Bronson Lakeview Hospital

All Charges

Charge

Type

Setting

Price

MALFUNCTION, REACTION, COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE

Facility

$3,189.22

Service Code	APR-DRG 4661
Min. Negotiated Rate	$3,037.35
Max. Negotiated Rate	$3,189.22
Rate for Payer: BCBS Complete	$3,189.22
Rate for Payer: Mclaren Medicaid	$3,037.35
Rate for Payer: Meridian Medicaid	$3,189.22
Rate for Payer: Priority Health Choice Medicaid	$3,037.35
Rate for Payer: UHC Medicaid	$3,037.35
Rate for Payer: UHCCP Medicaid	$3,037.35

MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE

Facility

$6,122.36

Service Code	APR-DRG 3492
Min. Negotiated Rate	$5,830.81
Max. Negotiated Rate	$6,122.36
Rate for Payer: BCBS Complete	$6,122.36
Rate for Payer: Mclaren Medicaid	$5,830.81
Rate for Payer: Meridian Medicaid	$6,122.36
Rate for Payer: Priority Health Choice Medicaid	$5,830.81
Rate for Payer: UHC Medicaid	$5,830.81
Rate for Payer: UHCCP Medicaid	$5,830.81

MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE

Facility

$6,593.51

Service Code	APR-DRG 3493
Min. Negotiated Rate	$6,279.53
Max. Negotiated Rate	$6,593.51
Rate for Payer: BCBS Complete	$6,593.51
Rate for Payer: Mclaren Medicaid	$6,279.53
Rate for Payer: Meridian Medicaid	$6,593.51
Rate for Payer: Priority Health Choice Medicaid	$6,279.53
Rate for Payer: UHC Medicaid	$6,279.53
Rate for Payer: UHCCP Medicaid	$6,279.53

MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE

Facility

$11,557.96

Service Code	APR-DRG 3494
Min. Negotiated Rate	$11,007.58
Max. Negotiated Rate	$11,557.96
Rate for Payer: BCBS Complete	$11,557.96
Rate for Payer: Mclaren Medicaid	$11,007.58
Rate for Payer: Meridian Medicaid	$11,557.96
Rate for Payer: Priority Health Choice Medicaid	$11,007.58
Rate for Payer: UHC Medicaid	$11,007.58
Rate for Payer: UHCCP Medicaid	$11,007.58

MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE

Facility

$4,303.47

Service Code	APR-DRG 3491
Min. Negotiated Rate	$4,098.55
Max. Negotiated Rate	$4,303.47
Rate for Payer: BCBS Complete	$4,303.47
Rate for Payer: Mclaren Medicaid	$4,098.55
Rate for Payer: Meridian Medicaid	$4,303.47
Rate for Payer: Priority Health Choice Medicaid	$4,098.55
Rate for Payer: UHC Medicaid	$4,098.55
Rate for Payer: UHCCP Medicaid	$4,098.55

MALIGNANCY, MALE REPRODUCTIVE SYSTEM

Facility

$6,864.84

Service Code	APR-DRG 5002
Min. Negotiated Rate	$6,537.94
Max. Negotiated Rate	$6,864.84
Rate for Payer: BCBS Complete	$6,864.84
Rate for Payer: Mclaren Medicaid	$6,537.94
Rate for Payer: Meridian Medicaid	$6,864.84
Rate for Payer: Priority Health Choice Medicaid	$6,537.94
Rate for Payer: UHC Medicaid	$6,537.94
Rate for Payer: UHCCP Medicaid	$6,537.94

MALIGNANCY, MALE REPRODUCTIVE SYSTEM

Facility

$10,330.65

Service Code	APR-DRG 5003
Min. Negotiated Rate	$9,838.72
Max. Negotiated Rate	$10,330.65
Rate for Payer: BCBS Complete	$10,330.65
Rate for Payer: Mclaren Medicaid	$9,838.72
Rate for Payer: Meridian Medicaid	$10,330.65
Rate for Payer: Priority Health Choice Medicaid	$9,838.72
Rate for Payer: UHC Medicaid	$9,838.72
Rate for Payer: UHCCP Medicaid	$9,838.72

MALIGNANCY, MALE REPRODUCTIVE SYSTEM

Facility

$16,441.97

Service Code	APR-DRG 5004
Min. Negotiated Rate	$15,659.01
Max. Negotiated Rate	$16,441.97
Rate for Payer: BCBS Complete	$16,441.97
Rate for Payer: Mclaren Medicaid	$15,659.01
Rate for Payer: Meridian Medicaid	$16,441.97
Rate for Payer: Priority Health Choice Medicaid	$15,659.01
Rate for Payer: UHC Medicaid	$15,659.01
Rate for Payer: UHCCP Medicaid	$15,659.01

MALIGNANCY, MALE REPRODUCTIVE SYSTEM

Facility

$3,951.69

Service Code	APR-DRG 5001
Min. Negotiated Rate	$3,763.51
Max. Negotiated Rate	$3,951.69
Rate for Payer: BCBS Complete	$3,951.69
Rate for Payer: Mclaren Medicaid	$3,763.51
Rate for Payer: Meridian Medicaid	$3,951.69
Rate for Payer: Priority Health Choice Medicaid	$3,763.51
Rate for Payer: UHC Medicaid	$3,763.51
Rate for Payer: UHCCP Medicaid	$3,763.51

MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS

Facility

$4,483.84

Service Code	APR-DRG 2811
Min. Negotiated Rate	$4,270.32
Max. Negotiated Rate	$4,483.84
Rate for Payer: BCBS Complete	$4,483.84
Rate for Payer: Mclaren Medicaid	$4,270.32
Rate for Payer: Meridian Medicaid	$4,483.84
Rate for Payer: Priority Health Choice Medicaid	$4,270.32
Rate for Payer: UHC Medicaid	$4,270.32
Rate for Payer: UHCCP Medicaid	$4,270.32

MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS

Facility

$10,950.62

Service Code	APR-DRG 2814
Min. Negotiated Rate	$10,429.16
Max. Negotiated Rate	$10,950.62
Rate for Payer: BCBS Complete	$10,950.62
Rate for Payer: Mclaren Medicaid	$10,429.16
Rate for Payer: Meridian Medicaid	$10,950.62
Rate for Payer: Priority Health Choice Medicaid	$10,429.16
Rate for Payer: UHC Medicaid	$10,429.16
Rate for Payer: UHCCP Medicaid	$10,429.16

MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS

Facility

$4,725.20

Service Code	APR-DRG 2812
Min. Negotiated Rate	$4,500.19
Max. Negotiated Rate	$4,725.20
Rate for Payer: BCBS Complete	$4,725.20
Rate for Payer: Mclaren Medicaid	$4,500.19
Rate for Payer: Meridian Medicaid	$4,725.20
Rate for Payer: Priority Health Choice Medicaid	$4,500.19
Rate for Payer: UHC Medicaid	$4,500.19
Rate for Payer: UHCCP Medicaid	$4,500.19

MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS

Facility

$7,228.72

Service Code	APR-DRG 2813
Min. Negotiated Rate	$6,884.50
Max. Negotiated Rate	$7,228.72
Rate for Payer: BCBS Complete	$7,228.72
Rate for Payer: Mclaren Medicaid	$6,884.50
Rate for Payer: Meridian Medicaid	$7,228.72
Rate for Payer: Priority Health Choice Medicaid	$6,884.50
Rate for Payer: UHC Medicaid	$6,884.50
Rate for Payer: UHCCP Medicaid	$6,884.50

MALIGNANT BREAST DISORDERS

Facility

$4,758.85

Service Code	APR-DRG 3822
Min. Negotiated Rate	$4,532.24
Max. Negotiated Rate	$4,758.85
Rate for Payer: BCBS Complete	$4,758.85
Rate for Payer: Mclaren Medicaid	$4,532.24
Rate for Payer: Meridian Medicaid	$4,758.85
Rate for Payer: Priority Health Choice Medicaid	$4,532.24
Rate for Payer: UHC Medicaid	$4,532.24
Rate for Payer: UHCCP Medicaid	$4,532.24

MALIGNANT BREAST DISORDERS

Facility

$15,239.89

Service Code	APR-DRG 3824
Min. Negotiated Rate	$14,514.19
Max. Negotiated Rate	$15,239.89
Rate for Payer: BCBS Complete	$15,239.89
Rate for Payer: Mclaren Medicaid	$14,514.19
Rate for Payer: Meridian Medicaid	$15,239.89
Rate for Payer: Priority Health Choice Medicaid	$14,514.19
Rate for Payer: UHC Medicaid	$14,514.19
Rate for Payer: UHCCP Medicaid	$14,514.19

MALIGNANT BREAST DISORDERS

Facility

$8,623.25

Service Code	APR-DRG 3823
Min. Negotiated Rate	$8,212.62
Max. Negotiated Rate	$8,623.25
Rate for Payer: BCBS Complete	$8,623.25
Rate for Payer: Mclaren Medicaid	$8,212.62
Rate for Payer: Meridian Medicaid	$8,623.25
Rate for Payer: Priority Health Choice Medicaid	$8,212.62
Rate for Payer: UHC Medicaid	$8,212.62
Rate for Payer: UHCCP Medicaid	$8,212.62

MALIGNANT BREAST DISORDERS

Facility

$4,254.57

Service Code	APR-DRG 3821
Min. Negotiated Rate	$4,051.97
Max. Negotiated Rate	$4,254.57
Rate for Payer: BCBS Complete	$4,254.57
Rate for Payer: Mclaren Medicaid	$4,051.97
Rate for Payer: Meridian Medicaid	$4,254.57
Rate for Payer: Priority Health Choice Medicaid	$4,051.97
Rate for Payer: UHC Medicaid	$4,051.97
Rate for Payer: UHCCP Medicaid	$4,051.97

MALNUTRITION, FAILURE TO THRIVE AND OTHER NUTRITIONAL DISORDERS

Facility

$8,119.50

Service Code	APR-DRG 4213
Min. Negotiated Rate	$7,732.85
Max. Negotiated Rate	$8,119.50
Rate for Payer: BCBS Complete	$8,119.50
Rate for Payer: Mclaren Medicaid	$7,732.85
Rate for Payer: Meridian Medicaid	$8,119.50
Rate for Payer: Priority Health Choice Medicaid	$7,732.85
Rate for Payer: UHC Medicaid	$7,732.85
Rate for Payer: UHCCP Medicaid	$7,732.85

MALNUTRITION, FAILURE TO THRIVE AND OTHER NUTRITIONAL DISORDERS

Facility

$5,421.94

Service Code	APR-DRG 4212
Min. Negotiated Rate	$5,163.75
Max. Negotiated Rate	$5,421.94
Rate for Payer: BCBS Complete	$5,421.94
Rate for Payer: Mclaren Medicaid	$5,163.75
Rate for Payer: Meridian Medicaid	$5,421.94
Rate for Payer: Priority Health Choice Medicaid	$5,163.75
Rate for Payer: UHC Medicaid	$5,163.75
Rate for Payer: UHCCP Medicaid	$5,163.75

MALNUTRITION, FAILURE TO THRIVE AND OTHER NUTRITIONAL DISORDERS

Facility

$10,229.17

Service Code	APR-DRG 4214
Min. Negotiated Rate	$9,742.06
Max. Negotiated Rate	$10,229.17
Rate for Payer: BCBS Complete	$10,229.17
Rate for Payer: Mclaren Medicaid	$9,742.06
Rate for Payer: Meridian Medicaid	$10,229.17
Rate for Payer: Priority Health Choice Medicaid	$9,742.06
Rate for Payer: UHC Medicaid	$9,742.06
Rate for Payer: UHCCP Medicaid	$9,742.06

MALNUTRITION, FAILURE TO THRIVE AND OTHER NUTRITIONAL DISORDERS

Facility

$2,599.23

Service Code	APR-DRG 4211
Min. Negotiated Rate	$2,475.45
Max. Negotiated Rate	$2,599.23
Rate for Payer: BCBS Complete	$2,599.23
Rate for Payer: Mclaren Medicaid	$2,475.45
Rate for Payer: Meridian Medicaid	$2,599.23
Rate for Payer: Priority Health Choice Medicaid	$2,475.45
Rate for Payer: UHC Medicaid	$2,475.45
Rate for Payer: UHCCP Medicaid	$2,475.45

MANNITOL 20 % INTRAVENOUS SOLUTION

Facility

$94.92

Service Code	NDC 00338035702
Hospital Charge Code	4749
Hospital Revenue Code	250
Min. Negotiated Rate	$16.73
Max. Negotiated Rate	$85.43
Rate for Payer: Aetna Commercial	$80.68
Rate for Payer: Aetna Medicare	$24.68
Rate for Payer: Allen County Amish Medical Aid Commercial	$29.66
Rate for Payer: Amish Plain Church Group Commercial	$29.66
Rate for Payer: BCBS Complete	$17.57
Rate for Payer: BCBS MAPPO	$23.73
Rate for Payer: BCBS Trust/PPO	$78.03
Rate for Payer: BCN Commercial	$78.03
Rate for Payer: BCN Medicare Advantage	$23.73
Rate for Payer: Cash Price	$75.94
Rate for Payer: Cofinity Commercial	$81.63
Rate for Payer: Encore Health Key Benefits Commercial	$75.94
Rate for Payer: Health Alliance Plan Medicare Advantage	$23.73
Rate for Payer: Healthscope Commercial	$85.43
Rate for Payer: Lakeland Regional Health Systems Commercial	$71.19
Rate for Payer: Mclaren Medicaid	$16.73
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$24.92
Rate for Payer: Meridian Medicaid	$17.57
Rate for Payer: MI Amish Medical Board Commercial	$27.29
Rate for Payer: Molina Medicare/Medicaid	$26.10
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$80.68
Rate for Payer: Nomi Health Commercial	$77.83
Rate for Payer: Opus (Opus Packaging Group) HMA	$71.19
Rate for Payer: PACE Senior Care Partners	$22.54
Rate for Payer: PACE SWMI	$23.73
Rate for Payer: PHP Commercial	$80.68
Rate for Payer: PHP Medicare Advantage	$23.73
Rate for Payer: Priority Health Choice Medicaid	$16.73
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$82.58
Rate for Payer: Priority Health Medicare	$23.97
Rate for Payer: Priority Health Narrow/Tiered Network	$66.06
Rate for Payer: Railroad Medicare Medicare	$23.73
Rate for Payer: UHC All Payor (Choice/PPO)	$83.53
Rate for Payer: UHC Core	$79.26
Rate for Payer: UHC Exchange	$23.73
Rate for Payer: UHC Medicaid	$16.73
Rate for Payer: UHC Medicare Advantage	$23.73
Rate for Payer: UHCCP Medicaid	$16.73
Rate for Payer: VA VA	$23.73
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$71.19

MANNITOL 20 % INTRAVENOUS SOLUTION

Facility

$94.92

Service Code	NDC 00338035702
Hospital Charge Code	4749
Hospital Revenue Code	250
Min. Negotiated Rate	$66.06
Max. Negotiated Rate	$85.43
Rate for Payer: Aetna Commercial	$80.68
Rate for Payer: BCBS Trust/PPO	$78.39
Rate for Payer: BCN Commercial	$78.39
Rate for Payer: Cash Price	$75.94
Rate for Payer: Cofinity Commercial	$81.63
Rate for Payer: Encore Health Key Benefits Commercial	$75.94
Rate for Payer: Healthscope Commercial	$85.43
Rate for Payer: Lakeland Regional Health Systems Commercial	$71.19
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$80.68
Rate for Payer: Nomi Health Commercial	$77.83
Rate for Payer: Opus (Opus Packaging Group) HMA	$71.19
Rate for Payer: PHP Commercial	$80.68
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$82.58
Rate for Payer: Priority Health Narrow/Tiered Network	$66.06
Rate for Payer: UHC All Payor (Choice/PPO)	$83.53
Rate for Payer: UHC Core	$79.26
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$71.19

MASTECTOMY PROCEDURES

Facility

$15,664.77

Service Code	APR-DRG 3624
Min. Negotiated Rate	$14,918.83
Max. Negotiated Rate	$15,664.77
Rate for Payer: BCBS Complete	$15,664.77
Rate for Payer: Mclaren Medicaid	$14,918.83
Rate for Payer: Meridian Medicaid	$15,664.77
Rate for Payer: Priority Health Choice Medicaid	$14,918.83
Rate for Payer: UHC Medicaid	$14,918.83
Rate for Payer: UHCCP Medicaid	$14,918.83

MASTECTOMY PROCEDURES

Facility

$10,290.69

Service Code	APR-DRG 3621
Min. Negotiated Rate	$9,800.66
Max. Negotiated Rate	$10,290.69
Rate for Payer: BCBS Complete	$10,290.69
Rate for Payer: Mclaren Medicaid	$9,800.66
Rate for Payer: Meridian Medicaid	$10,290.69
Rate for Payer: Priority Health Choice Medicaid	$9,800.66
Rate for Payer: UHC Medicaid	$9,800.66
Rate for Payer: UHCCP Medicaid	$9,800.66

Know your out-of-pocket cost for care.

All Charges