Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PR ANESTHESIA OPEN PROCEDURES HIP JOINT NOS

Professional

Both

$6.00

Service Code	HCPCS 01210
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 ANESTHESIA OPEN PROCEDURES UPPER 2/3 FEMUR NOS

Professional

Both

$6.00

Service Code	HCPCS 01230
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 ANESTHESIA OPEN PX HIP JOINT HIP DISARTICULATION

Professional

Both

$10.00

Service Code	HCPCS 01212
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 ANESTHESIA OPEN PX REVISION TOT HIP ARTHROPLASTY

Professional

Both

$10.00

Service Code	HCPCS 01215
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 ANESTHESIA OPEN PX TOTAL ANKLE REPLACEMENT

Professional

Both

$7.00

Service Code	HCPCS 01486
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 ANESTHESIA OPEN PX TOTAL HIP ARTHROPLASTY

Professional

Both

$8.00

Service Code	HCPCS 01214
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 ANESTHESIA OPEN PX UPPER 2/3 FEMUR AMPUTATION

Professional

Both

$5.00

Service Code	HCPCS 01232
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 ANESTHESIA OPEN/SURG ARTHROSCOPIC PX ELBOW NOS

Professional

Both

$4.00

Service Code	HCPCS 01740
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 ANESTHESIA OPEN/SURG ARTHRS ELBW OSTEOTOMY HUM

Professional

Both

$5.00

Service Code	HCPCS 01742
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 ANESTHESIA OPEN/SURG ARTHRS PX ELBOW RADICAL PX

Professional

Both

$6.00

Service Code	HCPCS 01756
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 ANESTHESIA PARTIAL RIB RESECTION NOS

Professional

Both

$6.00

Service Code	HCPCS 00470
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 ANESTHESIA PARTIAL RIB RESECTION RADICAL PX

Professional

Both

$13.00

Service Code	HCPCS 00474
Min. Negotiated Rate	$5.20
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Medicare	$6.50
Rate for Payer: BCBS Complete	$5.20
Rate for Payer: Cash Price	$10.40
Rate for Payer: Cash Price	$10.40
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$50.00
Rate for Payer: Opus (Opus Packaging Group) HMA	$9.75

PR ANESTHESIA PARTIAL RIB RESECTION THORACOPLASTY

Professional

Both

$10.00

Service Code	HCPCS 00472
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 ANESTHESIA PERINEAL PROSTATECTOMY

Professional

Both

$6.00

Service Code	HCPCS 00908
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 ANESTHESIA PROCEDURES IN LUMBAR REGION NOS

Professional

Both

$8.00

Service Code	HCPCS 00630
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 ANESTHESIA PROCEDURES ON BONY PELVIS

Professional

Both

$6.00

Service Code	HCPCS 01120
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 ANESTHESIA PX ARTERIES FOREARM WRIST&HAND NOS

Professional

Both

$6.00

Service Code	HCPCS 01840
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 ANESTHESIA PX ARTERIES LWR LEG W/BYPASS GRF NOS

Professional

Both

$8.00

Service Code	HCPCS 01500
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 ANESTHESIA PX ARTERIES SHOULDER&AXILLA NOS

Professional

Both

$6.00

Service Code	HCPCS 01650
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 ANESTHESIA PX ARTERIES UPPER ARM&ELBOW NOS

Professional

Both

$6.00

Service Code	HCPCS 01770
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 ANESTHESIA PX ARTERIES UPPER LEG NOS

Professional

Both

$8.00

Service Code	HCPCS 01270
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 ANESTHESIA PX ARTERIES UPR ARM&ELBW EMBOLECTOMY

Professional

Both

$6.00

Service Code	HCPCS 01772
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 ANESTHESIA PX CERVICAL SPINE & CORD NOS

Professional

Both

$10.00

Service Code	HCPCS 00600
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 ANESTHESIA PX CLAVICLE AND SCAPULA NOS

Professional

Both

$5.00

Service Code	HCPCS 00450
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 ANESTHESIA PX CLAVICLE & SCAPULA BIOPSY CLAVICLE

Professional

Both

$3.00

Service Code	HCPCS 00454
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

Know your out-of-pocket cost for care.

All Charges