Bronson South Haven Hospital

All Charges

Charge

Type

Setting

Price

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

Facility

$30,737.82

Service Code	MSDRG 715
Min. Negotiated Rate	$16,972.52
Max. Negotiated Rate	$30,737.82
Rate for Payer: Aetna Medicare	$17,865.81
Rate for Payer: Allen County Amish Medical Aid Commercial	$22,332.26
Rate for Payer: Amish Plain Church Group Commercial	$22,332.26
Rate for Payer: BCBS MAPPO	$17,865.81
Rate for Payer: BCN Medicare Advantage	$17,865.81
Rate for Payer: Health Alliance Plan Medicare Advantage	$17,865.81
Rate for Payer: Humana Choice PPO Medicare	$17,865.81
Rate for Payer: Mclaren Medicare	$17,865.81
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$18,759.10
Rate for Payer: MI Amish Medical Board Commercial	$20,545.68
Rate for Payer: Molina Medicare/Medicaid	$19,652.39
Rate for Payer: PACE Medicare	$16,972.52
Rate for Payer: PACE SWMI	$17,865.81
Rate for Payer: PHP Commercial	$19,652.39
Rate for Payer: PHP Medicare Advantage	$17,865.81
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$30,737.82
Rate for Payer: Priority Health Medicare	$17,865.81
Rate for Payer: Priority Health Narrow Network	$24,590.25
Rate for Payer: Railroad Medicare Medicare	$17,865.81
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$17,865.81
Rate for Payer: UHC Exchange	$27,692.01
Rate for Payer: UHCCP DNSP	$17,865.81
Rate for Payer: VA VA	$17,865.81

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

Facility

$20,209.77

Service Code	MSDRG 716
Min. Negotiated Rate	$11,730.12
Max. Negotiated Rate	$20,209.77
Rate for Payer: Aetna Medicare	$12,347.49
Rate for Payer: Allen County Amish Medical Aid Commercial	$15,434.36
Rate for Payer: Amish Plain Church Group Commercial	$15,434.36
Rate for Payer: BCBS MAPPO	$12,347.49
Rate for Payer: BCN Medicare Advantage	$12,347.49
Rate for Payer: Health Alliance Plan Medicare Advantage	$12,347.49
Rate for Payer: Humana Choice PPO Medicare	$12,347.49
Rate for Payer: Mclaren Medicare	$12,347.49
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$12,964.86
Rate for Payer: MI Amish Medical Board Commercial	$14,199.61
Rate for Payer: Molina Medicare/Medicaid	$13,582.24
Rate for Payer: PACE Medicare	$11,730.12
Rate for Payer: PACE SWMI	$12,347.49
Rate for Payer: PHP Commercial	$13,582.24
Rate for Payer: PHP Medicare Advantage	$12,347.49
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$20,209.77
Rate for Payer: Priority Health Medicare	$12,347.49
Rate for Payer: Priority Health Narrow Network	$16,167.82
Rate for Payer: Railroad Medicare Medicare	$12,347.49
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$12,347.49
Rate for Payer: UHC Exchange	$19,138.61
Rate for Payer: UHCCP DNSP	$12,347.49
Rate for Payer: VA VA	$12,347.49

OTHER MENTAL DISORDER DIAGNOSES

Facility

$14,712.88

Service Code	MSDRG 887
Min. Negotiated Rate	$8,992.96
Max. Negotiated Rate	$14,712.88
Rate for Payer: Aetna Medicare	$9,466.27
Rate for Payer: Allen County Amish Medical Aid Commercial	$11,832.84
Rate for Payer: Amish Plain Church Group Commercial	$11,832.84
Rate for Payer: BCBS MAPPO	$9,466.27
Rate for Payer: BCN Medicare Advantage	$9,466.27
Rate for Payer: Health Alliance Plan Medicare Advantage	$9,466.27
Rate for Payer: Humana Choice PPO Medicare	$9,466.27
Rate for Payer: Mclaren Medicare	$9,466.27
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$9,939.58
Rate for Payer: MI Amish Medical Board Commercial	$10,886.21
Rate for Payer: Molina Medicare/Medicaid	$10,412.90
Rate for Payer: PACE Medicare	$8,992.96
Rate for Payer: PACE SWMI	$9,466.27
Rate for Payer: PHP Commercial	$10,412.90
Rate for Payer: PHP Medicare Advantage	$9,466.27
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$14,712.88
Rate for Payer: Priority Health Medicare	$9,466.27
Rate for Payer: Priority Health Narrow Network	$11,770.30
Rate for Payer: Railroad Medicare Medicare	$9,466.27
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$9,466.27
Rate for Payer: UHC Exchange	$14,672.72
Rate for Payer: UHCCP DNSP	$9,466.27
Rate for Payer: VA VA	$9,466.27

OTHER MENTAL HEALTH CONDITIONS AND DISORDERS

Facility

$4,339.98

Service Code	APR-DRG 7603
Min. Negotiated Rate	$3,923.86
Max. Negotiated Rate	$4,339.98
Rate for Payer: BCBS Complete	$4,339.98
Rate for Payer: Mclaren Medicaid	$4,133.32
Rate for Payer: Meridian Medicaid	$4,339.98
Rate for Payer: PHP Medicaid	$3,923.86
Rate for Payer: Priority Health Choice Medicaid	$4,133.32
Rate for Payer: UHC Medicaid	$4,133.32
Rate for Payer: UHCCP Medicaid	$4,133.32

OTHER MENTAL HEALTH CONDITIONS AND DISORDERS

Facility

$2,130.75

Service Code	APR-DRG 7601
Min. Negotiated Rate	$1,926.46
Max. Negotiated Rate	$2,130.75
Rate for Payer: BCBS Complete	$2,130.75
Rate for Payer: Mclaren Medicaid	$2,029.29
Rate for Payer: Meridian Medicaid	$2,130.75
Rate for Payer: PHP Medicaid	$1,926.46
Rate for Payer: Priority Health Choice Medicaid	$2,029.29
Rate for Payer: UHC Medicaid	$2,029.29
Rate for Payer: UHCCP Medicaid	$2,029.29

OTHER MENTAL HEALTH CONDITIONS AND DISORDERS

Facility

$3,269.16

Service Code	APR-DRG 7602
Min. Negotiated Rate	$2,955.71
Max. Negotiated Rate	$3,269.16
Rate for Payer: BCBS Complete	$3,269.16
Rate for Payer: Mclaren Medicaid	$3,113.48
Rate for Payer: Meridian Medicaid	$3,269.16
Rate for Payer: PHP Medicaid	$2,955.71
Rate for Payer: Priority Health Choice Medicaid	$3,113.48
Rate for Payer: UHC Medicaid	$3,113.48
Rate for Payer: UHCCP Medicaid	$3,113.48

OTHER MENTAL HEALTH CONDITIONS AND DISORDERS

Facility

$9,909.37

Service Code	APR-DRG 7604
Min. Negotiated Rate	$8,959.26
Max. Negotiated Rate	$9,909.37
Rate for Payer: BCBS Complete	$9,909.37
Rate for Payer: Mclaren Medicaid	$9,437.50
Rate for Payer: Meridian Medicaid	$9,909.37
Rate for Payer: PHP Medicaid	$8,959.26
Rate for Payer: Priority Health Choice Medicaid	$9,437.50
Rate for Payer: UHC Medicaid	$9,437.50
Rate for Payer: UHCCP Medicaid	$9,437.50

OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC

Facility

$21,056.08

Service Code	MSDRG 964
Min. Negotiated Rate	$12,151.53
Max. Negotiated Rate	$21,056.08
Rate for Payer: Aetna Medicare	$12,791.08
Rate for Payer: Allen County Amish Medical Aid Commercial	$15,988.85
Rate for Payer: Amish Plain Church Group Commercial	$15,988.85
Rate for Payer: BCBS MAPPO	$12,791.08
Rate for Payer: BCN Medicare Advantage	$12,791.08
Rate for Payer: Health Alliance Plan Medicare Advantage	$12,791.08
Rate for Payer: Humana Choice PPO Medicare	$12,791.08
Rate for Payer: Mclaren Medicare	$12,791.08
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$13,430.63
Rate for Payer: MI Amish Medical Board Commercial	$14,709.74
Rate for Payer: Molina Medicare/Medicaid	$14,070.19
Rate for Payer: PACE Medicare	$12,151.53
Rate for Payer: PACE SWMI	$12,791.08
Rate for Payer: PHP Commercial	$14,070.19
Rate for Payer: PHP Medicare Advantage	$12,791.08
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$21,056.08
Rate for Payer: Priority Health Medicare	$12,791.08
Rate for Payer: Priority Health Narrow Network	$16,844.87
Rate for Payer: Railroad Medicare Medicare	$12,791.08
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$12,791.08
Rate for Payer: UHC Exchange	$19,826.17
Rate for Payer: UHCCP DNSP	$12,791.08
Rate for Payer: VA VA	$12,791.08

OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC

Facility

$37,559.13

Service Code	MSDRG 963
Min. Negotiated Rate	$20,369.16
Max. Negotiated Rate	$37,559.13
Rate for Payer: Aetna Medicare	$21,441.22
Rate for Payer: Allen County Amish Medical Aid Commercial	$26,801.53
Rate for Payer: Amish Plain Church Group Commercial	$26,801.53
Rate for Payer: BCBS MAPPO	$21,441.22
Rate for Payer: BCN Medicare Advantage	$21,441.22
Rate for Payer: Health Alliance Plan Medicare Advantage	$21,441.22
Rate for Payer: Humana Choice PPO Medicare	$21,441.22
Rate for Payer: Mclaren Medicare	$21,441.22
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$22,513.28
Rate for Payer: MI Amish Medical Board Commercial	$24,657.40
Rate for Payer: Molina Medicare/Medicaid	$23,585.34
Rate for Payer: PACE Medicare	$20,369.16
Rate for Payer: PACE SWMI	$21,441.22
Rate for Payer: PHP Commercial	$23,585.34
Rate for Payer: PHP Medicare Advantage	$21,441.22
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$37,559.13
Rate for Payer: Priority Health Medicare	$21,441.22
Rate for Payer: Priority Health Narrow Network	$30,047.31
Rate for Payer: Railroad Medicare Medicare	$21,441.22
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$21,441.22
Rate for Payer: UHC Exchange	$33,233.89
Rate for Payer: UHCCP DNSP	$21,441.22
Rate for Payer: VA VA	$21,441.22

OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC

Facility

$13,217.21

Service Code	MSDRG 965
Min. Negotiated Rate	$8,100.87
Max. Negotiated Rate	$13,217.21
Rate for Payer: Aetna Medicare	$8,527.23
Rate for Payer: Allen County Amish Medical Aid Commercial	$10,659.04
Rate for Payer: Amish Plain Church Group Commercial	$10,659.04
Rate for Payer: BCBS MAPPO	$8,527.23
Rate for Payer: BCN Medicare Advantage	$8,527.23
Rate for Payer: Health Alliance Plan Medicare Advantage	$8,527.23
Rate for Payer: Humana Choice PPO Medicare	$8,527.23
Rate for Payer: Mclaren Medicare	$8,527.23
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$8,953.59
Rate for Payer: MI Amish Medical Board Commercial	$9,806.31
Rate for Payer: Molina Medicare/Medicaid	$9,379.95
Rate for Payer: PACE Medicare	$8,100.87
Rate for Payer: PACE SWMI	$8,527.23
Rate for Payer: PHP Commercial	$9,379.95
Rate for Payer: PHP Medicare Advantage	$8,527.23
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$12,921.34
Rate for Payer: Priority Health Medicare	$8,527.23
Rate for Payer: Priority Health Narrow Network	$10,337.07
Rate for Payer: Railroad Medicare Medicare	$8,527.23
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$8,527.23
Rate for Payer: UHC Exchange	$13,217.21
Rate for Payer: UHCCP DNSP	$8,527.23
Rate for Payer: VA VA	$8,527.23

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES

Facility

$5,705.63

Service Code	APR-DRG 3513
Min. Negotiated Rate	$5,158.57
Max. Negotiated Rate	$5,705.63
Rate for Payer: BCBS Complete	$5,705.63
Rate for Payer: Mclaren Medicaid	$5,433.93
Rate for Payer: Meridian Medicaid	$5,705.63
Rate for Payer: PHP Medicaid	$5,158.57
Rate for Payer: Priority Health Choice Medicaid	$5,433.93
Rate for Payer: UHC Medicaid	$5,433.93
Rate for Payer: UHCCP Medicaid	$5,433.93

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES

Facility

$2,726.93

Service Code	APR-DRG 3511
Min. Negotiated Rate	$2,465.47
Max. Negotiated Rate	$2,726.93
Rate for Payer: BCBS Complete	$2,726.93
Rate for Payer: Mclaren Medicaid	$2,597.08
Rate for Payer: Meridian Medicaid	$2,726.93
Rate for Payer: PHP Medicaid	$2,465.47
Rate for Payer: Priority Health Choice Medicaid	$2,597.08
Rate for Payer: UHC Medicaid	$2,597.08
Rate for Payer: UHCCP Medicaid	$2,597.08

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES

Facility

$3,646.81

Service Code	APR-DRG 3512
Min. Negotiated Rate	$3,297.15
Max. Negotiated Rate	$3,646.81
Rate for Payer: BCBS Complete	$3,646.81
Rate for Payer: Mclaren Medicaid	$3,473.15
Rate for Payer: Meridian Medicaid	$3,646.81
Rate for Payer: PHP Medicaid	$3,297.15
Rate for Payer: Priority Health Choice Medicaid	$3,473.15
Rate for Payer: UHC Medicaid	$3,473.15
Rate for Payer: UHCCP Medicaid	$3,473.15

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES

Facility

$7,988.42

Service Code	APR-DRG 3514
Min. Negotiated Rate	$7,222.49
Max. Negotiated Rate	$7,988.42
Rate for Payer: BCBS Complete	$7,988.42
Rate for Payer: Mclaren Medicaid	$7,608.02
Rate for Payer: Meridian Medicaid	$7,988.42
Rate for Payer: PHP Medicaid	$7,222.49
Rate for Payer: Priority Health Choice Medicaid	$7,608.02
Rate for Payer: UHC Medicaid	$7,608.02
Rate for Payer: UHCCP Medicaid	$7,608.02

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC

Facility

$13,595.59

Service Code	MSDRG 565
Min. Negotiated Rate	$8,332.78
Max. Negotiated Rate	$13,595.59
Rate for Payer: Aetna Medicare	$8,771.35
Rate for Payer: Allen County Amish Medical Aid Commercial	$10,964.19
Rate for Payer: Amish Plain Church Group Commercial	$10,964.19
Rate for Payer: BCBS MAPPO	$8,771.35
Rate for Payer: BCN Medicare Advantage	$8,771.35
Rate for Payer: Health Alliance Plan Medicare Advantage	$8,771.35
Rate for Payer: Humana Choice PPO Medicare	$8,771.35
Rate for Payer: Mclaren Medicare	$8,771.35
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$9,209.92
Rate for Payer: MI Amish Medical Board Commercial	$10,087.05
Rate for Payer: Molina Medicare/Medicaid	$9,648.49
Rate for Payer: PACE Medicare	$8,332.78
Rate for Payer: PACE SWMI	$8,771.35
Rate for Payer: PHP Commercial	$9,648.49
Rate for Payer: PHP Medicare Advantage	$8,771.35
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$13,387.09
Rate for Payer: Priority Health Medicare	$8,771.35
Rate for Payer: Priority Health Narrow Network	$10,709.67
Rate for Payer: Railroad Medicare Medicare	$8,771.35
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$8,771.35
Rate for Payer: UHC Exchange	$13,595.59
Rate for Payer: UHCCP DNSP	$8,771.35
Rate for Payer: VA VA	$8,771.35

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC

Facility

$21,207.21

Service Code	MSDRG 564
Min. Negotiated Rate	$12,226.78
Max. Negotiated Rate	$21,207.21
Rate for Payer: Aetna Medicare	$12,870.30
Rate for Payer: Allen County Amish Medical Aid Commercial	$16,087.88
Rate for Payer: Amish Plain Church Group Commercial	$16,087.88
Rate for Payer: BCBS MAPPO	$12,870.30
Rate for Payer: BCN Medicare Advantage	$12,870.30
Rate for Payer: Health Alliance Plan Medicare Advantage	$12,870.30
Rate for Payer: Humana Choice PPO Medicare	$12,870.30
Rate for Payer: Mclaren Medicare	$12,870.30
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$13,513.82
Rate for Payer: MI Amish Medical Board Commercial	$14,800.84
Rate for Payer: Molina Medicare/Medicaid	$14,157.33
Rate for Payer: PACE Medicare	$12,226.78
Rate for Payer: PACE SWMI	$12,870.30
Rate for Payer: PHP Commercial	$14,157.33
Rate for Payer: PHP Medicare Advantage	$12,870.30
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$21,207.21
Rate for Payer: Priority Health Medicare	$12,870.30
Rate for Payer: Priority Health Narrow Network	$16,965.77
Rate for Payer: Railroad Medicare Medicare	$12,870.30
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$12,870.30
Rate for Payer: UHC Exchange	$19,948.97
Rate for Payer: UHCCP DNSP	$12,870.30
Rate for Payer: VA VA	$12,870.30

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC

Facility

$11,083.04

Service Code	MSDRG 566
Min. Negotiated Rate	$6,792.83
Max. Negotiated Rate	$11,083.04
Rate for Payer: Aetna Medicare	$7,150.35
Rate for Payer: Allen County Amish Medical Aid Commercial	$8,937.94
Rate for Payer: Amish Plain Church Group Commercial	$8,937.94
Rate for Payer: BCBS MAPPO	$7,150.35
Rate for Payer: BCN Medicare Advantage	$7,150.35
Rate for Payer: Health Alliance Plan Medicare Advantage	$7,150.35
Rate for Payer: Humana Choice PPO Medicare	$7,150.35
Rate for Payer: Mclaren Medicare	$7,150.35
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$7,507.87
Rate for Payer: MI Amish Medical Board Commercial	$8,222.90
Rate for Payer: Molina Medicare/Medicaid	$7,865.39
Rate for Payer: PACE Medicare	$6,792.83
Rate for Payer: PACE SWMI	$7,150.35
Rate for Payer: PHP Commercial	$7,865.39
Rate for Payer: PHP Medicare Advantage	$7,150.35
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$10,294.48
Rate for Payer: Priority Health Medicare	$7,150.35
Rate for Payer: Priority Health Narrow Network	$8,235.59
Rate for Payer: Railroad Medicare Medicare	$7,150.35
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$7,150.35
Rate for Payer: UHC Exchange	$11,083.04
Rate for Payer: UHCCP DNSP	$7,150.35
Rate for Payer: VA VA	$7,150.35

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC

Facility

$28,550.60

Service Code	MSDRG 516
Min. Negotiated Rate	$15,883.39
Max. Negotiated Rate	$28,550.60
Rate for Payer: Aetna Medicare	$16,719.36
Rate for Payer: Allen County Amish Medical Aid Commercial	$20,899.20
Rate for Payer: Amish Plain Church Group Commercial	$20,899.20
Rate for Payer: BCBS MAPPO	$16,719.36
Rate for Payer: BCN Medicare Advantage	$16,719.36
Rate for Payer: Health Alliance Plan Medicare Advantage	$16,719.36
Rate for Payer: Humana Choice PPO Medicare	$16,719.36
Rate for Payer: Mclaren Medicare	$16,719.36
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$17,555.33
Rate for Payer: MI Amish Medical Board Commercial	$19,227.26
Rate for Payer: Molina Medicare/Medicaid	$18,391.30
Rate for Payer: PACE Medicare	$15,883.39
Rate for Payer: PACE SWMI	$16,719.36
Rate for Payer: PHP Commercial	$18,391.30
Rate for Payer: PHP Medicare Advantage	$16,719.36
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$28,550.60
Rate for Payer: Priority Health Medicare	$16,719.36
Rate for Payer: Priority Health Narrow Network	$22,840.48
Rate for Payer: Railroad Medicare Medicare	$16,719.36
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$16,719.36
Rate for Payer: UHC Exchange	$25,915.01
Rate for Payer: UHCCP DNSP	$16,719.36
Rate for Payer: VA VA	$16,719.36

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC

Facility

$43,784.18

Service Code	MSDRG 515
Min. Negotiated Rate	$23,468.90
Max. Negotiated Rate	$43,784.18
Rate for Payer: Aetna Medicare	$24,704.10
Rate for Payer: Allen County Amish Medical Aid Commercial	$30,880.12
Rate for Payer: Amish Plain Church Group Commercial	$30,880.12
Rate for Payer: BCBS MAPPO	$24,704.10
Rate for Payer: BCN Medicare Advantage	$24,704.10
Rate for Payer: Health Alliance Plan Medicare Advantage	$24,704.10
Rate for Payer: Humana Choice PPO Medicare	$24,704.10
Rate for Payer: Mclaren Medicare	$24,704.10
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$25,939.31
Rate for Payer: MI Amish Medical Board Commercial	$28,409.72
Rate for Payer: Molina Medicare/Medicaid	$27,174.51
Rate for Payer: PACE Medicare	$23,468.90
Rate for Payer: PACE SWMI	$24,704.10
Rate for Payer: PHP Commercial	$27,174.51
Rate for Payer: PHP Medicare Advantage	$24,704.10
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$43,784.18
Rate for Payer: Priority Health Medicare	$24,704.10
Rate for Payer: Priority Health Narrow Network	$35,027.35
Rate for Payer: Railroad Medicare Medicare	$24,704.10
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$24,704.10
Rate for Payer: UHC Exchange	$38,291.36
Rate for Payer: UHCCP DNSP	$24,704.10
Rate for Payer: VA VA	$24,704.10

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC

Facility

$21,112.41

Service Code	MSDRG 517
Min. Negotiated Rate	$12,179.58
Max. Negotiated Rate	$21,112.41
Rate for Payer: Aetna Medicare	$12,820.61
Rate for Payer: Allen County Amish Medical Aid Commercial	$16,025.76
Rate for Payer: Amish Plain Church Group Commercial	$16,025.76
Rate for Payer: BCBS MAPPO	$12,820.61
Rate for Payer: BCN Medicare Advantage	$12,820.61
Rate for Payer: Health Alliance Plan Medicare Advantage	$12,820.61
Rate for Payer: Humana Choice PPO Medicare	$12,820.61
Rate for Payer: Mclaren Medicare	$12,820.61
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$13,461.64
Rate for Payer: MI Amish Medical Board Commercial	$14,743.70
Rate for Payer: Molina Medicare/Medicaid	$14,102.67
Rate for Payer: PACE Medicare	$12,179.58
Rate for Payer: PACE SWMI	$12,820.61
Rate for Payer: PHP Commercial	$14,102.67
Rate for Payer: PHP Medicare Advantage	$12,820.61
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$21,112.41
Rate for Payer: Priority Health Medicare	$12,820.61
Rate for Payer: Priority Health Narrow Network	$16,889.93
Rate for Payer: Railroad Medicare Medicare	$12,820.61
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$12,820.61
Rate for Payer: UHC Exchange	$19,871.95
Rate for Payer: UHCCP DNSP	$12,820.61
Rate for Payer: VA VA	$12,820.61

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES

Facility

$7,832.02

Service Code	APR-DRG 3201
Min. Negotiated Rate	$7,081.08
Max. Negotiated Rate	$7,832.02
Rate for Payer: BCBS Complete	$7,832.02
Rate for Payer: Mclaren Medicaid	$7,459.07
Rate for Payer: Meridian Medicaid	$7,832.02
Rate for Payer: PHP Medicaid	$7,081.08
Rate for Payer: Priority Health Choice Medicaid	$7,459.07
Rate for Payer: UHC Medicaid	$7,459.07
Rate for Payer: UHCCP Medicaid	$7,459.07

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES

Facility

$12,989.97

Service Code	APR-DRG 3203
Min. Negotiated Rate	$11,744.49
Max. Negotiated Rate	$12,989.97
Rate for Payer: BCBS Complete	$12,989.97
Rate for Payer: Mclaren Medicaid	$12,371.40
Rate for Payer: Meridian Medicaid	$12,989.97
Rate for Payer: PHP Medicaid	$11,744.49
Rate for Payer: Priority Health Choice Medicaid	$12,371.40
Rate for Payer: UHC Medicaid	$12,371.40
Rate for Payer: UHCCP Medicaid	$12,371.40

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES

Facility

$20,956.60

Service Code	APR-DRG 3204
Min. Negotiated Rate	$18,947.27
Max. Negotiated Rate	$20,956.60
Rate for Payer: BCBS Complete	$20,956.60
Rate for Payer: Mclaren Medicaid	$19,958.66
Rate for Payer: Meridian Medicaid	$20,956.60
Rate for Payer: PHP Medicaid	$18,947.27
Rate for Payer: Priority Health Choice Medicaid	$19,958.66
Rate for Payer: UHC Medicaid	$19,958.66
Rate for Payer: UHCCP Medicaid	$19,958.66

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES

Facility

$10,424.89

Service Code	APR-DRG 3202
Min. Negotiated Rate	$9,425.35
Max. Negotiated Rate	$10,424.89
Rate for Payer: BCBS Complete	$10,424.89
Rate for Payer: Mclaren Medicaid	$9,928.47
Rate for Payer: Meridian Medicaid	$10,424.89
Rate for Payer: PHP Medicaid	$9,425.35
Rate for Payer: Priority Health Choice Medicaid	$9,928.47
Rate for Payer: UHC Medicaid	$9,928.47
Rate for Payer: UHCCP Medicaid	$9,928.47

OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC

Facility

$16,725.62

Service Code	MSDRG 844
Min. Negotiated Rate	$9,995.19
Max. Negotiated Rate	$16,725.62
Rate for Payer: Aetna Medicare	$10,521.25
Rate for Payer: Allen County Amish Medical Aid Commercial	$13,151.56
Rate for Payer: Amish Plain Church Group Commercial	$13,151.56
Rate for Payer: BCBS MAPPO	$10,521.25
Rate for Payer: BCN Medicare Advantage	$10,521.25
Rate for Payer: Health Alliance Plan Medicare Advantage	$10,521.25
Rate for Payer: Humana Choice PPO Medicare	$10,521.25
Rate for Payer: Mclaren Medicare	$10,521.25
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$11,047.31
Rate for Payer: MI Amish Medical Board Commercial	$12,099.44
Rate for Payer: Molina Medicare/Medicaid	$11,573.38
Rate for Payer: PACE Medicare	$9,995.19
Rate for Payer: PACE SWMI	$10,521.25
Rate for Payer: PHP Commercial	$11,573.38
Rate for Payer: PHP Medicare Advantage	$10,521.25
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$16,725.62
Rate for Payer: Priority Health Medicare	$10,521.25
Rate for Payer: Priority Health Narrow Network	$13,380.49
Rate for Payer: Railroad Medicare Medicare	$10,521.25
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$10,521.25
Rate for Payer: UHC Exchange	$16,307.94
Rate for Payer: UHCCP DNSP	$10,521.25
Rate for Payer: VA VA	$10,521.25

Know your out-of-pocket cost for care.

All Charges