pocket cost for care.

All Charges