Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PR NASO/ORO-GASTRIC TUBE PLMT REQ PHYS&FLUOR GDNCE

Professional

Both

$117.00

Service Code	HCPCS 43752
Min. Negotiated Rate	$25.13
Max. Negotiated Rate	$1,612.37
Rate for Payer: Aetna Commercial	$54.32
Rate for Payer: BCBS Complete	$26.39
Rate for Payer: BCBS Trust/PPO	$1,612.37
Rate for Payer: Cash Price	$93.60
Rate for Payer: Cash Price	$93.60
Rate for Payer: Mclaren Medicaid	$25.13
Rate for Payer: Meridian Medicaid	$26.39
Rate for Payer: Priority Health Choice Medicaid	$25.13
Rate for Payer: Priority Health Cigna Priority Health	$81.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$69.98
Rate for Payer: Priority Health Narrow Network	$69.98
Rate for Payer: Priority Health SBD	$69.98

PR NASOPHARYNGOSCOPY W/ENDOSCOPE SPX

Professional

Both

$226.00

Service Code	HCPCS 92511
Min. Negotiated Rate	$24.07
Max. Negotiated Rate	$552.07
Rate for Payer: Aetna Commercial	$40.68
Rate for Payer: BCBS Complete	$25.27
Rate for Payer: BCBS Trust/PPO	$552.07
Rate for Payer: Cash Price	$180.80
Rate for Payer: Cash Price	$180.80
Rate for Payer: Mclaren Medicaid	$24.07
Rate for Payer: Meridian Medicaid	$25.27
Rate for Payer: Priority Health Choice Medicaid	$24.07
Rate for Payer: Priority Health Cigna Priority Health	$158.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$50.30
Rate for Payer: Priority Health Narrow Network	$50.30
Rate for Payer: Priority Health SBD	$50.30

PR NDL EMG 1 XTR W/WO RELATED PARASPINAL AREAS

Professional

Both

$211.00

Service Code	HCPCS 95860
Min. Negotiated Rate	$66.47
Max. Negotiated Rate	$1,210.86
Rate for Payer: Aetna Commercial	$127.72
Rate for Payer: BCBS Complete	$84.40
Rate for Payer: BCBS Trust/PPO	$1,210.86
Rate for Payer: Cash Price	$168.80
Rate for Payer: Cash Price	$168.80
Rate for Payer: Priority Health Cigna Priority Health	$147.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$66.47
Rate for Payer: Priority Health Narrow Network	$66.47
Rate for Payer: Priority Health SBD	$150.46

PR NDL EMG 2 XTR W/WO RELATED PARASPINAL AREAS

Professional

Both

$290.00

Service Code	HCPCS 95861
Min. Negotiated Rate	$106.44
Max. Negotiated Rate	$1,443.84
Rate for Payer: Aetna Commercial	$184.98
Rate for Payer: BCBS Complete	$116.00
Rate for Payer: BCBS Trust/PPO	$1,443.84
Rate for Payer: Cash Price	$232.00
Rate for Payer: Cash Price	$232.00
Rate for Payer: Priority Health Cigna Priority Health	$203.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$106.44
Rate for Payer: Priority Health Narrow Network	$106.44
Rate for Payer: Priority Health SBD	$215.14

PR NDL EMG 3 XTR W/WO RELATED PARASPINAL AREAS

Professional

Both

$354.00

Service Code	HCPCS 95863
Min. Negotiated Rate	$129.80
Max. Negotiated Rate	$706.87
Rate for Payer: Aetna Commercial	$240.60
Rate for Payer: BCBS Complete	$141.60
Rate for Payer: BCBS Trust/PPO	$706.87
Rate for Payer: Cash Price	$283.20
Rate for Payer: Cash Price	$283.20
Rate for Payer: Priority Health Cigna Priority Health	$247.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$129.80
Rate for Payer: Priority Health Narrow Network	$129.80
Rate for Payer: Priority Health SBD	$279.37

PR NDL EMG 4 XTR W/WO RELATED PARASPINAL AREAS

Professional

Both

$405.00

Service Code	HCPCS 95864
Min. Negotiated Rate	$138.33
Max. Negotiated Rate	$953.58
Rate for Payer: Aetna Commercial	$268.89
Rate for Payer: BCBS Complete	$162.00
Rate for Payer: BCBS Trust/PPO	$953.58
Rate for Payer: Cash Price	$324.00
Rate for Payer: Cash Price	$324.00
Rate for Payer: Priority Health Cigna Priority Health	$283.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$138.33
Rate for Payer: Priority Health Narrow Network	$138.33
Rate for Payer: Priority Health SBD	$313.05

PR NDSC EVAL INTSTINAL POUCH DX W/COLLJ SPEC SPX

Professional

Both

$856.00

Service Code	HCPCS 44385
Min. Negotiated Rate	$46.22
Max. Negotiated Rate	$1,990.63
Rate for Payer: Aetna Commercial	$95.20
Rate for Payer: BCBS Complete	$48.53
Rate for Payer: BCBS Trust/PPO	$1,990.63
Rate for Payer: Cash Price	$684.80
Rate for Payer: Cash Price	$684.80
Rate for Payer: Mclaren Medicaid	$46.22
Rate for Payer: Meridian Medicaid	$48.53
Rate for Payer: Priority Health Choice Medicaid	$46.22
Rate for Payer: Priority Health Cigna Priority Health	$599.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$127.01
Rate for Payer: Priority Health Narrow Network	$127.01
Rate for Payer: Priority Health SBD	$127.01

PR NDSC EVAL INTSTINAL POUCH W/BX SINGLE/MULTIPLE

Professional

Both

$1,018.00

Service Code	HCPCS 44386
Min. Negotiated Rate	$56.45
Max. Negotiated Rate	$3,257.50
Rate for Payer: Aetna Commercial	$117.55
Rate for Payer: BCBS Complete	$59.27
Rate for Payer: BCBS Trust/PPO	$3,257.50
Rate for Payer: Cash Price	$814.40
Rate for Payer: Cash Price	$814.40
Rate for Payer: Mclaren Medicaid	$56.45
Rate for Payer: Meridian Medicaid	$59.27
Rate for Payer: Priority Health Choice Medicaid	$56.45
Rate for Payer: Priority Health Cigna Priority Health	$712.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$154.63
Rate for Payer: Priority Health Narrow Network	$154.63
Rate for Payer: Priority Health SBD	$154.63

PR NDSC NJX IMPLT MATRL URT&/BLDR NCK

Professional

Both

$1,715.00

Service Code	HCPCS 51715
Min. Negotiated Rate	$126.10
Max. Negotiated Rate	$2,071.46
Rate for Payer: Aetna Commercial	$257.04
Rate for Payer: BCBS Complete	$132.40
Rate for Payer: BCBS Trust/PPO	$2,071.46
Rate for Payer: Cash Price	$1,372.00
Rate for Payer: Cash Price	$1,372.00
Rate for Payer: Mclaren Medicaid	$126.10
Rate for Payer: Meridian Medicaid	$132.40
Rate for Payer: Priority Health Choice Medicaid	$126.10
Rate for Payer: Priority Health Cigna Priority Health	$1,200.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$317.74
Rate for Payer: Priority Health Narrow Network	$317.74
Rate for Payer: Priority Health SBD	$317.74

PR NDSC SURG W/VIDEO-ASSISTED HARVEST VEIN CABG

Professional

Both

$335.00

Service Code	HCPCS 33508
Min. Negotiated Rate	$10.01
Max. Negotiated Rate	$878.56
Rate for Payer: Aetna Commercial	$21.23
Rate for Payer: BCBS Complete	$10.51
Rate for Payer: BCBS Trust/PPO	$878.56
Rate for Payer: Cash Price	$268.00
Rate for Payer: Cash Price	$268.00
Rate for Payer: Mclaren Medicaid	$10.01
Rate for Payer: Meridian Medicaid	$10.51
Rate for Payer: Priority Health Choice Medicaid	$10.01
Rate for Payer: Priority Health Cigna Priority Health	$234.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$25.01
Rate for Payer: Priority Health Narrow Network	$25.01
Rate for Payer: Priority Health SBD	$25.01

PR NDSC URETEROTOMY RMVL FB/CALCULUS

Professional

Both

$677.00

Service Code	HCPCS 50980
Min. Negotiated Rate	$223.22
Max. Negotiated Rate	$2,962.71
Rate for Payer: Aetna Commercial	$455.66
Rate for Payer: BCBS Complete	$234.38
Rate for Payer: BCBS Trust/PPO	$2,962.71
Rate for Payer: Cash Price	$541.60
Rate for Payer: Cash Price	$541.60
Rate for Payer: Mclaren Medicaid	$223.22
Rate for Payer: Meridian Medicaid	$234.38
Rate for Payer: Priority Health Choice Medicaid	$223.22
Rate for Payer: Priority Health Cigna Priority Health	$473.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$561.44
Rate for Payer: Priority Health Narrow Network	$561.44
Rate for Payer: Priority Health SBD	$561.44

PR NDSC URETEROTOMY URTRL CATHJ W/WO DILAT URETER

Professional

Both

$679.00

Service Code	HCPCS 50972
Min. Negotiated Rate	$224.29
Max. Negotiated Rate	$2,720.22
Rate for Payer: Aetna Commercial	$457.88
Rate for Payer: BCBS Complete	$235.50
Rate for Payer: BCBS Trust/PPO	$2,720.22
Rate for Payer: Cash Price	$543.20
Rate for Payer: Cash Price	$543.20
Rate for Payer: Mclaren Medicaid	$224.29
Rate for Payer: Meridian Medicaid	$235.50
Rate for Payer: Priority Health Choice Medicaid	$224.29
Rate for Payer: Priority Health Cigna Priority Health	$475.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$564.67
Rate for Payer: Priority Health Narrow Network	$564.67
Rate for Payer: Priority Health SBD	$564.67

PR NDSC WRST SURG W/RLS TRANSVRS CARPL LIGM

Professional

Both

$1,840.00

Service Code	HCPCS 29848
Min. Negotiated Rate	$333.98
Max. Negotiated Rate	$1,288.00
Rate for Payer: Aetna Commercial	$677.64
Rate for Payer: BCBS Complete	$350.68
Rate for Payer: BCBS Trust/PPO	$571.09
Rate for Payer: Cash Price	$1,472.00
Rate for Payer: Cash Price	$1,472.00
Rate for Payer: Mclaren Medicaid	$333.98
Rate for Payer: Meridian Medicaid	$350.68
Rate for Payer: Priority Health Choice Medicaid	$333.98
Rate for Payer: Priority Health Cigna Priority Health	$1,288.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$790.48
Rate for Payer: Priority Health Narrow Network	$790.48
Rate for Payer: Priority Health SBD	$790.48

PR NECK LIFT

Professional

Both

$2,000.00

Service Code	HCPCS 00541
Hospital Revenue Code	990
Min. Negotiated Rate	$800.00
Max. Negotiated Rate	$1,400.00
Rate for Payer: BCBS Complete	$800.00
Rate for Payer: Cash Price	$1,600.00
Rate for Payer: Priority Health Cigna Priority Health	$1,400.00

PR NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE BI

Professional

Both

$264.00

Service Code	HCPCS 95868
Min. Negotiated Rate	$81.30
Max. Negotiated Rate	$284.75
Rate for Payer: Aetna Commercial	$157.00
Rate for Payer: BCBS Complete	$105.60
Rate for Payer: BCBS Trust/PPO	$284.75
Rate for Payer: Cash Price	$211.20
Rate for Payer: Cash Price	$211.20
Rate for Payer: Priority Health Cigna Priority Health	$184.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$81.30
Rate for Payer: Priority Health Narrow Network	$81.30
Rate for Payer: Priority Health SBD	$186.84

PR NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE UNI

Professional

Both

$191.00

Service Code	HCPCS 95867
Min. Negotiated Rate	$54.79
Max. Negotiated Rate	$620.75
Rate for Payer: Aetna Commercial	$120.01
Rate for Payer: BCBS Complete	$76.40
Rate for Payer: BCBS Trust/PPO	$620.75
Rate for Payer: Cash Price	$152.80
Rate for Payer: Cash Price	$152.80
Rate for Payer: Priority Health Cigna Priority Health	$133.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$54.79
Rate for Payer: Priority Health Narrow Network	$54.79
Rate for Payer: Priority Health SBD	$143.73

PR NEEDLE ELECTROMYOGRAPHY HEMIDIAPHRAGM

Professional

Both

$232.00

Service Code	HCPCS 95866
Min. Negotiated Rate	$83.99
Max. Negotiated Rate	$665.13
Rate for Payer: Aetna Commercial	$146.53
Rate for Payer: BCBS Complete	$92.80
Rate for Payer: BCBS Trust/PPO	$665.13
Rate for Payer: Cash Price	$185.60
Rate for Payer: Cash Price	$185.60
Rate for Payer: Priority Health Cigna Priority Health	$162.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$83.99
Rate for Payer: Priority Health Narrow Network	$83.99
Rate for Payer: Priority Health SBD	$169.77

PR NEEDLE ELECTROMYOGRAPHY LARYNX

Professional

Both

$365.00

Service Code	HCPCS 95865
Min. Negotiated Rate	$92.53
Max. Negotiated Rate	$990.03
Rate for Payer: Aetna Commercial	$168.68
Rate for Payer: BCBS Complete	$146.00
Rate for Payer: BCBS Trust/PPO	$990.03
Rate for Payer: Cash Price	$292.00
Rate for Payer: Cash Price	$292.00
Rate for Payer: Priority Health Cigna Priority Health	$255.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$92.53
Rate for Payer: Priority Health Narrow Network	$92.53
Rate for Payer: Priority Health SBD	$200.32

PR NEEDLE EMG EA EXTREMITY W/PARASPINL AREA LIMITED

Professional

Both

$63.00

Service Code	HCPCS 95885
Min. Negotiated Rate	$23.80
Max. Negotiated Rate	$1,360.37
Rate for Payer: Aetna Commercial	$70.67
Rate for Payer: Aetna Commercial	$70.67
Rate for Payer: BCBS Complete	$60.40
Rate for Payer: BCBS Complete	$25.20
Rate for Payer: BCBS Trust/PPO	$1,360.37
Rate for Payer: BCBS Trust/PPO	$1,360.37
Rate for Payer: Cash Price	$50.40
Rate for Payer: Cash Price	$120.80
Rate for Payer: Cash Price	$50.40
Rate for Payer: Cash Price	$120.80
Rate for Payer: Priority Health Cigna Priority Health	$105.70
Rate for Payer: Priority Health Cigna Priority Health	$44.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$23.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$23.80
Rate for Payer: Priority Health Narrow Network	$23.80
Rate for Payer: Priority Health Narrow Network	$23.80
Rate for Payer: Priority Health SBD	$83.09
Rate for Payer: Priority Health SBD	$83.09

PR NEEDLE EMG EA EXTREMTY W/PARASPINL AREA COMPLETE

Professional

Both

$237.00

Service Code	HCPCS 95886
Min. Negotiated Rate	$67.22
Max. Negotiated Rate	$1,755.54
Rate for Payer: Aetna Commercial	$109.55
Rate for Payer: Aetna Commercial	$109.55
Rate for Payer: BCBS Complete	$66.80
Rate for Payer: BCBS Complete	$94.80
Rate for Payer: BCBS Trust/PPO	$1,755.54
Rate for Payer: BCBS Trust/PPO	$1,755.54
Rate for Payer: Cash Price	$189.60
Rate for Payer: Cash Price	$133.60
Rate for Payer: Cash Price	$133.60
Rate for Payer: Cash Price	$189.60
Rate for Payer: Priority Health Cigna Priority Health	$116.90
Rate for Payer: Priority Health Cigna Priority Health	$165.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$67.22
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$67.22
Rate for Payer: Priority Health Narrow Network	$67.22
Rate for Payer: Priority Health Narrow Network	$67.22
Rate for Payer: Priority Health SBD	$141.11
Rate for Payer: Priority Health SBD	$141.11

PR NEEDLE EMG GUID W/CHEMODENERVATION

Professional

Both

$124.00

Service Code	HCPCS 95874
Min. Negotiated Rate	$25.61
Max. Negotiated Rate	$1,247.84
Rate for Payer: Aetna Commercial	$87.83
Rate for Payer: BCBS Complete	$49.60
Rate for Payer: BCBS Trust/PPO	$1,247.84
Rate for Payer: Cash Price	$99.20
Rate for Payer: Cash Price	$99.20
Rate for Payer: Priority Health Cigna Priority Health	$86.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$25.61
Rate for Payer: Priority Health Narrow Network	$25.61
Rate for Payer: Priority Health SBD	$103.75

PR NEEDLE EMG LMTD STD MUSC 1 XTR/NON-LIMB UNI/BI

Professional

Both

$150.00

Service Code	HCPCS 95870
Min. Negotiated Rate	$25.61
Max. Negotiated Rate	$288.98
Rate for Payer: Aetna Commercial	$96.78
Rate for Payer: BCBS Complete	$60.00
Rate for Payer: BCBS Trust/PPO	$288.98
Rate for Payer: Cash Price	$120.00
Rate for Payer: Cash Price	$120.00
Rate for Payer: Priority Health Cigna Priority Health	$105.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$25.61
Rate for Payer: Priority Health Narrow Network	$25.61
Rate for Payer: Priority Health SBD	$111.84

PR NEEDLE EMG NONEXTREMTY MSCLES W/NERVE CONDUCTION

Professional

Both

$131.00

Service Code	HCPCS 95887
Min. Negotiated Rate	$48.96
Max. Negotiated Rate	$1,456.52
Rate for Payer: Aetna Commercial	$94.79
Rate for Payer: Aetna Commercial	$94.79
Rate for Payer: BCBS Complete	$106.80
Rate for Payer: BCBS Complete	$52.40
Rate for Payer: BCBS Trust/PPO	$1,456.52
Rate for Payer: BCBS Trust/PPO	$1,456.52
Rate for Payer: Cash Price	$213.60
Rate for Payer: Cash Price	$104.80
Rate for Payer: Cash Price	$104.80
Rate for Payer: Cash Price	$213.60
Rate for Payer: Priority Health Cigna Priority Health	$186.90
Rate for Payer: Priority Health Cigna Priority Health	$91.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$48.96
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$48.96
Rate for Payer: Priority Health Narrow Network	$48.96
Rate for Payer: Priority Health Narrow Network	$48.96
Rate for Payer: Priority Health SBD	$112.29
Rate for Payer: Priority Health SBD	$112.29

PR NEEDLE EMG THRC PARASPI MUSC EXCLUDING T1/T12

Professional

Both

$143.00

Service Code	HCPCS 95869
Min. Negotiated Rate	$26.04
Max. Negotiated Rate	$296.90
Rate for Payer: Aetna Commercial	$108.17
Rate for Payer: BCBS Complete	$57.20
Rate for Payer: BCBS Trust/PPO	$296.90
Rate for Payer: Cash Price	$114.40
Rate for Payer: Cash Price	$114.40
Rate for Payer: Priority Health Cigna Priority Health	$100.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$26.04
Rate for Payer: Priority Health Narrow Network	$26.04
Rate for Payer: Priority Health SBD	$128.91

PR NEEDLE EMG W/1 FIBER ELECTRODE QUAN MEAS JITTER

Professional

Both

$318.00

Service Code	HCPCS 95872
Min. Negotiated Rate	$66.92
Max. Negotiated Rate	$411.55
Rate for Payer: Aetna Commercial	$224.41
Rate for Payer: BCBS Complete	$127.20
Rate for Payer: BCBS Trust/PPO	$411.55
Rate for Payer: Cash Price	$254.40
Rate for Payer: Cash Price	$254.40
Rate for Payer: Priority Health Cigna Priority Health	$222.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$66.92
Rate for Payer: Priority Health Narrow Network	$66.92
Rate for Payer: Priority Health SBD	$264.10

Know your out-of-pocket cost for care.

All Charges