Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PR MEDIASTINOSCOPY WITH LYMPH NODE BIOPSY/IES

Professional

Both

$845.00

Service Code	HCPCS 39402
Min. Negotiated Rate	$338.00
Max. Negotiated Rate	$718.91
Rate for Payer: Aetna Commercial	$520.72
Rate for Payer: Aetna Medicare	$404.14
Rate for Payer: Aetna New Business (MI Preferred)	$559.58
Rate for Payer: Aetna New Business (MI Preferred)	$520.72
Rate for Payer: BCBS Complete	$338.00
Rate for Payer: BCBS MAPPO	$388.60
Rate for Payer: BCN Medicare Advantage	$388.60
Rate for Payer: Cash Price	$676.00
Rate for Payer: Cash Price	$676.00
Rate for Payer: Cofinity Commercial	$559.58
Rate for Payer: Cofinity Commercial	$520.72
Rate for Payer: Health Alliance Plan Medicare Advantage	$388.60
Rate for Payer: Healthscope Commercial	$718.91
Rate for Payer: Healthscope Commercial	$621.76
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$408.03
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$549.25
Rate for Payer: Nomi Health Commercial	$466.32
Rate for Payer: PACE SWMI	$388.60
Rate for Payer: PHP Medicare Advantage	$388.60
Rate for Payer: Priority Health Cigna Priority Health	$549.25
Rate for Payer: Priority Health Medicare	$388.60
Rate for Payer: UHC Dual Complete DSNP	$388.60
Rate for Payer: UHC Medicare Advantage	$388.60

PR MEDIAST W/EXPL DRG RMVL FB/BX CRV APPR

Professional

Both

$2,549.00

Service Code	HCPCS 39000
Min. Negotiated Rate	$484.23
Max. Negotiated Rate	$1,656.85
Rate for Payer: Aetna Commercial	$648.87
Rate for Payer: Aetna Medicare	$503.60
Rate for Payer: Aetna New Business (MI Preferred)	$697.29
Rate for Payer: Aetna New Business (MI Preferred)	$648.87
Rate for Payer: BCBS Complete	$1,019.60
Rate for Payer: BCBS MAPPO	$484.23
Rate for Payer: BCN Medicare Advantage	$484.23
Rate for Payer: Cash Price	$2,039.20
Rate for Payer: Cash Price	$2,039.20
Rate for Payer: Cofinity Commercial	$697.29
Rate for Payer: Cofinity Commercial	$648.87
Rate for Payer: Health Alliance Plan Medicare Advantage	$484.23
Rate for Payer: Healthscope Commercial	$774.77
Rate for Payer: Healthscope Commercial	$895.83
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$508.44
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,656.85
Rate for Payer: Nomi Health Commercial	$581.08
Rate for Payer: PACE SWMI	$484.23
Rate for Payer: PHP Medicare Advantage	$484.23
Rate for Payer: Priority Health Cigna Priority Health	$1,656.85
Rate for Payer: Priority Health Medicare	$484.23
Rate for Payer: UHC Dual Complete DSNP	$484.23
Rate for Payer: UHC Medicare Advantage	$484.23

PR MEDIAST W/EXPL DRG RMVL FB/BX TTHRC APPR

Professional

Both

$5,247.00

Service Code	HCPCS 39010
Min. Negotiated Rate	$760.02
Max. Negotiated Rate	$3,410.55
Rate for Payer: Aetna Commercial	$1,018.43
Rate for Payer: Aetna Medicare	$790.42
Rate for Payer: Aetna New Business (MI Preferred)	$1,094.43
Rate for Payer: Aetna New Business (MI Preferred)	$1,018.43
Rate for Payer: BCBS Complete	$2,098.80
Rate for Payer: BCBS MAPPO	$760.02
Rate for Payer: BCN Medicare Advantage	$760.02
Rate for Payer: Cash Price	$4,197.60
Rate for Payer: Cash Price	$4,197.60
Rate for Payer: Cofinity Commercial	$1,094.43
Rate for Payer: Cofinity Commercial	$1,018.43
Rate for Payer: Health Alliance Plan Medicare Advantage	$760.02
Rate for Payer: Healthscope Commercial	$1,406.04
Rate for Payer: Healthscope Commercial	$1,216.03
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$798.02
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3,410.55
Rate for Payer: Nomi Health Commercial	$912.02
Rate for Payer: PACE SWMI	$760.02
Rate for Payer: PHP Medicare Advantage	$760.02
Rate for Payer: Priority Health Cigna Priority Health	$3,410.55
Rate for Payer: Priority Health Medicare	$760.02
Rate for Payer: UHC Dual Complete DSNP	$760.02
Rate for Payer: UHC Medicare Advantage	$760.02

PR MEDICAL NUTRITION ASSMT&IVNTJ INDIV EACH 15 MI

Professional

Both

$61.00

Service Code	HCPCS 97802
Min. Negotiated Rate	$24.40
Max. Negotiated Rate	$55.85
Rate for Payer: Aetna Commercial	$40.45
Rate for Payer: Aetna Medicare	$31.40
Rate for Payer: Aetna New Business (MI Preferred)	$43.47
Rate for Payer: Aetna New Business (MI Preferred)	$40.45
Rate for Payer: BCBS Complete	$24.40
Rate for Payer: BCBS MAPPO	$30.19
Rate for Payer: BCN Medicare Advantage	$30.19
Rate for Payer: Cash Price	$48.80
Rate for Payer: Cash Price	$48.80
Rate for Payer: Cofinity Commercial	$43.47
Rate for Payer: Cofinity Commercial	$40.45
Rate for Payer: Health Alliance Plan Medicare Advantage	$30.19
Rate for Payer: Healthscope Commercial	$48.30
Rate for Payer: Healthscope Commercial	$55.85
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$31.70
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$39.65
Rate for Payer: Nomi Health Commercial	$36.23
Rate for Payer: PACE SWMI	$30.19
Rate for Payer: PHP Medicare Advantage	$30.19
Rate for Payer: Priority Health Cigna Priority Health	$39.65
Rate for Payer: Priority Health Medicare	$30.19
Rate for Payer: UHC Dual Complete DSNP	$30.19
Rate for Payer: UHC Medicare Advantage	$30.19

PR MEDICAL NUTRITION RE-ASSMT&IVNTJ INDIV EA 15 M

Professional

Both

$50.00

Service Code	HCPCS 97803
Min. Negotiated Rate	$20.00
Max. Negotiated Rate	$47.25
Rate for Payer: Aetna Commercial	$34.22
Rate for Payer: Aetna Medicare	$26.56
Rate for Payer: Aetna New Business (MI Preferred)	$36.78
Rate for Payer: Aetna New Business (MI Preferred)	$34.22
Rate for Payer: BCBS Complete	$20.00
Rate for Payer: BCBS MAPPO	$25.54
Rate for Payer: BCN Medicare Advantage	$25.54
Rate for Payer: Cash Price	$40.00
Rate for Payer: Cash Price	$40.00
Rate for Payer: Cofinity Commercial	$36.78
Rate for Payer: Cofinity Commercial	$34.22
Rate for Payer: Health Alliance Plan Medicare Advantage	$25.54
Rate for Payer: Healthscope Commercial	$47.25
Rate for Payer: Healthscope Commercial	$40.86
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$26.82
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$32.50
Rate for Payer: Nomi Health Commercial	$30.65
Rate for Payer: PACE SWMI	$25.54
Rate for Payer: PHP Medicare Advantage	$25.54
Rate for Payer: Priority Health Cigna Priority Health	$32.50
Rate for Payer: Priority Health Medicare	$25.54
Rate for Payer: UHC Dual Complete DSNP	$25.54
Rate for Payer: UHC Medicare Advantage	$25.54

PR MEDICAL NUTRITION THERAPY GRP2/ INDIV EA 30 MI

Professional

Both

$28.00

Service Code	HCPCS 97804
Min. Negotiated Rate	$11.20
Max. Negotiated Rate	$26.57
Rate for Payer: Aetna Commercial	$19.24
Rate for Payer: Aetna Medicare	$14.93
Rate for Payer: Aetna New Business (MI Preferred)	$20.68
Rate for Payer: Aetna New Business (MI Preferred)	$19.24
Rate for Payer: BCBS Complete	$11.20
Rate for Payer: BCBS MAPPO	$14.36
Rate for Payer: BCN Medicare Advantage	$14.36
Rate for Payer: Cash Price	$22.40
Rate for Payer: Cash Price	$22.40
Rate for Payer: Cofinity Commercial	$20.68
Rate for Payer: Cofinity Commercial	$19.24
Rate for Payer: Health Alliance Plan Medicare Advantage	$14.36
Rate for Payer: Healthscope Commercial	$22.98
Rate for Payer: Healthscope Commercial	$26.57
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$15.08
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$18.20
Rate for Payer: Nomi Health Commercial	$17.23
Rate for Payer: PACE SWMI	$14.36
Rate for Payer: PHP Medicare Advantage	$14.36
Rate for Payer: Priority Health Cigna Priority Health	$18.20
Rate for Payer: Priority Health Medicare	$14.36
Rate for Payer: UHC Dual Complete DSNP	$14.36
Rate for Payer: UHC Medicare Advantage	$14.36

PR MEDICATION ADMIN & HEMODYNAMIC MEASURMENT

Professional

Both

$328.00

Service Code	HCPCS 93463
Min. Negotiated Rate	$91.69
Max. Negotiated Rate	$213.20
Rate for Payer: Aetna Commercial	$122.86
Rate for Payer: Aetna Medicare	$95.36
Rate for Payer: Aetna New Business (MI Preferred)	$132.03
Rate for Payer: Aetna New Business (MI Preferred)	$122.86
Rate for Payer: BCBS Complete	$131.20
Rate for Payer: BCBS MAPPO	$91.69
Rate for Payer: BCN Medicare Advantage	$91.69
Rate for Payer: Cash Price	$262.40
Rate for Payer: Cash Price	$262.40
Rate for Payer: Cofinity Commercial	$132.03
Rate for Payer: Cofinity Commercial	$122.86
Rate for Payer: Health Alliance Plan Medicare Advantage	$91.69
Rate for Payer: Healthscope Commercial	$146.70
Rate for Payer: Healthscope Commercial	$169.63
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$96.27
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$213.20
Rate for Payer: Nomi Health Commercial	$110.03
Rate for Payer: PACE SWMI	$91.69
Rate for Payer: PHP Medicare Advantage	$91.69
Rate for Payer: Priority Health Cigna Priority Health	$213.20
Rate for Payer: Priority Health Medicare	$91.69
Rate for Payer: UHC Dual Complete DSNP	$91.69
Rate for Payer: UHC Medicare Advantage	$91.69

PR MEDICATION THERAPY EACH ADDITIONAL 15 MIN

Professional

Both

$13.00

Service Code	HCPCS 99607
Min. Negotiated Rate	$5.20
Max. Negotiated Rate	$8.45
Rate for Payer: Aetna Medicare	$6.50
Rate for Payer: BCBS Complete	$5.20
Rate for Payer: Cash Price	$10.40
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$8.45
Rate for Payer: Priority Health Cigna Priority Health	$8.45

PR MEDICATION THERAPY INITIAL 15 MIN ESTABLISHED PT

Professional

Both

$32.00

Service Code	HCPCS 99606
Min. Negotiated Rate	$12.80
Max. Negotiated Rate	$20.80
Rate for Payer: Aetna Medicare	$16.00
Rate for Payer: BCBS Complete	$12.80
Rate for Payer: Cash Price	$25.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$20.80
Rate for Payer: Priority Health Cigna Priority Health	$20.80

PR MEDICATION THERAPY INITIAL 15 MIN NEW PATIENT

Professional

Both

$64.00

Service Code	HCPCS 99605
Min. Negotiated Rate	$25.60
Max. Negotiated Rate	$41.60
Rate for Payer: Aetna Medicare	$32.00
Rate for Payer: BCBS Complete	$25.60
Rate for Payer: Cash Price	$51.20
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$41.60
Rate for Payer: Priority Health Cigna Priority Health	$41.60

PR MEDROXYPROGESTERONE ACETATE

Professional

Both

$1.00

Service Code	HCPCS J1050
Min. Negotiated Rate	$0.40
Max. Negotiated Rate	$0.65
Rate for Payer: Aetna Medicare	$0.50
Rate for Payer: BCBS Complete	$0.40
Rate for Payer: Cash Price	$0.80
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$0.65
Rate for Payer: Priority Health Cigna Priority Health	$0.65

PR MEDROXYPROGESTERONE INJ

Professional

Both

$31.00

Service Code	HCPCS J1051
Min. Negotiated Rate	$12.40
Max. Negotiated Rate	$20.15
Rate for Payer: Aetna Medicare	$15.50
Rate for Payer: BCBS Complete	$12.40
Rate for Payer: Cash Price	$24.80
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$20.15
Rate for Payer: Priority Health Cigna Priority Health	$20.15

PR MEDRXYPROGESTER ACETATE INJ

Professional

Both

$82.00

Service Code	HCPCS J1055
Min. Negotiated Rate	$32.80
Max. Negotiated Rate	$53.30
Rate for Payer: Aetna Medicare	$41.00
Rate for Payer: BCBS Complete	$32.80
Rate for Payer: Cash Price	$65.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$53.30
Rate for Payer: Priority Health Cigna Priority Health	$53.30

PR MENACWYD/MENACWY-CRM CONJ VACC GRPS ACWY IM USE

Professional

Both

$143.00

Service Code	HCPCS 90734
Min. Negotiated Rate	$57.20
Max. Negotiated Rate	$92.95
Rate for Payer: Aetna Medicare	$71.50
Rate for Payer: BCBS Complete	$57.20
Rate for Payer: Cash Price	$114.40
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$92.95
Rate for Payer: Priority Health Cigna Priority Health	$92.95

PR MENACWY-TT CONJ VACC SEROGROUPS ACWY FOR IM USE

Professional

Both

$184.00

Service Code	HCPCS 90619
Min. Negotiated Rate	$73.60
Max. Negotiated Rate	$119.60
Rate for Payer: Aetna Medicare	$92.00
Rate for Payer: BCBS Complete	$73.60
Rate for Payer: Cash Price	$147.20
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$119.60
Rate for Payer: Priority Health Cigna Priority Health	$119.60

PR MENB-4C RECOMBNT PROT & OUTER MEMB VESIC VACC IM

Professional

Both

$263.00

Service Code	HCPCS 90620
Min. Negotiated Rate	$105.20
Max. Negotiated Rate	$170.95
Rate for Payer: Aetna Medicare	$131.50
Rate for Payer: BCBS Complete	$105.20
Rate for Payer: Cash Price	$210.40
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$170.95
Rate for Payer: Priority Health Cigna Priority Health	$170.95

PR MENB-FHBP RECOMBNT LIPOPROTEIN VACC 2/3 DOSE IM

Professional

Both

$184.00

Service Code	HCPCS 90621
Min. Negotiated Rate	$73.60
Max. Negotiated Rate	$119.60
Rate for Payer: Aetna Medicare	$92.00
Rate for Payer: BCBS Complete	$73.60
Rate for Payer: Cash Price	$147.20
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$119.60
Rate for Payer: Priority Health Cigna Priority Health	$119.60

PR MEPERIDINE HYDROCHL /100 MG

Professional

Both

$10.00

Service Code	HCPCS J2175
Min. Negotiated Rate	$4.00
Max. Negotiated Rate	$29.03
Rate for Payer: Aetna Commercial	$21.02
Rate for Payer: Aetna Medicare	$16.32
Rate for Payer: Aetna New Business (MI Preferred)	$22.59
Rate for Payer: Aetna New Business (MI Preferred)	$21.02
Rate for Payer: BCBS Complete	$4.00
Rate for Payer: BCBS MAPPO	$15.69
Rate for Payer: BCN Medicare Advantage	$15.69
Rate for Payer: Cash Price	$8.00
Rate for Payer: Cash Price	$8.00
Rate for Payer: Cofinity Commercial	$21.02
Rate for Payer: Cofinity Commercial	$22.59
Rate for Payer: Health Alliance Plan Medicare Advantage	$15.69
Rate for Payer: Healthscope Commercial	$29.03
Rate for Payer: Healthscope Commercial	$25.10
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$16.47
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$6.50
Rate for Payer: Nomi Health Commercial	$18.83
Rate for Payer: PACE SWMI	$15.69
Rate for Payer: PHP Medicare Advantage	$15.69
Rate for Payer: Priority Health Cigna Priority Health	$6.50
Rate for Payer: Priority Health Medicare	$15.69
Rate for Payer: UHC Dual Complete DSNP	$15.69
Rate for Payer: UHC Medicare Advantage	$15.69

PR MEPERIDINE/PROMETHAZINE INJ

Professional

Both

$11.00

Service Code	HCPCS J2180
Min. Negotiated Rate	$4.40
Max. Negotiated Rate	$7.15
Rate for Payer: Aetna Medicare	$5.50
Rate for Payer: BCBS Complete	$4.40
Rate for Payer: Cash Price	$8.80
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$7.15
Rate for Payer: Priority Health Cigna Priority Health	$7.15

PR METATARSECTOMY

Professional

Both

$1,071.00

Service Code	HCPCS 28140
Min. Negotiated Rate	$407.56
Max. Negotiated Rate	$753.99
Rate for Payer: Aetna Commercial	$546.13
Rate for Payer: Aetna Medicare	$423.86
Rate for Payer: Aetna New Business (MI Preferred)	$586.89
Rate for Payer: Aetna New Business (MI Preferred)	$546.13
Rate for Payer: BCBS Complete	$428.40
Rate for Payer: BCBS MAPPO	$407.56
Rate for Payer: BCN Medicare Advantage	$407.56
Rate for Payer: Cash Price	$856.80
Rate for Payer: Cash Price	$856.80
Rate for Payer: Cofinity Commercial	$586.89
Rate for Payer: Cofinity Commercial	$546.13
Rate for Payer: Health Alliance Plan Medicare Advantage	$407.56
Rate for Payer: Healthscope Commercial	$652.10
Rate for Payer: Healthscope Commercial	$753.99
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$427.94
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$696.15
Rate for Payer: Nomi Health Commercial	$489.07
Rate for Payer: PACE SWMI	$407.56
Rate for Payer: PHP Medicare Advantage	$407.56
Rate for Payer: Priority Health Cigna Priority Health	$696.15
Rate for Payer: Priority Health Medicare	$407.56
Rate for Payer: UHC Dual Complete DSNP	$407.56
Rate for Payer: UHC Medicare Advantage	$407.56

PR METHYLPREDNISOLONE 20 MG INJ

Professional

Both

$10.00

Service Code	HCPCS J1020
Min. Negotiated Rate	$4.00
Max. Negotiated Rate	$6.50
Rate for Payer: Aetna Medicare	$5.00
Rate for Payer: BCBS Complete	$4.00
Rate for Payer: Cash Price	$8.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$6.50
Rate for Payer: Priority Health Cigna Priority Health	$6.50

PR METHYLPREDNISOLONE 40 MG INJ

Professional

Both

$15.00

Service Code	HCPCS J1030
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$9.75
Rate for Payer: Aetna Medicare	$7.50
Rate for Payer: BCBS Complete	$6.00
Rate for Payer: Cash Price	$12.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$9.75
Rate for Payer: Priority Health Cigna Priority Health	$9.75

PR METHYLPREDNISOLONE 80 MG INJ

Professional

Both

$26.00

Service Code	HCPCS J1040
Min. Negotiated Rate	$10.40
Max. Negotiated Rate	$16.90
Rate for Payer: Aetna Medicare	$13.00
Rate for Payer: BCBS Complete	$10.40
Rate for Payer: Cash Price	$20.80
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$16.90
Rate for Payer: Priority Health Cigna Priority Health	$16.90

PR METHYLPREDNISOLONE INJECTION

Professional

Both

$10.00

Service Code	HCPCS J2920
Min. Negotiated Rate	$4.00
Max. Negotiated Rate	$6.50
Rate for Payer: Aetna Medicare	$5.00
Rate for Payer: BCBS Complete	$4.00
Rate for Payer: Cash Price	$8.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$6.50
Rate for Payer: Priority Health Cigna Priority Health	$6.50

PR METHYLPREDNISOLONE INJECTION

Professional

Both

$26.00

Service Code	HCPCS J2930
Min. Negotiated Rate	$10.40
Max. Negotiated Rate	$16.90
Rate for Payer: Aetna Medicare	$13.00
Rate for Payer: BCBS Complete	$10.40
Rate for Payer: Cash Price	$20.80
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$16.90
Rate for Payer: Priority Health Cigna Priority Health	$16.90

Know your out-of-pocket cost for care.

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