Bronson Lakeview Hospital

All Charges

Charge

Type

Setting

Price

OTHER SIGNIFICANT HIP AND FEMUR SURGERY

Facility

$8,513.88

Service Code	APR-DRG 3091
Min. Negotiated Rate	$8,108.45
Max. Negotiated Rate	$8,513.88
Rate for Payer: BCBS Complete	$8,513.88
Rate for Payer: Mclaren Medicaid	$8,108.45
Rate for Payer: Meridian Medicaid	$8,513.88
Rate for Payer: Priority Health Choice Medicaid	$8,108.45
Rate for Payer: UHC Medicaid	$8,108.45
Rate for Payer: UHCCP Medicaid	$8,108.45

OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS

Facility

$4,296.11

Service Code	APR-DRG 3852
Min. Negotiated Rate	$4,091.54
Max. Negotiated Rate	$4,296.11
Rate for Payer: BCBS Complete	$4,296.11
Rate for Payer: Mclaren Medicaid	$4,091.54
Rate for Payer: Meridian Medicaid	$4,296.11
Rate for Payer: Priority Health Choice Medicaid	$4,091.54
Rate for Payer: UHC Medicaid	$4,091.54
Rate for Payer: UHCCP Medicaid	$4,091.54

OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS

Facility

$10,314.88

Service Code	APR-DRG 3854
Min. Negotiated Rate	$9,823.69
Max. Negotiated Rate	$10,314.88
Rate for Payer: BCBS Complete	$10,314.88
Rate for Payer: Mclaren Medicaid	$9,823.69
Rate for Payer: Meridian Medicaid	$10,314.88
Rate for Payer: Priority Health Choice Medicaid	$9,823.69
Rate for Payer: UHC Medicaid	$9,823.69
Rate for Payer: UHCCP Medicaid	$9,823.69

OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS

Facility

$6,201.76

Service Code	APR-DRG 3853
Min. Negotiated Rate	$5,906.44
Max. Negotiated Rate	$6,201.76
Rate for Payer: BCBS Complete	$6,201.76
Rate for Payer: Mclaren Medicaid	$5,906.44
Rate for Payer: Meridian Medicaid	$6,201.76
Rate for Payer: Priority Health Choice Medicaid	$5,906.44
Rate for Payer: UHC Medicaid	$5,906.44
Rate for Payer: UHCCP Medicaid	$5,906.44

OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS

Facility

$3,281.24

Service Code	APR-DRG 3851
Min. Negotiated Rate	$3,124.99
Max. Negotiated Rate	$3,281.24
Rate for Payer: BCBS Complete	$3,281.24
Rate for Payer: Mclaren Medicaid	$3,124.99
Rate for Payer: Meridian Medicaid	$3,281.24
Rate for Payer: Priority Health Choice Medicaid	$3,124.99
Rate for Payer: UHC Medicaid	$3,124.99
Rate for Payer: UHCCP Medicaid	$3,124.99

OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES

Facility

$9,456.71

Service Code	APR-DRG 3643
Min. Negotiated Rate	$9,006.39
Max. Negotiated Rate	$9,456.71
Rate for Payer: BCBS Complete	$9,456.71
Rate for Payer: Mclaren Medicaid	$9,006.39
Rate for Payer: Meridian Medicaid	$9,456.71
Rate for Payer: Priority Health Choice Medicaid	$9,006.39
Rate for Payer: UHC Medicaid	$9,006.39
Rate for Payer: UHCCP Medicaid	$9,006.39

OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES

Facility

$6,018.76

Service Code	APR-DRG 3642
Min. Negotiated Rate	$5,732.16
Max. Negotiated Rate	$6,018.76
Rate for Payer: BCBS Complete	$6,018.76
Rate for Payer: Mclaren Medicaid	$5,732.16
Rate for Payer: Meridian Medicaid	$6,018.76
Rate for Payer: Priority Health Choice Medicaid	$5,732.16
Rate for Payer: UHC Medicaid	$5,732.16
Rate for Payer: UHCCP Medicaid	$5,732.16

OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES

Facility

$11,956.02

Service Code	APR-DRG 3644
Min. Negotiated Rate	$11,386.69
Max. Negotiated Rate	$11,956.02
Rate for Payer: BCBS Complete	$11,956.02
Rate for Payer: Mclaren Medicaid	$11,386.69
Rate for Payer: Meridian Medicaid	$11,956.02
Rate for Payer: Priority Health Choice Medicaid	$11,386.69
Rate for Payer: UHC Medicaid	$11,386.69
Rate for Payer: UHCCP Medicaid	$11,386.69

OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES

Facility

$5,048.59

Service Code	APR-DRG 3641
Min. Negotiated Rate	$4,808.18
Max. Negotiated Rate	$5,048.59
Rate for Payer: BCBS Complete	$5,048.59
Rate for Payer: Mclaren Medicaid	$4,808.18
Rate for Payer: Meridian Medicaid	$5,048.59
Rate for Payer: Priority Health Choice Medicaid	$4,808.18
Rate for Payer: UHC Medicaid	$4,808.18
Rate for Payer: UHCCP Medicaid	$4,808.18

OTHER SMALL AND LARGE BOWEL PROCEDURES

Facility

$10,762.37

Service Code	APR-DRG 2233
Min. Negotiated Rate	$10,249.87
Max. Negotiated Rate	$10,762.37
Rate for Payer: BCBS Complete	$10,762.37
Rate for Payer: Mclaren Medicaid	$10,249.87
Rate for Payer: Meridian Medicaid	$10,762.37
Rate for Payer: Priority Health Choice Medicaid	$10,249.87
Rate for Payer: UHC Medicaid	$10,249.87
Rate for Payer: UHCCP Medicaid	$10,249.87

OTHER SMALL AND LARGE BOWEL PROCEDURES

Facility

$19,018.06

Service Code	APR-DRG 2234
Min. Negotiated Rate	$18,112.43
Max. Negotiated Rate	$19,018.06
Rate for Payer: BCBS Complete	$19,018.06
Rate for Payer: Mclaren Medicaid	$18,112.43
Rate for Payer: Meridian Medicaid	$19,018.06
Rate for Payer: Priority Health Choice Medicaid	$18,112.43
Rate for Payer: UHC Medicaid	$18,112.43
Rate for Payer: UHCCP Medicaid	$18,112.43

OTHER SMALL AND LARGE BOWEL PROCEDURES

Facility

$7,314.43

Service Code	APR-DRG 2231
Min. Negotiated Rate	$6,966.13
Max. Negotiated Rate	$7,314.43
Rate for Payer: BCBS Complete	$7,314.43
Rate for Payer: Mclaren Medicaid	$6,966.13
Rate for Payer: Meridian Medicaid	$7,314.43
Rate for Payer: Priority Health Choice Medicaid	$6,966.13
Rate for Payer: UHC Medicaid	$6,966.13
Rate for Payer: UHCCP Medicaid	$6,966.13

OTHER SMALL AND LARGE BOWEL PROCEDURES

Facility

$10,392.70

Service Code	APR-DRG 2232
Min. Negotiated Rate	$9,897.81
Max. Negotiated Rate	$10,392.70
Rate for Payer: BCBS Complete	$10,392.70
Rate for Payer: Mclaren Medicaid	$9,897.81
Rate for Payer: Meridian Medicaid	$10,392.70
Rate for Payer: Priority Health Choice Medicaid	$9,897.81
Rate for Payer: UHC Medicaid	$9,897.81
Rate for Payer: UHCCP Medicaid	$9,897.81

OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES

Facility

$4,998.11

Service Code	APR-DRG 2221
Min. Negotiated Rate	$4,760.10
Max. Negotiated Rate	$4,998.11
Rate for Payer: BCBS Complete	$4,998.11
Rate for Payer: Mclaren Medicaid	$4,760.10
Rate for Payer: Meridian Medicaid	$4,998.11
Rate for Payer: Priority Health Choice Medicaid	$4,760.10
Rate for Payer: UHC Medicaid	$4,760.10
Rate for Payer: UHCCP Medicaid	$4,760.10

OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES

Facility

$22,840.91

Service Code	APR-DRG 2224
Min. Negotiated Rate	$21,753.25
Max. Negotiated Rate	$22,840.91
Rate for Payer: BCBS Complete	$22,840.91
Rate for Payer: Mclaren Medicaid	$21,753.25
Rate for Payer: Meridian Medicaid	$22,840.91
Rate for Payer: Priority Health Choice Medicaid	$21,753.25
Rate for Payer: UHC Medicaid	$21,753.25
Rate for Payer: UHCCP Medicaid	$21,753.25

OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES

Facility

$12,685.89

Service Code	APR-DRG 2223
Min. Negotiated Rate	$12,081.80
Max. Negotiated Rate	$12,685.89
Rate for Payer: BCBS Complete	$12,685.89
Rate for Payer: Mclaren Medicaid	$12,081.80
Rate for Payer: Meridian Medicaid	$12,685.89
Rate for Payer: Priority Health Choice Medicaid	$12,081.80
Rate for Payer: UHC Medicaid	$12,081.80
Rate for Payer: UHCCP Medicaid	$12,081.80

OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES

Facility

$8,325.10

Service Code	APR-DRG 2222
Min. Negotiated Rate	$7,928.67
Max. Negotiated Rate	$8,325.10
Rate for Payer: BCBS Complete	$8,325.10
Rate for Payer: Mclaren Medicaid	$7,928.67
Rate for Payer: Meridian Medicaid	$8,325.10
Rate for Payer: Priority Health Choice Medicaid	$7,928.67
Rate for Payer: UHC Medicaid	$7,928.67
Rate for Payer: UHCCP Medicaid	$7,928.67

OTHER UPPER VASCULAR PROCEDURES

Facility

$14,889.69

Service Code	APR-DRG 1823
Min. Negotiated Rate	$14,180.65
Max. Negotiated Rate	$14,889.69
Rate for Payer: BCBS Complete	$14,889.69
Rate for Payer: Mclaren Medicaid	$14,180.65
Rate for Payer: Meridian Medicaid	$14,889.69
Rate for Payer: Priority Health Choice Medicaid	$14,180.65
Rate for Payer: UHC Medicaid	$14,180.65
Rate for Payer: UHCCP Medicaid	$14,180.65

OTHER UPPER VASCULAR PROCEDURES

Facility

$10,028.29

Service Code	APR-DRG 1821
Min. Negotiated Rate	$9,550.76
Max. Negotiated Rate	$10,028.29
Rate for Payer: BCBS Complete	$10,028.29
Rate for Payer: Mclaren Medicaid	$9,550.76
Rate for Payer: Meridian Medicaid	$10,028.29
Rate for Payer: Priority Health Choice Medicaid	$9,550.76
Rate for Payer: UHC Medicaid	$9,550.76
Rate for Payer: UHCCP Medicaid	$9,550.76

OTHER UPPER VASCULAR PROCEDURES

Facility

$23,787.42

Service Code	APR-DRG 1824
Min. Negotiated Rate	$22,654.69
Max. Negotiated Rate	$23,787.42
Rate for Payer: BCBS Complete	$23,787.42
Rate for Payer: Mclaren Medicaid	$22,654.69
Rate for Payer: Meridian Medicaid	$23,787.42
Rate for Payer: Priority Health Choice Medicaid	$22,654.69
Rate for Payer: UHC Medicaid	$22,654.69
Rate for Payer: UHCCP Medicaid	$22,654.69

OTHER UPPER VASCULAR PROCEDURES

Facility

$12,203.17

Service Code	APR-DRG 1822
Min. Negotiated Rate	$11,622.07
Max. Negotiated Rate	$12,203.17
Rate for Payer: BCBS Complete	$12,203.17
Rate for Payer: Mclaren Medicaid	$11,622.07
Rate for Payer: Meridian Medicaid	$12,203.17
Rate for Payer: Priority Health Choice Medicaid	$11,622.07
Rate for Payer: UHC Medicaid	$11,622.07
Rate for Payer: UHCCP Medicaid	$11,622.07

OXAZEPAM 15 MG CAPSULE

Facility

$980.87

Service Code	NDC 62584081301
Hospital Charge Code	5931
Hospital Revenue Code	637
Min. Negotiated Rate	$682.69
Max. Negotiated Rate	$882.78
Rate for Payer: Aetna Commercial	$833.74
Rate for Payer: BCBS Trust/PPO	$810.10
Rate for Payer: BCN Commercial	$810.10
Rate for Payer: Cash Price	$784.70
Rate for Payer: Cofinity Commercial	$843.55
Rate for Payer: Encore Health Key Benefits Commercial	$784.70
Rate for Payer: Healthscope Commercial	$882.78
Rate for Payer: Lakeland Regional Health Systems Commercial	$735.65
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$833.74
Rate for Payer: Nomi Health Commercial	$804.31
Rate for Payer: Opus (Opus Packaging Group) HMA	$735.65
Rate for Payer: PHP Commercial	$833.74
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$853.36
Rate for Payer: Priority Health Narrow/Tiered Network	$682.69
Rate for Payer: UHC All Payor (Choice/PPO)	$863.17
Rate for Payer: UHC Core	$819.03
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$735.65

OXAZEPAM 15 MG CAPSULE

Facility

$9.81

Service Code	NDC 62584081311
Hospital Charge Code	5931
Hospital Revenue Code	637
Min. Negotiated Rate	$1.73
Max. Negotiated Rate	$8.83
Rate for Payer: Aetna Commercial	$8.34
Rate for Payer: Aetna Medicare	$2.55
Rate for Payer: Allen County Amish Medical Aid Commercial	$3.07
Rate for Payer: Amish Plain Church Group Commercial	$3.07
Rate for Payer: BCBS Complete	$1.82
Rate for Payer: BCBS MAPPO	$2.45
Rate for Payer: BCBS Trust/PPO	$8.06
Rate for Payer: BCN Commercial	$8.06
Rate for Payer: BCN Medicare Advantage	$2.45
Rate for Payer: Cash Price	$7.85
Rate for Payer: Cofinity Commercial	$8.44
Rate for Payer: Encore Health Key Benefits Commercial	$7.85
Rate for Payer: Health Alliance Plan Medicare Advantage	$2.45
Rate for Payer: Healthscope Commercial	$8.83
Rate for Payer: Lakeland Regional Health Systems Commercial	$7.36
Rate for Payer: Mclaren Medicaid	$1.73
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$2.58
Rate for Payer: Meridian Medicaid	$1.82
Rate for Payer: MI Amish Medical Board Commercial	$2.82
Rate for Payer: Molina Medicare/Medicaid	$2.70
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$8.34
Rate for Payer: Nomi Health Commercial	$8.04
Rate for Payer: Opus (Opus Packaging Group) HMA	$7.36
Rate for Payer: PACE Senior Care Partners	$2.33
Rate for Payer: PACE SWMI	$2.45
Rate for Payer: PHP Commercial	$8.34
Rate for Payer: PHP Medicare Advantage	$2.45
Rate for Payer: Priority Health Choice Medicaid	$1.73
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$8.53
Rate for Payer: Priority Health Medicare	$2.48
Rate for Payer: Priority Health Narrow/Tiered Network	$6.83
Rate for Payer: Railroad Medicare Medicare	$2.45
Rate for Payer: UHC All Payor (Choice/PPO)	$8.63
Rate for Payer: UHC Core	$8.19
Rate for Payer: UHC Exchange	$2.45
Rate for Payer: UHC Medicaid	$1.73
Rate for Payer: UHC Medicare Advantage	$2.45
Rate for Payer: UHCCP Medicaid	$1.73
Rate for Payer: VA VA	$2.45
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$7.36

OXAZEPAM 15 MG CAPSULE

Facility

$9.81

Service Code	NDC 62584081311
Hospital Charge Code	5931
Hospital Revenue Code	637
Min. Negotiated Rate	$6.83
Max. Negotiated Rate	$8.83
Rate for Payer: Aetna Commercial	$8.34
Rate for Payer: BCBS Trust/PPO	$8.10
Rate for Payer: BCN Commercial	$8.10
Rate for Payer: Cash Price	$7.85
Rate for Payer: Cofinity Commercial	$8.44
Rate for Payer: Encore Health Key Benefits Commercial	$7.85
Rate for Payer: Healthscope Commercial	$8.83
Rate for Payer: Lakeland Regional Health Systems Commercial	$7.36
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$8.34
Rate for Payer: Nomi Health Commercial	$8.04
Rate for Payer: Opus (Opus Packaging Group) HMA	$7.36
Rate for Payer: PHP Commercial	$8.34
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$8.53
Rate for Payer: Priority Health Narrow/Tiered Network	$6.83
Rate for Payer: UHC All Payor (Choice/PPO)	$8.63
Rate for Payer: UHC Core	$8.19
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$7.36

OXAZEPAM 15 MG CAPSULE

Facility

$980.87

Service Code	NDC 62584081301
Hospital Charge Code	5931
Hospital Revenue Code	637
Min. Negotiated Rate	$172.93
Max. Negotiated Rate	$882.78
Rate for Payer: Aetna Commercial	$833.74
Rate for Payer: Aetna Medicare	$255.03
Rate for Payer: Allen County Amish Medical Aid Commercial	$306.52
Rate for Payer: Amish Plain Church Group Commercial	$306.52
Rate for Payer: BCBS Complete	$181.56
Rate for Payer: BCBS MAPPO	$245.22
Rate for Payer: BCBS Trust/PPO	$806.37
Rate for Payer: BCN Commercial	$806.37
Rate for Payer: BCN Medicare Advantage	$245.22
Rate for Payer: Cash Price	$784.70
Rate for Payer: Cofinity Commercial	$843.55
Rate for Payer: Encore Health Key Benefits Commercial	$784.70
Rate for Payer: Health Alliance Plan Medicare Advantage	$245.22
Rate for Payer: Healthscope Commercial	$882.78
Rate for Payer: Lakeland Regional Health Systems Commercial	$735.65
Rate for Payer: Mclaren Medicaid	$172.93
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$257.48
Rate for Payer: Meridian Medicaid	$181.56
Rate for Payer: MI Amish Medical Board Commercial	$282.00
Rate for Payer: Molina Medicare/Medicaid	$269.74
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$833.74
Rate for Payer: Nomi Health Commercial	$804.31
Rate for Payer: Opus (Opus Packaging Group) HMA	$735.65
Rate for Payer: PACE Senior Care Partners	$232.96
Rate for Payer: PACE SWMI	$245.22
Rate for Payer: PHP Commercial	$833.74
Rate for Payer: PHP Medicare Advantage	$245.22
Rate for Payer: Priority Health Choice Medicaid	$172.93
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$853.36
Rate for Payer: Priority Health Medicare	$247.67
Rate for Payer: Priority Health Narrow/Tiered Network	$682.69
Rate for Payer: Railroad Medicare Medicare	$245.22
Rate for Payer: UHC All Payor (Choice/PPO)	$863.17
Rate for Payer: UHC Core	$819.03
Rate for Payer: UHC Exchange	$245.22
Rate for Payer: UHC Medicaid	$172.93
Rate for Payer: UHC Medicare Advantage	$245.22
Rate for Payer: UHCCP Medicaid	$172.93
Rate for Payer: VA VA	$245.22
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$735.65

Know your out-of-pocket cost for care.

All Charges