Bronson Methodist Hospital

All Charges

Charge

Type

Setting

Price

OPIOID ABUSE AND DEPENDENCE

Facility

$3,849.87

Service Code	APR-DRG 7732
Min. Negotiated Rate	$3,666.54
Max. Negotiated Rate	$3,849.87
Rate for Payer: BCBS Complete	$3,849.87
Rate for Payer: Mclaren Medicaid	$3,666.54
Rate for Payer: Meridian Medicaid	$3,849.87
Rate for Payer: Priority Health Choice Medicaid	$3,666.54
Rate for Payer: UHC Medicaid	$3,666.54
Rate for Payer: UHCCP Medicaid	$3,666.54

OPIOID ABUSE AND DEPENDENCE

Facility

$4,829.28

Service Code	APR-DRG 7733
Min. Negotiated Rate	$4,599.32
Max. Negotiated Rate	$4,829.28
Rate for Payer: BCBS Complete	$4,829.28
Rate for Payer: Mclaren Medicaid	$4,599.32
Rate for Payer: Meridian Medicaid	$4,829.28
Rate for Payer: Priority Health Choice Medicaid	$4,599.32
Rate for Payer: UHC Medicaid	$4,599.32
Rate for Payer: UHCCP Medicaid	$4,599.32

OPIOID ABUSE AND DEPENDENCE

Facility

$2,180.38

Service Code	APR-DRG 7731
Min. Negotiated Rate	$2,076.55
Max. Negotiated Rate	$2,180.38
Rate for Payer: BCBS Complete	$2,180.38
Rate for Payer: Mclaren Medicaid	$2,076.55
Rate for Payer: Meridian Medicaid	$2,180.38
Rate for Payer: Priority Health Choice Medicaid	$2,076.55
Rate for Payer: UHC Medicaid	$2,076.55
Rate for Payer: UHCCP Medicaid	$2,076.55

OPIOID ABUSE AND DEPENDENCE

Facility

$14,274.17

Service Code	APR-DRG 7734
Min. Negotiated Rate	$13,594.45
Max. Negotiated Rate	$14,274.17
Rate for Payer: BCBS Complete	$14,274.17
Rate for Payer: Mclaren Medicaid	$13,594.45
Rate for Payer: Meridian Medicaid	$14,274.17
Rate for Payer: Priority Health Choice Medicaid	$13,594.45
Rate for Payer: UHC Medicaid	$13,594.45
Rate for Payer: UHCCP Medicaid	$13,594.45

OPIUM TINCTURE 10 MG/ML (MORPHINE) ORAL

Facility

$1,439.05

Service Code	NDC 62559015304
Hospital Charge Code	99405
Hospital Revenue Code	637
Min. Negotiated Rate	$532.45
Max. Negotiated Rate	$1,295.14
Rate for Payer: Aetna American Axle	$935.38
Rate for Payer: Aetna Commercial	$1,223.19
Rate for Payer: Aetna Medicare	$719.52
Rate for Payer: Aetna New Business (MI Preferred)	$935.38
Rate for Payer: BCBS Complete	$575.62
Rate for Payer: Cash Price	$1,151.24
Rate for Payer: Cofinity Advantage	$1,007.34
Rate for Payer: Cofinity Commercial	$1,237.58
Rate for Payer: Encore Health Key Benefits Commercial	$1,151.24
Rate for Payer: Healthscope Commercial	$1,295.14
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial	$1,007.34
Rate for Payer: Lakeland Regional Health Systems Commercial	$1,079.29
Rate for Payer: MI Amish Medical Board Commercial	$1,151.24
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,223.19
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,079.29
Rate for Payer: PHP Commercial	$1,223.19
Rate for Payer: Priority Health SBD	$906.60
Rate for Payer: UHC All Payor (Choice/PPO)	$935.38
Rate for Payer: UHC Core	$749.75
Rate for Payer: UHC Exchange	$565.55
Rate for Payer: UMR Bronson Commercial	$532.45
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$1,079.29

OPIUM TINCTURE 10 MG/ML (MORPHINE) ORAL

Facility

$2,240.26

Service Code	NDC 42799021701
Hospital Charge Code	99405
Hospital Revenue Code	637
Min. Negotiated Rate	$985.71
Max. Negotiated Rate	$2,016.23
Rate for Payer: Aetna American Axle	$1,456.17
Rate for Payer: Aetna Commercial	$1,904.22
Rate for Payer: Aetna New Business (MI Preferred)	$1,456.17
Rate for Payer: Cash Price	$1,792.21
Rate for Payer: Cofinity Advantage	$1,568.18
Rate for Payer: Cofinity Commercial	$1,926.62
Rate for Payer: Encore Health Key Benefits Commercial	$1,792.21
Rate for Payer: Healthscope Commercial	$2,016.23
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial	$1,568.18
Rate for Payer: Lakeland Regional Health Systems Commercial	$1,680.19
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,904.22
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,680.19
Rate for Payer: PHP Commercial	$1,904.22
Rate for Payer: Priority Health SBD	$1,411.36
Rate for Payer: UMR Bronson Commercial	$985.71
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$1,680.19

OPIUM TINCTURE 10 MG/ML (MORPHINE) ORAL

Facility

$1,439.05

Service Code	NDC 62559015304
Hospital Charge Code	99405
Hospital Revenue Code	637
Min. Negotiated Rate	$633.18
Max. Negotiated Rate	$1,295.14
Rate for Payer: Aetna American Axle	$935.38
Rate for Payer: Aetna Commercial	$1,223.19
Rate for Payer: Aetna New Business (MI Preferred)	$935.38
Rate for Payer: Cash Price	$1,151.24
Rate for Payer: Cofinity Advantage	$1,007.34
Rate for Payer: Cofinity Commercial	$1,237.58
Rate for Payer: Encore Health Key Benefits Commercial	$1,151.24
Rate for Payer: Healthscope Commercial	$1,295.14
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial	$1,007.34
Rate for Payer: Lakeland Regional Health Systems Commercial	$1,079.29
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,223.19
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,079.29
Rate for Payer: PHP Commercial	$1,223.19
Rate for Payer: Priority Health SBD	$906.60
Rate for Payer: UMR Bronson Commercial	$633.18
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$1,079.29

OPIUM TINCTURE 10 MG/ML (MORPHINE) ORAL

Facility

$11.46

Service Code	NDC 09900001924
Hospital Charge Code	99405
Hospital Revenue Code	637
Min. Negotiated Rate	$5.04
Max. Negotiated Rate	$10.31
Rate for Payer: Aetna American Axle	$7.45
Rate for Payer: Aetna Commercial	$9.74
Rate for Payer: Aetna New Business (MI Preferred)	$7.45
Rate for Payer: Cash Price	$9.17
Rate for Payer: Cofinity Advantage	$8.02
Rate for Payer: Cofinity Commercial	$9.86
Rate for Payer: Encore Health Key Benefits Commercial	$9.17
Rate for Payer: Healthscope Commercial	$10.31
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial	$8.02
Rate for Payer: Lakeland Regional Health Systems Commercial	$8.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$9.74
Rate for Payer: Opus (Opus Packaging Group) HMA	$8.60
Rate for Payer: PHP Commercial	$9.74
Rate for Payer: Priority Health SBD	$7.22
Rate for Payer: UMR Bronson Commercial	$5.04
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$8.60

OPIUM TINCTURE 10 MG/ML (MORPHINE) ORAL

Facility

$11.46

Service Code	NDC 09900001924
Hospital Charge Code	99405
Hospital Revenue Code	637
Min. Negotiated Rate	$4.24
Max. Negotiated Rate	$10.31
Rate for Payer: Aetna American Axle	$7.45
Rate for Payer: Aetna Commercial	$9.74
Rate for Payer: Aetna Medicare	$5.73
Rate for Payer: Aetna New Business (MI Preferred)	$7.45
Rate for Payer: BCBS Complete	$4.58
Rate for Payer: Cash Price	$9.17
Rate for Payer: Cofinity Advantage	$8.02
Rate for Payer: Cofinity Commercial	$9.86
Rate for Payer: Encore Health Key Benefits Commercial	$9.17
Rate for Payer: Healthscope Commercial	$10.31
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial	$8.02
Rate for Payer: Lakeland Regional Health Systems Commercial	$8.60
Rate for Payer: MI Amish Medical Board Commercial	$9.17
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$9.74
Rate for Payer: Opus (Opus Packaging Group) HMA	$8.60
Rate for Payer: PHP Commercial	$9.74
Rate for Payer: Priority Health SBD	$7.22
Rate for Payer: UHC All Payor (Choice/PPO)	$7.45
Rate for Payer: UHC Core	$5.97
Rate for Payer: UHC Exchange	$4.50
Rate for Payer: UMR Bronson Commercial	$4.24
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$8.60

OPIUM TINCTURE 10 MG/ML (MORPHINE) ORAL

Facility

$2,240.26

Service Code	NDC 42799021701
Hospital Charge Code	99405
Hospital Revenue Code	637
Min. Negotiated Rate	$828.90
Max. Negotiated Rate	$2,016.23
Rate for Payer: Aetna American Axle	$1,456.17
Rate for Payer: Aetna Commercial	$1,904.22
Rate for Payer: Aetna Medicare	$1,120.13
Rate for Payer: Aetna New Business (MI Preferred)	$1,456.17
Rate for Payer: BCBS Complete	$896.10
Rate for Payer: Cash Price	$1,792.21
Rate for Payer: Cofinity Advantage	$1,568.18
Rate for Payer: Cofinity Commercial	$1,926.62
Rate for Payer: Encore Health Key Benefits Commercial	$1,792.21
Rate for Payer: Healthscope Commercial	$2,016.23
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial	$1,568.18
Rate for Payer: Lakeland Regional Health Systems Commercial	$1,680.19
Rate for Payer: MI Amish Medical Board Commercial	$1,792.21
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,904.22
Rate for Payer: Opus (Opus Packaging Group) HMA	$1,680.19
Rate for Payer: PHP Commercial	$1,904.22
Rate for Payer: Priority Health SBD	$1,411.36
Rate for Payer: UHC All Payor (Choice/PPO)	$1,456.17
Rate for Payer: UHC Core	$1,167.18
Rate for Payer: UHC Exchange	$880.42
Rate for Payer: UMR Bronson Commercial	$828.90
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$1,680.19

ORBITAL PROCEDURES WITH CC/MCC

Facility

$50,002.00

Service Code	MSDRG 113
Min. Negotiated Rate	$19,241.78
Max. Negotiated Rate	$50,002.00
Rate for Payer: Aetna Medicare	$21,064.68
Rate for Payer: Allen County Amish Medical Aid Commercial	$25,318.12
Rate for Payer: Amish Plain Church Group Commercial	$25,318.12
Rate for Payer: BCBS MAPPO	$20,254.50
Rate for Payer: BCBS Trust/PPO	$50,002.00
Rate for Payer: BCN Commercial	$50,002.00
Rate for Payer: BCN Medicare Advantage	$20,254.50
Rate for Payer: Health Alliance Plan Medicare Advantage	$20,254.50
Rate for Payer: Mclaren Medicare	$20,254.50
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$21,267.22
Rate for Payer: MI Amish Medical Board Commercial	$23,292.67
Rate for Payer: Molina Medicare/Medicaid	$22,279.95
Rate for Payer: Nomi Health Commercial	$30,329.19
Rate for Payer: PACE Medicare	$19,241.78
Rate for Payer: PACE SWMI	$20,254.50
Rate for Payer: PHP Medicare Advantage	$20,254.50
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$37,904.76
Rate for Payer: Priority Health Medicare	$20,254.50
Rate for Payer: Priority Health Tiered Network	$30,323.81
Rate for Payer: Railroad Medicare Medicare	$20,254.50
Rate for Payer: UHC All Payor (Choice/PPO)	$38,322.93
Rate for Payer: UHC Core	$32,061.95
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$20,254.50
Rate for Payer: UHC Exchange	$26,184.20
Rate for Payer: VA VA	$20,254.50

ORBITAL PROCEDURES WITHOUT CC/MCC

Facility

$33,026.30

Service Code	MSDRG 114
Min. Negotiated Rate	$11,312.31
Max. Negotiated Rate	$33,026.30
Rate for Payer: Aetna Medicare	$12,384.00
Rate for Payer: Allen County Amish Medical Aid Commercial	$14,884.61
Rate for Payer: Amish Plain Church Group Commercial	$14,884.61
Rate for Payer: BCBS MAPPO	$11,907.69
Rate for Payer: BCBS Trust/PPO	$33,026.30
Rate for Payer: BCN Commercial	$33,026.30
Rate for Payer: BCN Medicare Advantage	$11,907.69
Rate for Payer: Health Alliance Plan Medicare Advantage	$11,907.69
Rate for Payer: Mclaren Medicare	$11,907.69
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$12,503.07
Rate for Payer: MI Amish Medical Board Commercial	$13,693.84
Rate for Payer: Molina Medicare/Medicaid	$13,098.46
Rate for Payer: Nomi Health Commercial	$17,453.70
Rate for Payer: PACE Medicare	$11,312.31
Rate for Payer: PACE SWMI	$11,907.69
Rate for Payer: PHP Medicare Advantage	$11,907.69
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$21,813.26
Rate for Payer: Priority Health Medicare	$11,907.69
Rate for Payer: Priority Health Tiered Network	$17,450.60
Rate for Payer: Railroad Medicare Medicare	$11,907.69
Rate for Payer: UHC All Payor (Choice/PPO)	$22,053.90
Rate for Payer: UHC Core	$18,450.86
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$11,907.69
Rate for Payer: UHC Exchange	$15,068.36
Rate for Payer: VA VA	$11,907.69

ORBIT AND EYE PROCEDURES

Facility

$7,978.79

Service Code	APR-DRG 0731
Min. Negotiated Rate	$7,598.85
Max. Negotiated Rate	$7,978.79
Rate for Payer: BCBS Complete	$7,978.79
Rate for Payer: Mclaren Medicaid	$7,598.85
Rate for Payer: Meridian Medicaid	$7,978.79
Rate for Payer: Priority Health Choice Medicaid	$7,598.85
Rate for Payer: UHC Medicaid	$7,598.85
Rate for Payer: UHCCP Medicaid	$7,598.85

ORBIT AND EYE PROCEDURES

Facility

$23,740.85

Service Code	APR-DRG 0734
Min. Negotiated Rate	$22,610.33
Max. Negotiated Rate	$23,740.85
Rate for Payer: BCBS Complete	$23,740.85
Rate for Payer: Mclaren Medicaid	$22,610.33
Rate for Payer: Meridian Medicaid	$23,740.85
Rate for Payer: Priority Health Choice Medicaid	$22,610.33
Rate for Payer: UHC Medicaid	$22,610.33
Rate for Payer: UHCCP Medicaid	$22,610.33

ORBIT AND EYE PROCEDURES

Facility

$9,861.95

Service Code	APR-DRG 0732
Min. Negotiated Rate	$9,392.34
Max. Negotiated Rate	$9,861.95
Rate for Payer: BCBS Complete	$9,861.95
Rate for Payer: Mclaren Medicaid	$9,392.34
Rate for Payer: Meridian Medicaid	$9,861.95
Rate for Payer: Priority Health Choice Medicaid	$9,392.34
Rate for Payer: UHC Medicaid	$9,392.34
Rate for Payer: UHCCP Medicaid	$9,392.34

ORBIT AND EYE PROCEDURES

Facility

$13,406.13

Service Code	APR-DRG 0733
Min. Negotiated Rate	$12,767.75
Max. Negotiated Rate	$13,406.13
Rate for Payer: BCBS Complete	$13,406.13
Rate for Payer: Mclaren Medicaid	$12,767.75
Rate for Payer: Meridian Medicaid	$13,406.13
Rate for Payer: Priority Health Choice Medicaid	$12,767.75
Rate for Payer: UHC Medicaid	$12,767.75
Rate for Payer: UHCCP Medicaid	$12,767.75

ORCHIECTOMY, RADICAL, FOR TUMOR; INGUINAL APPROACH

Facility

$11,537.07

Service Code	CPT 54530
Hospital Revenue Code	360
Min. Negotiated Rate	$1,865.82
Max. Negotiated Rate	$11,537.07
Rate for Payer: Aetna Medicare	$3,710.23
Rate for Payer: Allen County Amish Medical Aid Commercial	$4,459.41
Rate for Payer: Amish Plain Church Group Commercial	$4,459.41
Rate for Payer: BCBS Complete	$1,959.29
Rate for Payer: BCBS MAPPO	$3,567.53
Rate for Payer: BCBS Trust/PPO	$4,821.85
Rate for Payer: BCN Commercial	$4,821.85
Rate for Payer: BCN Medicare Advantage	$3,567.53
Rate for Payer: Health Alliance Plan Medicare Advantage	$3,567.53
Rate for Payer: Mclaren Medicaid	$3,567.53
Rate for Payer: Mclaren Medicare	$3,567.53
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$3,745.91
Rate for Payer: Meridian Medicaid	$3,745.91
Rate for Payer: MI Amish Medical Board Commercial	$4,102.66
Rate for Payer: Molina Medicare/Medicaid	$3,924.28
Rate for Payer: Nomi Health Commercial	$10,702.59
Rate for Payer: PACE Medicare	$3,389.15
Rate for Payer: PACE SWMI	$3,567.53
Rate for Payer: PHP Medicare Advantage	$3,567.53
Rate for Payer: Priority Health Choice Medicaid	$1,865.82
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$11,537.07
Rate for Payer: Priority Health Medicare	$3,567.53
Rate for Payer: Priority Health Tiered Network	$9,229.66
Rate for Payer: Railroad Medicare Medicare	$3,567.53
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$3,567.53
Rate for Payer: UHC Medicaid	$1,865.82
Rate for Payer: UHCCP Medicaid	$1,865.82
Rate for Payer: VA VA	$3,567.53

ORCHIECTOMY, SIMPLE (INCLUDING SUBCAPSULAR), WITH OR WITHOUT TESTICULAR PROSTHESIS, SCROTAL OR INGUINAL APPROACH

Facility

$11,358.48

Service Code	CPT 54520
Hospital Revenue Code	360
Min. Negotiated Rate	$1,836.94
Max. Negotiated Rate	$11,358.48
Rate for Payer: Aetna Medicare	$3,652.80
Rate for Payer: Allen County Amish Medical Aid Commercial	$4,390.39
Rate for Payer: Amish Plain Church Group Commercial	$4,390.39
Rate for Payer: BCBS Complete	$1,928.96
Rate for Payer: BCBS MAPPO	$3,512.31
Rate for Payer: BCBS Trust/PPO	$4,490.01
Rate for Payer: BCN Commercial	$4,490.01
Rate for Payer: BCN Medicare Advantage	$3,512.31
Rate for Payer: Health Alliance Plan Medicare Advantage	$3,512.31
Rate for Payer: Mclaren Medicaid	$3,512.31
Rate for Payer: Mclaren Medicare	$3,512.31
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$3,687.93
Rate for Payer: Meridian Medicaid	$3,687.93
Rate for Payer: MI Amish Medical Board Commercial	$4,039.16
Rate for Payer: Molina Medicare/Medicaid	$3,863.54
Rate for Payer: Nomi Health Commercial	$10,536.93
Rate for Payer: PACE Medicare	$3,336.69
Rate for Payer: PACE SWMI	$3,512.31
Rate for Payer: PHP Medicare Advantage	$3,512.31
Rate for Payer: Priority Health Choice Medicaid	$1,836.94
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$11,358.48
Rate for Payer: Priority Health Medicare	$3,512.31
Rate for Payer: Priority Health Tiered Network	$9,086.78
Rate for Payer: Railroad Medicare Medicare	$3,512.31
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$3,512.31
Rate for Payer: UHC Medicaid	$1,836.94
Rate for Payer: UHCCP Medicaid	$1,836.94
Rate for Payer: VA VA	$3,512.31

ORCHIOPEXY, INGUINAL OR SCROTAL APPROACH

Facility

$11,537.07

Service Code	CPT 54640
Hospital Revenue Code	360
Min. Negotiated Rate	$1,865.82
Max. Negotiated Rate	$11,537.07
Rate for Payer: Aetna Medicare	$3,710.23
Rate for Payer: Allen County Amish Medical Aid Commercial	$4,459.41
Rate for Payer: Amish Plain Church Group Commercial	$4,459.41
Rate for Payer: BCBS Complete	$1,959.29
Rate for Payer: BCBS MAPPO	$3,567.53
Rate for Payer: BCBS Trust/PPO	$4,470.61
Rate for Payer: BCN Commercial	$4,470.61
Rate for Payer: BCN Medicare Advantage	$3,567.53
Rate for Payer: Health Alliance Plan Medicare Advantage	$3,567.53
Rate for Payer: Mclaren Medicaid	$3,567.53
Rate for Payer: Mclaren Medicare	$3,567.53
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$3,745.91
Rate for Payer: Meridian Medicaid	$3,745.91
Rate for Payer: MI Amish Medical Board Commercial	$4,102.66
Rate for Payer: Molina Medicare/Medicaid	$3,924.28
Rate for Payer: Nomi Health Commercial	$10,702.59
Rate for Payer: PACE Medicare	$3,389.15
Rate for Payer: PACE SWMI	$3,567.53
Rate for Payer: PHP Medicare Advantage	$3,567.53
Rate for Payer: Priority Health Choice Medicaid	$1,865.82
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$11,537.07
Rate for Payer: Priority Health Medicare	$3,567.53
Rate for Payer: Priority Health Tiered Network	$9,229.66
Rate for Payer: Railroad Medicare Medicare	$3,567.53
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$3,567.53
Rate for Payer: UHC Medicaid	$1,865.82
Rate for Payer: UHCCP Medicaid	$1,865.82
Rate for Payer: VA VA	$3,567.53

ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY

Facility

$26,225.07

Service Code	MSDRG 884
Min. Negotiated Rate	$1,069.00
Max. Negotiated Rate	$26,225.07
Rate for Payer: Aetna Medicare	$14,609.62
Rate for Payer: Allen County Amish Medical Aid Commercial	$17,559.64
Rate for Payer: Amish Plain Church Group Commercial	$17,559.64
Rate for Payer: BCBS MAPPO	$14,047.71
Rate for Payer: BCBS Trust/PPO	$23,476.10
Rate for Payer: BCN Commercial	$23,476.10
Rate for Payer: BCN Medicare Advantage	$14,047.71
Rate for Payer: Health Alliance Plan Medicare Advantage	$14,047.71
Rate for Payer: Mclaren Medicare	$14,047.71
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$14,750.10
Rate for Payer: MI Amish Medical Board Commercial	$16,154.87
Rate for Payer: Molina Medicare/Medicaid	$15,452.48
Rate for Payer: Nomi Health Commercial	$1,069.00
Rate for Payer: PACE Medicare	$13,345.32
Rate for Payer: PACE SWMI	$14,047.71
Rate for Payer: PHP Medicare Advantage	$14,047.71
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$25,938.91
Rate for Payer: Priority Health Medicare	$14,047.71
Rate for Payer: Priority Health Tiered Network	$20,751.13
Rate for Payer: Railroad Medicare Medicare	$14,047.71
Rate for Payer: UHC All Payor (Choice/PPO)	$26,225.07
Rate for Payer: UHC Core	$21,940.57
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$14,047.71
Rate for Payer: UHC Exchange	$17,918.32
Rate for Payer: VA VA	$14,047.71

ORGANIC MENTAL HEALTH CONDITIONS AND DISTURBANCES

Facility

$4,777.22

Service Code	APR-DRG 7571
Min. Negotiated Rate	$4,549.74
Max. Negotiated Rate	$4,777.22
Rate for Payer: BCBS Complete	$4,777.22
Rate for Payer: Mclaren Medicaid	$4,549.74
Rate for Payer: Meridian Medicaid	$4,777.22
Rate for Payer: Priority Health Choice Medicaid	$4,549.74
Rate for Payer: UHC Medicaid	$4,549.74
Rate for Payer: UHCCP Medicaid	$4,549.74

ORGANIC MENTAL HEALTH CONDITIONS AND DISTURBANCES

Facility

$18,564.71

Service Code	APR-DRG 7574
Min. Negotiated Rate	$17,680.68
Max. Negotiated Rate	$18,564.71
Rate for Payer: BCBS Complete	$18,564.71
Rate for Payer: Mclaren Medicaid	$17,680.68
Rate for Payer: Meridian Medicaid	$18,564.71
Rate for Payer: Priority Health Choice Medicaid	$17,680.68
Rate for Payer: UHC Medicaid	$17,680.68
Rate for Payer: UHCCP Medicaid	$17,680.68

ORGANIC MENTAL HEALTH CONDITIONS AND DISTURBANCES

Facility

$8,223.95

Service Code	APR-DRG 7573
Min. Negotiated Rate	$7,832.33
Max. Negotiated Rate	$8,223.95
Rate for Payer: BCBS Complete	$8,223.95
Rate for Payer: Mclaren Medicaid	$7,832.33
Rate for Payer: Meridian Medicaid	$8,223.95
Rate for Payer: Priority Health Choice Medicaid	$7,832.33
Rate for Payer: UHC Medicaid	$7,832.33
Rate for Payer: UHCCP Medicaid	$7,832.33

ORGANIC MENTAL HEALTH CONDITIONS AND DISTURBANCES

Facility

$6,781.46

Service Code	APR-DRG 7572
Min. Negotiated Rate	$6,458.53
Max. Negotiated Rate	$6,781.46
Rate for Payer: BCBS Complete	$6,781.46
Rate for Payer: Mclaren Medicaid	$6,458.53
Rate for Payer: Meridian Medicaid	$6,781.46
Rate for Payer: Priority Health Choice Medicaid	$6,458.53
Rate for Payer: UHC Medicaid	$6,458.53
Rate for Payer: UHCCP Medicaid	$6,458.53

ORITAVANCIN 1,200 MG INTRAVENOUS SOLUTION

Facility

$12,887.66

Service Code	HCPCS J2406
Hospital Charge Code	197251
Hospital Revenue Code	636
Min. Negotiated Rate	$22.87
Max. Negotiated Rate	$11,598.89
Rate for Payer: Aetna American Axle	$8,376.98
Rate for Payer: Aetna Commercial	$10,954.51
Rate for Payer: Aetna Medicare	$45.47
Rate for Payer: Aetna New Business (MI Preferred)	$8,376.98
Rate for Payer: Allen County Amish Medical Aid Commercial	$54.65
Rate for Payer: Amish Plain Church Group Commercial	$54.65
Rate for Payer: BCBS Complete	$24.01
Rate for Payer: BCBS MAPPO	$43.72
Rate for Payer: BCBS Trust/PPO	$139.62
Rate for Payer: BCN Commercial	$139.62
Rate for Payer: BCN Medicare Advantage	$43.72
Rate for Payer: Cash Price	$10,310.13
Rate for Payer: Cash Price	$10,310.13
Rate for Payer: Cofinity Advantage	$9,021.36
Rate for Payer: Cofinity Commercial	$11,083.39
Rate for Payer: Encore Health Key Benefits Commercial	$10,310.13
Rate for Payer: Health Alliance Plan Medicare Advantage	$43.72
Rate for Payer: Healthscope Commercial	$11,598.89
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial	$9,021.36
Rate for Payer: Lakeland Regional Health Systems Commercial	$9,665.75
Rate for Payer: Mclaren Medicaid	$43.72
Rate for Payer: Mclaren Medicare	$43.72
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$45.91
Rate for Payer: Meridian Medicaid	$45.91
Rate for Payer: MI Amish Medical Board Commercial	$50.28
Rate for Payer: Molina Medicare/Medicaid	$48.09
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$10,954.51
Rate for Payer: Nomi Health Commercial	$131.16
Rate for Payer: Opus (Opus Packaging Group) HMA	$9,665.75
Rate for Payer: PACE Medicare	$41.53
Rate for Payer: PACE SWMI	$43.72
Rate for Payer: PHP Commercial	$10,954.51
Rate for Payer: PHP Medicare Advantage	$43.72
Rate for Payer: Priority Health Choice Medicaid	$22.87
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$133.98
Rate for Payer: Priority Health Medicare	$43.72
Rate for Payer: Priority Health SBD	$8,119.23
Rate for Payer: Priority Health Tiered Network	$107.18
Rate for Payer: Railroad Medicare Medicare	$43.72
Rate for Payer: UHC All Payor (Choice/PPO)	$71.05
Rate for Payer: UHC Core	$71.05
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$43.72
Rate for Payer: UHC Exchange	$71.05
Rate for Payer: UHC Medicaid	$22.87
Rate for Payer: UHCCP Medicaid	$22.87
Rate for Payer: UMR Bronson Commercial	$4,768.43
Rate for Payer: VA VA	$43.72
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$9,665.75

Know your out-of-pocket cost for care.

All Charges