Bronson South Haven Hospital

All Charges

Charge

Type

Setting

Price

OTHER RESPIRATORY AND CHEST PROCEDURES

Facility

$12,029.23

Service Code	APR-DRG 1212
Min. Negotiated Rate	$10,875.86
Max. Negotiated Rate	$12,029.23
Rate for Payer: BCBS Complete	$12,029.23
Rate for Payer: Mclaren Medicaid	$11,456.41
Rate for Payer: Meridian Medicaid	$12,029.23
Rate for Payer: PHP Medicaid	$10,875.86
Rate for Payer: Priority Health Choice Medicaid	$11,456.41
Rate for Payer: UHC Medicaid	$11,456.41
Rate for Payer: UHCCP Medicaid	$11,456.41

OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES

Facility

$7,236.94

Service Code	APR-DRG 1433
Min. Negotiated Rate	$6,543.06
Max. Negotiated Rate	$7,236.94
Rate for Payer: BCBS Complete	$7,236.94
Rate for Payer: Mclaren Medicaid	$6,892.32
Rate for Payer: Meridian Medicaid	$7,236.94
Rate for Payer: PHP Medicaid	$6,543.06
Rate for Payer: Priority Health Choice Medicaid	$6,892.32
Rate for Payer: UHC Medicaid	$6,892.32
Rate for Payer: UHCCP Medicaid	$6,892.32

OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES

Facility

$3,463.16

Service Code	APR-DRG 1431
Min. Negotiated Rate	$3,131.11
Max. Negotiated Rate	$3,463.16
Rate for Payer: BCBS Complete	$3,463.16
Rate for Payer: Mclaren Medicaid	$3,298.24
Rate for Payer: Meridian Medicaid	$3,463.16
Rate for Payer: PHP Medicaid	$3,131.11
Rate for Payer: Priority Health Choice Medicaid	$3,298.24
Rate for Payer: UHC Medicaid	$3,298.24
Rate for Payer: UHCCP Medicaid	$3,298.24

OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES

Facility

$5,076.21

Service Code	APR-DRG 1432
Min. Negotiated Rate	$4,589.50
Max. Negotiated Rate	$5,076.21
Rate for Payer: BCBS Complete	$5,076.21
Rate for Payer: Mclaren Medicaid	$4,834.48
Rate for Payer: Meridian Medicaid	$5,076.21
Rate for Payer: PHP Medicaid	$4,589.50
Rate for Payer: Priority Health Choice Medicaid	$4,834.48
Rate for Payer: UHC Medicaid	$4,834.48
Rate for Payer: UHCCP Medicaid	$4,834.48

OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES

Facility

$10,836.33

Service Code	APR-DRG 1434
Min. Negotiated Rate	$9,797.34
Max. Negotiated Rate	$10,836.33
Rate for Payer: BCBS Complete	$10,836.33
Rate for Payer: Mclaren Medicaid	$10,320.32
Rate for Payer: Meridian Medicaid	$10,836.33
Rate for Payer: PHP Medicaid	$9,797.34
Rate for Payer: Priority Health Choice Medicaid	$10,320.32
Rate for Payer: UHC Medicaid	$10,320.32
Rate for Payer: UHCCP Medicaid	$10,320.32

OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC

Facility

$25,155.74

Service Code	MSDRG 205
Min. Negotiated Rate	$14,192.94
Max. Negotiated Rate	$25,155.74
Rate for Payer: Aetna Medicare	$14,939.94
Rate for Payer: Allen County Amish Medical Aid Commercial	$18,674.92
Rate for Payer: Amish Plain Church Group Commercial	$18,674.92
Rate for Payer: BCBS MAPPO	$14,939.94
Rate for Payer: BCN Medicare Advantage	$14,939.94
Rate for Payer: Health Alliance Plan Medicare Advantage	$14,939.94
Rate for Payer: Humana Choice PPO Medicare	$14,939.94
Rate for Payer: Mclaren Medicare	$14,939.94
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$15,686.94
Rate for Payer: MI Amish Medical Board Commercial	$17,180.93
Rate for Payer: Molina Medicare/Medicaid	$16,433.93
Rate for Payer: PACE Medicare	$14,192.94
Rate for Payer: PACE SWMI	$14,939.94
Rate for Payer: PHP Commercial	$16,433.93
Rate for Payer: PHP Medicare Advantage	$14,939.94
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$25,155.74
Rate for Payer: Priority Health Medicare	$14,939.94
Rate for Payer: Priority Health Narrow Network	$20,124.59
Rate for Payer: Railroad Medicare Medicare	$14,939.94
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$14,939.94
Rate for Payer: UHC Exchange	$23,156.91
Rate for Payer: UHCCP DNSP	$14,939.94
Rate for Payer: VA VA	$14,939.94

OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC

Facility

$13,223.89

Service Code	MSDRG 206
Min. Negotiated Rate	$8,104.96
Max. Negotiated Rate	$13,223.89
Rate for Payer: Aetna Medicare	$8,531.54
Rate for Payer: Allen County Amish Medical Aid Commercial	$10,664.42
Rate for Payer: Amish Plain Church Group Commercial	$10,664.42
Rate for Payer: BCBS MAPPO	$8,531.54
Rate for Payer: BCN Medicare Advantage	$8,531.54
Rate for Payer: Health Alliance Plan Medicare Advantage	$8,531.54
Rate for Payer: Humana Choice PPO Medicare	$8,531.54
Rate for Payer: Mclaren Medicare	$8,531.54
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$8,958.12
Rate for Payer: MI Amish Medical Board Commercial	$9,811.27
Rate for Payer: Molina Medicare/Medicaid	$9,384.69
Rate for Payer: PACE Medicare	$8,104.96
Rate for Payer: PACE SWMI	$8,531.54
Rate for Payer: PHP Commercial	$9,384.69
Rate for Payer: PHP Medicare Advantage	$8,531.54
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$12,929.58
Rate for Payer: Priority Health Medicare	$8,531.54
Rate for Payer: Priority Health Narrow Network	$10,343.67
Rate for Payer: Railroad Medicare Medicare	$8,531.54
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$8,531.54
Rate for Payer: UHC Exchange	$13,223.89
Rate for Payer: UHCCP DNSP	$8,531.54
Rate for Payer: VA VA	$8,531.54

OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC

Facility

$24,776.55

Service Code	MSDRG 167
Min. Negotiated Rate	$14,004.12
Max. Negotiated Rate	$24,776.55
Rate for Payer: Aetna Medicare	$14,741.18
Rate for Payer: Allen County Amish Medical Aid Commercial	$18,426.47
Rate for Payer: Amish Plain Church Group Commercial	$18,426.47
Rate for Payer: BCBS MAPPO	$14,741.18
Rate for Payer: BCN Medicare Advantage	$14,741.18
Rate for Payer: Health Alliance Plan Medicare Advantage	$14,741.18
Rate for Payer: Humana Choice PPO Medicare	$14,741.18
Rate for Payer: Mclaren Medicare	$14,741.18
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$15,478.24
Rate for Payer: MI Amish Medical Board Commercial	$16,952.36
Rate for Payer: Molina Medicare/Medicaid	$16,215.30
Rate for Payer: PACE Medicare	$14,004.12
Rate for Payer: PACE SWMI	$14,741.18
Rate for Payer: PHP Commercial	$16,215.30
Rate for Payer: PHP Medicare Advantage	$14,741.18
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$24,776.55
Rate for Payer: Priority Health Medicare	$14,741.18
Rate for Payer: Priority Health Narrow Network	$19,821.24
Rate for Payer: Railroad Medicare Medicare	$14,741.18
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$14,741.18
Rate for Payer: UHC Exchange	$22,848.83
Rate for Payer: UHCCP DNSP	$14,741.18
Rate for Payer: VA VA	$14,741.18

OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC

Facility

$51,351.51

Service Code	MSDRG 166
Min. Negotiated Rate	$27,237.02
Max. Negotiated Rate	$51,351.51
Rate for Payer: Aetna Medicare	$28,670.55
Rate for Payer: Allen County Amish Medical Aid Commercial	$35,838.19
Rate for Payer: Amish Plain Church Group Commercial	$35,838.19
Rate for Payer: BCBS MAPPO	$28,670.55
Rate for Payer: BCN Medicare Advantage	$28,670.55
Rate for Payer: Health Alliance Plan Medicare Advantage	$28,670.55
Rate for Payer: Humana Choice PPO Medicare	$28,670.55
Rate for Payer: Mclaren Medicare	$28,670.55
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$30,104.08
Rate for Payer: MI Amish Medical Board Commercial	$32,971.13
Rate for Payer: Molina Medicare/Medicaid	$31,537.60
Rate for Payer: PACE Medicare	$27,237.02
Rate for Payer: PACE SWMI	$28,670.55
Rate for Payer: PHP Commercial	$31,537.60
Rate for Payer: PHP Medicare Advantage	$28,670.55
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$51,351.51
Rate for Payer: Priority Health Medicare	$28,670.55
Rate for Payer: Priority Health Narrow Network	$41,081.21
Rate for Payer: Railroad Medicare Medicare	$28,670.55
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$28,670.55
Rate for Payer: UHC Exchange	$44,439.35
Rate for Payer: UHCCP DNSP	$28,670.55
Rate for Payer: VA VA	$28,670.55

OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC

Facility

$18,772.70

Service Code	MSDRG 168
Min. Negotiated Rate	$11,014.53
Max. Negotiated Rate	$18,772.70
Rate for Payer: Aetna Medicare	$11,594.24
Rate for Payer: Allen County Amish Medical Aid Commercial	$14,492.80
Rate for Payer: Amish Plain Church Group Commercial	$14,492.80
Rate for Payer: BCBS MAPPO	$11,594.24
Rate for Payer: BCN Medicare Advantage	$11,594.24
Rate for Payer: Health Alliance Plan Medicare Advantage	$11,594.24
Rate for Payer: Humana Choice PPO Medicare	$11,594.24
Rate for Payer: Mclaren Medicare	$11,594.24
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$12,173.95
Rate for Payer: MI Amish Medical Board Commercial	$13,333.38
Rate for Payer: Molina Medicare/Medicaid	$12,753.66
Rate for Payer: PACE Medicare	$11,014.53
Rate for Payer: PACE SWMI	$11,594.24
Rate for Payer: PHP Commercial	$12,753.66
Rate for Payer: PHP Medicare Advantage	$11,594.24
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$18,772.70
Rate for Payer: Priority Health Medicare	$11,594.24
Rate for Payer: Priority Health Narrow Network	$15,018.16
Rate for Payer: Railroad Medicare Medicare	$11,594.24
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$11,594.24
Rate for Payer: UHC Exchange	$17,971.07
Rate for Payer: UHCCP DNSP	$11,594.24
Rate for Payer: VA VA	$11,594.24

OTHER SIGNIFICANT HIP AND FEMUR SURGERY

Facility

$12,126.77

Service Code	APR-DRG 3092
Min. Negotiated Rate	$10,964.05
Max. Negotiated Rate	$12,126.77
Rate for Payer: BCBS Complete	$12,126.77
Rate for Payer: Mclaren Medicaid	$11,549.31
Rate for Payer: Meridian Medicaid	$12,126.77
Rate for Payer: PHP Medicaid	$10,964.05
Rate for Payer: Priority Health Choice Medicaid	$11,549.31
Rate for Payer: UHC Medicaid	$11,549.31
Rate for Payer: UHCCP Medicaid	$11,549.31

OTHER SIGNIFICANT HIP AND FEMUR SURGERY

Facility

$8,823.29

Service Code	APR-DRG 3091
Min. Negotiated Rate	$7,977.31
Max. Negotiated Rate	$8,823.29
Rate for Payer: BCBS Complete	$8,823.29
Rate for Payer: Mclaren Medicaid	$8,403.13
Rate for Payer: Meridian Medicaid	$8,823.29
Rate for Payer: PHP Medicaid	$7,977.31
Rate for Payer: Priority Health Choice Medicaid	$8,403.13
Rate for Payer: UHC Medicaid	$8,403.13
Rate for Payer: UHCCP Medicaid	$8,403.13

OTHER SIGNIFICANT HIP AND FEMUR SURGERY

Facility

$14,707.66

Service Code	APR-DRG 3093
Min. Negotiated Rate	$13,297.48
Max. Negotiated Rate	$14,707.66
Rate for Payer: BCBS Complete	$14,707.66
Rate for Payer: Mclaren Medicaid	$14,007.29
Rate for Payer: Meridian Medicaid	$14,707.66
Rate for Payer: PHP Medicaid	$13,297.48
Rate for Payer: Priority Health Choice Medicaid	$14,007.29
Rate for Payer: UHC Medicaid	$14,007.29
Rate for Payer: UHCCP Medicaid	$14,007.29

OTHER SIGNIFICANT HIP AND FEMUR SURGERY

Facility

$19,493.95

Service Code	APR-DRG 3094
Min. Negotiated Rate	$17,624.86
Max. Negotiated Rate	$19,493.95
Rate for Payer: BCBS Complete	$19,493.95
Rate for Payer: Mclaren Medicaid	$18,565.67
Rate for Payer: Meridian Medicaid	$19,493.95
Rate for Payer: PHP Medicaid	$17,624.86
Rate for Payer: Priority Health Choice Medicaid	$18,565.67
Rate for Payer: UHC Medicaid	$18,565.67
Rate for Payer: UHCCP Medicaid	$18,565.67

OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS

Facility

$3,400.49

Service Code	APR-DRG 3851
Min. Negotiated Rate	$3,074.45
Max. Negotiated Rate	$3,400.49
Rate for Payer: BCBS Complete	$3,400.49
Rate for Payer: Mclaren Medicaid	$3,238.56
Rate for Payer: Meridian Medicaid	$3,400.49
Rate for Payer: PHP Medicaid	$3,074.45
Rate for Payer: Priority Health Choice Medicaid	$3,238.56
Rate for Payer: UHC Medicaid	$3,238.56
Rate for Payer: UHCCP Medicaid	$3,238.56

OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS

Facility

$10,689.74

Service Code	APR-DRG 3854
Min. Negotiated Rate	$9,664.80
Max. Negotiated Rate	$10,689.74
Rate for Payer: BCBS Complete	$10,689.74
Rate for Payer: Mclaren Medicaid	$10,180.70
Rate for Payer: Meridian Medicaid	$10,689.74
Rate for Payer: PHP Medicaid	$9,664.80
Rate for Payer: Priority Health Choice Medicaid	$10,180.70
Rate for Payer: UHC Medicaid	$10,180.70
Rate for Payer: UHCCP Medicaid	$10,180.70

OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS

Facility

$4,452.24

Service Code	APR-DRG 3852
Min. Negotiated Rate	$4,025.36
Max. Negotiated Rate	$4,452.24
Rate for Payer: BCBS Complete	$4,452.24
Rate for Payer: Mclaren Medicaid	$4,240.23
Rate for Payer: Meridian Medicaid	$4,452.24
Rate for Payer: PHP Medicaid	$4,025.36
Rate for Payer: Priority Health Choice Medicaid	$4,240.23
Rate for Payer: UHC Medicaid	$4,240.23
Rate for Payer: UHCCP Medicaid	$4,240.23

OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS

Facility

$6,427.14

Service Code	APR-DRG 3853
Min. Negotiated Rate	$5,810.90
Max. Negotiated Rate	$6,427.14
Rate for Payer: BCBS Complete	$6,427.14
Rate for Payer: Mclaren Medicaid	$6,121.09
Rate for Payer: Meridian Medicaid	$6,427.14
Rate for Payer: PHP Medicaid	$5,810.90
Rate for Payer: Priority Health Choice Medicaid	$6,121.09
Rate for Payer: UHC Medicaid	$6,121.09
Rate for Payer: UHCCP Medicaid	$6,121.09

OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC

Facility

$23,740.65

Service Code	MSDRG 580
Min. Negotiated Rate	$13,488.30
Max. Negotiated Rate	$23,740.65
Rate for Payer: Aetna Medicare	$14,198.21
Rate for Payer: Allen County Amish Medical Aid Commercial	$17,747.76
Rate for Payer: Amish Plain Church Group Commercial	$17,747.76
Rate for Payer: BCBS MAPPO	$14,198.21
Rate for Payer: BCN Medicare Advantage	$14,198.21
Rate for Payer: Health Alliance Plan Medicare Advantage	$14,198.21
Rate for Payer: Humana Choice PPO Medicare	$14,198.21
Rate for Payer: Mclaren Medicare	$14,198.21
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$14,908.12
Rate for Payer: MI Amish Medical Board Commercial	$16,327.94
Rate for Payer: Molina Medicare/Medicaid	$15,618.03
Rate for Payer: PACE Medicare	$13,488.30
Rate for Payer: PACE SWMI	$14,198.21
Rate for Payer: PHP Commercial	$15,618.03
Rate for Payer: PHP Medicare Advantage	$14,198.21
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$23,740.65
Rate for Payer: Priority Health Medicare	$14,198.21
Rate for Payer: Priority Health Narrow Network	$18,992.52
Rate for Payer: Railroad Medicare Medicare	$14,198.21
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$14,198.21
Rate for Payer: UHC Exchange	$22,007.23
Rate for Payer: UHCCP DNSP	$14,198.21
Rate for Payer: VA VA	$14,198.21

OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC

Facility

$44,493.10

Service Code	MSDRG 579
Min. Negotiated Rate	$23,821.91
Max. Negotiated Rate	$44,493.10
Rate for Payer: Aetna Medicare	$25,075.69
Rate for Payer: Allen County Amish Medical Aid Commercial	$31,344.61
Rate for Payer: Amish Plain Church Group Commercial	$31,344.61
Rate for Payer: BCBS MAPPO	$25,075.69
Rate for Payer: BCN Medicare Advantage	$25,075.69
Rate for Payer: Health Alliance Plan Medicare Advantage	$25,075.69
Rate for Payer: Humana Choice PPO Medicare	$25,075.69
Rate for Payer: Mclaren Medicare	$25,075.69
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$26,329.47
Rate for Payer: MI Amish Medical Board Commercial	$28,837.04
Rate for Payer: Molina Medicare/Medicaid	$27,583.26
Rate for Payer: PACE Medicare	$23,821.91
Rate for Payer: PACE SWMI	$25,075.69
Rate for Payer: PHP Commercial	$27,583.26
Rate for Payer: PHP Medicare Advantage	$25,075.69
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$44,493.10
Rate for Payer: Priority Health Medicare	$25,075.69
Rate for Payer: Priority Health Narrow Network	$35,594.48
Rate for Payer: Railroad Medicare Medicare	$25,075.69
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$25,075.69
Rate for Payer: UHC Exchange	$38,867.32
Rate for Payer: UHCCP DNSP	$25,075.69
Rate for Payer: VA VA	$25,075.69

OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC

Facility

$19,826.46

Service Code	MSDRG 581
Min. Negotiated Rate	$11,539.24
Max. Negotiated Rate	$19,826.46
Rate for Payer: Aetna Medicare	$12,146.57
Rate for Payer: Allen County Amish Medical Aid Commercial	$15,183.21
Rate for Payer: Amish Plain Church Group Commercial	$15,183.21
Rate for Payer: BCBS MAPPO	$12,146.57
Rate for Payer: BCN Medicare Advantage	$12,146.57
Rate for Payer: Health Alliance Plan Medicare Advantage	$12,146.57
Rate for Payer: Humana Choice PPO Medicare	$12,146.57
Rate for Payer: Mclaren Medicare	$12,146.57
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$12,753.90
Rate for Payer: MI Amish Medical Board Commercial	$13,968.56
Rate for Payer: Molina Medicare/Medicaid	$13,361.23
Rate for Payer: PACE Medicare	$11,539.24
Rate for Payer: PACE SWMI	$12,146.57
Rate for Payer: PHP Commercial	$13,361.23
Rate for Payer: PHP Medicare Advantage	$12,146.57
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$19,826.46
Rate for Payer: Priority Health Medicare	$12,146.57
Rate for Payer: Priority Health Narrow Network	$15,861.17
Rate for Payer: Railroad Medicare Medicare	$12,146.57
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$12,146.57
Rate for Payer: UHC Exchange	$18,827.18
Rate for Payer: UHCCP DNSP	$12,146.57
Rate for Payer: VA VA	$12,146.57

OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES

Facility

$5,232.06

Service Code	APR-DRG 3641
Min. Negotiated Rate	$4,730.41
Max. Negotiated Rate	$5,232.06
Rate for Payer: BCBS Complete	$5,232.06
Rate for Payer: Mclaren Medicaid	$4,982.92
Rate for Payer: Meridian Medicaid	$5,232.06
Rate for Payer: PHP Medicaid	$4,730.41
Rate for Payer: Priority Health Choice Medicaid	$4,982.92
Rate for Payer: UHC Medicaid	$4,982.92
Rate for Payer: UHCCP Medicaid	$4,982.92

OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES

Facility

$6,237.50

Service Code	APR-DRG 3642
Min. Negotiated Rate	$5,639.44
Max. Negotiated Rate	$6,237.50
Rate for Payer: BCBS Complete	$6,237.50
Rate for Payer: Mclaren Medicaid	$5,940.47
Rate for Payer: Meridian Medicaid	$6,237.50
Rate for Payer: PHP Medicaid	$5,639.44
Rate for Payer: Priority Health Choice Medicaid	$5,940.47
Rate for Payer: UHC Medicaid	$5,940.47
Rate for Payer: UHCCP Medicaid	$5,940.47

OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES

Facility

$9,800.38

Service Code	APR-DRG 3643
Min. Negotiated Rate	$8,860.72
Max. Negotiated Rate	$9,800.38
Rate for Payer: BCBS Complete	$9,800.38
Rate for Payer: Mclaren Medicaid	$9,333.70
Rate for Payer: Meridian Medicaid	$9,800.38
Rate for Payer: PHP Medicaid	$8,860.72
Rate for Payer: Priority Health Choice Medicaid	$9,333.70
Rate for Payer: UHC Medicaid	$9,333.70
Rate for Payer: UHCCP Medicaid	$9,333.70

OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES

Facility

$12,390.53

Service Code	APR-DRG 3644
Min. Negotiated Rate	$11,202.52
Max. Negotiated Rate	$12,390.53
Rate for Payer: BCBS Complete	$12,390.53
Rate for Payer: Mclaren Medicaid	$11,800.50
Rate for Payer: Meridian Medicaid	$12,390.53
Rate for Payer: PHP Medicaid	$11,202.52
Rate for Payer: Priority Health Choice Medicaid	$11,800.50
Rate for Payer: UHC Medicaid	$11,800.50
Rate for Payer: UHCCP Medicaid	$11,800.50

Know your out-of-pocket cost for care.

All Charges