Bronson South Haven Hospital

All Charges

Charge

Type

Setting

Price

NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <

Facility

$94,399.51

Service Code	APR-DRG 5893
Min. Negotiated Rate	$85,348.45
Max. Negotiated Rate	$94,399.51
Rate for Payer: BCBS Complete	$94,399.51
Rate for Payer: Mclaren Medicaid	$89,904.29
Rate for Payer: Meridian Medicaid	$94,399.51
Rate for Payer: PHP Medicaid	$85,348.45
Rate for Payer: Priority Health Choice Medicaid	$89,904.29
Rate for Payer: UHC Medicaid	$89,904.29
Rate for Payer: UHCCP Medicaid	$89,904.29

NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <

Facility

$94,467.63

Service Code	APR-DRG 5892
Min. Negotiated Rate	$85,410.04
Max. Negotiated Rate	$94,467.63
Rate for Payer: BCBS Complete	$94,467.63
Rate for Payer: Mclaren Medicaid	$89,969.17
Rate for Payer: Meridian Medicaid	$94,467.63
Rate for Payer: PHP Medicaid	$85,410.04
Rate for Payer: Priority Health Choice Medicaid	$89,969.17
Rate for Payer: UHC Medicaid	$89,969.17
Rate for Payer: UHCCP Medicaid	$89,969.17

NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <

Facility

$1,810.87

Service Code	APR-DRG 5894
Min. Negotiated Rate	$1,637.24
Max. Negotiated Rate	$1,810.87
Rate for Payer: BCBS Complete	$1,810.87
Rate for Payer: Mclaren Medicaid	$1,724.64
Rate for Payer: Meridian Medicaid	$1,810.87
Rate for Payer: PHP Medicaid	$1,637.24
Rate for Payer: Priority Health Choice Medicaid	$1,724.64
Rate for Payer: UHC Medicaid	$1,724.64
Rate for Payer: UHCCP Medicaid	$1,724.64

NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <

Facility

$93,248.57

Service Code	APR-DRG 5891
Min. Negotiated Rate	$84,307.87
Max. Negotiated Rate	$93,248.57
Rate for Payer: BCBS Complete	$93,248.57
Rate for Payer: Mclaren Medicaid	$88,808.17
Rate for Payer: Meridian Medicaid	$93,248.57
Rate for Payer: PHP Medicaid	$84,307.87
Rate for Payer: Priority Health Choice Medicaid	$88,808.17
Rate for Payer: UHC Medicaid	$88,808.17
Rate for Payer: UHCCP Medicaid	$88,808.17

NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE

Facility

$121,207.23

Service Code	APR-DRG 5934
Min. Negotiated Rate	$109,585.84
Max. Negotiated Rate	$121,207.23
Rate for Payer: BCBS Complete	$121,207.23
Rate for Payer: Mclaren Medicaid	$115,435.46
Rate for Payer: Meridian Medicaid	$121,207.23
Rate for Payer: PHP Medicaid	$109,585.84
Rate for Payer: Priority Health Choice Medicaid	$115,435.46
Rate for Payer: UHC Medicaid	$115,435.46
Rate for Payer: UHCCP Medicaid	$115,435.46

NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE

Facility

$81,939.77

Service Code	APR-DRG 5933
Min. Negotiated Rate	$74,083.36
Max. Negotiated Rate	$81,939.77
Rate for Payer: BCBS Complete	$81,939.77
Rate for Payer: Mclaren Medicaid	$78,037.88
Rate for Payer: Meridian Medicaid	$81,939.77
Rate for Payer: PHP Medicaid	$74,083.36
Rate for Payer: Priority Health Choice Medicaid	$78,037.88
Rate for Payer: UHC Medicaid	$78,037.88
Rate for Payer: UHCCP Medicaid	$78,037.88

NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE

Facility

$50,751.74

Service Code	APR-DRG 5932
Min. Negotiated Rate	$45,885.64
Max. Negotiated Rate	$50,751.74
Rate for Payer: BCBS Complete	$50,751.74
Rate for Payer: Mclaren Medicaid	$48,334.99
Rate for Payer: Meridian Medicaid	$50,751.74
Rate for Payer: PHP Medicaid	$45,885.64
Rate for Payer: Priority Health Choice Medicaid	$48,334.99
Rate for Payer: UHC Medicaid	$48,334.99
Rate for Payer: UHCCP Medicaid	$48,334.99

NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE

Facility

$26,242.61

Service Code	APR-DRG 5931
Min. Negotiated Rate	$23,726.46
Max. Negotiated Rate	$26,242.61
Rate for Payer: BCBS Complete	$26,242.61
Rate for Payer: Mclaren Medicaid	$24,992.96
Rate for Payer: Meridian Medicaid	$26,242.61
Rate for Payer: PHP Medicaid	$23,726.46
Rate for Payer: Priority Health Choice Medicaid	$24,992.96
Rate for Payer: UHC Medicaid	$24,992.96
Rate for Payer: UHCCP Medicaid	$24,992.96

NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY

Facility

$31,406.90

Service Code	MSDRG 789
Min. Negotiated Rate	$13,995.91
Max. Negotiated Rate	$31,406.90
Rate for Payer: Aetna Medicare	$14,732.54
Rate for Payer: Allen County Amish Medical Aid Commercial	$18,415.67
Rate for Payer: Amish Plain Church Group Commercial	$18,415.67
Rate for Payer: BCBS MAPPO	$14,732.54
Rate for Payer: BCN Medicare Advantage	$14,732.54
Rate for Payer: Health Alliance Plan Medicare Advantage	$14,732.54
Rate for Payer: Humana Choice PPO Medicare	$14,732.54
Rate for Payer: Mclaren Medicare	$14,732.54
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$15,469.17
Rate for Payer: MI Amish Medical Board Commercial	$16,942.42
Rate for Payer: Molina Medicare/Medicaid	$16,205.79
Rate for Payer: PACE Medicare	$13,995.91
Rate for Payer: PACE SWMI	$14,732.54
Rate for Payer: PHP Commercial	$16,205.79
Rate for Payer: PHP Medicare Advantage	$14,732.54
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$31,406.90
Rate for Payer: Priority Health Medicare	$14,732.54
Rate for Payer: Priority Health Narrow Network	$25,125.52
Rate for Payer: Railroad Medicare Medicare	$14,732.54
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$14,732.54
Rate for Payer: UHC Exchange	$22,835.44
Rate for Payer: UHCCP DNSP	$14,732.54
Rate for Payer: VA VA	$14,732.54

NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE

Facility

$1,113.88

Service Code	APR-DRG 5812
Min. Negotiated Rate	$1,007.08
Max. Negotiated Rate	$1,113.88
Rate for Payer: BCBS Complete	$1,113.88
Rate for Payer: Mclaren Medicaid	$1,060.84
Rate for Payer: Meridian Medicaid	$1,113.88
Rate for Payer: PHP Medicaid	$1,007.08
Rate for Payer: Priority Health Choice Medicaid	$1,060.84
Rate for Payer: UHC Medicaid	$1,060.84
Rate for Payer: UHCCP Medicaid	$1,060.84

NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE

Facility

$12,816.13

Service Code	APR-DRG 5814
Min. Negotiated Rate	$11,587.32
Max. Negotiated Rate	$12,816.13
Rate for Payer: BCBS Complete	$12,816.13
Rate for Payer: Mclaren Medicaid	$12,205.84
Rate for Payer: Meridian Medicaid	$12,816.13
Rate for Payer: PHP Medicaid	$11,587.32
Rate for Payer: Priority Health Choice Medicaid	$12,205.84
Rate for Payer: UHC Medicaid	$12,205.84
Rate for Payer: UHCCP Medicaid	$12,205.84

NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE

Facility

$653.40

Service Code	APR-DRG 5811
Min. Negotiated Rate	$590.75
Max. Negotiated Rate	$653.40
Rate for Payer: BCBS Complete	$653.40
Rate for Payer: Mclaren Medicaid	$622.28
Rate for Payer: Meridian Medicaid	$653.40
Rate for Payer: PHP Medicaid	$590.75
Rate for Payer: Priority Health Choice Medicaid	$622.28
Rate for Payer: UHC Medicaid	$622.28
Rate for Payer: UHCCP Medicaid	$622.28

NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE

Facility

$2,623.39

Service Code	APR-DRG 5813
Min. Negotiated Rate	$2,371.86
Max. Negotiated Rate	$2,623.39
Rate for Payer: BCBS Complete	$2,623.39
Rate for Payer: Mclaren Medicaid	$2,498.47
Rate for Payer: Meridian Medicaid	$2,623.39
Rate for Payer: PHP Medicaid	$2,371.86
Rate for Payer: Priority Health Choice Medicaid	$2,498.47
Rate for Payer: UHC Medicaid	$2,498.47
Rate for Payer: UHCCP Medicaid	$2,498.47

NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE

Facility

$9,210.74

Service Code	APR-DRG 5804
Min. Negotiated Rate	$8,327.62
Max. Negotiated Rate	$9,210.74
Rate for Payer: BCBS Complete	$9,210.74
Rate for Payer: Mclaren Medicaid	$8,772.14
Rate for Payer: Meridian Medicaid	$9,210.74
Rate for Payer: PHP Medicaid	$8,327.62
Rate for Payer: Priority Health Choice Medicaid	$8,772.14
Rate for Payer: UHC Medicaid	$8,772.14
Rate for Payer: UHCCP Medicaid	$8,772.14

NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE

Facility

$4,742.15

Service Code	APR-DRG 5803
Min. Negotiated Rate	$4,287.48
Max. Negotiated Rate	$4,742.15
Rate for Payer: BCBS Complete	$4,742.15
Rate for Payer: Mclaren Medicaid	$4,516.34
Rate for Payer: Meridian Medicaid	$4,742.15
Rate for Payer: PHP Medicaid	$4,287.48
Rate for Payer: Priority Health Choice Medicaid	$4,516.34
Rate for Payer: UHC Medicaid	$4,516.34
Rate for Payer: UHCCP Medicaid	$4,516.34

NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE

Facility

$2,440.83

Service Code	APR-DRG 5802
Min. Negotiated Rate	$2,206.80
Max. Negotiated Rate	$2,440.83
Rate for Payer: BCBS Complete	$2,440.83
Rate for Payer: Mclaren Medicaid	$2,324.60
Rate for Payer: Meridian Medicaid	$2,440.83
Rate for Payer: PHP Medicaid	$2,206.80
Rate for Payer: Priority Health Choice Medicaid	$2,324.60
Rate for Payer: UHC Medicaid	$2,324.60
Rate for Payer: UHCCP Medicaid	$2,324.60

NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE

Facility

$1,803.24

Service Code	APR-DRG 5801
Min. Negotiated Rate	$1,630.34
Max. Negotiated Rate	$1,803.24
Rate for Payer: BCBS Complete	$1,803.24
Rate for Payer: Mclaren Medicaid	$1,717.37
Rate for Payer: Meridian Medicaid	$1,803.24
Rate for Payer: PHP Medicaid	$1,630.34
Rate for Payer: Priority Health Choice Medicaid	$1,717.37
Rate for Payer: UHC Medicaid	$1,717.37
Rate for Payer: UHCCP Medicaid	$1,717.37

NEONATE WITH ECMO

Facility

$182,693.94

Service Code	APR-DRG 5833
Min. Negotiated Rate	$165,177.18
Max. Negotiated Rate	$182,693.94
Rate for Payer: BCBS Complete	$182,693.94
Rate for Payer: Mclaren Medicaid	$173,994.23
Rate for Payer: Meridian Medicaid	$182,693.94
Rate for Payer: PHP Medicaid	$165,177.18
Rate for Payer: Priority Health Choice Medicaid	$173,994.23
Rate for Payer: UHC Medicaid	$173,994.23
Rate for Payer: UHCCP Medicaid	$173,994.23

NEONATE WITH ECMO

Facility

$302,188.94

Service Code	APR-DRG 5834
Min. Negotiated Rate	$273,214.96
Max. Negotiated Rate	$302,188.94
Rate for Payer: BCBS Complete	$302,188.94
Rate for Payer: Mclaren Medicaid	$287,798.99
Rate for Payer: Meridian Medicaid	$302,188.94
Rate for Payer: PHP Medicaid	$273,214.96
Rate for Payer: Priority Health Choice Medicaid	$287,798.99
Rate for Payer: UHC Medicaid	$287,798.99
Rate for Payer: UHCCP Medicaid	$287,798.99

NEONATE WITH ECMO

Facility

$101,288.22

Service Code	APR-DRG 5832
Min. Negotiated Rate	$91,576.67
Max. Negotiated Rate	$101,288.22
Rate for Payer: BCBS Complete	$101,288.22
Rate for Payer: Mclaren Medicaid	$96,464.97
Rate for Payer: Meridian Medicaid	$101,288.22
Rate for Payer: PHP Medicaid	$91,576.67
Rate for Payer: Priority Health Choice Medicaid	$96,464.97
Rate for Payer: UHC Medicaid	$96,464.97
Rate for Payer: UHCCP Medicaid	$96,464.97

NEONATE WITH ECMO

Facility

$86,406.18

Service Code	APR-DRG 5831
Min. Negotiated Rate	$78,121.53
Max. Negotiated Rate	$86,406.18
Rate for Payer: BCBS Complete	$86,406.18
Rate for Payer: Mclaren Medicaid	$82,291.60
Rate for Payer: Meridian Medicaid	$86,406.18
Rate for Payer: PHP Medicaid	$78,121.53
Rate for Payer: Priority Health Choice Medicaid	$82,291.60
Rate for Payer: UHC Medicaid	$82,291.60
Rate for Payer: UHCCP Medicaid	$82,291.60

NEONATE WITH OTHER SIGNIFICANT PROBLEMS

Facility

$19,193.31

Service Code	MSDRG 794
Min. Negotiated Rate	$2,289.43
Max. Negotiated Rate	$19,193.31
Rate for Payer: Aetna Medicare	$12,382.78
Rate for Payer: Allen County Amish Medical Aid Commercial	$15,478.48
Rate for Payer: Amish Plain Church Group Commercial	$15,478.48
Rate for Payer: BCBS MAPPO	$12,382.78
Rate for Payer: BCN Medicare Advantage	$12,382.78
Rate for Payer: Health Alliance Plan Medicare Advantage	$12,382.78
Rate for Payer: Humana Choice PPO Medicare	$12,382.78
Rate for Payer: Mclaren Medicare	$12,382.78
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$13,001.92
Rate for Payer: MI Amish Medical Board Commercial	$14,240.20
Rate for Payer: Molina Medicare/Medicaid	$13,621.06
Rate for Payer: PACE Medicare	$11,763.64
Rate for Payer: PACE SWMI	$12,382.78
Rate for Payer: PHP Commercial	$13,621.06
Rate for Payer: PHP Medicare Advantage	$12,382.78
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$2,861.79
Rate for Payer: Priority Health Medicare	$12,382.78
Rate for Payer: Priority Health Narrow Network	$2,289.43
Rate for Payer: Railroad Medicare Medicare	$12,382.78
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$12,382.78
Rate for Payer: UHC Exchange	$19,193.31
Rate for Payer: UHCCP DNSP	$12,382.78
Rate for Payer: VA VA	$12,382.78

NEPHRITIS AND NEPHROSIS

Facility

$3,101.31

Service Code	APR-DRG 4621
Min. Negotiated Rate	$2,803.96
Max. Negotiated Rate	$3,101.31
Rate for Payer: BCBS Complete	$3,101.31
Rate for Payer: Mclaren Medicaid	$2,953.63
Rate for Payer: Meridian Medicaid	$3,101.31
Rate for Payer: PHP Medicaid	$2,803.96
Rate for Payer: Priority Health Choice Medicaid	$2,953.63
Rate for Payer: UHC Medicaid	$2,953.63
Rate for Payer: UHCCP Medicaid	$2,953.63

NEPHRITIS AND NEPHROSIS

Facility

$4,434.26

Service Code	APR-DRG 4622
Min. Negotiated Rate	$4,009.10
Max. Negotiated Rate	$4,434.26
Rate for Payer: BCBS Complete	$4,434.26
Rate for Payer: Mclaren Medicaid	$4,223.10
Rate for Payer: Meridian Medicaid	$4,434.26
Rate for Payer: PHP Medicaid	$4,009.10
Rate for Payer: Priority Health Choice Medicaid	$4,223.10
Rate for Payer: UHC Medicaid	$4,223.10
Rate for Payer: UHCCP Medicaid	$4,223.10

NEPHRITIS AND NEPHROSIS

Facility

$7,343.20

Service Code	APR-DRG 4623
Min. Negotiated Rate	$6,639.13
Max. Negotiated Rate	$7,343.20
Rate for Payer: BCBS Complete	$7,343.20
Rate for Payer: Mclaren Medicaid	$6,993.52
Rate for Payer: Meridian Medicaid	$7,343.20
Rate for Payer: PHP Medicaid	$6,639.13
Rate for Payer: Priority Health Choice Medicaid	$6,993.52
Rate for Payer: UHC Medicaid	$6,993.52
Rate for Payer: UHCCP Medicaid	$6,993.52

Know your out-of-pocket cost for care.

All Charges