Bronson South Haven Hospital

All Charges

Charge

Type

Setting

Price

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

Facility

$54,736.75

Service Code	MSDRG 802
Min. Negotiated Rate	$28,922.68
Max. Negotiated Rate	$54,736.75
Rate for Payer: Aetna Medicare	$30,444.93
Rate for Payer: Allen County Amish Medical Aid Commercial	$38,056.16
Rate for Payer: Amish Plain Church Group Commercial	$38,056.16
Rate for Payer: BCBS MAPPO	$30,444.93
Rate for Payer: BCN Medicare Advantage	$30,444.93
Rate for Payer: Health Alliance Plan Medicare Advantage	$30,444.93
Rate for Payer: Humana Choice PPO Medicare	$30,444.93
Rate for Payer: Mclaren Medicare	$30,444.93
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$31,967.18
Rate for Payer: MI Amish Medical Board Commercial	$35,011.67
Rate for Payer: Molina Medicare/Medicaid	$33,489.42
Rate for Payer: PACE Medicare	$28,922.68
Rate for Payer: PACE SWMI	$30,444.93
Rate for Payer: PHP Commercial	$33,489.42
Rate for Payer: PHP Medicare Advantage	$30,444.93
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$54,736.75
Rate for Payer: Priority Health Medicare	$30,444.93
Rate for Payer: Priority Health Narrow Network	$43,789.40
Rate for Payer: Railroad Medicare Medicare	$30,444.93
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$30,444.93
Rate for Payer: UHC Exchange	$47,189.64
Rate for Payer: UHCCP DNSP	$30,444.93
Rate for Payer: VA VA	$30,444.93

OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC

Facility

$18,629.81

Service Code	MSDRG 804
Min. Negotiated Rate	$10,943.37
Max. Negotiated Rate	$18,629.81
Rate for Payer: Aetna Medicare	$11,519.34
Rate for Payer: Allen County Amish Medical Aid Commercial	$14,399.17
Rate for Payer: Amish Plain Church Group Commercial	$14,399.17
Rate for Payer: BCBS MAPPO	$11,519.34
Rate for Payer: BCN Medicare Advantage	$11,519.34
Rate for Payer: Health Alliance Plan Medicare Advantage	$11,519.34
Rate for Payer: Humana Choice PPO Medicare	$11,519.34
Rate for Payer: Mclaren Medicare	$11,519.34
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$12,095.31
Rate for Payer: MI Amish Medical Board Commercial	$13,247.24
Rate for Payer: Molina Medicare/Medicaid	$12,671.27
Rate for Payer: PACE Medicare	$10,943.37
Rate for Payer: PACE SWMI	$11,519.34
Rate for Payer: PHP Commercial	$12,671.27
Rate for Payer: PHP Medicare Advantage	$11,519.34
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$18,629.81
Rate for Payer: Priority Health Medicare	$11,519.34
Rate for Payer: Priority Health Narrow Network	$14,903.85
Rate for Payer: Railroad Medicare Medicare	$11,519.34
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$11,519.34
Rate for Payer: UHC Exchange	$17,854.98
Rate for Payer: UHCCP DNSP	$11,519.34
Rate for Payer: VA VA	$11,519.34

OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES

Facility

$22,031.24

Service Code	APR-DRG 0294
Min. Negotiated Rate	$19,918.88
Max. Negotiated Rate	$22,031.24
Rate for Payer: BCBS Complete	$22,031.24
Rate for Payer: Mclaren Medicaid	$20,982.13
Rate for Payer: Meridian Medicaid	$22,031.24
Rate for Payer: PHP Medicaid	$19,918.88
Rate for Payer: Priority Health Choice Medicaid	$20,982.13
Rate for Payer: UHC Medicaid	$20,982.13
Rate for Payer: UHCCP Medicaid	$20,982.13

OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES

Facility

$17,112.52

Service Code	APR-DRG 0292
Min. Negotiated Rate	$15,471.77
Max. Negotiated Rate	$17,112.52
Rate for Payer: BCBS Complete	$17,112.52
Rate for Payer: Mclaren Medicaid	$16,297.64
Rate for Payer: Meridian Medicaid	$17,112.52
Rate for Payer: PHP Medicaid	$15,471.77
Rate for Payer: Priority Health Choice Medicaid	$16,297.64
Rate for Payer: UHC Medicaid	$16,297.64
Rate for Payer: UHCCP Medicaid	$16,297.64

OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES

Facility

$15,810.63

Service Code	APR-DRG 0291
Min. Negotiated Rate	$14,294.71
Max. Negotiated Rate	$15,810.63
Rate for Payer: BCBS Complete	$15,810.63
Rate for Payer: Mclaren Medicaid	$15,057.75
Rate for Payer: Meridian Medicaid	$15,810.63
Rate for Payer: PHP Medicaid	$14,294.71
Rate for Payer: Priority Health Choice Medicaid	$15,057.75
Rate for Payer: UHC Medicaid	$15,057.75
Rate for Payer: UHCCP Medicaid	$15,057.75

OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES

Facility

$21,708.08

Service Code	APR-DRG 0293
Min. Negotiated Rate	$19,626.70
Max. Negotiated Rate	$21,708.08
Rate for Payer: BCBS Complete	$21,708.08
Rate for Payer: Mclaren Medicaid	$20,674.37
Rate for Payer: Meridian Medicaid	$21,708.08
Rate for Payer: PHP Medicaid	$19,626.70
Rate for Payer: Priority Health Choice Medicaid	$20,674.37
Rate for Payer: UHC Medicaid	$20,674.37
Rate for Payer: UHCCP Medicaid	$20,674.37

OTHER PERIPHERAL VASCULAR AND CIRCULATORY PROCEDURES

Facility

$20,430.72

Service Code	APR-DRG 1804
Min. Negotiated Rate	$18,471.82
Max. Negotiated Rate	$20,430.72
Rate for Payer: BCBS Complete	$20,430.72
Rate for Payer: Mclaren Medicaid	$19,457.83
Rate for Payer: Meridian Medicaid	$20,430.72
Rate for Payer: PHP Medicaid	$18,471.82
Rate for Payer: Priority Health Choice Medicaid	$19,457.83
Rate for Payer: UHC Medicaid	$19,457.83
Rate for Payer: UHCCP Medicaid	$19,457.83

OTHER PERIPHERAL VASCULAR AND CIRCULATORY PROCEDURES

Facility

$8,538.28

Service Code	APR-DRG 1802
Min. Negotiated Rate	$7,719.62
Max. Negotiated Rate	$8,538.28
Rate for Payer: BCBS Complete	$8,538.28
Rate for Payer: Mclaren Medicaid	$8,131.69
Rate for Payer: Meridian Medicaid	$8,538.28
Rate for Payer: PHP Medicaid	$7,719.62
Rate for Payer: Priority Health Choice Medicaid	$8,131.69
Rate for Payer: UHC Medicaid	$8,131.69
Rate for Payer: UHCCP Medicaid	$8,131.69

OTHER PERIPHERAL VASCULAR AND CIRCULATORY PROCEDURES

Facility

$8,081.06

Service Code	APR-DRG 1801
Min. Negotiated Rate	$7,306.25
Max. Negotiated Rate	$8,081.06
Rate for Payer: BCBS Complete	$8,081.06
Rate for Payer: Mclaren Medicaid	$7,696.25
Rate for Payer: Meridian Medicaid	$8,081.06
Rate for Payer: PHP Medicaid	$7,306.25
Rate for Payer: Priority Health Choice Medicaid	$7,696.25
Rate for Payer: UHC Medicaid	$7,696.25
Rate for Payer: UHCCP Medicaid	$7,696.25

OTHER PERIPHERAL VASCULAR AND CIRCULATORY PROCEDURES

Facility

$10,656.50

Service Code	APR-DRG 1803
Min. Negotiated Rate	$9,634.75
Max. Negotiated Rate	$10,656.50
Rate for Payer: BCBS Complete	$10,656.50
Rate for Payer: Mclaren Medicaid	$10,149.05
Rate for Payer: Meridian Medicaid	$10,656.50
Rate for Payer: PHP Medicaid	$9,634.75
Rate for Payer: Priority Health Choice Medicaid	$10,149.05
Rate for Payer: UHC Medicaid	$10,149.05
Rate for Payer: UHCCP Medicaid	$10,149.05

OTHER PNEUMONIA

Facility

$5,943.22

Service Code	APR-DRG 1393
Min. Negotiated Rate	$5,373.39
Max. Negotiated Rate	$5,943.22
Rate for Payer: BCBS Complete	$5,943.22
Rate for Payer: Mclaren Medicaid	$5,660.21
Rate for Payer: Meridian Medicaid	$5,943.22
Rate for Payer: PHP Medicaid	$5,373.39
Rate for Payer: Priority Health Choice Medicaid	$5,660.21
Rate for Payer: UHC Medicaid	$5,660.21
Rate for Payer: UHCCP Medicaid	$5,660.21

OTHER PNEUMONIA

Facility

$8,700.13

Service Code	APR-DRG 1394
Min. Negotiated Rate	$7,865.96
Max. Negotiated Rate	$8,700.13
Rate for Payer: BCBS Complete	$8,700.13
Rate for Payer: Mclaren Medicaid	$8,285.83
Rate for Payer: Meridian Medicaid	$8,700.13
Rate for Payer: PHP Medicaid	$7,865.96
Rate for Payer: Priority Health Choice Medicaid	$8,285.83
Rate for Payer: UHC Medicaid	$8,285.83
Rate for Payer: UHCCP Medicaid	$8,285.83

OTHER PNEUMONIA

Facility

$3,790.67

Service Code	APR-DRG 1392
Min. Negotiated Rate	$3,427.22
Max. Negotiated Rate	$3,790.67
Rate for Payer: BCBS Complete	$3,790.67
Rate for Payer: Mclaren Medicaid	$3,610.16
Rate for Payer: Meridian Medicaid	$3,790.67
Rate for Payer: PHP Medicaid	$3,427.22
Rate for Payer: Priority Health Choice Medicaid	$3,610.16
Rate for Payer: UHC Medicaid	$3,610.16
Rate for Payer: UHCCP Medicaid	$3,610.16

OTHER PNEUMONIA

Facility

$2,837.55

Service Code	APR-DRG 1391
Min. Negotiated Rate	$2,565.49
Max. Negotiated Rate	$2,837.55
Rate for Payer: BCBS Complete	$2,837.55
Rate for Payer: Mclaren Medicaid	$2,702.43
Rate for Payer: Meridian Medicaid	$2,837.55
Rate for Payer: PHP Medicaid	$2,565.49
Rate for Payer: Priority Health Choice Medicaid	$2,702.43
Rate for Payer: UHC Medicaid	$2,702.43
Rate for Payer: UHCCP Medicaid	$2,702.43

OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS

Facility

$9,284.31

Service Code	APR-DRG 4052
Min. Negotiated Rate	$8,394.13
Max. Negotiated Rate	$9,284.31
Rate for Payer: BCBS Complete	$9,284.31
Rate for Payer: Mclaren Medicaid	$8,842.20
Rate for Payer: Meridian Medicaid	$9,284.31
Rate for Payer: PHP Medicaid	$8,394.13
Rate for Payer: Priority Health Choice Medicaid	$8,842.20
Rate for Payer: UHC Medicaid	$8,842.20
Rate for Payer: UHCCP Medicaid	$8,842.20

OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS

Facility

$7,406.96

Service Code	APR-DRG 4051
Min. Negotiated Rate	$6,696.78
Max. Negotiated Rate	$7,406.96
Rate for Payer: BCBS Complete	$7,406.96
Rate for Payer: Mclaren Medicaid	$7,054.25
Rate for Payer: Meridian Medicaid	$7,406.96
Rate for Payer: PHP Medicaid	$6,696.78
Rate for Payer: Priority Health Choice Medicaid	$7,054.25
Rate for Payer: UHC Medicaid	$7,054.25
Rate for Payer: UHCCP Medicaid	$7,054.25

OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS

Facility

$14,307.66

Service Code	APR-DRG 4053
Min. Negotiated Rate	$12,935.84
Max. Negotiated Rate	$14,307.66
Rate for Payer: BCBS Complete	$14,307.66
Rate for Payer: Mclaren Medicaid	$13,626.34
Rate for Payer: Meridian Medicaid	$14,307.66
Rate for Payer: PHP Medicaid	$12,935.84
Rate for Payer: Priority Health Choice Medicaid	$13,626.34
Rate for Payer: UHC Medicaid	$13,626.34
Rate for Payer: UHCCP Medicaid	$13,626.34

OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS

Facility

$24,957.08

Service Code	APR-DRG 4054
Min. Negotiated Rate	$22,564.18
Max. Negotiated Rate	$24,957.08
Rate for Payer: BCBS Complete	$24,957.08
Rate for Payer: Mclaren Medicaid	$23,768.64
Rate for Payer: Meridian Medicaid	$24,957.08
Rate for Payer: PHP Medicaid	$22,564.18
Rate for Payer: Priority Health Choice Medicaid	$23,768.64
Rate for Payer: UHC Medicaid	$23,768.64
Rate for Payer: UHCCP Medicaid	$23,768.64

OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS

Facility

$35,719.29

Service Code	APR-DRG 6514
Min. Negotiated Rate	$32,294.51
Max. Negotiated Rate	$35,719.29
Rate for Payer: BCBS Complete	$35,719.29
Rate for Payer: Mclaren Medicaid	$34,018.37
Rate for Payer: Meridian Medicaid	$35,719.29
Rate for Payer: PHP Medicaid	$32,294.51
Rate for Payer: Priority Health Choice Medicaid	$34,018.37
Rate for Payer: UHC Medicaid	$34,018.37
Rate for Payer: UHCCP Medicaid	$34,018.37

OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS

Facility

$7,233.12

Service Code	APR-DRG 6511
Min. Negotiated Rate	$6,539.61
Max. Negotiated Rate	$7,233.12
Rate for Payer: BCBS Complete	$7,233.12
Rate for Payer: Mclaren Medicaid	$6,888.69
Rate for Payer: Meridian Medicaid	$7,233.12
Rate for Payer: PHP Medicaid	$6,539.61
Rate for Payer: Priority Health Choice Medicaid	$6,888.69
Rate for Payer: UHC Medicaid	$6,888.69
Rate for Payer: UHCCP Medicaid	$6,888.69

OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS

Facility

$10,559.50

Service Code	APR-DRG 6512
Min. Negotiated Rate	$9,547.05
Max. Negotiated Rate	$10,559.50
Rate for Payer: BCBS Complete	$10,559.50
Rate for Payer: Mclaren Medicaid	$10,056.66
Rate for Payer: Meridian Medicaid	$10,559.50
Rate for Payer: PHP Medicaid	$9,547.05
Rate for Payer: Priority Health Choice Medicaid	$10,056.66
Rate for Payer: UHC Medicaid	$10,056.66
Rate for Payer: UHCCP Medicaid	$10,056.66

OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS

Facility

$15,271.13

Service Code	APR-DRG 6513
Min. Negotiated Rate	$13,806.93
Max. Negotiated Rate	$15,271.13
Rate for Payer: BCBS Complete	$15,271.13
Rate for Payer: Mclaren Medicaid	$14,543.94
Rate for Payer: Meridian Medicaid	$15,271.13
Rate for Payer: PHP Medicaid	$13,806.93
Rate for Payer: Priority Health Choice Medicaid	$14,543.94
Rate for Payer: UHC Medicaid	$14,543.94
Rate for Payer: UHCCP Medicaid	$14,543.94

OTHER RESPIRATORY AND CHEST PROCEDURES

Facility

$14,938.71

Service Code	APR-DRG 1213
Min. Negotiated Rate	$13,506.39
Max. Negotiated Rate	$14,938.71
Rate for Payer: BCBS Complete	$14,938.71
Rate for Payer: Mclaren Medicaid	$14,227.35
Rate for Payer: Meridian Medicaid	$14,938.71
Rate for Payer: PHP Medicaid	$13,506.39
Rate for Payer: Priority Health Choice Medicaid	$14,227.35
Rate for Payer: UHC Medicaid	$14,227.35
Rate for Payer: UHCCP Medicaid	$14,227.35

OTHER RESPIRATORY AND CHEST PROCEDURES

Facility

$9,230.36

Service Code	APR-DRG 1211
Min. Negotiated Rate	$8,345.35
Max. Negotiated Rate	$9,230.36
Rate for Payer: BCBS Complete	$9,230.36
Rate for Payer: Mclaren Medicaid	$8,790.82
Rate for Payer: Meridian Medicaid	$9,230.36
Rate for Payer: PHP Medicaid	$8,345.35
Rate for Payer: Priority Health Choice Medicaid	$8,790.82
Rate for Payer: UHC Medicaid	$8,790.82
Rate for Payer: UHCCP Medicaid	$8,790.82

OTHER RESPIRATORY AND CHEST PROCEDURES

Facility

$22,217.07

Service Code	APR-DRG 1214
Min. Negotiated Rate	$20,086.89
Max. Negotiated Rate	$22,217.07
Rate for Payer: BCBS Complete	$22,217.07
Rate for Payer: Mclaren Medicaid	$21,159.11
Rate for Payer: Meridian Medicaid	$22,217.07
Rate for Payer: PHP Medicaid	$20,086.89
Rate for Payer: Priority Health Choice Medicaid	$21,159.11
Rate for Payer: UHC Medicaid	$21,159.11
Rate for Payer: UHCCP Medicaid	$21,159.11

Know your out-of-pocket cost for care.

All Charges