Bronson Lakeview Hospital

All Charges

Charge

Type

Setting

Price

ACUTE AND SUBACUTE ENDOCARDITIS

Facility

$7,128.29

Service Code	APR-DRG 1932
Min. Negotiated Rate	$6,788.84
Max. Negotiated Rate	$7,128.29
Rate for Payer: BCBS Complete	$7,128.29
Rate for Payer: Mclaren Medicaid	$6,788.84
Rate for Payer: Meridian Medicaid	$7,128.29
Rate for Payer: Priority Health Choice Medicaid	$6,788.84
Rate for Payer: UHC Medicaid	$6,788.84
Rate for Payer: UHCCP Medicaid	$6,788.84

ACUTE AND SUBACUTE ENDOCARDITIS

Facility

$10,745.54

Service Code	APR-DRG 1933
Min. Negotiated Rate	$10,233.85
Max. Negotiated Rate	$10,745.54
Rate for Payer: BCBS Complete	$10,745.54
Rate for Payer: Mclaren Medicaid	$10,233.85
Rate for Payer: Meridian Medicaid	$10,745.54
Rate for Payer: Priority Health Choice Medicaid	$10,233.85
Rate for Payer: UHC Medicaid	$10,233.85
Rate for Payer: UHCCP Medicaid	$10,233.85

ACUTE ANXIETY AND STRESS SYNDROMES

Facility

$2,979.94

Service Code	APR-DRG 7561
Min. Negotiated Rate	$2,838.03
Max. Negotiated Rate	$2,979.94
Rate for Payer: BCBS Complete	$2,979.94
Rate for Payer: Mclaren Medicaid	$2,838.03
Rate for Payer: Meridian Medicaid	$2,979.94
Rate for Payer: Priority Health Choice Medicaid	$2,838.03
Rate for Payer: UHC Medicaid	$2,838.03
Rate for Payer: UHCCP Medicaid	$2,838.03

ACUTE ANXIETY AND STRESS SYNDROMES

Facility

$7,549.48

Service Code	APR-DRG 7563
Min. Negotiated Rate	$7,189.99
Max. Negotiated Rate	$7,549.48
Rate for Payer: BCBS Complete	$7,549.48
Rate for Payer: Mclaren Medicaid	$7,189.99
Rate for Payer: Meridian Medicaid	$7,549.48
Rate for Payer: Priority Health Choice Medicaid	$7,189.99
Rate for Payer: UHC Medicaid	$7,189.99
Rate for Payer: UHCCP Medicaid	$7,189.99

ACUTE ANXIETY AND STRESS SYNDROMES

Facility

$4,662.10

Service Code	APR-DRG 7562
Min. Negotiated Rate	$4,440.09
Max. Negotiated Rate	$4,662.10
Rate for Payer: BCBS Complete	$4,662.10
Rate for Payer: Mclaren Medicaid	$4,440.09
Rate for Payer: Meridian Medicaid	$4,662.10
Rate for Payer: Priority Health Choice Medicaid	$4,440.09
Rate for Payer: UHC Medicaid	$4,440.09
Rate for Payer: UHCCP Medicaid	$4,440.09

ACUTE ANXIETY AND STRESS SYNDROMES

Facility

$12,318.33

Service Code	APR-DRG 7564
Min. Negotiated Rate	$11,731.74
Max. Negotiated Rate	$12,318.33
Rate for Payer: BCBS Complete	$12,318.33
Rate for Payer: Mclaren Medicaid	$11,731.74
Rate for Payer: Meridian Medicaid	$12,318.33
Rate for Payer: Priority Health Choice Medicaid	$11,731.74
Rate for Payer: UHC Medicaid	$11,731.74
Rate for Payer: UHCCP Medicaid	$11,731.74

ACUTE BRONCHITIS AND RELATED SYMPTOMS

Facility

$2,873.19

Service Code	APR-DRG 1451
Min. Negotiated Rate	$2,736.37
Max. Negotiated Rate	$2,873.19
Rate for Payer: BCBS Complete	$2,873.19
Rate for Payer: Mclaren Medicaid	$2,736.37
Rate for Payer: Meridian Medicaid	$2,873.19
Rate for Payer: Priority Health Choice Medicaid	$2,736.37
Rate for Payer: UHC Medicaid	$2,736.37
Rate for Payer: UHCCP Medicaid	$2,736.37

ACUTE BRONCHITIS AND RELATED SYMPTOMS

Facility

$3,596.22

Service Code	APR-DRG 1452
Min. Negotiated Rate	$3,424.97
Max. Negotiated Rate	$3,596.22
Rate for Payer: BCBS Complete	$3,596.22
Rate for Payer: Mclaren Medicaid	$3,424.97
Rate for Payer: Meridian Medicaid	$3,596.22
Rate for Payer: Priority Health Choice Medicaid	$3,424.97
Rate for Payer: UHC Medicaid	$3,424.97
Rate for Payer: UHCCP Medicaid	$3,424.97

ACUTE BRONCHITIS AND RELATED SYMPTOMS

Facility

$8,287.76

Service Code	APR-DRG 1454
Min. Negotiated Rate	$7,893.11
Max. Negotiated Rate	$8,287.76
Rate for Payer: BCBS Complete	$8,287.76
Rate for Payer: Mclaren Medicaid	$7,893.11
Rate for Payer: Meridian Medicaid	$8,287.76
Rate for Payer: Priority Health Choice Medicaid	$7,893.11
Rate for Payer: UHC Medicaid	$7,893.11
Rate for Payer: UHCCP Medicaid	$7,893.11

ACUTE BRONCHITIS AND RELATED SYMPTOMS

Facility

$5,014.94

Service Code	APR-DRG 1453
Min. Negotiated Rate	$4,776.13
Max. Negotiated Rate	$5,014.94
Rate for Payer: BCBS Complete	$5,014.94
Rate for Payer: Mclaren Medicaid	$4,776.13
Rate for Payer: Meridian Medicaid	$5,014.94
Rate for Payer: Priority Health Choice Medicaid	$4,776.13
Rate for Payer: UHC Medicaid	$4,776.13
Rate for Payer: UHCCP Medicaid	$4,776.13

ACUTE KIDNEY INJURY

Facility

$2,800.10

Service Code	APR-DRG 4691
Min. Negotiated Rate	$2,666.76
Max. Negotiated Rate	$2,800.10
Rate for Payer: BCBS Complete	$2,800.10
Rate for Payer: Mclaren Medicaid	$2,666.76
Rate for Payer: Meridian Medicaid	$2,800.10
Rate for Payer: Priority Health Choice Medicaid	$2,666.76
Rate for Payer: UHC Medicaid	$2,666.76
Rate for Payer: UHCCP Medicaid	$2,666.76

ACUTE KIDNEY INJURY

Facility

$6,967.91

Service Code	APR-DRG 4693
Min. Negotiated Rate	$6,636.10
Max. Negotiated Rate	$6,967.91
Rate for Payer: BCBS Complete	$6,967.91
Rate for Payer: Mclaren Medicaid	$6,636.10
Rate for Payer: Meridian Medicaid	$6,967.91
Rate for Payer: Priority Health Choice Medicaid	$6,636.10
Rate for Payer: UHC Medicaid	$6,636.10
Rate for Payer: UHCCP Medicaid	$6,636.10

ACUTE KIDNEY INJURY

Facility

$3,843.36

Service Code	APR-DRG 4692
Min. Negotiated Rate	$3,660.35
Max. Negotiated Rate	$3,843.36
Rate for Payer: BCBS Complete	$3,843.36
Rate for Payer: Mclaren Medicaid	$3,660.35
Rate for Payer: Meridian Medicaid	$3,843.36
Rate for Payer: Priority Health Choice Medicaid	$3,660.35
Rate for Payer: UHC Medicaid	$3,660.35
Rate for Payer: UHCCP Medicaid	$3,660.35

ACUTE KIDNEY INJURY

Facility

$13,900.58

Service Code	APR-DRG 4694
Min. Negotiated Rate	$13,238.65
Max. Negotiated Rate	$13,900.58
Rate for Payer: BCBS Complete	$13,900.58
Rate for Payer: Mclaren Medicaid	$13,238.65
Rate for Payer: Meridian Medicaid	$13,900.58
Rate for Payer: Priority Health Choice Medicaid	$13,238.65
Rate for Payer: UHC Medicaid	$13,238.65
Rate for Payer: UHCCP Medicaid	$13,238.65

ACUTE LEUKEMIA

Facility

$37,091.70

Service Code	APR-DRG 6904
Min. Negotiated Rate	$35,325.43
Max. Negotiated Rate	$37,091.70
Rate for Payer: BCBS Complete	$37,091.70
Rate for Payer: Mclaren Medicaid	$35,325.43
Rate for Payer: Meridian Medicaid	$37,091.70
Rate for Payer: Priority Health Choice Medicaid	$35,325.43
Rate for Payer: UHC Medicaid	$35,325.43
Rate for Payer: UHCCP Medicaid	$35,325.43

ACUTE LEUKEMIA

Facility

$14,907.56

Service Code	APR-DRG 6902
Min. Negotiated Rate	$14,197.68
Max. Negotiated Rate	$14,907.56
Rate for Payer: BCBS Complete	$14,907.56
Rate for Payer: Mclaren Medicaid	$14,197.68
Rate for Payer: Meridian Medicaid	$14,907.56
Rate for Payer: Priority Health Choice Medicaid	$14,197.68
Rate for Payer: UHC Medicaid	$14,197.68
Rate for Payer: UHCCP Medicaid	$14,197.68

ACUTE LEUKEMIA

Facility

$9,619.19

Service Code	APR-DRG 6901
Min. Negotiated Rate	$9,161.13
Max. Negotiated Rate	$9,619.19
Rate for Payer: BCBS Complete	$9,619.19
Rate for Payer: Mclaren Medicaid	$9,161.13
Rate for Payer: Meridian Medicaid	$9,619.19
Rate for Payer: Priority Health Choice Medicaid	$9,161.13
Rate for Payer: UHC Medicaid	$9,161.13
Rate for Payer: UHCCP Medicaid	$9,161.13

ACUTE LEUKEMIA

Facility

$25,682.03

Service Code	APR-DRG 6903
Min. Negotiated Rate	$24,459.07
Max. Negotiated Rate	$25,682.03
Rate for Payer: BCBS Complete	$25,682.03
Rate for Payer: Mclaren Medicaid	$24,459.07
Rate for Payer: Meridian Medicaid	$25,682.03
Rate for Payer: Priority Health Choice Medicaid	$24,459.07
Rate for Payer: UHC Medicaid	$24,459.07
Rate for Payer: UHCCP Medicaid	$24,459.07

ACUTE MYOCARDIAL INFARCTION

Facility

$2,884.76

Service Code	APR-DRG 1901
Min. Negotiated Rate	$2,747.39
Max. Negotiated Rate	$2,884.76
Rate for Payer: BCBS Complete	$2,884.76
Rate for Payer: Mclaren Medicaid	$2,747.39
Rate for Payer: Meridian Medicaid	$2,884.76
Rate for Payer: Priority Health Choice Medicaid	$2,747.39
Rate for Payer: UHC Medicaid	$2,747.39
Rate for Payer: UHCCP Medicaid	$2,747.39

ACUTE MYOCARDIAL INFARCTION

Facility

$12,601.23

Service Code	APR-DRG 1904
Min. Negotiated Rate	$12,001.17
Max. Negotiated Rate	$12,601.23
Rate for Payer: BCBS Complete	$12,601.23
Rate for Payer: Mclaren Medicaid	$12,001.17
Rate for Payer: Meridian Medicaid	$12,601.23
Rate for Payer: Priority Health Choice Medicaid	$12,001.17
Rate for Payer: UHC Medicaid	$12,001.17
Rate for Payer: UHCCP Medicaid	$12,001.17

ACUTE MYOCARDIAL INFARCTION

Facility

$4,530.11

Service Code	APR-DRG 1902
Min. Negotiated Rate	$4,314.39
Max. Negotiated Rate	$4,530.11
Rate for Payer: BCBS Complete	$4,530.11
Rate for Payer: Mclaren Medicaid	$4,314.39
Rate for Payer: Meridian Medicaid	$4,530.11
Rate for Payer: Priority Health Choice Medicaid	$4,314.39
Rate for Payer: UHC Medicaid	$4,314.39
Rate for Payer: UHCCP Medicaid	$4,314.39

ACUTE MYOCARDIAL INFARCTION

Facility

$6,109.21

Service Code	APR-DRG 1903
Min. Negotiated Rate	$5,818.29
Max. Negotiated Rate	$6,109.21
Rate for Payer: BCBS Complete	$6,109.21
Rate for Payer: Mclaren Medicaid	$5,818.29
Rate for Payer: Meridian Medicaid	$6,109.21
Rate for Payer: Priority Health Choice Medicaid	$5,818.29
Rate for Payer: UHC Medicaid	$5,818.29
Rate for Payer: UHCCP Medicaid	$5,818.29

ACYCLOVIR 200 MG CAPSULE

Facility

$282.00

Service Code	NDC 72578000201
Hospital Charge Code	8969
Hospital Revenue Code	637
Min. Negotiated Rate	$49.72
Max. Negotiated Rate	$253.80
Rate for Payer: Aetna Commercial	$239.70
Rate for Payer: Aetna Medicare	$73.32
Rate for Payer: Allen County Amish Medical Aid Commercial	$88.12
Rate for Payer: Amish Plain Church Group Commercial	$88.12
Rate for Payer: BCBS Complete	$52.20
Rate for Payer: BCBS MAPPO	$70.50
Rate for Payer: BCBS Trust/PPO	$231.83
Rate for Payer: BCN Commercial	$231.83
Rate for Payer: BCN Medicare Advantage	$70.50
Rate for Payer: Cash Price	$225.60
Rate for Payer: Cofinity Commercial	$242.52
Rate for Payer: Encore Health Key Benefits Commercial	$225.60
Rate for Payer: Health Alliance Plan Medicare Advantage	$70.50
Rate for Payer: Healthscope Commercial	$253.80
Rate for Payer: Lakeland Regional Health Systems Commercial	$211.50
Rate for Payer: Mclaren Medicaid	$49.72
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$74.03
Rate for Payer: Meridian Medicaid	$52.20
Rate for Payer: MI Amish Medical Board Commercial	$81.08
Rate for Payer: Molina Medicare/Medicaid	$77.55
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$239.70
Rate for Payer: Nomi Health Commercial	$231.24
Rate for Payer: Opus (Opus Packaging Group) HMA	$211.50
Rate for Payer: PACE Senior Care Partners	$66.97
Rate for Payer: PACE SWMI	$70.50
Rate for Payer: PHP Commercial	$239.70
Rate for Payer: PHP Medicare Advantage	$70.50
Rate for Payer: Priority Health Choice Medicaid	$49.72
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$245.34
Rate for Payer: Priority Health Medicare	$71.20
Rate for Payer: Priority Health Narrow/Tiered Network	$196.27
Rate for Payer: Railroad Medicare Medicare	$70.50
Rate for Payer: UHC All Payor (Choice/PPO)	$248.16
Rate for Payer: UHC Core	$235.47
Rate for Payer: UHC Exchange	$70.50
Rate for Payer: UHC Medicaid	$49.72
Rate for Payer: UHC Medicare Advantage	$70.50
Rate for Payer: UHCCP Medicaid	$49.72
Rate for Payer: VA VA	$70.50
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$211.50

ACYCLOVIR 200 MG CAPSULE

Facility

$2.62

Service Code	NDC 68084010711
Hospital Charge Code	8969
Hospital Revenue Code	637
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$2.36
Rate for Payer: Aetna Commercial	$2.23
Rate for Payer: Aetna Medicare	$0.68
Rate for Payer: Allen County Amish Medical Aid Commercial	$0.82
Rate for Payer: Amish Plain Church Group Commercial	$0.82
Rate for Payer: BCBS Complete	$0.48
Rate for Payer: BCBS MAPPO	$0.66
Rate for Payer: BCBS Trust/PPO	$2.15
Rate for Payer: BCN Commercial	$2.15
Rate for Payer: BCN Medicare Advantage	$0.66
Rate for Payer: Cash Price	$2.10
Rate for Payer: Cofinity Commercial	$2.25
Rate for Payer: Encore Health Key Benefits Commercial	$2.10
Rate for Payer: Health Alliance Plan Medicare Advantage	$0.66
Rate for Payer: Healthscope Commercial	$2.36
Rate for Payer: Lakeland Regional Health Systems Commercial	$1.97
Rate for Payer: Mclaren Medicaid	$0.46
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$0.69
Rate for Payer: Meridian Medicaid	$0.48
Rate for Payer: MI Amish Medical Board Commercial	$0.75
Rate for Payer: Molina Medicare/Medicaid	$0.72
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2.23
Rate for Payer: Nomi Health Commercial	$2.15
Rate for Payer: Opus (Opus Packaging Group) HMA	$1.97
Rate for Payer: PACE Senior Care Partners	$0.62
Rate for Payer: PACE SWMI	$0.66
Rate for Payer: PHP Commercial	$2.23
Rate for Payer: PHP Medicare Advantage	$0.66
Rate for Payer: Priority Health Choice Medicaid	$0.46
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$2.28
Rate for Payer: Priority Health Medicare	$0.66
Rate for Payer: Priority Health Narrow/Tiered Network	$1.82
Rate for Payer: Railroad Medicare Medicare	$0.66
Rate for Payer: UHC All Payor (Choice/PPO)	$2.31
Rate for Payer: UHC Core	$2.19
Rate for Payer: UHC Exchange	$0.66
Rate for Payer: UHC Medicaid	$0.46
Rate for Payer: UHC Medicare Advantage	$0.66
Rate for Payer: UHCCP Medicaid	$0.46
Rate for Payer: VA VA	$0.66
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$1.97

ACYCLOVIR 200 MG CAPSULE

Facility

$261.25

Service Code	NDC 68084010701
Hospital Charge Code	8969
Hospital Revenue Code	637
Min. Negotiated Rate	$181.83
Max. Negotiated Rate	$235.12
Rate for Payer: Aetna Commercial	$222.06
Rate for Payer: BCBS Trust/PPO	$215.77
Rate for Payer: BCN Commercial	$215.77
Rate for Payer: Cash Price	$209.00
Rate for Payer: Cofinity Commercial	$224.68
Rate for Payer: Encore Health Key Benefits Commercial	$209.00
Rate for Payer: Healthscope Commercial	$235.12
Rate for Payer: Lakeland Regional Health Systems Commercial	$195.94
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$222.06
Rate for Payer: Nomi Health Commercial	$214.22
Rate for Payer: Opus (Opus Packaging Group) HMA	$195.94
Rate for Payer: PHP Commercial	$222.06
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$227.29
Rate for Payer: Priority Health Narrow/Tiered Network	$181.83
Rate for Payer: UHC All Payor (Choice/PPO)	$229.90
Rate for Payer: UHC Core	$218.14
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$195.94

Know your out-of-pocket cost for care.

All Charges