Bronson South Haven Hospital

All Charges

Charge

Type

Setting

Price

INPATIENT APRDRG 6233: NEONATE BWT 2000-2499G W CONGENITAL/PERINATAL INFECTION

Facility

$23,143.95

Service Code	APR-DRG 6233
Hospital Charge Code	APRDRG 6233
Min. Negotiated Rate	$22,041.86
Max. Negotiated Rate	$23,143.95
Rate for Payer: BCBS Complete	$23,143.95
Rate for Payer: Mclaren Medicaid	$22,041.86
Rate for Payer: Meridian Medicaid	$23,143.95
Rate for Payer: PHP Medicaid	$22,041.86
Rate for Payer: Priority Health Choice Medicaid	$22,041.86

INPATIENT APRDRG 6234: NEONATE BWT 2000-2499G W CONGENITAL/PERINATAL INFECTION

Facility

$28,772.03

Service Code	APR-DRG 6234
Hospital Charge Code	APRDRG 6234
Min. Negotiated Rate	$27,401.93
Max. Negotiated Rate	$28,772.03
Rate for Payer: BCBS Complete	$28,772.03
Rate for Payer: Mclaren Medicaid	$27,401.93
Rate for Payer: Meridian Medicaid	$28,772.03
Rate for Payer: PHP Medicaid	$27,401.93
Rate for Payer: Priority Health Choice Medicaid	$27,401.93

INPATIENT APRDRG 6251: NEONATE BWT 2000-2499G W OTHER SIGNIFICANT CONDITION

Facility

$5,000.51

Service Code	APR-DRG 6251
Hospital Charge Code	APRDRG 6251
Min. Negotiated Rate	$4,762.39
Max. Negotiated Rate	$5,000.51
Rate for Payer: BCBS Complete	$5,000.51
Rate for Payer: Mclaren Medicaid	$4,762.39
Rate for Payer: Meridian Medicaid	$5,000.51
Rate for Payer: PHP Medicaid	$4,762.39
Rate for Payer: Priority Health Choice Medicaid	$4,762.39

INPATIENT APRDRG 6252: NEONATE BWT 2000-2499G W OTHER SIGNIFICANT CONDITION

Facility

$8,139.85

Service Code	APR-DRG 6252
Hospital Charge Code	APRDRG 6252
Min. Negotiated Rate	$7,752.24
Max. Negotiated Rate	$8,139.85
Rate for Payer: BCBS Complete	$8,139.85
Rate for Payer: Mclaren Medicaid	$7,752.24
Rate for Payer: Meridian Medicaid	$8,139.85
Rate for Payer: PHP Medicaid	$7,752.24
Rate for Payer: Priority Health Choice Medicaid	$7,752.24

INPATIENT APRDRG 6253: NEONATE BWT 2000-2499G W OTHER SIGNIFICANT CONDITION

Facility

$17,358.60

Service Code	APR-DRG 6253
Hospital Charge Code	APRDRG 6253
Min. Negotiated Rate	$16,532.00
Max. Negotiated Rate	$17,358.60
Rate for Payer: BCBS Complete	$17,358.60
Rate for Payer: Mclaren Medicaid	$16,532.00
Rate for Payer: Meridian Medicaid	$17,358.60
Rate for Payer: PHP Medicaid	$16,532.00
Rate for Payer: Priority Health Choice Medicaid	$16,532.00

INPATIENT APRDRG 6254: NEONATE BWT 2000-2499G W OTHER SIGNIFICANT CONDITION

Facility

$35,520.48

Service Code	APR-DRG 6254
Hospital Charge Code	APRDRG 6254
Min. Negotiated Rate	$33,829.03
Max. Negotiated Rate	$35,520.48
Rate for Payer: BCBS Complete	$35,520.48
Rate for Payer: Mclaren Medicaid	$33,829.03
Rate for Payer: Meridian Medicaid	$35,520.48
Rate for Payer: PHP Medicaid	$33,829.03
Rate for Payer: Priority Health Choice Medicaid	$33,829.03

INPATIENT APRDRG 6261: NEONATE BWT 2000-2499G, NORMAL NEWBORN OR NEONATE W OTHER PROBLEM

Facility

$1,004.61

Service Code	APR-DRG 6261
Hospital Charge Code	APRDRG 6261
Min. Negotiated Rate	$956.77
Max. Negotiated Rate	$1,004.61
Rate for Payer: BCBS Complete	$1,004.61
Rate for Payer: Mclaren Medicaid	$956.77
Rate for Payer: Meridian Medicaid	$1,004.61
Rate for Payer: PHP Medicaid	$956.77
Rate for Payer: Priority Health Choice Medicaid	$956.77

INPATIENT APRDRG 6262: NEONATE BWT 2000-2499G, NORMAL NEWBORN OR NEONATE W OTHER PROBLEM

Facility

$964.66

Service Code	APR-DRG 6262
Hospital Charge Code	APRDRG 6262
Min. Negotiated Rate	$918.72
Max. Negotiated Rate	$964.66
Rate for Payer: BCBS Complete	$964.66
Rate for Payer: Mclaren Medicaid	$918.72
Rate for Payer: Meridian Medicaid	$964.66
Rate for Payer: PHP Medicaid	$918.72
Rate for Payer: Priority Health Choice Medicaid	$918.72

INPATIENT APRDRG 6263: NEONATE BWT 2000-2499G, NORMAL NEWBORN OR NEONATE W OTHER PROBLEM

Facility

$2,372.43

Service Code	APR-DRG 6263
Hospital Charge Code	APRDRG 6263
Min. Negotiated Rate	$2,259.46
Max. Negotiated Rate	$2,372.43
Rate for Payer: BCBS Complete	$2,372.43
Rate for Payer: Mclaren Medicaid	$2,259.46
Rate for Payer: Meridian Medicaid	$2,372.43
Rate for Payer: PHP Medicaid	$2,259.46
Rate for Payer: Priority Health Choice Medicaid	$2,259.46

INPATIENT APRDRG 6264: NEONATE BWT 2000-2499G, NORMAL NEWBORN OR NEONATE W OTHER PROBLEM

Facility

$7,251.03

Service Code	APR-DRG 6264
Hospital Charge Code	APRDRG 6264
Min. Negotiated Rate	$6,905.74
Max. Negotiated Rate	$7,251.03
Rate for Payer: BCBS Complete	$7,251.03
Rate for Payer: Mclaren Medicaid	$6,905.74
Rate for Payer: Meridian Medicaid	$7,251.03
Rate for Payer: PHP Medicaid	$6,905.74
Rate for Payer: Priority Health Choice Medicaid	$6,905.74

INPATIENT APRDRG 6301: NEONATE BIRTHWT >2499G W MAJOR CARDIOVASCULAR PROCEDURE

Facility

$17,644.98

Service Code	APR-DRG 6301
Hospital Charge Code	APRDRG 6301
Min. Negotiated Rate	$16,804.74
Max. Negotiated Rate	$17,644.98
Rate for Payer: BCBS Complete	$17,644.98
Rate for Payer: Mclaren Medicaid	$16,804.74
Rate for Payer: Meridian Medicaid	$17,644.98
Rate for Payer: PHP Medicaid	$16,804.74
Rate for Payer: Priority Health Choice Medicaid	$16,804.74

INPATIENT APRDRG 6302: NEONATE BIRTHWT >2499G W MAJOR CARDIOVASCULAR PROCEDURE

Facility

$37,331.96

Service Code	APR-DRG 6302
Hospital Charge Code	APRDRG 6302
Min. Negotiated Rate	$35,554.25
Max. Negotiated Rate	$37,331.96
Rate for Payer: BCBS Complete	$37,331.96
Rate for Payer: Mclaren Medicaid	$35,554.25
Rate for Payer: Meridian Medicaid	$37,331.96
Rate for Payer: PHP Medicaid	$35,554.25
Rate for Payer: Priority Health Choice Medicaid	$35,554.25

INPATIENT APRDRG 6303: NEONATE BIRTHWT >2499G W MAJOR CARDIOVASCULAR PROCEDURE

Facility

$67,352.96

Service Code	APR-DRG 6303
Hospital Charge Code	APRDRG 6303
Min. Negotiated Rate	$64,145.68
Max. Negotiated Rate	$67,352.96
Rate for Payer: BCBS Complete	$67,352.96
Rate for Payer: Mclaren Medicaid	$64,145.68
Rate for Payer: Meridian Medicaid	$67,352.96
Rate for Payer: PHP Medicaid	$64,145.68
Rate for Payer: Priority Health Choice Medicaid	$64,145.68

INPATIENT APRDRG 6304: NEONATE BIRTHWT >2499G W MAJOR CARDIOVASCULAR PROCEDURE

Facility

$140,509.71

Service Code	APR-DRG 6304
Hospital Charge Code	APRDRG 6304
Min. Negotiated Rate	$133,818.77
Max. Negotiated Rate	$140,509.71
Rate for Payer: BCBS Complete	$140,509.71
Rate for Payer: Mclaren Medicaid	$133,818.77
Rate for Payer: Meridian Medicaid	$140,509.71
Rate for Payer: PHP Medicaid	$133,818.77
Rate for Payer: Priority Health Choice Medicaid	$133,818.77

INPATIENT APRDRG 6311: NEONATE BIRTHWT >2499G W OTHER MAJOR PROCEDURE

Facility

$4,772.03

Service Code	APR-DRG 6311
Hospital Charge Code	APRDRG 6311
Min. Negotiated Rate	$4,544.79
Max. Negotiated Rate	$4,772.03
Rate for Payer: BCBS Complete	$4,772.03
Rate for Payer: Mclaren Medicaid	$4,544.79
Rate for Payer: Meridian Medicaid	$4,772.03
Rate for Payer: PHP Medicaid	$4,544.79
Rate for Payer: Priority Health Choice Medicaid	$4,544.79

INPATIENT APRDRG 6312: NEONATE BIRTHWT >2499G W OTHER MAJOR PROCEDURE

Facility

$11,555.84

Service Code	APR-DRG 6312
Hospital Charge Code	APRDRG 6312
Min. Negotiated Rate	$11,005.56
Max. Negotiated Rate	$11,555.84
Rate for Payer: BCBS Complete	$11,555.84
Rate for Payer: Mclaren Medicaid	$11,005.56
Rate for Payer: Meridian Medicaid	$11,555.84
Rate for Payer: PHP Medicaid	$11,005.56
Rate for Payer: Priority Health Choice Medicaid	$11,005.56

INPATIENT APRDRG 6313: NEONATE BIRTHWT >2499G W OTHER MAJOR PROCEDURE

Facility

$39,385.75

Service Code	APR-DRG 6313
Hospital Charge Code	APRDRG 6313
Min. Negotiated Rate	$37,510.24
Max. Negotiated Rate	$39,385.75
Rate for Payer: BCBS Complete	$39,385.75
Rate for Payer: Mclaren Medicaid	$37,510.24
Rate for Payer: Meridian Medicaid	$39,385.75
Rate for Payer: PHP Medicaid	$37,510.24
Rate for Payer: Priority Health Choice Medicaid	$37,510.24

INPATIENT APRDRG 6314: NEONATE BIRTHWT >2499G W OTHER MAJOR PROCEDURE

Facility

$152,955.92

Service Code	APR-DRG 6314
Hospital Charge Code	APRDRG 6314
Min. Negotiated Rate	$145,672.30
Max. Negotiated Rate	$152,955.92
Rate for Payer: BCBS Complete	$152,955.92
Rate for Payer: Mclaren Medicaid	$145,672.30
Rate for Payer: Meridian Medicaid	$152,955.92
Rate for Payer: PHP Medicaid	$145,672.30
Rate for Payer: Priority Health Choice Medicaid	$145,672.30

INPATIENT APRDRG 6331: NEONATE BIRTHWT >2499G W MAJOR ANOMALY

Facility

$1,023.56

Service Code	APR-DRG 6331
Hospital Charge Code	APRDRG 6331
Min. Negotiated Rate	$974.82
Max. Negotiated Rate	$1,023.56
Rate for Payer: BCBS Complete	$1,023.56
Rate for Payer: Mclaren Medicaid	$974.82
Rate for Payer: Meridian Medicaid	$1,023.56
Rate for Payer: PHP Medicaid	$974.82
Rate for Payer: Priority Health Choice Medicaid	$974.82

INPATIENT APRDRG 6332: NEONATE BIRTHWT >2499G W MAJOR ANOMALY

Facility

$2,962.09

Service Code	APR-DRG 6332
Hospital Charge Code	APRDRG 6332
Min. Negotiated Rate	$2,821.04
Max. Negotiated Rate	$2,962.09
Rate for Payer: BCBS Complete	$2,962.09
Rate for Payer: Mclaren Medicaid	$2,821.04
Rate for Payer: Meridian Medicaid	$2,962.09
Rate for Payer: PHP Medicaid	$2,821.04
Rate for Payer: Priority Health Choice Medicaid	$2,821.04

INPATIENT APRDRG 6333: NEONATE BIRTHWT >2499G W MAJOR ANOMALY

Facility

$8,475.93

Service Code	APR-DRG 6333
Hospital Charge Code	APRDRG 6333
Min. Negotiated Rate	$8,072.31
Max. Negotiated Rate	$8,475.93
Rate for Payer: BCBS Complete	$8,475.93
Rate for Payer: Mclaren Medicaid	$8,072.31
Rate for Payer: Meridian Medicaid	$8,475.93
Rate for Payer: PHP Medicaid	$8,072.31
Rate for Payer: Priority Health Choice Medicaid	$8,072.31

INPATIENT APRDRG 6334: NEONATE BIRTHWT >2499G W MAJOR ANOMALY

Facility

$22,335.03

Service Code	APR-DRG 6334
Hospital Charge Code	APRDRG 6334
Min. Negotiated Rate	$21,271.46
Max. Negotiated Rate	$22,335.03
Rate for Payer: BCBS Complete	$22,335.03
Rate for Payer: Mclaren Medicaid	$21,271.46
Rate for Payer: Meridian Medicaid	$22,335.03
Rate for Payer: PHP Medicaid	$21,271.46
Rate for Payer: Priority Health Choice Medicaid	$21,271.46

INPATIENT APRDRG 6341: NEONATE, BIRTHWT >2499G W RESP DIST SYND/OTH MAJ RESP COND

Facility

$3,213.63

Service Code	APR-DRG 6341
Hospital Charge Code	APRDRG 6341
Min. Negotiated Rate	$3,060.60
Max. Negotiated Rate	$3,213.63
Rate for Payer: BCBS Complete	$3,213.63
Rate for Payer: Mclaren Medicaid	$3,060.60
Rate for Payer: Meridian Medicaid	$3,213.63
Rate for Payer: PHP Medicaid	$3,060.60
Rate for Payer: Priority Health Choice Medicaid	$3,060.60

INPATIENT APRDRG 6342: NEONATE, BIRTHWT >2499G W RESP DIST SYND/OTH MAJ RESP COND

Facility

$4,783.30

Service Code	APR-DRG 6342
Hospital Charge Code	APRDRG 6342
Min. Negotiated Rate	$4,555.52
Max. Negotiated Rate	$4,783.30
Rate for Payer: BCBS Complete	$4,783.30
Rate for Payer: Mclaren Medicaid	$4,555.52
Rate for Payer: Meridian Medicaid	$4,783.30
Rate for Payer: PHP Medicaid	$4,555.52
Rate for Payer: Priority Health Choice Medicaid	$4,555.52

INPATIENT APRDRG 6343: NEONATE, BIRTHWT >2499G W RESP DIST SYND/OTH MAJ RESP COND

Facility

$5,030.74

Service Code	APR-DRG 6343
Hospital Charge Code	APRDRG 6343
Min. Negotiated Rate	$4,791.18
Max. Negotiated Rate	$5,030.74
Rate for Payer: BCBS Complete	$5,030.74
Rate for Payer: Mclaren Medicaid	$4,791.18
Rate for Payer: Meridian Medicaid	$5,030.74
Rate for Payer: PHP Medicaid	$4,791.18
Rate for Payer: Priority Health Choice Medicaid	$4,791.18

Know your out-of-pocket cost for care.

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