Bronson South Haven Hospital

All Charges

Charge

Type

Setting

Price

MAJOR BLADDER PROCEDURES WITH MCC

Facility

$71,392.30

Service Code	MSDRG 653
Min. Negotiated Rate	$37,216.25
Max. Negotiated Rate	$71,392.30
Rate for Payer: Aetna Medicare	$39,175.00
Rate for Payer: Allen County Amish Medical Aid Commercial	$48,968.75
Rate for Payer: Amish Plain Church Group Commercial	$48,968.75
Rate for Payer: BCBS MAPPO	$39,175.00
Rate for Payer: BCN Medicare Advantage	$39,175.00
Rate for Payer: Health Alliance Plan Medicare Advantage	$39,175.00
Rate for Payer: Humana Choice PPO Medicare	$39,175.00
Rate for Payer: Mclaren Medicare	$39,175.00
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$41,133.75
Rate for Payer: MI Amish Medical Board Commercial	$45,051.25
Rate for Payer: Molina Medicare/Medicaid	$43,092.50
Rate for Payer: PACE Medicare	$37,216.25
Rate for Payer: PACE SWMI	$39,175.00
Rate for Payer: PHP Commercial	$43,092.50
Rate for Payer: PHP Medicare Advantage	$39,175.00
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$71,392.30
Rate for Payer: Priority Health Medicare	$39,175.00
Rate for Payer: Priority Health Narrow Network	$57,113.84
Rate for Payer: Railroad Medicare Medicare	$39,175.00
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$39,175.00
Rate for Payer: UHC Exchange	$60,721.25
Rate for Payer: UHCCP DNSP	$39,175.00
Rate for Payer: VA VA	$39,175.00

MAJOR BLADDER PROCEDURES WITHOUT CC/MCC

Facility

$29,079.54

Service Code	MSDRG 655
Min. Negotiated Rate	$16,146.78
Max. Negotiated Rate	$29,079.54
Rate for Payer: Aetna Medicare	$16,996.61
Rate for Payer: Allen County Amish Medical Aid Commercial	$21,245.76
Rate for Payer: Amish Plain Church Group Commercial	$21,245.76
Rate for Payer: BCBS MAPPO	$16,996.61
Rate for Payer: BCN Medicare Advantage	$16,996.61
Rate for Payer: Health Alliance Plan Medicare Advantage	$16,996.61
Rate for Payer: Humana Choice PPO Medicare	$16,996.61
Rate for Payer: Mclaren Medicare	$16,996.61
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$17,846.44
Rate for Payer: MI Amish Medical Board Commercial	$19,546.10
Rate for Payer: Molina Medicare/Medicaid	$18,696.27
Rate for Payer: PACE Medicare	$16,146.78
Rate for Payer: PACE SWMI	$16,996.61
Rate for Payer: PHP Commercial	$18,696.27
Rate for Payer: PHP Medicare Advantage	$16,996.61
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$29,079.54
Rate for Payer: Priority Health Medicare	$16,996.61
Rate for Payer: Priority Health Narrow Network	$23,263.64
Rate for Payer: Railroad Medicare Medicare	$16,996.61
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$16,996.61
Rate for Payer: UHC Exchange	$26,344.75
Rate for Payer: UHCCP DNSP	$16,996.61
Rate for Payer: VA VA	$16,996.61

MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY

Facility

$91,649.69

Service Code	APR-DRG 1604
Min. Negotiated Rate	$82,862.29
Max. Negotiated Rate	$91,649.69
Rate for Payer: BCBS Complete	$91,649.69
Rate for Payer: Mclaren Medicaid	$87,285.42
Rate for Payer: Meridian Medicaid	$91,649.69
Rate for Payer: PHP Medicaid	$82,862.29
Rate for Payer: Priority Health Choice Medicaid	$87,285.42
Rate for Payer: UHC Medicaid	$87,285.42
Rate for Payer: UHCCP Medicaid	$87,285.42

MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY

Facility

$36,954.69

Service Code	APR-DRG 1602
Min. Negotiated Rate	$33,411.47
Max. Negotiated Rate	$36,954.69
Rate for Payer: BCBS Complete	$36,954.69
Rate for Payer: Mclaren Medicaid	$35,194.95
Rate for Payer: Meridian Medicaid	$36,954.69
Rate for Payer: PHP Medicaid	$33,411.47
Rate for Payer: Priority Health Choice Medicaid	$35,194.95
Rate for Payer: UHC Medicaid	$35,194.95
Rate for Payer: UHCCP Medicaid	$35,194.95

MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY

Facility

$46,885.32

Service Code	APR-DRG 1603
Min. Negotiated Rate	$42,389.94
Max. Negotiated Rate	$46,885.32
Rate for Payer: BCBS Complete	$46,885.32
Rate for Payer: Mclaren Medicaid	$44,652.68
Rate for Payer: Meridian Medicaid	$46,885.32
Rate for Payer: PHP Medicaid	$42,389.94
Rate for Payer: Priority Health Choice Medicaid	$44,652.68
Rate for Payer: UHC Medicaid	$44,652.68
Rate for Payer: UHCCP Medicaid	$44,652.68

MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY

Facility

$27,416.43

Service Code	APR-DRG 1601
Min. Negotiated Rate	$24,787.74
Max. Negotiated Rate	$27,416.43
Rate for Payer: BCBS Complete	$27,416.43
Rate for Payer: Mclaren Medicaid	$26,110.89
Rate for Payer: Meridian Medicaid	$27,416.43
Rate for Payer: PHP Medicaid	$24,787.74
Rate for Payer: Priority Health Choice Medicaid	$26,110.89
Rate for Payer: UHC Medicaid	$26,110.89
Rate for Payer: UHCCP Medicaid	$26,110.89

MAJOR CHEST AND RESPIRATORY TRAUMA

Facility

$12,174.73

Service Code	APR-DRG 1354
Min. Negotiated Rate	$11,007.41
Max. Negotiated Rate	$12,174.73
Rate for Payer: BCBS Complete	$12,174.73
Rate for Payer: Mclaren Medicaid	$11,594.98
Rate for Payer: Meridian Medicaid	$12,174.73
Rate for Payer: PHP Medicaid	$11,007.41
Rate for Payer: Priority Health Choice Medicaid	$11,594.98
Rate for Payer: UHC Medicaid	$11,594.98
Rate for Payer: UHCCP Medicaid	$11,594.98

MAJOR CHEST AND RESPIRATORY TRAUMA

Facility

$4,221.73

Service Code	APR-DRG 1351
Min. Negotiated Rate	$3,816.95
Max. Negotiated Rate	$4,221.73
Rate for Payer: BCBS Complete	$4,221.73
Rate for Payer: Mclaren Medicaid	$4,020.69
Rate for Payer: Meridian Medicaid	$4,221.73
Rate for Payer: PHP Medicaid	$3,816.95
Rate for Payer: Priority Health Choice Medicaid	$4,020.69
Rate for Payer: UHC Medicaid	$4,020.69
Rate for Payer: UHCCP Medicaid	$4,020.69

MAJOR CHEST AND RESPIRATORY TRAUMA

Facility

$5,229.34

Service Code	APR-DRG 1352
Min. Negotiated Rate	$4,727.95
Max. Negotiated Rate	$5,229.34
Rate for Payer: BCBS Complete	$5,229.34
Rate for Payer: Mclaren Medicaid	$4,980.32
Rate for Payer: Meridian Medicaid	$5,229.34
Rate for Payer: PHP Medicaid	$4,727.95
Rate for Payer: Priority Health Choice Medicaid	$4,980.32
Rate for Payer: UHC Medicaid	$4,980.32
Rate for Payer: UHCCP Medicaid	$4,980.32

MAJOR CHEST AND RESPIRATORY TRAUMA

Facility

$7,374.26

Service Code	APR-DRG 1353
Min. Negotiated Rate	$6,667.22
Max. Negotiated Rate	$7,374.26
Rate for Payer: BCBS Complete	$7,374.26
Rate for Payer: Mclaren Medicaid	$7,023.11
Rate for Payer: Meridian Medicaid	$7,374.26
Rate for Payer: PHP Medicaid	$6,667.22
Rate for Payer: Priority Health Choice Medicaid	$7,023.11
Rate for Payer: UHC Medicaid	$7,023.11
Rate for Payer: UHCCP Medicaid	$7,023.11

MAJOR CHEST PROCEDURES WITH CC

Facility

$34,676.73

Service Code	MSDRG 164
Min. Negotiated Rate	$18,933.88
Max. Negotiated Rate	$34,676.73
Rate for Payer: Aetna Medicare	$19,930.40
Rate for Payer: Allen County Amish Medical Aid Commercial	$24,913.00
Rate for Payer: Amish Plain Church Group Commercial	$24,913.00
Rate for Payer: BCBS MAPPO	$19,930.40
Rate for Payer: BCN Medicare Advantage	$19,930.40
Rate for Payer: Health Alliance Plan Medicare Advantage	$19,930.40
Rate for Payer: Humana Choice PPO Medicare	$19,930.40
Rate for Payer: Mclaren Medicare	$19,930.40
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$20,926.92
Rate for Payer: MI Amish Medical Board Commercial	$22,919.96
Rate for Payer: Molina Medicare/Medicaid	$21,923.44
Rate for Payer: PACE Medicare	$18,933.88
Rate for Payer: PACE SWMI	$19,930.40
Rate for Payer: PHP Commercial	$21,923.44
Rate for Payer: PHP Medicare Advantage	$19,930.40
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$34,676.73
Rate for Payer: Priority Health Medicare	$19,930.40
Rate for Payer: Priority Health Narrow Network	$27,741.38
Rate for Payer: Railroad Medicare Medicare	$19,930.40
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$19,930.40
Rate for Payer: UHC Exchange	$30,892.12
Rate for Payer: UHCCP DNSP	$19,930.40
Rate for Payer: VA VA	$19,930.40

MAJOR CHEST PROCEDURES WITH MCC

Facility

$61,574.55

Service Code	MSDRG 163
Min. Negotiated Rate	$32,327.54
Max. Negotiated Rate	$61,574.55
Rate for Payer: Aetna Medicare	$34,028.99
Rate for Payer: Allen County Amish Medical Aid Commercial	$42,536.24
Rate for Payer: Amish Plain Church Group Commercial	$42,536.24
Rate for Payer: BCBS MAPPO	$34,028.99
Rate for Payer: BCN Medicare Advantage	$34,028.99
Rate for Payer: Health Alliance Plan Medicare Advantage	$34,028.99
Rate for Payer: Humana Choice PPO Medicare	$34,028.99
Rate for Payer: Mclaren Medicare	$34,028.99
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$35,730.44
Rate for Payer: MI Amish Medical Board Commercial	$39,133.34
Rate for Payer: Molina Medicare/Medicaid	$37,431.89
Rate for Payer: PACE Medicare	$32,327.54
Rate for Payer: PACE SWMI	$34,028.99
Rate for Payer: PHP Commercial	$37,431.89
Rate for Payer: PHP Medicare Advantage	$34,028.99
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$61,574.55
Rate for Payer: Priority Health Medicare	$34,028.99
Rate for Payer: Priority Health Narrow Network	$49,259.64
Rate for Payer: Railroad Medicare Medicare	$34,028.99
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$34,028.99
Rate for Payer: UHC Exchange	$52,744.93
Rate for Payer: UHCCP DNSP	$34,028.99
Rate for Payer: VA VA	$34,028.99

MAJOR CHEST PROCEDURES WITHOUT CC/MCC

Facility

$26,298.81

Service Code	MSDRG 165
Min. Negotiated Rate	$14,762.14
Max. Negotiated Rate	$26,298.81
Rate for Payer: Aetna Medicare	$15,539.09
Rate for Payer: Allen County Amish Medical Aid Commercial	$19,423.86
Rate for Payer: Amish Plain Church Group Commercial	$19,423.86
Rate for Payer: BCBS MAPPO	$15,539.09
Rate for Payer: BCN Medicare Advantage	$15,539.09
Rate for Payer: Health Alliance Plan Medicare Advantage	$15,539.09
Rate for Payer: Humana Choice PPO Medicare	$15,539.09
Rate for Payer: Mclaren Medicare	$15,539.09
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$16,316.04
Rate for Payer: MI Amish Medical Board Commercial	$17,869.95
Rate for Payer: Molina Medicare/Medicaid	$17,093.00
Rate for Payer: PACE Medicare	$14,762.14
Rate for Payer: PACE SWMI	$15,539.09
Rate for Payer: PHP Commercial	$17,093.00
Rate for Payer: PHP Medicare Advantage	$15,539.09
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$26,298.81
Rate for Payer: Priority Health Medicare	$15,539.09
Rate for Payer: Priority Health Narrow Network	$21,039.05
Rate for Payer: Railroad Medicare Medicare	$15,539.09
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$15,539.09
Rate for Payer: UHC Exchange	$24,085.59
Rate for Payer: UHCCP DNSP	$15,539.09
Rate for Payer: VA VA	$15,539.09

MAJOR CHEST TRAUMA WITH CC

Facility

$14,619.46

Service Code	MSDRG 184
Min. Negotiated Rate	$8,946.43
Max. Negotiated Rate	$14,619.46
Rate for Payer: Aetna Medicare	$9,417.30
Rate for Payer: Allen County Amish Medical Aid Commercial	$11,771.62
Rate for Payer: Amish Plain Church Group Commercial	$11,771.62
Rate for Payer: BCBS MAPPO	$9,417.30
Rate for Payer: BCN Medicare Advantage	$9,417.30
Rate for Payer: Health Alliance Plan Medicare Advantage	$9,417.30
Rate for Payer: Humana Choice PPO Medicare	$9,417.30
Rate for Payer: Mclaren Medicare	$9,417.30
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$9,888.17
Rate for Payer: MI Amish Medical Board Commercial	$10,829.90
Rate for Payer: Molina Medicare/Medicaid	$10,359.03
Rate for Payer: PACE Medicare	$8,946.43
Rate for Payer: PACE SWMI	$9,417.30
Rate for Payer: PHP Commercial	$10,359.03
Rate for Payer: PHP Medicare Advantage	$9,417.30
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$14,619.46
Rate for Payer: Priority Health Medicare	$9,417.30
Rate for Payer: Priority Health Narrow Network	$11,695.57
Rate for Payer: Railroad Medicare Medicare	$9,417.30
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$9,417.30
Rate for Payer: UHC Exchange	$14,596.82
Rate for Payer: UHCCP DNSP	$9,417.30
Rate for Payer: VA VA	$9,417.30

MAJOR CHEST TRAUMA WITH MCC

Facility

$21,018.99

Service Code	MSDRG 183
Min. Negotiated Rate	$12,133.07
Max. Negotiated Rate	$21,018.99
Rate for Payer: Aetna Medicare	$12,771.65
Rate for Payer: Allen County Amish Medical Aid Commercial	$15,964.56
Rate for Payer: Amish Plain Church Group Commercial	$15,964.56
Rate for Payer: BCBS MAPPO	$12,771.65
Rate for Payer: BCN Medicare Advantage	$12,771.65
Rate for Payer: Health Alliance Plan Medicare Advantage	$12,771.65
Rate for Payer: Humana Choice PPO Medicare	$12,771.65
Rate for Payer: Mclaren Medicare	$12,771.65
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$13,410.23
Rate for Payer: MI Amish Medical Board Commercial	$14,687.40
Rate for Payer: Molina Medicare/Medicaid	$14,048.82
Rate for Payer: PACE Medicare	$12,133.07
Rate for Payer: PACE SWMI	$12,771.65
Rate for Payer: PHP Commercial	$14,048.82
Rate for Payer: PHP Medicare Advantage	$12,771.65
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$21,018.99
Rate for Payer: Priority Health Medicare	$12,771.65
Rate for Payer: Priority Health Narrow Network	$16,815.19
Rate for Payer: Railroad Medicare Medicare	$12,771.65
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$12,771.65
Rate for Payer: UHC Exchange	$19,796.06
Rate for Payer: UHCCP DNSP	$12,771.65
Rate for Payer: VA VA	$12,771.65

MAJOR CHEST TRAUMA WITHOUT CC/MCC

Facility

$11,498.27

Service Code	MSDRG 185
Min. Negotiated Rate	$7,047.33
Max. Negotiated Rate	$11,498.27
Rate for Payer: Aetna Medicare	$7,418.24
Rate for Payer: Allen County Amish Medical Aid Commercial	$9,272.80
Rate for Payer: Amish Plain Church Group Commercial	$9,272.80
Rate for Payer: BCBS MAPPO	$7,418.24
Rate for Payer: BCN Medicare Advantage	$7,418.24
Rate for Payer: Health Alliance Plan Medicare Advantage	$7,418.24
Rate for Payer: Humana Choice PPO Medicare	$7,418.24
Rate for Payer: Mclaren Medicare	$7,418.24
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$7,789.15
Rate for Payer: MI Amish Medical Board Commercial	$8,530.98
Rate for Payer: Molina Medicare/Medicaid	$8,160.06
Rate for Payer: PACE Medicare	$7,047.33
Rate for Payer: PACE SWMI	$7,418.24
Rate for Payer: PHP Commercial	$8,160.06
Rate for Payer: PHP Medicare Advantage	$7,418.24
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$10,805.57
Rate for Payer: Priority Health Medicare	$7,418.24
Rate for Payer: Priority Health Narrow Network	$8,644.45
Rate for Payer: Railroad Medicare Medicare	$7,418.24
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$7,418.24
Rate for Payer: UHC Exchange	$11,498.27
Rate for Payer: UHCCP DNSP	$7,418.24
Rate for Payer: VA VA	$7,418.24

MAJOR CRANIAL OR FACIAL BONE PROCEDURES

Facility

$22,775.10

Service Code	APR-DRG 0893
Min. Negotiated Rate	$20,591.41
Max. Negotiated Rate	$22,775.10
Rate for Payer: BCBS Complete	$22,775.10
Rate for Payer: Mclaren Medicaid	$21,690.57
Rate for Payer: Meridian Medicaid	$22,775.10
Rate for Payer: PHP Medicaid	$20,591.41
Rate for Payer: Priority Health Choice Medicaid	$21,690.57
Rate for Payer: UHC Medicaid	$21,690.57
Rate for Payer: UHCCP Medicaid	$21,690.57

MAJOR CRANIAL OR FACIAL BONE PROCEDURES

Facility

$11,674.46

Service Code	APR-DRG 0891
Min. Negotiated Rate	$10,555.11
Max. Negotiated Rate	$11,674.46
Rate for Payer: BCBS Complete	$11,674.46
Rate for Payer: Mclaren Medicaid	$11,118.54
Rate for Payer: Meridian Medicaid	$11,674.46
Rate for Payer: PHP Medicaid	$10,555.11
Rate for Payer: Priority Health Choice Medicaid	$11,118.54
Rate for Payer: UHC Medicaid	$11,118.54
Rate for Payer: UHCCP Medicaid	$11,118.54

MAJOR CRANIAL OR FACIAL BONE PROCEDURES

Facility

$16,727.79

Service Code	APR-DRG 0892
Min. Negotiated Rate	$15,123.92
Max. Negotiated Rate	$16,727.79
Rate for Payer: BCBS Complete	$16,727.79
Rate for Payer: Mclaren Medicaid	$15,931.22
Rate for Payer: Meridian Medicaid	$16,727.79
Rate for Payer: PHP Medicaid	$15,123.92
Rate for Payer: Priority Health Choice Medicaid	$15,931.22
Rate for Payer: UHC Medicaid	$15,931.22
Rate for Payer: UHCCP Medicaid	$15,931.22

MAJOR CRANIAL OR FACIAL BONE PROCEDURES

Facility

$32,459.95

Service Code	APR-DRG 0894
Min. Negotiated Rate	$29,347.68
Max. Negotiated Rate	$32,459.95
Rate for Payer: BCBS Complete	$32,459.95
Rate for Payer: Mclaren Medicaid	$30,914.24
Rate for Payer: Meridian Medicaid	$32,459.95
Rate for Payer: PHP Medicaid	$29,347.68
Rate for Payer: Priority Health Choice Medicaid	$30,914.24
Rate for Payer: UHC Medicaid	$30,914.24
Rate for Payer: UHCCP Medicaid	$30,914.24

MAJOR ESOPHAGEAL DISORDERS

Facility

$4,057.70

Service Code	APR-DRG 2421
Min. Negotiated Rate	$3,668.64
Max. Negotiated Rate	$4,057.70
Rate for Payer: BCBS Complete	$4,057.70
Rate for Payer: Mclaren Medicaid	$3,864.47
Rate for Payer: Meridian Medicaid	$4,057.70
Rate for Payer: PHP Medicaid	$3,668.64
Rate for Payer: Priority Health Choice Medicaid	$3,864.47
Rate for Payer: UHC Medicaid	$3,864.47
Rate for Payer: UHCCP Medicaid	$3,864.47

MAJOR ESOPHAGEAL DISORDERS

Facility

$5,594.46

Service Code	APR-DRG 2422
Min. Negotiated Rate	$5,058.06
Max. Negotiated Rate	$5,594.46
Rate for Payer: BCBS Complete	$5,594.46
Rate for Payer: Mclaren Medicaid	$5,328.05
Rate for Payer: Meridian Medicaid	$5,594.46
Rate for Payer: PHP Medicaid	$5,058.06
Rate for Payer: Priority Health Choice Medicaid	$5,328.05
Rate for Payer: UHC Medicaid	$5,328.05
Rate for Payer: UHCCP Medicaid	$5,328.05

MAJOR ESOPHAGEAL DISORDERS

Facility

$7,925.75

Service Code	APR-DRG 2423
Min. Negotiated Rate	$7,165.83
Max. Negotiated Rate	$7,925.75
Rate for Payer: BCBS Complete	$7,925.75
Rate for Payer: Mclaren Medicaid	$7,548.34
Rate for Payer: Meridian Medicaid	$7,925.75
Rate for Payer: PHP Medicaid	$7,165.83
Rate for Payer: Priority Health Choice Medicaid	$7,548.34
Rate for Payer: UHC Medicaid	$7,548.34
Rate for Payer: UHCCP Medicaid	$7,548.34

MAJOR ESOPHAGEAL DISORDERS

Facility

$12,114.78

Service Code	APR-DRG 2424
Min. Negotiated Rate	$10,953.21
Max. Negotiated Rate	$12,114.78
Rate for Payer: BCBS Complete	$12,114.78
Rate for Payer: Mclaren Medicaid	$11,537.89
Rate for Payer: Meridian Medicaid	$12,114.78
Rate for Payer: PHP Medicaid	$10,953.21
Rate for Payer: Priority Health Choice Medicaid	$11,537.89
Rate for Payer: UHC Medicaid	$11,537.89
Rate for Payer: UHCCP Medicaid	$11,537.89

MAJOR ESOPHAGEAL DISORDERS WITH CC

Facility

$13,883.57

Service Code	MSDRG 369
Min. Negotiated Rate	$8,509.28
Max. Negotiated Rate	$13,883.57
Rate for Payer: Aetna Medicare	$8,957.14
Rate for Payer: Allen County Amish Medical Aid Commercial	$11,196.42
Rate for Payer: Amish Plain Church Group Commercial	$11,196.42
Rate for Payer: BCBS MAPPO	$8,957.14
Rate for Payer: BCN Medicare Advantage	$8,957.14
Rate for Payer: Health Alliance Plan Medicare Advantage	$8,957.14
Rate for Payer: Humana Choice PPO Medicare	$8,957.14
Rate for Payer: Mclaren Medicare	$8,957.14
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$9,405.00
Rate for Payer: MI Amish Medical Board Commercial	$10,300.71
Rate for Payer: Molina Medicare/Medicaid	$9,852.85
Rate for Payer: PACE Medicare	$8,509.28
Rate for Payer: PACE SWMI	$8,957.14
Rate for Payer: PHP Commercial	$9,852.85
Rate for Payer: PHP Medicare Advantage	$8,957.14
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$13,741.55
Rate for Payer: Priority Health Medicare	$8,957.14
Rate for Payer: Priority Health Narrow Network	$10,993.24
Rate for Payer: Railroad Medicare Medicare	$8,957.14
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$8,957.14
Rate for Payer: UHC Exchange	$13,883.57
Rate for Payer: UHCCP DNSP	$8,957.14
Rate for Payer: VA VA	$8,957.14

Know your out-of-pocket cost for care.

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