Bronson South Haven Hospital

All Charges

Charge

Type

Setting

Price

OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC

Facility

$57,724.94

Service Code	MSDRG 673
Min. Negotiated Rate	$30,410.65
Max. Negotiated Rate	$57,724.94
Rate for Payer: Aetna Medicare	$32,011.21
Rate for Payer: Allen County Amish Medical Aid Commercial	$40,014.01
Rate for Payer: Amish Plain Church Group Commercial	$40,014.01
Rate for Payer: BCBS MAPPO	$32,011.21
Rate for Payer: BCN Medicare Advantage	$32,011.21
Rate for Payer: Health Alliance Plan Medicare Advantage	$32,011.21
Rate for Payer: Humana Choice PPO Medicare	$32,011.21
Rate for Payer: Mclaren Medicare	$32,011.21
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$33,611.77
Rate for Payer: MI Amish Medical Board Commercial	$36,812.89
Rate for Payer: Molina Medicare/Medicaid	$35,212.33
Rate for Payer: PACE Medicare	$30,410.65
Rate for Payer: PACE SWMI	$32,011.21
Rate for Payer: PHP Commercial	$35,212.33
Rate for Payer: PHP Medicare Advantage	$32,011.21
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$57,724.94
Rate for Payer: Priority Health Medicare	$32,011.21
Rate for Payer: Priority Health Narrow Network	$46,179.95
Rate for Payer: Railroad Medicare Medicare	$32,011.21
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$32,011.21
Rate for Payer: UHC Exchange	$49,617.38
Rate for Payer: UHCCP DNSP	$32,011.21
Rate for Payer: VA VA	$32,011.21

OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC

Facility

$22,550.87

Service Code	MSDRG 675
Min. Negotiated Rate	$12,895.85
Max. Negotiated Rate	$22,550.87
Rate for Payer: Aetna Medicare	$13,574.58
Rate for Payer: Allen County Amish Medical Aid Commercial	$16,968.22
Rate for Payer: Amish Plain Church Group Commercial	$16,968.22
Rate for Payer: BCBS MAPPO	$13,574.58
Rate for Payer: BCN Medicare Advantage	$13,574.58
Rate for Payer: Health Alliance Plan Medicare Advantage	$13,574.58
Rate for Payer: Humana Choice PPO Medicare	$13,574.58
Rate for Payer: Mclaren Medicare	$13,574.58
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$14,253.31
Rate for Payer: MI Amish Medical Board Commercial	$15,610.77
Rate for Payer: Molina Medicare/Medicaid	$14,932.04
Rate for Payer: PACE Medicare	$12,895.85
Rate for Payer: PACE SWMI	$13,574.58
Rate for Payer: PHP Commercial	$14,932.04
Rate for Payer: PHP Medicare Advantage	$13,574.58
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$22,550.87
Rate for Payer: Priority Health Medicare	$13,574.58
Rate for Payer: Priority Health Narrow Network	$18,040.69
Rate for Payer: Railroad Medicare Medicare	$13,574.58
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$13,574.58
Rate for Payer: UHC Exchange	$21,040.60
Rate for Payer: UHCCP DNSP	$13,574.58
Rate for Payer: VA VA	$13,574.58

OTHER KIDNEY, URINARY TRACT AND RELATED NON-PERCUTANEOUS PROCEDURES

Facility

$9,738.26

Service Code	APR-DRG 4472
Min. Negotiated Rate	$8,804.55
Max. Negotiated Rate	$9,738.26
Rate for Payer: BCBS Complete	$9,738.26
Rate for Payer: Mclaren Medicaid	$9,274.53
Rate for Payer: Meridian Medicaid	$9,738.26
Rate for Payer: PHP Medicaid	$8,804.55
Rate for Payer: Priority Health Choice Medicaid	$9,274.53
Rate for Payer: UHC Medicaid	$9,274.53
Rate for Payer: UHCCP Medicaid	$9,274.53

OTHER KIDNEY, URINARY TRACT AND RELATED NON-PERCUTANEOUS PROCEDURES

Facility

$21,268.85

Service Code	APR-DRG 4474
Min. Negotiated Rate	$19,229.59
Max. Negotiated Rate	$21,268.85
Rate for Payer: BCBS Complete	$21,268.85
Rate for Payer: Mclaren Medicaid	$20,256.05
Rate for Payer: Meridian Medicaid	$21,268.85
Rate for Payer: PHP Medicaid	$19,229.59
Rate for Payer: Priority Health Choice Medicaid	$20,256.05
Rate for Payer: UHC Medicaid	$20,256.05
Rate for Payer: UHCCP Medicaid	$20,256.05

OTHER KIDNEY, URINARY TRACT AND RELATED NON-PERCUTANEOUS PROCEDURES

Facility

$8,418.93

Service Code	APR-DRG 4471
Min. Negotiated Rate	$7,611.72
Max. Negotiated Rate	$8,418.93
Rate for Payer: BCBS Complete	$8,418.93
Rate for Payer: Mclaren Medicaid	$8,018.03
Rate for Payer: Meridian Medicaid	$8,418.93
Rate for Payer: PHP Medicaid	$7,611.72
Rate for Payer: Priority Health Choice Medicaid	$8,018.03
Rate for Payer: UHC Medicaid	$8,018.03
Rate for Payer: UHCCP Medicaid	$8,018.03

OTHER KIDNEY, URINARY TRACT AND RELATED NON-PERCUTANEOUS PROCEDURES

Facility

$13,365.44

Service Code	APR-DRG 4473
Min. Negotiated Rate	$12,083.96
Max. Negotiated Rate	$13,365.44
Rate for Payer: BCBS Complete	$13,365.44
Rate for Payer: Mclaren Medicaid	$12,728.99
Rate for Payer: Meridian Medicaid	$13,365.44
Rate for Payer: PHP Medicaid	$12,083.96
Rate for Payer: Priority Health Choice Medicaid	$12,728.99
Rate for Payer: UHC Medicaid	$12,728.99
Rate for Payer: UHCCP Medicaid	$12,728.99

OTHER KIDNEY, URINARY TRACT AND RELATED PERCUTANEOUS PROCEDURES

Facility

$20,857.42

Service Code	APR-DRG 4484
Min. Negotiated Rate	$18,857.60
Max. Negotiated Rate	$20,857.42
Rate for Payer: BCBS Complete	$20,857.42
Rate for Payer: Mclaren Medicaid	$19,864.21
Rate for Payer: Meridian Medicaid	$20,857.42
Rate for Payer: PHP Medicaid	$18,857.60
Rate for Payer: Priority Health Choice Medicaid	$19,864.21
Rate for Payer: UHC Medicaid	$19,864.21
Rate for Payer: UHCCP Medicaid	$19,864.21

OTHER KIDNEY, URINARY TRACT AND RELATED PERCUTANEOUS PROCEDURES

Facility

$9,029.82

Service Code	APR-DRG 4482
Min. Negotiated Rate	$8,164.04
Max. Negotiated Rate	$9,029.82
Rate for Payer: BCBS Complete	$9,029.82
Rate for Payer: Mclaren Medicaid	$8,599.83
Rate for Payer: Meridian Medicaid	$9,029.82
Rate for Payer: PHP Medicaid	$8,164.04
Rate for Payer: Priority Health Choice Medicaid	$8,599.83
Rate for Payer: UHC Medicaid	$8,599.83
Rate for Payer: UHCCP Medicaid	$8,599.83

OTHER KIDNEY, URINARY TRACT AND RELATED PERCUTANEOUS PROCEDURES

Facility

$12,302.79

Service Code	APR-DRG 4483
Min. Negotiated Rate	$11,123.20
Max. Negotiated Rate	$12,302.79
Rate for Payer: BCBS Complete	$12,302.79
Rate for Payer: Mclaren Medicaid	$11,716.94
Rate for Payer: Meridian Medicaid	$12,302.79
Rate for Payer: PHP Medicaid	$11,123.20
Rate for Payer: Priority Health Choice Medicaid	$11,716.94
Rate for Payer: UHC Medicaid	$11,716.94
Rate for Payer: UHCCP Medicaid	$11,716.94

OTHER KIDNEY, URINARY TRACT AND RELATED PERCUTANEOUS PROCEDURES

Facility

$7,235.85

Service Code	APR-DRG 4481
Min. Negotiated Rate	$6,542.07
Max. Negotiated Rate	$7,235.85
Rate for Payer: BCBS Complete	$7,235.85
Rate for Payer: Mclaren Medicaid	$6,891.28
Rate for Payer: Meridian Medicaid	$7,235.85
Rate for Payer: PHP Medicaid	$6,542.07
Rate for Payer: Priority Health Choice Medicaid	$6,891.28
Rate for Payer: UHC Medicaid	$6,891.28
Rate for Payer: UHCCP Medicaid	$6,891.28

OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC

Facility

$48,859.29

Service Code	MSDRG 271
Min. Negotiated Rate	$25,996.04
Max. Negotiated Rate	$48,859.29
Rate for Payer: Aetna Medicare	$27,364.25
Rate for Payer: Allen County Amish Medical Aid Commercial	$34,205.31
Rate for Payer: Amish Plain Church Group Commercial	$34,205.31
Rate for Payer: BCBS MAPPO	$27,364.25
Rate for Payer: BCN Medicare Advantage	$27,364.25
Rate for Payer: Health Alliance Plan Medicare Advantage	$27,364.25
Rate for Payer: Humana Choice PPO Medicare	$27,364.25
Rate for Payer: Mclaren Medicare	$27,364.25
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$28,732.46
Rate for Payer: MI Amish Medical Board Commercial	$31,468.89
Rate for Payer: Molina Medicare/Medicaid	$30,100.67
Rate for Payer: PACE Medicare	$25,996.04
Rate for Payer: PACE SWMI	$27,364.25
Rate for Payer: PHP Commercial	$30,100.67
Rate for Payer: PHP Medicare Advantage	$27,364.25
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$48,859.29
Rate for Payer: Priority Health Medicare	$27,364.25
Rate for Payer: Priority Health Narrow Network	$39,087.44
Rate for Payer: Railroad Medicare Medicare	$27,364.25
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$27,364.25
Rate for Payer: UHC Exchange	$42,414.59
Rate for Payer: UHCCP DNSP	$27,364.25
Rate for Payer: VA VA	$27,364.25

OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC

Facility

$72,490.03

Service Code	MSDRG 270
Min. Negotiated Rate	$37,762.86
Max. Negotiated Rate	$72,490.03
Rate for Payer: Aetna Medicare	$39,750.38
Rate for Payer: Allen County Amish Medical Aid Commercial	$49,687.97
Rate for Payer: Amish Plain Church Group Commercial	$49,687.97
Rate for Payer: BCBS MAPPO	$39,750.38
Rate for Payer: BCN Medicare Advantage	$39,750.38
Rate for Payer: Health Alliance Plan Medicare Advantage	$39,750.38
Rate for Payer: Humana Choice PPO Medicare	$39,750.38
Rate for Payer: Mclaren Medicare	$39,750.38
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$41,737.90
Rate for Payer: MI Amish Medical Board Commercial	$45,712.94
Rate for Payer: Molina Medicare/Medicaid	$43,725.42
Rate for Payer: PACE Medicare	$37,762.86
Rate for Payer: PACE SWMI	$39,750.38
Rate for Payer: PHP Commercial	$43,725.42
Rate for Payer: PHP Medicare Advantage	$39,750.38
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$72,490.03
Rate for Payer: Priority Health Medicare	$39,750.38
Rate for Payer: Priority Health Narrow Network	$57,992.02
Rate for Payer: Railroad Medicare Medicare	$39,750.38
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$39,750.38
Rate for Payer: UHC Exchange	$61,613.09
Rate for Payer: UHCCP DNSP	$39,750.38
Rate for Payer: VA VA	$39,750.38

OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC

Facility

$35,075.16

Service Code	MSDRG 272
Min. Negotiated Rate	$19,132.27
Max. Negotiated Rate	$35,075.16
Rate for Payer: Aetna Medicare	$20,139.23
Rate for Payer: Allen County Amish Medical Aid Commercial	$25,174.04
Rate for Payer: Amish Plain Church Group Commercial	$25,174.04
Rate for Payer: BCBS MAPPO	$20,139.23
Rate for Payer: BCN Medicare Advantage	$20,139.23
Rate for Payer: Health Alliance Plan Medicare Advantage	$20,139.23
Rate for Payer: Humana Choice PPO Medicare	$20,139.23
Rate for Payer: Mclaren Medicare	$20,139.23
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$21,146.19
Rate for Payer: MI Amish Medical Board Commercial	$23,160.11
Rate for Payer: Molina Medicare/Medicaid	$22,153.15
Rate for Payer: PACE Medicare	$19,132.27
Rate for Payer: PACE SWMI	$20,139.23
Rate for Payer: PHP Commercial	$22,153.15
Rate for Payer: PHP Medicare Advantage	$20,139.23
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$35,075.16
Rate for Payer: Priority Health Medicare	$20,139.23
Rate for Payer: Priority Health Narrow Network	$28,060.13
Rate for Payer: Railroad Medicare Medicare	$20,139.23
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$20,139.23
Rate for Payer: UHC Exchange	$31,215.81
Rate for Payer: UHCCP DNSP	$20,139.23
Rate for Payer: VA VA	$20,139.23

OTHER MAJOR HEAD AND NECK PROCEDURES

Facility

$27,455.67

Service Code	APR-DRG 0912
Min. Negotiated Rate	$24,823.21
Max. Negotiated Rate	$27,455.67
Rate for Payer: BCBS Complete	$27,455.67
Rate for Payer: Mclaren Medicaid	$26,148.26
Rate for Payer: Meridian Medicaid	$27,455.67
Rate for Payer: PHP Medicaid	$24,823.21
Rate for Payer: Priority Health Choice Medicaid	$26,148.26
Rate for Payer: UHC Medicaid	$26,148.26
Rate for Payer: UHCCP Medicaid	$26,148.26

OTHER MAJOR HEAD AND NECK PROCEDURES

Facility

$40,549.18

Service Code	APR-DRG 0914
Min. Negotiated Rate	$36,661.31
Max. Negotiated Rate	$40,549.18
Rate for Payer: BCBS Complete	$40,549.18
Rate for Payer: Mclaren Medicaid	$38,618.27
Rate for Payer: Meridian Medicaid	$40,549.18
Rate for Payer: PHP Medicaid	$36,661.31
Rate for Payer: Priority Health Choice Medicaid	$38,618.27
Rate for Payer: UHC Medicaid	$38,618.27
Rate for Payer: UHCCP Medicaid	$38,618.27

OTHER MAJOR HEAD AND NECK PROCEDURES

Facility

$12,910.96

Service Code	APR-DRG 0911
Min. Negotiated Rate	$11,673.05
Max. Negotiated Rate	$12,910.96
Rate for Payer: BCBS Complete	$12,910.96
Rate for Payer: Mclaren Medicaid	$12,296.15
Rate for Payer: Meridian Medicaid	$12,910.96
Rate for Payer: PHP Medicaid	$11,673.05
Rate for Payer: Priority Health Choice Medicaid	$12,296.15
Rate for Payer: UHC Medicaid	$12,296.15
Rate for Payer: UHCCP Medicaid	$12,296.15

OTHER MAJOR HEAD AND NECK PROCEDURES

Facility

$37,528.53

Service Code	APR-DRG 0913
Min. Negotiated Rate	$33,930.28
Max. Negotiated Rate	$37,528.53
Rate for Payer: BCBS Complete	$37,528.53
Rate for Payer: Mclaren Medicaid	$35,741.45
Rate for Payer: Meridian Medicaid	$37,528.53
Rate for Payer: PHP Medicaid	$33,930.28
Rate for Payer: Priority Health Choice Medicaid	$35,741.45
Rate for Payer: UHC Medicaid	$35,741.45
Rate for Payer: UHCCP Medicaid	$35,741.45

OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES

Facility

$28,449.11

Service Code	APR-DRG 4844
Min. Negotiated Rate	$25,721.40
Max. Negotiated Rate	$28,449.11
Rate for Payer: BCBS Complete	$28,449.11
Rate for Payer: Mclaren Medicaid	$27,094.40
Rate for Payer: Meridian Medicaid	$28,449.11
Rate for Payer: PHP Medicaid	$25,721.40
Rate for Payer: Priority Health Choice Medicaid	$27,094.40
Rate for Payer: UHC Medicaid	$27,094.40
Rate for Payer: UHCCP Medicaid	$27,094.40

OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES

Facility

$10,891.37

Service Code	APR-DRG 4842
Min. Negotiated Rate	$9,847.10
Max. Negotiated Rate	$10,891.37
Rate for Payer: BCBS Complete	$10,891.37
Rate for Payer: Mclaren Medicaid	$10,372.73
Rate for Payer: Meridian Medicaid	$10,891.37
Rate for Payer: PHP Medicaid	$9,847.10
Rate for Payer: Priority Health Choice Medicaid	$10,372.73
Rate for Payer: UHC Medicaid	$10,372.73
Rate for Payer: UHCCP Medicaid	$10,372.73

OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES

Facility

$15,267.86

Service Code	APR-DRG 4843
Min. Negotiated Rate	$13,803.98
Max. Negotiated Rate	$15,267.86
Rate for Payer: BCBS Complete	$15,267.86
Rate for Payer: Mclaren Medicaid	$14,540.82
Rate for Payer: Meridian Medicaid	$15,267.86
Rate for Payer: PHP Medicaid	$13,803.98
Rate for Payer: Priority Health Choice Medicaid	$14,540.82
Rate for Payer: UHC Medicaid	$14,540.82
Rate for Payer: UHCCP Medicaid	$14,540.82

OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES

Facility

$8,577.51

Service Code	APR-DRG 4841
Min. Negotiated Rate	$7,755.10
Max. Negotiated Rate	$8,577.51
Rate for Payer: BCBS Complete	$8,577.51
Rate for Payer: Mclaren Medicaid	$8,169.06
Rate for Payer: Meridian Medicaid	$8,577.51
Rate for Payer: PHP Medicaid	$7,755.10
Rate for Payer: Priority Health Choice Medicaid	$8,169.06
Rate for Payer: UHC Medicaid	$8,169.06
Rate for Payer: UHCCP Medicaid	$8,169.06

OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC

Facility

$14,545.27

Service Code	MSDRG 729
Min. Negotiated Rate	$8,909.49
Max. Negotiated Rate	$14,545.27
Rate for Payer: Aetna Medicare	$9,378.41
Rate for Payer: Allen County Amish Medical Aid Commercial	$11,723.01
Rate for Payer: Amish Plain Church Group Commercial	$11,723.01
Rate for Payer: BCBS MAPPO	$9,378.41
Rate for Payer: BCN Medicare Advantage	$9,378.41
Rate for Payer: Health Alliance Plan Medicare Advantage	$9,378.41
Rate for Payer: Humana Choice PPO Medicare	$9,378.41
Rate for Payer: Mclaren Medicare	$9,378.41
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$9,847.33
Rate for Payer: MI Amish Medical Board Commercial	$10,785.17
Rate for Payer: Molina Medicare/Medicaid	$10,316.25
Rate for Payer: PACE Medicare	$8,909.49
Rate for Payer: PACE SWMI	$9,378.41
Rate for Payer: PHP Commercial	$10,316.25
Rate for Payer: PHP Medicare Advantage	$9,378.41
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$14,545.27
Rate for Payer: Priority Health Medicare	$9,378.41
Rate for Payer: Priority Health Narrow Network	$11,636.21
Rate for Payer: Railroad Medicare Medicare	$9,378.41
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$9,378.41
Rate for Payer: UHC Exchange	$14,536.54
Rate for Payer: UHCCP DNSP	$9,378.41
Rate for Payer: VA VA	$9,378.41

OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC

Facility

$10,220.22

Service Code	MSDRG 730
Min. Negotiated Rate	$6,264.01
Max. Negotiated Rate	$10,220.22
Rate for Payer: Aetna Medicare	$6,593.69
Rate for Payer: Allen County Amish Medical Aid Commercial	$8,242.11
Rate for Payer: Amish Plain Church Group Commercial	$8,242.11
Rate for Payer: BCBS MAPPO	$6,593.69
Rate for Payer: BCN Medicare Advantage	$6,593.69
Rate for Payer: Health Alliance Plan Medicare Advantage	$6,593.69
Rate for Payer: Humana Choice PPO Medicare	$6,593.69
Rate for Payer: Mclaren Medicare	$6,593.69
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$6,923.37
Rate for Payer: MI Amish Medical Board Commercial	$7,582.74
Rate for Payer: Molina Medicare/Medicaid	$7,253.06
Rate for Payer: PACE Medicare	$6,264.01
Rate for Payer: PACE SWMI	$6,593.69
Rate for Payer: PHP Commercial	$7,253.06
Rate for Payer: PHP Medicare Advantage	$6,593.69
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$9,232.47
Rate for Payer: Priority Health Medicare	$6,593.69
Rate for Payer: Priority Health Narrow Network	$7,385.98
Rate for Payer: Railroad Medicare Medicare	$6,593.69
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$6,593.69
Rate for Payer: UHC Exchange	$10,220.22
Rate for Payer: UHCCP DNSP	$6,593.69
Rate for Payer: VA VA	$6,593.69

OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC

Facility

$25,973.20

Service Code	MSDRG 717
Min. Negotiated Rate	$14,600.00
Max. Negotiated Rate	$25,973.20
Rate for Payer: Aetna Medicare	$15,368.42
Rate for Payer: Allen County Amish Medical Aid Commercial	$19,210.53
Rate for Payer: Amish Plain Church Group Commercial	$19,210.53
Rate for Payer: BCBS MAPPO	$15,368.42
Rate for Payer: BCN Medicare Advantage	$15,368.42
Rate for Payer: Health Alliance Plan Medicare Advantage	$15,368.42
Rate for Payer: Humana Choice PPO Medicare	$15,368.42
Rate for Payer: Mclaren Medicare	$15,368.42
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$16,136.84
Rate for Payer: MI Amish Medical Board Commercial	$17,673.68
Rate for Payer: Molina Medicare/Medicaid	$16,905.26
Rate for Payer: PACE Medicare	$14,600.00
Rate for Payer: PACE SWMI	$15,368.42
Rate for Payer: PHP Commercial	$16,905.26
Rate for Payer: PHP Medicare Advantage	$15,368.42
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$25,973.20
Rate for Payer: Priority Health Medicare	$15,368.42
Rate for Payer: Priority Health Narrow Network	$20,778.56
Rate for Payer: Railroad Medicare Medicare	$15,368.42
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$15,368.42
Rate for Payer: UHC Exchange	$23,821.05
Rate for Payer: UHCCP DNSP	$15,368.42
Rate for Payer: VA VA	$15,368.42

OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC

Facility

$18,452.58

Service Code	MSDRG 718
Min. Negotiated Rate	$10,855.13
Max. Negotiated Rate	$18,452.58
Rate for Payer: Aetna Medicare	$11,426.45
Rate for Payer: Allen County Amish Medical Aid Commercial	$14,283.06
Rate for Payer: Amish Plain Church Group Commercial	$14,283.06
Rate for Payer: BCBS MAPPO	$11,426.45
Rate for Payer: BCN Medicare Advantage	$11,426.45
Rate for Payer: Health Alliance Plan Medicare Advantage	$11,426.45
Rate for Payer: Humana Choice PPO Medicare	$11,426.45
Rate for Payer: Mclaren Medicare	$11,426.45
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$11,997.77
Rate for Payer: MI Amish Medical Board Commercial	$13,140.42
Rate for Payer: Molina Medicare/Medicaid	$12,569.09
Rate for Payer: PACE Medicare	$10,855.13
Rate for Payer: PACE SWMI	$11,426.45
Rate for Payer: PHP Commercial	$12,569.09
Rate for Payer: PHP Medicare Advantage	$11,426.45
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$18,452.58
Rate for Payer: Priority Health Medicare	$11,426.45
Rate for Payer: Priority Health Narrow Network	$14,762.07
Rate for Payer: Railroad Medicare Medicare	$11,426.45
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$11,426.45
Rate for Payer: UHC Exchange	$17,711.00
Rate for Payer: UHCCP DNSP	$11,426.45
Rate for Payer: VA VA	$11,426.45

Know your out-of-pocket cost for care.

All Charges