Bronson Methodist Hospital

All Charges

Charge

Type

Setting

Price

EXPLORATION FOR POSTOPERATIVE HEMORRHAGE, THROMBOSIS OR INFECTION; NECK

Facility

$17,930.33

Service Code	CPT 35800
Hospital Revenue Code	360
Min. Negotiated Rate	$2,899.76
Max. Negotiated Rate	$17,930.33
Rate for Payer: Aetna Medicare	$5,766.26
Rate for Payer: Allen County Amish Medical Aid Commercial	$6,930.60
Rate for Payer: Amish Plain Church Group Commercial	$6,930.60
Rate for Payer: BCBS Complete	$3,045.03
Rate for Payer: BCBS MAPPO	$5,544.48
Rate for Payer: BCBS Trust/PPO	$3,182.56
Rate for Payer: BCN Commercial	$3,182.56
Rate for Payer: BCN Medicare Advantage	$5,544.48
Rate for Payer: Health Alliance Plan Medicare Advantage	$5,544.48
Rate for Payer: Mclaren Medicaid	$5,544.48
Rate for Payer: Mclaren Medicare	$5,544.48
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$5,821.70
Rate for Payer: Meridian Medicaid	$5,821.70
Rate for Payer: MI Amish Medical Board Commercial	$6,376.15
Rate for Payer: Molina Medicare/Medicaid	$6,098.93
Rate for Payer: Nomi Health Commercial	$16,633.44
Rate for Payer: PACE Medicare	$5,267.26
Rate for Payer: PACE SWMI	$5,544.48
Rate for Payer: PHP Medicare Advantage	$5,544.48
Rate for Payer: Priority Health Choice Medicaid	$2,899.76
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$17,930.33
Rate for Payer: Priority Health Medicare	$5,544.48
Rate for Payer: Priority Health Tiered Network	$14,344.26
Rate for Payer: Railroad Medicare Medicare	$5,544.48
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$5,544.48
Rate for Payer: UHC Medicaid	$2,899.76
Rate for Payer: UHCCP Medicaid	$2,899.76
Rate for Payer: VA VA	$5,544.48

EXPLORATION OF PENETRATING WOUND (SEPARATE PROCEDURE); EXTREMITY

Facility

$5,321.93

Service Code	CPT 20103
Hospital Revenue Code	360
Min. Negotiated Rate	$860.68
Max. Negotiated Rate	$5,321.93
Rate for Payer: Aetna Medicare	$1,711.49
Rate for Payer: Allen County Amish Medical Aid Commercial	$2,057.07
Rate for Payer: Amish Plain Church Group Commercial	$2,057.07
Rate for Payer: BCBS Complete	$903.80
Rate for Payer: BCBS MAPPO	$1,645.66
Rate for Payer: BCBS Trust/PPO	$965.82
Rate for Payer: BCN Commercial	$965.82
Rate for Payer: BCN Medicare Advantage	$1,645.66
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,645.66
Rate for Payer: Mclaren Medicaid	$1,645.66
Rate for Payer: Mclaren Medicare	$1,645.66
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$1,727.94
Rate for Payer: Meridian Medicaid	$1,727.94
Rate for Payer: MI Amish Medical Board Commercial	$1,892.51
Rate for Payer: Molina Medicare/Medicaid	$1,810.23
Rate for Payer: Nomi Health Commercial	$4,936.98
Rate for Payer: PACE Medicare	$1,563.38
Rate for Payer: PACE SWMI	$1,645.66
Rate for Payer: PHP Medicare Advantage	$1,645.66
Rate for Payer: Priority Health Choice Medicaid	$860.68
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$5,321.93
Rate for Payer: Priority Health Medicare	$1,645.66
Rate for Payer: Priority Health Tiered Network	$4,257.54
Rate for Payer: Railroad Medicare Medicare	$1,645.66
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$1,645.66
Rate for Payer: UHC Medicaid	$860.68
Rate for Payer: UHCCP Medicaid	$860.68
Rate for Payer: VA VA	$1,645.66

EXTENSIVE ABDOMINAL OR THORACIC PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA

Facility

$12,268.12

Service Code	APR-DRG 9111
Min. Negotiated Rate	$11,683.93
Max. Negotiated Rate	$12,268.12
Rate for Payer: BCBS Complete	$12,268.12
Rate for Payer: Mclaren Medicaid	$11,683.93
Rate for Payer: Meridian Medicaid	$12,268.12
Rate for Payer: Priority Health Choice Medicaid	$11,683.93
Rate for Payer: UHC Medicaid	$11,683.93
Rate for Payer: UHCCP Medicaid	$11,683.93

EXTENSIVE ABDOMINAL OR THORACIC PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA

Facility

$14,771.75

Service Code	APR-DRG 9112
Min. Negotiated Rate	$14,068.33
Max. Negotiated Rate	$14,771.75
Rate for Payer: BCBS Complete	$14,771.75
Rate for Payer: Mclaren Medicaid	$14,068.33
Rate for Payer: Meridian Medicaid	$14,771.75
Rate for Payer: Priority Health Choice Medicaid	$14,068.33
Rate for Payer: UHC Medicaid	$14,068.33
Rate for Payer: UHCCP Medicaid	$14,068.33

EXTENSIVE ABDOMINAL OR THORACIC PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA

Facility

$21,257.80

Service Code	APR-DRG 9113
Min. Negotiated Rate	$20,245.53
Max. Negotiated Rate	$21,257.80
Rate for Payer: BCBS Complete	$21,257.80
Rate for Payer: Mclaren Medicaid	$20,245.53
Rate for Payer: Meridian Medicaid	$21,257.80
Rate for Payer: Priority Health Choice Medicaid	$20,245.53
Rate for Payer: UHC Medicaid	$20,245.53
Rate for Payer: UHCCP Medicaid	$20,245.53

EXTENSIVE ABDOMINAL OR THORACIC PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA

Facility

$43,892.72

Service Code	APR-DRG 9114
Min. Negotiated Rate	$41,802.59
Max. Negotiated Rate	$43,892.72
Rate for Payer: BCBS Complete	$43,892.72
Rate for Payer: Mclaren Medicaid	$41,802.59
Rate for Payer: Meridian Medicaid	$43,892.72
Rate for Payer: Priority Health Choice Medicaid	$41,802.59
Rate for Payer: UHC Medicaid	$41,802.59
Rate for Payer: UHCCP Medicaid	$41,802.59

EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT

Facility

$62,782.84

Service Code	MSDRG 933
Min. Negotiated Rate	$31,501.03
Max. Negotiated Rate	$62,782.84
Rate for Payer: Aetna Medicare	$34,485.34
Rate for Payer: Allen County Amish Medical Aid Commercial	$41,448.72
Rate for Payer: Amish Plain Church Group Commercial	$41,448.72
Rate for Payer: BCBS MAPPO	$33,158.98
Rate for Payer: BCBS Trust/PPO	$58,226.32
Rate for Payer: BCN Commercial	$58,226.32
Rate for Payer: BCN Medicare Advantage	$33,158.98
Rate for Payer: Health Alliance Plan Medicare Advantage	$33,158.98
Rate for Payer: Mclaren Medicare	$33,158.98
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$34,816.93
Rate for Payer: MI Amish Medical Board Commercial	$38,132.83
Rate for Payer: Molina Medicare/Medicaid	$36,474.88
Rate for Payer: Nomi Health Commercial	$49,235.43
Rate for Payer: PACE Medicare	$31,501.03
Rate for Payer: PACE SWMI	$33,158.98
Rate for Payer: PHP Medicare Advantage	$33,158.98
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$62,782.84
Rate for Payer: Priority Health Medicare	$33,158.98
Rate for Payer: Priority Health Tiered Network	$50,226.26
Rate for Payer: Railroad Medicare Medicare	$33,158.98
Rate for Payer: UHC All Payor (Choice/PPO)	$62,212.21
Rate for Payer: UHC Core	$52,048.34
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$33,158.98
Rate for Payer: UHC Exchange	$42,506.59
Rate for Payer: VA VA	$33,158.98

EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT

Facility

$680,211.07

Service Code	MSDRG 927
Min. Negotiated Rate	$170,183.63
Max. Negotiated Rate	$680,211.07
Rate for Payer: Aetna Medicare	$186,306.29
Rate for Payer: Allen County Amish Medical Aid Commercial	$223,925.83
Rate for Payer: Amish Plain Church Group Commercial	$223,925.83
Rate for Payer: BCBS MAPPO	$179,140.66
Rate for Payer: BCBS Trust/PPO	$680,211.07
Rate for Payer: BCN Commercial	$680,211.07
Rate for Payer: BCN Medicare Advantage	$179,140.66
Rate for Payer: Health Alliance Plan Medicare Advantage	$179,140.66
Rate for Payer: Mclaren Medicare	$179,140.66
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$188,097.69
Rate for Payer: MI Amish Medical Board Commercial	$206,011.76
Rate for Payer: Molina Medicare/Medicaid	$197,054.73
Rate for Payer: Nomi Health Commercial	$237,749.58
Rate for Payer: PACE Medicare	$170,183.63
Rate for Payer: PACE SWMI	$179,140.66
Rate for Payer: PHP Medicare Advantage	$179,140.66
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$344,215.75
Rate for Payer: Priority Health Medicare	$179,140.66
Rate for Payer: Priority Health Tiered Network	$275,372.56
Rate for Payer: Railroad Medicare Medicare	$179,140.66
Rate for Payer: UHC All Payor (Choice/PPO)	$300,412.26
Rate for Payer: UHC Core	$251,332.64
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$179,140.66
Rate for Payer: UHC Exchange	$205,257.14
Rate for Payer: VA VA	$179,140.66

EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility

$12,612.55

Service Code	APR-DRG 7922
Min. Negotiated Rate	$12,011.95
Max. Negotiated Rate	$12,612.55
Rate for Payer: BCBS Complete	$12,612.55
Rate for Payer: Mclaren Medicaid	$12,011.95
Rate for Payer: Meridian Medicaid	$12,612.55
Rate for Payer: Priority Health Choice Medicaid	$12,011.95
Rate for Payer: UHC Medicaid	$12,011.95
Rate for Payer: UHCCP Medicaid	$12,011.95

EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility

$17,989.65

Service Code	APR-DRG 7923
Min. Negotiated Rate	$17,133.00
Max. Negotiated Rate	$17,989.65
Rate for Payer: BCBS Complete	$17,989.65
Rate for Payer: Mclaren Medicaid	$17,133.00
Rate for Payer: Meridian Medicaid	$17,989.65
Rate for Payer: Priority Health Choice Medicaid	$17,133.00
Rate for Payer: UHC Medicaid	$17,133.00
Rate for Payer: UHCCP Medicaid	$17,133.00

EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility

$9,987.86

Service Code	APR-DRG 7921
Min. Negotiated Rate	$9,512.25
Max. Negotiated Rate	$9,987.86
Rate for Payer: BCBS Complete	$9,987.86
Rate for Payer: Mclaren Medicaid	$9,512.25
Rate for Payer: Meridian Medicaid	$9,987.86
Rate for Payer: Priority Health Choice Medicaid	$9,512.25
Rate for Payer: UHC Medicaid	$9,512.25
Rate for Payer: UHCCP Medicaid	$9,512.25

EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility

$30,672.42

Service Code	APR-DRG 7924
Min. Negotiated Rate	$29,211.83
Max. Negotiated Rate	$30,672.42
Rate for Payer: BCBS Complete	$30,672.42
Rate for Payer: Mclaren Medicaid	$29,211.83
Rate for Payer: Meridian Medicaid	$30,672.42
Rate for Payer: Priority Health Choice Medicaid	$29,211.83
Rate for Payer: UHC Medicaid	$29,211.83
Rate for Payer: UHCCP Medicaid	$29,211.83

EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC

Facility

$50,833.76

Service Code	MSDRG 982
Min. Negotiated Rate	$20,095.03
Max. Negotiated Rate	$50,833.76
Rate for Payer: Aetna Medicare	$21,998.77
Rate for Payer: Allen County Amish Medical Aid Commercial	$26,440.83
Rate for Payer: Amish Plain Church Group Commercial	$26,440.83
Rate for Payer: BCBS MAPPO	$21,152.66
Rate for Payer: BCBS Trust/PPO	$50,833.76
Rate for Payer: BCN Commercial	$50,833.76
Rate for Payer: BCN Medicare Advantage	$21,152.66
Rate for Payer: Health Alliance Plan Medicare Advantage	$21,152.66
Rate for Payer: Mclaren Medicare	$21,152.66
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$22,210.29
Rate for Payer: MI Amish Medical Board Commercial	$24,325.56
Rate for Payer: Molina Medicare/Medicaid	$23,267.93
Rate for Payer: Nomi Health Commercial	$31,714.65
Rate for Payer: PACE Medicare	$20,095.03
Rate for Payer: PACE SWMI	$21,152.66
Rate for Payer: PHP Medicare Advantage	$21,152.66
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$39,636.28
Rate for Payer: Priority Health Medicare	$21,152.66
Rate for Payer: Priority Health Tiered Network	$31,709.02
Rate for Payer: Railroad Medicare Medicare	$21,152.66
Rate for Payer: UHC All Payor (Choice/PPO)	$40,073.55
Rate for Payer: UHC Core	$33,526.56
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$21,152.66
Rate for Payer: UHC Exchange	$27,380.31
Rate for Payer: VA VA	$21,152.66

EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC

Facility

$121,898.91

Service Code	MSDRG 981
Min. Negotiated Rate	$37,837.60
Max. Negotiated Rate	$121,898.91
Rate for Payer: Aetna Medicare	$41,422.21
Rate for Payer: Allen County Amish Medical Aid Commercial	$49,786.31
Rate for Payer: Amish Plain Church Group Commercial	$49,786.31
Rate for Payer: BCBS MAPPO	$39,829.05
Rate for Payer: BCBS Trust/PPO	$121,898.91
Rate for Payer: BCN Commercial	$121,898.91
Rate for Payer: BCN Medicare Advantage	$39,829.05
Rate for Payer: Health Alliance Plan Medicare Advantage	$39,829.05
Rate for Payer: Mclaren Medicare	$39,829.05
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$41,820.50
Rate for Payer: MI Amish Medical Board Commercial	$45,803.41
Rate for Payer: Molina Medicare/Medicaid	$43,811.96
Rate for Payer: Nomi Health Commercial	$60,524.22
Rate for Payer: PACE Medicare	$37,837.60
Rate for Payer: PACE SWMI	$39,829.05
Rate for Payer: PHP Medicare Advantage	$39,829.05
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$75,641.86
Rate for Payer: Priority Health Medicare	$39,829.05
Rate for Payer: Priority Health Tiered Network	$60,513.48
Rate for Payer: Railroad Medicare Medicare	$39,829.05
Rate for Payer: UHC All Payor (Choice/PPO)	$76,476.34
Rate for Payer: UHC Core	$63,982.08
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$39,829.05
Rate for Payer: UHC Exchange	$52,252.58
Rate for Payer: VA VA	$39,829.05

EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC

Facility

$38,494.54

Service Code	MSDRG 983
Min. Negotiated Rate	$14,180.29
Max. Negotiated Rate	$38,494.54
Rate for Payer: Aetna Medicare	$15,523.68
Rate for Payer: Allen County Amish Medical Aid Commercial	$18,658.28
Rate for Payer: Amish Plain Church Group Commercial	$18,658.28
Rate for Payer: BCBS MAPPO	$14,926.62
Rate for Payer: BCBS Trust/PPO	$38,494.54
Rate for Payer: BCN Commercial	$38,494.54
Rate for Payer: BCN Medicare Advantage	$14,926.62
Rate for Payer: Health Alliance Plan Medicare Advantage	$14,926.62
Rate for Payer: Mclaren Medicare	$14,926.62
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$15,672.95
Rate for Payer: MI Amish Medical Board Commercial	$17,165.61
Rate for Payer: Molina Medicare/Medicaid	$16,419.28
Rate for Payer: Nomi Health Commercial	$22,110.60
Rate for Payer: PACE Medicare	$14,180.29
Rate for Payer: PACE SWMI	$14,926.62
Rate for Payer: PHP Medicare Advantage	$14,926.62
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$27,633.35
Rate for Payer: Priority Health Medicare	$14,926.62
Rate for Payer: Priority Health Tiered Network	$22,106.67
Rate for Payer: Railroad Medicare Medicare	$14,926.62
Rate for Payer: UHC All Payor (Choice/PPO)	$27,938.20
Rate for Payer: UHC Core	$23,373.82
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$14,926.62
Rate for Payer: UHC Exchange	$19,088.82
Rate for Payer: VA VA	$14,926.62

EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility

$9,564.14

Service Code	APR-DRG 9501
Min. Negotiated Rate	$9,108.70
Max. Negotiated Rate	$9,564.14
Rate for Payer: BCBS Complete	$9,564.14
Rate for Payer: Mclaren Medicaid	$9,108.70
Rate for Payer: Meridian Medicaid	$9,564.14
Rate for Payer: Priority Health Choice Medicaid	$9,108.70
Rate for Payer: UHC Medicaid	$9,108.70
Rate for Payer: UHCCP Medicaid	$9,108.70

EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility

$19,475.12

Service Code	APR-DRG 9503
Min. Negotiated Rate	$18,547.73
Max. Negotiated Rate	$19,475.12
Rate for Payer: BCBS Complete	$19,475.12
Rate for Payer: Mclaren Medicaid	$18,547.73
Rate for Payer: Meridian Medicaid	$19,475.12
Rate for Payer: Priority Health Choice Medicaid	$18,547.73
Rate for Payer: UHC Medicaid	$18,547.73
Rate for Payer: UHCCP Medicaid	$18,547.73

EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility

$30,880.05

Service Code	APR-DRG 9504
Min. Negotiated Rate	$29,409.57
Max. Negotiated Rate	$30,880.05
Rate for Payer: BCBS Complete	$30,880.05
Rate for Payer: Mclaren Medicaid	$29,409.57
Rate for Payer: Meridian Medicaid	$30,880.05
Rate for Payer: Priority Health Choice Medicaid	$29,409.57
Rate for Payer: UHC Medicaid	$29,409.57
Rate for Payer: UHCCP Medicaid	$29,409.57

EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility

$13,512.06

Service Code	APR-DRG 9502
Min. Negotiated Rate	$12,868.63
Max. Negotiated Rate	$13,512.06
Rate for Payer: BCBS Complete	$13,512.06
Rate for Payer: Mclaren Medicaid	$12,868.63
Rate for Payer: Meridian Medicaid	$13,512.06
Rate for Payer: Priority Health Choice Medicaid	$12,868.63
Rate for Payer: UHC Medicaid	$12,868.63
Rate for Payer: UHCCP Medicaid	$12,868.63

EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT

Facility

$18,853.45

Service Code	APR-DRG 8433
Min. Negotiated Rate	$17,955.67
Max. Negotiated Rate	$18,853.45
Rate for Payer: BCBS Complete	$18,853.45
Rate for Payer: Mclaren Medicaid	$17,955.67
Rate for Payer: Meridian Medicaid	$18,853.45
Rate for Payer: Priority Health Choice Medicaid	$17,955.67
Rate for Payer: UHC Medicaid	$17,955.67
Rate for Payer: UHCCP Medicaid	$17,955.67

EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT

Facility

$4,096.84

Service Code	APR-DRG 8431
Min. Negotiated Rate	$3,901.75
Max. Negotiated Rate	$4,096.84
Rate for Payer: BCBS Complete	$4,096.84
Rate for Payer: Mclaren Medicaid	$3,901.75
Rate for Payer: Meridian Medicaid	$4,096.84
Rate for Payer: Priority Health Choice Medicaid	$3,901.75
Rate for Payer: UHC Medicaid	$3,901.75
Rate for Payer: UHCCP Medicaid	$3,901.75

EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT

Facility

$28,265.05

Service Code	APR-DRG 8434
Min. Negotiated Rate	$26,919.09
Max. Negotiated Rate	$28,265.05
Rate for Payer: BCBS Complete	$28,265.05
Rate for Payer: Mclaren Medicaid	$26,919.09
Rate for Payer: Meridian Medicaid	$28,265.05
Rate for Payer: Priority Health Choice Medicaid	$26,919.09
Rate for Payer: UHC Medicaid	$26,919.09
Rate for Payer: UHCCP Medicaid	$26,919.09

EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT

Facility

$6,282.06

Service Code	APR-DRG 8432
Min. Negotiated Rate	$5,982.92
Max. Negotiated Rate	$6,282.06
Rate for Payer: BCBS Complete	$6,282.06
Rate for Payer: Mclaren Medicaid	$5,982.92
Rate for Payer: Meridian Medicaid	$6,282.06
Rate for Payer: Priority Health Choice Medicaid	$5,982.92
Rate for Payer: UHC Medicaid	$5,982.92
Rate for Payer: UHCCP Medicaid	$5,982.92

EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT

Facility

$37,038.02

Service Code	APR-DRG 8412
Min. Negotiated Rate	$35,274.31
Max. Negotiated Rate	$37,038.02
Rate for Payer: BCBS Complete	$37,038.02
Rate for Payer: Mclaren Medicaid	$35,274.31
Rate for Payer: Meridian Medicaid	$37,038.02
Rate for Payer: Priority Health Choice Medicaid	$35,274.31
Rate for Payer: UHC Medicaid	$35,274.31
Rate for Payer: UHCCP Medicaid	$35,274.31

EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT

Facility

$56,349.10

Service Code	APR-DRG 8413
Min. Negotiated Rate	$53,665.81
Max. Negotiated Rate	$56,349.10
Rate for Payer: BCBS Complete	$56,349.10
Rate for Payer: Mclaren Medicaid	$53,665.81
Rate for Payer: Meridian Medicaid	$56,349.10
Rate for Payer: Priority Health Choice Medicaid	$53,665.81
Rate for Payer: UHC Medicaid	$53,665.81
Rate for Payer: UHCCP Medicaid	$53,665.81

Know your out-of-pocket cost for care.

All Charges