Bronson South Haven Hospital

All Charges

Charge

Type

Setting

Price

MAJOR SKIN DISORDERS WITH MCC

Facility

$29,135.87

Service Code	MSDRG 595
Min. Negotiated Rate	$16,174.83
Max. Negotiated Rate	$29,135.87
Rate for Payer: Aetna Medicare	$17,026.14
Rate for Payer: Allen County Amish Medical Aid Commercial	$21,282.67
Rate for Payer: Amish Plain Church Group Commercial	$21,282.67
Rate for Payer: BCBS MAPPO	$17,026.14
Rate for Payer: BCN Medicare Advantage	$17,026.14
Rate for Payer: Health Alliance Plan Medicare Advantage	$17,026.14
Rate for Payer: Humana Choice PPO Medicare	$17,026.14
Rate for Payer: Mclaren Medicare	$17,026.14
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$17,877.45
Rate for Payer: MI Amish Medical Board Commercial	$19,580.06
Rate for Payer: Molina Medicare/Medicaid	$18,728.75
Rate for Payer: PACE Medicare	$16,174.83
Rate for Payer: PACE SWMI	$17,026.14
Rate for Payer: PHP Commercial	$18,728.75
Rate for Payer: PHP Medicare Advantage	$17,026.14
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$29,135.87
Rate for Payer: Priority Health Medicare	$17,026.14
Rate for Payer: Priority Health Narrow Network	$23,308.70
Rate for Payer: Railroad Medicare Medicare	$17,026.14
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$17,026.14
Rate for Payer: UHC Exchange	$26,390.52
Rate for Payer: UHCCP DNSP	$17,026.14
Rate for Payer: VA VA	$17,026.14

MAJOR SKIN DISORDERS WITHOUT MCC

Facility

$14,872.25

Service Code	MSDRG 596
Min. Negotiated Rate	$9,072.31
Max. Negotiated Rate	$14,872.25
Rate for Payer: Aetna Medicare	$9,549.80
Rate for Payer: Allen County Amish Medical Aid Commercial	$11,937.25
Rate for Payer: Amish Plain Church Group Commercial	$11,937.25
Rate for Payer: BCBS MAPPO	$9,549.80
Rate for Payer: BCN Medicare Advantage	$9,549.80
Rate for Payer: Health Alliance Plan Medicare Advantage	$9,549.80
Rate for Payer: Humana Choice PPO Medicare	$9,549.80
Rate for Payer: Mclaren Medicare	$9,549.80
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$10,027.29
Rate for Payer: MI Amish Medical Board Commercial	$10,982.27
Rate for Payer: Molina Medicare/Medicaid	$10,504.78
Rate for Payer: PACE Medicare	$9,072.31
Rate for Payer: PACE SWMI	$9,549.80
Rate for Payer: PHP Commercial	$10,504.78
Rate for Payer: PHP Medicare Advantage	$9,549.80
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$14,872.25
Rate for Payer: Priority Health Medicare	$9,549.80
Rate for Payer: Priority Health Narrow Network	$11,897.80
Rate for Payer: Railroad Medicare Medicare	$9,549.80
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$9,549.80
Rate for Payer: UHC Exchange	$14,802.19
Rate for Payer: UHCCP DNSP	$9,549.80
Rate for Payer: VA VA	$9,549.80

MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC

Facility

$32,934.65

Service Code	MSDRG 330
Min. Negotiated Rate	$18,066.43
Max. Negotiated Rate	$32,934.65
Rate for Payer: Aetna Medicare	$19,017.29
Rate for Payer: Allen County Amish Medical Aid Commercial	$23,771.61
Rate for Payer: Amish Plain Church Group Commercial	$23,771.61
Rate for Payer: BCBS MAPPO	$19,017.29
Rate for Payer: BCN Medicare Advantage	$19,017.29
Rate for Payer: Health Alliance Plan Medicare Advantage	$19,017.29
Rate for Payer: Humana Choice PPO Medicare	$19,017.29
Rate for Payer: Mclaren Medicare	$19,017.29
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$19,968.15
Rate for Payer: MI Amish Medical Board Commercial	$21,869.88
Rate for Payer: Molina Medicare/Medicaid	$20,919.02
Rate for Payer: PACE Medicare	$18,066.43
Rate for Payer: PACE SWMI	$19,017.29
Rate for Payer: PHP Commercial	$20,919.02
Rate for Payer: PHP Medicare Advantage	$19,017.29
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$32,934.65
Rate for Payer: Priority Health Medicare	$19,017.29
Rate for Payer: Priority Health Narrow Network	$26,347.72
Rate for Payer: Railroad Medicare Medicare	$19,017.29
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$19,017.29
Rate for Payer: UHC Exchange	$29,476.80
Rate for Payer: UHCCP DNSP	$19,017.29
Rate for Payer: VA VA	$19,017.29

MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC

Facility

$63,150.39

Service Code	MSDRG 329
Min. Negotiated Rate	$33,112.22
Max. Negotiated Rate	$63,150.39
Rate for Payer: Aetna Medicare	$34,854.97
Rate for Payer: Allen County Amish Medical Aid Commercial	$43,568.71
Rate for Payer: Amish Plain Church Group Commercial	$43,568.71
Rate for Payer: BCBS MAPPO	$34,854.97
Rate for Payer: BCN Medicare Advantage	$34,854.97
Rate for Payer: Health Alliance Plan Medicare Advantage	$34,854.97
Rate for Payer: Humana Choice PPO Medicare	$34,854.97
Rate for Payer: Mclaren Medicare	$34,854.97
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$36,597.72
Rate for Payer: MI Amish Medical Board Commercial	$40,083.22
Rate for Payer: Molina Medicare/Medicaid	$38,340.47
Rate for Payer: PACE Medicare	$33,112.22
Rate for Payer: PACE SWMI	$34,854.97
Rate for Payer: PHP Commercial	$38,340.47
Rate for Payer: PHP Medicare Advantage	$34,854.97
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$63,150.39
Rate for Payer: Priority Health Medicare	$34,854.97
Rate for Payer: Priority Health Narrow Network	$50,520.32
Rate for Payer: Railroad Medicare Medicare	$34,854.97
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$34,854.97
Rate for Payer: UHC Exchange	$54,025.20
Rate for Payer: UHCCP DNSP	$34,854.97
Rate for Payer: VA VA	$34,854.97

MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC

Facility

$23,121.03

Service Code	MSDRG 331
Min. Negotiated Rate	$13,179.76
Max. Negotiated Rate	$23,121.03
Rate for Payer: Aetna Medicare	$13,873.43
Rate for Payer: Allen County Amish Medical Aid Commercial	$17,341.79
Rate for Payer: Amish Plain Church Group Commercial	$17,341.79
Rate for Payer: BCBS MAPPO	$13,873.43
Rate for Payer: BCN Medicare Advantage	$13,873.43
Rate for Payer: Health Alliance Plan Medicare Advantage	$13,873.43
Rate for Payer: Humana Choice PPO Medicare	$13,873.43
Rate for Payer: Mclaren Medicare	$13,873.43
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$14,567.10
Rate for Payer: MI Amish Medical Board Commercial	$15,954.44
Rate for Payer: Molina Medicare/Medicaid	$15,260.77
Rate for Payer: PACE Medicare	$13,179.76
Rate for Payer: PACE SWMI	$13,873.43
Rate for Payer: PHP Commercial	$15,260.77
Rate for Payer: PHP Medicare Advantage	$13,873.43
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$23,121.03
Rate for Payer: Priority Health Medicare	$13,873.43
Rate for Payer: Priority Health Narrow Network	$18,496.82
Rate for Payer: Railroad Medicare Medicare	$13,873.43
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$13,873.43
Rate for Payer: UHC Exchange	$21,503.82
Rate for Payer: UHCCP DNSP	$13,873.43
Rate for Payer: VA VA	$13,873.43

MAJOR SMALL BOWEL PROCEDURES

Facility

$6,947.02

Service Code	APR-DRG 2301
Min. Negotiated Rate	$6,280.94
Max. Negotiated Rate	$6,947.02
Rate for Payer: BCBS Complete	$6,947.02
Rate for Payer: Mclaren Medicaid	$6,616.21
Rate for Payer: Meridian Medicaid	$6,947.02
Rate for Payer: PHP Medicaid	$6,280.94
Rate for Payer: Priority Health Choice Medicaid	$6,616.21
Rate for Payer: UHC Medicaid	$6,616.21
Rate for Payer: UHCCP Medicaid	$6,616.21

MAJOR SMALL BOWEL PROCEDURES

Facility

$11,519.15

Service Code	APR-DRG 2302
Min. Negotiated Rate	$10,414.69
Max. Negotiated Rate	$11,519.15
Rate for Payer: BCBS Complete	$11,519.15
Rate for Payer: Mclaren Medicaid	$10,970.62
Rate for Payer: Meridian Medicaid	$11,519.15
Rate for Payer: PHP Medicaid	$10,414.69
Rate for Payer: Priority Health Choice Medicaid	$10,970.62
Rate for Payer: UHC Medicaid	$10,970.62
Rate for Payer: UHCCP Medicaid	$10,970.62

MAJOR SMALL BOWEL PROCEDURES

Facility

$26,961.40

Service Code	APR-DRG 2304
Min. Negotiated Rate	$24,376.33
Max. Negotiated Rate	$26,961.40
Rate for Payer: BCBS Complete	$26,961.40
Rate for Payer: Mclaren Medicaid	$25,677.53
Rate for Payer: Meridian Medicaid	$26,961.40
Rate for Payer: PHP Medicaid	$24,376.33
Rate for Payer: Priority Health Choice Medicaid	$25,677.53
Rate for Payer: UHC Medicaid	$25,677.53
Rate for Payer: UHCCP Medicaid	$25,677.53

MAJOR SMALL BOWEL PROCEDURES

Facility

$16,949.03

Service Code	APR-DRG 2303
Min. Negotiated Rate	$15,323.96
Max. Negotiated Rate	$16,949.03
Rate for Payer: BCBS Complete	$16,949.03
Rate for Payer: Mclaren Medicaid	$16,141.94
Rate for Payer: Meridian Medicaid	$16,949.03
Rate for Payer: PHP Medicaid	$15,323.96
Rate for Payer: Priority Health Choice Medicaid	$16,141.94
Rate for Payer: UHC Medicaid	$16,141.94
Rate for Payer: UHCCP Medicaid	$16,141.94

MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES

Facility

$9,556.24

Service Code	APR-DRG 2201
Min. Negotiated Rate	$8,639.99
Max. Negotiated Rate	$9,556.24
Rate for Payer: BCBS Complete	$9,556.24
Rate for Payer: Mclaren Medicaid	$9,101.18
Rate for Payer: Meridian Medicaid	$9,556.24
Rate for Payer: PHP Medicaid	$8,639.99
Rate for Payer: Priority Health Choice Medicaid	$9,101.18
Rate for Payer: UHC Medicaid	$9,101.18
Rate for Payer: UHCCP Medicaid	$9,101.18

MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES

Facility

$16,197.55

Service Code	APR-DRG 2203
Min. Negotiated Rate	$14,644.52
Max. Negotiated Rate	$16,197.55
Rate for Payer: BCBS Complete	$16,197.55
Rate for Payer: Mclaren Medicaid	$15,426.24
Rate for Payer: Meridian Medicaid	$16,197.55
Rate for Payer: PHP Medicaid	$14,644.52
Rate for Payer: Priority Health Choice Medicaid	$15,426.24
Rate for Payer: UHC Medicaid	$15,426.24
Rate for Payer: UHCCP Medicaid	$15,426.24

MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES

Facility

$26,381.57

Service Code	APR-DRG 2204
Min. Negotiated Rate	$23,852.10
Max. Negotiated Rate	$26,381.57
Rate for Payer: BCBS Complete	$26,381.57
Rate for Payer: Mclaren Medicaid	$25,125.31
Rate for Payer: Meridian Medicaid	$26,381.57
Rate for Payer: PHP Medicaid	$23,852.10
Rate for Payer: Priority Health Choice Medicaid	$25,125.31
Rate for Payer: UHC Medicaid	$25,125.31
Rate for Payer: UHCCP Medicaid	$25,125.31

MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES

Facility

$11,503.35

Service Code	APR-DRG 2202
Min. Negotiated Rate	$10,400.40
Max. Negotiated Rate	$11,503.35
Rate for Payer: BCBS Complete	$11,503.35
Rate for Payer: Mclaren Medicaid	$10,955.57
Rate for Payer: Meridian Medicaid	$11,503.35
Rate for Payer: PHP Medicaid	$10,400.40
Rate for Payer: Priority Health Choice Medicaid	$10,955.57
Rate for Payer: UHC Medicaid	$10,955.57
Rate for Payer: UHCCP Medicaid	$10,955.57

MAJOR THUMB OR JOINT PROCEDURES

Facility

$18,536.39

Service Code	MSDRG 506
Min. Negotiated Rate	$10,896.85
Max. Negotiated Rate	$18,536.39
Rate for Payer: Aetna Medicare	$11,470.37
Rate for Payer: Allen County Amish Medical Aid Commercial	$14,337.96
Rate for Payer: Amish Plain Church Group Commercial	$14,337.96
Rate for Payer: BCBS MAPPO	$11,470.37
Rate for Payer: BCN Medicare Advantage	$11,470.37
Rate for Payer: Health Alliance Plan Medicare Advantage	$11,470.37
Rate for Payer: Humana Choice PPO Medicare	$11,470.37
Rate for Payer: Mclaren Medicare	$11,470.37
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$12,043.89
Rate for Payer: MI Amish Medical Board Commercial	$13,190.93
Rate for Payer: Molina Medicare/Medicaid	$12,617.41
Rate for Payer: PACE Medicare	$10,896.85
Rate for Payer: PACE SWMI	$11,470.37
Rate for Payer: PHP Commercial	$12,617.41
Rate for Payer: PHP Medicare Advantage	$11,470.37
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$18,536.39
Rate for Payer: Priority Health Medicare	$11,470.37
Rate for Payer: Priority Health Narrow Network	$14,829.11
Rate for Payer: Railroad Medicare Medicare	$11,470.37
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$11,470.37
Rate for Payer: UHC Exchange	$17,779.07
Rate for Payer: UHCCP DNSP	$11,470.37
Rate for Payer: VA VA	$11,470.37

MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY

Facility

$11,672.28

Service Code	APR-DRG 5014
Min. Negotiated Rate	$10,553.14
Max. Negotiated Rate	$11,672.28
Rate for Payer: BCBS Complete	$11,672.28
Rate for Payer: Mclaren Medicaid	$11,116.46
Rate for Payer: Meridian Medicaid	$11,672.28
Rate for Payer: PHP Medicaid	$10,553.14
Rate for Payer: Priority Health Choice Medicaid	$11,116.46
Rate for Payer: UHC Medicaid	$11,116.46
Rate for Payer: UHCCP Medicaid	$11,116.46

MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY

Facility

$5,808.62

Service Code	APR-DRG 5013
Min. Negotiated Rate	$5,251.69
Max. Negotiated Rate	$5,808.62
Rate for Payer: BCBS Complete	$5,808.62
Rate for Payer: Mclaren Medicaid	$5,532.02
Rate for Payer: Meridian Medicaid	$5,808.62
Rate for Payer: PHP Medicaid	$5,251.69
Rate for Payer: Priority Health Choice Medicaid	$5,532.02
Rate for Payer: UHC Medicaid	$5,532.02
Rate for Payer: UHCCP Medicaid	$5,532.02

MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY

Facility

$3,906.75

Service Code	APR-DRG 5012
Min. Negotiated Rate	$3,532.17
Max. Negotiated Rate	$3,906.75
Rate for Payer: BCBS Complete	$3,906.75
Rate for Payer: Mclaren Medicaid	$3,720.71
Rate for Payer: Meridian Medicaid	$3,906.75
Rate for Payer: PHP Medicaid	$3,532.17
Rate for Payer: Priority Health Choice Medicaid	$3,720.71
Rate for Payer: UHC Medicaid	$3,720.71
Rate for Payer: UHCCP Medicaid	$3,720.71

MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY

Facility

$3,269.16

Service Code	APR-DRG 5011
Min. Negotiated Rate	$2,955.71
Max. Negotiated Rate	$3,269.16
Rate for Payer: BCBS Complete	$3,269.16
Rate for Payer: Mclaren Medicaid	$3,113.48
Rate for Payer: Meridian Medicaid	$3,269.16
Rate for Payer: PHP Medicaid	$2,955.71
Rate for Payer: Priority Health Choice Medicaid	$3,113.48
Rate for Payer: UHC Medicaid	$3,113.48
Rate for Payer: UHCCP Medicaid	$3,113.48

MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE

Facility

$3,965.06

Service Code	APR-DRG 2521
Min. Negotiated Rate	$3,584.89
Max. Negotiated Rate	$3,965.06
Rate for Payer: BCBS Complete	$3,965.06
Rate for Payer: Mclaren Medicaid	$3,776.24
Rate for Payer: Meridian Medicaid	$3,965.06
Rate for Payer: PHP Medicaid	$3,584.89
Rate for Payer: Priority Health Choice Medicaid	$3,776.24
Rate for Payer: UHC Medicaid	$3,776.24
Rate for Payer: UHCCP Medicaid	$3,776.24

MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE

Facility

$6,697.44

Service Code	APR-DRG 2523
Min. Negotiated Rate	$6,055.28
Max. Negotiated Rate	$6,697.44
Rate for Payer: BCBS Complete	$6,697.44
Rate for Payer: Mclaren Medicaid	$6,378.51
Rate for Payer: Meridian Medicaid	$6,697.44
Rate for Payer: PHP Medicaid	$6,055.28
Rate for Payer: Priority Health Choice Medicaid	$6,378.51
Rate for Payer: UHC Medicaid	$6,378.51
Rate for Payer: UHCCP Medicaid	$6,378.51

MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE

Facility

$11,326.24

Service Code	APR-DRG 2524
Min. Negotiated Rate	$10,240.28
Max. Negotiated Rate	$11,326.24
Rate for Payer: BCBS Complete	$11,326.24
Rate for Payer: Mclaren Medicaid	$10,786.90
Rate for Payer: Meridian Medicaid	$11,326.24
Rate for Payer: PHP Medicaid	$10,240.28
Rate for Payer: Priority Health Choice Medicaid	$10,786.90
Rate for Payer: UHC Medicaid	$10,786.90
Rate for Payer: UHCCP Medicaid	$10,786.90

MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE

Facility

$5,702.90

Service Code	APR-DRG 2522
Min. Negotiated Rate	$5,156.11
Max. Negotiated Rate	$5,702.90
Rate for Payer: BCBS Complete	$5,702.90
Rate for Payer: Mclaren Medicaid	$5,431.34
Rate for Payer: Meridian Medicaid	$5,702.90
Rate for Payer: PHP Medicaid	$5,156.11
Rate for Payer: Priority Health Choice Medicaid	$5,431.34
Rate for Payer: UHC Medicaid	$5,431.34
Rate for Payer: UHCCP Medicaid	$5,431.34

MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE

Facility

$13,121.85

Service Code	APR-DRG 2064
Min. Negotiated Rate	$11,863.72
Max. Negotiated Rate	$13,121.85
Rate for Payer: BCBS Complete	$13,121.85
Rate for Payer: Mclaren Medicaid	$12,497.00
Rate for Payer: Meridian Medicaid	$13,121.85
Rate for Payer: PHP Medicaid	$11,863.72
Rate for Payer: Priority Health Choice Medicaid	$12,497.00
Rate for Payer: UHC Medicaid	$12,497.00
Rate for Payer: UHCCP Medicaid	$12,497.00

MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE

Facility

$7,105.06

Service Code	APR-DRG 2063
Min. Negotiated Rate	$6,423.82
Max. Negotiated Rate	$7,105.06
Rate for Payer: BCBS Complete	$7,105.06
Rate for Payer: Mclaren Medicaid	$6,766.72
Rate for Payer: Meridian Medicaid	$7,105.06
Rate for Payer: PHP Medicaid	$6,423.82
Rate for Payer: Priority Health Choice Medicaid	$6,766.72
Rate for Payer: UHC Medicaid	$6,766.72
Rate for Payer: UHCCP Medicaid	$6,766.72

MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE

Facility

$4,045.71

Service Code	APR-DRG 2061
Min. Negotiated Rate	$3,657.80
Max. Negotiated Rate	$4,045.71
Rate for Payer: BCBS Complete	$4,045.71
Rate for Payer: Mclaren Medicaid	$3,853.06
Rate for Payer: Meridian Medicaid	$4,045.71
Rate for Payer: PHP Medicaid	$3,657.80
Rate for Payer: Priority Health Choice Medicaid	$3,853.06
Rate for Payer: UHC Medicaid	$3,853.06
Rate for Payer: UHCCP Medicaid	$3,853.06

Know your out-of-pocket cost for care.

All Charges