Bronson South Haven Hospital

All Charges

Charge

Type

Setting

Price

MAJOR ESOPHAGEAL DISORDERS WITH MCC

Facility

$21,870.80

Service Code	MSDRG 368
Min. Negotiated Rate	$12,557.21
Max. Negotiated Rate	$21,870.80
Rate for Payer: Aetna Medicare	$13,218.12
Rate for Payer: Allen County Amish Medical Aid Commercial	$16,522.65
Rate for Payer: Amish Plain Church Group Commercial	$16,522.65
Rate for Payer: BCBS MAPPO	$13,218.12
Rate for Payer: BCN Medicare Advantage	$13,218.12
Rate for Payer: Health Alliance Plan Medicare Advantage	$13,218.12
Rate for Payer: Humana Choice PPO Medicare	$13,218.12
Rate for Payer: Mclaren Medicare	$13,218.12
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$13,879.03
Rate for Payer: MI Amish Medical Board Commercial	$15,200.84
Rate for Payer: Molina Medicare/Medicaid	$14,539.93
Rate for Payer: PACE Medicare	$12,557.21
Rate for Payer: PACE SWMI	$13,218.12
Rate for Payer: PHP Commercial	$14,539.93
Rate for Payer: PHP Medicare Advantage	$13,218.12
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$21,870.80
Rate for Payer: Priority Health Medicare	$13,218.12
Rate for Payer: Priority Health Narrow Network	$17,496.64
Rate for Payer: Railroad Medicare Medicare	$13,218.12
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$13,218.12
Rate for Payer: UHC Exchange	$20,488.09
Rate for Payer: UHCCP DNSP	$13,218.12
Rate for Payer: VA VA	$13,218.12

MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC

Facility

$10,541.69

Service Code	MSDRG 370
Min. Negotiated Rate	$6,461.04
Max. Negotiated Rate	$10,541.69
Rate for Payer: Aetna Medicare	$6,801.09
Rate for Payer: Allen County Amish Medical Aid Commercial	$8,501.36
Rate for Payer: Amish Plain Church Group Commercial	$8,501.36
Rate for Payer: BCBS MAPPO	$6,801.09
Rate for Payer: BCN Medicare Advantage	$6,801.09
Rate for Payer: Health Alliance Plan Medicare Advantage	$6,801.09
Rate for Payer: Humana Choice PPO Medicare	$6,801.09
Rate for Payer: Mclaren Medicare	$6,801.09
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$7,141.14
Rate for Payer: MI Amish Medical Board Commercial	$7,821.25
Rate for Payer: Molina Medicare/Medicaid	$7,481.20
Rate for Payer: PACE Medicare	$6,461.04
Rate for Payer: PACE SWMI	$6,801.09
Rate for Payer: PHP Commercial	$7,481.20
Rate for Payer: PHP Medicare Advantage	$6,801.09
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$9,628.15
Rate for Payer: Priority Health Medicare	$6,801.09
Rate for Payer: Priority Health Narrow Network	$7,702.52
Rate for Payer: Railroad Medicare Medicare	$6,801.09
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$6,801.09
Rate for Payer: UHC Exchange	$10,541.69
Rate for Payer: UHCCP DNSP	$6,801.09
Rate for Payer: VA VA	$6,801.09

MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS

Facility

$4,720.90

Service Code	APR-DRG 2482
Min. Negotiated Rate	$4,268.26
Max. Negotiated Rate	$4,720.90
Rate for Payer: BCBS Complete	$4,720.90
Rate for Payer: Mclaren Medicaid	$4,496.10
Rate for Payer: Meridian Medicaid	$4,720.90
Rate for Payer: PHP Medicaid	$4,268.26
Rate for Payer: Priority Health Choice Medicaid	$4,496.10
Rate for Payer: UHC Medicaid	$4,496.10
Rate for Payer: UHCCP Medicaid	$4,496.10

MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS

Facility

$10,078.31

Service Code	APR-DRG 2484
Min. Negotiated Rate	$9,111.99
Max. Negotiated Rate	$10,078.31
Rate for Payer: BCBS Complete	$10,078.31
Rate for Payer: Mclaren Medicaid	$9,598.39
Rate for Payer: Meridian Medicaid	$10,078.31
Rate for Payer: PHP Medicaid	$9,111.99
Rate for Payer: Priority Health Choice Medicaid	$9,598.39
Rate for Payer: UHC Medicaid	$9,598.39
Rate for Payer: UHCCP Medicaid	$9,598.39

MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS

Facility

$6,192.27

Service Code	APR-DRG 2483
Min. Negotiated Rate	$5,598.55
Max. Negotiated Rate	$6,192.27
Rate for Payer: BCBS Complete	$6,192.27
Rate for Payer: Mclaren Medicaid	$5,897.40
Rate for Payer: Meridian Medicaid	$6,192.27
Rate for Payer: PHP Medicaid	$5,598.55
Rate for Payer: Priority Health Choice Medicaid	$5,897.40
Rate for Payer: UHC Medicaid	$5,897.40
Rate for Payer: UHCCP Medicaid	$5,897.40

MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS

Facility

$3,617.38

Service Code	APR-DRG 2481
Min. Negotiated Rate	$3,270.54
Max. Negotiated Rate	$3,617.38
Rate for Payer: BCBS Complete	$3,617.38
Rate for Payer: Mclaren Medicaid	$3,445.12
Rate for Payer: Meridian Medicaid	$3,617.38
Rate for Payer: PHP Medicaid	$3,270.54
Rate for Payer: Priority Health Choice Medicaid	$3,445.12
Rate for Payer: UHC Medicaid	$3,445.12
Rate for Payer: UHCCP Medicaid	$3,445.12

MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC

Facility

$14,115.73

Service Code	MSDRG 372
Min. Negotiated Rate	$8,651.57
Max. Negotiated Rate	$14,115.73
Rate for Payer: Aetna Medicare	$9,106.92
Rate for Payer: Allen County Amish Medical Aid Commercial	$11,383.65
Rate for Payer: Amish Plain Church Group Commercial	$11,383.65
Rate for Payer: BCBS MAPPO	$9,106.92
Rate for Payer: BCN Medicare Advantage	$9,106.92
Rate for Payer: Health Alliance Plan Medicare Advantage	$9,106.92
Rate for Payer: Humana Choice PPO Medicare	$9,106.92
Rate for Payer: Mclaren Medicare	$9,106.92
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$9,562.27
Rate for Payer: MI Amish Medical Board Commercial	$10,472.96
Rate for Payer: Molina Medicare/Medicaid	$10,017.61
Rate for Payer: PACE Medicare	$8,651.57
Rate for Payer: PACE SWMI	$9,106.92
Rate for Payer: PHP Commercial	$10,017.61
Rate for Payer: PHP Medicare Advantage	$9,106.92
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$14,027.31
Rate for Payer: Priority Health Medicare	$9,106.92
Rate for Payer: Priority Health Narrow Network	$11,221.85
Rate for Payer: Railroad Medicare Medicare	$9,106.92
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$9,106.92
Rate for Payer: UHC Exchange	$14,115.73
Rate for Payer: UHCCP DNSP	$9,106.92
Rate for Payer: VA VA	$9,106.92

MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC

Facility

$24,360.27

Service Code	MSDRG 371
Min. Negotiated Rate	$13,796.83
Max. Negotiated Rate	$24,360.27
Rate for Payer: Aetna Medicare	$14,522.98
Rate for Payer: Allen County Amish Medical Aid Commercial	$18,153.72
Rate for Payer: Amish Plain Church Group Commercial	$18,153.72
Rate for Payer: BCBS MAPPO	$14,522.98
Rate for Payer: BCN Medicare Advantage	$14,522.98
Rate for Payer: Health Alliance Plan Medicare Advantage	$14,522.98
Rate for Payer: Humana Choice PPO Medicare	$14,522.98
Rate for Payer: Mclaren Medicare	$14,522.98
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$15,249.13
Rate for Payer: MI Amish Medical Board Commercial	$16,701.43
Rate for Payer: Molina Medicare/Medicaid	$15,975.28
Rate for Payer: PACE Medicare	$13,796.83
Rate for Payer: PACE SWMI	$14,522.98
Rate for Payer: PHP Commercial	$15,975.28
Rate for Payer: PHP Medicare Advantage	$14,522.98
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$24,360.27
Rate for Payer: Priority Health Medicare	$14,522.98
Rate for Payer: Priority Health Narrow Network	$19,488.21
Rate for Payer: Railroad Medicare Medicare	$14,522.98
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$14,522.98
Rate for Payer: UHC Exchange	$22,510.62
Rate for Payer: UHCCP DNSP	$14,522.98
Rate for Payer: VA VA	$14,522.98

MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC

Facility

$10,838.61

Service Code	MSDRG 373
Min. Negotiated Rate	$6,643.02
Max. Negotiated Rate	$10,838.61
Rate for Payer: Aetna Medicare	$6,992.65
Rate for Payer: Allen County Amish Medical Aid Commercial	$8,740.81
Rate for Payer: Amish Plain Church Group Commercial	$8,740.81
Rate for Payer: BCBS MAPPO	$6,992.65
Rate for Payer: BCN Medicare Advantage	$6,992.65
Rate for Payer: Health Alliance Plan Medicare Advantage	$6,992.65
Rate for Payer: Humana Choice PPO Medicare	$6,992.65
Rate for Payer: Mclaren Medicare	$6,992.65
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$7,342.28
Rate for Payer: MI Amish Medical Board Commercial	$8,041.55
Rate for Payer: Molina Medicare/Medicaid	$7,691.91
Rate for Payer: PACE Medicare	$6,643.02
Rate for Payer: PACE SWMI	$6,992.65
Rate for Payer: PHP Commercial	$7,691.91
Rate for Payer: PHP Medicare Advantage	$6,992.65
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$9,993.60
Rate for Payer: Priority Health Medicare	$6,992.65
Rate for Payer: Priority Health Narrow Network	$7,994.88
Rate for Payer: Railroad Medicare Medicare	$6,992.65
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$6,992.65
Rate for Payer: UHC Exchange	$10,838.61
Rate for Payer: UHCCP DNSP	$6,992.65
Rate for Payer: VA VA	$6,992.65

MAJOR HEAD AND NECK PROCEDURES WITH CC

Facility

$29,965.70

Service Code	MSDRG 141
Min. Negotiated Rate	$16,588.04
Max. Negotiated Rate	$29,965.70
Rate for Payer: Aetna Medicare	$17,461.09
Rate for Payer: Allen County Amish Medical Aid Commercial	$21,826.36
Rate for Payer: Amish Plain Church Group Commercial	$21,826.36
Rate for Payer: BCBS MAPPO	$17,461.09
Rate for Payer: BCN Medicare Advantage	$17,461.09
Rate for Payer: Health Alliance Plan Medicare Advantage	$17,461.09
Rate for Payer: Humana Choice PPO Medicare	$17,461.09
Rate for Payer: Mclaren Medicare	$17,461.09
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$18,334.14
Rate for Payer: MI Amish Medical Board Commercial	$20,080.25
Rate for Payer: Molina Medicare/Medicaid	$19,207.20
Rate for Payer: PACE Medicare	$16,588.04
Rate for Payer: PACE SWMI	$17,461.09
Rate for Payer: PHP Commercial	$19,207.20
Rate for Payer: PHP Medicare Advantage	$17,461.09
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$29,965.70
Rate for Payer: Priority Health Medicare	$17,461.09
Rate for Payer: Priority Health Narrow Network	$23,972.56
Rate for Payer: Railroad Medicare Medicare	$17,461.09
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$17,461.09
Rate for Payer: UHC Exchange	$27,064.69
Rate for Payer: UHCCP DNSP	$17,461.09
Rate for Payer: VA VA	$17,461.09

MAJOR HEAD AND NECK PROCEDURES WITH MCC

Facility

$58,600.10

Service Code	MSDRG 140
Min. Negotiated Rate	$30,846.43
Max. Negotiated Rate	$58,600.10
Rate for Payer: Aetna Medicare	$32,469.93
Rate for Payer: Allen County Amish Medical Aid Commercial	$40,587.41
Rate for Payer: Amish Plain Church Group Commercial	$40,587.41
Rate for Payer: BCBS MAPPO	$32,469.93
Rate for Payer: BCN Medicare Advantage	$32,469.93
Rate for Payer: Health Alliance Plan Medicare Advantage	$32,469.93
Rate for Payer: Humana Choice PPO Medicare	$32,469.93
Rate for Payer: Mclaren Medicare	$32,469.93
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$34,093.43
Rate for Payer: MI Amish Medical Board Commercial	$37,340.42
Rate for Payer: Molina Medicare/Medicaid	$35,716.92
Rate for Payer: PACE Medicare	$30,846.43
Rate for Payer: PACE SWMI	$32,469.93
Rate for Payer: PHP Commercial	$35,716.92
Rate for Payer: PHP Medicare Advantage	$32,469.93
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$58,600.10
Rate for Payer: Priority Health Medicare	$32,469.93
Rate for Payer: Priority Health Narrow Network	$46,880.08
Rate for Payer: Railroad Medicare Medicare	$32,469.93
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$32,469.93
Rate for Payer: UHC Exchange	$50,328.39
Rate for Payer: UHCCP DNSP	$32,469.93
Rate for Payer: VA VA	$32,469.93

MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC

Facility

$21,932.62

Service Code	MSDRG 142
Min. Negotiated Rate	$12,588.00
Max. Negotiated Rate	$21,932.62
Rate for Payer: Aetna Medicare	$13,250.53
Rate for Payer: Allen County Amish Medical Aid Commercial	$16,563.16
Rate for Payer: Amish Plain Church Group Commercial	$16,563.16
Rate for Payer: BCBS MAPPO	$13,250.53
Rate for Payer: BCN Medicare Advantage	$13,250.53
Rate for Payer: Health Alliance Plan Medicare Advantage	$13,250.53
Rate for Payer: Humana Choice PPO Medicare	$13,250.53
Rate for Payer: Mclaren Medicare	$13,250.53
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$13,913.06
Rate for Payer: MI Amish Medical Board Commercial	$15,238.11
Rate for Payer: Molina Medicare/Medicaid	$14,575.58
Rate for Payer: PACE Medicare	$12,588.00
Rate for Payer: PACE SWMI	$13,250.53
Rate for Payer: PHP Commercial	$14,575.58
Rate for Payer: PHP Medicare Advantage	$13,250.53
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$21,932.62
Rate for Payer: Priority Health Medicare	$13,250.53
Rate for Payer: Priority Health Narrow Network	$17,546.10
Rate for Payer: Railroad Medicare Medicare	$13,250.53
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$13,250.53
Rate for Payer: UHC Exchange	$20,538.32
Rate for Payer: UHCCP DNSP	$13,250.53
Rate for Payer: VA VA	$13,250.53

MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC

Facility

$17,391.95

Service Code	MSDRG 809
Min. Negotiated Rate	$10,326.99
Max. Negotiated Rate	$17,391.95
Rate for Payer: Aetna Medicare	$10,870.52
Rate for Payer: Allen County Amish Medical Aid Commercial	$13,588.15
Rate for Payer: Amish Plain Church Group Commercial	$13,588.15
Rate for Payer: BCBS MAPPO	$10,870.52
Rate for Payer: BCN Medicare Advantage	$10,870.52
Rate for Payer: Health Alliance Plan Medicare Advantage	$10,870.52
Rate for Payer: Humana Choice PPO Medicare	$10,870.52
Rate for Payer: Mclaren Medicare	$10,870.52
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$11,414.05
Rate for Payer: MI Amish Medical Board Commercial	$12,501.10
Rate for Payer: Molina Medicare/Medicaid	$11,957.57
Rate for Payer: PACE Medicare	$10,326.99
Rate for Payer: PACE SWMI	$10,870.52
Rate for Payer: PHP Commercial	$11,957.57
Rate for Payer: PHP Medicare Advantage	$10,870.52
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$17,391.95
Rate for Payer: Priority Health Medicare	$10,870.52
Rate for Payer: Priority Health Narrow Network	$13,913.56
Rate for Payer: Railroad Medicare Medicare	$10,870.52
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$10,870.52
Rate for Payer: UHC Exchange	$16,849.31
Rate for Payer: UHCCP DNSP	$10,870.52
Rate for Payer: VA VA	$10,870.52

MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC

Facility

$30,333.90

Service Code	MSDRG 808
Min. Negotiated Rate	$16,771.39
Max. Negotiated Rate	$30,333.90
Rate for Payer: Aetna Medicare	$17,654.09
Rate for Payer: Allen County Amish Medical Aid Commercial	$22,067.61
Rate for Payer: Amish Plain Church Group Commercial	$22,067.61
Rate for Payer: BCBS MAPPO	$17,654.09
Rate for Payer: BCN Medicare Advantage	$17,654.09
Rate for Payer: Health Alliance Plan Medicare Advantage	$17,654.09
Rate for Payer: Humana Choice PPO Medicare	$17,654.09
Rate for Payer: Mclaren Medicare	$17,654.09
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$18,536.79
Rate for Payer: MI Amish Medical Board Commercial	$20,302.20
Rate for Payer: Molina Medicare/Medicaid	$19,419.50
Rate for Payer: PACE Medicare	$16,771.39
Rate for Payer: PACE SWMI	$17,654.09
Rate for Payer: PHP Commercial	$19,419.50
Rate for Payer: PHP Medicare Advantage	$17,654.09
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$30,333.90
Rate for Payer: Priority Health Medicare	$17,654.09
Rate for Payer: Priority Health Narrow Network	$24,267.12
Rate for Payer: Railroad Medicare Medicare	$17,654.09
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$17,654.09
Rate for Payer: UHC Exchange	$27,363.84
Rate for Payer: UHCCP DNSP	$17,654.09
Rate for Payer: VA VA	$17,654.09

MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC

Facility

$14,401.47

Service Code	MSDRG 810
Min. Negotiated Rate	$8,826.71
Max. Negotiated Rate	$14,401.47
Rate for Payer: Aetna Medicare	$9,291.27
Rate for Payer: Allen County Amish Medical Aid Commercial	$11,614.09
Rate for Payer: Amish Plain Church Group Commercial	$11,614.09
Rate for Payer: BCBS MAPPO	$9,291.27
Rate for Payer: BCN Medicare Advantage	$9,291.27
Rate for Payer: Health Alliance Plan Medicare Advantage	$9,291.27
Rate for Payer: Humana Choice PPO Medicare	$9,291.27
Rate for Payer: Mclaren Medicare	$9,291.27
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$9,755.83
Rate for Payer: MI Amish Medical Board Commercial	$10,684.96
Rate for Payer: Molina Medicare/Medicaid	$10,220.40
Rate for Payer: PACE Medicare	$8,826.71
Rate for Payer: PACE SWMI	$9,291.27
Rate for Payer: PHP Commercial	$10,220.40
Rate for Payer: PHP Medicare Advantage	$9,291.27
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$14,379.03
Rate for Payer: Priority Health Medicare	$9,291.27
Rate for Payer: Priority Health Narrow Network	$11,503.22
Rate for Payer: Railroad Medicare Medicare	$9,291.27
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$9,291.27
Rate for Payer: UHC Exchange	$14,401.47
Rate for Payer: UHCCP DNSP	$9,291.27
Rate for Payer: VA VA	$9,291.27

MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION

Facility

$16,440.05

Service Code	APR-DRG 6604
Min. Negotiated Rate	$14,863.77
Max. Negotiated Rate	$16,440.05
Rate for Payer: BCBS Complete	$16,440.05
Rate for Payer: Mclaren Medicaid	$15,657.19
Rate for Payer: Meridian Medicaid	$16,440.05
Rate for Payer: PHP Medicaid	$14,863.77
Rate for Payer: Priority Health Choice Medicaid	$15,657.19
Rate for Payer: UHC Medicaid	$15,657.19
Rate for Payer: UHCCP Medicaid	$15,657.19

MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION

Facility

$3,517.65

Service Code	APR-DRG 6601
Min. Negotiated Rate	$3,180.38
Max. Negotiated Rate	$3,517.65
Rate for Payer: BCBS Complete	$3,517.65
Rate for Payer: Mclaren Medicaid	$3,350.14
Rate for Payer: Meridian Medicaid	$3,517.65
Rate for Payer: PHP Medicaid	$3,180.38
Rate for Payer: Priority Health Choice Medicaid	$3,350.14
Rate for Payer: UHC Medicaid	$3,350.14
Rate for Payer: UHCCP Medicaid	$3,350.14

MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION

Facility

$8,477.79

Service Code	APR-DRG 6603
Min. Negotiated Rate	$7,664.93
Max. Negotiated Rate	$8,477.79
Rate for Payer: BCBS Complete	$8,477.79
Rate for Payer: Mclaren Medicaid	$8,074.08
Rate for Payer: Meridian Medicaid	$8,477.79
Rate for Payer: PHP Medicaid	$7,664.93
Rate for Payer: Priority Health Choice Medicaid	$8,074.08
Rate for Payer: UHC Medicaid	$8,074.08
Rate for Payer: UHCCP Medicaid	$8,074.08

MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION

Facility

$4,619.00

Service Code	APR-DRG 6602
Min. Negotiated Rate	$4,176.13
Max. Negotiated Rate	$4,619.00
Rate for Payer: BCBS Complete	$4,619.00
Rate for Payer: Mclaren Medicaid	$4,399.04
Rate for Payer: Meridian Medicaid	$4,619.00
Rate for Payer: PHP Medicaid	$4,176.13
Rate for Payer: Priority Health Choice Medicaid	$4,399.04
Rate for Payer: UHC Medicaid	$4,399.04
Rate for Payer: UHCCP Medicaid	$4,399.04

MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT

Facility

$41,672.53

Service Code	MSDRG 469
Min. Negotiated Rate	$22,417.41
Max. Negotiated Rate	$41,672.53
Rate for Payer: Aetna Medicare	$23,597.27
Rate for Payer: Allen County Amish Medical Aid Commercial	$29,496.59
Rate for Payer: Amish Plain Church Group Commercial	$29,496.59
Rate for Payer: BCBS MAPPO	$23,597.27
Rate for Payer: BCN Medicare Advantage	$23,597.27
Rate for Payer: Health Alliance Plan Medicare Advantage	$23,597.27
Rate for Payer: Humana Choice PPO Medicare	$23,597.27
Rate for Payer: Mclaren Medicare	$23,597.27
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$24,777.13
Rate for Payer: MI Amish Medical Board Commercial	$27,136.86
Rate for Payer: Molina Medicare/Medicaid	$25,957.00
Rate for Payer: PACE Medicare	$22,417.41
Rate for Payer: PACE SWMI	$23,597.27
Rate for Payer: PHP Commercial	$25,957.00
Rate for Payer: PHP Medicare Advantage	$23,597.27
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$41,672.53
Rate for Payer: Priority Health Medicare	$23,597.27
Rate for Payer: Priority Health Narrow Network	$33,338.02
Rate for Payer: Railroad Medicare Medicare	$23,597.27
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$23,597.27
Rate for Payer: UHC Exchange	$36,575.77
Rate for Payer: UHCCP DNSP	$23,597.27
Rate for Payer: VA VA	$23,597.27

MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC

Facility

$26,500.77

Service Code	MSDRG 470
Min. Negotiated Rate	$14,862.69
Max. Negotiated Rate	$26,500.77
Rate for Payer: Aetna Medicare	$15,644.94
Rate for Payer: Allen County Amish Medical Aid Commercial	$19,556.17
Rate for Payer: Amish Plain Church Group Commercial	$19,556.17
Rate for Payer: BCBS MAPPO	$15,644.94
Rate for Payer: BCN Medicare Advantage	$15,644.94
Rate for Payer: Health Alliance Plan Medicare Advantage	$15,644.94
Rate for Payer: Humana Choice PPO Medicare	$15,644.94
Rate for Payer: Mclaren Medicare	$15,644.94
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$16,427.19
Rate for Payer: MI Amish Medical Board Commercial	$17,991.68
Rate for Payer: Molina Medicare/Medicaid	$17,209.43
Rate for Payer: PACE Medicare	$14,862.69
Rate for Payer: PACE SWMI	$15,644.94
Rate for Payer: PHP Commercial	$17,209.43
Rate for Payer: PHP Medicare Advantage	$15,644.94
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$26,500.77
Rate for Payer: Priority Health Medicare	$15,644.94
Rate for Payer: Priority Health Narrow Network	$21,200.62
Rate for Payer: Railroad Medicare Medicare	$15,644.94
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$15,644.94
Rate for Payer: UHC Exchange	$24,249.66
Rate for Payer: UHCCP DNSP	$15,644.94
Rate for Payer: VA VA	$15,644.94

MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES

Facility

$38,082.58

Service Code	MSDRG 483
Min. Negotiated Rate	$20,629.81
Max. Negotiated Rate	$38,082.58
Rate for Payer: Aetna Medicare	$21,715.59
Rate for Payer: Allen County Amish Medical Aid Commercial	$27,144.49
Rate for Payer: Amish Plain Church Group Commercial	$27,144.49
Rate for Payer: BCBS MAPPO	$21,715.59
Rate for Payer: BCN Medicare Advantage	$21,715.59
Rate for Payer: Health Alliance Plan Medicare Advantage	$21,715.59
Rate for Payer: Humana Choice PPO Medicare	$21,715.59
Rate for Payer: Mclaren Medicare	$21,715.59
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$22,801.37
Rate for Payer: MI Amish Medical Board Commercial	$24,972.93
Rate for Payer: Molina Medicare/Medicaid	$23,887.15
Rate for Payer: PACE Medicare	$20,629.81
Rate for Payer: PACE SWMI	$21,715.59
Rate for Payer: PHP Commercial	$23,887.15
Rate for Payer: PHP Medicare Advantage	$21,715.59
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$38,082.58
Rate for Payer: Priority Health Medicare	$21,715.59
Rate for Payer: Priority Health Narrow Network	$30,466.06
Rate for Payer: Railroad Medicare Medicare	$21,715.59
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$21,715.59
Rate for Payer: UHC Exchange	$33,659.16
Rate for Payer: UHCCP DNSP	$21,715.59
Rate for Payer: VA VA	$21,715.59

MAJOR LARGE BOWEL PROCEDURES

Facility

$24,112.95

Service Code	APR-DRG 2314
Min. Negotiated Rate	$21,800.99
Max. Negotiated Rate	$24,112.95
Rate for Payer: BCBS Complete	$24,112.95
Rate for Payer: Mclaren Medicaid	$22,964.71
Rate for Payer: Meridian Medicaid	$24,112.95
Rate for Payer: PHP Medicaid	$21,800.99
Rate for Payer: Priority Health Choice Medicaid	$22,964.71
Rate for Payer: UHC Medicaid	$22,964.71
Rate for Payer: UHCCP Medicaid	$22,964.71

MAJOR LARGE BOWEL PROCEDURES

Facility

$8,579.69

Service Code	APR-DRG 2311
Min. Negotiated Rate	$7,757.07
Max. Negotiated Rate	$8,579.69
Rate for Payer: BCBS Complete	$8,579.69
Rate for Payer: Mclaren Medicaid	$8,171.14
Rate for Payer: Meridian Medicaid	$8,579.69
Rate for Payer: PHP Medicaid	$7,757.07
Rate for Payer: Priority Health Choice Medicaid	$8,171.14
Rate for Payer: UHC Medicaid	$8,171.14
Rate for Payer: UHCCP Medicaid	$8,171.14

MAJOR LARGE BOWEL PROCEDURES

Facility

$11,087.01

Service Code	APR-DRG 2312
Min. Negotiated Rate	$10,023.98
Max. Negotiated Rate	$11,087.01
Rate for Payer: BCBS Complete	$11,087.01
Rate for Payer: Mclaren Medicaid	$10,559.06
Rate for Payer: Meridian Medicaid	$11,087.01
Rate for Payer: PHP Medicaid	$10,023.98
Rate for Payer: Priority Health Choice Medicaid	$10,559.06
Rate for Payer: UHC Medicaid	$10,559.06
Rate for Payer: UHCCP Medicaid	$10,559.06

Know your out-of-pocket cost for care.

All Charges