Bronson South Haven Hospital

All Charges

Charge

Type

Setting

Price

INPATIENT APRDRG 6112: NEONATE BIRTHWT 1500-1999G W MAJOR ANOMALY

Facility

$13,142.42

Service Code	APR-DRG 6112
Hospital Charge Code	APRDRG 6112
Min. Negotiated Rate	$12,516.59
Max. Negotiated Rate	$13,142.42
Rate for Payer: BCBS Complete	$13,142.42
Rate for Payer: Mclaren Medicaid	$12,516.59
Rate for Payer: Meridian Medicaid	$13,142.42
Rate for Payer: PHP Medicaid	$12,516.59
Rate for Payer: Priority Health Choice Medicaid	$12,516.59

INPATIENT APRDRG 6113: NEONATE BIRTHWT 1500-1999G W MAJOR ANOMALY

Facility

$18,073.25

Service Code	APR-DRG 6113
Hospital Charge Code	APRDRG 6113
Min. Negotiated Rate	$17,212.62
Max. Negotiated Rate	$18,073.25
Rate for Payer: BCBS Complete	$18,073.25
Rate for Payer: Mclaren Medicaid	$17,212.62
Rate for Payer: Meridian Medicaid	$18,073.25
Rate for Payer: PHP Medicaid	$17,212.62
Rate for Payer: Priority Health Choice Medicaid	$17,212.62

INPATIENT APRDRG 6114: NEONATE BIRTHWT 1500-1999G W MAJOR ANOMALY

Facility

$29,557.89

Service Code	APR-DRG 6114
Hospital Charge Code	APRDRG 6114
Min. Negotiated Rate	$28,150.37
Max. Negotiated Rate	$29,557.89
Rate for Payer: BCBS Complete	$29,557.89
Rate for Payer: Mclaren Medicaid	$28,150.37
Rate for Payer: Meridian Medicaid	$29,557.89
Rate for Payer: PHP Medicaid	$28,150.37
Rate for Payer: Priority Health Choice Medicaid	$28,150.37

INPATIENT APRDRG 6121: NEONATE BWT 1500-1999G W RESP DIST SYND/OTH MAJ RESP COND

Facility

$10,038.93

Service Code	APR-DRG 6121
Hospital Charge Code	APRDRG 6121
Min. Negotiated Rate	$9,560.89
Max. Negotiated Rate	$10,038.93
Rate for Payer: BCBS Complete	$10,038.93
Rate for Payer: Mclaren Medicaid	$9,560.89
Rate for Payer: Meridian Medicaid	$10,038.93
Rate for Payer: PHP Medicaid	$9,560.89
Rate for Payer: Priority Health Choice Medicaid	$9,560.89

INPATIENT APRDRG 6122: NEONATE BWT 1500-1999G W RESP DIST SYND/OTH MAJ RESP COND

Facility

$16,469.78

Service Code	APR-DRG 6122
Hospital Charge Code	APRDRG 6122
Min. Negotiated Rate	$15,685.50
Max. Negotiated Rate	$16,469.78
Rate for Payer: BCBS Complete	$16,469.78
Rate for Payer: Mclaren Medicaid	$15,685.50
Rate for Payer: Meridian Medicaid	$16,469.78
Rate for Payer: PHP Medicaid	$15,685.50
Rate for Payer: Priority Health Choice Medicaid	$15,685.50

INPATIENT APRDRG 6123: NEONATE BWT 1500-1999G W RESP DIST SYND/OTH MAJ RESP COND

Facility

$27,880.11

Service Code	APR-DRG 6123
Hospital Charge Code	APRDRG 6123
Min. Negotiated Rate	$26,552.49
Max. Negotiated Rate	$27,880.11
Rate for Payer: BCBS Complete	$27,880.11
Rate for Payer: Mclaren Medicaid	$26,552.49
Rate for Payer: Meridian Medicaid	$27,880.11
Rate for Payer: PHP Medicaid	$26,552.49
Rate for Payer: Priority Health Choice Medicaid	$26,552.49

INPATIENT APRDRG 6124: NEONATE BWT 1500-1999G W RESP DIST SYND/OTH MAJ RESP COND

Facility

$44,486.67

Service Code	APR-DRG 6124
Hospital Charge Code	APRDRG 6124
Min. Negotiated Rate	$42,368.26
Max. Negotiated Rate	$44,486.67
Rate for Payer: BCBS Complete	$44,486.67
Rate for Payer: Mclaren Medicaid	$42,368.26
Rate for Payer: Meridian Medicaid	$44,486.67
Rate for Payer: PHP Medicaid	$42,368.26
Rate for Payer: Priority Health Choice Medicaid	$42,368.26

INPATIENT APRDRG 6131: NEONATE BIRTHWT 1500-1999G W CONGENITAL/PERINATAL INFECTION

Facility

$4,958.50

Service Code	APR-DRG 6131
Hospital Charge Code	APRDRG 6131
Min. Negotiated Rate	$4,722.38
Max. Negotiated Rate	$4,958.50
Rate for Payer: BCBS Complete	$4,958.50
Rate for Payer: Mclaren Medicaid	$4,722.38
Rate for Payer: Meridian Medicaid	$4,958.50
Rate for Payer: PHP Medicaid	$4,722.38
Rate for Payer: Priority Health Choice Medicaid	$4,722.38

INPATIENT APRDRG 6132: NEONATE BIRTHWT 1500-1999G W CONGENITAL/PERINATAL INFECTION

Facility

$16,168.54

Service Code	APR-DRG 6132
Hospital Charge Code	APRDRG 6132
Min. Negotiated Rate	$15,398.61
Max. Negotiated Rate	$16,168.54
Rate for Payer: BCBS Complete	$16,168.54
Rate for Payer: Mclaren Medicaid	$15,398.61
Rate for Payer: Meridian Medicaid	$16,168.54
Rate for Payer: PHP Medicaid	$15,398.61
Rate for Payer: Priority Health Choice Medicaid	$15,398.61

INPATIENT APRDRG 6133: NEONATE BIRTHWT 1500-1999G W CONGENITAL/PERINATAL INFECTION

Facility

$28,150.62

Service Code	APR-DRG 6133
Hospital Charge Code	APRDRG 6133
Min. Negotiated Rate	$26,810.11
Max. Negotiated Rate	$28,150.62
Rate for Payer: BCBS Complete	$28,150.62
Rate for Payer: Mclaren Medicaid	$26,810.11
Rate for Payer: Meridian Medicaid	$28,150.62
Rate for Payer: PHP Medicaid	$26,810.11
Rate for Payer: Priority Health Choice Medicaid	$26,810.11

INPATIENT APRDRG 6134: NEONATE BIRTHWT 1500-1999G W CONGENITAL/PERINATAL INFECTION

Facility

$51,157.77

Service Code	APR-DRG 6134
Hospital Charge Code	APRDRG 6134
Min. Negotiated Rate	$48,721.69
Max. Negotiated Rate	$51,157.77
Rate for Payer: BCBS Complete	$51,157.77
Rate for Payer: Mclaren Medicaid	$48,721.69
Rate for Payer: Meridian Medicaid	$51,157.77
Rate for Payer: PHP Medicaid	$48,721.69
Rate for Payer: Priority Health Choice Medicaid	$48,721.69

INPATIENT APRDRG 6141: NEONATE BWT 1500-1999G W OR W/O OTHER SIGNIFICANT CONDITION

Facility

$4,085.55

Service Code	APR-DRG 6141
Hospital Charge Code	APRDRG 6141
Min. Negotiated Rate	$3,891.00
Max. Negotiated Rate	$4,085.55
Rate for Payer: BCBS Complete	$4,085.55
Rate for Payer: Mclaren Medicaid	$3,891.00
Rate for Payer: Meridian Medicaid	$4,085.55
Rate for Payer: PHP Medicaid	$3,891.00
Rate for Payer: Priority Health Choice Medicaid	$3,891.00

INPATIENT APRDRG 6142: NEONATE BWT 1500-1999G W OR W/O OTHER SIGNIFICANT CONDITION

Facility

$10,227.97

Service Code	APR-DRG 6142
Hospital Charge Code	APRDRG 6142
Min. Negotiated Rate	$9,740.92
Max. Negotiated Rate	$10,227.97
Rate for Payer: BCBS Complete	$10,227.97
Rate for Payer: Mclaren Medicaid	$9,740.92
Rate for Payer: Meridian Medicaid	$10,227.97
Rate for Payer: PHP Medicaid	$9,740.92
Rate for Payer: Priority Health Choice Medicaid	$9,740.92

INPATIENT APRDRG 6143: NEONATE BWT 1500-1999G W OR W/O OTHER SIGNIFICANT CONDITION

Facility

$20,291.49

Service Code	APR-DRG 6143
Hospital Charge Code	APRDRG 6143
Min. Negotiated Rate	$19,325.23
Max. Negotiated Rate	$20,291.49
Rate for Payer: BCBS Complete	$20,291.49
Rate for Payer: Mclaren Medicaid	$19,325.23
Rate for Payer: Meridian Medicaid	$20,291.49
Rate for Payer: PHP Medicaid	$19,325.23
Rate for Payer: Priority Health Choice Medicaid	$19,325.23

INPATIENT APRDRG 6144: NEONATE BWT 1500-1999G W OR W/O OTHER SIGNIFICANT CONDITION

Facility

$26,997.95

Service Code	APR-DRG 6144
Hospital Charge Code	APRDRG 6144
Min. Negotiated Rate	$25,712.33
Max. Negotiated Rate	$26,997.95
Rate for Payer: BCBS Complete	$26,997.95
Rate for Payer: Mclaren Medicaid	$25,712.33
Rate for Payer: Meridian Medicaid	$26,997.95
Rate for Payer: PHP Medicaid	$25,712.33
Rate for Payer: Priority Health Choice Medicaid	$25,712.33

INPATIENT APRDRG 6211: NEONATE BWT 2000-2499G W MAJOR ANOMALY

Facility

$1,211.57

Service Code	APR-DRG 6211
Hospital Charge Code	APRDRG 6211
Min. Negotiated Rate	$1,153.88
Max. Negotiated Rate	$1,211.57
Rate for Payer: BCBS Complete	$1,211.57
Rate for Payer: Mclaren Medicaid	$1,153.88
Rate for Payer: Meridian Medicaid	$1,211.57
Rate for Payer: PHP Medicaid	$1,153.88
Rate for Payer: Priority Health Choice Medicaid	$1,153.88

INPATIENT APRDRG 6212: NEONATE BWT 2000-2499G W MAJOR ANOMALY

Facility

$7,134.73

Service Code	APR-DRG 6212
Hospital Charge Code	APRDRG 6212
Min. Negotiated Rate	$6,794.98
Max. Negotiated Rate	$7,134.73
Rate for Payer: BCBS Complete	$7,134.73
Rate for Payer: Mclaren Medicaid	$6,794.98
Rate for Payer: Meridian Medicaid	$7,134.73
Rate for Payer: PHP Medicaid	$6,794.98
Rate for Payer: Priority Health Choice Medicaid	$6,794.98

INPATIENT APRDRG 6213: NEONATE BWT 2000-2499G W MAJOR ANOMALY

Facility

$8,634.22

Service Code	APR-DRG 6213
Hospital Charge Code	APRDRG 6213
Min. Negotiated Rate	$8,223.07
Max. Negotiated Rate	$8,634.22
Rate for Payer: BCBS Complete	$8,634.22
Rate for Payer: Mclaren Medicaid	$8,223.07
Rate for Payer: Meridian Medicaid	$8,634.22
Rate for Payer: PHP Medicaid	$8,223.07
Rate for Payer: Priority Health Choice Medicaid	$8,223.07

INPATIENT APRDRG 6214: NEONATE BWT 2000-2499G W MAJOR ANOMALY

Facility

$17,548.16

Service Code	APR-DRG 6214
Hospital Charge Code	APRDRG 6214
Min. Negotiated Rate	$16,712.53
Max. Negotiated Rate	$17,548.16
Rate for Payer: BCBS Complete	$17,548.16
Rate for Payer: Mclaren Medicaid	$16,712.53
Rate for Payer: Meridian Medicaid	$17,548.16
Rate for Payer: PHP Medicaid	$16,712.53
Rate for Payer: Priority Health Choice Medicaid	$16,712.53

INPATIENT APRDRG 6221: NEONATE BWT 2000-2499G W RESP DIST SYND/OTH MAJ RESP COND

Facility

$6,248.47

Service Code	APR-DRG 6221
Hospital Charge Code	APRDRG 6221
Min. Negotiated Rate	$5,950.92
Max. Negotiated Rate	$6,248.47
Rate for Payer: BCBS Complete	$6,248.47
Rate for Payer: Mclaren Medicaid	$5,950.92
Rate for Payer: Meridian Medicaid	$6,248.47
Rate for Payer: PHP Medicaid	$5,950.92
Rate for Payer: Priority Health Choice Medicaid	$5,950.92

INPATIENT APRDRG 6222: NEONATE BWT 2000-2499G W RESP DIST SYND/OTH MAJ RESP COND

Facility

$8,155.22

Service Code	APR-DRG 6222
Hospital Charge Code	APRDRG 6222
Min. Negotiated Rate	$7,766.88
Max. Negotiated Rate	$8,155.22
Rate for Payer: BCBS Complete	$8,155.22
Rate for Payer: Mclaren Medicaid	$7,766.88
Rate for Payer: Meridian Medicaid	$8,155.22
Rate for Payer: PHP Medicaid	$7,766.88
Rate for Payer: Priority Health Choice Medicaid	$7,766.88

INPATIENT APRDRG 6223: NEONATE BWT 2000-2499G W RESP DIST SYND/OTH MAJ RESP COND

Facility

$15,856.04

Service Code	APR-DRG 6223
Hospital Charge Code	APRDRG 6223
Min. Negotiated Rate	$15,100.99
Max. Negotiated Rate	$15,856.04
Rate for Payer: BCBS Complete	$15,856.04
Rate for Payer: Mclaren Medicaid	$15,100.99
Rate for Payer: Meridian Medicaid	$15,856.04
Rate for Payer: PHP Medicaid	$15,100.99
Rate for Payer: Priority Health Choice Medicaid	$15,100.99

INPATIENT APRDRG 6224: NEONATE BWT 2000-2499G W RESP DIST SYND/OTH MAJ RESP COND

Facility

$26,827.35

Service Code	APR-DRG 6224
Hospital Charge Code	APRDRG 6224
Min. Negotiated Rate	$25,549.86
Max. Negotiated Rate	$26,827.35
Rate for Payer: BCBS Complete	$26,827.35
Rate for Payer: Mclaren Medicaid	$25,549.86
Rate for Payer: Meridian Medicaid	$26,827.35
Rate for Payer: PHP Medicaid	$25,549.86
Rate for Payer: Priority Health Choice Medicaid	$25,549.86

INPATIENT APRDRG 6231: NEONATE BWT 2000-2499G W CONGENITAL/PERINATAL INFECTION

Facility

$3,697.23

Service Code	APR-DRG 6231
Hospital Charge Code	APRDRG 6231
Min. Negotiated Rate	$3,521.17
Max. Negotiated Rate	$3,697.23
Rate for Payer: BCBS Complete	$3,697.23
Rate for Payer: Mclaren Medicaid	$3,521.17
Rate for Payer: Meridian Medicaid	$3,697.23
Rate for Payer: PHP Medicaid	$3,521.17
Rate for Payer: Priority Health Choice Medicaid	$3,521.17

INPATIENT APRDRG 6232: NEONATE BWT 2000-2499G W CONGENITAL/PERINATAL INFECTION

Facility

$6,322.23

Service Code	APR-DRG 6232
Hospital Charge Code	APRDRG 6232
Min. Negotiated Rate	$6,021.17
Max. Negotiated Rate	$6,322.23
Rate for Payer: BCBS Complete	$6,322.23
Rate for Payer: Mclaren Medicaid	$6,021.17
Rate for Payer: Meridian Medicaid	$6,322.23
Rate for Payer: PHP Medicaid	$6,021.17
Rate for Payer: Priority Health Choice Medicaid	$6,021.17

Know your out-of-pocket cost for care.

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