Bronson Methodist Hospital

All Charges

Charge

Type

Setting

Price

APPLICATION OF SKIN SUBSTITUTE GRAFT TO FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORBITS, GENITALIA, HANDS, FEET, AND/OR MULTIPLE DIGITS, TOTAL WOUND SURFACE AREA UP TO 100 SQ CM; FIRST 25 SQ CM OR LESS WOUND SURFACE AREA

Facility

$5,021.81

Service Code	CPT 15275
Hospital Revenue Code	360
Min. Negotiated Rate	$956.23
Max. Negotiated Rate	$5,021.81
Rate for Payer: Aetna Medicare	$1,855.37
Rate for Payer: Allen County Amish Medical Aid Commercial	$2,230.01
Rate for Payer: Amish Plain Church Group Commercial	$2,230.01
Rate for Payer: BCBS Complete	$1,004.04
Rate for Payer: BCBS MAPPO	$1,784.01
Rate for Payer: BCN Medicare Advantage	$1,784.01
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,784.01
Rate for Payer: Mclaren Medicaid	$956.23
Rate for Payer: Mclaren Medicare	$1,784.01
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$1,873.21
Rate for Payer: Meridian Medicaid	$1,004.04
Rate for Payer: MI Amish Medical Board Commercial	$2,051.61
Rate for Payer: PACE Medicare	$1,694.81
Rate for Payer: PACE SWMI	$1,784.01
Rate for Payer: PHP Medicare Advantage	$1,784.01
Rate for Payer: Priority Health Choice Medicaid	$956.23
Rate for Payer: Priority Health Medicare	$1,784.01
Rate for Payer: Railroad Medicare Medicare	$1,784.01
Rate for Payer: UHC All Payor (Choice/PPO)	$5,021.81
Rate for Payer: UHC Dual Complete DSNP	$1,784.01
Rate for Payer: UHC Exchange	$3,409.42
Rate for Payer: UHC Medicare Advantage	$1,784.01
Rate for Payer: UHCCP Medicaid	$956.23
Rate for Payer: VA VA	$1,784.01

APPLICATION OF SKIN SUBSTITUTE GRAFT TO TRUNK, ARMS, LEGS, TOTAL WOUND SURFACE AREA GREATER THAN OR EQUAL TO 100 SQ CM; FIRST 100 SQ CM WOUND SURFACE AREA, OR 1% OF BODY AREA OF INFANTS AND CHILDREN

Facility

$10,050.52

Service Code	CPT 15273
Hospital Revenue Code	360
Min. Negotiated Rate	$1,913.77
Max. Negotiated Rate	$10,050.52
Rate for Payer: Aetna Medicare	$3,713.29
Rate for Payer: Allen County Amish Medical Aid Commercial	$4,463.09
Rate for Payer: Amish Plain Church Group Commercial	$4,463.09
Rate for Payer: BCBS Complete	$2,009.46
Rate for Payer: BCBS MAPPO	$3,570.47
Rate for Payer: BCN Medicare Advantage	$3,570.47
Rate for Payer: Health Alliance Plan Medicare Advantage	$3,570.47
Rate for Payer: Mclaren Medicaid	$1,913.77
Rate for Payer: Mclaren Medicare	$3,570.47
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$3,748.99
Rate for Payer: Meridian Medicaid	$2,009.46
Rate for Payer: MI Amish Medical Board Commercial	$4,106.04
Rate for Payer: PACE Medicare	$3,391.95
Rate for Payer: PACE SWMI	$3,570.47
Rate for Payer: PHP Medicare Advantage	$3,570.47
Rate for Payer: Priority Health Choice Medicaid	$1,913.77
Rate for Payer: Priority Health Medicare	$3,570.47
Rate for Payer: Railroad Medicare Medicare	$3,570.47
Rate for Payer: UHC All Payor (Choice/PPO)	$10,050.52
Rate for Payer: UHC Dual Complete DSNP	$3,570.47
Rate for Payer: UHC Exchange	$6,823.53
Rate for Payer: UHC Medicare Advantage	$3,570.47
Rate for Payer: UHCCP Medicaid	$1,913.77
Rate for Payer: VA VA	$3,570.47

APPLICATION OF SKIN SUBSTITUTE GRAFT TO TRUNK, ARMS, LEGS, TOTAL WOUND SURFACE AREA UP TO 100 SQ CM; FIRST 25 SQ CM OR LESS WOUND SURFACE AREA

Facility

$5,021.81

Service Code	CPT 15271
Hospital Revenue Code	360
Min. Negotiated Rate	$956.23
Max. Negotiated Rate	$5,021.81
Rate for Payer: Aetna Medicare	$1,855.37
Rate for Payer: Allen County Amish Medical Aid Commercial	$2,230.01
Rate for Payer: Amish Plain Church Group Commercial	$2,230.01
Rate for Payer: BCBS Complete	$1,004.04
Rate for Payer: BCBS MAPPO	$1,784.01
Rate for Payer: BCN Medicare Advantage	$1,784.01
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,784.01
Rate for Payer: Mclaren Medicaid	$956.23
Rate for Payer: Mclaren Medicare	$1,784.01
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$1,873.21
Rate for Payer: Meridian Medicaid	$1,004.04
Rate for Payer: MI Amish Medical Board Commercial	$2,051.61
Rate for Payer: PACE Medicare	$1,694.81
Rate for Payer: PACE SWMI	$1,784.01
Rate for Payer: PHP Medicare Advantage	$1,784.01
Rate for Payer: Priority Health Choice Medicaid	$956.23
Rate for Payer: Priority Health Medicare	$1,784.01
Rate for Payer: Railroad Medicare Medicare	$1,784.01
Rate for Payer: UHC All Payor (Choice/PPO)	$5,021.81
Rate for Payer: UHC Dual Complete DSNP	$1,784.01
Rate for Payer: UHC Exchange	$3,409.42
Rate for Payer: UHC Medicare Advantage	$1,784.01
Rate for Payer: UHCCP Medicaid	$956.23
Rate for Payer: VA VA	$1,784.01

APPLICATION OF SKIN SUBSTITUTE GRAFT TO TRUNK, ARMS, LEGS, TOTAL WOUND SURFACE AREA UP TO 100 SQ CM; FIRST 25 SQ CM OR LESS WOUND SURFACE AREA

Facility

$5,021.81

Service Code	CPT 15271
Hospital Revenue Code	361
Min. Negotiated Rate	$956.23
Max. Negotiated Rate	$5,021.81
Rate for Payer: Aetna Medicare	$1,855.37
Rate for Payer: Allen County Amish Medical Aid Commercial	$2,230.01
Rate for Payer: Amish Plain Church Group Commercial	$2,230.01
Rate for Payer: BCBS Complete	$1,004.04
Rate for Payer: BCBS MAPPO	$1,784.01
Rate for Payer: BCN Medicare Advantage	$1,784.01
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,784.01
Rate for Payer: Mclaren Medicaid	$956.23
Rate for Payer: Mclaren Medicare	$1,784.01
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$1,873.21
Rate for Payer: Meridian Medicaid	$1,004.04
Rate for Payer: MI Amish Medical Board Commercial	$2,051.61
Rate for Payer: PACE Medicare	$1,694.81
Rate for Payer: PACE SWMI	$1,784.01
Rate for Payer: PHP Medicare Advantage	$1,784.01
Rate for Payer: Priority Health Choice Medicaid	$956.23
Rate for Payer: Priority Health Medicare	$1,784.01
Rate for Payer: Railroad Medicare Medicare	$1,784.01
Rate for Payer: UHC All Payor (Choice/PPO)	$5,021.81
Rate for Payer: UHC Dual Complete DSNP	$1,784.01
Rate for Payer: UHC Exchange	$3,409.42
Rate for Payer: UHC Medicare Advantage	$1,784.01
Rate for Payer: UHCCP Medicaid	$956.23
Rate for Payer: VA VA	$1,784.01

APRACLONIDINE 0.5 % EYE DROPS

Facility

$146.86

Service Code	NDC 61314066505
Hospital Charge Code	9119
Hospital Revenue Code	637
Min. Negotiated Rate	$54.34
Max. Negotiated Rate	$132.17
Rate for Payer: Aetna American Axle	$95.46
Rate for Payer: Aetna Commercial	$124.83
Rate for Payer: Aetna Medicare	$73.43
Rate for Payer: Aetna New Business (MI Preferred)	$95.46
Rate for Payer: BCBS Complete	$58.74
Rate for Payer: Cash Price	$117.49
Rate for Payer: Cofinity Commercial	$102.80
Rate for Payer: Cofinity Commercial	$126.30
Rate for Payer: Cofinity Medicare Advantage	$102.80
Rate for Payer: Encore Health Key Benefits Commercial	$117.49
Rate for Payer: Healthscope Commercial	$132.17
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial	$102.80
Rate for Payer: Lakeland Regional Health Systems Commercial	$110.14
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$124.83
Rate for Payer: PHP Commercial	$124.83
Rate for Payer: Priority Health Cigna Priority Health	$95.46
Rate for Payer: Priority Health SBD	$92.52
Rate for Payer: UMR Bronson Commercial	$54.34
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$110.14

APRACLONIDINE 0.5 % EYE DROPS

Facility

$146.86

Service Code	NDC 61314066505
Hospital Charge Code	9119
Hospital Revenue Code	637
Min. Negotiated Rate	$64.62
Max. Negotiated Rate	$132.17
Rate for Payer: Aetna American Axle	$95.46
Rate for Payer: Aetna Commercial	$124.83
Rate for Payer: Aetna New Business (MI Preferred)	$95.46
Rate for Payer: Cash Price	$117.49
Rate for Payer: Cofinity Commercial	$102.80
Rate for Payer: Cofinity Commercial	$126.30
Rate for Payer: Cofinity Medicare Advantage	$102.80
Rate for Payer: Encore Health Key Benefits Commercial	$117.49
Rate for Payer: Healthscope Commercial	$132.17
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial	$102.80
Rate for Payer: Lakeland Regional Health Systems Commercial	$110.14
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$124.83
Rate for Payer: PHP Commercial	$124.83
Rate for Payer: Priority Health Cigna Priority Health	$95.46
Rate for Payer: Priority Health SBD	$92.52
Rate for Payer: UMR Bronson Commercial	$64.62
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$110.14

APRACLONIDINE 1 % EYE DROPS IN A DROPPERETTE

Facility

$95.42

Service Code	NDC 00065066010
Hospital Charge Code	9120
Hospital Revenue Code	637
Min. Negotiated Rate	$41.98
Max. Negotiated Rate	$85.88
Rate for Payer: Aetna American Axle	$62.02
Rate for Payer: Aetna Commercial	$81.11
Rate for Payer: Aetna New Business (MI Preferred)	$62.02
Rate for Payer: Cash Price	$76.34
Rate for Payer: Cofinity Commercial	$66.79
Rate for Payer: Cofinity Commercial	$82.06
Rate for Payer: Cofinity Medicare Advantage	$66.79
Rate for Payer: Encore Health Key Benefits Commercial	$76.34
Rate for Payer: Healthscope Commercial	$85.88
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial	$66.79
Rate for Payer: Lakeland Regional Health Systems Commercial	$71.56
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$81.11
Rate for Payer: PHP Commercial	$81.11
Rate for Payer: Priority Health Cigna Priority Health	$62.02
Rate for Payer: Priority Health SBD	$60.11
Rate for Payer: UMR Bronson Commercial	$41.98
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$71.56

APRACLONIDINE 1 % EYE DROPS IN A DROPPERETTE

Facility

$2,289.89

Service Code	NDC 82667020001
Hospital Charge Code	9120
Hospital Revenue Code	637
Min. Negotiated Rate	$847.26
Max. Negotiated Rate	$2,060.90
Rate for Payer: Aetna American Axle	$1,488.43
Rate for Payer: Aetna Commercial	$1,946.41
Rate for Payer: Aetna Medicare	$1,144.94
Rate for Payer: Aetna New Business (MI Preferred)	$1,488.43
Rate for Payer: BCBS Complete	$915.96
Rate for Payer: Cash Price	$1,831.91
Rate for Payer: Cofinity Commercial	$1,602.92
Rate for Payer: Cofinity Commercial	$1,969.31
Rate for Payer: Cofinity Medicare Advantage	$1,602.92
Rate for Payer: Encore Health Key Benefits Commercial	$1,831.91
Rate for Payer: Healthscope Commercial	$2,060.90
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial	$1,602.92
Rate for Payer: Lakeland Regional Health Systems Commercial	$1,717.42
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,946.41
Rate for Payer: PHP Commercial	$1,946.41
Rate for Payer: Priority Health Cigna Priority Health	$1,488.43
Rate for Payer: Priority Health SBD	$1,442.63
Rate for Payer: UMR Bronson Commercial	$847.26
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$1,717.42

APRACLONIDINE 1 % EYE DROPS IN A DROPPERETTE

Facility

$2,289.89

Service Code	NDC 82667020001
Hospital Charge Code	9120
Hospital Revenue Code	637
Min. Negotiated Rate	$1,007.55
Max. Negotiated Rate	$2,060.90
Rate for Payer: Aetna American Axle	$1,488.43
Rate for Payer: Aetna Commercial	$1,946.41
Rate for Payer: Aetna New Business (MI Preferred)	$1,488.43
Rate for Payer: Cash Price	$1,831.91
Rate for Payer: Cofinity Commercial	$1,602.92
Rate for Payer: Cofinity Commercial	$1,969.31
Rate for Payer: Cofinity Medicare Advantage	$1,602.92
Rate for Payer: Encore Health Key Benefits Commercial	$1,831.91
Rate for Payer: Healthscope Commercial	$2,060.90
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial	$1,602.92
Rate for Payer: Lakeland Regional Health Systems Commercial	$1,717.42
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,946.41
Rate for Payer: PHP Commercial	$1,946.41
Rate for Payer: Priority Health Cigna Priority Health	$1,488.43
Rate for Payer: Priority Health SBD	$1,442.63
Rate for Payer: UMR Bronson Commercial	$1,007.55
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$1,717.42

APRACLONIDINE 1 % EYE DROPS IN A DROPPERETTE

Facility

$95.42

Service Code	NDC 00065066010
Hospital Charge Code	9120
Hospital Revenue Code	637
Min. Negotiated Rate	$35.31
Max. Negotiated Rate	$85.88
Rate for Payer: Aetna American Axle	$62.02
Rate for Payer: Aetna Commercial	$81.11
Rate for Payer: Aetna Medicare	$47.71
Rate for Payer: Aetna New Business (MI Preferred)	$62.02
Rate for Payer: BCBS Complete	$38.17
Rate for Payer: Cash Price	$76.34
Rate for Payer: Cofinity Commercial	$66.79
Rate for Payer: Cofinity Commercial	$82.06
Rate for Payer: Cofinity Medicare Advantage	$66.79
Rate for Payer: Encore Health Key Benefits Commercial	$76.34
Rate for Payer: Healthscope Commercial	$85.88
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial	$66.79
Rate for Payer: Lakeland Regional Health Systems Commercial	$71.56
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$81.11
Rate for Payer: PHP Commercial	$81.11
Rate for Payer: Priority Health Cigna Priority Health	$62.02
Rate for Payer: Priority Health SBD	$60.11
Rate for Payer: UMR Bronson Commercial	$35.31
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$71.56

APR-DRG 42.00: ABDOMINAL PAIN

Facility

$3,297.14

Service Code	APR-DRG 2511
Min. Negotiated Rate	$3,140.13
Max. Negotiated Rate	$3,297.14
Rate for Payer: BCBS Complete	$3,297.14
Rate for Payer: Mclaren Medicaid	$3,140.13
Rate for Payer: Meridian Medicaid	$3,297.14
Rate for Payer: Priority Health Choice Medicaid	$3,140.13
Rate for Payer: UHCCP Medicaid	$3,140.13

APR-DRG 42.00: ABDOMINAL PAIN

Facility

$5,437.38

Service Code	APR-DRG 2513
Min. Negotiated Rate	$5,178.46
Max. Negotiated Rate	$5,437.38
Rate for Payer: BCBS Complete	$5,437.38
Rate for Payer: Mclaren Medicaid	$5,178.46
Rate for Payer: Meridian Medicaid	$5,437.38
Rate for Payer: Priority Health Choice Medicaid	$5,178.46
Rate for Payer: UHCCP Medicaid	$5,178.46

APR-DRG 42.00: ABDOMINAL PAIN

Facility

$8,560.99

Service Code	APR-DRG 2514
Min. Negotiated Rate	$8,153.32
Max. Negotiated Rate	$8,560.99
Rate for Payer: BCBS Complete	$8,560.99
Rate for Payer: Mclaren Medicaid	$8,153.32
Rate for Payer: Meridian Medicaid	$8,560.99
Rate for Payer: Priority Health Choice Medicaid	$8,153.32
Rate for Payer: UHCCP Medicaid	$8,153.32

APR-DRG 42.00: ABDOMINAL PAIN

Facility

$4,164.80

Service Code	APR-DRG 2512
Min. Negotiated Rate	$3,966.48
Max. Negotiated Rate	$4,164.80
Rate for Payer: BCBS Complete	$4,164.80
Rate for Payer: Mclaren Medicaid	$3,966.48
Rate for Payer: Meridian Medicaid	$4,164.80
Rate for Payer: Priority Health Choice Medicaid	$3,966.48
Rate for Payer: UHCCP Medicaid	$3,966.48

APR-DRG 42.00: ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY

Facility

$4,164.80

Service Code	APR-DRG 5432
Min. Negotiated Rate	$3,966.48
Max. Negotiated Rate	$4,164.80
Rate for Payer: BCBS Complete	$4,164.80
Rate for Payer: Mclaren Medicaid	$3,966.48
Rate for Payer: Meridian Medicaid	$4,164.80
Rate for Payer: Priority Health Choice Medicaid	$3,966.48
Rate for Payer: UHCCP Medicaid	$3,966.48

APR-DRG 42.00: ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY

Facility

$13,072.86

Service Code	APR-DRG 5434
Min. Negotiated Rate	$12,450.34
Max. Negotiated Rate	$13,072.86
Rate for Payer: BCBS Complete	$13,072.86
Rate for Payer: Mclaren Medicaid	$12,450.34
Rate for Payer: Meridian Medicaid	$13,072.86
Rate for Payer: Priority Health Choice Medicaid	$12,450.34
Rate for Payer: UHCCP Medicaid	$12,450.34

APR-DRG 42.00: ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY

Facility

$3,297.14

Service Code	APR-DRG 5431
Min. Negotiated Rate	$3,140.13
Max. Negotiated Rate	$3,297.14
Rate for Payer: BCBS Complete	$3,297.14
Rate for Payer: Mclaren Medicaid	$3,140.13
Rate for Payer: Meridian Medicaid	$3,297.14
Rate for Payer: Priority Health Choice Medicaid	$3,140.13
Rate for Payer: UHCCP Medicaid	$3,140.13

APR-DRG 42.00: ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY

Facility

$6,767.81

Service Code	APR-DRG 5433
Min. Negotiated Rate	$6,445.53
Max. Negotiated Rate	$6,767.81
Rate for Payer: BCBS Complete	$6,767.81
Rate for Payer: Mclaren Medicaid	$6,445.53
Rate for Payer: Meridian Medicaid	$6,767.81
Rate for Payer: Priority Health Choice Medicaid	$6,445.53
Rate for Payer: UHCCP Medicaid	$6,445.53

APR-DRG 42.00: ABORTION WITHOUT D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY

Facility

$4,743.25

Service Code	APR-DRG 5643
Min. Negotiated Rate	$4,517.38
Max. Negotiated Rate	$4,743.25
Rate for Payer: BCBS Complete	$4,743.25
Rate for Payer: Mclaren Medicaid	$4,517.38
Rate for Payer: Meridian Medicaid	$4,743.25
Rate for Payer: Priority Health Choice Medicaid	$4,517.38
Rate for Payer: UHCCP Medicaid	$4,517.38

APR-DRG 42.00: ABORTION WITHOUT D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY

Facility

$2,834.38

Service Code	APR-DRG 5642
Min. Negotiated Rate	$2,699.41
Max. Negotiated Rate	$2,834.38
Rate for Payer: BCBS Complete	$2,834.38
Rate for Payer: Mclaren Medicaid	$2,699.41
Rate for Payer: Meridian Medicaid	$2,834.38
Rate for Payer: Priority Health Choice Medicaid	$2,699.41
Rate for Payer: UHCCP Medicaid	$2,699.41

APR-DRG 42.00: ABORTION WITHOUT D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY

Facility

$2,024.56

Service Code	APR-DRG 5641
Min. Negotiated Rate	$1,928.15
Max. Negotiated Rate	$2,024.56
Rate for Payer: BCBS Complete	$2,024.56
Rate for Payer: Mclaren Medicaid	$1,928.15
Rate for Payer: Meridian Medicaid	$2,024.56
Rate for Payer: Priority Health Choice Medicaid	$1,928.15
Rate for Payer: UHCCP Medicaid	$1,928.15

APR-DRG 42.00: ABORTION WITHOUT D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY

Facility

$10,296.32

Service Code	APR-DRG 5644
Min. Negotiated Rate	$9,806.02
Max. Negotiated Rate	$10,296.32
Rate for Payer: BCBS Complete	$10,296.32
Rate for Payer: Mclaren Medicaid	$9,806.02
Rate for Payer: Meridian Medicaid	$10,296.32
Rate for Payer: Priority Health Choice Medicaid	$9,806.02
Rate for Payer: UHCCP Medicaid	$9,806.02

APR-DRG 42.00: ACUTE AND SUBACUTE ENDOCARDITIS

Facility

$14,114.06

Service Code	APR-DRG 1934
Min. Negotiated Rate	$13,441.96
Max. Negotiated Rate	$14,114.06
Rate for Payer: BCBS Complete	$14,114.06
Rate for Payer: Mclaren Medicaid	$13,441.96
Rate for Payer: Meridian Medicaid	$14,114.06
Rate for Payer: Priority Health Choice Medicaid	$13,441.96
Rate for Payer: UHCCP Medicaid	$13,441.96

APR-DRG 42.00: ACUTE AND SUBACUTE ENDOCARDITIS

Facility

$6,420.74

Service Code	APR-DRG 1931
Min. Negotiated Rate	$6,114.99
Max. Negotiated Rate	$6,420.74
Rate for Payer: BCBS Complete	$6,420.74
Rate for Payer: Mclaren Medicaid	$6,114.99
Rate for Payer: Meridian Medicaid	$6,420.74
Rate for Payer: Priority Health Choice Medicaid	$6,114.99
Rate for Payer: UHCCP Medicaid	$6,114.99

APR-DRG 42.00: ACUTE AND SUBACUTE ENDOCARDITIS

Facility

$9,602.19

Service Code	APR-DRG 1933
Min. Negotiated Rate	$9,144.94
Max. Negotiated Rate	$9,602.19
Rate for Payer: BCBS Complete	$9,602.19
Rate for Payer: Mclaren Medicaid	$9,144.94
Rate for Payer: Meridian Medicaid	$9,602.19
Rate for Payer: Priority Health Choice Medicaid	$9,144.94
Rate for Payer: UHCCP Medicaid	$9,144.94

Know your out-of-pocket cost for care.

All Charges