Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PROTEIN SUPPLEMENT ORAL

Facility

$3.43

Service Code	NDC 4390028430
Hospital Charge Code	150950
Hospital Revenue Code	637
Min. Negotiated Rate	$2.16
Max. Negotiated Rate	$3.09
Rate for Payer: Aetna Commercial	$2.92
Rate for Payer: Aetna New Business (MI Preferred)	$2.23
Rate for Payer: Cash Price	$2.74
Rate for Payer: Cofinity Commercial	$2.40
Rate for Payer: Cofinity Commercial	$2.95
Rate for Payer: Healthscope Commercial	$3.09
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2.92
Rate for Payer: PHP Commercial	$2.92
Rate for Payer: Priority Health Cigna Priority Health	$2.40
Rate for Payer: Priority Health SBD	$2.16

PR OTHER CRANIAL DECOMPRESSION POSTERIOR FOSSA

Professional

Both

$4,394.00

Service Code	HCPCS 61345
Min. Negotiated Rate	$660.90
Max. Negotiated Rate	$3,492.46
Rate for Payer: Aetna Commercial	$2,639.58
Rate for Payer: BCBS Complete	$1,391.55
Rate for Payer: BCBS Trust/PPO	$660.90
Rate for Payer: Cash Price	$3,515.20
Rate for Payer: Cash Price	$3,515.20
Rate for Payer: Mclaren Medicaid	$1,325.29
Rate for Payer: Meridian Medicaid	$1,391.55
Rate for Payer: Priority Health Choice Medicaid	$1,325.29
Rate for Payer: Priority Health Cigna Priority Health	$3,075.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$3,492.46
Rate for Payer: Priority Health Narrow Network	$3,492.46
Rate for Payer: Priority Health SBD	$3,492.46

PR OTOLARYNGOLOGIC EXAM UNDER GENERAL ANESTHESIA

Professional

Both

$326.00

Service Code	HCPCS 92502
Min. Negotiated Rate	$60.71
Max. Negotiated Rate	$1,298.03
Rate for Payer: Aetna Commercial	$102.71
Rate for Payer: BCBS Complete	$63.75
Rate for Payer: BCBS Trust/PPO	$1,298.03
Rate for Payer: Cash Price	$260.80
Rate for Payer: Cash Price	$260.80
Rate for Payer: Mclaren Medicaid	$60.71
Rate for Payer: Meridian Medicaid	$63.75
Rate for Payer: Priority Health Choice Medicaid	$60.71
Rate for Payer: Priority Health Cigna Priority Health	$228.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$126.21
Rate for Payer: Priority Health Narrow Network	$126.21
Rate for Payer: Priority Health SBD	$126.21

PR OTOPLASTY PROTRUDING EAR W/WO SIZE RDCTJ

Professional

Both

$1,550.00

Service Code	HCPCS 69300
Min. Negotiated Rate	$302.89
Max. Negotiated Rate	$1,934.63
Rate for Payer: Aetna Commercial	$518.23
Rate for Payer: BCBS Complete	$318.03
Rate for Payer: BCBS Trust/PPO	$1,934.63
Rate for Payer: Cash Price	$1,240.00
Rate for Payer: Cash Price	$1,240.00
Rate for Payer: Mclaren Medicaid	$302.89
Rate for Payer: Meridian Medicaid	$318.03
Rate for Payer: Priority Health Choice Medicaid	$302.89
Rate for Payer: Priority Health Cigna Priority Health	$1,085.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$663.34
Rate for Payer: Priority Health Narrow Network	$663.34
Rate for Payer: Priority Health SBD	$663.34

PR OUTPATIENT CARDIAC REHAB W/O CONT ECG MONITOR

Professional

Both

$32.00

Service Code	HCPCS 93797
Min. Negotiated Rate	$5.54
Max. Negotiated Rate	$118.87
Rate for Payer: Aetna Commercial	$10.29
Rate for Payer: BCBS Complete	$5.82
Rate for Payer: BCBS Trust/PPO	$118.87
Rate for Payer: Cash Price	$25.60
Rate for Payer: Cash Price	$25.60
Rate for Payer: Mclaren Medicaid	$5.54
Rate for Payer: Meridian Medicaid	$5.82
Rate for Payer: Priority Health Choice Medicaid	$5.54
Rate for Payer: Priority Health Cigna Priority Health	$22.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$12.29
Rate for Payer: Priority Health Narrow Network	$12.29
Rate for Payer: Priority Health SBD	$12.29

PR OVARIAN CYSTECTOMY UNI/BI

Professional

Both

$2,338.00

Service Code	HCPCS 58925
Min. Negotiated Rate	$164.83
Max. Negotiated Rate	$1,636.60
Rate for Payer: Aetna Commercial	$912.21
Rate for Payer: BCBS Complete	$517.98
Rate for Payer: BCBS Trust/PPO	$164.83
Rate for Payer: Cash Price	$1,870.40
Rate for Payer: Cash Price	$1,870.40
Rate for Payer: Mclaren Medicaid	$493.31
Rate for Payer: Meridian Medicaid	$517.98
Rate for Payer: Priority Health Choice Medicaid	$493.31
Rate for Payer: Priority Health Cigna Priority Health	$1,636.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,091.72
Rate for Payer: Priority Health Narrow Network	$1,091.72
Rate for Payer: Priority Health SBD	$1,091.72

PROVENTIL HFA 90 MCG/ACTUATION AEROSOL COMMON CANISTER INHALER

Facility

$102.90

Service Code	NDC 66993-019-68
Hospital Charge Code	300058
Hospital Revenue Code	637
Min. Negotiated Rate	$64.83
Max. Negotiated Rate	$92.61
Rate for Payer: Aetna Commercial	$87.46
Rate for Payer: Aetna New Business (MI Preferred)	$66.88
Rate for Payer: Cash Price	$82.32
Rate for Payer: Cofinity Commercial	$72.03
Rate for Payer: Cofinity Commercial	$88.49
Rate for Payer: Healthscope Commercial	$92.61
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$87.46
Rate for Payer: PHP Commercial	$87.46
Rate for Payer: Priority Health Cigna Priority Health	$72.03
Rate for Payer: Priority Health SBD	$64.83

PROVENTIL HFA 90 MCG/ACTUATION AEROSOL COMMON CANISTER INHALER

Facility

$50.40

Service Code	NDC 69097-142-60
Hospital Charge Code	300058
Hospital Revenue Code	637
Min. Negotiated Rate	$31.75
Max. Negotiated Rate	$45.36
Rate for Payer: Aetna Commercial	$42.84
Rate for Payer: Aetna New Business (MI Preferred)	$32.76
Rate for Payer: Cash Price	$40.32
Rate for Payer: Cofinity Commercial	$35.28
Rate for Payer: Cofinity Commercial	$43.34
Rate for Payer: Healthscope Commercial	$45.36
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$42.84
Rate for Payer: PHP Commercial	$42.84
Rate for Payer: Priority Health Cigna Priority Health	$35.28
Rate for Payer: Priority Health SBD	$31.75

PROVENTIL HFA 90 MCG/ACTUATION AEROSOL COMMON CANISTER INHALER

Facility

$149.10

Service Code	NDC 0085-1132-04
Hospital Charge Code	300058
Hospital Revenue Code	637
Min. Negotiated Rate	$93.93
Max. Negotiated Rate	$134.19
Rate for Payer: Aetna Commercial	$126.74
Rate for Payer: Aetna New Business (MI Preferred)	$96.92
Rate for Payer: Cash Price	$119.28
Rate for Payer: Cofinity Commercial	$104.37
Rate for Payer: Cofinity Commercial	$128.23
Rate for Payer: Healthscope Commercial	$134.19
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$126.74
Rate for Payer: PHP Commercial	$126.74
Rate for Payer: Priority Health Cigna Priority Health	$104.37
Rate for Payer: Priority Health SBD	$93.93

PROVENTIL HFA 90 MCG/ACTUATION AEROSOL COMMON CANISTER INHALER

Facility

$46.90

Service Code	NDC 0781-7296-85
Hospital Charge Code	300058
Hospital Revenue Code	637
Min. Negotiated Rate	$29.55
Max. Negotiated Rate	$42.21
Rate for Payer: Aetna Commercial	$39.86
Rate for Payer: Aetna New Business (MI Preferred)	$30.48
Rate for Payer: Cash Price	$37.52
Rate for Payer: Cofinity Commercial	$32.83
Rate for Payer: Cofinity Commercial	$40.33
Rate for Payer: Healthscope Commercial	$42.21
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$39.86
Rate for Payer: PHP Commercial	$39.86
Rate for Payer: Priority Health Cigna Priority Health	$32.83
Rate for Payer: Priority Health SBD	$29.55

PROVENTIL HFA 90 MCG/ACTUATION AEROSOL COMMON CANISTER INHALER

Facility

$114.80

Service Code	NDC 0254-1007-52
Hospital Charge Code	300058
Hospital Revenue Code	637
Min. Negotiated Rate	$72.32
Max. Negotiated Rate	$103.32
Rate for Payer: Aetna Commercial	$97.58
Rate for Payer: Aetna New Business (MI Preferred)	$74.62
Rate for Payer: Cash Price	$91.84
Rate for Payer: Cofinity Commercial	$80.36
Rate for Payer: Cofinity Commercial	$98.73
Rate for Payer: Healthscope Commercial	$103.32
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$97.58
Rate for Payer: PHP Commercial	$97.58
Rate for Payer: Priority Health Cigna Priority Health	$80.36
Rate for Payer: Priority Health SBD	$72.32

PROVENTIL HFA 90 MCG/ACTUATION AEROSOL INHALER

Facility

$50.40

Service Code	NDC 69097-142-60
Hospital Charge Code	17934
Hospital Revenue Code	637
Min. Negotiated Rate	$31.75
Max. Negotiated Rate	$45.36
Rate for Payer: Aetna Commercial	$42.84
Rate for Payer: Aetna New Business (MI Preferred)	$32.76
Rate for Payer: Cash Price	$40.32
Rate for Payer: Cofinity Commercial	$35.28
Rate for Payer: Cofinity Commercial	$43.34
Rate for Payer: Healthscope Commercial	$45.36
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$42.84
Rate for Payer: PHP Commercial	$42.84
Rate for Payer: Priority Health Cigna Priority Health	$35.28
Rate for Payer: Priority Health SBD	$31.75

PROVENTIL HFA 90 MCG/ACTUATION AEROSOL INHALER

Facility

$114.80

Service Code	NDC 0254-1007-52
Hospital Charge Code	17934
Hospital Revenue Code	637
Min. Negotiated Rate	$72.32
Max. Negotiated Rate	$103.32
Rate for Payer: Aetna Commercial	$97.58
Rate for Payer: Aetna New Business (MI Preferred)	$74.62
Rate for Payer: Cash Price	$91.84
Rate for Payer: Cofinity Commercial	$80.36
Rate for Payer: Cofinity Commercial	$98.73
Rate for Payer: Healthscope Commercial	$103.32
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$97.58
Rate for Payer: PHP Commercial	$97.58
Rate for Payer: Priority Health Cigna Priority Health	$80.36
Rate for Payer: Priority Health SBD	$72.32

PROVENTIL HFA 90 MCG/ACTUATION AEROSOL INHALER

Facility

$149.10

Service Code	NDC 0085-1132-04
Hospital Charge Code	17934
Hospital Revenue Code	637
Min. Negotiated Rate	$93.93
Max. Negotiated Rate	$134.19
Rate for Payer: Aetna Commercial	$126.74
Rate for Payer: Aetna New Business (MI Preferred)	$96.92
Rate for Payer: Cash Price	$119.28
Rate for Payer: Cofinity Commercial	$104.37
Rate for Payer: Cofinity Commercial	$128.23
Rate for Payer: Healthscope Commercial	$134.19
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$126.74
Rate for Payer: PHP Commercial	$126.74
Rate for Payer: Priority Health Cigna Priority Health	$104.37
Rate for Payer: Priority Health SBD	$93.93

PR OVINE, UP TO 999 USP UNITS

Professional

Both

$2.00

Service Code	HCPCS J3471
Min. Negotiated Rate	$0.50
Max. Negotiated Rate	$1.40
Rate for Payer: Aetna Commercial	$0.51
Rate for Payer: BCBS Complete	$0.80
Rate for Payer: BCBS Trust/PPO	$0.50
Rate for Payer: Cash Price	$1.60
Rate for Payer: Cash Price	$1.60
Rate for Payer: Priority Health Cigna Priority Health	$1.40

PR PACKING STRIPS, NON-IMPREG

Professional

Both

$6.00

Service Code	HCPCS A6407
Min. Negotiated Rate	$1.74
Max. Negotiated Rate	$4.20
Rate for Payer: Aetna Commercial	$1.74
Rate for Payer: BCBS Complete	$2.40
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 PALATOPHARYNGOPLASTY

Professional

Both

$2,424.00

Service Code	HCPCS 42145
Min. Negotiated Rate	$442.83
Max. Negotiated Rate	$1,696.80
Rate for Payer: Aetna Commercial	$914.29
Rate for Payer: BCBS Complete	$464.97
Rate for Payer: BCBS Trust/PPO	$1,006.94
Rate for Payer: Cash Price	$1,939.20
Rate for Payer: Cash Price	$1,939.20
Rate for Payer: Mclaren Medicaid	$442.83
Rate for Payer: Meridian Medicaid	$464.97
Rate for Payer: Priority Health Choice Medicaid	$442.83
Rate for Payer: Priority Health Cigna Priority Health	$1,696.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,216.52
Rate for Payer: Priority Health Narrow Network	$1,216.52
Rate for Payer: Priority Health SBD	$1,216.52

PR PANCREATECTOMY W/TRNSPLJ PANCREAS/ISLET CELLS

Professional

Both

$7,449.00

Service Code	HCPCS 48160
Min. Negotiated Rate	$809.36
Max. Negotiated Rate	$5,468.15
Rate for Payer: Aetna Commercial	$4,176.69
Rate for Payer: BCBS Complete	$2,979.60
Rate for Payer: BCBS Trust/PPO	$809.36
Rate for Payer: Cash Price	$5,959.20
Rate for Payer: Cash Price	$5,959.20
Rate for Payer: Priority Health Cigna Priority Health	$5,214.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$5,468.15
Rate for Payer: Priority Health Narrow Network	$5,468.15
Rate for Payer: Priority Health SBD	$5,468.15

PR PANCREATICOJEJUNOSTOMY SIDE-TO-SIDE ANAST

Professional

Both

$3,379.00

Service Code	HCPCS 48548
Min. Negotiated Rate	$484.98
Max. Negotiated Rate	$2,932.80
Rate for Payer: Aetna Commercial	$2,265.27
Rate for Payer: BCBS Complete	$1,120.49
Rate for Payer: BCBS Trust/PPO	$484.98
Rate for Payer: Cash Price	$2,703.20
Rate for Payer: Cash Price	$2,703.20
Rate for Payer: Mclaren Medicaid	$1,067.13
Rate for Payer: Meridian Medicaid	$1,120.49
Rate for Payer: Priority Health Choice Medicaid	$1,067.13
Rate for Payer: Priority Health Cigna Priority Health	$2,365.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,932.80
Rate for Payer: Priority Health Narrow Network	$2,932.80
Rate for Payer: Priority Health SBD	$2,932.80

PR PANCREATORRHAPHY INJURY

Professional

Both

$3,208.00

Service Code	HCPCS 48545
Min. Negotiated Rate	$525.66
Max. Negotiated Rate	$2,366.00
Rate for Payer: Aetna Commercial	$1,824.64
Rate for Payer: BCBS Complete	$904.22
Rate for Payer: BCBS Trust/PPO	$525.66
Rate for Payer: Cash Price	$2,566.40
Rate for Payer: Cash Price	$2,566.40
Rate for Payer: Mclaren Medicaid	$861.16
Rate for Payer: Meridian Medicaid	$904.22
Rate for Payer: Priority Health Choice Medicaid	$861.16
Rate for Payer: Priority Health Cigna Priority Health	$2,245.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$2,366.00
Rate for Payer: Priority Health Narrow Network	$2,366.00
Rate for Payer: Priority Health SBD	$2,366.00

PR PARATHYRDEC/EXPL PARATHYR MEDSTNL STERNAL/TTHRC

Professional

Both

$2,485.00

Service Code	HCPCS 60505
Min. Negotiated Rate	$576.38
Max. Negotiated Rate	$1,977.27
Rate for Payer: Aetna Commercial	$1,795.96
Rate for Payer: BCBS Complete	$941.57
Rate for Payer: BCBS Trust/PPO	$576.38
Rate for Payer: Cash Price	$1,988.00
Rate for Payer: Cash Price	$1,988.00
Rate for Payer: Mclaren Medicaid	$896.73
Rate for Payer: Meridian Medicaid	$941.57
Rate for Payer: Priority Health Choice Medicaid	$896.73
Rate for Payer: Priority Health Cigna Priority Health	$1,739.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,977.27
Rate for Payer: Priority Health Narrow Network	$1,977.27
Rate for Payer: Priority Health SBD	$1,977.27

PR PARATHYROID AUTOTRANSPLANTATION ADD-ON

Professional

Both

$475.00

Service Code	HCPCS 60512
Min. Negotiated Rate	$153.15
Max. Negotiated Rate	$663.02
Rate for Payer: Aetna Commercial	$313.69
Rate for Payer: BCBS Complete	$160.81
Rate for Payer: BCBS Trust/PPO	$663.02
Rate for Payer: Cash Price	$380.00
Rate for Payer: Cash Price	$380.00
Rate for Payer: Mclaren Medicaid	$153.15
Rate for Payer: Meridian Medicaid	$160.81
Rate for Payer: Priority Health Choice Medicaid	$153.15
Rate for Payer: Priority Health Cigna Priority Health	$332.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$339.72
Rate for Payer: Priority Health Narrow Network	$339.72
Rate for Payer: Priority Health SBD	$339.72

PR PARATHYROIDECTOMY/EXPLORATION PARATHYROIDS

Professional

Both

$3,438.00

Service Code	HCPCS 60500
Min. Negotiated Rate	$621.96
Max. Negotiated Rate	$3,645.80
Rate for Payer: Aetna Commercial	$1,250.32
Rate for Payer: BCBS Complete	$653.06
Rate for Payer: BCBS Trust/PPO	$3,645.80
Rate for Payer: Cash Price	$2,750.40
Rate for Payer: Cash Price	$2,750.40
Rate for Payer: Mclaren Medicaid	$621.96
Rate for Payer: Meridian Medicaid	$653.06
Rate for Payer: Priority Health Choice Medicaid	$621.96
Rate for Payer: Priority Health Cigna Priority Health	$2,406.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,374.00
Rate for Payer: Priority Health Narrow Network	$1,374.00
Rate for Payer: Priority Health SBD	$1,374.00

PR PARATHYROIDECTOMY/EXPLOR PARATHYROIDS RE-EXPLOR

Professional

Both

$3,803.00

Service Code	HCPCS 60502
Min. Negotiated Rate	$834.96
Max. Negotiated Rate	$2,662.10
Rate for Payer: Aetna Commercial	$1,675.74
Rate for Payer: BCBS Complete	$876.71
Rate for Payer: BCBS Trust/PPO	$1,254.71
Rate for Payer: Cash Price	$3,042.40
Rate for Payer: Cash Price	$3,042.40
Rate for Payer: Mclaren Medicaid	$834.96
Rate for Payer: Meridian Medicaid	$876.71
Rate for Payer: Priority Health Choice Medicaid	$834.96
Rate for Payer: Priority Health Cigna Priority Health	$2,662.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,841.95
Rate for Payer: Priority Health Narrow Network	$1,841.95
Rate for Payer: Priority Health SBD	$1,841.95

PR PARAVAGINAL DEFECT REPAIR VAGINAL APPROACH

Professional

Both

$1,892.00

Service Code	HCPCS 57285
Min. Negotiated Rate	$444.53
Max. Negotiated Rate	$2,721.80
Rate for Payer: Aetna Commercial	$826.70
Rate for Payer: BCBS Complete	$466.76
Rate for Payer: BCBS Trust/PPO	$2,721.80
Rate for Payer: Cash Price	$1,513.60
Rate for Payer: Cash Price	$1,513.60
Rate for Payer: Mclaren Medicaid	$444.53
Rate for Payer: Meridian Medicaid	$466.76
Rate for Payer: Priority Health Choice Medicaid	$444.53
Rate for Payer: Priority Health Cigna Priority Health	$1,324.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$983.31
Rate for Payer: Priority Health Narrow Network	$983.31
Rate for Payer: Priority Health SBD	$983.31

Know your out-of-pocket cost for care.

All Charges