Bronson South Haven Hospital

All Charges

Charge

Type

Setting

Price

OTHER HEPATOBILIARY, PANCREAS AND ABDOMINAL PROCEDURES

Facility

$13,055.37

Service Code	APR-DRG 2643
Min. Negotiated Rate	$11,803.61
Max. Negotiated Rate	$13,055.37
Rate for Payer: BCBS Complete	$13,055.37
Rate for Payer: Mclaren Medicaid	$12,433.68
Rate for Payer: Meridian Medicaid	$13,055.37
Rate for Payer: PHP Medicaid	$11,803.61
Rate for Payer: Priority Health Choice Medicaid	$12,433.68
Rate for Payer: UHC Medicaid	$12,433.68
Rate for Payer: UHCCP Medicaid	$12,433.68

OTHER HEPATOBILIARY, PANCREAS AND ABDOMINAL PROCEDURES

Facility

$6,880.54

Service Code	APR-DRG 2642
Min. Negotiated Rate	$6,220.83
Max. Negotiated Rate	$6,880.54
Rate for Payer: BCBS Complete	$6,880.54
Rate for Payer: Mclaren Medicaid	$6,552.89
Rate for Payer: Meridian Medicaid	$6,880.54
Rate for Payer: PHP Medicaid	$6,220.83
Rate for Payer: Priority Health Choice Medicaid	$6,552.89
Rate for Payer: UHC Medicaid	$6,552.89
Rate for Payer: UHCCP Medicaid	$6,552.89

OTHER HEPATOBILIARY, PANCREAS AND ABDOMINAL PROCEDURES

Facility

$4,942.15

Service Code	APR-DRG 2641
Min. Negotiated Rate	$4,468.30
Max. Negotiated Rate	$4,942.15
Rate for Payer: BCBS Complete	$4,942.15
Rate for Payer: Mclaren Medicaid	$4,706.81
Rate for Payer: Meridian Medicaid	$4,942.15
Rate for Payer: PHP Medicaid	$4,468.30
Rate for Payer: Priority Health Choice Medicaid	$4,706.81
Rate for Payer: UHC Medicaid	$4,706.81
Rate for Payer: UHCCP Medicaid	$4,706.81

OTHER HEPATOBILIARY, PANCREAS AND ABDOMINAL PROCEDURES

Facility

$24,878.06

Service Code	APR-DRG 2644
Min. Negotiated Rate	$22,492.74
Max. Negotiated Rate	$24,878.06
Rate for Payer: BCBS Complete	$24,878.06
Rate for Payer: Mclaren Medicaid	$23,693.39
Rate for Payer: Meridian Medicaid	$24,878.06
Rate for Payer: PHP Medicaid	$22,492.74
Rate for Payer: Priority Health Choice Medicaid	$23,693.39
Rate for Payer: UHC Medicaid	$23,693.39
Rate for Payer: UHCCP Medicaid	$23,693.39

OTHER INFECTIOUS AND PARASITIC DISEASES

Facility

$14,047.72

Service Code	APR-DRG 7244
Min. Negotiated Rate	$12,700.82
Max. Negotiated Rate	$14,047.72
Rate for Payer: BCBS Complete	$14,047.72
Rate for Payer: Mclaren Medicaid	$13,378.78
Rate for Payer: Meridian Medicaid	$14,047.72
Rate for Payer: PHP Medicaid	$12,700.82
Rate for Payer: Priority Health Choice Medicaid	$13,378.78
Rate for Payer: UHC Medicaid	$13,378.78
Rate for Payer: UHCCP Medicaid	$13,378.78

OTHER INFECTIOUS AND PARASITIC DISEASES

Facility

$9,773.68

Service Code	APR-DRG 7243
Min. Negotiated Rate	$8,836.57
Max. Negotiated Rate	$9,773.68
Rate for Payer: BCBS Complete	$9,773.68
Rate for Payer: Mclaren Medicaid	$9,308.26
Rate for Payer: Meridian Medicaid	$9,773.68
Rate for Payer: PHP Medicaid	$8,836.57
Rate for Payer: Priority Health Choice Medicaid	$9,308.26
Rate for Payer: UHC Medicaid	$9,308.26
Rate for Payer: UHCCP Medicaid	$9,308.26

OTHER INFECTIOUS AND PARASITIC DISEASES

Facility

$5,321.98

Service Code	APR-DRG 7242
Min. Negotiated Rate	$4,811.71
Max. Negotiated Rate	$5,321.98
Rate for Payer: BCBS Complete	$5,321.98
Rate for Payer: Mclaren Medicaid	$5,068.55
Rate for Payer: Meridian Medicaid	$5,321.98
Rate for Payer: PHP Medicaid	$4,811.71
Rate for Payer: Priority Health Choice Medicaid	$5,068.55
Rate for Payer: UHC Medicaid	$5,068.55
Rate for Payer: UHCCP Medicaid	$5,068.55

OTHER INFECTIOUS AND PARASITIC DISEASES

Facility

$2,832.11

Service Code	APR-DRG 7241
Min. Negotiated Rate	$2,560.56
Max. Negotiated Rate	$2,832.11
Rate for Payer: BCBS Complete	$2,832.11
Rate for Payer: Mclaren Medicaid	$2,697.24
Rate for Payer: Meridian Medicaid	$2,832.11
Rate for Payer: PHP Medicaid	$2,560.56
Rate for Payer: Priority Health Choice Medicaid	$2,697.24
Rate for Payer: UHC Medicaid	$2,697.24
Rate for Payer: UHCCP Medicaid	$2,697.24

OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC

Facility

$14,228.47

Service Code	MSDRG 868
Min. Negotiated Rate	$8,720.68
Max. Negotiated Rate	$14,228.47
Rate for Payer: Aetna Medicare	$9,179.66
Rate for Payer: Allen County Amish Medical Aid Commercial	$11,474.58
Rate for Payer: Amish Plain Church Group Commercial	$11,474.58
Rate for Payer: BCBS MAPPO	$9,179.66
Rate for Payer: BCN Medicare Advantage	$9,179.66
Rate for Payer: Health Alliance Plan Medicare Advantage	$9,179.66
Rate for Payer: Humana Choice PPO Medicare	$9,179.66
Rate for Payer: Mclaren Medicare	$9,179.66
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$9,638.64
Rate for Payer: MI Amish Medical Board Commercial	$10,556.61
Rate for Payer: Molina Medicare/Medicaid	$10,097.63
Rate for Payer: PACE Medicare	$8,720.68
Rate for Payer: PACE SWMI	$9,179.66
Rate for Payer: PHP Commercial	$10,097.63
Rate for Payer: PHP Medicare Advantage	$9,179.66
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$14,166.08
Rate for Payer: Priority Health Medicare	$9,179.66
Rate for Payer: Priority Health Narrow Network	$11,332.86
Rate for Payer: Railroad Medicare Medicare	$9,179.66
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$9,179.66
Rate for Payer: UHC Exchange	$14,228.47
Rate for Payer: UHCCP DNSP	$9,179.66
Rate for Payer: VA VA	$9,179.66

OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC

Facility

$28,758.06

Service Code	MSDRG 867
Min. Negotiated Rate	$15,986.69
Max. Negotiated Rate	$28,758.06
Rate for Payer: Aetna Medicare	$16,828.10
Rate for Payer: Allen County Amish Medical Aid Commercial	$21,035.12
Rate for Payer: Amish Plain Church Group Commercial	$21,035.12
Rate for Payer: BCBS MAPPO	$16,828.10
Rate for Payer: BCN Medicare Advantage	$16,828.10
Rate for Payer: Health Alliance Plan Medicare Advantage	$16,828.10
Rate for Payer: Humana Choice PPO Medicare	$16,828.10
Rate for Payer: Mclaren Medicare	$16,828.10
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$17,669.51
Rate for Payer: MI Amish Medical Board Commercial	$19,352.31
Rate for Payer: Molina Medicare/Medicaid	$18,510.91
Rate for Payer: PACE Medicare	$15,986.69
Rate for Payer: PACE SWMI	$16,828.10
Rate for Payer: PHP Commercial	$18,510.91
Rate for Payer: PHP Medicare Advantage	$16,828.10
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$28,758.06
Rate for Payer: Priority Health Medicare	$16,828.10
Rate for Payer: Priority Health Narrow Network	$23,006.44
Rate for Payer: Railroad Medicare Medicare	$16,828.10
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$16,828.10
Rate for Payer: UHC Exchange	$26,083.56
Rate for Payer: UHCCP DNSP	$16,828.10
Rate for Payer: VA VA	$16,828.10

OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC

Facility

$10,864.28

Service Code	MSDRG 869
Min. Negotiated Rate	$6,658.75
Max. Negotiated Rate	$10,864.28
Rate for Payer: Aetna Medicare	$7,009.21
Rate for Payer: Allen County Amish Medical Aid Commercial	$8,761.51
Rate for Payer: Amish Plain Church Group Commercial	$8,761.51
Rate for Payer: BCBS MAPPO	$7,009.21
Rate for Payer: BCN Medicare Advantage	$7,009.21
Rate for Payer: Health Alliance Plan Medicare Advantage	$7,009.21
Rate for Payer: Humana Choice PPO Medicare	$7,009.21
Rate for Payer: Mclaren Medicare	$7,009.21
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$7,359.67
Rate for Payer: MI Amish Medical Board Commercial	$8,060.59
Rate for Payer: Molina Medicare/Medicaid	$7,710.13
Rate for Payer: PACE Medicare	$6,658.75
Rate for Payer: PACE SWMI	$7,009.21
Rate for Payer: PHP Commercial	$7,710.13
Rate for Payer: PHP Medicare Advantage	$7,009.21
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$10,025.20
Rate for Payer: Priority Health Medicare	$7,009.21
Rate for Payer: Priority Health Narrow Network	$8,020.16
Rate for Payer: Railroad Medicare Medicare	$7,009.21
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$7,009.21
Rate for Payer: UHC Exchange	$10,864.28
Rate for Payer: UHCCP DNSP	$7,009.21
Rate for Payer: VA VA	$7,009.21

OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES

Facility

$8,358.44

Service Code	APR-DRG 8153
Min. Negotiated Rate	$7,557.03
Max. Negotiated Rate	$8,358.44
Rate for Payer: BCBS Complete	$8,358.44
Rate for Payer: Mclaren Medicaid	$7,960.42
Rate for Payer: Meridian Medicaid	$8,358.44
Rate for Payer: PHP Medicaid	$7,557.03
Rate for Payer: Priority Health Choice Medicaid	$7,960.42
Rate for Payer: UHC Medicaid	$7,960.42
Rate for Payer: UHCCP Medicaid	$7,960.42

OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES

Facility

$2,207.59

Service Code	APR-DRG 8151
Min. Negotiated Rate	$1,995.93
Max. Negotiated Rate	$2,207.59
Rate for Payer: BCBS Complete	$2,207.59
Rate for Payer: Mclaren Medicaid	$2,102.47
Rate for Payer: Meridian Medicaid	$2,207.59
Rate for Payer: PHP Medicaid	$1,995.93
Rate for Payer: Priority Health Choice Medicaid	$2,102.47
Rate for Payer: UHC Medicaid	$2,102.47
Rate for Payer: UHCCP Medicaid	$2,102.47

OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES

Facility

$12,724.04

Service Code	APR-DRG 8154
Min. Negotiated Rate	$11,504.05
Max. Negotiated Rate	$12,724.04
Rate for Payer: BCBS Complete	$12,724.04
Rate for Payer: Mclaren Medicaid	$12,118.13
Rate for Payer: Meridian Medicaid	$12,724.04
Rate for Payer: PHP Medicaid	$11,504.05
Rate for Payer: Priority Health Choice Medicaid	$12,118.13
Rate for Payer: UHC Medicaid	$12,118.13
Rate for Payer: UHCCP Medicaid	$12,118.13

OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES

Facility

$4,918.17

Service Code	APR-DRG 8152
Min. Negotiated Rate	$4,446.62
Max. Negotiated Rate	$4,918.17
Rate for Payer: BCBS Complete	$4,918.17
Rate for Payer: Mclaren Medicaid	$4,683.98
Rate for Payer: Meridian Medicaid	$4,918.17
Rate for Payer: PHP Medicaid	$4,446.62
Rate for Payer: Priority Health Choice Medicaid	$4,683.98
Rate for Payer: UHC Medicaid	$4,683.98
Rate for Payer: UHCCP Medicaid	$4,683.98

OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC

Facility

$24,034.66

Service Code	MSDRG 922
Min. Negotiated Rate	$13,634.69
Max. Negotiated Rate	$24,034.66
Rate for Payer: Aetna Medicare	$14,352.31
Rate for Payer: Allen County Amish Medical Aid Commercial	$17,940.39
Rate for Payer: Amish Plain Church Group Commercial	$17,940.39
Rate for Payer: BCBS MAPPO	$14,352.31
Rate for Payer: BCN Medicare Advantage	$14,352.31
Rate for Payer: Health Alliance Plan Medicare Advantage	$14,352.31
Rate for Payer: Humana Choice PPO Medicare	$14,352.31
Rate for Payer: Mclaren Medicare	$14,352.31
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$15,069.93
Rate for Payer: MI Amish Medical Board Commercial	$16,505.16
Rate for Payer: Molina Medicare/Medicaid	$15,787.54
Rate for Payer: PACE Medicare	$13,634.69
Rate for Payer: PACE SWMI	$14,352.31
Rate for Payer: PHP Commercial	$15,787.54
Rate for Payer: PHP Medicare Advantage	$14,352.31
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$24,034.66
Rate for Payer: Priority Health Medicare	$14,352.31
Rate for Payer: Priority Health Narrow Network	$19,227.73
Rate for Payer: Railroad Medicare Medicare	$14,352.31
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$14,352.31
Rate for Payer: UHC Exchange	$22,246.08
Rate for Payer: UHCCP DNSP	$14,352.31
Rate for Payer: VA VA	$14,352.31

OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC

Facility

$14,078.90

Service Code	MSDRG 923
Min. Negotiated Rate	$8,629.00
Max. Negotiated Rate	$14,078.90
Rate for Payer: Aetna Medicare	$9,083.16
Rate for Payer: Allen County Amish Medical Aid Commercial	$11,353.95
Rate for Payer: Amish Plain Church Group Commercial	$11,353.95
Rate for Payer: BCBS MAPPO	$9,083.16
Rate for Payer: BCN Medicare Advantage	$9,083.16
Rate for Payer: Health Alliance Plan Medicare Advantage	$9,083.16
Rate for Payer: Humana Choice PPO Medicare	$9,083.16
Rate for Payer: Mclaren Medicare	$9,083.16
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$9,537.32
Rate for Payer: MI Amish Medical Board Commercial	$10,445.63
Rate for Payer: Molina Medicare/Medicaid	$9,991.48
Rate for Payer: PACE Medicare	$8,629.00
Rate for Payer: PACE SWMI	$9,083.16
Rate for Payer: PHP Commercial	$9,991.48
Rate for Payer: PHP Medicare Advantage	$9,083.16
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$13,981.98
Rate for Payer: Priority Health Medicare	$9,083.16
Rate for Payer: Priority Health Narrow Network	$11,185.58
Rate for Payer: Railroad Medicare Medicare	$9,083.16
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$9,083.16
Rate for Payer: UHC Exchange	$14,078.90
Rate for Payer: UHCCP DNSP	$9,083.16
Rate for Payer: VA VA	$9,083.16

OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS

Facility

$10,036.34

Service Code	APR-DRG 4684
Min. Negotiated Rate	$9,074.06
Max. Negotiated Rate	$10,036.34
Rate for Payer: BCBS Complete	$10,036.34
Rate for Payer: Mclaren Medicaid	$9,558.42
Rate for Payer: Meridian Medicaid	$10,036.34
Rate for Payer: PHP Medicaid	$9,074.06
Rate for Payer: Priority Health Choice Medicaid	$9,558.42
Rate for Payer: UHC Medicaid	$9,558.42
Rate for Payer: UHCCP Medicaid	$9,558.42

OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS

Facility

$4,232.08

Service Code	APR-DRG 4682
Min. Negotiated Rate	$3,826.31
Max. Negotiated Rate	$4,232.08
Rate for Payer: BCBS Complete	$4,232.08
Rate for Payer: Mclaren Medicaid	$4,030.55
Rate for Payer: Meridian Medicaid	$4,232.08
Rate for Payer: PHP Medicaid	$3,826.31
Rate for Payer: Priority Health Choice Medicaid	$4,030.55
Rate for Payer: UHC Medicaid	$4,030.55
Rate for Payer: UHCCP Medicaid	$4,030.55

OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS

Facility

$6,120.88

Service Code	APR-DRG 4683
Min. Negotiated Rate	$5,534.01
Max. Negotiated Rate	$6,120.88
Rate for Payer: BCBS Complete	$6,120.88
Rate for Payer: Mclaren Medicaid	$5,829.41
Rate for Payer: Meridian Medicaid	$6,120.88
Rate for Payer: PHP Medicaid	$5,534.01
Rate for Payer: Priority Health Choice Medicaid	$5,829.41
Rate for Payer: UHC Medicaid	$5,829.41
Rate for Payer: UHCCP Medicaid	$5,829.41

OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS

Facility

$3,651.16

Service Code	APR-DRG 4681
Min. Negotiated Rate	$3,301.09
Max. Negotiated Rate	$3,651.16
Rate for Payer: BCBS Complete	$3,651.16
Rate for Payer: Mclaren Medicaid	$3,477.30
Rate for Payer: Meridian Medicaid	$3,651.16
Rate for Payer: PHP Medicaid	$3,301.09
Rate for Payer: Priority Health Choice Medicaid	$3,477.30
Rate for Payer: UHC Medicaid	$3,477.30
Rate for Payer: UHCCP Medicaid	$3,477.30

OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC

Facility

$14,048.77

Service Code	MSDRG 699
Min. Negotiated Rate	$8,610.53
Max. Negotiated Rate	$14,048.77
Rate for Payer: Aetna Medicare	$9,063.72
Rate for Payer: Allen County Amish Medical Aid Commercial	$11,329.65
Rate for Payer: Amish Plain Church Group Commercial	$11,329.65
Rate for Payer: BCBS MAPPO	$9,063.72
Rate for Payer: BCN Medicare Advantage	$9,063.72
Rate for Payer: Health Alliance Plan Medicare Advantage	$9,063.72
Rate for Payer: Humana Choice PPO Medicare	$9,063.72
Rate for Payer: Mclaren Medicare	$9,063.72
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$9,516.91
Rate for Payer: MI Amish Medical Board Commercial	$10,423.28
Rate for Payer: Molina Medicare/Medicaid	$9,970.09
Rate for Payer: PACE Medicare	$8,610.53
Rate for Payer: PACE SWMI	$9,063.72
Rate for Payer: PHP Commercial	$9,970.09
Rate for Payer: PHP Medicare Advantage	$9,063.72
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$13,944.88
Rate for Payer: Priority Health Medicare	$9,063.72
Rate for Payer: Priority Health Narrow Network	$11,155.91
Rate for Payer: Railroad Medicare Medicare	$9,063.72
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$9,063.72
Rate for Payer: UHC Exchange	$14,048.77
Rate for Payer: UHCCP DNSP	$9,063.72
Rate for Payer: VA VA	$9,063.72

OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC

Facility

$22,729.47

Service Code	MSDRG 698
Min. Negotiated Rate	$12,984.78
Max. Negotiated Rate	$22,729.47
Rate for Payer: Aetna Medicare	$13,668.19
Rate for Payer: Allen County Amish Medical Aid Commercial	$17,085.24
Rate for Payer: Amish Plain Church Group Commercial	$17,085.24
Rate for Payer: BCBS MAPPO	$13,668.19
Rate for Payer: BCN Medicare Advantage	$13,668.19
Rate for Payer: Health Alliance Plan Medicare Advantage	$13,668.19
Rate for Payer: Humana Choice PPO Medicare	$13,668.19
Rate for Payer: Mclaren Medicare	$13,668.19
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$14,351.60
Rate for Payer: MI Amish Medical Board Commercial	$15,718.42
Rate for Payer: Molina Medicare/Medicaid	$15,035.01
Rate for Payer: PACE Medicare	$12,984.78
Rate for Payer: PACE SWMI	$13,668.19
Rate for Payer: PHP Commercial	$15,035.01
Rate for Payer: PHP Medicare Advantage	$13,668.19
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$22,729.47
Rate for Payer: Priority Health Medicare	$13,668.19
Rate for Payer: Priority Health Narrow Network	$18,183.58
Rate for Payer: Railroad Medicare Medicare	$13,668.19
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$13,668.19
Rate for Payer: UHC Exchange	$21,185.69
Rate for Payer: UHCCP DNSP	$13,668.19
Rate for Payer: VA VA	$13,668.19

OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC

Facility

$10,420.03

Service Code	MSDRG 700
Min. Negotiated Rate	$6,386.47
Max. Negotiated Rate	$10,420.03
Rate for Payer: Aetna Medicare	$6,722.60
Rate for Payer: Allen County Amish Medical Aid Commercial	$8,403.25
Rate for Payer: Amish Plain Church Group Commercial	$8,403.25
Rate for Payer: BCBS MAPPO	$6,722.60
Rate for Payer: BCN Medicare Advantage	$6,722.60
Rate for Payer: Health Alliance Plan Medicare Advantage	$6,722.60
Rate for Payer: Humana Choice PPO Medicare	$6,722.60
Rate for Payer: Mclaren Medicare	$6,722.60
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$7,058.73
Rate for Payer: MI Amish Medical Board Commercial	$7,730.99
Rate for Payer: Molina Medicare/Medicaid	$7,394.86
Rate for Payer: PACE Medicare	$6,386.47
Rate for Payer: PACE SWMI	$6,722.60
Rate for Payer: PHP Commercial	$7,394.86
Rate for Payer: PHP Medicare Advantage	$6,722.60
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$9,478.40
Rate for Payer: Priority Health Medicare	$6,722.60
Rate for Payer: Priority Health Narrow Network	$7,582.72
Rate for Payer: Railroad Medicare Medicare	$6,722.60
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$6,722.60
Rate for Payer: UHC Exchange	$10,420.03
Rate for Payer: UHCCP DNSP	$6,722.60
Rate for Payer: VA VA	$6,722.60

OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC

Facility

$32,129.56

Service Code	MSDRG 674
Min. Negotiated Rate	$17,665.53
Max. Negotiated Rate	$32,129.56
Rate for Payer: Aetna Medicare	$18,595.29
Rate for Payer: Allen County Amish Medical Aid Commercial	$23,244.11
Rate for Payer: Amish Plain Church Group Commercial	$23,244.11
Rate for Payer: BCBS MAPPO	$18,595.29
Rate for Payer: BCN Medicare Advantage	$18,595.29
Rate for Payer: Health Alliance Plan Medicare Advantage	$18,595.29
Rate for Payer: Humana Choice PPO Medicare	$18,595.29
Rate for Payer: Mclaren Medicare	$18,595.29
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$19,525.05
Rate for Payer: MI Amish Medical Board Commercial	$21,384.58
Rate for Payer: Molina Medicare/Medicaid	$20,454.82
Rate for Payer: PACE Medicare	$17,665.53
Rate for Payer: PACE SWMI	$18,595.29
Rate for Payer: PHP Commercial	$20,454.82
Rate for Payer: PHP Medicare Advantage	$18,595.29
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$32,129.56
Rate for Payer: Priority Health Medicare	$18,595.29
Rate for Payer: Priority Health Narrow Network	$25,703.65
Rate for Payer: Railroad Medicare Medicare	$18,595.29
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$18,595.29
Rate for Payer: UHC Exchange	$28,822.70
Rate for Payer: UHCCP DNSP	$18,595.29
Rate for Payer: VA VA	$18,595.29

Know your out-of-pocket cost for care.

All Charges