Bronson South Haven Hospital

All Charges

Charge

Type

Setting

Price

OTHER BLADDER PROCEDURES

Facility

$11,975.82

Service Code	APR-DRG 4454
Min. Negotiated Rate	$10,827.58
Max. Negotiated Rate	$11,975.82
Rate for Payer: BCBS Complete	$11,975.82
Rate for Payer: Mclaren Medicaid	$11,405.54
Rate for Payer: Meridian Medicaid	$11,975.82
Rate for Payer: PHP Medicaid	$10,827.58
Rate for Payer: Priority Health Choice Medicaid	$11,405.54
Rate for Payer: UHC Medicaid	$11,405.54
Rate for Payer: UHCCP Medicaid	$11,405.54

OTHER BLADDER PROCEDURES

Facility

$10,112.09

Service Code	APR-DRG 4452
Min. Negotiated Rate	$9,142.54
Max. Negotiated Rate	$10,112.09
Rate for Payer: BCBS Complete	$10,112.09
Rate for Payer: Mclaren Medicaid	$9,630.56
Rate for Payer: Meridian Medicaid	$10,112.09
Rate for Payer: PHP Medicaid	$9,142.54
Rate for Payer: Priority Health Choice Medicaid	$9,630.56
Rate for Payer: UHC Medicaid	$9,630.56
Rate for Payer: UHCCP Medicaid	$9,630.56

OTHER CARDIOTHORACIC AND THORACIC CIRCULATORY PROCEDURES

Facility

$22,395.27

Service Code	APR-DRG 1673
Min. Negotiated Rate	$20,248.00
Max. Negotiated Rate	$22,395.27
Rate for Payer: BCBS Complete	$22,395.27
Rate for Payer: Mclaren Medicaid	$21,328.82
Rate for Payer: Meridian Medicaid	$22,395.27
Rate for Payer: PHP Medicaid	$20,248.00
Rate for Payer: Priority Health Choice Medicaid	$21,328.82
Rate for Payer: UHC Medicaid	$21,328.82
Rate for Payer: UHCCP Medicaid	$21,328.82

OTHER CARDIOTHORACIC AND THORACIC CIRCULATORY PROCEDURES

Facility

$44,156.75

Service Code	APR-DRG 1674
Min. Negotiated Rate	$39,922.99
Max. Negotiated Rate	$44,156.75
Rate for Payer: BCBS Complete	$44,156.75
Rate for Payer: Mclaren Medicaid	$42,054.05
Rate for Payer: Meridian Medicaid	$44,156.75
Rate for Payer: PHP Medicaid	$39,922.99
Rate for Payer: Priority Health Choice Medicaid	$42,054.05
Rate for Payer: UHC Medicaid	$42,054.05
Rate for Payer: UHCCP Medicaid	$42,054.05

OTHER CARDIOTHORACIC AND THORACIC CIRCULATORY PROCEDURES

Facility

$15,299.47

Service Code	APR-DRG 1672
Min. Negotiated Rate	$13,832.55
Max. Negotiated Rate	$15,299.47
Rate for Payer: BCBS Complete	$15,299.47
Rate for Payer: Mclaren Medicaid	$14,570.92
Rate for Payer: Meridian Medicaid	$15,299.47
Rate for Payer: PHP Medicaid	$13,832.55
Rate for Payer: Priority Health Choice Medicaid	$14,570.92
Rate for Payer: UHC Medicaid	$14,570.92
Rate for Payer: UHCCP Medicaid	$14,570.92

OTHER CARDIOTHORACIC AND THORACIC CIRCULATORY PROCEDURES

Facility

$10,433.07

Service Code	APR-DRG 1671
Min. Negotiated Rate	$9,432.74
Max. Negotiated Rate	$10,433.07
Rate for Payer: BCBS Complete	$10,433.07
Rate for Payer: Mclaren Medicaid	$9,936.25
Rate for Payer: Meridian Medicaid	$10,433.07
Rate for Payer: PHP Medicaid	$9,432.74
Rate for Payer: Priority Health Choice Medicaid	$9,936.25
Rate for Payer: UHC Medicaid	$9,936.25
Rate for Payer: UHCCP Medicaid	$9,936.25

OTHER CARDIOTHORACIC PROCEDURES WITH MCC

Facility

$67,971.34

Service Code	MSDRG 228
Min. Negotiated Rate	$35,512.80
Max. Negotiated Rate	$67,971.34
Rate for Payer: Aetna Medicare	$37,381.89
Rate for Payer: Allen County Amish Medical Aid Commercial	$46,727.36
Rate for Payer: Amish Plain Church Group Commercial	$46,727.36
Rate for Payer: BCBS MAPPO	$37,381.89
Rate for Payer: BCN Medicare Advantage	$37,381.89
Rate for Payer: Health Alliance Plan Medicare Advantage	$37,381.89
Rate for Payer: Humana Choice PPO Medicare	$37,381.89
Rate for Payer: Mclaren Medicare	$37,381.89
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$39,250.98
Rate for Payer: MI Amish Medical Board Commercial	$42,989.17
Rate for Payer: Molina Medicare/Medicaid	$41,120.08
Rate for Payer: PACE Medicare	$35,512.80
Rate for Payer: PACE SWMI	$37,381.89
Rate for Payer: PHP Commercial	$41,120.08
Rate for Payer: PHP Medicare Advantage	$37,381.89
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$67,971.34
Rate for Payer: Priority Health Medicare	$37,381.89
Rate for Payer: Priority Health Narrow Network	$54,377.07
Rate for Payer: Railroad Medicare Medicare	$37,381.89
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$37,381.89
Rate for Payer: UHC Exchange	$57,941.93
Rate for Payer: UHCCP DNSP	$37,381.89
Rate for Payer: VA VA	$37,381.89

OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC

Facility

$43,270.35

Service Code	MSDRG 229
Min. Negotiated Rate	$23,213.03
Max. Negotiated Rate	$43,270.35
Rate for Payer: Aetna Medicare	$24,434.77
Rate for Payer: Allen County Amish Medical Aid Commercial	$30,543.46
Rate for Payer: Amish Plain Church Group Commercial	$30,543.46
Rate for Payer: BCBS MAPPO	$24,434.77
Rate for Payer: BCN Medicare Advantage	$24,434.77
Rate for Payer: Health Alliance Plan Medicare Advantage	$24,434.77
Rate for Payer: Humana Choice PPO Medicare	$24,434.77
Rate for Payer: Mclaren Medicare	$24,434.77
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$25,656.51
Rate for Payer: MI Amish Medical Board Commercial	$28,099.99
Rate for Payer: Molina Medicare/Medicaid	$26,878.25
Rate for Payer: PACE Medicare	$23,213.03
Rate for Payer: PACE SWMI	$24,434.77
Rate for Payer: PHP Commercial	$26,878.25
Rate for Payer: PHP Medicare Advantage	$24,434.77
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$43,270.35
Rate for Payer: Priority Health Medicare	$24,434.77
Rate for Payer: Priority Health Narrow Network	$34,616.28
Rate for Payer: Railroad Medicare Medicare	$24,434.77
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$24,434.77
Rate for Payer: UHC Exchange	$37,873.89
Rate for Payer: UHCCP DNSP	$24,434.77
Rate for Payer: VA VA	$24,434.77

OTHER CEREBROVASCULAR DISORDERS WITH CC

Facility

$14,171.54

Service Code	MSDRG 071
Min. Negotiated Rate	$8,685.78
Max. Negotiated Rate	$14,171.54
Rate for Payer: Aetna Medicare	$9,142.93
Rate for Payer: Allen County Amish Medical Aid Commercial	$11,428.66
Rate for Payer: Amish Plain Church Group Commercial	$11,428.66
Rate for Payer: BCBS MAPPO	$9,142.93
Rate for Payer: BCN Medicare Advantage	$9,142.93
Rate for Payer: Health Alliance Plan Medicare Advantage	$9,142.93
Rate for Payer: Humana Choice PPO Medicare	$9,142.93
Rate for Payer: Mclaren Medicare	$9,142.93
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$9,600.08
Rate for Payer: MI Amish Medical Board Commercial	$10,514.37
Rate for Payer: Molina Medicare/Medicaid	$10,057.22
Rate for Payer: PACE Medicare	$8,685.78
Rate for Payer: PACE SWMI	$9,142.93
Rate for Payer: PHP Commercial	$10,057.22
Rate for Payer: PHP Medicare Advantage	$9,142.93
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$14,096.01
Rate for Payer: Priority Health Medicare	$9,142.93
Rate for Payer: Priority Health Narrow Network	$11,276.81
Rate for Payer: Railroad Medicare Medicare	$9,142.93
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$9,142.93
Rate for Payer: UHC Exchange	$14,171.54
Rate for Payer: UHCCP DNSP	$9,142.93
Rate for Payer: VA VA	$9,142.93

OTHER CEREBROVASCULAR DISORDERS WITH MCC

Facility

$22,872.35

Service Code	MSDRG 070
Min. Negotiated Rate	$13,055.94
Max. Negotiated Rate	$22,872.35
Rate for Payer: Aetna Medicare	$13,743.10
Rate for Payer: Allen County Amish Medical Aid Commercial	$17,178.88
Rate for Payer: Amish Plain Church Group Commercial	$17,178.88
Rate for Payer: BCBS MAPPO	$13,743.10
Rate for Payer: BCN Medicare Advantage	$13,743.10
Rate for Payer: Health Alliance Plan Medicare Advantage	$13,743.10
Rate for Payer: Humana Choice PPO Medicare	$13,743.10
Rate for Payer: Mclaren Medicare	$13,743.10
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$14,430.25
Rate for Payer: MI Amish Medical Board Commercial	$15,804.57
Rate for Payer: Molina Medicare/Medicaid	$15,117.41
Rate for Payer: PACE Medicare	$13,055.94
Rate for Payer: PACE SWMI	$13,743.10
Rate for Payer: PHP Commercial	$15,117.41
Rate for Payer: PHP Medicare Advantage	$13,743.10
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$22,872.35
Rate for Payer: Priority Health Medicare	$13,743.10
Rate for Payer: Priority Health Narrow Network	$18,297.88
Rate for Payer: Railroad Medicare Medicare	$13,743.10
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$13,743.10
Rate for Payer: UHC Exchange	$21,301.81
Rate for Payer: UHCCP DNSP	$13,743.10
Rate for Payer: VA VA	$13,743.10

OTHER CEREBROVASCULAR DISORDERS WITHOUT CC/MCC

Facility

$11,160.06

Service Code	MSDRG 072
Min. Negotiated Rate	$6,840.04
Max. Negotiated Rate	$11,160.06
Rate for Payer: Aetna Medicare	$7,200.04
Rate for Payer: Allen County Amish Medical Aid Commercial	$9,000.05
Rate for Payer: Amish Plain Church Group Commercial	$9,000.05
Rate for Payer: BCBS MAPPO	$7,200.04
Rate for Payer: BCN Medicare Advantage	$7,200.04
Rate for Payer: Health Alliance Plan Medicare Advantage	$7,200.04
Rate for Payer: Humana Choice PPO Medicare	$7,200.04
Rate for Payer: Mclaren Medicare	$7,200.04
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$7,560.04
Rate for Payer: MI Amish Medical Board Commercial	$8,280.05
Rate for Payer: Molina Medicare/Medicaid	$7,920.04
Rate for Payer: PACE Medicare	$6,840.04
Rate for Payer: PACE SWMI	$7,200.04
Rate for Payer: PHP Commercial	$7,920.04
Rate for Payer: PHP Medicare Advantage	$7,200.04
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$10,389.28
Rate for Payer: Priority Health Medicare	$7,200.04
Rate for Payer: Priority Health Narrow Network	$8,311.42
Rate for Payer: Railroad Medicare Medicare	$7,200.04
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$7,200.04
Rate for Payer: UHC Exchange	$11,160.06
Rate for Payer: UHCCP DNSP	$7,200.04
Rate for Payer: VA VA	$7,200.04

OTHER CHEMOTHERAPY

Facility

$4,186.31

Service Code	APR-DRG 6961
Min. Negotiated Rate	$3,784.92
Max. Negotiated Rate	$4,186.31
Rate for Payer: BCBS Complete	$4,186.31
Rate for Payer: Mclaren Medicaid	$3,986.96
Rate for Payer: Meridian Medicaid	$4,186.31
Rate for Payer: PHP Medicaid	$3,784.92
Rate for Payer: Priority Health Choice Medicaid	$3,986.96
Rate for Payer: UHC Medicaid	$3,986.96
Rate for Payer: UHCCP Medicaid	$3,986.96

OTHER CHEMOTHERAPY

Facility

$16,908.16

Service Code	APR-DRG 6964
Min. Negotiated Rate	$15,287.00
Max. Negotiated Rate	$16,908.16
Rate for Payer: BCBS Complete	$16,908.16
Rate for Payer: Mclaren Medicaid	$16,103.01
Rate for Payer: Meridian Medicaid	$16,908.16
Rate for Payer: PHP Medicaid	$15,287.00
Rate for Payer: Priority Health Choice Medicaid	$16,103.01
Rate for Payer: UHC Medicaid	$16,103.01
Rate for Payer: UHCCP Medicaid	$16,103.01

OTHER CHEMOTHERAPY

Facility

$5,675.65

Service Code	APR-DRG 6962
Min. Negotiated Rate	$5,131.47
Max. Negotiated Rate	$5,675.65
Rate for Payer: BCBS Complete	$5,675.65
Rate for Payer: Mclaren Medicaid	$5,405.39
Rate for Payer: Meridian Medicaid	$5,675.65
Rate for Payer: PHP Medicaid	$5,131.47
Rate for Payer: Priority Health Choice Medicaid	$5,405.39
Rate for Payer: UHC Medicaid	$5,405.39
Rate for Payer: UHCCP Medicaid	$5,405.39

OTHER CHEMOTHERAPY

Facility

$9,142.63

Service Code	APR-DRG 6963
Min. Negotiated Rate	$8,266.03
Max. Negotiated Rate	$9,142.63
Rate for Payer: BCBS Complete	$9,142.63
Rate for Payer: Mclaren Medicaid	$8,707.26
Rate for Payer: Meridian Medicaid	$9,142.63
Rate for Payer: PHP Medicaid	$8,266.03
Rate for Payer: Priority Health Choice Medicaid	$8,707.26
Rate for Payer: UHC Medicaid	$8,707.26
Rate for Payer: UHCCP Medicaid	$8,707.26

OTHER CIRCULATORY SYSTEM DIAGNOSES

Facility

$6,957.38

Service Code	APR-DRG 2073
Min. Negotiated Rate	$6,290.30
Max. Negotiated Rate	$6,957.38
Rate for Payer: BCBS Complete	$6,957.38
Rate for Payer: Mclaren Medicaid	$6,626.07
Rate for Payer: Meridian Medicaid	$6,957.38
Rate for Payer: PHP Medicaid	$6,290.30
Rate for Payer: Priority Health Choice Medicaid	$6,626.07
Rate for Payer: UHC Medicaid	$6,626.07
Rate for Payer: UHCCP Medicaid	$6,626.07

OTHER CIRCULATORY SYSTEM DIAGNOSES

Facility

$4,005.93

Service Code	APR-DRG 2072
Min. Negotiated Rate	$3,621.84
Max. Negotiated Rate	$4,005.93
Rate for Payer: BCBS Complete	$4,005.93
Rate for Payer: Mclaren Medicaid	$3,815.17
Rate for Payer: Meridian Medicaid	$4,005.93
Rate for Payer: PHP Medicaid	$3,621.84
Rate for Payer: Priority Health Choice Medicaid	$3,815.17
Rate for Payer: UHC Medicaid	$3,815.17
Rate for Payer: UHCCP Medicaid	$3,815.17

OTHER CIRCULATORY SYSTEM DIAGNOSES

Facility

$3,101.86

Service Code	APR-DRG 2071
Min. Negotiated Rate	$2,804.45
Max. Negotiated Rate	$3,101.86
Rate for Payer: BCBS Complete	$3,101.86
Rate for Payer: Mclaren Medicaid	$2,954.15
Rate for Payer: Meridian Medicaid	$3,101.86
Rate for Payer: PHP Medicaid	$2,804.45
Rate for Payer: Priority Health Choice Medicaid	$2,954.15
Rate for Payer: UHC Medicaid	$2,954.15
Rate for Payer: UHCCP Medicaid	$2,954.15

OTHER CIRCULATORY SYSTEM DIAGNOSES

Facility

$11,991.62

Service Code	APR-DRG 2074
Min. Negotiated Rate	$10,841.86
Max. Negotiated Rate	$11,991.62
Rate for Payer: BCBS Complete	$11,991.62
Rate for Payer: Mclaren Medicaid	$11,420.59
Rate for Payer: Meridian Medicaid	$11,991.62
Rate for Payer: PHP Medicaid	$10,841.86
Rate for Payer: Priority Health Choice Medicaid	$11,420.59
Rate for Payer: UHC Medicaid	$11,420.59
Rate for Payer: UHCCP Medicaid	$11,420.59

OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC

Facility

$13,471.70

Service Code	MSDRG 315
Min. Negotiated Rate	$8,256.85
Max. Negotiated Rate	$13,471.70
Rate for Payer: Aetna Medicare	$8,691.42
Rate for Payer: Allen County Amish Medical Aid Commercial	$10,864.27
Rate for Payer: Amish Plain Church Group Commercial	$10,864.27
Rate for Payer: BCBS MAPPO	$8,691.42
Rate for Payer: BCN Medicare Advantage	$8,691.42
Rate for Payer: Health Alliance Plan Medicare Advantage	$8,691.42
Rate for Payer: Humana Choice PPO Medicare	$8,691.42
Rate for Payer: Mclaren Medicare	$8,691.42
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$9,125.99
Rate for Payer: MI Amish Medical Board Commercial	$9,995.13
Rate for Payer: Molina Medicare/Medicaid	$9,560.56
Rate for Payer: PACE Medicare	$8,256.85
Rate for Payer: PACE SWMI	$8,691.42
Rate for Payer: PHP Commercial	$9,560.56
Rate for Payer: PHP Medicare Advantage	$8,691.42
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$13,234.59
Rate for Payer: Priority Health Medicare	$8,691.42
Rate for Payer: Priority Health Narrow Network	$10,587.67
Rate for Payer: Railroad Medicare Medicare	$8,691.42
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$8,691.42
Rate for Payer: UHC Exchange	$13,471.70
Rate for Payer: UHCCP DNSP	$8,691.42
Rate for Payer: VA VA	$8,691.42

OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC

Facility

$28,648.15

Service Code	MSDRG 314
Min. Negotiated Rate	$15,931.97
Max. Negotiated Rate	$28,648.15
Rate for Payer: Aetna Medicare	$16,770.49
Rate for Payer: Allen County Amish Medical Aid Commercial	$20,963.11
Rate for Payer: Amish Plain Church Group Commercial	$20,963.11
Rate for Payer: BCBS MAPPO	$16,770.49
Rate for Payer: BCN Medicare Advantage	$16,770.49
Rate for Payer: Health Alliance Plan Medicare Advantage	$16,770.49
Rate for Payer: Humana Choice PPO Medicare	$16,770.49
Rate for Payer: Mclaren Medicare	$16,770.49
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$17,609.01
Rate for Payer: MI Amish Medical Board Commercial	$19,286.06
Rate for Payer: Molina Medicare/Medicaid	$18,447.54
Rate for Payer: PACE Medicare	$15,931.97
Rate for Payer: PACE SWMI	$16,770.49
Rate for Payer: PHP Commercial	$18,447.54
Rate for Payer: PHP Medicare Advantage	$16,770.49
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$28,648.15
Rate for Payer: Priority Health Medicare	$16,770.49
Rate for Payer: Priority Health Narrow Network	$22,918.52
Rate for Payer: Railroad Medicare Medicare	$16,770.49
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$16,770.49
Rate for Payer: UHC Exchange	$25,994.26
Rate for Payer: UHCCP DNSP	$16,770.49
Rate for Payer: VA VA	$16,770.49

OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC

Facility

$10,332.97

Service Code	MSDRG 316
Min. Negotiated Rate	$6,333.11
Max. Negotiated Rate	$10,332.97
Rate for Payer: Aetna Medicare	$6,666.43
Rate for Payer: Allen County Amish Medical Aid Commercial	$8,333.04
Rate for Payer: Amish Plain Church Group Commercial	$8,333.04
Rate for Payer: BCBS MAPPO	$6,666.43
Rate for Payer: BCN Medicare Advantage	$6,666.43
Rate for Payer: Health Alliance Plan Medicare Advantage	$6,666.43
Rate for Payer: Humana Choice PPO Medicare	$6,666.43
Rate for Payer: Mclaren Medicare	$6,666.43
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$6,999.75
Rate for Payer: MI Amish Medical Board Commercial	$7,666.39
Rate for Payer: Molina Medicare/Medicaid	$7,333.07
Rate for Payer: PACE Medicare	$6,333.11
Rate for Payer: PACE SWMI	$6,666.43
Rate for Payer: PHP Commercial	$7,333.07
Rate for Payer: PHP Medicare Advantage	$6,666.43
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$9,371.24
Rate for Payer: Priority Health Medicare	$6,666.43
Rate for Payer: Priority Health Narrow Network	$7,496.99
Rate for Payer: Railroad Medicare Medicare	$6,666.43
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$6,666.43
Rate for Payer: UHC Exchange	$10,332.97
Rate for Payer: UHCCP DNSP	$6,666.43
Rate for Payer: VA VA	$6,666.43

OTHER CIRCULATORY SYSTEM O.R. PROCEDURES

Facility

$45,895.84

Service Code	MSDRG 264
Min. Negotiated Rate	$24,520.38
Max. Negotiated Rate	$45,895.84
Rate for Payer: Aetna Medicare	$25,810.93
Rate for Payer: Allen County Amish Medical Aid Commercial	$32,263.66
Rate for Payer: Amish Plain Church Group Commercial	$32,263.66
Rate for Payer: BCBS MAPPO	$25,810.93
Rate for Payer: BCN Medicare Advantage	$25,810.93
Rate for Payer: Health Alliance Plan Medicare Advantage	$25,810.93
Rate for Payer: Humana Choice PPO Medicare	$25,810.93
Rate for Payer: Mclaren Medicare	$25,810.93
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$27,101.48
Rate for Payer: MI Amish Medical Board Commercial	$29,682.57
Rate for Payer: Molina Medicare/Medicaid	$28,392.02
Rate for Payer: PACE Medicare	$24,520.38
Rate for Payer: PACE SWMI	$25,810.93
Rate for Payer: PHP Commercial	$28,392.02
Rate for Payer: PHP Medicare Advantage	$25,810.93
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$45,895.84
Rate for Payer: Priority Health Medicare	$25,810.93
Rate for Payer: Priority Health Narrow Network	$36,716.67
Rate for Payer: Railroad Medicare Medicare	$25,810.93
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$25,810.93
Rate for Payer: UHC Exchange	$40,006.94
Rate for Payer: UHCCP DNSP	$25,810.93
Rate for Payer: VA VA	$25,810.93

OTHER COMPLICATIONS OF TREATMENT

Facility

$3,773.23

Service Code	APR-DRG 8131
Min. Negotiated Rate	$3,411.45
Max. Negotiated Rate	$3,773.23
Rate for Payer: BCBS Complete	$3,773.23
Rate for Payer: Mclaren Medicaid	$3,593.56
Rate for Payer: Meridian Medicaid	$3,773.23
Rate for Payer: PHP Medicaid	$3,411.45
Rate for Payer: Priority Health Choice Medicaid	$3,593.56
Rate for Payer: UHC Medicaid	$3,593.56
Rate for Payer: UHCCP Medicaid	$3,593.56

OTHER COMPLICATIONS OF TREATMENT

Facility

$6,895.80

Service Code	APR-DRG 8133
Min. Negotiated Rate	$6,234.63
Max. Negotiated Rate	$6,895.80
Rate for Payer: BCBS Complete	$6,895.80
Rate for Payer: Mclaren Medicaid	$6,567.43
Rate for Payer: Meridian Medicaid	$6,895.80
Rate for Payer: PHP Medicaid	$6,234.63
Rate for Payer: Priority Health Choice Medicaid	$6,567.43
Rate for Payer: UHC Medicaid	$6,567.43
Rate for Payer: UHCCP Medicaid	$6,567.43

Know your out-of-pocket cost for care.

All Charges