Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES

Facility

$2,063.88

Service Code	APR-DRG 8161
Min. Negotiated Rate	$1,965.60
Max. Negotiated Rate	$2,063.88
Rate for Payer: BCBS Complete	$2,063.88
Rate for Payer: Mclaren Medicaid	$1,965.60
Rate for Payer: Meridian Medicaid	$2,063.88
Rate for Payer: Priority Health Choice Medicaid	$1,965.60
Rate for Payer: UHC Medicaid	$1,965.60
Rate for Payer: UHCCP Medicaid	$1,965.60

TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES

Facility

$12,470.42

Service Code	APR-DRG 8164
Min. Negotiated Rate	$11,876.59
Max. Negotiated Rate	$12,470.42
Rate for Payer: BCBS Complete	$12,470.42
Rate for Payer: Mclaren Medicaid	$11,876.59
Rate for Payer: Meridian Medicaid	$12,470.42
Rate for Payer: Priority Health Choice Medicaid	$11,876.59
Rate for Payer: UHC Medicaid	$11,876.59
Rate for Payer: UHCCP Medicaid	$11,876.59

TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES

Facility

$3,323.99

Service Code	APR-DRG 8162
Min. Negotiated Rate	$3,165.71
Max. Negotiated Rate	$3,323.99
Rate for Payer: BCBS Complete	$3,323.99
Rate for Payer: Mclaren Medicaid	$3,165.71
Rate for Payer: Meridian Medicaid	$3,323.99
Rate for Payer: Priority Health Choice Medicaid	$3,165.71
Rate for Payer: UHC Medicaid	$3,165.71
Rate for Payer: UHCCP Medicaid	$3,165.71

TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES

Facility

$7,302.12

Service Code	APR-DRG 8163
Min. Negotiated Rate	$6,954.40
Max. Negotiated Rate	$7,302.12
Rate for Payer: BCBS Complete	$7,302.12
Rate for Payer: Mclaren Medicaid	$6,954.40
Rate for Payer: Meridian Medicaid	$7,302.12
Rate for Payer: Priority Health Choice Medicaid	$6,954.40
Rate for Payer: UHC Medicaid	$6,954.40
Rate for Payer: UHCCP Medicaid	$6,954.40

TRABECTEDIN 1 MG INTRAVENOUS SOLUTION

Facility

$16,565.14

Service Code	HCPCS J9352
Hospital Charge Code	175966
Hospital Revenue Code	636
Min. Negotiated Rate	$10,436.04
Max. Negotiated Rate	$14,908.63
Rate for Payer: Aetna Commercial	$14,080.37
Rate for Payer: Aetna New Business (MI Preferred)	$10,767.34
Rate for Payer: Cash Price	$13,252.11
Rate for Payer: Cofinity Advantage	$11,595.60
Rate for Payer: Cofinity Commercial	$14,246.02
Rate for Payer: Encore Health Key Benefits Commercial	$13,252.11
Rate for Payer: Healthscope Commercial	$14,908.63
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$14,080.37
Rate for Payer: Opus (Opus Packaging Group) HMA	$12,423.85
Rate for Payer: PHP Commercial	$14,080.37
Rate for Payer: Priority Health SBD	$10,436.04

TRABECTEDIN 1 MG INTRAVENOUS SOLUTION

Facility

$16,565.14

Service Code	HCPCS J9352
Hospital Charge Code	175966
Hospital Revenue Code	636
Min. Negotiated Rate	$204.53
Max. Negotiated Rate	$14,908.63
Rate for Payer: Aetna Commercial	$14,080.37
Rate for Payer: Aetna Medicare	$406.71
Rate for Payer: Aetna New Business (MI Preferred)	$10,767.34
Rate for Payer: Allen County Amish Medical Aid Commercial	$488.84
Rate for Payer: Amish Plain Church Group Commercial	$488.84
Rate for Payer: BCBS Complete	$214.78
Rate for Payer: BCBS MAPPO	$391.07
Rate for Payer: BCBS Trust/PPO	$981.12
Rate for Payer: BCN Commercial	$981.12
Rate for Payer: BCN Medicare Advantage	$391.07
Rate for Payer: Cash Price	$13,252.11
Rate for Payer: Cash Price	$13,252.11
Rate for Payer: Cofinity Advantage	$11,595.60
Rate for Payer: Cofinity Commercial	$14,246.02
Rate for Payer: Encore Health Key Benefits Commercial	$13,252.11
Rate for Payer: Health Alliance Plan Medicare Advantage	$391.07
Rate for Payer: Healthscope Commercial	$14,908.63
Rate for Payer: Mclaren Medicaid	$204.53
Rate for Payer: Mclaren Medicare	$391.07
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$410.62
Rate for Payer: Meridian Medicaid	$410.62
Rate for Payer: MI Amish Medical Board Commercial	$449.73
Rate for Payer: Molina Medicare/Medicaid	$430.18
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$14,080.37
Rate for Payer: Nomi Health Commercial	$1,173.21
Rate for Payer: Opus (Opus Packaging Group) HMA	$12,423.85
Rate for Payer: PACE Medicare	$371.52
Rate for Payer: PACE SWMI	$391.07
Rate for Payer: PHP Commercial	$14,080.37
Rate for Payer: PHP Medicare Advantage	$391.07
Rate for Payer: Priority Health Choice Medicaid	$204.53
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$1,233.43
Rate for Payer: Priority Health Medicare	$391.07
Rate for Payer: Priority Health SBD	$10,436.04
Rate for Payer: Priority Health Tiered Network	$986.74
Rate for Payer: Railroad Medicare Medicare	$391.07
Rate for Payer: UHC All Payor (Choice/PPO)	$645.27
Rate for Payer: UHC Core	$645.27
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$391.07
Rate for Payer: UHC Exchange	$645.27
Rate for Payer: UHC Medicaid	$204.53
Rate for Payer: UHCCP Medicaid	$204.53
Rate for Payer: VA VA	$391.07

TRACE ELEMENTS CR-CU-MN-ZN 10 MCG-1 MG-0.5 MG-5 MG/ML INTRAVENOUS SOLN

Facility

$47.26

Service Code	NDC 00517720125
Hospital Charge Code	18262
Hospital Revenue Code	250
Min. Negotiated Rate	$18.57
Max. Negotiated Rate	$42.53
Rate for Payer: Aetna Commercial	$40.17
Rate for Payer: Aetna Medicare	$23.63
Rate for Payer: Aetna New Business (MI Preferred)	$30.72
Rate for Payer: BCBS Complete	$18.90
Rate for Payer: Cash Price	$37.81
Rate for Payer: Cofinity Advantage	$33.08
Rate for Payer: Cofinity Commercial	$40.64
Rate for Payer: Encore Health Key Benefits Commercial	$37.81
Rate for Payer: Healthscope Commercial	$42.53
Rate for Payer: MI Amish Medical Board Commercial	$37.81
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$40.17
Rate for Payer: Opus (Opus Packaging Group) HMA	$35.45
Rate for Payer: PHP Commercial	$40.17
Rate for Payer: Priority Health SBD	$29.77
Rate for Payer: UHC All Payor (Choice/PPO)	$30.72
Rate for Payer: UHC Core	$24.62
Rate for Payer: UHC Exchange	$18.57

TRACE ELEMENTS CR-CU-MN-ZN 10 MCG-1 MG-0.5 MG-5 MG/ML INTRAVENOUS SOLN

Facility

$47.26

Service Code	NDC 00517720125
Hospital Charge Code	18262
Hospital Revenue Code	250
Min. Negotiated Rate	$29.77
Max. Negotiated Rate	$42.53
Rate for Payer: Aetna Commercial	$40.17
Rate for Payer: Aetna New Business (MI Preferred)	$30.72
Rate for Payer: Cash Price	$37.81
Rate for Payer: Cofinity Advantage	$33.08
Rate for Payer: Cofinity Commercial	$40.64
Rate for Payer: Encore Health Key Benefits Commercial	$37.81
Rate for Payer: Healthscope Commercial	$42.53
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$40.17
Rate for Payer: Opus (Opus Packaging Group) HMA	$35.45
Rate for Payer: PHP Commercial	$40.17
Rate for Payer: Priority Health SBD	$29.77

TRACE ELEMENTS ZN 3 MG-CU 0.3 MG-MN 55 MCG-SE 60 MCG/ML IV SOLUTION

Facility

$104.62

Service Code	NDC 00517930525
Hospital Charge Code	194947
Hospital Revenue Code	250
Min. Negotiated Rate	$65.91
Max. Negotiated Rate	$94.16
Rate for Payer: Aetna Commercial	$88.93
Rate for Payer: Aetna New Business (MI Preferred)	$68.00
Rate for Payer: Cash Price	$83.70
Rate for Payer: Cofinity Advantage	$73.23
Rate for Payer: Cofinity Commercial	$89.97
Rate for Payer: Encore Health Key Benefits Commercial	$83.70
Rate for Payer: Healthscope Commercial	$94.16
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$88.93
Rate for Payer: Opus (Opus Packaging Group) HMA	$78.47
Rate for Payer: PHP Commercial	$88.93
Rate for Payer: Priority Health SBD	$65.91

TRACE ELEMENTS ZN 3 MG-CU 0.3 MG-MN 55 MCG-SE 60 MCG/ML IV SOLUTION

Facility

$104.62

Service Code	NDC 00517930501
Hospital Charge Code	194947
Hospital Revenue Code	250
Min. Negotiated Rate	$65.91
Max. Negotiated Rate	$94.16
Rate for Payer: Aetna Commercial	$88.93
Rate for Payer: Aetna New Business (MI Preferred)	$68.00
Rate for Payer: Cash Price	$83.70
Rate for Payer: Cofinity Advantage	$73.23
Rate for Payer: Cofinity Commercial	$89.97
Rate for Payer: Encore Health Key Benefits Commercial	$83.70
Rate for Payer: Healthscope Commercial	$94.16
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$88.93
Rate for Payer: Opus (Opus Packaging Group) HMA	$78.47
Rate for Payer: PHP Commercial	$88.93
Rate for Payer: Priority Health SBD	$65.91

TRACE ELEMENTS ZN 3 MG-CU 0.3 MG-MN 55 MCG-SE 60 MCG/ML IV SOLUTION

Facility

$104.62

Service Code	NDC 00517930501
Hospital Charge Code	194947
Hospital Revenue Code	250
Min. Negotiated Rate	$41.12
Max. Negotiated Rate	$94.16
Rate for Payer: Aetna Commercial	$88.93
Rate for Payer: Aetna Medicare	$52.31
Rate for Payer: Aetna New Business (MI Preferred)	$68.00
Rate for Payer: BCBS Complete	$41.85
Rate for Payer: Cash Price	$83.70
Rate for Payer: Cofinity Advantage	$73.23
Rate for Payer: Cofinity Commercial	$89.97
Rate for Payer: Encore Health Key Benefits Commercial	$83.70
Rate for Payer: Healthscope Commercial	$94.16
Rate for Payer: MI Amish Medical Board Commercial	$83.70
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$88.93
Rate for Payer: Opus (Opus Packaging Group) HMA	$78.47
Rate for Payer: PHP Commercial	$88.93
Rate for Payer: Priority Health SBD	$65.91
Rate for Payer: UHC All Payor (Choice/PPO)	$68.00
Rate for Payer: UHC Core	$54.51
Rate for Payer: UHC Exchange	$41.12

TRACE ELEMENTS ZN 3 MG-CU 0.3 MG-MN 55 MCG-SE 60 MCG/ML IV SOLUTION

Facility

$104.62

Service Code	NDC 00517930525
Hospital Charge Code	194947
Hospital Revenue Code	250
Min. Negotiated Rate	$41.12
Max. Negotiated Rate	$94.16
Rate for Payer: Aetna Commercial	$88.93
Rate for Payer: Aetna Medicare	$52.31
Rate for Payer: Aetna New Business (MI Preferred)	$68.00
Rate for Payer: BCBS Complete	$41.85
Rate for Payer: Cash Price	$83.70
Rate for Payer: Cofinity Advantage	$73.23
Rate for Payer: Cofinity Commercial	$89.97
Rate for Payer: Encore Health Key Benefits Commercial	$83.70
Rate for Payer: Healthscope Commercial	$94.16
Rate for Payer: MI Amish Medical Board Commercial	$83.70
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$88.93
Rate for Payer: Opus (Opus Packaging Group) HMA	$78.47
Rate for Payer: PHP Commercial	$88.93
Rate for Payer: Priority Health SBD	$65.91
Rate for Payer: UHC All Payor (Choice/PPO)	$68.00
Rate for Payer: UHC Core	$54.51
Rate for Payer: UHC Exchange	$41.12

TRACHEOSTOMY, EMERGENCY PROCEDURE; CRICOTHYROID MEMBRANE

Facility

$763.21

Service Code	CPT 31605
Hospital Revenue Code	361
Min. Negotiated Rate	$123.43
Max. Negotiated Rate	$763.21
Rate for Payer: Aetna Medicare	$245.44
Rate for Payer: Allen County Amish Medical Aid Commercial	$295.00
Rate for Payer: Amish Plain Church Group Commercial	$295.00
Rate for Payer: BCBS Complete	$129.61
Rate for Payer: BCBS MAPPO	$236.00
Rate for Payer: BCBS Trust/PPO	$397.15
Rate for Payer: BCN Commercial	$397.15
Rate for Payer: BCN Medicare Advantage	$236.00
Rate for Payer: Health Alliance Plan Medicare Advantage	$236.00
Rate for Payer: Mclaren Medicaid	$123.43
Rate for Payer: Mclaren Medicare	$236.00
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$247.80
Rate for Payer: Meridian Medicaid	$247.80
Rate for Payer: MI Amish Medical Board Commercial	$271.40
Rate for Payer: Molina Medicare/Medicaid	$259.60
Rate for Payer: Nomi Health Commercial	$708.00
Rate for Payer: PACE Medicare	$224.20
Rate for Payer: PACE SWMI	$236.00
Rate for Payer: PHP Medicare Advantage	$236.00
Rate for Payer: Priority Health Choice Medicaid	$123.43
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$763.21
Rate for Payer: Priority Health Medicare	$236.00
Rate for Payer: Priority Health Tiered Network	$610.57
Rate for Payer: Railroad Medicare Medicare	$236.00
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$236.00
Rate for Payer: UHC Medicaid	$123.43
Rate for Payer: UHCCP Medicaid	$123.43
Rate for Payer: VA VA	$236.00

TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC

Facility

$96,761.65

Service Code	MSDRG 012
Min. Negotiated Rate	$31,503.15
Max. Negotiated Rate	$96,761.65
Rate for Payer: Aetna Medicare	$34,487.66
Rate for Payer: Allen County Amish Medical Aid Commercial	$41,451.51
Rate for Payer: Amish Plain Church Group Commercial	$41,451.51
Rate for Payer: BCBS MAPPO	$33,161.21
Rate for Payer: BCBS Trust/PPO	$96,761.65
Rate for Payer: BCN Commercial	$96,761.65
Rate for Payer: BCN Medicare Advantage	$33,161.21
Rate for Payer: Health Alliance Plan Medicare Advantage	$33,161.21
Rate for Payer: Mclaren Medicare	$33,161.21
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$34,819.27
Rate for Payer: MI Amish Medical Board Commercial	$38,135.39
Rate for Payer: Molina Medicare/Medicaid	$36,477.33
Rate for Payer: Nomi Health Commercial	$54,386.40
Rate for Payer: PACE Medicare	$31,503.15
Rate for Payer: PACE SWMI	$33,161.21
Rate for Payer: PHP Medicare Advantage	$33,161.21
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$67,970.94
Rate for Payer: Priority Health Medicare	$33,161.21
Rate for Payer: Priority Health Tiered Network	$54,376.75
Rate for Payer: Railroad Medicare Medicare	$33,161.21
Rate for Payer: UHC All Payor (Choice/PPO)	$68,720.80
Rate for Payer: UHC Core	$57,493.59
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$33,161.21
Rate for Payer: UHC Exchange	$46,953.59
Rate for Payer: VA VA	$33,161.21

TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC

Facility

$96,855.28

Service Code	MSDRG 011
Min. Negotiated Rate	$40,593.04
Max. Negotiated Rate	$96,855.28
Rate for Payer: Aetna Medicare	$44,438.70
Rate for Payer: Allen County Amish Medical Aid Commercial	$53,411.90
Rate for Payer: Amish Plain Church Group Commercial	$53,411.90
Rate for Payer: BCBS MAPPO	$42,729.52
Rate for Payer: BCBS Trust/PPO	$96,855.28
Rate for Payer: BCN Commercial	$96,855.28
Rate for Payer: BCN Medicare Advantage	$42,729.52
Rate for Payer: Health Alliance Plan Medicare Advantage	$42,729.52
Rate for Payer: Mclaren Medicare	$42,729.52
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$44,866.00
Rate for Payer: MI Amish Medical Board Commercial	$49,138.95
Rate for Payer: Molina Medicare/Medicaid	$47,002.47
Rate for Payer: Nomi Health Commercial	$70,357.89
Rate for Payer: PACE Medicare	$40,593.04
Rate for Payer: PACE SWMI	$42,729.52
Rate for Payer: PHP Medicare Advantage	$42,729.52
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$87,931.76
Rate for Payer: Priority Health Medicare	$42,729.52
Rate for Payer: Priority Health Tiered Network	$70,345.40
Rate for Payer: Railroad Medicare Medicare	$42,729.52
Rate for Payer: UHC All Payor (Choice/PPO)	$88,901.83
Rate for Payer: UHC Core	$74,377.56
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$42,729.52
Rate for Payer: UHC Exchange	$60,742.31
Rate for Payer: VA VA	$42,729.52

TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC

Facility

$67,801.27

Service Code	MSDRG 013
Min. Negotiated Rate	$21,707.70
Max. Negotiated Rate	$67,801.27
Rate for Payer: Aetna Medicare	$23,764.22
Rate for Payer: Allen County Amish Medical Aid Commercial	$28,562.76
Rate for Payer: Amish Plain Church Group Commercial	$28,562.76
Rate for Payer: BCBS MAPPO	$22,850.21
Rate for Payer: BCBS Trust/PPO	$67,801.27
Rate for Payer: BCN Commercial	$67,801.27
Rate for Payer: BCN Medicare Advantage	$22,850.21
Rate for Payer: Health Alliance Plan Medicare Advantage	$22,850.21
Rate for Payer: Mclaren Medicare	$22,850.21
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$23,992.72
Rate for Payer: MI Amish Medical Board Commercial	$26,277.74
Rate for Payer: Molina Medicare/Medicaid	$25,135.23
Rate for Payer: Nomi Health Commercial	$37,175.22
Rate for Payer: PACE Medicare	$21,707.70
Rate for Payer: PACE SWMI	$22,850.21
Rate for Payer: PHP Medicare Advantage	$22,850.21
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$46,460.78
Rate for Payer: Priority Health Medicare	$22,850.21
Rate for Payer: Priority Health Tiered Network	$37,168.62
Rate for Payer: Railroad Medicare Medicare	$22,850.21
Rate for Payer: UHC All Payor (Choice/PPO)	$46,973.34
Rate for Payer: UHC Core	$39,299.11
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$22,850.21
Rate for Payer: UHC Exchange	$32,094.61
Rate for Payer: VA VA	$22,850.21

TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES

Facility

$225,777.82

Service Code	MSDRG 004
Min. Negotiated Rate	$102,244.46
Max. Negotiated Rate	$225,777.82
Rate for Payer: Aetna Medicare	$111,930.78
Rate for Payer: Allen County Amish Medical Aid Commercial	$134,532.19
Rate for Payer: Amish Plain Church Group Commercial	$134,532.19
Rate for Payer: BCBS MAPPO	$107,625.75
Rate for Payer: BCBS Trust/PPO	$212,413.56
Rate for Payer: BCN Commercial	$212,413.56
Rate for Payer: BCN Medicare Advantage	$107,625.75
Rate for Payer: Health Alliance Plan Medicare Advantage	$107,625.75
Rate for Payer: Mclaren Medicare	$107,625.75
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$113,007.04
Rate for Payer: MI Amish Medical Board Commercial	$123,769.61
Rate for Payer: Molina Medicare/Medicaid	$118,388.32
Rate for Payer: Nomi Health Commercial	$178,683.06
Rate for Payer: PACE Medicare	$102,244.46
Rate for Payer: PACE SWMI	$107,625.75
Rate for Payer: PHP Medicare Advantage	$107,625.75
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$223,314.21
Rate for Payer: Priority Health Medicare	$107,625.75
Rate for Payer: Priority Health Tiered Network	$178,651.34
Rate for Payer: Railroad Medicare Medicare	$107,625.75
Rate for Payer: UHC All Payor (Choice/PPO)	$225,777.82
Rate for Payer: UHC Core	$188,891.54
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$107,625.75
Rate for Payer: UHC Exchange	$154,263.04
Rate for Payer: VA VA	$107,625.75

TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE

Facility

$66,034.99

Service Code	APR-DRG 0043
Min. Negotiated Rate	$62,890.46
Max. Negotiated Rate	$66,034.99
Rate for Payer: BCBS Complete	$66,034.99
Rate for Payer: Mclaren Medicaid	$62,890.46
Rate for Payer: Meridian Medicaid	$66,034.99
Rate for Payer: Priority Health Choice Medicaid	$62,890.46
Rate for Payer: UHC Medicaid	$62,890.46
Rate for Payer: UHCCP Medicaid	$62,890.46

TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE

Facility

$27,774.67

Service Code	APR-DRG 0041
Min. Negotiated Rate	$26,452.06
Max. Negotiated Rate	$27,774.67
Rate for Payer: BCBS Complete	$27,774.67
Rate for Payer: Mclaren Medicaid	$26,452.06
Rate for Payer: Meridian Medicaid	$27,774.67
Rate for Payer: Priority Health Choice Medicaid	$26,452.06
Rate for Payer: UHC Medicaid	$26,452.06
Rate for Payer: UHCCP Medicaid	$26,452.06

TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE

Facility

$41,429.52

Service Code	APR-DRG 0042
Min. Negotiated Rate	$39,456.69
Max. Negotiated Rate	$41,429.52
Rate for Payer: BCBS Complete	$41,429.52
Rate for Payer: Mclaren Medicaid	$39,456.69
Rate for Payer: Meridian Medicaid	$41,429.52
Rate for Payer: Priority Health Choice Medicaid	$39,456.69
Rate for Payer: UHC Medicaid	$39,456.69
Rate for Payer: UHCCP Medicaid	$39,456.69

TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE

Facility

$106,642.40

Service Code	APR-DRG 0044
Min. Negotiated Rate	$101,564.19
Max. Negotiated Rate	$106,642.40
Rate for Payer: BCBS Complete	$106,642.40
Rate for Payer: Mclaren Medicaid	$101,564.19
Rate for Payer: Meridian Medicaid	$106,642.40
Rate for Payer: Priority Health Choice Medicaid	$101,564.19
Rate for Payer: UHC Medicaid	$101,564.19
Rate for Payer: UHCCP Medicaid	$101,564.19

TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE

Facility

$12,674.52

Service Code	APR-DRG 0051
Min. Negotiated Rate	$12,070.97
Max. Negotiated Rate	$12,674.52
Rate for Payer: BCBS Complete	$12,674.52
Rate for Payer: Mclaren Medicaid	$12,070.97
Rate for Payer: Meridian Medicaid	$12,674.52
Rate for Payer: Priority Health Choice Medicaid	$12,070.97
Rate for Payer: UHC Medicaid	$12,070.97
Rate for Payer: UHCCP Medicaid	$12,070.97

TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE

Facility

$68,444.57

Service Code	APR-DRG 0054
Min. Negotiated Rate	$65,185.30
Max. Negotiated Rate	$68,444.57
Rate for Payer: BCBS Complete	$68,444.57
Rate for Payer: Mclaren Medicaid	$65,185.30
Rate for Payer: Meridian Medicaid	$68,444.57
Rate for Payer: Priority Health Choice Medicaid	$65,185.30
Rate for Payer: UHC Medicaid	$65,185.30
Rate for Payer: UHCCP Medicaid	$65,185.30

TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE

Facility

$55,373.33

Service Code	APR-DRG 0053
Min. Negotiated Rate	$52,736.50
Max. Negotiated Rate	$55,373.33
Rate for Payer: BCBS Complete	$55,373.33
Rate for Payer: Mclaren Medicaid	$52,736.50
Rate for Payer: Meridian Medicaid	$55,373.33
Rate for Payer: Priority Health Choice Medicaid	$52,736.50
Rate for Payer: UHC Medicaid	$52,736.50
Rate for Payer: UHCCP Medicaid	$52,736.50

TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE

Facility

$24,338.30

Service Code	APR-DRG 0052
Min. Negotiated Rate	$23,179.34
Max. Negotiated Rate	$24,338.30
Rate for Payer: BCBS Complete	$24,338.30
Rate for Payer: Mclaren Medicaid	$23,179.34
Rate for Payer: Meridian Medicaid	$24,338.30
Rate for Payer: Priority Health Choice Medicaid	$23,179.34
Rate for Payer: UHC Medicaid	$23,179.34
Rate for Payer: UHCCP Medicaid	$23,179.34

Know your out-of-pocket cost for care.

All Charges