Bronson South Haven Hospital

All Charges

Charge

Type

Setting

Price

ACUTE ANXIETY AND STRESS SYNDROMES

Facility

$4,831.53

Service Code	APR-DRG 7562
Min. Negotiated Rate	$4,368.28
Max. Negotiated Rate	$4,831.53
Rate for Payer: BCBS Complete	$4,831.53
Rate for Payer: Mclaren Medicaid	$4,601.45
Rate for Payer: Meridian Medicaid	$4,831.53
Rate for Payer: PHP Medicaid	$4,368.28
Rate for Payer: Priority Health Choice Medicaid	$4,601.45
Rate for Payer: UHC Medicaid	$4,601.45
Rate for Payer: UHCCP Medicaid	$4,601.45

ACUTE ANXIETY AND STRESS SYNDROMES

Facility

$7,823.85

Service Code	APR-DRG 7563
Min. Negotiated Rate	$7,073.69
Max. Negotiated Rate	$7,823.85
Rate for Payer: BCBS Complete	$7,823.85
Rate for Payer: Mclaren Medicaid	$7,451.28
Rate for Payer: Meridian Medicaid	$7,823.85
Rate for Payer: PHP Medicaid	$7,073.69
Rate for Payer: Priority Health Choice Medicaid	$7,451.28
Rate for Payer: UHC Medicaid	$7,451.28
Rate for Payer: UHCCP Medicaid	$7,451.28

ACUTE BRONCHITIS AND RELATED SYMPTOMS

Facility

$8,588.96

Service Code	APR-DRG 1454
Min. Negotiated Rate	$7,765.44
Max. Negotiated Rate	$8,588.96
Rate for Payer: BCBS Complete	$8,588.96
Rate for Payer: Mclaren Medicaid	$8,179.96
Rate for Payer: Meridian Medicaid	$8,588.96
Rate for Payer: PHP Medicaid	$7,765.44
Rate for Payer: Priority Health Choice Medicaid	$8,179.96
Rate for Payer: UHC Medicaid	$8,179.96
Rate for Payer: UHCCP Medicaid	$8,179.96

ACUTE BRONCHITIS AND RELATED SYMPTOMS

Facility

$3,726.91

Service Code	APR-DRG 1452
Min. Negotiated Rate	$3,369.58
Max. Negotiated Rate	$3,726.91
Rate for Payer: BCBS Complete	$3,726.91
Rate for Payer: Mclaren Medicaid	$3,549.44
Rate for Payer: Meridian Medicaid	$3,726.91
Rate for Payer: PHP Medicaid	$3,369.58
Rate for Payer: Priority Health Choice Medicaid	$3,549.44
Rate for Payer: UHC Medicaid	$3,549.44
Rate for Payer: UHCCP Medicaid	$3,549.44

ACUTE BRONCHITIS AND RELATED SYMPTOMS

Facility

$5,197.19

Service Code	APR-DRG 1453
Min. Negotiated Rate	$4,698.88
Max. Negotiated Rate	$5,197.19
Rate for Payer: BCBS Complete	$5,197.19
Rate for Payer: Mclaren Medicaid	$4,949.70
Rate for Payer: Meridian Medicaid	$5,197.19
Rate for Payer: PHP Medicaid	$4,698.88
Rate for Payer: Priority Health Choice Medicaid	$4,949.70
Rate for Payer: UHC Medicaid	$4,949.70
Rate for Payer: UHCCP Medicaid	$4,949.70

ACUTE BRONCHITIS AND RELATED SYMPTOMS

Facility

$2,977.61

Service Code	APR-DRG 1451
Min. Negotiated Rate	$2,692.11
Max. Negotiated Rate	$2,977.61
Rate for Payer: BCBS Complete	$2,977.61
Rate for Payer: Mclaren Medicaid	$2,835.82
Rate for Payer: Meridian Medicaid	$2,977.61
Rate for Payer: PHP Medicaid	$2,692.11
Rate for Payer: Priority Health Choice Medicaid	$2,835.82
Rate for Payer: UHC Medicaid	$2,835.82
Rate for Payer: UHCCP Medicaid	$2,835.82

ACUTE KIDNEY INJURY

Facility

$3,983.04

Service Code	APR-DRG 4692
Min. Negotiated Rate	$3,601.14
Max. Negotiated Rate	$3,983.04
Rate for Payer: BCBS Complete	$3,983.04
Rate for Payer: Mclaren Medicaid	$3,793.37
Rate for Payer: Meridian Medicaid	$3,983.04
Rate for Payer: PHP Medicaid	$3,601.14
Rate for Payer: Priority Health Choice Medicaid	$3,793.37
Rate for Payer: UHC Medicaid	$3,793.37
Rate for Payer: UHCCP Medicaid	$3,793.37

ACUTE KIDNEY INJURY

Facility

$7,221.13

Service Code	APR-DRG 4693
Min. Negotiated Rate	$6,528.77
Max. Negotiated Rate	$7,221.13
Rate for Payer: BCBS Complete	$7,221.13
Rate for Payer: Mclaren Medicaid	$6,877.27
Rate for Payer: Meridian Medicaid	$7,221.13
Rate for Payer: PHP Medicaid	$6,528.77
Rate for Payer: Priority Health Choice Medicaid	$6,877.27
Rate for Payer: UHC Medicaid	$6,877.27
Rate for Payer: UHCCP Medicaid	$6,877.27

ACUTE KIDNEY INJURY

Facility

$14,405.75

Service Code	APR-DRG 4694
Min. Negotiated Rate	$13,024.52
Max. Negotiated Rate	$14,405.75
Rate for Payer: BCBS Complete	$14,405.75
Rate for Payer: Mclaren Medicaid	$13,719.76
Rate for Payer: Meridian Medicaid	$14,405.75
Rate for Payer: PHP Medicaid	$13,024.52
Rate for Payer: Priority Health Choice Medicaid	$13,719.76
Rate for Payer: UHC Medicaid	$13,719.76
Rate for Payer: UHCCP Medicaid	$13,719.76

ACUTE KIDNEY INJURY

Facility

$2,901.86

Service Code	APR-DRG 4691
Min. Negotiated Rate	$2,623.63
Max. Negotiated Rate	$2,901.86
Rate for Payer: BCBS Complete	$2,901.86
Rate for Payer: Mclaren Medicaid	$2,763.68
Rate for Payer: Meridian Medicaid	$2,901.86
Rate for Payer: PHP Medicaid	$2,623.63
Rate for Payer: Priority Health Choice Medicaid	$2,763.68
Rate for Payer: UHC Medicaid	$2,763.68
Rate for Payer: UHCCP Medicaid	$2,763.68

ACUTE LEUKEMIA

Facility

$15,449.33

Service Code	APR-DRG 6902
Min. Negotiated Rate	$13,968.05
Max. Negotiated Rate	$15,449.33
Rate for Payer: BCBS Complete	$15,449.33
Rate for Payer: Mclaren Medicaid	$14,713.65
Rate for Payer: Meridian Medicaid	$15,449.33
Rate for Payer: PHP Medicaid	$13,968.05
Rate for Payer: Priority Health Choice Medicaid	$14,713.65
Rate for Payer: UHC Medicaid	$14,713.65
Rate for Payer: UHCCP Medicaid	$14,713.65

ACUTE LEUKEMIA

Facility

$38,439.68

Service Code	APR-DRG 6904
Min. Negotiated Rate	$34,754.07
Max. Negotiated Rate	$38,439.68
Rate for Payer: BCBS Complete	$38,439.68
Rate for Payer: Mclaren Medicaid	$36,609.22
Rate for Payer: Meridian Medicaid	$38,439.68
Rate for Payer: PHP Medicaid	$34,754.07
Rate for Payer: Priority Health Choice Medicaid	$36,609.22
Rate for Payer: UHC Medicaid	$36,609.22
Rate for Payer: UHCCP Medicaid	$36,609.22

ACUTE LEUKEMIA

Facility

$9,968.77

Service Code	APR-DRG 6901
Min. Negotiated Rate	$9,012.96
Max. Negotiated Rate	$9,968.77
Rate for Payer: BCBS Complete	$9,968.77
Rate for Payer: Mclaren Medicaid	$9,494.07
Rate for Payer: Meridian Medicaid	$9,968.77
Rate for Payer: PHP Medicaid	$9,012.96
Rate for Payer: Priority Health Choice Medicaid	$9,494.07
Rate for Payer: UHC Medicaid	$9,494.07
Rate for Payer: UHCCP Medicaid	$9,494.07

ACUTE LEUKEMIA

Facility

$26,615.36

Service Code	APR-DRG 6903
Min. Negotiated Rate	$24,063.47
Max. Negotiated Rate	$26,615.36
Rate for Payer: BCBS Complete	$26,615.36
Rate for Payer: Mclaren Medicaid	$25,347.96
Rate for Payer: Meridian Medicaid	$26,615.36
Rate for Payer: PHP Medicaid	$24,063.47
Rate for Payer: Priority Health Choice Medicaid	$25,347.96
Rate for Payer: UHC Medicaid	$25,347.96
Rate for Payer: UHCCP Medicaid	$25,347.96

ACUTE LEUKEMIA WITH CC

Facility

$28,656.39

Service Code	MSDRG 835
Min. Negotiated Rate	$15,936.07
Max. Negotiated Rate	$28,656.39
Rate for Payer: Aetna Medicare	$16,774.81
Rate for Payer: Allen County Amish Medical Aid Commercial	$20,968.51
Rate for Payer: Amish Plain Church Group Commercial	$20,968.51
Rate for Payer: BCBS MAPPO	$16,774.81
Rate for Payer: BCN Medicare Advantage	$16,774.81
Rate for Payer: Health Alliance Plan Medicare Advantage	$16,774.81
Rate for Payer: Humana Choice PPO Medicare	$16,774.81
Rate for Payer: Mclaren Medicare	$16,774.81
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$17,613.55
Rate for Payer: MI Amish Medical Board Commercial	$19,291.03
Rate for Payer: Molina Medicare/Medicaid	$18,452.29
Rate for Payer: PACE Medicare	$15,936.07
Rate for Payer: PACE SWMI	$16,774.81
Rate for Payer: PHP Commercial	$18,452.29
Rate for Payer: PHP Medicare Advantage	$16,774.81
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$28,656.39
Rate for Payer: Priority Health Medicare	$16,774.81
Rate for Payer: Priority Health Narrow Network	$22,925.11
Rate for Payer: Railroad Medicare Medicare	$16,774.81
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$16,774.81
Rate for Payer: UHC Exchange	$26,000.96
Rate for Payer: UHCCP DNSP	$16,774.81
Rate for Payer: VA VA	$16,774.81

ACUTE LEUKEMIA WITH MCC

Facility

$75,424.64

Service Code	MSDRG 834
Min. Negotiated Rate	$39,224.14
Max. Negotiated Rate	$75,424.64
Rate for Payer: Aetna Medicare	$41,288.57
Rate for Payer: Allen County Amish Medical Aid Commercial	$51,610.71
Rate for Payer: Amish Plain Church Group Commercial	$51,610.71
Rate for Payer: BCBS MAPPO	$41,288.57
Rate for Payer: BCN Medicare Advantage	$41,288.57
Rate for Payer: Health Alliance Plan Medicare Advantage	$41,288.57
Rate for Payer: Humana Choice PPO Medicare	$41,288.57
Rate for Payer: Mclaren Medicare	$41,288.57
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$43,353.00
Rate for Payer: MI Amish Medical Board Commercial	$47,481.86
Rate for Payer: Molina Medicare/Medicaid	$45,417.43
Rate for Payer: PACE Medicare	$39,224.14
Rate for Payer: PACE SWMI	$41,288.57
Rate for Payer: PHP Commercial	$45,417.43
Rate for Payer: PHP Medicare Advantage	$41,288.57
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$75,424.64
Rate for Payer: Priority Health Medicare	$41,288.57
Rate for Payer: Priority Health Narrow Network	$60,339.71
Rate for Payer: Railroad Medicare Medicare	$41,288.57
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$41,288.57
Rate for Payer: UHC Exchange	$63,997.28
Rate for Payer: UHCCP DNSP	$41,288.57
Rate for Payer: VA VA	$41,288.57

ACUTE LEUKEMIA WITH OTHER PROCEDURES

Facility

$118,971.14

Service Code	MSDRG 850
Min. Negotiated Rate	$60,907.95
Max. Negotiated Rate	$118,971.14
Rate for Payer: Aetna Medicare	$64,113.63
Rate for Payer: Allen County Amish Medical Aid Commercial	$80,142.04
Rate for Payer: Amish Plain Church Group Commercial	$80,142.04
Rate for Payer: BCBS MAPPO	$64,113.63
Rate for Payer: BCN Medicare Advantage	$64,113.63
Rate for Payer: Health Alliance Plan Medicare Advantage	$64,113.63
Rate for Payer: Humana Choice PPO Medicare	$64,113.63
Rate for Payer: Mclaren Medicare	$64,113.63
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$67,319.31
Rate for Payer: MI Amish Medical Board Commercial	$73,730.67
Rate for Payer: Molina Medicare/Medicaid	$70,524.99
Rate for Payer: PACE Medicare	$60,907.95
Rate for Payer: PACE SWMI	$64,113.63
Rate for Payer: PHP Commercial	$70,524.99
Rate for Payer: PHP Medicare Advantage	$64,113.63
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$118,971.14
Rate for Payer: Priority Health Medicare	$64,113.63
Rate for Payer: Priority Health Narrow Network	$95,176.91
Rate for Payer: Railroad Medicare Medicare	$64,113.63
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$64,113.63
Rate for Payer: UHC Exchange	$99,376.13
Rate for Payer: UHCCP DNSP	$64,113.63
Rate for Payer: VA VA	$64,113.63

ACUTE LEUKEMIA WITHOUT CC/MCC

Facility

$16,754.47

Service Code	MSDRG 836
Min. Negotiated Rate	$10,009.56
Max. Negotiated Rate	$16,754.47
Rate for Payer: Aetna Medicare	$10,536.38
Rate for Payer: Allen County Amish Medical Aid Commercial	$13,170.48
Rate for Payer: Amish Plain Church Group Commercial	$13,170.48
Rate for Payer: BCBS MAPPO	$10,536.38
Rate for Payer: BCN Medicare Advantage	$10,536.38
Rate for Payer: Health Alliance Plan Medicare Advantage	$10,536.38
Rate for Payer: Humana Choice PPO Medicare	$10,536.38
Rate for Payer: Mclaren Medicare	$10,536.38
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$11,063.20
Rate for Payer: MI Amish Medical Board Commercial	$12,116.84
Rate for Payer: Molina Medicare/Medicaid	$11,590.02
Rate for Payer: PACE Medicare	$10,009.56
Rate for Payer: PACE SWMI	$10,536.38
Rate for Payer: PHP Commercial	$11,590.02
Rate for Payer: PHP Medicare Advantage	$10,536.38
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$16,754.47
Rate for Payer: Priority Health Medicare	$10,536.38
Rate for Payer: Priority Health Narrow Network	$13,403.57
Rate for Payer: Railroad Medicare Medicare	$10,536.38
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$10,536.38
Rate for Payer: UHC Exchange	$16,331.39
Rate for Payer: UHCCP DNSP	$10,536.38
Rate for Payer: VA VA	$10,536.38

ACUTE MAJOR EYE INFECTIONS WITH CC/MCC

Facility

$15,982.35

Service Code	MSDRG 121
Min. Negotiated Rate	$9,625.09
Max. Negotiated Rate	$15,982.35
Rate for Payer: Aetna Medicare	$10,131.67
Rate for Payer: Allen County Amish Medical Aid Commercial	$12,664.59
Rate for Payer: Amish Plain Church Group Commercial	$12,664.59
Rate for Payer: BCBS MAPPO	$10,131.67
Rate for Payer: BCN Medicare Advantage	$10,131.67
Rate for Payer: Health Alliance Plan Medicare Advantage	$10,131.67
Rate for Payer: Humana Choice PPO Medicare	$10,131.67
Rate for Payer: Mclaren Medicare	$10,131.67
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$10,638.25
Rate for Payer: MI Amish Medical Board Commercial	$11,651.42
Rate for Payer: Molina Medicare/Medicaid	$11,144.84
Rate for Payer: PACE Medicare	$9,625.09
Rate for Payer: PACE SWMI	$10,131.67
Rate for Payer: PHP Commercial	$11,144.84
Rate for Payer: PHP Medicare Advantage	$10,131.67
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$15,982.35
Rate for Payer: Priority Health Medicare	$10,131.67
Rate for Payer: Priority Health Narrow Network	$12,785.88
Rate for Payer: Railroad Medicare Medicare	$10,131.67
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$10,131.67
Rate for Payer: UHC Exchange	$15,704.09
Rate for Payer: UHCCP DNSP	$10,131.67
Rate for Payer: VA VA	$10,131.67

ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC

Facility

$11,490.46

Service Code	MSDRG 122
Min. Negotiated Rate	$7,042.54
Max. Negotiated Rate	$11,490.46
Rate for Payer: Aetna Medicare	$7,413.20
Rate for Payer: Allen County Amish Medical Aid Commercial	$9,266.50
Rate for Payer: Amish Plain Church Group Commercial	$9,266.50
Rate for Payer: BCBS MAPPO	$7,413.20
Rate for Payer: BCN Medicare Advantage	$7,413.20
Rate for Payer: Health Alliance Plan Medicare Advantage	$7,413.20
Rate for Payer: Humana Choice PPO Medicare	$7,413.20
Rate for Payer: Mclaren Medicare	$7,413.20
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$7,783.86
Rate for Payer: MI Amish Medical Board Commercial	$8,525.18
Rate for Payer: Molina Medicare/Medicaid	$8,154.52
Rate for Payer: PACE Medicare	$7,042.54
Rate for Payer: PACE SWMI	$7,413.20
Rate for Payer: PHP Commercial	$8,154.52
Rate for Payer: PHP Medicare Advantage	$7,413.20
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$10,795.95
Rate for Payer: Priority Health Medicare	$7,413.20
Rate for Payer: Priority Health Narrow Network	$8,636.76
Rate for Payer: Railroad Medicare Medicare	$7,413.20
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$7,413.20
Rate for Payer: UHC Exchange	$11,490.46
Rate for Payer: UHCCP DNSP	$7,413.20
Rate for Payer: VA VA	$7,413.20

ACUTE MYOCARDIAL INFARCTION

Facility

$2,989.60

Service Code	APR-DRG 1901
Min. Negotiated Rate	$2,702.95
Max. Negotiated Rate	$2,989.60
Rate for Payer: BCBS Complete	$2,989.60
Rate for Payer: Mclaren Medicaid	$2,847.23
Rate for Payer: Meridian Medicaid	$2,989.60
Rate for Payer: PHP Medicaid	$2,702.95
Rate for Payer: Priority Health Choice Medicaid	$2,847.23
Rate for Payer: UHC Medicaid	$2,847.23
Rate for Payer: UHCCP Medicaid	$2,847.23

ACUTE MYOCARDIAL INFARCTION

Facility

$13,059.18

Service Code	APR-DRG 1904
Min. Negotiated Rate	$11,807.06
Max. Negotiated Rate	$13,059.18
Rate for Payer: BCBS Complete	$13,059.18
Rate for Payer: Mclaren Medicaid	$12,437.32
Rate for Payer: Meridian Medicaid	$13,059.18
Rate for Payer: PHP Medicaid	$11,807.06
Rate for Payer: Priority Health Choice Medicaid	$12,437.32
Rate for Payer: UHC Medicaid	$12,437.32
Rate for Payer: UHCCP Medicaid	$12,437.32

ACUTE MYOCARDIAL INFARCTION

Facility

$4,694.74

Service Code	APR-DRG 1902
Min. Negotiated Rate	$4,244.61
Max. Negotiated Rate	$4,694.74
Rate for Payer: BCBS Complete	$4,694.74
Rate for Payer: Mclaren Medicaid	$4,471.19
Rate for Payer: Meridian Medicaid	$4,694.74
Rate for Payer: PHP Medicaid	$4,244.61
Rate for Payer: Priority Health Choice Medicaid	$4,471.19
Rate for Payer: UHC Medicaid	$4,471.19
Rate for Payer: UHCCP Medicaid	$4,471.19

ACUTE MYOCARDIAL INFARCTION

Facility

$6,331.23

Service Code	APR-DRG 1903
Min. Negotiated Rate	$5,724.19
Max. Negotiated Rate	$6,331.23
Rate for Payer: BCBS Complete	$6,331.23
Rate for Payer: Mclaren Medicaid	$6,029.74
Rate for Payer: Meridian Medicaid	$6,331.23
Rate for Payer: PHP Medicaid	$5,724.19
Rate for Payer: Priority Health Choice Medicaid	$6,029.74
Rate for Payer: UHC Medicaid	$6,029.74
Rate for Payer: UHCCP Medicaid	$6,029.74

ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC

Facility

$12,978.34

Service Code	MSDRG 281
Min. Negotiated Rate	$7,954.46
Max. Negotiated Rate	$12,978.34
Rate for Payer: Aetna Medicare	$8,373.12
Rate for Payer: Allen County Amish Medical Aid Commercial	$10,466.40
Rate for Payer: Amish Plain Church Group Commercial	$10,466.40
Rate for Payer: BCBS MAPPO	$8,373.12
Rate for Payer: BCN Medicare Advantage	$8,373.12
Rate for Payer: Health Alliance Plan Medicare Advantage	$8,373.12
Rate for Payer: Humana Choice PPO Medicare	$8,373.12
Rate for Payer: Mclaren Medicare	$8,373.12
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$8,791.78
Rate for Payer: MI Amish Medical Board Commercial	$9,629.09
Rate for Payer: Molina Medicare/Medicaid	$9,210.43
Rate for Payer: PACE Medicare	$7,954.46
Rate for Payer: PACE SWMI	$8,373.12
Rate for Payer: PHP Commercial	$9,210.43
Rate for Payer: PHP Medicare Advantage	$8,373.12
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$12,627.33
Rate for Payer: Priority Health Medicare	$8,373.12
Rate for Payer: Priority Health Narrow Network	$10,101.86
Rate for Payer: Railroad Medicare Medicare	$8,373.12
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$8,373.12
Rate for Payer: UHC Exchange	$12,978.34
Rate for Payer: UHCCP DNSP	$8,373.12
Rate for Payer: VA VA	$8,373.12

Know your out-of-pocket cost for care.

All Charges