Bronson Methodist Hospital

All Charges

Charge

Type

Setting

Price

OTHER NERVOUS SYSTEM AND RELATED PROCEDURES

Facility

$13,693.66

Service Code	APR-DRG 0262
Min. Negotiated Rate	$13,041.58
Max. Negotiated Rate	$13,693.66
Rate for Payer: BCBS Complete	$13,693.66
Rate for Payer: Mclaren Medicaid	$13,041.58
Rate for Payer: Meridian Medicaid	$13,693.66
Rate for Payer: Priority Health Choice Medicaid	$13,041.58
Rate for Payer: UHC Medicaid	$13,041.58
Rate for Payer: UHCCP Medicaid	$13,041.58

OTHER NERVOUS SYSTEM AND RELATED PROCEDURES

Facility

$20,728.14

Service Code	APR-DRG 0264
Min. Negotiated Rate	$19,741.09
Max. Negotiated Rate	$20,728.14
Rate for Payer: BCBS Complete	$20,728.14
Rate for Payer: Mclaren Medicaid	$19,741.09
Rate for Payer: Meridian Medicaid	$20,728.14
Rate for Payer: Priority Health Choice Medicaid	$19,741.09
Rate for Payer: UHC Medicaid	$19,741.09
Rate for Payer: UHCCP Medicaid	$19,741.09

OTHER NERVOUS SYSTEM AND RELATED PROCEDURES

Facility

$14,263.27

Service Code	APR-DRG 0263
Min. Negotiated Rate	$13,584.07
Max. Negotiated Rate	$14,263.27
Rate for Payer: BCBS Complete	$14,263.27
Rate for Payer: Mclaren Medicaid	$13,584.07
Rate for Payer: Meridian Medicaid	$14,263.27
Rate for Payer: Priority Health Choice Medicaid	$13,584.07
Rate for Payer: UHC Medicaid	$13,584.07
Rate for Payer: UHCCP Medicaid	$13,584.07

OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS

Facility

$4,395.87

Service Code	APR-DRG 4252
Min. Negotiated Rate	$4,186.54
Max. Negotiated Rate	$4,395.87
Rate for Payer: BCBS Complete	$4,395.87
Rate for Payer: Mclaren Medicaid	$4,186.54
Rate for Payer: Meridian Medicaid	$4,395.87
Rate for Payer: Priority Health Choice Medicaid	$4,186.54
Rate for Payer: UHC Medicaid	$4,186.54
Rate for Payer: UHCCP Medicaid	$4,186.54

OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS

Facility

$6,243.32

Service Code	APR-DRG 4253
Min. Negotiated Rate	$5,946.02
Max. Negotiated Rate	$6,243.32
Rate for Payer: BCBS Complete	$6,243.32
Rate for Payer: Mclaren Medicaid	$5,946.02
Rate for Payer: Meridian Medicaid	$6,243.32
Rate for Payer: Priority Health Choice Medicaid	$5,946.02
Rate for Payer: UHC Medicaid	$5,946.02
Rate for Payer: UHCCP Medicaid	$5,946.02

OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS

Facility

$3,075.66

Service Code	APR-DRG 4251
Min. Negotiated Rate	$2,929.20
Max. Negotiated Rate	$3,075.66
Rate for Payer: BCBS Complete	$3,075.66
Rate for Payer: Mclaren Medicaid	$2,929.20
Rate for Payer: Meridian Medicaid	$3,075.66
Rate for Payer: Priority Health Choice Medicaid	$2,929.20
Rate for Payer: UHC Medicaid	$2,929.20
Rate for Payer: UHCCP Medicaid	$2,929.20

OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS

Facility

$12,248.75

Service Code	APR-DRG 4254
Min. Negotiated Rate	$11,665.48
Max. Negotiated Rate	$12,248.75
Rate for Payer: BCBS Complete	$12,248.75
Rate for Payer: Mclaren Medicaid	$11,665.48
Rate for Payer: Meridian Medicaid	$12,248.75
Rate for Payer: Priority Health Choice Medicaid	$11,665.48
Rate for Payer: UHC Medicaid	$11,665.48
Rate for Payer: UHCCP Medicaid	$11,665.48

OTHER OPEN CRANIOTOMY

Facility

$27,547.74

Service Code	APR-DRG 0274
Min. Negotiated Rate	$26,235.94
Max. Negotiated Rate	$27,547.74
Rate for Payer: BCBS Complete	$27,547.74
Rate for Payer: Mclaren Medicaid	$26,235.94
Rate for Payer: Meridian Medicaid	$27,547.74
Rate for Payer: Priority Health Choice Medicaid	$26,235.94
Rate for Payer: UHC Medicaid	$26,235.94
Rate for Payer: UHCCP Medicaid	$26,235.94

OTHER OPEN CRANIOTOMY

Facility

$19,332.26

Service Code	APR-DRG 0273
Min. Negotiated Rate	$18,411.68
Max. Negotiated Rate	$19,332.26
Rate for Payer: BCBS Complete	$19,332.26
Rate for Payer: Mclaren Medicaid	$18,411.68
Rate for Payer: Meridian Medicaid	$19,332.26
Rate for Payer: Priority Health Choice Medicaid	$18,411.68
Rate for Payer: UHC Medicaid	$18,411.68
Rate for Payer: UHCCP Medicaid	$18,411.68

OTHER OPEN CRANIOTOMY

Facility

$9,469.70

Service Code	APR-DRG 0271
Min. Negotiated Rate	$9,018.77
Max. Negotiated Rate	$9,469.70
Rate for Payer: BCBS Complete	$9,469.70
Rate for Payer: Mclaren Medicaid	$9,018.77
Rate for Payer: Meridian Medicaid	$9,469.70
Rate for Payer: Priority Health Choice Medicaid	$9,018.77
Rate for Payer: UHC Medicaid	$9,018.77
Rate for Payer: UHCCP Medicaid	$9,018.77

OTHER OPEN CRANIOTOMY

Facility

$13,445.48

Service Code	APR-DRG 0272
Min. Negotiated Rate	$12,805.22
Max. Negotiated Rate	$13,445.48
Rate for Payer: BCBS Complete	$13,445.48
Rate for Payer: Mclaren Medicaid	$12,805.22
Rate for Payer: Meridian Medicaid	$13,445.48
Rate for Payer: Priority Health Choice Medicaid	$12,805.22
Rate for Payer: UHC Medicaid	$12,805.22
Rate for Payer: UHCCP Medicaid	$12,805.22

OTHER O.R. PROCEDURES FOR INJURIES WITH CC

Facility

$38,250.22

Service Code	MSDRG 908
Min. Negotiated Rate	$16,414.33
Max. Negotiated Rate	$38,250.22
Rate for Payer: Aetna Medicare	$17,969.37
Rate for Payer: Allen County Amish Medical Aid Commercial	$21,597.80
Rate for Payer: Amish Plain Church Group Commercial	$21,597.80
Rate for Payer: BCBS MAPPO	$17,278.24
Rate for Payer: BCBS Trust/PPO	$38,250.22
Rate for Payer: BCN Commercial	$38,250.22
Rate for Payer: BCN Medicare Advantage	$17,278.24
Rate for Payer: Health Alliance Plan Medicare Advantage	$17,278.24
Rate for Payer: Mclaren Medicare	$17,278.24
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$18,142.15
Rate for Payer: MI Amish Medical Board Commercial	$19,869.98
Rate for Payer: Molina Medicare/Medicaid	$19,006.06
Rate for Payer: Nomi Health Commercial	$25,738.08
Rate for Payer: PACE Medicare	$16,414.33
Rate for Payer: PACE SWMI	$17,278.24
Rate for Payer: PHP Medicare Advantage	$17,278.24
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$32,166.89
Rate for Payer: Priority Health Medicare	$17,278.24
Rate for Payer: Priority Health Tiered Network	$25,733.51
Rate for Payer: Railroad Medicare Medicare	$17,278.24
Rate for Payer: UHC All Payor (Choice/PPO)	$32,521.76
Rate for Payer: UHC Core	$27,208.54
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$17,278.24
Rate for Payer: UHC Exchange	$22,220.54
Rate for Payer: VA VA	$17,278.24

OTHER O.R. PROCEDURES FOR INJURIES WITH MCC

Facility

$75,034.56

Service Code	MSDRG 907
Min. Negotiated Rate	$31,064.86
Max. Negotiated Rate	$75,034.56
Rate for Payer: Aetna Medicare	$34,007.84
Rate for Payer: Allen County Amish Medical Aid Commercial	$40,874.81
Rate for Payer: Amish Plain Church Group Commercial	$40,874.81
Rate for Payer: BCBS MAPPO	$32,699.85
Rate for Payer: BCBS Trust/PPO	$75,034.56
Rate for Payer: BCN Commercial	$75,034.56
Rate for Payer: BCN Medicare Advantage	$32,699.85
Rate for Payer: Health Alliance Plan Medicare Advantage	$32,699.85
Rate for Payer: Mclaren Medicare	$32,699.85
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$34,334.84
Rate for Payer: MI Amish Medical Board Commercial	$37,604.83
Rate for Payer: Molina Medicare/Medicaid	$35,969.83
Rate for Payer: Nomi Health Commercial	$49,526.97
Rate for Payer: PACE Medicare	$31,064.86
Rate for Payer: PACE SWMI	$32,699.85
Rate for Payer: PHP Medicare Advantage	$32,699.85
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$61,897.73
Rate for Payer: Priority Health Medicare	$32,699.85
Rate for Payer: Priority Health Tiered Network	$49,518.18
Rate for Payer: Railroad Medicare Medicare	$32,699.85
Rate for Payer: UHC All Payor (Choice/PPO)	$62,580.59
Rate for Payer: UHC Core	$52,356.53
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$32,699.85
Rate for Payer: UHC Exchange	$42,758.28
Rate for Payer: VA VA	$32,699.85

OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC

Facility

$25,054.53

Service Code	MSDRG 909
Min. Negotiated Rate	$10,992.16
Max. Negotiated Rate	$25,054.53
Rate for Payer: Aetna Medicare	$12,033.52
Rate for Payer: Allen County Amish Medical Aid Commercial	$14,463.36
Rate for Payer: Amish Plain Church Group Commercial	$14,463.36
Rate for Payer: BCBS MAPPO	$11,570.69
Rate for Payer: BCBS Trust/PPO	$25,054.53
Rate for Payer: BCN Commercial	$25,054.53
Rate for Payer: BCN Medicare Advantage	$11,570.69
Rate for Payer: Health Alliance Plan Medicare Advantage	$11,570.69
Rate for Payer: Mclaren Medicare	$11,570.69
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$12,149.22
Rate for Payer: MI Amish Medical Board Commercial	$13,306.29
Rate for Payer: Molina Medicare/Medicaid	$12,727.76
Rate for Payer: Nomi Health Commercial	$16,933.83
Rate for Payer: PACE Medicare	$10,992.16
Rate for Payer: PACE SWMI	$11,570.69
Rate for Payer: PHP Medicare Advantage	$11,570.69
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$21,163.53
Rate for Payer: Priority Health Medicare	$11,570.69
Rate for Payer: Priority Health Tiered Network	$16,930.82
Rate for Payer: Railroad Medicare Medicare	$11,570.69
Rate for Payer: UHC All Payor (Choice/PPO)	$21,397.01
Rate for Payer: UHC Core	$17,901.29
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$11,570.69
Rate for Payer: UHC Exchange	$14,619.54
Rate for Payer: VA VA	$11,570.69

OTHER O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS

Facility

$13,038.10

Service Code	APR-DRG 6812
Min. Negotiated Rate	$12,417.23
Max. Negotiated Rate	$13,038.10
Rate for Payer: BCBS Complete	$13,038.10
Rate for Payer: Mclaren Medicaid	$12,417.23
Rate for Payer: Meridian Medicaid	$13,038.10
Rate for Payer: Priority Health Choice Medicaid	$12,417.23
Rate for Payer: UHC Medicaid	$12,417.23
Rate for Payer: UHCCP Medicaid	$12,417.23

OTHER O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS

Facility

$10,233.02

Service Code	APR-DRG 6811
Min. Negotiated Rate	$9,745.73
Max. Negotiated Rate	$10,233.02
Rate for Payer: BCBS Complete	$10,233.02
Rate for Payer: Mclaren Medicaid	$9,745.73
Rate for Payer: Meridian Medicaid	$10,233.02
Rate for Payer: Priority Health Choice Medicaid	$9,745.73
Rate for Payer: UHC Medicaid	$9,745.73
Rate for Payer: UHCCP Medicaid	$9,745.73

OTHER O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS

Facility

$34,591.30

Service Code	APR-DRG 6814
Min. Negotiated Rate	$32,944.09
Max. Negotiated Rate	$34,591.30
Rate for Payer: BCBS Complete	$34,591.30
Rate for Payer: Mclaren Medicaid	$32,944.09
Rate for Payer: Meridian Medicaid	$34,591.30
Rate for Payer: Priority Health Choice Medicaid	$32,944.09
Rate for Payer: UHC Medicaid	$32,944.09
Rate for Payer: UHCCP Medicaid	$32,944.09

OTHER O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS

Facility

$15,907.94

Service Code	APR-DRG 6813
Min. Negotiated Rate	$15,150.42
Max. Negotiated Rate	$15,907.94
Rate for Payer: BCBS Complete	$15,907.94
Rate for Payer: Mclaren Medicaid	$15,150.42
Rate for Payer: Meridian Medicaid	$15,907.94
Rate for Payer: Priority Health Choice Medicaid	$15,150.42
Rate for Payer: UHC Medicaid	$15,150.42
Rate for Payer: UHCCP Medicaid	$15,150.42

OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC

Facility

$83,489.47

Service Code	MSDRG 958
Min. Negotiated Rate	$34,040.90
Max. Negotiated Rate	$83,489.47
Rate for Payer: Aetna Medicare	$37,265.83
Rate for Payer: Allen County Amish Medical Aid Commercial	$44,790.66
Rate for Payer: Amish Plain Church Group Commercial	$44,790.66
Rate for Payer: BCBS MAPPO	$35,832.53
Rate for Payer: BCBS Trust/PPO	$83,489.47
Rate for Payer: BCN Commercial	$83,489.47
Rate for Payer: BCN Medicare Advantage	$35,832.53
Rate for Payer: Health Alliance Plan Medicare Advantage	$35,832.53
Rate for Payer: Mclaren Medicare	$35,832.53
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$37,624.16
Rate for Payer: MI Amish Medical Board Commercial	$41,207.41
Rate for Payer: Molina Medicare/Medicaid	$39,415.78
Rate for Payer: Nomi Health Commercial	$54,359.31
Rate for Payer: PACE Medicare	$34,040.90
Rate for Payer: PACE SWMI	$35,832.53
Rate for Payer: PHP Medicare Advantage	$35,832.53
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$67,937.09
Rate for Payer: Priority Health Medicare	$35,832.53
Rate for Payer: Priority Health Tiered Network	$54,349.66
Rate for Payer: Railroad Medicare Medicare	$35,832.53
Rate for Payer: UHC All Payor (Choice/PPO)	$68,686.57
Rate for Payer: UHC Core	$57,464.95
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$35,832.53
Rate for Payer: UHC Exchange	$46,930.20
Rate for Payer: VA VA	$35,832.53

OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC

Facility

$175,831.89

Service Code	MSDRG 957
Min. Negotiated Rate	$61,100.07
Max. Negotiated Rate	$175,831.89
Rate for Payer: Aetna Medicare	$66,888.49
Rate for Payer: Allen County Amish Medical Aid Commercial	$80,394.82
Rate for Payer: Amish Plain Church Group Commercial	$80,394.82
Rate for Payer: BCBS MAPPO	$64,315.86
Rate for Payer: BCBS Trust/PPO	$175,831.89
Rate for Payer: BCN Commercial	$175,831.89
Rate for Payer: BCN Medicare Advantage	$64,315.86
Rate for Payer: Health Alliance Plan Medicare Advantage	$64,315.86
Rate for Payer: Mclaren Medicare	$64,315.86
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$67,531.65
Rate for Payer: MI Amish Medical Board Commercial	$73,963.24
Rate for Payer: Molina Medicare/Medicaid	$70,747.45
Rate for Payer: Nomi Health Commercial	$98,296.71
Rate for Payer: PACE Medicare	$61,100.07
Rate for Payer: PACE SWMI	$64,315.86
Rate for Payer: PHP Medicare Advantage	$64,315.86
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$122,849.09
Rate for Payer: Priority Health Medicare	$64,315.86
Rate for Payer: Priority Health Tiered Network	$98,279.26
Rate for Payer: Railroad Medicare Medicare	$64,315.86
Rate for Payer: UHC All Payor (Choice/PPO)	$124,204.37
Rate for Payer: UHC Core	$103,912.58
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$64,315.86
Rate for Payer: UHC Exchange	$84,862.83
Rate for Payer: VA VA	$64,315.86

OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC

Facility

$49,776.90

Service Code	MSDRG 959
Min. Negotiated Rate	$23,952.88
Max. Negotiated Rate	$49,776.90
Rate for Payer: Aetna Medicare	$26,222.10
Rate for Payer: Allen County Amish Medical Aid Commercial	$31,516.95
Rate for Payer: Amish Plain Church Group Commercial	$31,516.95
Rate for Payer: BCBS MAPPO	$25,213.56
Rate for Payer: BCBS Trust/PPO	$49,776.90
Rate for Payer: BCN Commercial	$49,776.90
Rate for Payer: BCN Medicare Advantage	$25,213.56
Rate for Payer: Health Alliance Plan Medicare Advantage	$25,213.56
Rate for Payer: Mclaren Medicare	$25,213.56
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$26,474.24
Rate for Payer: MI Amish Medical Board Commercial	$28,995.59
Rate for Payer: Molina Medicare/Medicaid	$27,734.92
Rate for Payer: Nomi Health Commercial	$37,978.89
Rate for Payer: PACE Medicare	$23,952.88
Rate for Payer: PACE SWMI	$25,213.56
Rate for Payer: PHP Medicare Advantage	$25,213.56
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$47,465.19
Rate for Payer: Priority Health Medicare	$25,213.56
Rate for Payer: Priority Health Tiered Network	$37,972.15
Rate for Payer: Railroad Medicare Medicare	$25,213.56
Rate for Payer: UHC All Payor (Choice/PPO)	$47,988.83
Rate for Payer: UHC Core	$40,148.69
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$25,213.56
Rate for Payer: UHC Exchange	$32,788.44
Rate for Payer: VA VA	$25,213.56

OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC

Facility

$36,323.16

Service Code	MSDRG 803
Min. Negotiated Rate	$15,331.45
Max. Negotiated Rate	$36,323.16
Rate for Payer: Aetna Medicare	$16,783.90
Rate for Payer: Allen County Amish Medical Aid Commercial	$20,172.96
Rate for Payer: Amish Plain Church Group Commercial	$20,172.96
Rate for Payer: BCBS MAPPO	$16,138.37
Rate for Payer: BCBS Trust/PPO	$36,323.16
Rate for Payer: BCN Commercial	$36,323.16
Rate for Payer: BCN Medicare Advantage	$16,138.37
Rate for Payer: Health Alliance Plan Medicare Advantage	$16,138.37
Rate for Payer: Mclaren Medicare	$16,138.37
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$16,945.29
Rate for Payer: MI Amish Medical Board Commercial	$18,559.13
Rate for Payer: Molina Medicare/Medicaid	$17,752.21
Rate for Payer: Nomi Health Commercial	$23,979.81
Rate for Payer: PACE Medicare	$15,331.45
Rate for Payer: PACE SWMI	$16,138.37
Rate for Payer: PHP Medicare Advantage	$16,138.37
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$29,969.45
Rate for Payer: Priority Health Medicare	$16,138.37
Rate for Payer: Priority Health Tiered Network	$23,975.55
Rate for Payer: Railroad Medicare Medicare	$16,138.37
Rate for Payer: UHC All Payor (Choice/PPO)	$30,300.07
Rate for Payer: UHC Core	$25,349.82
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$16,138.37
Rate for Payer: UHC Exchange	$20,702.57
Rate for Payer: VA VA	$16,138.37

OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC

Facility

$66,799.26

Service Code	MSDRG 802
Min. Negotiated Rate	$32,215.23
Max. Negotiated Rate	$66,799.26
Rate for Payer: Aetna Medicare	$35,267.20
Rate for Payer: Allen County Amish Medical Aid Commercial	$42,388.46
Rate for Payer: Amish Plain Church Group Commercial	$42,388.46
Rate for Payer: BCBS MAPPO	$33,910.77
Rate for Payer: BCBS Trust/PPO	$66,799.26
Rate for Payer: BCN Commercial	$66,799.26
Rate for Payer: BCN Medicare Advantage	$33,910.77
Rate for Payer: Health Alliance Plan Medicare Advantage	$33,910.77
Rate for Payer: Mclaren Medicare	$33,910.77
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$35,606.31
Rate for Payer: MI Amish Medical Board Commercial	$38,997.39
Rate for Payer: Molina Medicare/Medicaid	$37,301.85
Rate for Payer: Nomi Health Commercial	$51,394.89
Rate for Payer: PACE Medicare	$32,215.23
Rate for Payer: PACE SWMI	$33,910.77
Rate for Payer: PHP Medicare Advantage	$33,910.77
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$64,232.22
Rate for Payer: Priority Health Medicare	$33,910.77
Rate for Payer: Priority Health Tiered Network	$51,385.77
Rate for Payer: Railroad Medicare Medicare	$33,910.77
Rate for Payer: UHC All Payor (Choice/PPO)	$64,940.83
Rate for Payer: UHC Core	$54,331.17
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$33,910.77
Rate for Payer: UHC Exchange	$44,370.92
Rate for Payer: VA VA	$33,910.77

OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC

Facility

$34,796.89

Service Code	MSDRG 804
Min. Negotiated Rate	$11,336.15
Max. Negotiated Rate	$34,796.89
Rate for Payer: Aetna Medicare	$12,410.10
Rate for Payer: Allen County Amish Medical Aid Commercial	$14,915.99
Rate for Payer: Amish Plain Church Group Commercial	$14,915.99
Rate for Payer: BCBS MAPPO	$11,932.79
Rate for Payer: BCBS Trust/PPO	$34,796.89
Rate for Payer: BCN Commercial	$34,796.89
Rate for Payer: BCN Medicare Advantage	$11,932.79
Rate for Payer: Health Alliance Plan Medicare Advantage	$11,932.79
Rate for Payer: Mclaren Medicare	$11,932.79
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$12,529.43
Rate for Payer: MI Amish Medical Board Commercial	$13,722.71
Rate for Payer: Molina Medicare/Medicaid	$13,126.07
Rate for Payer: Nomi Health Commercial	$17,492.40
Rate for Payer: PACE Medicare	$11,336.15
Rate for Payer: PACE SWMI	$11,932.79
Rate for Payer: PHP Medicare Advantage	$11,932.79
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$21,861.62
Rate for Payer: Priority Health Medicare	$11,932.79
Rate for Payer: Priority Health Tiered Network	$17,489.29
Rate for Payer: Railroad Medicare Medicare	$11,932.79
Rate for Payer: UHC All Payor (Choice/PPO)	$22,102.80
Rate for Payer: UHC Core	$18,491.77
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$11,932.79
Rate for Payer: UHC Exchange	$15,101.77
Rate for Payer: VA VA	$11,932.79

OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES

Facility

$17,562.29

Service Code	APR-DRG 0291
Min. Negotiated Rate	$16,725.99
Max. Negotiated Rate	$17,562.29
Rate for Payer: BCBS Complete	$17,562.29
Rate for Payer: Mclaren Medicaid	$16,725.99
Rate for Payer: Meridian Medicaid	$17,562.29
Rate for Payer: Priority Health Choice Medicaid	$16,725.99
Rate for Payer: UHC Medicaid	$16,725.99
Rate for Payer: UHCCP Medicaid	$16,725.99

Know your out-of-pocket cost for care.

All Charges