Bronson Methodist Hospital

All Charges

Charge

Type

Setting

Price

OTHER KIDNEY, URINARY TRACT AND RELATED NON-PERCUTANEOUS PROCEDURES

Facility

$10,817.16

Service Code	APR-DRG 4472
Min. Negotiated Rate	$10,302.06
Max. Negotiated Rate	$10,817.16
Rate for Payer: BCBS Complete	$10,817.16
Rate for Payer: Mclaren Medicaid	$10,302.06
Rate for Payer: Meridian Medicaid	$10,817.16
Rate for Payer: Priority Health Choice Medicaid	$10,302.06
Rate for Payer: UHC Medicaid	$10,302.06
Rate for Payer: UHCCP Medicaid	$10,302.06

OTHER KIDNEY, URINARY TRACT AND RELATED NON-PERCUTANEOUS PROCEDURES

Facility

$23,625.23

Service Code	APR-DRG 4474
Min. Negotiated Rate	$22,500.22
Max. Negotiated Rate	$23,625.23
Rate for Payer: BCBS Complete	$23,625.23
Rate for Payer: Mclaren Medicaid	$22,500.22
Rate for Payer: Meridian Medicaid	$23,625.23
Rate for Payer: Priority Health Choice Medicaid	$22,500.22
Rate for Payer: UHC Medicaid	$22,500.22
Rate for Payer: UHCCP Medicaid	$22,500.22

OTHER KIDNEY, URINARY TRACT AND RELATED NON-PERCUTANEOUS PROCEDURES

Facility

$9,351.67

Service Code	APR-DRG 4471
Min. Negotiated Rate	$8,906.35
Max. Negotiated Rate	$9,351.67
Rate for Payer: BCBS Complete	$9,351.67
Rate for Payer: Mclaren Medicaid	$8,906.35
Rate for Payer: Meridian Medicaid	$9,351.67
Rate for Payer: Priority Health Choice Medicaid	$8,906.35
Rate for Payer: UHC Medicaid	$8,906.35
Rate for Payer: UHCCP Medicaid	$8,906.35

OTHER KIDNEY, URINARY TRACT AND RELATED PERCUTANEOUS PROCEDURES

Facility

$8,037.51

Service Code	APR-DRG 4481
Min. Negotiated Rate	$7,654.77
Max. Negotiated Rate	$8,037.51
Rate for Payer: BCBS Complete	$8,037.51
Rate for Payer: Mclaren Medicaid	$7,654.77
Rate for Payer: Meridian Medicaid	$8,037.51
Rate for Payer: Priority Health Choice Medicaid	$7,654.77
Rate for Payer: UHC Medicaid	$7,654.77
Rate for Payer: UHCCP Medicaid	$7,654.77

OTHER KIDNEY, URINARY TRACT AND RELATED PERCUTANEOUS PROCEDURES

Facility

$10,030.24

Service Code	APR-DRG 4482
Min. Negotiated Rate	$9,552.60
Max. Negotiated Rate	$10,030.24
Rate for Payer: BCBS Complete	$10,030.24
Rate for Payer: Mclaren Medicaid	$9,552.60
Rate for Payer: Meridian Medicaid	$10,030.24
Rate for Payer: Priority Health Choice Medicaid	$9,552.60
Rate for Payer: UHC Medicaid	$9,552.60
Rate for Payer: UHCCP Medicaid	$9,552.60

OTHER KIDNEY, URINARY TRACT AND RELATED PERCUTANEOUS PROCEDURES

Facility

$23,168.21

Service Code	APR-DRG 4484
Min. Negotiated Rate	$22,064.96
Max. Negotiated Rate	$23,168.21
Rate for Payer: BCBS Complete	$23,168.21
Rate for Payer: Mclaren Medicaid	$22,064.96
Rate for Payer: Meridian Medicaid	$23,168.21
Rate for Payer: Priority Health Choice Medicaid	$22,064.96
Rate for Payer: UHC Medicaid	$22,064.96
Rate for Payer: UHCCP Medicaid	$22,064.96

OTHER KIDNEY, URINARY TRACT AND RELATED PERCUTANEOUS PROCEDURES

Facility

$13,665.82

Service Code	APR-DRG 4483
Min. Negotiated Rate	$13,015.06
Max. Negotiated Rate	$13,665.82
Rate for Payer: BCBS Complete	$13,665.82
Rate for Payer: Mclaren Medicaid	$13,015.06
Rate for Payer: Meridian Medicaid	$13,665.82
Rate for Payer: Priority Health Choice Medicaid	$13,015.06
Rate for Payer: UHC Medicaid	$13,015.06
Rate for Payer: UHCCP Medicaid	$13,015.06

OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC

Facility

$74,828.68

Service Code	MSDRG 271
Min. Negotiated Rate	$28,816.56
Max. Negotiated Rate	$74,828.68
Rate for Payer: Aetna Medicare	$31,546.55
Rate for Payer: Allen County Amish Medical Aid Commercial	$37,916.53
Rate for Payer: Amish Plain Church Group Commercial	$37,916.53
Rate for Payer: BCBS MAPPO	$30,333.22
Rate for Payer: BCBS Trust/PPO	$74,828.68
Rate for Payer: BCN Commercial	$74,828.68
Rate for Payer: BCN Medicare Advantage	$30,333.22
Rate for Payer: Health Alliance Plan Medicare Advantage	$30,333.22
Rate for Payer: Mclaren Medicare	$30,333.22
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$31,849.88
Rate for Payer: MI Amish Medical Board Commercial	$34,883.20
Rate for Payer: Molina Medicare/Medicaid	$33,366.54
Rate for Payer: Nomi Health Commercial	$45,876.27
Rate for Payer: PACE Medicare	$28,816.56
Rate for Payer: PACE SWMI	$30,333.22
Rate for Payer: PHP Medicare Advantage	$30,333.22
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$57,335.17
Rate for Payer: Priority Health Medicare	$30,333.22
Rate for Payer: Priority Health Tiered Network	$45,868.13
Rate for Payer: Railroad Medicare Medicare	$30,333.22
Rate for Payer: UHC All Payor (Choice/PPO)	$57,967.69
Rate for Payer: UHC Core	$48,497.26
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$30,333.22
Rate for Payer: UHC Exchange	$39,606.51
Rate for Payer: VA VA	$30,333.22

OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC

Facility

$118,187.54

Service Code	MSDRG 270
Min. Negotiated Rate	$42,481.19
Max. Negotiated Rate	$118,187.54
Rate for Payer: Aetna Medicare	$46,505.72
Rate for Payer: Allen County Amish Medical Aid Commercial	$55,896.30
Rate for Payer: Amish Plain Church Group Commercial	$55,896.30
Rate for Payer: BCBS MAPPO	$44,717.04
Rate for Payer: BCBS Trust/PPO	$118,187.54
Rate for Payer: BCN Commercial	$118,187.54
Rate for Payer: BCN Medicare Advantage	$44,717.04
Rate for Payer: Health Alliance Plan Medicare Advantage	$44,717.04
Rate for Payer: Mclaren Medicare	$44,717.04
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$46,952.89
Rate for Payer: MI Amish Medical Board Commercial	$51,424.60
Rate for Payer: Molina Medicare/Medicaid	$49,188.74
Rate for Payer: Nomi Health Commercial	$68,064.27
Rate for Payer: PACE Medicare	$42,481.19
Rate for Payer: PACE SWMI	$44,717.04
Rate for Payer: PHP Medicare Advantage	$44,717.04
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$85,065.25
Rate for Payer: Priority Health Medicare	$44,717.04
Rate for Payer: Priority Health Tiered Network	$68,052.19
Rate for Payer: Railroad Medicare Medicare	$44,717.04
Rate for Payer: UHC All Payor (Choice/PPO)	$86,003.69
Rate for Payer: UHC Core	$71,952.90
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$44,717.04
Rate for Payer: UHC Exchange	$58,762.15
Rate for Payer: VA VA	$44,717.04

OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC

Facility

$54,649.45

Service Code	MSDRG 272
Min. Negotiated Rate	$20,845.77
Max. Negotiated Rate	$54,649.45
Rate for Payer: Aetna Medicare	$22,820.64
Rate for Payer: Allen County Amish Medical Aid Commercial	$27,428.65
Rate for Payer: Amish Plain Church Group Commercial	$27,428.65
Rate for Payer: BCBS MAPPO	$21,942.92
Rate for Payer: BCBS Trust/PPO	$54,649.45
Rate for Payer: BCN Commercial	$54,649.45
Rate for Payer: BCN Medicare Advantage	$21,942.92
Rate for Payer: Health Alliance Plan Medicare Advantage	$21,942.92
Rate for Payer: Mclaren Medicare	$21,942.92
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$23,040.07
Rate for Payer: MI Amish Medical Board Commercial	$25,234.36
Rate for Payer: Molina Medicare/Medicaid	$24,137.21
Rate for Payer: Nomi Health Commercial	$32,933.70
Rate for Payer: PACE Medicare	$20,845.77
Rate for Payer: PACE SWMI	$21,942.92
Rate for Payer: PHP Medicare Advantage	$21,942.92
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$41,159.82
Rate for Payer: Priority Health Medicare	$21,942.92
Rate for Payer: Priority Health Tiered Network	$32,927.85
Rate for Payer: Railroad Medicare Medicare	$21,942.92
Rate for Payer: UHC All Payor (Choice/PPO)	$41,613.90
Rate for Payer: UHC Core	$34,815.26
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$21,942.92
Rate for Payer: UHC Exchange	$28,432.76
Rate for Payer: VA VA	$21,942.92

OTHER MAJOR HEAD AND NECK PROCEDURES

Facility

$45,041.63

Service Code	APR-DRG 0914
Min. Negotiated Rate	$42,896.79
Max. Negotiated Rate	$45,041.63
Rate for Payer: BCBS Complete	$45,041.63
Rate for Payer: Mclaren Medicaid	$42,896.79
Rate for Payer: Meridian Medicaid	$45,041.63
Rate for Payer: Priority Health Choice Medicaid	$42,896.79
Rate for Payer: UHC Medicaid	$42,896.79
Rate for Payer: UHCCP Medicaid	$42,896.79

OTHER MAJOR HEAD AND NECK PROCEDURES

Facility

$41,686.31

Service Code	APR-DRG 0913
Min. Negotiated Rate	$39,701.25
Max. Negotiated Rate	$41,686.31
Rate for Payer: BCBS Complete	$41,686.31
Rate for Payer: Mclaren Medicaid	$39,701.25
Rate for Payer: Meridian Medicaid	$41,686.31
Rate for Payer: Priority Health Choice Medicaid	$39,701.25
Rate for Payer: UHC Medicaid	$39,701.25
Rate for Payer: UHCCP Medicaid	$39,701.25

OTHER MAJOR HEAD AND NECK PROCEDURES

Facility

$30,497.48

Service Code	APR-DRG 0912
Min. Negotiated Rate	$29,045.22
Max. Negotiated Rate	$30,497.48
Rate for Payer: BCBS Complete	$30,497.48
Rate for Payer: Mclaren Medicaid	$29,045.22
Rate for Payer: Meridian Medicaid	$30,497.48
Rate for Payer: Priority Health Choice Medicaid	$29,045.22
Rate for Payer: UHC Medicaid	$29,045.22
Rate for Payer: UHCCP Medicaid	$29,045.22

OTHER MAJOR HEAD AND NECK PROCEDURES

Facility

$14,341.36

Service Code	APR-DRG 0911
Min. Negotiated Rate	$13,658.44
Max. Negotiated Rate	$14,341.36
Rate for Payer: BCBS Complete	$14,341.36
Rate for Payer: Mclaren Medicaid	$13,658.44
Rate for Payer: Meridian Medicaid	$14,341.36
Rate for Payer: Priority Health Choice Medicaid	$13,658.44
Rate for Payer: UHC Medicaid	$13,658.44
Rate for Payer: UHCCP Medicaid	$13,658.44

OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES

Facility

$9,527.82

Service Code	APR-DRG 4841
Min. Negotiated Rate	$9,074.11
Max. Negotiated Rate	$9,527.82
Rate for Payer: BCBS Complete	$9,527.82
Rate for Payer: Mclaren Medicaid	$9,074.11
Rate for Payer: Meridian Medicaid	$9,527.82
Rate for Payer: Priority Health Choice Medicaid	$9,074.11
Rate for Payer: UHC Medicaid	$9,074.11
Rate for Payer: UHCCP Medicaid	$9,074.11

OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES

Facility

$31,600.99

Service Code	APR-DRG 4844
Min. Negotiated Rate	$30,096.18
Max. Negotiated Rate	$31,600.99
Rate for Payer: BCBS Complete	$31,600.99
Rate for Payer: Mclaren Medicaid	$30,096.18
Rate for Payer: Meridian Medicaid	$31,600.99
Rate for Payer: Priority Health Choice Medicaid	$30,096.18
Rate for Payer: UHC Medicaid	$30,096.18
Rate for Payer: UHCCP Medicaid	$30,096.18

OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES

Facility

$16,959.39

Service Code	APR-DRG 4843
Min. Negotiated Rate	$16,151.80
Max. Negotiated Rate	$16,959.39
Rate for Payer: BCBS Complete	$16,959.39
Rate for Payer: Mclaren Medicaid	$16,151.80
Rate for Payer: Meridian Medicaid	$16,959.39
Rate for Payer: Priority Health Choice Medicaid	$16,151.80
Rate for Payer: UHC Medicaid	$16,151.80
Rate for Payer: UHCCP Medicaid	$16,151.80

OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES

Facility

$12,098.03

Service Code	APR-DRG 4842
Min. Negotiated Rate	$11,521.93
Max. Negotiated Rate	$12,098.03
Rate for Payer: BCBS Complete	$12,098.03
Rate for Payer: Mclaren Medicaid	$11,521.93
Rate for Payer: Meridian Medicaid	$12,098.03
Rate for Payer: Priority Health Choice Medicaid	$11,521.93
Rate for Payer: UHC Medicaid	$11,521.93
Rate for Payer: UHCCP Medicaid	$11,521.93

OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC

Facility

$22,940.80

Service Code	MSDRG 729
Min. Negotiated Rate	$8,974.21
Max. Negotiated Rate	$22,940.80
Rate for Payer: Aetna Medicare	$9,824.40
Rate for Payer: Allen County Amish Medical Aid Commercial	$11,808.17
Rate for Payer: Amish Plain Church Group Commercial	$11,808.17
Rate for Payer: BCBS MAPPO	$9,446.54
Rate for Payer: BCBS Trust/PPO	$22,940.80
Rate for Payer: BCN Commercial	$22,940.80
Rate for Payer: BCN Medicare Advantage	$9,446.54
Rate for Payer: Health Alliance Plan Medicare Advantage	$9,446.54
Rate for Payer: Mclaren Medicare	$9,446.54
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$9,918.87
Rate for Payer: MI Amish Medical Board Commercial	$10,863.52
Rate for Payer: Molina Medicare/Medicaid	$10,391.19
Rate for Payer: Nomi Health Commercial	$13,657.23
Rate for Payer: PACE Medicare	$8,974.21
Rate for Payer: PACE SWMI	$9,446.54
Rate for Payer: PHP Medicare Advantage	$9,446.54
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$17,068.51
Rate for Payer: Priority Health Medicare	$9,446.54
Rate for Payer: Priority Health Tiered Network	$13,654.81
Rate for Payer: Railroad Medicare Medicare	$9,446.54
Rate for Payer: UHC All Payor (Choice/PPO)	$17,256.81
Rate for Payer: UHC Core	$14,437.49
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$9,446.54
Rate for Payer: UHC Exchange	$11,790.74
Rate for Payer: VA VA	$9,446.54

OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC

Facility

$15,504.32

Service Code	MSDRG 730
Min. Negotiated Rate	$5,902.06
Max. Negotiated Rate	$15,504.32
Rate for Payer: Aetna Medicare	$6,461.20
Rate for Payer: Allen County Amish Medical Aid Commercial	$7,765.86
Rate for Payer: Amish Plain Church Group Commercial	$7,765.86
Rate for Payer: BCBS MAPPO	$6,212.69
Rate for Payer: BCBS Trust/PPO	$15,504.32
Rate for Payer: BCN Commercial	$15,504.32
Rate for Payer: BCN Medicare Advantage	$6,212.69
Rate for Payer: Health Alliance Plan Medicare Advantage	$6,212.69
Rate for Payer: Mclaren Medicare	$6,212.69
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$6,523.32
Rate for Payer: MI Amish Medical Board Commercial	$7,144.59
Rate for Payer: Molina Medicare/Medicaid	$6,833.96
Rate for Payer: Nomi Health Commercial	$8,668.80
Rate for Payer: PACE Medicare	$5,902.06
Rate for Payer: PACE SWMI	$6,212.69
Rate for Payer: PHP Medicare Advantage	$6,212.69
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$10,834.08
Rate for Payer: Priority Health Medicare	$6,212.69
Rate for Payer: Priority Health Tiered Network	$8,667.26
Rate for Payer: Railroad Medicare Medicare	$6,212.69
Rate for Payer: UHC All Payor (Choice/PPO)	$10,953.60
Rate for Payer: UHC Core	$9,164.06
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$6,212.69
Rate for Payer: UHC Exchange	$7,484.06
Rate for Payer: VA VA	$6,212.69

OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC

Facility

$32,153.36

Service Code	MSDRG 717
Min. Negotiated Rate	$15,582.52
Max. Negotiated Rate	$32,153.36
Rate for Payer: Aetna Medicare	$17,058.76
Rate for Payer: Allen County Amish Medical Aid Commercial	$20,503.31
Rate for Payer: Amish Plain Church Group Commercial	$20,503.31
Rate for Payer: BCBS MAPPO	$16,402.65
Rate for Payer: BCBS Trust/PPO	$32,153.36
Rate for Payer: BCN Commercial	$32,153.36
Rate for Payer: BCN Medicare Advantage	$16,402.65
Rate for Payer: Health Alliance Plan Medicare Advantage	$16,402.65
Rate for Payer: Mclaren Medicare	$16,402.65
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$17,222.78
Rate for Payer: MI Amish Medical Board Commercial	$18,863.05
Rate for Payer: Molina Medicare/Medicaid	$18,042.92
Rate for Payer: Nomi Health Commercial	$24,387.45
Rate for Payer: PACE Medicare	$15,582.52
Rate for Payer: PACE SWMI	$16,402.65
Rate for Payer: PHP Medicare Advantage	$16,402.65
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$30,478.91
Rate for Payer: Priority Health Medicare	$16,402.65
Rate for Payer: Priority Health Tiered Network	$24,383.12
Rate for Payer: Railroad Medicare Medicare	$16,402.65
Rate for Payer: UHC All Payor (Choice/PPO)	$30,815.15
Rate for Payer: UHC Core	$25,780.75
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$16,402.65
Rate for Payer: UHC Exchange	$21,054.50
Rate for Payer: VA VA	$16,402.65

OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC

Facility

$21,947.07

Service Code	MSDRG 718
Min. Negotiated Rate	$11,233.66
Max. Negotiated Rate	$21,947.07
Rate for Payer: Aetna Medicare	$12,297.91
Rate for Payer: Allen County Amish Medical Aid Commercial	$14,781.14
Rate for Payer: Amish Plain Church Group Commercial	$14,781.14
Rate for Payer: BCBS MAPPO	$11,824.91
Rate for Payer: BCBS Trust/PPO	$21,947.07
Rate for Payer: BCN Commercial	$21,947.07
Rate for Payer: BCN Medicare Advantage	$11,824.91
Rate for Payer: Health Alliance Plan Medicare Advantage	$11,824.91
Rate for Payer: Mclaren Medicare	$11,824.91
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$12,416.16
Rate for Payer: MI Amish Medical Board Commercial	$13,598.65
Rate for Payer: Molina Medicare/Medicaid	$13,007.40
Rate for Payer: Nomi Health Commercial	$17,325.99
Rate for Payer: PACE Medicare	$11,233.66
Rate for Payer: PACE SWMI	$11,824.91
Rate for Payer: PHP Medicare Advantage	$11,824.91
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$21,653.65
Rate for Payer: Priority Health Medicare	$11,824.91
Rate for Payer: Priority Health Tiered Network	$17,322.91
Rate for Payer: Railroad Medicare Medicare	$11,824.91
Rate for Payer: UHC All Payor (Choice/PPO)	$21,892.53
Rate for Payer: UHC Core	$18,315.85
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$11,824.91
Rate for Payer: UHC Exchange	$14,958.10
Rate for Payer: VA VA	$11,824.91

OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC

Facility

$57,048.67

Service Code	MSDRG 715
Min. Negotiated Rate	$18,337.69
Max. Negotiated Rate	$57,048.67
Rate for Payer: Aetna Medicare	$20,074.94
Rate for Payer: Allen County Amish Medical Aid Commercial	$24,128.54
Rate for Payer: Amish Plain Church Group Commercial	$24,128.54
Rate for Payer: BCBS MAPPO	$19,302.83
Rate for Payer: BCBS Trust/PPO	$57,048.67
Rate for Payer: BCN Commercial	$57,048.67
Rate for Payer: BCN Medicare Advantage	$19,302.83
Rate for Payer: Health Alliance Plan Medicare Advantage	$19,302.83
Rate for Payer: Mclaren Medicare	$19,302.83
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$20,267.97
Rate for Payer: MI Amish Medical Board Commercial	$22,198.25
Rate for Payer: Molina Medicare/Medicaid	$21,233.11
Rate for Payer: Nomi Health Commercial	$28,861.17
Rate for Payer: PACE Medicare	$18,337.69
Rate for Payer: PACE SWMI	$19,302.83
Rate for Payer: PHP Medicare Advantage	$19,302.83
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$36,070.06
Rate for Payer: Priority Health Medicare	$19,302.83
Rate for Payer: Priority Health Tiered Network	$28,856.05
Rate for Payer: Railroad Medicare Medicare	$19,302.83
Rate for Payer: UHC All Payor (Choice/PPO)	$36,467.99
Rate for Payer: UHC Core	$30,510.06
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$19,302.83
Rate for Payer: UHC Exchange	$24,916.81
Rate for Payer: VA VA	$19,302.83

OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC

Facility

$37,396.50

Service Code	MSDRG 716
Min. Negotiated Rate	$12,249.77
Max. Negotiated Rate	$37,396.50
Rate for Payer: Aetna Medicare	$13,410.27
Rate for Payer: Allen County Amish Medical Aid Commercial	$16,118.11
Rate for Payer: Amish Plain Church Group Commercial	$16,118.11
Rate for Payer: BCBS MAPPO	$12,894.49
Rate for Payer: BCBS Trust/PPO	$37,396.50
Rate for Payer: BCN Commercial	$37,396.50
Rate for Payer: BCN Medicare Advantage	$12,894.49
Rate for Payer: Health Alliance Plan Medicare Advantage	$12,894.49
Rate for Payer: Mclaren Medicare	$12,894.49
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$13,539.21
Rate for Payer: MI Amish Medical Board Commercial	$14,828.66
Rate for Payer: Molina Medicare/Medicaid	$14,183.94
Rate for Payer: Nomi Health Commercial	$18,975.90
Rate for Payer: PACE Medicare	$12,249.77
Rate for Payer: PACE SWMI	$12,894.49
Rate for Payer: PHP Medicare Advantage	$12,894.49
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$23,715.67
Rate for Payer: Priority Health Medicare	$12,894.49
Rate for Payer: Priority Health Tiered Network	$18,972.53
Rate for Payer: Railroad Medicare Medicare	$12,894.49
Rate for Payer: UHC All Payor (Choice/PPO)	$23,977.30
Rate for Payer: UHC Core	$20,060.03
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$12,894.49
Rate for Payer: UHC Exchange	$16,382.53
Rate for Payer: VA VA	$12,894.49

OTHER MENTAL DISORDER DIAGNOSES

Facility

$19,210.21

Service Code	MSDRG 887
Min. Negotiated Rate	$1,069.00
Max. Negotiated Rate	$19,210.21
Rate for Payer: Aetna Medicare	$9,930.53
Rate for Payer: Allen County Amish Medical Aid Commercial	$11,935.74
Rate for Payer: Amish Plain Church Group Commercial	$11,935.74
Rate for Payer: BCBS MAPPO	$9,548.59
Rate for Payer: BCBS Trust/PPO	$19,210.21
Rate for Payer: BCN Commercial	$19,210.21
Rate for Payer: BCN Medicare Advantage	$9,548.59
Rate for Payer: Health Alliance Plan Medicare Advantage	$9,548.59
Rate for Payer: Mclaren Medicare	$9,548.59
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$10,026.02
Rate for Payer: MI Amish Medical Board Commercial	$10,980.88
Rate for Payer: Molina Medicare/Medicaid	$10,503.45
Rate for Payer: Nomi Health Commercial	$1,069.00
Rate for Payer: PACE Medicare	$9,071.16
Rate for Payer: PACE SWMI	$9,548.59
Rate for Payer: PHP Medicare Advantage	$9,548.59
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$17,265.20
Rate for Payer: Priority Health Medicare	$9,548.59
Rate for Payer: Priority Health Tiered Network	$13,812.16
Rate for Payer: Railroad Medicare Medicare	$9,548.59
Rate for Payer: UHC All Payor (Choice/PPO)	$17,455.67
Rate for Payer: UHC Core	$14,603.86
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$9,548.59
Rate for Payer: UHC Exchange	$11,926.61
Rate for Payer: VA VA	$9,548.59

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