Bronson Methodist Hospital

All Charges

Charge

Type

Setting

Price

SHOULDER AND ELBOW JOINT REPLACEMENT

Facility

$10,719.10

Service Code	APR-DRG 3221
Min. Negotiated Rate	$10,208.66
Max. Negotiated Rate	$10,719.10
Rate for Payer: BCBS Complete	$10,719.10
Rate for Payer: Mclaren Medicaid	$10,208.66
Rate for Payer: Meridian Medicaid	$10,719.10
Rate for Payer: Priority Health Choice Medicaid	$10,208.66
Rate for Payer: UHC Medicaid	$10,208.66
Rate for Payer: UHCCP Medicaid	$10,208.66

SHOULDER AND ELBOW JOINT REPLACEMENT

Facility

$17,539.90

Service Code	APR-DRG 3223
Min. Negotiated Rate	$16,704.66
Max. Negotiated Rate	$17,539.90
Rate for Payer: BCBS Complete	$17,539.90
Rate for Payer: Mclaren Medicaid	$16,704.66
Rate for Payer: Meridian Medicaid	$17,539.90
Rate for Payer: Priority Health Choice Medicaid	$16,704.66
Rate for Payer: UHC Medicaid	$16,704.66
Rate for Payer: UHCCP Medicaid	$16,704.66

SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC

Facility

$47,004.35

Service Code	MSDRG 511
Min. Negotiated Rate	$17,083.23
Max. Negotiated Rate	$47,004.35
Rate for Payer: Aetna Medicare	$18,701.64
Rate for Payer: Allen County Amish Medical Aid Commercial	$22,477.94
Rate for Payer: Amish Plain Church Group Commercial	$22,477.94
Rate for Payer: BCBS MAPPO	$17,982.35
Rate for Payer: BCBS Trust/PPO	$47,004.35
Rate for Payer: BCN Commercial	$47,004.35
Rate for Payer: BCN Medicare Advantage	$17,982.35
Rate for Payer: Health Alliance Plan Medicare Advantage	$17,982.35
Rate for Payer: Mclaren Medicare	$17,982.35
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$18,881.47
Rate for Payer: MI Amish Medical Board Commercial	$20,679.70
Rate for Payer: Molina Medicare/Medicaid	$19,780.58
Rate for Payer: Nomi Health Commercial	$26,824.26
Rate for Payer: PACE Medicare	$17,083.23
Rate for Payer: PACE SWMI	$17,982.35
Rate for Payer: PHP Medicare Advantage	$17,982.35
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$33,524.38
Rate for Payer: Priority Health Medicare	$17,982.35
Rate for Payer: Priority Health Tiered Network	$26,819.50
Rate for Payer: Railroad Medicare Medicare	$17,982.35
Rate for Payer: UHC All Payor (Choice/PPO)	$33,894.22
Rate for Payer: UHC Core	$28,356.78
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$17,982.35
Rate for Payer: UHC Exchange	$23,158.28
Rate for Payer: VA VA	$17,982.35

SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC

Facility

$49,234.15

Service Code	MSDRG 510
Min. Negotiated Rate	$24,559.87
Max. Negotiated Rate	$49,234.15
Rate for Payer: Aetna Medicare	$26,886.59
Rate for Payer: Allen County Amish Medical Aid Commercial	$32,315.61
Rate for Payer: Amish Plain Church Group Commercial	$32,315.61
Rate for Payer: BCBS MAPPO	$25,852.49
Rate for Payer: BCBS Trust/PPO	$48,434.54
Rate for Payer: BCN Commercial	$48,434.54
Rate for Payer: BCN Medicare Advantage	$25,852.49
Rate for Payer: Health Alliance Plan Medicare Advantage	$25,852.49
Rate for Payer: Mclaren Medicare	$25,852.49
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$27,145.11
Rate for Payer: MI Amish Medical Board Commercial	$29,730.36
Rate for Payer: Molina Medicare/Medicaid	$28,437.74
Rate for Payer: Nomi Health Commercial	$38,964.45
Rate for Payer: PACE Medicare	$24,559.87
Rate for Payer: PACE SWMI	$25,852.49
Rate for Payer: PHP Medicare Advantage	$25,852.49
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$48,696.92
Rate for Payer: Priority Health Medicare	$25,852.49
Rate for Payer: Priority Health Tiered Network	$38,957.53
Rate for Payer: Railroad Medicare Medicare	$25,852.49
Rate for Payer: UHC All Payor (Choice/PPO)	$49,234.15
Rate for Payer: UHC Core	$41,190.56
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$25,852.49
Rate for Payer: UHC Exchange	$33,639.31
Rate for Payer: VA VA	$25,852.49

SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/MCC

Facility

$40,015.32

Service Code	MSDRG 512
Min. Negotiated Rate	$13,714.73
Max. Negotiated Rate	$40,015.32
Rate for Payer: Aetna Medicare	$15,014.02
Rate for Payer: Allen County Amish Medical Aid Commercial	$18,045.70
Rate for Payer: Amish Plain Church Group Commercial	$18,045.70
Rate for Payer: BCBS MAPPO	$14,436.56
Rate for Payer: BCBS Trust/PPO	$40,015.32
Rate for Payer: BCN Commercial	$40,015.32
Rate for Payer: BCN Medicare Advantage	$14,436.56
Rate for Payer: Health Alliance Plan Medicare Advantage	$14,436.56
Rate for Payer: Mclaren Medicare	$14,436.56
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$15,158.39
Rate for Payer: MI Amish Medical Board Commercial	$16,602.04
Rate for Payer: Molina Medicare/Medicaid	$15,880.22
Rate for Payer: Nomi Health Commercial	$21,354.66
Rate for Payer: PACE Medicare	$13,714.73
Rate for Payer: PACE SWMI	$14,436.56
Rate for Payer: PHP Medicare Advantage	$14,436.56
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$26,688.59
Rate for Payer: Priority Health Medicare	$14,436.56
Rate for Payer: Priority Health Tiered Network	$21,350.87
Rate for Payer: Railroad Medicare Medicare	$14,436.56
Rate for Payer: UHC All Payor (Choice/PPO)	$26,983.02
Rate for Payer: UHC Core	$22,574.69
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$14,436.56
Rate for Payer: UHC Exchange	$18,436.19
Rate for Payer: VA VA	$14,436.56

SHOULDER, UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT

Facility

$25,617.35

Service Code	APR-DRG 3154
Min. Negotiated Rate	$24,397.48
Max. Negotiated Rate	$25,617.35
Rate for Payer: BCBS Complete	$25,617.35
Rate for Payer: Mclaren Medicaid	$24,397.48
Rate for Payer: Meridian Medicaid	$25,617.35
Rate for Payer: Priority Health Choice Medicaid	$24,397.48
Rate for Payer: UHC Medicaid	$24,397.48
Rate for Payer: UHCCP Medicaid	$24,397.48

SHOULDER, UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT

Facility

$12,271.15

Service Code	APR-DRG 3152
Min. Negotiated Rate	$11,686.81
Max. Negotiated Rate	$12,271.15
Rate for Payer: BCBS Complete	$12,271.15
Rate for Payer: Mclaren Medicaid	$11,686.81
Rate for Payer: Meridian Medicaid	$12,271.15
Rate for Payer: Priority Health Choice Medicaid	$11,686.81
Rate for Payer: UHC Medicaid	$11,686.81
Rate for Payer: UHCCP Medicaid	$11,686.81

SHOULDER, UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT

Facility

$16,329.25

Service Code	APR-DRG 3153
Min. Negotiated Rate	$15,551.66
Max. Negotiated Rate	$16,329.25
Rate for Payer: BCBS Complete	$16,329.25
Rate for Payer: Mclaren Medicaid	$15,551.66
Rate for Payer: Meridian Medicaid	$16,329.25
Rate for Payer: Priority Health Choice Medicaid	$15,551.66
Rate for Payer: UHC Medicaid	$15,551.66
Rate for Payer: UHCCP Medicaid	$15,551.66

SHOULDER, UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT

Facility

$8,251.79

Service Code	APR-DRG 3151
Min. Negotiated Rate	$7,858.85
Max. Negotiated Rate	$8,251.79
Rate for Payer: BCBS Complete	$8,251.79
Rate for Payer: Mclaren Medicaid	$7,858.85
Rate for Payer: Meridian Medicaid	$8,251.79
Rate for Payer: Priority Health Choice Medicaid	$7,858.85
Rate for Payer: UHC Medicaid	$7,858.85
Rate for Payer: UHCCP Medicaid	$7,858.85

SICKLE CELL ANEMIA CRISIS

Facility

$5,046.59

Service Code	APR-DRG 6622
Min. Negotiated Rate	$4,806.28
Max. Negotiated Rate	$5,046.59
Rate for Payer: BCBS Complete	$5,046.59
Rate for Payer: Mclaren Medicaid	$4,806.28
Rate for Payer: Meridian Medicaid	$5,046.59
Rate for Payer: Priority Health Choice Medicaid	$4,806.28
Rate for Payer: UHC Medicaid	$4,806.28
Rate for Payer: UHCCP Medicaid	$4,806.28

SICKLE CELL ANEMIA CRISIS

Facility

$3,478.20

Service Code	APR-DRG 6621
Min. Negotiated Rate	$3,312.57
Max. Negotiated Rate	$3,478.20
Rate for Payer: BCBS Complete	$3,478.20
Rate for Payer: Mclaren Medicaid	$3,312.57
Rate for Payer: Meridian Medicaid	$3,478.20
Rate for Payer: Priority Health Choice Medicaid	$3,312.57
Rate for Payer: UHC Medicaid	$3,312.57
Rate for Payer: UHCCP Medicaid	$3,312.57

SICKLE CELL ANEMIA CRISIS

Facility

$13,404.92

Service Code	APR-DRG 6624
Min. Negotiated Rate	$12,766.59
Max. Negotiated Rate	$13,404.92
Rate for Payer: BCBS Complete	$13,404.92
Rate for Payer: Mclaren Medicaid	$12,766.59
Rate for Payer: Meridian Medicaid	$13,404.92
Rate for Payer: Priority Health Choice Medicaid	$12,766.59
Rate for Payer: UHC Medicaid	$12,766.59
Rate for Payer: UHCCP Medicaid	$12,766.59

SICKLE CELL ANEMIA CRISIS

Facility

$8,684.60

Service Code	APR-DRG 6623
Min. Negotiated Rate	$8,271.05
Max. Negotiated Rate	$8,684.60
Rate for Payer: BCBS Complete	$8,684.60
Rate for Payer: Mclaren Medicaid	$8,271.05
Rate for Payer: Meridian Medicaid	$8,684.60
Rate for Payer: Priority Health Choice Medicaid	$8,271.05
Rate for Payer: UHC Medicaid	$8,271.05
Rate for Payer: UHCCP Medicaid	$8,271.05

SIGMOIDOSCOPY, FLEXIBLE; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING, WHEN PERFORMED (SEPARATE PROCEDURE)

Facility

$2,996.60

Service Code	CPT 45330
Hospital Revenue Code	360
Min. Negotiated Rate	$484.62
Max. Negotiated Rate	$2,996.60
Rate for Payer: Aetna Medicare	$963.67
Rate for Payer: Allen County Amish Medical Aid Commercial	$1,158.26
Rate for Payer: Amish Plain Church Group Commercial	$1,158.26
Rate for Payer: BCBS Complete	$508.89
Rate for Payer: BCBS MAPPO	$926.61
Rate for Payer: BCBS Trust/PPO	$1,126.06
Rate for Payer: BCN Commercial	$1,126.06
Rate for Payer: BCN Medicare Advantage	$926.61
Rate for Payer: Health Alliance Plan Medicare Advantage	$926.61
Rate for Payer: Mclaren Medicaid	$926.61
Rate for Payer: Mclaren Medicare	$926.61
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$972.94
Rate for Payer: Meridian Medicaid	$972.94
Rate for Payer: MI Amish Medical Board Commercial	$1,065.60
Rate for Payer: Molina Medicare/Medicaid	$1,019.27
Rate for Payer: Nomi Health Commercial	$2,779.83
Rate for Payer: PACE Medicare	$880.28
Rate for Payer: PACE SWMI	$926.61
Rate for Payer: PHP Medicare Advantage	$926.61
Rate for Payer: Priority Health Choice Medicaid	$484.62
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$2,996.60
Rate for Payer: Priority Health Medicare	$926.61
Rate for Payer: Priority Health Tiered Network	$2,397.28
Rate for Payer: Railroad Medicare Medicare	$926.61
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$926.61
Rate for Payer: UHC Medicaid	$484.62
Rate for Payer: UHCCP Medicaid	$484.62
Rate for Payer: VA VA	$926.61

SIGMOIDOSCOPY, FLEXIBLE; WITH BIOPSY, SINGLE OR MULTIPLE

Facility

$2,996.60

Service Code	CPT 45331
Hospital Revenue Code	360
Min. Negotiated Rate	$484.62
Max. Negotiated Rate	$2,996.60
Rate for Payer: Aetna Medicare	$963.67
Rate for Payer: Allen County Amish Medical Aid Commercial	$1,158.26
Rate for Payer: Amish Plain Church Group Commercial	$1,158.26
Rate for Payer: BCBS Complete	$508.89
Rate for Payer: BCBS MAPPO	$926.61
Rate for Payer: BCBS Trust/PPO	$1,406.30
Rate for Payer: BCN Commercial	$1,406.30
Rate for Payer: BCN Medicare Advantage	$926.61
Rate for Payer: Health Alliance Plan Medicare Advantage	$926.61
Rate for Payer: Mclaren Medicaid	$926.61
Rate for Payer: Mclaren Medicare	$926.61
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$972.94
Rate for Payer: Meridian Medicaid	$972.94
Rate for Payer: MI Amish Medical Board Commercial	$1,065.60
Rate for Payer: Molina Medicare/Medicaid	$1,019.27
Rate for Payer: Nomi Health Commercial	$2,779.83
Rate for Payer: PACE Medicare	$880.28
Rate for Payer: PACE SWMI	$926.61
Rate for Payer: PHP Medicare Advantage	$926.61
Rate for Payer: Priority Health Choice Medicaid	$484.62
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$2,996.60
Rate for Payer: Priority Health Medicare	$926.61
Rate for Payer: Priority Health Tiered Network	$2,397.28
Rate for Payer: Railroad Medicare Medicare	$926.61
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$926.61
Rate for Payer: UHC Medicaid	$484.62
Rate for Payer: UHCCP Medicaid	$484.62
Rate for Payer: VA VA	$926.61

SIGMOIDOSCOPY, FLEXIBLE; WITH CONTROL OF BLEEDING, ANY METHOD

Facility

$3,855.91

Service Code	CPT 45334
Hospital Revenue Code	360
Min. Negotiated Rate	$623.59
Max. Negotiated Rate	$3,855.91
Rate for Payer: Aetna Medicare	$1,240.03
Rate for Payer: Allen County Amish Medical Aid Commercial	$1,490.42
Rate for Payer: Amish Plain Church Group Commercial	$1,490.42
Rate for Payer: BCBS Complete	$654.83
Rate for Payer: BCBS MAPPO	$1,192.34
Rate for Payer: BCBS Trust/PPO	$892.35
Rate for Payer: BCN Commercial	$892.35
Rate for Payer: BCN Medicare Advantage	$1,192.34
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,192.34
Rate for Payer: Mclaren Medicaid	$1,192.34
Rate for Payer: Mclaren Medicare	$1,192.34
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$1,251.96
Rate for Payer: Meridian Medicaid	$1,251.96
Rate for Payer: MI Amish Medical Board Commercial	$1,371.19
Rate for Payer: Molina Medicare/Medicaid	$1,311.57
Rate for Payer: Nomi Health Commercial	$3,577.02
Rate for Payer: PACE Medicare	$1,132.72
Rate for Payer: PACE SWMI	$1,192.34
Rate for Payer: PHP Medicare Advantage	$1,192.34
Rate for Payer: Priority Health Choice Medicaid	$623.59
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$3,855.91
Rate for Payer: Priority Health Medicare	$1,192.34
Rate for Payer: Priority Health Tiered Network	$3,084.73
Rate for Payer: Railroad Medicare Medicare	$1,192.34
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$1,192.34
Rate for Payer: UHC Medicaid	$623.59
Rate for Payer: UHCCP Medicaid	$623.59
Rate for Payer: VA VA	$1,192.34

SIGMOIDOSCOPY, FLEXIBLE; WITH DIRECTED SUBMUCOSAL INJECTION(S), ANY SUBSTANCE

Facility

$2,996.60

Service Code	CPT 45335
Hospital Revenue Code	360
Min. Negotiated Rate	$484.62
Max. Negotiated Rate	$2,996.60
Rate for Payer: Aetna Medicare	$963.67
Rate for Payer: Allen County Amish Medical Aid Commercial	$1,158.26
Rate for Payer: Amish Plain Church Group Commercial	$1,158.26
Rate for Payer: BCBS Complete	$508.89
Rate for Payer: BCBS MAPPO	$926.61
Rate for Payer: BCBS Trust/PPO	$678.88
Rate for Payer: BCN Commercial	$678.88
Rate for Payer: BCN Medicare Advantage	$926.61
Rate for Payer: Health Alliance Plan Medicare Advantage	$926.61
Rate for Payer: Mclaren Medicaid	$926.61
Rate for Payer: Mclaren Medicare	$926.61
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$972.94
Rate for Payer: Meridian Medicaid	$972.94
Rate for Payer: MI Amish Medical Board Commercial	$1,065.60
Rate for Payer: Molina Medicare/Medicaid	$1,019.27
Rate for Payer: Nomi Health Commercial	$2,779.83
Rate for Payer: PACE Medicare	$880.28
Rate for Payer: PACE SWMI	$926.61
Rate for Payer: PHP Medicare Advantage	$926.61
Rate for Payer: Priority Health Choice Medicaid	$484.62
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$2,996.60
Rate for Payer: Priority Health Medicare	$926.61
Rate for Payer: Priority Health Tiered Network	$2,397.28
Rate for Payer: Railroad Medicare Medicare	$926.61
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$926.61
Rate for Payer: UHC Medicaid	$484.62
Rate for Payer: UHCCP Medicaid	$484.62
Rate for Payer: VA VA	$926.61

SIGMOIDOSCOPY, FLEXIBLE; WITH ENDOSCOPIC MUCOSAL RESECTION

Facility

$8,943.95

Service Code	CPT 45349
Hospital Revenue Code	360
Min. Negotiated Rate	$1,041.07
Max. Negotiated Rate	$8,943.95
Rate for Payer: Aetna Medicare	$2,876.31
Rate for Payer: Allen County Amish Medical Aid Commercial	$3,457.10
Rate for Payer: Amish Plain Church Group Commercial	$3,457.10
Rate for Payer: BCBS Complete	$1,518.91
Rate for Payer: BCBS MAPPO	$2,765.68
Rate for Payer: BCBS Trust/PPO	$1,041.07
Rate for Payer: BCN Commercial	$1,041.07
Rate for Payer: BCN Medicare Advantage	$2,765.68
Rate for Payer: Health Alliance Plan Medicare Advantage	$2,765.68
Rate for Payer: Mclaren Medicaid	$2,765.68
Rate for Payer: Mclaren Medicare	$2,765.68
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$2,903.96
Rate for Payer: Meridian Medicaid	$2,903.96
Rate for Payer: MI Amish Medical Board Commercial	$3,180.53
Rate for Payer: Molina Medicare/Medicaid	$3,042.25
Rate for Payer: Nomi Health Commercial	$8,297.04
Rate for Payer: PACE Medicare	$2,627.40
Rate for Payer: PACE SWMI	$2,765.68
Rate for Payer: PHP Medicare Advantage	$2,765.68
Rate for Payer: Priority Health Choice Medicaid	$1,446.45
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$8,943.95
Rate for Payer: Priority Health Medicare	$2,765.68
Rate for Payer: Priority Health Tiered Network	$7,155.16
Rate for Payer: Railroad Medicare Medicare	$2,765.68
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$2,765.68
Rate for Payer: UHC Medicaid	$1,446.45
Rate for Payer: UHCCP Medicaid	$1,446.45
Rate for Payer: VA VA	$2,765.68

SIGMOIDOSCOPY, FLEXIBLE; WITH ENDOSCOPIC ULTRASOUND EXAMINATION

Facility

$2,996.60

Service Code	CPT 45341
Hospital Revenue Code	360
Min. Negotiated Rate	$484.62
Max. Negotiated Rate	$2,996.60
Rate for Payer: Aetna Medicare	$963.67
Rate for Payer: Allen County Amish Medical Aid Commercial	$1,158.26
Rate for Payer: Amish Plain Church Group Commercial	$1,158.26
Rate for Payer: BCBS Complete	$508.89
Rate for Payer: BCBS MAPPO	$926.61
Rate for Payer: BCBS Trust/PPO	$1,879.71
Rate for Payer: BCN Commercial	$1,879.71
Rate for Payer: BCN Medicare Advantage	$926.61
Rate for Payer: Health Alliance Plan Medicare Advantage	$926.61
Rate for Payer: Mclaren Medicaid	$926.61
Rate for Payer: Mclaren Medicare	$926.61
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$972.94
Rate for Payer: Meridian Medicaid	$972.94
Rate for Payer: MI Amish Medical Board Commercial	$1,065.60
Rate for Payer: Molina Medicare/Medicaid	$1,019.27
Rate for Payer: Nomi Health Commercial	$2,779.83
Rate for Payer: PACE Medicare	$880.28
Rate for Payer: PACE SWMI	$926.61
Rate for Payer: PHP Medicare Advantage	$926.61
Rate for Payer: Priority Health Choice Medicaid	$484.62
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$2,996.60
Rate for Payer: Priority Health Medicare	$926.61
Rate for Payer: Priority Health Tiered Network	$2,397.28
Rate for Payer: Railroad Medicare Medicare	$926.61
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$926.61
Rate for Payer: UHC Medicaid	$484.62
Rate for Payer: UHCCP Medicaid	$484.62
Rate for Payer: VA VA	$926.61

SIGMOIDOSCOPY, FLEXIBLE; WITH REMOVAL OF FOREIGN BODY(S)

Facility

$3,855.91

Service Code	CPT 45332
Hospital Revenue Code	360
Min. Negotiated Rate	$623.59
Max. Negotiated Rate	$3,855.91
Rate for Payer: Aetna Medicare	$1,240.03
Rate for Payer: Allen County Amish Medical Aid Commercial	$1,490.42
Rate for Payer: Amish Plain Church Group Commercial	$1,490.42
Rate for Payer: BCBS Complete	$654.83
Rate for Payer: BCBS MAPPO	$1,192.34
Rate for Payer: BCBS Trust/PPO	$892.35
Rate for Payer: BCN Commercial	$892.35
Rate for Payer: BCN Medicare Advantage	$1,192.34
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,192.34
Rate for Payer: Mclaren Medicaid	$1,192.34
Rate for Payer: Mclaren Medicare	$1,192.34
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$1,251.96
Rate for Payer: Meridian Medicaid	$1,251.96
Rate for Payer: MI Amish Medical Board Commercial	$1,371.19
Rate for Payer: Molina Medicare/Medicaid	$1,311.57
Rate for Payer: Nomi Health Commercial	$3,577.02
Rate for Payer: PACE Medicare	$1,132.72
Rate for Payer: PACE SWMI	$1,192.34
Rate for Payer: PHP Medicare Advantage	$1,192.34
Rate for Payer: Priority Health Choice Medicaid	$623.59
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$3,855.91
Rate for Payer: Priority Health Medicare	$1,192.34
Rate for Payer: Priority Health Tiered Network	$3,084.73
Rate for Payer: Railroad Medicare Medicare	$1,192.34
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$1,192.34
Rate for Payer: UHC Medicaid	$623.59
Rate for Payer: UHCCP Medicaid	$623.59
Rate for Payer: VA VA	$1,192.34

SIGMOIDOSCOPY, FLEXIBLE; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY SNARE TECHNIQUE

Facility

$3,855.91

Service Code	CPT 45338
Hospital Revenue Code	360
Min. Negotiated Rate	$623.59
Max. Negotiated Rate	$3,855.91
Rate for Payer: Aetna Medicare	$1,240.03
Rate for Payer: Allen County Amish Medical Aid Commercial	$1,490.42
Rate for Payer: Amish Plain Church Group Commercial	$1,490.42
Rate for Payer: BCBS Complete	$654.83
Rate for Payer: BCBS MAPPO	$1,192.34
Rate for Payer: BCBS Trust/PPO	$1,792.33
Rate for Payer: BCN Commercial	$1,792.33
Rate for Payer: BCN Medicare Advantage	$1,192.34
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,192.34
Rate for Payer: Mclaren Medicaid	$1,192.34
Rate for Payer: Mclaren Medicare	$1,192.34
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$1,251.96
Rate for Payer: Meridian Medicaid	$1,251.96
Rate for Payer: MI Amish Medical Board Commercial	$1,371.19
Rate for Payer: Molina Medicare/Medicaid	$1,311.57
Rate for Payer: Nomi Health Commercial	$3,577.02
Rate for Payer: PACE Medicare	$1,132.72
Rate for Payer: PACE SWMI	$1,192.34
Rate for Payer: PHP Medicare Advantage	$1,192.34
Rate for Payer: Priority Health Choice Medicaid	$623.59
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$3,855.91
Rate for Payer: Priority Health Medicare	$1,192.34
Rate for Payer: Priority Health Tiered Network	$3,084.73
Rate for Payer: Railroad Medicare Medicare	$1,192.34
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$1,192.34
Rate for Payer: UHC Medicaid	$623.59
Rate for Payer: UHCCP Medicaid	$623.59
Rate for Payer: VA VA	$1,192.34

SIGMOIDOSCOPY, FLEXIBLE; WITH TRANSENDOSCOPIC BALLOON DILATION

Facility

$3,855.91

Service Code	CPT 45340
Hospital Revenue Code	360
Min. Negotiated Rate	$623.59
Max. Negotiated Rate	$3,855.91
Rate for Payer: Aetna Medicare	$1,240.03
Rate for Payer: Allen County Amish Medical Aid Commercial	$1,490.42
Rate for Payer: Amish Plain Church Group Commercial	$1,490.42
Rate for Payer: BCBS Complete	$654.83
Rate for Payer: BCBS MAPPO	$1,192.34
Rate for Payer: BCBS Trust/PPO	$1,041.07
Rate for Payer: BCN Commercial	$1,041.07
Rate for Payer: BCN Medicare Advantage	$1,192.34
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,192.34
Rate for Payer: Mclaren Medicaid	$1,192.34
Rate for Payer: Mclaren Medicare	$1,192.34
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$1,251.96
Rate for Payer: Meridian Medicaid	$1,251.96
Rate for Payer: MI Amish Medical Board Commercial	$1,371.19
Rate for Payer: Molina Medicare/Medicaid	$1,311.57
Rate for Payer: Nomi Health Commercial	$3,577.02
Rate for Payer: PACE Medicare	$1,132.72
Rate for Payer: PACE SWMI	$1,192.34
Rate for Payer: PHP Medicare Advantage	$1,192.34
Rate for Payer: Priority Health Choice Medicaid	$623.59
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$3,855.91
Rate for Payer: Priority Health Medicare	$1,192.34
Rate for Payer: Priority Health Tiered Network	$3,084.73
Rate for Payer: Railroad Medicare Medicare	$1,192.34
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$1,192.34
Rate for Payer: UHC Medicaid	$623.59
Rate for Payer: UHCCP Medicaid	$623.59
Rate for Payer: VA VA	$1,192.34

SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC

Facility

$34,547.08

Service Code	MSDRG 555
Min. Negotiated Rate	$11,064.43
Max. Negotiated Rate	$34,547.08
Rate for Payer: Aetna Medicare	$12,112.64
Rate for Payer: Allen County Amish Medical Aid Commercial	$14,558.46
Rate for Payer: Amish Plain Church Group Commercial	$14,558.46
Rate for Payer: BCBS MAPPO	$11,646.77
Rate for Payer: BCBS Trust/PPO	$34,547.08
Rate for Payer: BCN Commercial	$34,547.08
Rate for Payer: BCN Medicare Advantage	$11,646.77
Rate for Payer: Health Alliance Plan Medicare Advantage	$11,646.77
Rate for Payer: Mclaren Medicare	$11,646.77
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$12,229.11
Rate for Payer: MI Amish Medical Board Commercial	$13,393.79
Rate for Payer: Molina Medicare/Medicaid	$12,811.45
Rate for Payer: Nomi Health Commercial	$17,051.22
Rate for Payer: PACE Medicare	$11,064.43
Rate for Payer: PACE SWMI	$11,646.77
Rate for Payer: PHP Medicare Advantage	$11,646.77
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$21,310.24
Rate for Payer: Priority Health Medicare	$11,646.77
Rate for Payer: Priority Health Tiered Network	$17,048.19
Rate for Payer: Railroad Medicare Medicare	$11,646.77
Rate for Payer: UHC All Payor (Choice/PPO)	$21,545.34
Rate for Payer: UHC Core	$18,025.39
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$11,646.77
Rate for Payer: UHC Exchange	$14,720.89
Rate for Payer: VA VA	$11,646.77

SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC

Facility

$19,473.74

Service Code	MSDRG 556
Min. Negotiated Rate	$7,162.07
Max. Negotiated Rate	$19,473.74
Rate for Payer: Aetna Medicare	$7,840.58
Rate for Payer: Allen County Amish Medical Aid Commercial	$9,423.77
Rate for Payer: Amish Plain Church Group Commercial	$9,423.77
Rate for Payer: BCBS MAPPO	$7,539.02
Rate for Payer: BCBS Trust/PPO	$19,473.74
Rate for Payer: BCN Commercial	$19,473.74
Rate for Payer: BCN Medicare Advantage	$7,539.02
Rate for Payer: Health Alliance Plan Medicare Advantage	$7,539.02
Rate for Payer: Mclaren Medicare	$7,539.02
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$7,915.97
Rate for Payer: MI Amish Medical Board Commercial	$8,669.87
Rate for Payer: Molina Medicare/Medicaid	$8,292.92
Rate for Payer: Nomi Health Commercial	$10,714.74
Rate for Payer: PACE Medicare	$7,162.07
Rate for Payer: PACE SWMI	$7,539.02
Rate for Payer: PHP Medicare Advantage	$7,539.02
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$13,391.05
Rate for Payer: Priority Health Medicare	$7,539.02
Rate for Payer: Priority Health Tiered Network	$10,712.84
Rate for Payer: Railroad Medicare Medicare	$7,539.02
Rate for Payer: UHC All Payor (Choice/PPO)	$13,538.78
Rate for Payer: UHC Core	$11,326.89
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$7,539.02
Rate for Payer: UHC Exchange	$9,250.39
Rate for Payer: VA VA	$7,539.02

SIGNS AND SYMPTOMS WITH MCC

Facility

$26,248.65

Service Code	MSDRG 947
Min. Negotiated Rate	$10,648.14
Max. Negotiated Rate	$26,248.65
Rate for Payer: Aetna Medicare	$11,656.91
Rate for Payer: Allen County Amish Medical Aid Commercial	$14,010.71
Rate for Payer: Amish Plain Church Group Commercial	$14,010.71
Rate for Payer: BCBS MAPPO	$11,208.57
Rate for Payer: BCBS Trust/PPO	$26,248.65
Rate for Payer: BCN Commercial	$26,248.65
Rate for Payer: BCN Medicare Advantage	$11,208.57
Rate for Payer: Health Alliance Plan Medicare Advantage	$11,208.57
Rate for Payer: Mclaren Medicare	$11,208.57
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$11,769.00
Rate for Payer: MI Amish Medical Board Commercial	$12,889.86
Rate for Payer: Molina Medicare/Medicaid	$12,329.43
Rate for Payer: Nomi Health Commercial	$16,375.26
Rate for Payer: PACE Medicare	$10,648.14
Rate for Payer: PACE SWMI	$11,208.57
Rate for Payer: PHP Medicare Advantage	$11,208.57
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$20,465.44
Rate for Payer: Priority Health Medicare	$11,208.57
Rate for Payer: Priority Health Tiered Network	$16,372.35
Rate for Payer: Railroad Medicare Medicare	$11,208.57
Rate for Payer: UHC All Payor (Choice/PPO)	$20,691.22
Rate for Payer: UHC Core	$17,310.81
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$11,208.57
Rate for Payer: UHC Exchange	$14,137.31
Rate for Payer: VA VA	$11,208.57

Know your out-of-pocket cost for care.

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