Bronson South Haven Hospital

All Charges

Charge

Type

Setting

Price

OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC

Facility

$27,406.16

Service Code	MSDRG 843
Min. Negotiated Rate	$15,313.52
Max. Negotiated Rate	$27,406.16
Rate for Payer: Aetna Medicare	$16,119.50
Rate for Payer: Allen County Amish Medical Aid Commercial	$20,149.38
Rate for Payer: Amish Plain Church Group Commercial	$20,149.38
Rate for Payer: BCBS MAPPO	$16,119.50
Rate for Payer: BCN Medicare Advantage	$16,119.50
Rate for Payer: Health Alliance Plan Medicare Advantage	$16,119.50
Rate for Payer: Humana Choice PPO Medicare	$16,119.50
Rate for Payer: Mclaren Medicare	$16,119.50
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$16,925.47
Rate for Payer: MI Amish Medical Board Commercial	$18,537.42
Rate for Payer: Molina Medicare/Medicaid	$17,731.45
Rate for Payer: PACE Medicare	$15,313.52
Rate for Payer: PACE SWMI	$16,119.50
Rate for Payer: PHP Commercial	$17,731.45
Rate for Payer: PHP Medicare Advantage	$16,119.50
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$27,406.16
Rate for Payer: Priority Health Medicare	$16,119.50
Rate for Payer: Priority Health Narrow Network	$21,924.93
Rate for Payer: Railroad Medicare Medicare	$16,119.50
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$16,119.50
Rate for Payer: UHC Exchange	$24,985.22
Rate for Payer: UHCCP DNSP	$16,119.50
Rate for Payer: VA VA	$16,119.50

OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITHOUT CC/MCC

Facility

$12,224.91

Service Code	MSDRG 845
Min. Negotiated Rate	$7,492.69
Max. Negotiated Rate	$12,224.91
Rate for Payer: Aetna Medicare	$7,887.04
Rate for Payer: Allen County Amish Medical Aid Commercial	$9,858.80
Rate for Payer: Amish Plain Church Group Commercial	$9,858.80
Rate for Payer: BCBS MAPPO	$7,887.04
Rate for Payer: BCN Medicare Advantage	$7,887.04
Rate for Payer: Health Alliance Plan Medicare Advantage	$7,887.04
Rate for Payer: Humana Choice PPO Medicare	$7,887.04
Rate for Payer: Mclaren Medicare	$7,887.04
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$8,281.39
Rate for Payer: MI Amish Medical Board Commercial	$9,070.10
Rate for Payer: Molina Medicare/Medicaid	$8,675.74
Rate for Payer: PACE Medicare	$7,492.69
Rate for Payer: PACE SWMI	$7,887.04
Rate for Payer: PHP Commercial	$8,675.74
Rate for Payer: PHP Medicare Advantage	$7,887.04
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$11,699.96
Rate for Payer: Priority Health Medicare	$7,887.04
Rate for Payer: Priority Health Narrow Network	$9,359.97
Rate for Payer: Railroad Medicare Medicare	$7,887.04
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$7,887.04
Rate for Payer: UHC Exchange	$12,224.91
Rate for Payer: UHCCP DNSP	$7,887.04
Rate for Payer: VA VA	$7,887.04

OTHER NERVOUS SYSTEM AND RELATED PROCEDURES

Facility

$18,660.72

Service Code	APR-DRG 0264
Min. Negotiated Rate	$16,871.53
Max. Negotiated Rate	$18,660.72
Rate for Payer: BCBS Complete	$18,660.72
Rate for Payer: Mclaren Medicaid	$17,772.12
Rate for Payer: Meridian Medicaid	$18,660.72
Rate for Payer: PHP Medicaid	$16,871.53
Rate for Payer: Priority Health Choice Medicaid	$17,772.12
Rate for Payer: UHC Medicaid	$17,772.12
Rate for Payer: UHCCP Medicaid	$17,772.12

OTHER NERVOUS SYSTEM AND RELATED PROCEDURES

Facility

$12,327.86

Service Code	APR-DRG 0262
Min. Negotiated Rate	$11,145.86
Max. Negotiated Rate	$12,327.86
Rate for Payer: BCBS Complete	$12,327.86
Rate for Payer: Mclaren Medicaid	$11,740.82
Rate for Payer: Meridian Medicaid	$12,327.86
Rate for Payer: PHP Medicaid	$11,145.86
Rate for Payer: Priority Health Choice Medicaid	$11,740.82
Rate for Payer: UHC Medicaid	$11,740.82
Rate for Payer: UHCCP Medicaid	$11,740.82

OTHER NERVOUS SYSTEM AND RELATED PROCEDURES

Facility

$8,032.56

Service Code	APR-DRG 0261
Min. Negotiated Rate	$7,262.40
Max. Negotiated Rate	$8,032.56
Rate for Payer: BCBS Complete	$8,032.56
Rate for Payer: Mclaren Medicaid	$7,650.06
Rate for Payer: Meridian Medicaid	$8,032.56
Rate for Payer: PHP Medicaid	$7,262.40
Rate for Payer: Priority Health Choice Medicaid	$7,650.06
Rate for Payer: UHC Medicaid	$7,650.06
Rate for Payer: UHCCP Medicaid	$7,650.06

OTHER NERVOUS SYSTEM AND RELATED PROCEDURES

Facility

$12,840.66

Service Code	APR-DRG 0263
Min. Negotiated Rate	$11,609.49
Max. Negotiated Rate	$12,840.66
Rate for Payer: BCBS Complete	$12,840.66
Rate for Payer: Mclaren Medicaid	$12,229.20
Rate for Payer: Meridian Medicaid	$12,840.66
Rate for Payer: PHP Medicaid	$11,609.49
Rate for Payer: Priority Health Choice Medicaid	$12,229.20
Rate for Payer: UHC Medicaid	$12,229.20
Rate for Payer: UHCCP Medicaid	$12,229.20

OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS

Facility

$3,957.43

Service Code	APR-DRG 4252
Min. Negotiated Rate	$3,577.99
Max. Negotiated Rate	$3,957.43
Rate for Payer: BCBS Complete	$3,957.43
Rate for Payer: Mclaren Medicaid	$3,768.98
Rate for Payer: Meridian Medicaid	$3,957.43
Rate for Payer: PHP Medicaid	$3,577.99
Rate for Payer: Priority Health Choice Medicaid	$3,768.98
Rate for Payer: UHC Medicaid	$3,768.98
Rate for Payer: UHCCP Medicaid	$3,768.98

OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS

Facility

$5,620.61

Service Code	APR-DRG 4253
Min. Negotiated Rate	$5,081.71
Max. Negotiated Rate	$5,620.61
Rate for Payer: BCBS Complete	$5,620.61
Rate for Payer: Mclaren Medicaid	$5,352.97
Rate for Payer: Meridian Medicaid	$5,620.61
Rate for Payer: PHP Medicaid	$5,081.71
Rate for Payer: Priority Health Choice Medicaid	$5,352.97
Rate for Payer: UHC Medicaid	$5,352.97
Rate for Payer: UHCCP Medicaid	$5,352.97

OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS

Facility

$11,027.06

Service Code	APR-DRG 4254
Min. Negotiated Rate	$9,969.78
Max. Negotiated Rate	$11,027.06
Rate for Payer: BCBS Complete	$11,027.06
Rate for Payer: Mclaren Medicaid	$10,501.97
Rate for Payer: Meridian Medicaid	$11,027.06
Rate for Payer: PHP Medicaid	$9,969.78
Rate for Payer: Priority Health Choice Medicaid	$10,501.97
Rate for Payer: UHC Medicaid	$10,501.97
Rate for Payer: UHCCP Medicaid	$10,501.97

OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS

Facility

$2,768.89

Service Code	APR-DRG 4251
Min. Negotiated Rate	$2,503.41
Max. Negotiated Rate	$2,768.89
Rate for Payer: BCBS Complete	$2,768.89
Rate for Payer: Mclaren Medicaid	$2,637.04
Rate for Payer: Meridian Medicaid	$2,768.89
Rate for Payer: PHP Medicaid	$2,503.41
Rate for Payer: Priority Health Choice Medicaid	$2,637.04
Rate for Payer: UHC Medicaid	$2,637.04
Rate for Payer: UHCCP Medicaid	$2,637.04

OTHER OPEN CRANIOTOMY

Facility

$17,404.07

Service Code	APR-DRG 0273
Min. Negotiated Rate	$15,735.36
Max. Negotiated Rate	$17,404.07
Rate for Payer: BCBS Complete	$17,404.07
Rate for Payer: Mclaren Medicaid	$16,575.30
Rate for Payer: Meridian Medicaid	$17,404.07
Rate for Payer: PHP Medicaid	$15,735.36
Rate for Payer: Priority Health Choice Medicaid	$16,575.30
Rate for Payer: UHC Medicaid	$16,575.30
Rate for Payer: UHCCP Medicaid	$16,575.30

OTHER OPEN CRANIOTOMY

Facility

$8,525.20

Service Code	APR-DRG 0271
Min. Negotiated Rate	$7,707.80
Max. Negotiated Rate	$8,525.20
Rate for Payer: BCBS Complete	$8,525.20
Rate for Payer: Mclaren Medicaid	$8,119.24
Rate for Payer: Meridian Medicaid	$8,525.20
Rate for Payer: PHP Medicaid	$7,707.80
Rate for Payer: Priority Health Choice Medicaid	$8,119.24
Rate for Payer: UHC Medicaid	$8,119.24
Rate for Payer: UHCCP Medicaid	$8,119.24

OTHER OPEN CRANIOTOMY

Facility

$12,104.43

Service Code	APR-DRG 0272
Min. Negotiated Rate	$10,943.85
Max. Negotiated Rate	$12,104.43
Rate for Payer: BCBS Complete	$12,104.43
Rate for Payer: Mclaren Medicaid	$11,528.03
Rate for Payer: Meridian Medicaid	$12,104.43
Rate for Payer: PHP Medicaid	$10,943.85
Rate for Payer: Priority Health Choice Medicaid	$11,528.03
Rate for Payer: UHC Medicaid	$11,528.03
Rate for Payer: UHCCP Medicaid	$11,528.03

OTHER OPEN CRANIOTOMY

Facility

$24,800.13

Service Code	APR-DRG 0274
Min. Negotiated Rate	$22,422.28
Max. Negotiated Rate	$24,800.13
Rate for Payer: BCBS Complete	$24,800.13
Rate for Payer: Mclaren Medicaid	$23,619.17
Rate for Payer: Meridian Medicaid	$24,800.13
Rate for Payer: PHP Medicaid	$22,422.28
Rate for Payer: Priority Health Choice Medicaid	$23,619.17
Rate for Payer: UHC Medicaid	$23,619.17
Rate for Payer: UHCCP Medicaid	$23,619.17

OTHER O.R. PROCEDURES FOR INJURIES WITH CC

Facility

$27,411.65

Service Code	MSDRG 908
Min. Negotiated Rate	$15,316.27
Max. Negotiated Rate	$27,411.65
Rate for Payer: Aetna Medicare	$16,122.39
Rate for Payer: Allen County Amish Medical Aid Commercial	$20,152.99
Rate for Payer: Amish Plain Church Group Commercial	$20,152.99
Rate for Payer: BCBS MAPPO	$16,122.39
Rate for Payer: BCN Medicare Advantage	$16,122.39
Rate for Payer: Health Alliance Plan Medicare Advantage	$16,122.39
Rate for Payer: Humana Choice PPO Medicare	$16,122.39
Rate for Payer: Mclaren Medicare	$16,122.39
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$16,928.51
Rate for Payer: MI Amish Medical Board Commercial	$18,540.75
Rate for Payer: Molina Medicare/Medicaid	$17,734.63
Rate for Payer: PACE Medicare	$15,316.27
Rate for Payer: PACE SWMI	$16,122.39
Rate for Payer: PHP Commercial	$17,734.63
Rate for Payer: PHP Medicare Advantage	$16,122.39
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$27,411.65
Rate for Payer: Priority Health Medicare	$16,122.39
Rate for Payer: Priority Health Narrow Network	$21,929.32
Rate for Payer: Railroad Medicare Medicare	$16,122.39
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$16,122.39
Rate for Payer: UHC Exchange	$24,989.70
Rate for Payer: UHCCP DNSP	$16,122.39
Rate for Payer: VA VA	$16,122.39

OTHER O.R. PROCEDURES FOR INJURIES WITH MCC

Facility

$52,747.37

Service Code	MSDRG 907
Min. Negotiated Rate	$27,932.08
Max. Negotiated Rate	$52,747.37
Rate for Payer: Aetna Medicare	$29,402.19
Rate for Payer: Allen County Amish Medical Aid Commercial	$36,752.74
Rate for Payer: Amish Plain Church Group Commercial	$36,752.74
Rate for Payer: BCBS MAPPO	$29,402.19
Rate for Payer: BCN Medicare Advantage	$29,402.19
Rate for Payer: Health Alliance Plan Medicare Advantage	$29,402.19
Rate for Payer: Humana Choice PPO Medicare	$29,402.19
Rate for Payer: Mclaren Medicare	$29,402.19
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$30,872.30
Rate for Payer: MI Amish Medical Board Commercial	$33,812.52
Rate for Payer: Molina Medicare/Medicaid	$32,342.41
Rate for Payer: PACE Medicare	$27,932.08
Rate for Payer: PACE SWMI	$29,402.19
Rate for Payer: PHP Commercial	$32,342.41
Rate for Payer: PHP Medicare Advantage	$29,402.19
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$52,747.37
Rate for Payer: Priority Health Medicare	$29,402.19
Rate for Payer: Priority Health Narrow Network	$42,197.90
Rate for Payer: Railroad Medicare Medicare	$29,402.19
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$29,402.19
Rate for Payer: UHC Exchange	$45,573.39
Rate for Payer: UHCCP DNSP	$29,402.19
Rate for Payer: VA VA	$29,402.19

OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC

Facility

$18,034.92

Service Code	MSDRG 909
Min. Negotiated Rate	$10,647.16
Max. Negotiated Rate	$18,034.92
Rate for Payer: Aetna Medicare	$11,207.54
Rate for Payer: Allen County Amish Medical Aid Commercial	$14,009.42
Rate for Payer: Amish Plain Church Group Commercial	$14,009.42
Rate for Payer: BCBS MAPPO	$11,207.54
Rate for Payer: BCN Medicare Advantage	$11,207.54
Rate for Payer: Health Alliance Plan Medicare Advantage	$11,207.54
Rate for Payer: Humana Choice PPO Medicare	$11,207.54
Rate for Payer: Mclaren Medicare	$11,207.54
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$11,767.92
Rate for Payer: MI Amish Medical Board Commercial	$12,888.67
Rate for Payer: Molina Medicare/Medicaid	$12,328.29
Rate for Payer: PACE Medicare	$10,647.16
Rate for Payer: PACE SWMI	$11,207.54
Rate for Payer: PHP Commercial	$12,328.29
Rate for Payer: PHP Medicare Advantage	$11,207.54
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$18,034.92
Rate for Payer: Priority Health Medicare	$11,207.54
Rate for Payer: Priority Health Narrow Network	$14,427.94
Rate for Payer: Railroad Medicare Medicare	$11,207.54
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$11,207.54
Rate for Payer: UHC Exchange	$17,371.69
Rate for Payer: UHCCP DNSP	$11,207.54
Rate for Payer: VA VA	$11,207.54

OTHER O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS

Facility

$11,737.68

Service Code	APR-DRG 6812
Min. Negotiated Rate	$10,612.27
Max. Negotiated Rate	$11,737.68
Rate for Payer: BCBS Complete	$11,737.68
Rate for Payer: Mclaren Medicaid	$11,178.74
Rate for Payer: Meridian Medicaid	$11,737.68
Rate for Payer: PHP Medicaid	$10,612.27
Rate for Payer: Priority Health Choice Medicaid	$11,178.74
Rate for Payer: UHC Medicaid	$11,178.74
Rate for Payer: UHCCP Medicaid	$11,178.74

OTHER O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS

Facility

$14,321.29

Service Code	APR-DRG 6813
Min. Negotiated Rate	$12,948.16
Max. Negotiated Rate	$14,321.29
Rate for Payer: BCBS Complete	$14,321.29
Rate for Payer: Mclaren Medicaid	$13,639.32
Rate for Payer: Meridian Medicaid	$14,321.29
Rate for Payer: PHP Medicaid	$12,948.16
Rate for Payer: Priority Health Choice Medicaid	$13,639.32
Rate for Payer: UHC Medicaid	$13,639.32
Rate for Payer: UHCCP Medicaid	$13,639.32

OTHER O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS

Facility

$9,212.38

Service Code	APR-DRG 6811
Min. Negotiated Rate	$8,329.09
Max. Negotiated Rate	$9,212.38
Rate for Payer: BCBS Complete	$9,212.38
Rate for Payer: Mclaren Medicaid	$8,773.69
Rate for Payer: Meridian Medicaid	$9,212.38
Rate for Payer: PHP Medicaid	$8,329.09
Rate for Payer: Priority Health Choice Medicaid	$8,773.69
Rate for Payer: UHC Medicaid	$8,773.69
Rate for Payer: UHCCP Medicaid	$8,773.69

OTHER O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS

Facility

$31,141.17

Service Code	APR-DRG 6814
Min. Negotiated Rate	$28,155.34
Max. Negotiated Rate	$31,141.17
Rate for Payer: BCBS Complete	$31,141.17
Rate for Payer: Mclaren Medicaid	$29,658.26
Rate for Payer: Meridian Medicaid	$31,141.17
Rate for Payer: PHP Medicaid	$28,155.34
Rate for Payer: Priority Health Choice Medicaid	$29,658.26
Rate for Payer: UHC Medicaid	$29,658.26
Rate for Payer: UHCCP Medicaid	$29,658.26

OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC

Facility

$57,893.93

Service Code	MSDRG 958
Min. Negotiated Rate	$30,494.79
Max. Negotiated Rate	$57,893.93
Rate for Payer: Aetna Medicare	$32,099.78
Rate for Payer: Allen County Amish Medical Aid Commercial	$40,124.72
Rate for Payer: Amish Plain Church Group Commercial	$40,124.72
Rate for Payer: BCBS MAPPO	$32,099.78
Rate for Payer: BCN Medicare Advantage	$32,099.78
Rate for Payer: Health Alliance Plan Medicare Advantage	$32,099.78
Rate for Payer: Humana Choice PPO Medicare	$32,099.78
Rate for Payer: Mclaren Medicare	$32,099.78
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$33,704.77
Rate for Payer: MI Amish Medical Board Commercial	$36,914.75
Rate for Payer: Molina Medicare/Medicaid	$35,309.76
Rate for Payer: PACE Medicare	$30,494.79
Rate for Payer: PACE SWMI	$32,099.78
Rate for Payer: PHP Commercial	$35,309.76
Rate for Payer: PHP Medicare Advantage	$32,099.78
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$57,893.93
Rate for Payer: Priority Health Medicare	$32,099.78
Rate for Payer: Priority Health Narrow Network	$46,315.14
Rate for Payer: Railroad Medicare Medicare	$32,099.78
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$32,099.78
Rate for Payer: UHC Exchange	$49,754.66
Rate for Payer: UHCCP DNSP	$32,099.78
Rate for Payer: VA VA	$32,099.78

OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC

Facility

$104,688.28

Service Code	MSDRG 957
Min. Negotiated Rate	$53,795.86
Max. Negotiated Rate	$104,688.28
Rate for Payer: Aetna Medicare	$56,627.22
Rate for Payer: Allen County Amish Medical Aid Commercial	$70,784.02
Rate for Payer: Amish Plain Church Group Commercial	$70,784.02
Rate for Payer: BCBS MAPPO	$56,627.22
Rate for Payer: BCN Medicare Advantage	$56,627.22
Rate for Payer: Health Alliance Plan Medicare Advantage	$56,627.22
Rate for Payer: Humana Choice PPO Medicare	$56,627.22
Rate for Payer: Mclaren Medicare	$56,627.22
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$59,458.58
Rate for Payer: MI Amish Medical Board Commercial	$65,121.30
Rate for Payer: Molina Medicare/Medicaid	$62,289.94
Rate for Payer: PACE Medicare	$53,795.86
Rate for Payer: PACE SWMI	$56,627.22
Rate for Payer: PHP Commercial	$62,289.94
Rate for Payer: PHP Medicare Advantage	$56,627.22
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$104,688.28
Rate for Payer: Priority Health Medicare	$56,627.22
Rate for Payer: Priority Health Narrow Network	$83,750.63
Rate for Payer: Railroad Medicare Medicare	$56,627.22
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$56,627.22
Rate for Payer: UHC Exchange	$87,772.19
Rate for Payer: UHCCP DNSP	$56,627.22
Rate for Payer: VA VA	$56,627.22

OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC

Facility

$40,448.40

Service Code	MSDRG 959
Min. Negotiated Rate	$21,807.85
Max. Negotiated Rate	$40,448.40
Rate for Payer: Aetna Medicare	$22,955.63
Rate for Payer: Allen County Amish Medical Aid Commercial	$28,694.54
Rate for Payer: Amish Plain Church Group Commercial	$28,694.54
Rate for Payer: BCBS MAPPO	$22,955.63
Rate for Payer: BCN Medicare Advantage	$22,955.63
Rate for Payer: Health Alliance Plan Medicare Advantage	$22,955.63
Rate for Payer: Humana Choice PPO Medicare	$22,955.63
Rate for Payer: Mclaren Medicare	$22,955.63
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$24,103.41
Rate for Payer: MI Amish Medical Board Commercial	$26,398.97
Rate for Payer: Molina Medicare/Medicaid	$25,251.19
Rate for Payer: PACE Medicare	$21,807.85
Rate for Payer: PACE SWMI	$22,955.63
Rate for Payer: PHP Commercial	$25,251.19
Rate for Payer: PHP Medicare Advantage	$22,955.63
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$40,448.40
Rate for Payer: Priority Health Medicare	$22,955.63
Rate for Payer: Priority Health Narrow Network	$32,358.72
Rate for Payer: Railroad Medicare Medicare	$22,955.63
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$22,955.63
Rate for Payer: UHC Exchange	$35,581.23
Rate for Payer: UHCCP DNSP	$22,955.63
Rate for Payer: VA VA	$22,955.63

OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC

Facility

$25,539.06

Service Code	MSDRG 803
Min. Negotiated Rate	$14,383.81
Max. Negotiated Rate	$25,539.06
Rate for Payer: Aetna Medicare	$15,140.85
Rate for Payer: Allen County Amish Medical Aid Commercial	$18,926.06
Rate for Payer: Amish Plain Church Group Commercial	$18,926.06
Rate for Payer: BCBS MAPPO	$15,140.85
Rate for Payer: BCN Medicare Advantage	$15,140.85
Rate for Payer: Health Alliance Plan Medicare Advantage	$15,140.85
Rate for Payer: Humana Choice PPO Medicare	$15,140.85
Rate for Payer: Mclaren Medicare	$15,140.85
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$15,897.89
Rate for Payer: MI Amish Medical Board Commercial	$17,411.98
Rate for Payer: Molina Medicare/Medicaid	$16,654.94
Rate for Payer: PACE Medicare	$14,383.81
Rate for Payer: PACE SWMI	$15,140.85
Rate for Payer: PHP Commercial	$16,654.94
Rate for Payer: PHP Medicare Advantage	$15,140.85
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$25,539.06
Rate for Payer: Priority Health Medicare	$15,140.85
Rate for Payer: Priority Health Narrow Network	$20,431.24
Rate for Payer: Railroad Medicare Medicare	$15,140.85
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$15,140.85
Rate for Payer: UHC Exchange	$23,468.32
Rate for Payer: UHCCP DNSP	$15,140.85
Rate for Payer: VA VA	$15,140.85

Know your out-of-pocket cost for care.

All Charges