Bronson South Haven Hospital

All Charges

Charge

Type

Setting

Price

PEPTIC ULCER AND GASTRITIS

Facility

$4,042.44

Service Code	APR-DRG 2411
Min. Negotiated Rate	$3,654.85
Max. Negotiated Rate	$4,042.44
Rate for Payer: BCBS Complete	$4,042.44
Rate for Payer: Mclaren Medicaid	$3,849.94
Rate for Payer: Meridian Medicaid	$4,042.44
Rate for Payer: PHP Medicaid	$3,654.85
Rate for Payer: Priority Health Choice Medicaid	$3,849.94
Rate for Payer: UHC Medicaid	$3,849.94
Rate for Payer: UHCCP Medicaid	$3,849.94

PEPTIC ULCER AND GASTRITIS

Facility

$5,083.84

Service Code	APR-DRG 2412
Min. Negotiated Rate	$4,596.40
Max. Negotiated Rate	$5,083.84
Rate for Payer: BCBS Complete	$5,083.84
Rate for Payer: Mclaren Medicaid	$4,841.75
Rate for Payer: Meridian Medicaid	$5,083.84
Rate for Payer: PHP Medicaid	$4,596.40
Rate for Payer: Priority Health Choice Medicaid	$4,841.75
Rate for Payer: UHC Medicaid	$4,841.75
Rate for Payer: UHCCP Medicaid	$4,841.75

PEPTIC ULCER AND GASTRITIS

Facility

$13,720.21

Service Code	APR-DRG 2414
Min. Negotiated Rate	$12,404.71
Max. Negotiated Rate	$13,720.21
Rate for Payer: BCBS Complete	$13,720.21
Rate for Payer: Mclaren Medicaid	$13,066.86
Rate for Payer: Meridian Medicaid	$13,720.21
Rate for Payer: PHP Medicaid	$12,404.71
Rate for Payer: Priority Health Choice Medicaid	$13,066.86
Rate for Payer: UHC Medicaid	$13,066.86
Rate for Payer: UHCCP Medicaid	$13,066.86

PEPTIC ULCER AND GASTRITIS

Facility

$7,388.43

Service Code	APR-DRG 2413
Min. Negotiated Rate	$6,680.03
Max. Negotiated Rate	$7,388.43
Rate for Payer: BCBS Complete	$7,388.43
Rate for Payer: Mclaren Medicaid	$7,036.60
Rate for Payer: Meridian Medicaid	$7,388.43
Rate for Payer: PHP Medicaid	$6,680.03
Rate for Payer: Priority Health Choice Medicaid	$7,036.60
Rate for Payer: UHC Medicaid	$7,036.60
Rate for Payer: UHCCP Medicaid	$7,036.60

PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC

Facility

$56,679.42

Service Code	MSDRG 273
Min. Negotiated Rate	$29,890.03
Max. Negotiated Rate	$56,679.42
Rate for Payer: Aetna Medicare	$31,463.19
Rate for Payer: Allen County Amish Medical Aid Commercial	$39,328.99
Rate for Payer: Amish Plain Church Group Commercial	$39,328.99
Rate for Payer: BCBS MAPPO	$31,463.19
Rate for Payer: BCN Medicare Advantage	$31,463.19
Rate for Payer: Health Alliance Plan Medicare Advantage	$31,463.19
Rate for Payer: Humana Choice PPO Medicare	$31,463.19
Rate for Payer: Mclaren Medicare	$31,463.19
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$33,036.35
Rate for Payer: MI Amish Medical Board Commercial	$36,182.67
Rate for Payer: Molina Medicare/Medicaid	$34,609.51
Rate for Payer: PACE Medicare	$29,890.03
Rate for Payer: PACE SWMI	$31,463.19
Rate for Payer: PHP Commercial	$34,609.51
Rate for Payer: PHP Medicare Advantage	$31,463.19
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$56,679.42
Rate for Payer: Priority Health Medicare	$31,463.19
Rate for Payer: Priority Health Narrow Network	$45,343.54
Rate for Payer: Railroad Medicare Medicare	$31,463.19
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$31,463.19
Rate for Payer: UHC Exchange	$48,767.94
Rate for Payer: UHCCP DNSP	$31,463.19
Rate for Payer: VA VA	$31,463.19

PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC

Facility

$45,224.01

Service Code	MSDRG 274
Min. Negotiated Rate	$24,185.86
Max. Negotiated Rate	$45,224.01
Rate for Payer: Aetna Medicare	$25,458.80
Rate for Payer: Allen County Amish Medical Aid Commercial	$31,823.50
Rate for Payer: Amish Plain Church Group Commercial	$31,823.50
Rate for Payer: BCBS MAPPO	$25,458.80
Rate for Payer: BCN Medicare Advantage	$25,458.80
Rate for Payer: Health Alliance Plan Medicare Advantage	$25,458.80
Rate for Payer: Humana Choice PPO Medicare	$25,458.80
Rate for Payer: Mclaren Medicare	$25,458.80
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$26,731.74
Rate for Payer: MI Amish Medical Board Commercial	$29,277.62
Rate for Payer: Molina Medicare/Medicaid	$28,004.68
Rate for Payer: PACE Medicare	$24,185.86
Rate for Payer: PACE SWMI	$25,458.80
Rate for Payer: PHP Commercial	$28,004.68
Rate for Payer: PHP Medicare Advantage	$25,458.80
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$45,224.01
Rate for Payer: Priority Health Medicare	$25,458.80
Rate for Payer: Priority Health Narrow Network	$36,179.21
Rate for Payer: Railroad Medicare Medicare	$25,458.80
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$25,458.80
Rate for Payer: UHC Exchange	$39,461.14
Rate for Payer: UHCCP DNSP	$25,458.80
Rate for Payer: VA VA	$25,458.80

PERCUTANEOUS CARDIAC INTERVENTION WITH AMI

Facility

$10,441.24

Service Code	APR-DRG 1741
Min. Negotiated Rate	$9,440.13
Max. Negotiated Rate	$10,441.24
Rate for Payer: BCBS Complete	$10,441.24
Rate for Payer: Mclaren Medicaid	$9,944.04
Rate for Payer: Meridian Medicaid	$10,441.24
Rate for Payer: PHP Medicaid	$9,440.13
Rate for Payer: Priority Health Choice Medicaid	$9,944.04
Rate for Payer: UHC Medicaid	$9,944.04
Rate for Payer: UHCCP Medicaid	$9,944.04

PERCUTANEOUS CARDIAC INTERVENTION WITH AMI

Facility

$14,712.56

Service Code	APR-DRG 1743
Min. Negotiated Rate	$13,301.91
Max. Negotiated Rate	$14,712.56
Rate for Payer: BCBS Complete	$14,712.56
Rate for Payer: Mclaren Medicaid	$14,011.96
Rate for Payer: Meridian Medicaid	$14,712.56
Rate for Payer: PHP Medicaid	$13,301.91
Rate for Payer: Priority Health Choice Medicaid	$14,011.96
Rate for Payer: UHC Medicaid	$14,011.96
Rate for Payer: UHCCP Medicaid	$14,011.96

PERCUTANEOUS CARDIAC INTERVENTION WITH AMI

Facility

$13,083.16

Service Code	APR-DRG 1742
Min. Negotiated Rate	$11,828.74
Max. Negotiated Rate	$13,083.16
Rate for Payer: BCBS Complete	$13,083.16
Rate for Payer: Mclaren Medicaid	$12,460.15
Rate for Payer: Meridian Medicaid	$13,083.16
Rate for Payer: PHP Medicaid	$11,828.74
Rate for Payer: Priority Health Choice Medicaid	$12,460.15
Rate for Payer: UHC Medicaid	$12,460.15
Rate for Payer: UHCCP Medicaid	$12,460.15

PERCUTANEOUS CARDIAC INTERVENTION WITH AMI

Facility

$21,265.04

Service Code	APR-DRG 1744
Min. Negotiated Rate	$19,226.14
Max. Negotiated Rate	$21,265.04
Rate for Payer: BCBS Complete	$21,265.04
Rate for Payer: Mclaren Medicaid	$20,252.42
Rate for Payer: Meridian Medicaid	$21,265.04
Rate for Payer: PHP Medicaid	$19,226.14
Rate for Payer: Priority Health Choice Medicaid	$20,252.42
Rate for Payer: UHC Medicaid	$20,252.42
Rate for Payer: UHCCP Medicaid	$20,252.42

PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI

Facility

$23,867.18

Service Code	APR-DRG 1754
Min. Negotiated Rate	$21,578.78
Max. Negotiated Rate	$23,867.18
Rate for Payer: BCBS Complete	$23,867.18
Rate for Payer: Mclaren Medicaid	$22,730.64
Rate for Payer: Meridian Medicaid	$23,867.18
Rate for Payer: PHP Medicaid	$21,578.78
Rate for Payer: Priority Health Choice Medicaid	$22,730.64
Rate for Payer: UHC Medicaid	$22,730.64
Rate for Payer: UHCCP Medicaid	$22,730.64

PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI

Facility

$8,594.95

Service Code	APR-DRG 1751
Min. Negotiated Rate	$7,770.86
Max. Negotiated Rate	$8,594.95
Rate for Payer: BCBS Complete	$8,594.95
Rate for Payer: Mclaren Medicaid	$8,185.67
Rate for Payer: Meridian Medicaid	$8,594.95
Rate for Payer: PHP Medicaid	$7,770.86
Rate for Payer: Priority Health Choice Medicaid	$8,185.67
Rate for Payer: UHC Medicaid	$8,185.67
Rate for Payer: UHCCP Medicaid	$8,185.67

PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI

Facility

$11,425.42

Service Code	APR-DRG 1752
Min. Negotiated Rate	$10,329.95
Max. Negotiated Rate	$11,425.42
Rate for Payer: BCBS Complete	$11,425.42
Rate for Payer: Mclaren Medicaid	$10,881.35
Rate for Payer: Meridian Medicaid	$11,425.42
Rate for Payer: PHP Medicaid	$10,329.95
Rate for Payer: Priority Health Choice Medicaid	$10,881.35
Rate for Payer: UHC Medicaid	$10,881.35
Rate for Payer: UHCCP Medicaid	$10,881.35

PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI

Facility

$14,734.36

Service Code	APR-DRG 1753
Min. Negotiated Rate	$13,321.62
Max. Negotiated Rate	$14,734.36
Rate for Payer: BCBS Complete	$14,734.36
Rate for Payer: Mclaren Medicaid	$14,032.72
Rate for Payer: Meridian Medicaid	$14,734.36
Rate for Payer: PHP Medicaid	$13,321.62
Rate for Payer: Priority Health Choice Medicaid	$14,032.72
Rate for Payer: UHC Medicaid	$14,032.72
Rate for Payer: UHCCP Medicaid	$14,032.72

PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIES/INTRALUMINAL DEVICES

Facility

$37,380.53

Service Code	MSDRG 321
Min. Negotiated Rate	$20,280.21
Max. Negotiated Rate	$37,380.53
Rate for Payer: Aetna Medicare	$21,347.59
Rate for Payer: Allen County Amish Medical Aid Commercial	$26,684.49
Rate for Payer: Amish Plain Church Group Commercial	$26,684.49
Rate for Payer: BCBS MAPPO	$21,347.59
Rate for Payer: BCN Medicare Advantage	$21,347.59
Rate for Payer: Health Alliance Plan Medicare Advantage	$21,347.59
Rate for Payer: Humana Choice PPO Medicare	$21,347.59
Rate for Payer: Mclaren Medicare	$21,347.59
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$22,414.97
Rate for Payer: MI Amish Medical Board Commercial	$24,549.73
Rate for Payer: Molina Medicare/Medicaid	$23,482.35
Rate for Payer: PACE Medicare	$20,280.21
Rate for Payer: PACE SWMI	$21,347.59
Rate for Payer: PHP Commercial	$23,482.35
Rate for Payer: PHP Medicare Advantage	$21,347.59
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$37,380.53
Rate for Payer: Priority Health Medicare	$21,347.59
Rate for Payer: Priority Health Narrow Network	$29,904.42
Rate for Payer: Railroad Medicare Medicare	$21,347.59
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$21,347.59
Rate for Payer: UHC Exchange	$33,088.76
Rate for Payer: UHCCP DNSP	$21,347.59
Rate for Payer: VA VA	$21,347.59

PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC

Facility

$24,221.50

Service Code	MSDRG 322
Min. Negotiated Rate	$13,727.74
Max. Negotiated Rate	$24,221.50
Rate for Payer: Aetna Medicare	$14,450.25
Rate for Payer: Allen County Amish Medical Aid Commercial	$18,062.81
Rate for Payer: Amish Plain Church Group Commercial	$18,062.81
Rate for Payer: BCBS MAPPO	$14,450.25
Rate for Payer: BCN Medicare Advantage	$14,450.25
Rate for Payer: Health Alliance Plan Medicare Advantage	$14,450.25
Rate for Payer: Humana Choice PPO Medicare	$14,450.25
Rate for Payer: Mclaren Medicare	$14,450.25
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$15,172.76
Rate for Payer: MI Amish Medical Board Commercial	$16,617.79
Rate for Payer: Molina Medicare/Medicaid	$15,895.27
Rate for Payer: PACE Medicare	$13,727.74
Rate for Payer: PACE SWMI	$14,450.25
Rate for Payer: PHP Commercial	$15,895.27
Rate for Payer: PHP Medicare Advantage	$14,450.25
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$24,221.50
Rate for Payer: Priority Health Medicare	$14,450.25
Rate for Payer: Priority Health Narrow Network	$19,377.20
Rate for Payer: Railroad Medicare Medicare	$14,450.25
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$14,450.25
Rate for Payer: UHC Exchange	$22,397.89
Rate for Payer: UHCCP DNSP	$14,450.25
Rate for Payer: VA VA	$14,450.25

PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC

Facility

$29,984.93

Service Code	MSDRG 250
Min. Negotiated Rate	$16,597.61
Max. Negotiated Rate	$29,984.93
Rate for Payer: Aetna Medicare	$17,471.17
Rate for Payer: Allen County Amish Medical Aid Commercial	$21,838.96
Rate for Payer: Amish Plain Church Group Commercial	$21,838.96
Rate for Payer: BCBS MAPPO	$17,471.17
Rate for Payer: BCN Medicare Advantage	$17,471.17
Rate for Payer: Health Alliance Plan Medicare Advantage	$17,471.17
Rate for Payer: Humana Choice PPO Medicare	$17,471.17
Rate for Payer: Mclaren Medicare	$17,471.17
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$18,344.73
Rate for Payer: MI Amish Medical Board Commercial	$20,091.85
Rate for Payer: Molina Medicare/Medicaid	$19,218.29
Rate for Payer: PACE Medicare	$16,597.61
Rate for Payer: PACE SWMI	$17,471.17
Rate for Payer: PHP Commercial	$19,218.29
Rate for Payer: PHP Medicare Advantage	$17,471.17
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$29,984.93
Rate for Payer: Priority Health Medicare	$17,471.17
Rate for Payer: Priority Health Narrow Network	$23,987.94
Rate for Payer: Railroad Medicare Medicare	$17,471.17
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$17,471.17
Rate for Payer: UHC Exchange	$27,080.31
Rate for Payer: UHCCP DNSP	$17,471.17
Rate for Payer: VA VA	$17,471.17

PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC

Facility

$20,532.64

Service Code	MSDRG 251
Min. Negotiated Rate	$11,890.88
Max. Negotiated Rate	$20,532.64
Rate for Payer: Aetna Medicare	$12,516.72
Rate for Payer: Allen County Amish Medical Aid Commercial	$15,645.90
Rate for Payer: Amish Plain Church Group Commercial	$15,645.90
Rate for Payer: BCBS MAPPO	$12,516.72
Rate for Payer: BCN Medicare Advantage	$12,516.72
Rate for Payer: Health Alliance Plan Medicare Advantage	$12,516.72
Rate for Payer: Humana Choice PPO Medicare	$12,516.72
Rate for Payer: Mclaren Medicare	$12,516.72
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$13,142.56
Rate for Payer: MI Amish Medical Board Commercial	$14,394.23
Rate for Payer: Molina Medicare/Medicaid	$13,768.39
Rate for Payer: PACE Medicare	$11,890.88
Rate for Payer: PACE SWMI	$12,516.72
Rate for Payer: PHP Commercial	$13,768.39
Rate for Payer: PHP Medicare Advantage	$12,516.72
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$20,532.64
Rate for Payer: Priority Health Medicare	$12,516.72
Rate for Payer: Priority Health Narrow Network	$16,426.11
Rate for Payer: Railroad Medicare Medicare	$12,516.72
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$12,516.72
Rate for Payer: UHC Exchange	$19,400.92
Rate for Payer: UHCCP DNSP	$12,516.72
Rate for Payer: VA VA	$12,516.72

PERCUTANEOUS CORONARY ATHERECTOMY WITH INTRALUMINAL DEVICE WITH MCC

Facility

$47,242.24

Service Code	MSDRG 359
Min. Negotiated Rate	$25,190.82
Max. Negotiated Rate	$47,242.24
Rate for Payer: Aetna Medicare	$26,516.65
Rate for Payer: Allen County Amish Medical Aid Commercial	$33,145.81
Rate for Payer: Amish Plain Church Group Commercial	$33,145.81
Rate for Payer: BCBS MAPPO	$26,516.65
Rate for Payer: BCN Medicare Advantage	$26,516.65
Rate for Payer: Health Alliance Plan Medicare Advantage	$26,516.65
Rate for Payer: Humana Choice PPO Medicare	$26,516.65
Rate for Payer: Mclaren Medicare	$26,516.65
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$27,842.48
Rate for Payer: MI Amish Medical Board Commercial	$30,494.15
Rate for Payer: Molina Medicare/Medicaid	$29,168.31
Rate for Payer: PACE Medicare	$25,190.82
Rate for Payer: PACE SWMI	$26,516.65
Rate for Payer: PHP Commercial	$29,168.31
Rate for Payer: PHP Medicare Advantage	$26,516.65
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$47,242.24
Rate for Payer: Priority Health Medicare	$26,516.65
Rate for Payer: Priority Health Narrow Network	$37,793.79
Rate for Payer: Railroad Medicare Medicare	$26,516.65
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$26,516.65
Rate for Payer: UHC Exchange	$41,100.81
Rate for Payer: UHCCP DNSP	$26,516.65
Rate for Payer: VA VA	$26,516.65

PERCUTANEOUS CORONARY ATHERECTOMY WITH INTRALUMINAL DEVICE WITHOUT MCC

Facility

$33,169.58

Service Code	MSDRG 360
Min. Negotiated Rate	$18,183.41
Max. Negotiated Rate	$33,169.58
Rate for Payer: Aetna Medicare	$19,140.43
Rate for Payer: Allen County Amish Medical Aid Commercial	$23,925.54
Rate for Payer: Amish Plain Church Group Commercial	$23,925.54
Rate for Payer: BCBS MAPPO	$19,140.43
Rate for Payer: BCN Medicare Advantage	$19,140.43
Rate for Payer: Health Alliance Plan Medicare Advantage	$19,140.43
Rate for Payer: Humana Choice PPO Medicare	$19,140.43
Rate for Payer: Mclaren Medicare	$19,140.43
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$20,097.45
Rate for Payer: MI Amish Medical Board Commercial	$22,011.49
Rate for Payer: Molina Medicare/Medicaid	$21,054.47
Rate for Payer: PACE Medicare	$18,183.41
Rate for Payer: PACE SWMI	$19,140.43
Rate for Payer: PHP Commercial	$21,054.47
Rate for Payer: PHP Medicare Advantage	$19,140.43
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$33,169.58
Rate for Payer: Priority Health Medicare	$19,140.43
Rate for Payer: Priority Health Narrow Network	$26,535.67
Rate for Payer: Railroad Medicare Medicare	$19,140.43
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$19,140.43
Rate for Payer: UHC Exchange	$29,667.67
Rate for Payer: UHCCP DNSP	$19,140.43
Rate for Payer: VA VA	$19,140.43

PERCUTANEOUS CORONARY ATHERECTOMY WITHOUT INTRALUMINAL DEVICE

Facility

$33,278.12

Service Code	MSDRG 318
Min. Negotiated Rate	$18,237.44
Max. Negotiated Rate	$33,278.12
Rate for Payer: Aetna Medicare	$19,197.31
Rate for Payer: Allen County Amish Medical Aid Commercial	$23,996.64
Rate for Payer: Amish Plain Church Group Commercial	$23,996.64
Rate for Payer: BCBS MAPPO	$19,197.31
Rate for Payer: BCN Medicare Advantage	$19,197.31
Rate for Payer: Health Alliance Plan Medicare Advantage	$19,197.31
Rate for Payer: Humana Choice PPO Medicare	$19,197.31
Rate for Payer: Mclaren Medicare	$19,197.31
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$20,157.18
Rate for Payer: MI Amish Medical Board Commercial	$22,076.91
Rate for Payer: Molina Medicare/Medicaid	$21,117.04
Rate for Payer: PACE Medicare	$18,237.44
Rate for Payer: PACE SWMI	$19,197.31
Rate for Payer: PHP Commercial	$21,117.04
Rate for Payer: PHP Medicare Advantage	$19,197.31
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network	$33,278.12
Rate for Payer: Priority Health Medicare	$19,197.31
Rate for Payer: Priority Health Narrow Network	$26,622.50
Rate for Payer: Railroad Medicare Medicare	$19,197.31
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$19,197.31
Rate for Payer: UHC Exchange	$29,755.83
Rate for Payer: UHCCP DNSP	$19,197.31
Rate for Payer: VA VA	$19,197.31

PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES

Facility

$16,606.81

Service Code	APR-DRG 0303
Min. Negotiated Rate	$15,014.54
Max. Negotiated Rate	$16,606.81
Rate for Payer: BCBS Complete	$16,606.81
Rate for Payer: Mclaren Medicaid	$15,816.01
Rate for Payer: Meridian Medicaid	$16,606.81
Rate for Payer: PHP Medicaid	$15,014.54
Rate for Payer: Priority Health Choice Medicaid	$15,816.01
Rate for Payer: UHC Medicaid	$15,816.01
Rate for Payer: UHCCP Medicaid	$15,816.01

PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES

Facility

$7,574.26

Service Code	APR-DRG 0301
Min. Negotiated Rate	$6,848.04
Max. Negotiated Rate	$7,574.26
Rate for Payer: BCBS Complete	$7,574.26
Rate for Payer: Mclaren Medicaid	$7,213.58
Rate for Payer: Meridian Medicaid	$7,574.26
Rate for Payer: PHP Medicaid	$6,848.04
Rate for Payer: Priority Health Choice Medicaid	$7,213.58
Rate for Payer: UHC Medicaid	$7,213.58
Rate for Payer: UHCCP Medicaid	$7,213.58

PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES

Facility

$22,447.58

Service Code	APR-DRG 0304
Min. Negotiated Rate	$20,295.30
Max. Negotiated Rate	$22,447.58
Rate for Payer: BCBS Complete	$22,447.58
Rate for Payer: Mclaren Medicaid	$21,378.65
Rate for Payer: Meridian Medicaid	$22,447.58
Rate for Payer: PHP Medicaid	$20,295.30
Rate for Payer: Priority Health Choice Medicaid	$21,378.65
Rate for Payer: UHC Medicaid	$21,378.65
Rate for Payer: UHCCP Medicaid	$21,378.65

PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES

Facility

$12,920.22

Service Code	APR-DRG 0302
Min. Negotiated Rate	$11,681.42
Max. Negotiated Rate	$12,920.22
Rate for Payer: BCBS Complete	$12,920.22
Rate for Payer: Mclaren Medicaid	$12,304.97
Rate for Payer: Meridian Medicaid	$12,920.22
Rate for Payer: PHP Medicaid	$11,681.42
Rate for Payer: Priority Health Choice Medicaid	$12,304.97
Rate for Payer: UHC Medicaid	$12,304.97
Rate for Payer: UHCCP Medicaid	$12,304.97

Know your out-of-pocket cost for care.

All Charges