Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

GYNECOLOGIC PROCEDURES FOR LEIOMYOMA

Facility

$22,535.85

Service Code	APR-DRG 5194
Min. Negotiated Rate	$21,462.71
Max. Negotiated Rate	$22,535.85
Rate for Payer: BCBS Complete	$22,535.85
Rate for Payer: Mclaren Medicaid	$21,462.71
Rate for Payer: Meridian Medicaid	$22,535.85
Rate for Payer: Priority Health Choice Medicaid	$21,462.71
Rate for Payer: UHC Medicaid	$21,462.71
Rate for Payer: UHCCP Medicaid	$21,462.71

GYNECOLOGIC PROCEDURES FOR LEIOMYOMA

Facility

$9,517.35

Service Code	APR-DRG 5192
Min. Negotiated Rate	$9,064.15
Max. Negotiated Rate	$9,517.35
Rate for Payer: BCBS Complete	$9,517.35
Rate for Payer: Mclaren Medicaid	$9,064.15
Rate for Payer: Meridian Medicaid	$9,517.35
Rate for Payer: Priority Health Choice Medicaid	$9,064.15
Rate for Payer: UHC Medicaid	$9,064.15
Rate for Payer: UHCCP Medicaid	$9,064.15

GYNECOLOGIC PROCEDURES FOR LEIOMYOMA

Facility

$14,189.17

Service Code	APR-DRG 5193
Min. Negotiated Rate	$13,513.50
Max. Negotiated Rate	$14,189.17
Rate for Payer: BCBS Complete	$14,189.17
Rate for Payer: Mclaren Medicaid	$13,513.50
Rate for Payer: Meridian Medicaid	$14,189.17
Rate for Payer: Priority Health Choice Medicaid	$13,513.50
Rate for Payer: UHC Medicaid	$13,513.50
Rate for Payer: UHCCP Medicaid	$13,513.50

GYNECOLOGIC PROCEDURES FOR MALIGNANCY

Facility

$10,492.54

Service Code	APR-DRG 5112
Min. Negotiated Rate	$9,992.89
Max. Negotiated Rate	$10,492.54
Rate for Payer: BCBS Complete	$10,492.54
Rate for Payer: Mclaren Medicaid	$9,992.89
Rate for Payer: Meridian Medicaid	$10,492.54
Rate for Payer: Priority Health Choice Medicaid	$9,992.89
Rate for Payer: UHC Medicaid	$9,992.89
Rate for Payer: UHCCP Medicaid	$9,992.89

GYNECOLOGIC PROCEDURES FOR MALIGNANCY

Facility

$26,505.38

Service Code	APR-DRG 5114
Min. Negotiated Rate	$25,243.22
Max. Negotiated Rate	$26,505.38
Rate for Payer: BCBS Complete	$26,505.38
Rate for Payer: Mclaren Medicaid	$25,243.22
Rate for Payer: Meridian Medicaid	$26,505.38
Rate for Payer: Priority Health Choice Medicaid	$25,243.22
Rate for Payer: UHC Medicaid	$25,243.22
Rate for Payer: UHCCP Medicaid	$25,243.22

GYNECOLOGIC PROCEDURES FOR MALIGNANCY

Facility

$7,888.03

Service Code	APR-DRG 5111
Min. Negotiated Rate	$7,512.41
Max. Negotiated Rate	$7,888.03
Rate for Payer: BCBS Complete	$7,888.03
Rate for Payer: Mclaren Medicaid	$7,512.41
Rate for Payer: Meridian Medicaid	$7,888.03
Rate for Payer: Priority Health Choice Medicaid	$7,512.41
Rate for Payer: UHC Medicaid	$7,512.41
Rate for Payer: UHCCP Medicaid	$7,512.41

GYNECOLOGIC PROCEDURES FOR MALIGNANCY

Facility

$15,042.82

Service Code	APR-DRG 5113
Min. Negotiated Rate	$14,326.49
Max. Negotiated Rate	$15,042.82
Rate for Payer: BCBS Complete	$15,042.82
Rate for Payer: Mclaren Medicaid	$14,326.49
Rate for Payer: Meridian Medicaid	$15,042.82
Rate for Payer: Priority Health Choice Medicaid	$14,326.49
Rate for Payer: UHC Medicaid	$14,326.49
Rate for Payer: UHCCP Medicaid	$14,326.49

GYNECOLOGIC PROCEDURES WITHOUT MALIGNANCY

Facility

$29,595.47

Service Code	APR-DRG 5134
Min. Negotiated Rate	$28,186.16
Max. Negotiated Rate	$29,595.47
Rate for Payer: BCBS Complete	$29,595.47
Rate for Payer: Mclaren Medicaid	$28,186.16
Rate for Payer: Meridian Medicaid	$29,595.47
Rate for Payer: Priority Health Choice Medicaid	$28,186.16
Rate for Payer: UHC Medicaid	$28,186.16
Rate for Payer: UHCCP Medicaid	$28,186.16

GYNECOLOGIC PROCEDURES WITHOUT MALIGNANCY

Facility

$9,761.58

Service Code	APR-DRG 5132
Min. Negotiated Rate	$9,296.74
Max. Negotiated Rate	$9,761.58
Rate for Payer: BCBS Complete	$9,761.58
Rate for Payer: Mclaren Medicaid	$9,296.74
Rate for Payer: Meridian Medicaid	$9,761.58
Rate for Payer: Priority Health Choice Medicaid	$9,296.74
Rate for Payer: UHC Medicaid	$9,296.74
Rate for Payer: UHCCP Medicaid	$9,296.74

GYNECOLOGIC PROCEDURES WITHOUT MALIGNANCY

Facility

$14,842.74

Service Code	APR-DRG 5133
Min. Negotiated Rate	$14,135.94
Max. Negotiated Rate	$14,842.74
Rate for Payer: BCBS Complete	$14,842.74
Rate for Payer: Mclaren Medicaid	$14,135.94
Rate for Payer: Meridian Medicaid	$14,842.74
Rate for Payer: Priority Health Choice Medicaid	$14,135.94
Rate for Payer: UHC Medicaid	$14,135.94
Rate for Payer: UHCCP Medicaid	$14,135.94

GYNECOLOGIC PROCEDURES WITHOUT MALIGNANCY

Facility

$7,528.00

Service Code	APR-DRG 5131
Min. Negotiated Rate	$7,169.53
Max. Negotiated Rate	$7,528.00
Rate for Payer: BCBS Complete	$7,528.00
Rate for Payer: Mclaren Medicaid	$7,169.53
Rate for Payer: Meridian Medicaid	$7,528.00
Rate for Payer: Priority Health Choice Medicaid	$7,169.53
Rate for Payer: UHC Medicaid	$7,169.53
Rate for Payer: UHCCP Medicaid	$7,169.53

HAEMOPHILUS B POLYSACCHARID CONJ-TETANUS TOX(PF) 10 MCG/0.5 ML IM SOLN

Facility

$52.93

Service Code	HCPCS 90648
Hospital Charge Code	11931
Hospital Revenue Code	636
Min. Negotiated Rate	$21.17
Max. Negotiated Rate	$47.64
Rate for Payer: Aetna Commercial	$44.99
Rate for Payer: Aetna Medicare	$26.46
Rate for Payer: Aetna New Business (MI Preferred)	$34.40
Rate for Payer: BCBS Complete	$21.17
Rate for Payer: BCBS Trust/PPO	$32.43
Rate for Payer: BCN Commercial	$32.43
Rate for Payer: Cash Price	$42.34
Rate for Payer: Cash Price	$42.34
Rate for Payer: Cofinity Advantage	$37.05
Rate for Payer: Cofinity Commercial	$45.52
Rate for Payer: Encore Health Key Benefits Commercial	$42.34
Rate for Payer: Healthscope Commercial	$47.64
Rate for Payer: MI Amish Medical Board Commercial	$42.34
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$44.99
Rate for Payer: Opus (Opus Packaging Group) HMA	$39.70
Rate for Payer: PHP Commercial	$44.99
Rate for Payer: Priority Health SBD	$33.35
Rate for Payer: UHC All Payor (Choice/PPO)	$26.93
Rate for Payer: UHC Core	$26.93
Rate for Payer: UHC Exchange	$26.93

HAEMOPHILUS B POLYSACCHARID CONJ-TETANUS TOX(PF) 10 MCG/0.5 ML IM SOLN

Facility

$52.93

Service Code	HCPCS 90648
Hospital Charge Code	11931
Hospital Revenue Code	636
Min. Negotiated Rate	$33.35
Max. Negotiated Rate	$47.64
Rate for Payer: Aetna Commercial	$44.99
Rate for Payer: Aetna New Business (MI Preferred)	$34.40
Rate for Payer: Cash Price	$42.34
Rate for Payer: Cofinity Advantage	$37.05
Rate for Payer: Cofinity Commercial	$45.52
Rate for Payer: Encore Health Key Benefits Commercial	$42.34
Rate for Payer: Healthscope Commercial	$47.64
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$44.99
Rate for Payer: Opus (Opus Packaging Group) HMA	$39.70
Rate for Payer: PHP Commercial	$44.99
Rate for Payer: Priority Health SBD	$33.35

HAIR REMOVAL

Professional

Both

$84.00

Hospital Revenue Code	960
Min. Negotiated Rate	$33.60
Max. Negotiated Rate	$63.00
Rate for Payer: Aetna Medicare	$42.00
Rate for Payer: BCBS Complete	$33.60
Rate for Payer: Cash Price	$67.20
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$54.60
Rate for Payer: Opus (Opus Packaging Group) HMA	$63.00

HALLUX RIGIDUS CORRECTION WITH CHEILECTOMY, DEBRIDEMENT AND CAPSULAR RELEASE OF THE FIRST METATARSOPHALANGEAL JOINT; WITHOUT IMPLANT

Facility

$10,543.31

Service Code	CPT 28289
Hospital Revenue Code	360
Min. Negotiated Rate	$1,628.11
Max. Negotiated Rate	$10,543.31
Rate for Payer: Aetna Medicare	$3,390.64
Rate for Payer: Allen County Amish Medical Aid Commercial	$4,075.29
Rate for Payer: Amish Plain Church Group Commercial	$4,075.29
Rate for Payer: BCBS Complete	$1,790.52
Rate for Payer: BCBS MAPPO	$3,260.23
Rate for Payer: BCBS Trust/PPO	$1,628.11
Rate for Payer: BCN Commercial	$1,628.11
Rate for Payer: BCN Medicare Advantage	$3,260.23
Rate for Payer: Health Alliance Plan Medicare Advantage	$3,260.23
Rate for Payer: Mclaren Medicaid	$1,705.10
Rate for Payer: Mclaren Medicare	$3,260.23
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$3,423.24
Rate for Payer: Meridian Medicaid	$3,423.24
Rate for Payer: MI Amish Medical Board Commercial	$3,749.26
Rate for Payer: Molina Medicare/Medicaid	$3,586.25
Rate for Payer: Nomi Health Commercial	$9,780.69
Rate for Payer: PACE Medicare	$3,097.22
Rate for Payer: PACE SWMI	$3,260.23
Rate for Payer: PHP Medicare Advantage	$3,260.23
Rate for Payer: Priority Health Choice Medicaid	$1,705.10
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$10,543.31
Rate for Payer: Priority Health Medicare	$3,260.23
Rate for Payer: Priority Health Tiered Network	$8,434.65
Rate for Payer: Railroad Medicare Medicare	$3,260.23
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$3,260.23
Rate for Payer: UHC Medicaid	$1,705.10
Rate for Payer: UHCCP Medicaid	$1,705.10
Rate for Payer: VA VA	$3,260.23

HALOPERIDOL 0.5 MG TABLET

Facility

$2,299.00

Service Code	NDC 00378035110
Hospital Charge Code	3578
Hospital Revenue Code	637
Min. Negotiated Rate	$903.51
Max. Negotiated Rate	$2,069.10
Rate for Payer: Aetna Commercial	$1,954.15
Rate for Payer: Aetna Medicare	$1,149.50
Rate for Payer: Aetna New Business (MI Preferred)	$1,494.35
Rate for Payer: BCBS Complete	$919.60
Rate for Payer: Cash Price	$1,839.20
Rate for Payer: Cofinity Advantage	$1,609.30
Rate for Payer: Cofinity Commercial	$1,977.14
Rate for Payer: Encore Health Key Benefits Commercial	$1,839.20
Rate for Payer: Healthscope Commercial	$2,069.10
Rate for Payer: MI Amish Medical Board Commercial	$1,839.20
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,954.15
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,724.25
Rate for Payer: PHP Commercial	$1,954.15
Rate for Payer: Priority Health SBD	$1,448.37
Rate for Payer: UHC All Payor (Choice/PPO)	$1,494.35
Rate for Payer: UHC Core	$1,197.78
Rate for Payer: UHC Exchange	$903.51

HALOPERIDOL 0.5 MG TABLET

Facility

$2.72

Service Code	NDC 51079073301
Hospital Charge Code	3578
Hospital Revenue Code	637
Min. Negotiated Rate	$1.07
Max. Negotiated Rate	$2.45
Rate for Payer: Aetna Commercial	$2.31
Rate for Payer: Aetna Medicare	$1.36
Rate for Payer: Aetna New Business (MI Preferred)	$1.77
Rate for Payer: BCBS Complete	$1.09
Rate for Payer: Cash Price	$2.18
Rate for Payer: Cofinity Advantage	$1.90
Rate for Payer: Cofinity Commercial	$2.34
Rate for Payer: Encore Health Key Benefits Commercial	$2.18
Rate for Payer: Healthscope Commercial	$2.45
Rate for Payer: MI Amish Medical Board Commercial	$2.18
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2.31
Rate for Payer: Opus (Opus Packaging Group) HMA	$2.04
Rate for Payer: PHP Commercial	$2.31
Rate for Payer: Priority Health SBD	$1.71
Rate for Payer: UHC All Payor (Choice/PPO)	$1.77
Rate for Payer: UHC Core	$1.42
Rate for Payer: UHC Exchange	$1.07

HALOPERIDOL 0.5 MG TABLET

Facility

$271.70

Service Code	NDC 51079073320
Hospital Charge Code	3578
Hospital Revenue Code	637
Min. Negotiated Rate	$171.17
Max. Negotiated Rate	$244.53
Rate for Payer: Aetna Commercial	$230.94
Rate for Payer: Aetna New Business (MI Preferred)	$176.60
Rate for Payer: Cash Price	$217.36
Rate for Payer: Cofinity Advantage	$190.19
Rate for Payer: Cofinity Commercial	$233.66
Rate for Payer: Encore Health Key Benefits Commercial	$217.36
Rate for Payer: Healthscope Commercial	$244.53
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$230.94
Rate for Payer: Opus (Opus Packaging Group) HMA	$203.78
Rate for Payer: PHP Commercial	$230.94
Rate for Payer: Priority Health SBD	$171.17

HALOPERIDOL 0.5 MG TABLET

Facility

$2.72

Service Code	NDC 51079073301
Hospital Charge Code	3578
Hospital Revenue Code	637
Min. Negotiated Rate	$1.71
Max. Negotiated Rate	$2.45
Rate for Payer: Aetna Commercial	$2.31
Rate for Payer: Aetna New Business (MI Preferred)	$1.77
Rate for Payer: Cash Price	$2.18
Rate for Payer: Cofinity Advantage	$1.90
Rate for Payer: Cofinity Commercial	$2.34
Rate for Payer: Encore Health Key Benefits Commercial	$2.18
Rate for Payer: Healthscope Commercial	$2.45
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2.31
Rate for Payer: Opus (Opus Packaging Group) HMA	$2.04
Rate for Payer: PHP Commercial	$2.31
Rate for Payer: Priority Health SBD	$1.71

HALOPERIDOL 0.5 MG TABLET

Facility

$2,299.00

Service Code	NDC 00378035110
Hospital Charge Code	3578
Hospital Revenue Code	637
Min. Negotiated Rate	$1,448.37
Max. Negotiated Rate	$2,069.10
Rate for Payer: Aetna Commercial	$1,954.15
Rate for Payer: Aetna New Business (MI Preferred)	$1,494.35
Rate for Payer: Cash Price	$1,839.20
Rate for Payer: Cofinity Advantage	$1,609.30
Rate for Payer: Cofinity Commercial	$1,977.14
Rate for Payer: Encore Health Key Benefits Commercial	$1,839.20
Rate for Payer: Healthscope Commercial	$2,069.10
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,954.15
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,724.25
Rate for Payer: PHP Commercial	$1,954.15
Rate for Payer: Priority Health SBD	$1,448.37

HALOPERIDOL 0.5 MG TABLET

Facility

$271.70

Service Code	NDC 51079073320
Hospital Charge Code	3578
Hospital Revenue Code	637
Min. Negotiated Rate	$106.78
Max. Negotiated Rate	$244.53
Rate for Payer: Aetna Commercial	$230.94
Rate for Payer: Aetna Medicare	$135.85
Rate for Payer: Aetna New Business (MI Preferred)	$176.60
Rate for Payer: BCBS Complete	$108.68
Rate for Payer: Cash Price	$217.36
Rate for Payer: Cofinity Advantage	$190.19
Rate for Payer: Cofinity Commercial	$233.66
Rate for Payer: Encore Health Key Benefits Commercial	$217.36
Rate for Payer: Healthscope Commercial	$244.53
Rate for Payer: MI Amish Medical Board Commercial	$217.36
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$230.94
Rate for Payer: Opus (Opus Packaging Group) HMA	$203.78
Rate for Payer: PHP Commercial	$230.94
Rate for Payer: Priority Health SBD	$171.17
Rate for Payer: UHC All Payor (Choice/PPO)	$176.60
Rate for Payer: UHC Core	$141.56
Rate for Payer: UHC Exchange	$106.78

HALOPERIDOL 2 MG TABLET

Facility

$266.40

Service Code	NDC 51079073520
Hospital Charge Code	3581
Hospital Revenue Code	637
Min. Negotiated Rate	$167.83
Max. Negotiated Rate	$239.76
Rate for Payer: Aetna Commercial	$226.44
Rate for Payer: Aetna New Business (MI Preferred)	$173.16
Rate for Payer: Cash Price	$213.12
Rate for Payer: Cofinity Advantage	$186.48
Rate for Payer: Cofinity Commercial	$229.10
Rate for Payer: Encore Health Key Benefits Commercial	$213.12
Rate for Payer: Healthscope Commercial	$239.76
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$226.44
Rate for Payer: Opus (Opus Packaging Group) HMA	$199.80
Rate for Payer: PHP Commercial	$226.44
Rate for Payer: Priority Health SBD	$167.83

HALOPERIDOL 2 MG TABLET

Facility

$4,474.50

Service Code	NDC 00378021410
Hospital Charge Code	3581
Hospital Revenue Code	637
Min. Negotiated Rate	$1,758.48
Max. Negotiated Rate	$4,027.05
Rate for Payer: Aetna Commercial	$3,803.32
Rate for Payer: Aetna Medicare	$2,237.25
Rate for Payer: Aetna New Business (MI Preferred)	$2,908.43
Rate for Payer: BCBS Complete	$1,789.80
Rate for Payer: Cash Price	$3,579.60
Rate for Payer: Cofinity Advantage	$3,132.15
Rate for Payer: Cofinity Commercial	$3,848.07
Rate for Payer: Encore Health Key Benefits Commercial	$3,579.60
Rate for Payer: Healthscope Commercial	$4,027.05
Rate for Payer: MI Amish Medical Board Commercial	$3,579.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3,803.32
Rate for Payer: Opus (Opus Packaging Group) HMA	$3,355.88
Rate for Payer: PHP Commercial	$3,803.32
Rate for Payer: Priority Health SBD	$2,818.93
Rate for Payer: UHC All Payor (Choice/PPO)	$2,908.43
Rate for Payer: UHC Core	$2,331.21
Rate for Payer: UHC Exchange	$1,758.48

HALOPERIDOL 2 MG TABLET

Facility

$2.67

Service Code	NDC 51079073501
Hospital Charge Code	3581
Hospital Revenue Code	637
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$2.40
Rate for Payer: Aetna Commercial	$2.27
Rate for Payer: Aetna Medicare	$1.33
Rate for Payer: Aetna New Business (MI Preferred)	$1.74
Rate for Payer: BCBS Complete	$1.07
Rate for Payer: Cash Price	$2.14
Rate for Payer: Cofinity Advantage	$1.87
Rate for Payer: Cofinity Commercial	$2.30
Rate for Payer: Encore Health Key Benefits Commercial	$2.14
Rate for Payer: Healthscope Commercial	$2.40
Rate for Payer: MI Amish Medical Board Commercial	$2.14
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2.27
Rate for Payer: Opus (Opus Packaging Group) HMA	$2.00
Rate for Payer: PHP Commercial	$2.27
Rate for Payer: Priority Health SBD	$1.68
Rate for Payer: UHC All Payor (Choice/PPO)	$1.74
Rate for Payer: UHC Core	$1.39
Rate for Payer: UHC Exchange	$1.05

HALOPERIDOL 2 MG TABLET

Facility

$266.40

Service Code	NDC 51079073520
Hospital Charge Code	3581
Hospital Revenue Code	637
Min. Negotiated Rate	$104.70
Max. Negotiated Rate	$239.76
Rate for Payer: Aetna Commercial	$226.44
Rate for Payer: Aetna Medicare	$133.20
Rate for Payer: Aetna New Business (MI Preferred)	$173.16
Rate for Payer: BCBS Complete	$106.56
Rate for Payer: Cash Price	$213.12
Rate for Payer: Cofinity Advantage	$186.48
Rate for Payer: Cofinity Commercial	$229.10
Rate for Payer: Encore Health Key Benefits Commercial	$213.12
Rate for Payer: Healthscope Commercial	$239.76
Rate for Payer: MI Amish Medical Board Commercial	$213.12
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$226.44
Rate for Payer: Opus (Opus Packaging Group) HMA	$199.80
Rate for Payer: PHP Commercial	$226.44
Rate for Payer: Priority Health SBD	$167.83
Rate for Payer: UHC All Payor (Choice/PPO)	$173.16
Rate for Payer: UHC Core	$138.79
Rate for Payer: UHC Exchange	$104.70

Know your out-of-pocket cost for care.

All Charges