Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PR OPTX PST/ANT ACTBLR WALL FX W/INT FIXJ

Professional

Both

$3,037.00

Service Code	HCPCS 27226
Min. Negotiated Rate	$558.94
Max. Negotiated Rate	$2,125.90
Rate for Payer: Aetna Commercial	$1,412.38
Rate for Payer: BCBS Complete	$714.34
Rate for Payer: BCBS Trust/PPO	$558.94
Rate for Payer: Cash Price	$2,429.60
Rate for Payer: Cash Price	$2,429.60
Rate for Payer: Mclaren Medicaid	$680.32
Rate for Payer: Meridian Medicaid	$714.34
Rate for Payer: Priority Health Choice Medicaid	$680.32
Rate for Payer: Priority Health Cigna Priority Health	$2,125.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,616.21
Rate for Payer: Priority Health Narrow Network	$1,616.21
Rate for Payer: Priority Health SBD	$1,616.21

PR OPTX&/RDCTJ ODNTD FX&/DISLC ANT FIXJ W/O GRAFT

Professional

Both

$5,599.00

Service Code	HCPCS 22318
Min. Negotiated Rate	$33.96
Max. Negotiated Rate	$3,919.30
Rate for Payer: Aetna Commercial	$2,196.46
Rate for Payer: BCBS Complete	$1,127.65
Rate for Payer: BCBS Trust/PPO	$33.96
Rate for Payer: Cash Price	$4,479.20
Rate for Payer: Cash Price	$4,479.20
Rate for Payer: Mclaren Medicaid	$1,073.95
Rate for Payer: Meridian Medicaid	$1,127.65
Rate for Payer: Priority Health Choice Medicaid	$1,073.95
Rate for Payer: Priority Health Cigna Priority Health	$3,919.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,545.59
Rate for Payer: Priority Health Narrow Network	$2,545.59
Rate for Payer: Priority Health SBD	$2,545.59

PR OPTX&/RDCTJ ODNTD FX&/DISLC ANT W/INT FIXJ

Professional

Both

$10,531.00

Service Code	HCPCS 22319
Min. Negotiated Rate	$1,190.67
Max. Negotiated Rate	$7,371.70
Rate for Payer: Aetna Commercial	$2,450.58
Rate for Payer: BCBS Complete	$1,250.20
Rate for Payer: BCBS Trust/PPO	$5,215.40
Rate for Payer: Cash Price	$8,424.80
Rate for Payer: Cash Price	$8,424.80
Rate for Payer: Mclaren Medicaid	$1,190.67
Rate for Payer: Meridian Medicaid	$1,250.20
Rate for Payer: Priority Health Choice Medicaid	$1,190.67
Rate for Payer: Priority Health Cigna Priority Health	$7,371.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,825.94
Rate for Payer: Priority Health Narrow Network	$2,825.94
Rate for Payer: Priority Health SBD	$2,825.94

PR OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM CR

Professional

Both

$3,987.00

Service Code	HCPCS 22326
Min. Negotiated Rate	$979.59
Max. Negotiated Rate	$2,790.90
Rate for Payer: Aetna Commercial	$2,012.34
Rate for Payer: BCBS Complete	$1,028.57
Rate for Payer: BCBS Trust/PPO	$1,741.59
Rate for Payer: Cash Price	$3,189.60
Rate for Payer: Cash Price	$3,189.60
Rate for Payer: Mclaren Medicaid	$979.59
Rate for Payer: Meridian Medicaid	$1,028.57
Rate for Payer: Priority Health Choice Medicaid	$979.59
Rate for Payer: Priority Health Cigna Priority Health	$2,790.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,327.03
Rate for Payer: Priority Health Narrow Network	$2,327.03
Rate for Payer: Priority Health SBD	$2,327.03

PR OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM EA

Professional

Both

$1,148.00

Service Code	HCPCS 22328
Min. Negotiated Rate	$179.35
Max. Negotiated Rate	$950.50
Rate for Payer: Aetna Commercial	$380.05
Rate for Payer: BCBS Complete	$188.32
Rate for Payer: BCBS Trust/PPO	$950.50
Rate for Payer: Cash Price	$918.40
Rate for Payer: Cash Price	$918.40
Rate for Payer: Mclaren Medicaid	$179.35
Rate for Payer: Meridian Medicaid	$188.32
Rate for Payer: Priority Health Choice Medicaid	$179.35
Rate for Payer: Priority Health Cigna Priority Health	$803.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$430.48
Rate for Payer: Priority Health Narrow Network	$430.48
Rate for Payer: Priority Health SBD	$430.48

PR OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM LM

Professional

Both

$3,668.00

Service Code	HCPCS 22325
Min. Negotiated Rate	$957.44
Max. Negotiated Rate	$17,177.60
Rate for Payer: Aetna Commercial	$1,958.38
Rate for Payer: BCBS Complete	$1,005.31
Rate for Payer: BCBS Trust/PPO	$17,177.60
Rate for Payer: Cash Price	$2,934.40
Rate for Payer: Cash Price	$2,934.40
Rate for Payer: Mclaren Medicaid	$957.44
Rate for Payer: Meridian Medicaid	$1,005.31
Rate for Payer: Priority Health Choice Medicaid	$957.44
Rate for Payer: Priority Health Cigna Priority Health	$2,567.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,270.34
Rate for Payer: Priority Health Narrow Network	$2,270.34
Rate for Payer: Priority Health SBD	$2,270.34

PR OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM TH

Professional

Both

$3,828.00

Service Code	HCPCS 22327
Min. Negotiated Rate	$950.50
Max. Negotiated Rate	$2,679.60
Rate for Payer: Aetna Commercial	$2,041.44
Rate for Payer: BCBS Complete	$1,047.57
Rate for Payer: BCBS Trust/PPO	$950.50
Rate for Payer: Cash Price	$3,062.40
Rate for Payer: Cash Price	$3,062.40
Rate for Payer: Mclaren Medicaid	$997.69
Rate for Payer: Meridian Medicaid	$1,047.57
Rate for Payer: Priority Health Choice Medicaid	$997.69
Rate for Payer: Priority Health Cigna Priority Health	$2,679.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,365.84
Rate for Payer: Priority Health Narrow Network	$2,365.84
Rate for Payer: Priority Health SBD	$2,365.84

PR OPTX SHO DISLC W/FX GR HUMERAL TUBRST INT FIXJ

Professional

Both

$2,881.00

Service Code	HCPCS 23670
Min. Negotiated Rate	$196.12
Max. Negotiated Rate	$2,016.70
Rate for Payer: Aetna Commercial	$1,162.77
Rate for Payer: BCBS Complete	$592.00
Rate for Payer: BCBS Trust/PPO	$196.12
Rate for Payer: Cash Price	$2,304.80
Rate for Payer: Cash Price	$2,304.80
Rate for Payer: Mclaren Medicaid	$563.81
Rate for Payer: Meridian Medicaid	$592.00
Rate for Payer: Priority Health Choice Medicaid	$563.81
Rate for Payer: Priority Health Cigna Priority Health	$2,016.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,337.40
Rate for Payer: Priority Health Narrow Network	$1,337.40
Rate for Payer: Priority Health SBD	$1,337.40

PR OPTX SHO DISLC W/SURG/ANTMCL NECK FX INT FIXJ

Professional

Both

$1,623.00

Service Code	HCPCS 23680
Min. Negotiated Rate	$228.81
Max. Negotiated Rate	$1,427.27
Rate for Payer: Aetna Commercial	$1,237.80
Rate for Payer: BCBS Complete	$623.98
Rate for Payer: BCBS Trust/PPO	$228.81
Rate for Payer: Cash Price	$1,298.40
Rate for Payer: Cash Price	$1,298.40
Rate for Payer: Mclaren Medicaid	$594.27
Rate for Payer: Meridian Medicaid	$623.98
Rate for Payer: Priority Health Choice Medicaid	$594.27
Rate for Payer: Priority Health Cigna Priority Health	$1,136.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,427.27
Rate for Payer: Priority Health Narrow Network	$1,427.27
Rate for Payer: Priority Health SBD	$1,427.27

PR OPTX SLP FEM EPIPHYSIS CLSD MANJ SINGL/MLTPL PIN

Professional

Both

$1,615.00

Service Code	HCPCS 27178
Min. Negotiated Rate	$595.12
Max. Negotiated Rate	$1,416.03
Rate for Payer: Aetna Commercial	$1,230.99
Rate for Payer: BCBS Complete	$624.88
Rate for Payer: BCBS Trust/PPO	$969.43
Rate for Payer: Cash Price	$1,292.00
Rate for Payer: Cash Price	$1,292.00
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	$1,130.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,416.03
Rate for Payer: Priority Health Narrow Network	$1,416.03
Rate for Payer: Priority Health SBD	$1,416.03

PR OPTX SLP FEM EPIPHYSIS OSTEOT&INT FIXJ

Professional

Both

$2,305.00

Service Code	HCPCS 27181
Min. Negotiated Rate	$381.43
Max. Negotiated Rate	$1,714.25
Rate for Payer: Aetna Commercial	$1,496.07
Rate for Payer: BCBS Complete	$757.06
Rate for Payer: BCBS Trust/PPO	$381.43
Rate for Payer: Cash Price	$1,844.00
Rate for Payer: Cash Price	$1,844.00
Rate for Payer: Mclaren Medicaid	$721.01
Rate for Payer: Meridian Medicaid	$757.06
Rate for Payer: Priority Health Choice Medicaid	$721.01
Rate for Payer: Priority Health Cigna Priority Health	$1,613.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,714.25
Rate for Payer: Priority Health Narrow Network	$1,714.25
Rate for Payer: Priority Health SBD	$1,714.25

PR OPTX SLP FEM EPIPHYSIS SINGLE/MULT PIN/BONE GRFT

Professional

Both

$1,952.00

Service Code	HCPCS 27177
Min. Negotiated Rate	$718.02
Max. Negotiated Rate	$1,708.64
Rate for Payer: Aetna Commercial	$1,490.05
Rate for Payer: BCBS Complete	$753.92
Rate for Payer: BCBS Trust/PPO	$1,238.86
Rate for Payer: Cash Price	$1,561.60
Rate for Payer: Cash Price	$1,561.60
Rate for Payer: Mclaren Medicaid	$718.02
Rate for Payer: Meridian Medicaid	$753.92
Rate for Payer: Priority Health Choice Medicaid	$718.02
Rate for Payer: Priority Health Cigna Priority Health	$1,366.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,708.64
Rate for Payer: Priority Health Narrow Network	$1,708.64
Rate for Payer: Priority Health SBD	$1,708.64

PR OPTX SPON HIP DISLC RPLCMT FEM HEAD ACTBLM

Professional

Both

$1,947.00

Service Code	HCPCS 27258
Min. Negotiated Rate	$715.04
Max. Negotiated Rate	$2,598.71
Rate for Payer: Aetna Commercial	$1,486.20
Rate for Payer: BCBS Complete	$750.79
Rate for Payer: BCBS Trust/PPO	$2,598.71
Rate for Payer: Cash Price	$1,557.60
Rate for Payer: Cash Price	$1,557.60
Rate for Payer: Mclaren Medicaid	$715.04
Rate for Payer: Meridian Medicaid	$750.79
Rate for Payer: Priority Health Choice Medicaid	$715.04
Rate for Payer: Priority Health Cigna Priority Health	$1,362.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,701.48
Rate for Payer: Priority Health Narrow Network	$1,701.48
Rate for Payer: Priority Health SBD	$1,701.48

PR OPTX STRNCLAV DISLC ACUTE/CHRONIC W/FASCIAL GRF

Professional

Both

$2,096.00

Service Code	HCPCS 23532
Min. Negotiated Rate	$407.68
Max. Negotiated Rate	$1,467.20
Rate for Payer: Aetna Commercial	$835.21
Rate for Payer: BCBS Complete	$428.06
Rate for Payer: BCBS Trust/PPO	$525.66
Rate for Payer: Cash Price	$1,676.80
Rate for Payer: Cash Price	$1,676.80
Rate for Payer: Mclaren Medicaid	$407.68
Rate for Payer: Meridian Medicaid	$428.06
Rate for Payer: Priority Health Choice Medicaid	$407.68
Rate for Payer: Priority Health Cigna Priority Health	$1,467.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$968.19
Rate for Payer: Priority Health Narrow Network	$968.19
Rate for Payer: Priority Health SBD	$968.19

PR OPTX TIBIAL FX PROX BICONDYLAR W/WO INT FIXJ

Professional

Both

$3,036.00

Service Code	HCPCS 27536
Min. Negotiated Rate	$763.39
Max. Negotiated Rate	$2,125.20
Rate for Payer: Aetna Commercial	$1,583.28
Rate for Payer: BCBS Complete	$801.56
Rate for Payer: BCBS Trust/PPO	$803.02
Rate for Payer: Cash Price	$2,428.80
Rate for Payer: Cash Price	$2,428.80
Rate for Payer: Mclaren Medicaid	$763.39
Rate for Payer: Meridian Medicaid	$801.56
Rate for Payer: Priority Health Choice Medicaid	$763.39
Rate for Payer: Priority Health Cigna Priority Health	$2,125.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,815.36
Rate for Payer: Priority Health Narrow Network	$1,815.36
Rate for Payer: Priority Health SBD	$1,815.36

PR OPTX TIBIAL SHFT FX W/PLATE/SCREWS W/WO CERCLAGE

Professional

Both

$3,516.00

Service Code	HCPCS 27758
Min. Negotiated Rate	$578.72
Max. Negotiated Rate	$2,461.20
Rate for Payer: Aetna Commercial	$1,195.54
Rate for Payer: BCBS Complete	$607.66
Rate for Payer: BCBS Trust/PPO	$623.39
Rate for Payer: Cash Price	$2,812.80
Rate for Payer: Cash Price	$2,812.80
Rate for Payer: Mclaren Medicaid	$578.72
Rate for Payer: Meridian Medicaid	$607.66
Rate for Payer: Priority Health Choice Medicaid	$578.72
Rate for Payer: Priority Health Cigna Priority Health	$2,461.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,375.69
Rate for Payer: Priority Health Narrow Network	$1,375.69
Rate for Payer: Priority Health SBD	$1,375.69

PROPYLTHIOURACIL 50 MG TABLET

Facility

$8.00

Service Code	NDC 68084-964-95
Hospital Charge Code	6662
Hospital Revenue Code	637
Min. Negotiated Rate	$5.04
Max. Negotiated Rate	$7.20
Rate for Payer: Aetna Commercial	$6.80
Rate for Payer: Aetna New Business (MI Preferred)	$5.20
Rate for Payer: Cash Price	$6.40
Rate for Payer: Cofinity Commercial	$5.60
Rate for Payer: Cofinity Commercial	$6.88
Rate for Payer: Healthscope Commercial	$7.20
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$6.80
Rate for Payer: PHP Commercial	$6.80
Rate for Payer: Priority Health Cigna Priority Health	$5.60
Rate for Payer: Priority Health SBD	$5.04

PROPYLTHIOURACIL 50 MG TABLET

Facility

$239.88

Service Code	NDC 68084-964-25
Hospital Charge Code	6662
Hospital Revenue Code	637
Min. Negotiated Rate	$151.12
Max. Negotiated Rate	$215.89
Rate for Payer: Aetna Commercial	$203.90
Rate for Payer: Aetna New Business (MI Preferred)	$155.92
Rate for Payer: Cash Price	$191.90
Rate for Payer: Cofinity Commercial	$167.92
Rate for Payer: Cofinity Commercial	$206.30
Rate for Payer: Healthscope Commercial	$215.89
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$203.90
Rate for Payer: PHP Commercial	$203.90
Rate for Payer: Priority Health Cigna Priority Health	$167.92
Rate for Payer: Priority Health SBD	$151.12

PROPYLTHIOURACIL 50 MG TABLET

Facility

$251.04

Service Code	NDC 0228-2348-10
Hospital Charge Code	6662
Hospital Revenue Code	637
Min. Negotiated Rate	$158.16
Max. Negotiated Rate	$225.94
Rate for Payer: Aetna Commercial	$213.38
Rate for Payer: Aetna New Business (MI Preferred)	$163.18
Rate for Payer: Cash Price	$200.83
Rate for Payer: Cofinity Commercial	$175.73
Rate for Payer: Cofinity Commercial	$215.89
Rate for Payer: Healthscope Commercial	$225.94
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$213.38
Rate for Payer: PHP Commercial	$213.38
Rate for Payer: Priority Health Cigna Priority Health	$175.73
Rate for Payer: Priority Health SBD	$158.16

PR ORAL DEXAMETHASONE

Professional

Both

$1.00

Service Code	HCPCS J8540
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.70
Rate for Payer: Aetna Commercial	$0.09
Rate for Payer: BCBS Complete	$0.40
Rate for Payer: BCBS Trust/PPO	$0.01
Rate for Payer: Cash Price	$0.80
Rate for Payer: Cash Price	$0.80
Rate for Payer: Priority Health Cigna Priority Health	$0.70

PR ORAL POLIOVIRUS IMMUNIZATN,LIVE,OPC

Professional

Both

$27.00

Service Code	HCPCS 90712
Min. Negotiated Rate	$10.80
Max. Negotiated Rate	$18.90
Rate for Payer: BCBS Complete	$10.80
Rate for Payer: Cash Price	$21.60
Rate for Payer: Priority Health Cigna Priority Health	$18.90

PR ORAL PRESCRIP DRUG NON CHEMO

Professional

Both

$4.00

Service Code	HCPCS J8499
Min. Negotiated Rate	$1.60
Max. Negotiated Rate	$2.80
Rate for Payer: BCBS Complete	$1.60
Rate for Payer: Cash Price	$3.20
Rate for Payer: Priority Health Cigna Priority Health	$2.80

PR ORBICULARIS OCULI REFLX ELECTRODIAGNOSTIC TEST

Professional

Both

$165.00

Service Code	HCPCS 95933
Min. Negotiated Rate	$41.33
Max. Negotiated Rate	$115.50
Rate for Payer: Aetna Commercial	$92.26
Rate for Payer: BCBS Complete	$66.00
Rate for Payer: BCBS Trust/PPO	$63.40
Rate for Payer: Cash Price	$132.00
Rate for Payer: Cash Price	$132.00
Rate for Payer: Priority Health Cigna Priority Health	$115.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$41.33
Rate for Payer: Priority Health Narrow Network	$41.33
Rate for Payer: Priority Health SBD	$110.49

PR ORBITOCRANIAL ANT CRANIAL FOSSA W/O ORBIT EXNTJ

Professional

Both

$7,800.00

Service Code	HCPCS 61584
Min. Negotiated Rate	$420.53
Max. Negotiated Rate	$5,460.00
Rate for Payer: Aetna Commercial	$3,731.75
Rate for Payer: BCBS Complete	$1,950.90
Rate for Payer: BCBS Trust/PPO	$420.53
Rate for Payer: Cash Price	$6,240.00
Rate for Payer: Cash Price	$6,240.00
Rate for Payer: Mclaren Medicaid	$1,858.00
Rate for Payer: Meridian Medicaid	$1,950.90
Rate for Payer: Priority Health Choice Medicaid	$1,858.00
Rate for Payer: Priority Health Cigna Priority Health	$5,460.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$4,957.28
Rate for Payer: Priority Health Narrow Network	$4,957.28
Rate for Payer: Priority Health SBD	$4,957.28

PR ORBITOCRNL APPR MID CRANIAL FOSSA TEMPORAL LOBE

Professional

Both

$5,646.00

Service Code	HCPCS 61592
Min. Negotiated Rate	$397.28
Max. Negotiated Rate	$5,405.73
Rate for Payer: Aetna Commercial	$4,118.86
Rate for Payer: BCBS Complete	$2,148.60
Rate for Payer: BCBS Trust/PPO	$397.28
Rate for Payer: Cash Price	$4,516.80
Rate for Payer: Cash Price	$4,516.80
Rate for Payer: Mclaren Medicaid	$2,046.29
Rate for Payer: Meridian Medicaid	$2,148.60
Rate for Payer: Priority Health Choice Medicaid	$2,046.29
Rate for Payer: Priority Health Cigna Priority Health	$3,952.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$5,405.73
Rate for Payer: Priority Health Narrow Network	$5,405.73
Rate for Payer: Priority Health SBD	$5,405.73

Know your out-of-pocket cost for care.

All Charges