Bronson South Haven Hospital

All Charges

Charge

Type

Setting

Price

OTHER DISORDERS OF THE LIVER

Facility

$3,016.30

Service Code	APR-DRG 2831
Min. Negotiated Rate	$2,727.09
Max. Negotiated Rate	$3,016.30
Rate for Payer: BCBS Complete	$3,016.30
Rate for Payer: Mclaren Medicaid	$2,872.66
Rate for Payer: Meridian Medicaid	$3,016.30
Rate for Payer: PHP Medicaid	$2,727.09
Rate for Payer: Priority Health Choice Medicaid	$2,872.66
Rate for Payer: UHC Medicaid	$2,872.66
Rate for Payer: UHCCP Medicaid	$2,872.66

OTHER DISORDERS OF THE LIVER

Facility

$10,987.83

Service Code	APR-DRG 2834
Min. Negotiated Rate	$9,934.31
Max. Negotiated Rate	$10,987.83
Rate for Payer: BCBS Complete	$10,987.83
Rate for Payer: Mclaren Medicaid	$10,464.60
Rate for Payer: Meridian Medicaid	$10,987.83
Rate for Payer: PHP Medicaid	$9,934.31
Rate for Payer: Priority Health Choice Medicaid	$10,464.60
Rate for Payer: UHC Medicaid	$10,464.60
Rate for Payer: UHCCP Medicaid	$10,464.60

OTHER DISORDERS OF THE LIVER

Facility

$4,513.28

Service Code	APR-DRG 2832
Min. Negotiated Rate	$4,080.54
Max. Negotiated Rate	$4,513.28
Rate for Payer: BCBS Complete	$4,513.28
Rate for Payer: Mclaren Medicaid	$4,298.36
Rate for Payer: Meridian Medicaid	$4,513.28
Rate for Payer: PHP Medicaid	$4,080.54
Rate for Payer: Priority Health Choice Medicaid	$4,298.36
Rate for Payer: UHC Medicaid	$4,298.36
Rate for Payer: UHCCP Medicaid	$4,298.36

OTHER DISORDERS OF THE LIVER

Facility

$6,818.96

Service Code	APR-DRG 2833
Min. Negotiated Rate	$6,165.16
Max. Negotiated Rate	$6,818.96
Rate for Payer: BCBS Complete	$6,818.96
Rate for Payer: Mclaren Medicaid	$6,494.25
Rate for Payer: Meridian Medicaid	$6,818.96
Rate for Payer: PHP Medicaid	$6,165.16
Rate for Payer: Priority Health Choice Medicaid	$6,494.25
Rate for Payer: UHC Medicaid	$6,494.25
Rate for Payer: UHCCP Medicaid	$6,494.25

OTHER DRUG ABUSE AND DEPENDENCE

Facility

$3,416.29

Service Code	APR-DRG 7761
Min. Negotiated Rate	$3,088.74
Max. Negotiated Rate	$3,416.29
Rate for Payer: BCBS Complete	$3,416.29
Rate for Payer: Mclaren Medicaid	$3,253.61
Rate for Payer: Meridian Medicaid	$3,416.29
Rate for Payer: PHP Medicaid	$3,088.74
Rate for Payer: Priority Health Choice Medicaid	$3,253.61
Rate for Payer: UHC Medicaid	$3,253.61
Rate for Payer: UHCCP Medicaid	$3,253.61

OTHER DRUG ABUSE AND DEPENDENCE

Facility

$12,308.24

Service Code	APR-DRG 7764
Min. Negotiated Rate	$11,128.12
Max. Negotiated Rate	$12,308.24
Rate for Payer: BCBS Complete	$12,308.24
Rate for Payer: Mclaren Medicaid	$11,722.13
Rate for Payer: Meridian Medicaid	$12,308.24
Rate for Payer: PHP Medicaid	$11,128.12
Rate for Payer: Priority Health Choice Medicaid	$11,722.13
Rate for Payer: UHC Medicaid	$11,722.13
Rate for Payer: UHCCP Medicaid	$11,722.13

OTHER DRUG ABUSE AND DEPENDENCE

Facility

$6,718.69

Service Code	APR-DRG 7763
Min. Negotiated Rate	$6,074.50
Max. Negotiated Rate	$6,718.69
Rate for Payer: BCBS Complete	$6,718.69
Rate for Payer: Mclaren Medicaid	$6,398.75
Rate for Payer: Meridian Medicaid	$6,718.69
Rate for Payer: PHP Medicaid	$6,074.50
Rate for Payer: Priority Health Choice Medicaid	$6,398.75
Rate for Payer: UHC Medicaid	$6,398.75
Rate for Payer: UHCCP Medicaid	$6,398.75

OTHER DRUG ABUSE AND DEPENDENCE

Facility

$4,264.78

Service Code	APR-DRG 7762
Min. Negotiated Rate	$3,855.87
Max. Negotiated Rate	$4,264.78
Rate for Payer: BCBS Complete	$4,264.78
Rate for Payer: Mclaren Medicaid	$4,061.69
Rate for Payer: Meridian Medicaid	$4,264.78
Rate for Payer: PHP Medicaid	$3,855.87
Rate for Payer: Priority Health Choice Medicaid	$4,061.69
Rate for Payer: UHC Medicaid	$4,061.69
Rate for Payer: UHCCP Medicaid	$4,061.69

OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC

Facility

$12,949.32

Service Code	MSDRG 155
Min. Negotiated Rate	$7,936.68
Max. Negotiated Rate	$12,949.32
Rate for Payer: Aetna Medicare	$8,354.40
Rate for Payer: Allen County Amish Medical Aid Commercial	$10,443.00
Rate for Payer: Amish Plain Church Group Commercial	$10,443.00
Rate for Payer: BCBS MAPPO	$8,354.40
Rate for Payer: BCN Medicare Advantage	$8,354.40
Rate for Payer: Health Alliance Plan Medicare Advantage	$8,354.40
Rate for Payer: Humana Choice PPO Medicare	$8,354.40
Rate for Payer: Mclaren Medicare	$8,354.40
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$8,772.12
Rate for Payer: MI Amish Medical Board Commercial	$9,607.56
Rate for Payer: Molina Medicare/Medicaid	$9,189.84
Rate for Payer: PACE Medicare	$7,936.68
Rate for Payer: PACE SWMI	$8,354.40
Rate for Payer: PHP Commercial	$9,189.84
Rate for Payer: PHP Medicare Advantage	$8,354.40
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$12,591.61
Rate for Payer: Priority Health Medicare	$8,354.40
Rate for Payer: Priority Health Narrow Network	$10,073.29
Rate for Payer: Railroad Medicare Medicare	$8,354.40
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$8,354.40
Rate for Payer: UHC Exchange	$12,949.32
Rate for Payer: UHCCP DNSP	$8,354.40
Rate for Payer: VA VA	$8,354.40

OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC

Facility

$21,480.61

Service Code	MSDRG 154
Min. Negotiated Rate	$12,362.93
Max. Negotiated Rate	$21,480.61
Rate for Payer: Aetna Medicare	$13,013.61
Rate for Payer: Allen County Amish Medical Aid Commercial	$16,267.01
Rate for Payer: Amish Plain Church Group Commercial	$16,267.01
Rate for Payer: BCBS MAPPO	$13,013.61
Rate for Payer: BCN Medicare Advantage	$13,013.61
Rate for Payer: Health Alliance Plan Medicare Advantage	$13,013.61
Rate for Payer: Humana Choice PPO Medicare	$13,013.61
Rate for Payer: Mclaren Medicare	$13,013.61
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$13,664.29
Rate for Payer: MI Amish Medical Board Commercial	$14,965.65
Rate for Payer: Molina Medicare/Medicaid	$14,314.97
Rate for Payer: PACE Medicare	$12,362.93
Rate for Payer: PACE SWMI	$13,013.61
Rate for Payer: PHP Commercial	$14,314.97
Rate for Payer: PHP Medicare Advantage	$13,013.61
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$21,480.61
Rate for Payer: Priority Health Medicare	$13,013.61
Rate for Payer: Priority Health Narrow Network	$17,184.49
Rate for Payer: Railroad Medicare Medicare	$13,013.61
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$13,013.61
Rate for Payer: UHC Exchange	$20,171.10
Rate for Payer: UHCCP DNSP	$13,013.61
Rate for Payer: VA VA	$13,013.61

OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC

Facility

$10,433.42

Service Code	MSDRG 156
Min. Negotiated Rate	$6,394.68
Max. Negotiated Rate	$10,433.42
Rate for Payer: Aetna Medicare	$6,731.24
Rate for Payer: Allen County Amish Medical Aid Commercial	$8,414.05
Rate for Payer: Amish Plain Church Group Commercial	$8,414.05
Rate for Payer: BCBS MAPPO	$6,731.24
Rate for Payer: BCN Medicare Advantage	$6,731.24
Rate for Payer: Health Alliance Plan Medicare Advantage	$6,731.24
Rate for Payer: Humana Choice PPO Medicare	$6,731.24
Rate for Payer: Mclaren Medicare	$6,731.24
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$7,067.80
Rate for Payer: MI Amish Medical Board Commercial	$7,740.93
Rate for Payer: Molina Medicare/Medicaid	$7,404.36
Rate for Payer: PACE Medicare	$6,394.68
Rate for Payer: PACE SWMI	$6,731.24
Rate for Payer: PHP Commercial	$7,404.36
Rate for Payer: PHP Medicare Advantage	$6,731.24
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$9,494.88
Rate for Payer: Priority Health Medicare	$6,731.24
Rate for Payer: Priority Health Narrow Network	$7,595.91
Rate for Payer: Railroad Medicare Medicare	$6,731.24
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$6,731.24
Rate for Payer: UHC Exchange	$10,433.42
Rate for Payer: UHCCP DNSP	$6,731.24
Rate for Payer: VA VA	$6,731.24

OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC

Facility

$23,807.97

Service Code	MSDRG 144
Min. Negotiated Rate	$13,521.83
Max. Negotiated Rate	$23,807.97
Rate for Payer: Aetna Medicare	$14,233.50
Rate for Payer: Allen County Amish Medical Aid Commercial	$17,791.88
Rate for Payer: Amish Plain Church Group Commercial	$17,791.88
Rate for Payer: BCBS MAPPO	$14,233.50
Rate for Payer: BCN Medicare Advantage	$14,233.50
Rate for Payer: Health Alliance Plan Medicare Advantage	$14,233.50
Rate for Payer: Humana Choice PPO Medicare	$14,233.50
Rate for Payer: Mclaren Medicare	$14,233.50
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$14,945.17
Rate for Payer: MI Amish Medical Board Commercial	$16,368.52
Rate for Payer: Molina Medicare/Medicaid	$15,656.85
Rate for Payer: PACE Medicare	$13,521.83
Rate for Payer: PACE SWMI	$14,233.50
Rate for Payer: PHP Commercial	$15,656.85
Rate for Payer: PHP Medicare Advantage	$14,233.50
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$23,807.97
Rate for Payer: Priority Health Medicare	$14,233.50
Rate for Payer: Priority Health Narrow Network	$19,046.37
Rate for Payer: Railroad Medicare Medicare	$14,233.50
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$14,233.50
Rate for Payer: UHC Exchange	$22,061.92
Rate for Payer: UHCCP DNSP	$14,233.50
Rate for Payer: VA VA	$14,233.50

OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC

Facility

$51,473.79

Service Code	MSDRG 143
Min. Negotiated Rate	$27,297.90
Max. Negotiated Rate	$51,473.79
Rate for Payer: Aetna Medicare	$28,734.63
Rate for Payer: Allen County Amish Medical Aid Commercial	$35,918.29
Rate for Payer: Amish Plain Church Group Commercial	$35,918.29
Rate for Payer: BCBS MAPPO	$28,734.63
Rate for Payer: BCN Medicare Advantage	$28,734.63
Rate for Payer: Health Alliance Plan Medicare Advantage	$28,734.63
Rate for Payer: Humana Choice PPO Medicare	$28,734.63
Rate for Payer: Mclaren Medicare	$28,734.63
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$30,171.36
Rate for Payer: MI Amish Medical Board Commercial	$33,044.82
Rate for Payer: Molina Medicare/Medicaid	$31,608.09
Rate for Payer: PACE Medicare	$27,297.90
Rate for Payer: PACE SWMI	$28,734.63
Rate for Payer: PHP Commercial	$31,608.09
Rate for Payer: PHP Medicare Advantage	$28,734.63
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$51,473.79
Rate for Payer: Priority Health Medicare	$28,734.63
Rate for Payer: Priority Health Narrow Network	$41,179.03
Rate for Payer: Railroad Medicare Medicare	$28,734.63
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$28,734.63
Rate for Payer: UHC Exchange	$44,538.68
Rate for Payer: UHCCP DNSP	$28,734.63
Rate for Payer: VA VA	$28,734.63

OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC

Facility

$16,518.16

Service Code	MSDRG 145
Min. Negotiated Rate	$9,891.88
Max. Negotiated Rate	$16,518.16
Rate for Payer: Aetna Medicare	$10,412.51
Rate for Payer: Allen County Amish Medical Aid Commercial	$13,015.64
Rate for Payer: Amish Plain Church Group Commercial	$13,015.64
Rate for Payer: BCBS MAPPO	$10,412.51
Rate for Payer: BCN Medicare Advantage	$10,412.51
Rate for Payer: Health Alliance Plan Medicare Advantage	$10,412.51
Rate for Payer: Humana Choice PPO Medicare	$10,412.51
Rate for Payer: Mclaren Medicare	$10,412.51
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$10,933.14
Rate for Payer: MI Amish Medical Board Commercial	$11,974.39
Rate for Payer: Molina Medicare/Medicaid	$11,453.76
Rate for Payer: PACE Medicare	$9,891.88
Rate for Payer: PACE SWMI	$10,412.51
Rate for Payer: PHP Commercial	$11,453.76
Rate for Payer: PHP Medicare Advantage	$10,412.51
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$16,518.16
Rate for Payer: Priority Health Medicare	$10,412.51
Rate for Payer: Priority Health Narrow Network	$13,214.53
Rate for Payer: Railroad Medicare Medicare	$10,412.51
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$10,412.51
Rate for Payer: UHC Exchange	$16,139.39
Rate for Payer: UHCCP DNSP	$10,412.51
Rate for Payer: VA VA	$10,412.51

OTHER EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL DIAGNOSES

Facility

$3,407.57

Service Code	APR-DRG 1151
Min. Negotiated Rate	$3,080.85
Max. Negotiated Rate	$3,407.57
Rate for Payer: BCBS Complete	$3,407.57
Rate for Payer: Mclaren Medicaid	$3,245.31
Rate for Payer: Meridian Medicaid	$3,407.57
Rate for Payer: PHP Medicaid	$3,080.85
Rate for Payer: Priority Health Choice Medicaid	$3,245.31
Rate for Payer: UHC Medicaid	$3,245.31
Rate for Payer: UHCCP Medicaid	$3,245.31

OTHER EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL DIAGNOSES

Facility

$4,349.25

Service Code	APR-DRG 1152
Min. Negotiated Rate	$3,932.24
Max. Negotiated Rate	$4,349.25
Rate for Payer: BCBS Complete	$4,349.25
Rate for Payer: Mclaren Medicaid	$4,142.14
Rate for Payer: Meridian Medicaid	$4,349.25
Rate for Payer: PHP Medicaid	$3,932.24
Rate for Payer: Priority Health Choice Medicaid	$4,142.14
Rate for Payer: UHC Medicaid	$4,142.14
Rate for Payer: UHCCP Medicaid	$4,142.14

OTHER EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL DIAGNOSES

Facility

$12,043.94

Service Code	APR-DRG 1154
Min. Negotiated Rate	$10,889.16
Max. Negotiated Rate	$12,043.94
Rate for Payer: BCBS Complete	$12,043.94
Rate for Payer: Mclaren Medicaid	$11,470.42
Rate for Payer: Meridian Medicaid	$12,043.94
Rate for Payer: PHP Medicaid	$10,889.16
Rate for Payer: Priority Health Choice Medicaid	$11,470.42
Rate for Payer: UHC Medicaid	$11,470.42
Rate for Payer: UHCCP Medicaid	$11,470.42

OTHER EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL DIAGNOSES

Facility

$7,190.62

Service Code	APR-DRG 1153
Min. Negotiated Rate	$6,501.18
Max. Negotiated Rate	$7,190.62
Rate for Payer: BCBS Complete	$7,190.62
Rate for Payer: Mclaren Medicaid	$6,848.20
Rate for Payer: Meridian Medicaid	$7,190.62
Rate for Payer: PHP Medicaid	$6,501.18
Rate for Payer: Priority Health Choice Medicaid	$6,848.20
Rate for Payer: UHC Medicaid	$6,848.20
Rate for Payer: UHCCP Medicaid	$6,848.20

OTHER EAR, NOSE, MOUTH, THROAT, CRANIOFACIAL, AND NECK PROCEDURES

Facility

$5,849.49

Service Code	APR-DRG 0981
Min. Negotiated Rate	$5,288.64
Max. Negotiated Rate	$5,849.49
Rate for Payer: BCBS Complete	$5,849.49
Rate for Payer: Mclaren Medicaid	$5,570.95
Rate for Payer: Meridian Medicaid	$5,849.49
Rate for Payer: PHP Medicaid	$5,288.64
Rate for Payer: Priority Health Choice Medicaid	$5,570.95
Rate for Payer: UHC Medicaid	$5,570.95
Rate for Payer: UHCCP Medicaid	$5,570.95

OTHER EAR, NOSE, MOUTH, THROAT, CRANIOFACIAL, AND NECK PROCEDURES

Facility

$9,732.81

Service Code	APR-DRG 0982
Min. Negotiated Rate	$8,799.62
Max. Negotiated Rate	$9,732.81
Rate for Payer: BCBS Complete	$9,732.81
Rate for Payer: Mclaren Medicaid	$9,269.34
Rate for Payer: Meridian Medicaid	$9,732.81
Rate for Payer: PHP Medicaid	$8,799.62
Rate for Payer: Priority Health Choice Medicaid	$9,269.34
Rate for Payer: UHC Medicaid	$9,269.34
Rate for Payer: UHCCP Medicaid	$9,269.34

OTHER EAR, NOSE, MOUTH, THROAT, CRANIOFACIAL, AND NECK PROCEDURES

Facility

$19,036.74

Service Code	APR-DRG 0984
Min. Negotiated Rate	$17,211.49
Max. Negotiated Rate	$19,036.74
Rate for Payer: BCBS Complete	$19,036.74
Rate for Payer: Mclaren Medicaid	$18,130.23
Rate for Payer: Meridian Medicaid	$19,036.74
Rate for Payer: PHP Medicaid	$17,211.49
Rate for Payer: Priority Health Choice Medicaid	$18,130.23
Rate for Payer: UHC Medicaid	$18,130.23
Rate for Payer: UHCCP Medicaid	$18,130.23

OTHER EAR, NOSE, MOUTH, THROAT, CRANIOFACIAL, AND NECK PROCEDURES

Facility

$14,747.44

Service Code	APR-DRG 0983
Min. Negotiated Rate	$13,333.45
Max. Negotiated Rate	$14,747.44
Rate for Payer: BCBS Complete	$14,747.44
Rate for Payer: Mclaren Medicaid	$14,045.18
Rate for Payer: Meridian Medicaid	$14,747.44
Rate for Payer: PHP Medicaid	$13,333.45
Rate for Payer: Priority Health Choice Medicaid	$14,045.18
Rate for Payer: UHC Medicaid	$14,045.18
Rate for Payer: UHCCP Medicaid	$14,045.18

OTHER ENDOCRINE DISORDERS

Facility

$13,669.53

Service Code	APR-DRG 4244
Min. Negotiated Rate	$12,358.89
Max. Negotiated Rate	$13,669.53
Rate for Payer: BCBS Complete	$13,669.53
Rate for Payer: Mclaren Medicaid	$13,018.60
Rate for Payer: Meridian Medicaid	$13,669.53
Rate for Payer: PHP Medicaid	$12,358.89
Rate for Payer: Priority Health Choice Medicaid	$13,018.60
Rate for Payer: UHC Medicaid	$13,018.60
Rate for Payer: UHCCP Medicaid	$13,018.60

OTHER ENDOCRINE DISORDERS

Facility

$3,816.28

Service Code	APR-DRG 4241
Min. Negotiated Rate	$3,450.38
Max. Negotiated Rate	$3,816.28
Rate for Payer: BCBS Complete	$3,816.28
Rate for Payer: Mclaren Medicaid	$3,634.56
Rate for Payer: Meridian Medicaid	$3,816.28
Rate for Payer: PHP Medicaid	$3,450.38
Rate for Payer: Priority Health Choice Medicaid	$3,634.56
Rate for Payer: UHC Medicaid	$3,634.56
Rate for Payer: UHCCP Medicaid	$3,634.56

OTHER ENDOCRINE DISORDERS

Facility

$7,465.81

Service Code	APR-DRG 4243
Min. Negotiated Rate	$6,749.99
Max. Negotiated Rate	$7,465.81
Rate for Payer: BCBS Complete	$7,465.81
Rate for Payer: Mclaren Medicaid	$7,110.30
Rate for Payer: Meridian Medicaid	$7,465.81
Rate for Payer: PHP Medicaid	$6,749.99
Rate for Payer: Priority Health Choice Medicaid	$7,110.30
Rate for Payer: UHC Medicaid	$7,110.30
Rate for Payer: UHCCP Medicaid	$7,110.30

Know your out-of-pocket cost for care.

All Charges