Bronson Lakeview Hospital

All Charges

Charge

Type

Setting

Price

PERIPHERAL AND OTHER VASCULAR DISORDERS

Facility

$4,579.54

Service Code	APR-DRG 1972
Min. Negotiated Rate	$4,361.47
Max. Negotiated Rate	$4,579.54
Rate for Payer: BCBS Complete	$4,579.54
Rate for Payer: Mclaren Medicaid	$4,361.47
Rate for Payer: Meridian Medicaid	$4,579.54
Rate for Payer: Priority Health Choice Medicaid	$4,361.47
Rate for Payer: UHC Medicaid	$4,361.47
Rate for Payer: UHCCP Medicaid	$4,361.47

PERIPHERAL, CRANIAL AND AUTONOMIC NERVE DISORDERS

Facility

$7,519.51

Service Code	APR-DRG 0483
Min. Negotiated Rate	$7,161.44
Max. Negotiated Rate	$7,519.51
Rate for Payer: BCBS Complete	$7,519.51
Rate for Payer: Mclaren Medicaid	$7,161.44
Rate for Payer: Meridian Medicaid	$7,519.51
Rate for Payer: Priority Health Choice Medicaid	$7,161.44
Rate for Payer: UHC Medicaid	$7,161.44
Rate for Payer: UHCCP Medicaid	$7,161.44

PERIPHERAL, CRANIAL AND AUTONOMIC NERVE DISORDERS

Facility

$11,959.70

Service Code	APR-DRG 0484
Min. Negotiated Rate	$11,390.20
Max. Negotiated Rate	$11,959.70
Rate for Payer: BCBS Complete	$11,959.70
Rate for Payer: Mclaren Medicaid	$11,390.20
Rate for Payer: Meridian Medicaid	$11,959.70
Rate for Payer: Priority Health Choice Medicaid	$11,390.20
Rate for Payer: UHC Medicaid	$11,390.20
Rate for Payer: UHCCP Medicaid	$11,390.20

PERIPHERAL, CRANIAL AND AUTONOMIC NERVE DISORDERS

Facility

$4,937.11

Service Code	APR-DRG 0482
Min. Negotiated Rate	$4,702.01
Max. Negotiated Rate	$4,937.11
Rate for Payer: BCBS Complete	$4,937.11
Rate for Payer: Mclaren Medicaid	$4,702.01
Rate for Payer: Meridian Medicaid	$4,937.11
Rate for Payer: Priority Health Choice Medicaid	$4,702.01
Rate for Payer: UHC Medicaid	$4,702.01
Rate for Payer: UHCCP Medicaid	$4,702.01

PERIPHERAL, CRANIAL AND AUTONOMIC NERVE DISORDERS

Facility

$3,837.05

Service Code	APR-DRG 0481
Min. Negotiated Rate	$3,654.34
Max. Negotiated Rate	$3,837.05
Rate for Payer: BCBS Complete	$3,837.05
Rate for Payer: Mclaren Medicaid	$3,654.34
Rate for Payer: Meridian Medicaid	$3,837.05
Rate for Payer: Priority Health Choice Medicaid	$3,654.34
Rate for Payer: UHC Medicaid	$3,654.34
Rate for Payer: UHCCP Medicaid	$3,654.34

PERITONEAL ADHESIOLYSIS

Facility

$10,648.79

Service Code	APR-DRG 2242
Min. Negotiated Rate	$10,141.70
Max. Negotiated Rate	$10,648.79
Rate for Payer: BCBS Complete	$10,648.79
Rate for Payer: Mclaren Medicaid	$10,141.70
Rate for Payer: Meridian Medicaid	$10,648.79
Rate for Payer: Priority Health Choice Medicaid	$10,141.70
Rate for Payer: UHC Medicaid	$10,141.70
Rate for Payer: UHCCP Medicaid	$10,141.70

PERITONEAL ADHESIOLYSIS

Facility

$25,784.56

Service Code	APR-DRG 2244
Min. Negotiated Rate	$24,556.73
Max. Negotiated Rate	$25,784.56
Rate for Payer: BCBS Complete	$25,784.56
Rate for Payer: Mclaren Medicaid	$24,556.73
Rate for Payer: Meridian Medicaid	$25,784.56
Rate for Payer: Priority Health Choice Medicaid	$24,556.73
Rate for Payer: UHC Medicaid	$24,556.73
Rate for Payer: UHCCP Medicaid	$24,556.73

PERITONEAL ADHESIOLYSIS

Facility

$8,125.28

Service Code	APR-DRG 2241
Min. Negotiated Rate	$7,738.36
Max. Negotiated Rate	$8,125.28
Rate for Payer: BCBS Complete	$8,125.28
Rate for Payer: Mclaren Medicaid	$7,738.36
Rate for Payer: Meridian Medicaid	$8,125.28
Rate for Payer: Priority Health Choice Medicaid	$7,738.36
Rate for Payer: UHC Medicaid	$7,738.36
Rate for Payer: UHCCP Medicaid	$7,738.36

PERITONEAL ADHESIOLYSIS

Facility

$13,802.77

Service Code	APR-DRG 2243
Min. Negotiated Rate	$13,145.50
Max. Negotiated Rate	$13,802.77
Rate for Payer: BCBS Complete	$13,802.77
Rate for Payer: Mclaren Medicaid	$13,145.50
Rate for Payer: Meridian Medicaid	$13,802.77
Rate for Payer: Priority Health Choice Medicaid	$13,145.50
Rate for Payer: UHC Medicaid	$13,145.50
Rate for Payer: UHCCP Medicaid	$13,145.50

PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK

Facility

$11,415.99

Service Code	APR-DRG 1701
Min. Negotiated Rate	$10,872.37
Max. Negotiated Rate	$11,415.99
Rate for Payer: BCBS Complete	$11,415.99
Rate for Payer: Mclaren Medicaid	$10,872.37
Rate for Payer: Meridian Medicaid	$11,415.99
Rate for Payer: Priority Health Choice Medicaid	$10,872.37
Rate for Payer: UHC Medicaid	$10,872.37
Rate for Payer: UHCCP Medicaid	$10,872.37

PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK

Facility

$15,412.37

Service Code	APR-DRG 1702
Min. Negotiated Rate	$14,678.45
Max. Negotiated Rate	$15,412.37
Rate for Payer: BCBS Complete	$15,412.37
Rate for Payer: Mclaren Medicaid	$14,678.45
Rate for Payer: Meridian Medicaid	$15,412.37
Rate for Payer: Priority Health Choice Medicaid	$14,678.45
Rate for Payer: UHC Medicaid	$14,678.45
Rate for Payer: UHCCP Medicaid	$14,678.45

PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK

Facility

$22,392.90

Service Code	APR-DRG 1703
Min. Negotiated Rate	$21,326.57
Max. Negotiated Rate	$22,392.90
Rate for Payer: BCBS Complete	$22,392.90
Rate for Payer: Mclaren Medicaid	$21,326.57
Rate for Payer: Meridian Medicaid	$22,392.90
Rate for Payer: Priority Health Choice Medicaid	$21,326.57
Rate for Payer: UHC Medicaid	$21,326.57
Rate for Payer: UHCCP Medicaid	$21,326.57

PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK

Facility

$36,944.47

Service Code	APR-DRG 1704
Min. Negotiated Rate	$35,185.21
Max. Negotiated Rate	$36,944.47
Rate for Payer: BCBS Complete	$36,944.47
Rate for Payer: Mclaren Medicaid	$35,185.21
Rate for Payer: Meridian Medicaid	$36,944.47
Rate for Payer: Priority Health Choice Medicaid	$35,185.21
Rate for Payer: UHC Medicaid	$35,185.21
Rate for Payer: UHCCP Medicaid	$35,185.21

PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK

Facility

$8,936.12

Service Code	APR-DRG 1711
Min. Negotiated Rate	$8,510.60
Max. Negotiated Rate	$8,936.12
Rate for Payer: BCBS Complete	$8,936.12
Rate for Payer: Mclaren Medicaid	$8,510.60
Rate for Payer: Meridian Medicaid	$8,936.12
Rate for Payer: Priority Health Choice Medicaid	$8,510.60
Rate for Payer: UHC Medicaid	$8,510.60
Rate for Payer: UHCCP Medicaid	$8,510.60

PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK

Facility

$22,795.16

Service Code	APR-DRG 1714
Min. Negotiated Rate	$21,709.68
Max. Negotiated Rate	$22,795.16
Rate for Payer: BCBS Complete	$22,795.16
Rate for Payer: Mclaren Medicaid	$21,709.68
Rate for Payer: Meridian Medicaid	$22,795.16
Rate for Payer: Priority Health Choice Medicaid	$21,709.68
Rate for Payer: UHC Medicaid	$21,709.68
Rate for Payer: UHCCP Medicaid	$21,709.68

PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK

Facility

$11,586.36

Service Code	APR-DRG 1712
Min. Negotiated Rate	$11,034.63
Max. Negotiated Rate	$11,586.36
Rate for Payer: BCBS Complete	$11,586.36
Rate for Payer: Mclaren Medicaid	$11,034.63
Rate for Payer: Meridian Medicaid	$11,586.36
Rate for Payer: Priority Health Choice Medicaid	$11,034.63
Rate for Payer: UHC Medicaid	$11,034.63
Rate for Payer: UHCCP Medicaid	$11,034.63

PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK

Facility

$15,921.91

Service Code	APR-DRG 1713
Min. Negotiated Rate	$15,163.72
Max. Negotiated Rate	$15,921.91
Rate for Payer: BCBS Complete	$15,921.91
Rate for Payer: Mclaren Medicaid	$15,163.72
Rate for Payer: Meridian Medicaid	$15,921.91
Rate for Payer: Priority Health Choice Medicaid	$15,163.72
Rate for Payer: UHC Medicaid	$15,163.72
Rate for Payer: UHCCP Medicaid	$15,163.72

PERMETHRIN 1 % TOPICAL LIQUID

Facility

$39.65

Service Code	NDC 63736012002
Hospital Charge Code	10918
Hospital Revenue Code	637
Min. Negotiated Rate	$6.99
Max. Negotiated Rate	$35.69
Rate for Payer: Aetna Commercial	$33.70
Rate for Payer: Aetna Medicare	$10.31
Rate for Payer: Allen County Amish Medical Aid Commercial	$12.39
Rate for Payer: Amish Plain Church Group Commercial	$12.39
Rate for Payer: BCBS Complete	$7.34
Rate for Payer: BCBS MAPPO	$9.91
Rate for Payer: BCBS Trust/PPO	$32.60
Rate for Payer: BCN Commercial	$32.60
Rate for Payer: BCN Medicare Advantage	$9.91
Rate for Payer: Cash Price	$31.72
Rate for Payer: Cofinity Commercial	$34.10
Rate for Payer: Encore Health Key Benefits Commercial	$31.72
Rate for Payer: Health Alliance Plan Medicare Advantage	$9.91
Rate for Payer: Healthscope Commercial	$35.69
Rate for Payer: Lakeland Regional Health Systems Commercial	$29.74
Rate for Payer: Mclaren Medicaid	$6.99
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$10.41
Rate for Payer: Meridian Medicaid	$7.34
Rate for Payer: MI Amish Medical Board Commercial	$11.40
Rate for Payer: Molina Medicare/Medicaid	$10.90
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$33.70
Rate for Payer: Nomi Health Commercial	$32.51
Rate for Payer: Opus (Opus Packaging Group) HMA	$29.74
Rate for Payer: PACE Senior Care Partners	$9.42
Rate for Payer: PACE SWMI	$9.91
Rate for Payer: PHP Commercial	$33.70
Rate for Payer: PHP Medicare Advantage	$9.91
Rate for Payer: Priority Health Choice Medicaid	$6.99
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$34.50
Rate for Payer: Priority Health Medicare	$10.01
Rate for Payer: Priority Health Narrow/Tiered Network	$27.60
Rate for Payer: Railroad Medicare Medicare	$9.91
Rate for Payer: UHC All Payor (Choice/PPO)	$34.89
Rate for Payer: UHC Core	$33.11
Rate for Payer: UHC Exchange	$9.91
Rate for Payer: UHC Medicaid	$6.99
Rate for Payer: UHC Medicare Advantage	$9.91
Rate for Payer: UHCCP Medicaid	$6.99
Rate for Payer: VA VA	$9.91
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$29.74

PERMETHRIN 1 % TOPICAL LIQUID

Facility

$39.65

Service Code	NDC 63736012002
Hospital Charge Code	10918
Hospital Revenue Code	637
Min. Negotiated Rate	$27.60
Max. Negotiated Rate	$35.69
Rate for Payer: Aetna Commercial	$33.70
Rate for Payer: BCBS Trust/PPO	$32.75
Rate for Payer: BCN Commercial	$32.75
Rate for Payer: Cash Price	$31.72
Rate for Payer: Cofinity Commercial	$34.10
Rate for Payer: Encore Health Key Benefits Commercial	$31.72
Rate for Payer: Healthscope Commercial	$35.69
Rate for Payer: Lakeland Regional Health Systems Commercial	$29.74
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$33.70
Rate for Payer: Nomi Health Commercial	$32.51
Rate for Payer: Opus (Opus Packaging Group) HMA	$29.74
Rate for Payer: PHP Commercial	$33.70
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$34.50
Rate for Payer: Priority Health Narrow/Tiered Network	$27.60
Rate for Payer: UHC All Payor (Choice/PPO)	$34.89
Rate for Payer: UHC Core	$33.11
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$29.74

PERPHENAZINE 2 MG TABLET

Facility

$371.04

Service Code	NDC 00904659961
Hospital Charge Code	6157
Hospital Revenue Code	637
Min. Negotiated Rate	$258.24
Max. Negotiated Rate	$333.94
Rate for Payer: Aetna Commercial	$315.38
Rate for Payer: BCBS Trust/PPO	$306.44
Rate for Payer: BCN Commercial	$306.44
Rate for Payer: Cash Price	$296.83
Rate for Payer: Cofinity Commercial	$319.09
Rate for Payer: Encore Health Key Benefits Commercial	$296.83
Rate for Payer: Healthscope Commercial	$333.94
Rate for Payer: Lakeland Regional Health Systems Commercial	$278.28
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$315.38
Rate for Payer: Nomi Health Commercial	$304.25
Rate for Payer: Opus (Opus Packaging Group) HMA	$278.28
Rate for Payer: PHP Commercial	$315.38
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$322.80
Rate for Payer: Priority Health Narrow/Tiered Network	$258.24
Rate for Payer: UHC All Payor (Choice/PPO)	$326.52
Rate for Payer: UHC Core	$309.82
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$278.28

PERPHENAZINE 2 MG TABLET

Facility

$371.04

Service Code	NDC 00904659961
Hospital Charge Code	6157
Hospital Revenue Code	637
Min. Negotiated Rate	$65.41
Max. Negotiated Rate	$333.94
Rate for Payer: Aetna Commercial	$315.38
Rate for Payer: Aetna Medicare	$96.47
Rate for Payer: Allen County Amish Medical Aid Commercial	$115.95
Rate for Payer: Amish Plain Church Group Commercial	$115.95
Rate for Payer: BCBS Complete	$68.68
Rate for Payer: BCBS MAPPO	$92.76
Rate for Payer: BCBS Trust/PPO	$305.03
Rate for Payer: BCN Commercial	$305.03
Rate for Payer: BCN Medicare Advantage	$92.76
Rate for Payer: Cash Price	$296.83
Rate for Payer: Cofinity Commercial	$319.09
Rate for Payer: Encore Health Key Benefits Commercial	$296.83
Rate for Payer: Health Alliance Plan Medicare Advantage	$92.76
Rate for Payer: Healthscope Commercial	$333.94
Rate for Payer: Lakeland Regional Health Systems Commercial	$278.28
Rate for Payer: Mclaren Medicaid	$65.41
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$97.40
Rate for Payer: Meridian Medicaid	$68.68
Rate for Payer: MI Amish Medical Board Commercial	$106.67
Rate for Payer: Molina Medicare/Medicaid	$102.04
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$315.38
Rate for Payer: Nomi Health Commercial	$304.25
Rate for Payer: Opus (Opus Packaging Group) HMA	$278.28
Rate for Payer: PACE Senior Care Partners	$88.12
Rate for Payer: PACE SWMI	$92.76
Rate for Payer: PHP Commercial	$315.38
Rate for Payer: PHP Medicare Advantage	$92.76
Rate for Payer: Priority Health Choice Medicaid	$65.41
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$322.80
Rate for Payer: Priority Health Medicare	$93.69
Rate for Payer: Priority Health Narrow/Tiered Network	$258.24
Rate for Payer: Railroad Medicare Medicare	$92.76
Rate for Payer: UHC All Payor (Choice/PPO)	$326.52
Rate for Payer: UHC Core	$309.82
Rate for Payer: UHC Exchange	$92.76
Rate for Payer: UHC Medicaid	$65.41
Rate for Payer: UHC Medicare Advantage	$92.76
Rate for Payer: UHCCP Medicaid	$65.41
Rate for Payer: VA VA	$92.76
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$278.28

PERSONALITY DISORDERS

Facility

$2,365.75

Service Code	APR-DRG 7521
Min. Negotiated Rate	$2,253.10
Max. Negotiated Rate	$2,365.75
Rate for Payer: BCBS Complete	$2,365.75
Rate for Payer: Mclaren Medicaid	$2,253.10
Rate for Payer: Meridian Medicaid	$2,365.75
Rate for Payer: Priority Health Choice Medicaid	$2,253.10
Rate for Payer: UHC Medicaid	$2,253.10
Rate for Payer: UHCCP Medicaid	$2,253.10

PERSONALITY DISORDERS

Facility

$2,953.12

Service Code	APR-DRG 7522
Min. Negotiated Rate	$2,812.49
Max. Negotiated Rate	$2,953.12
Rate for Payer: BCBS Complete	$2,953.12
Rate for Payer: Mclaren Medicaid	$2,812.49
Rate for Payer: Meridian Medicaid	$2,953.12
Rate for Payer: Priority Health Choice Medicaid	$2,812.49
Rate for Payer: UHC Medicaid	$2,812.49
Rate for Payer: UHCCP Medicaid	$2,812.49

PERSONALITY DISORDERS

Facility

$6,853.80

Service Code	APR-DRG 7523
Min. Negotiated Rate	$6,527.43
Max. Negotiated Rate	$6,853.80
Rate for Payer: BCBS Complete	$6,853.80
Rate for Payer: Mclaren Medicaid	$6,527.43
Rate for Payer: Meridian Medicaid	$6,853.80
Rate for Payer: Priority Health Choice Medicaid	$6,527.43
Rate for Payer: UHC Medicaid	$6,527.43
Rate for Payer: UHCCP Medicaid	$6,527.43

PERSONALITY DISORDERS

Facility

$15,122.11

Service Code	APR-DRG 7524
Min. Negotiated Rate	$14,402.01
Max. Negotiated Rate	$15,122.11
Rate for Payer: BCBS Complete	$15,122.11
Rate for Payer: Mclaren Medicaid	$14,402.01
Rate for Payer: Meridian Medicaid	$15,122.11
Rate for Payer: Priority Health Choice Medicaid	$14,402.01
Rate for Payer: UHC Medicaid	$14,402.01
Rate for Payer: UHCCP Medicaid	$14,402.01

Know your out-of-pocket cost for care.

All Charges