Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

SOTALOL 80 MG TABLET

Facility

$4.88

Service Code	NDC 68084065411
Hospital Charge Code	11421
Hospital Revenue Code	637
Min. Negotiated Rate	$3.07
Max. Negotiated Rate	$4.39
Rate for Payer: Aetna Commercial	$4.15
Rate for Payer: Aetna New Business (MI Preferred)	$3.17
Rate for Payer: Cash Price	$3.90
Rate for Payer: Cofinity Advantage	$3.42
Rate for Payer: Cofinity Commercial	$4.20
Rate for Payer: Encore Health Key Benefits Commercial	$3.90
Rate for Payer: Healthscope Commercial	$4.39
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4.15
Rate for Payer: Opus (Opus Packaging Group) HMA	$3.66
Rate for Payer: PHP Commercial	$4.15
Rate for Payer: Priority Health SBD	$3.07

SOTALOL 80 MG TABLET

Facility

$4.88

Service Code	NDC 68084065411
Hospital Charge Code	11421
Hospital Revenue Code	637
Min. Negotiated Rate	$1.92
Max. Negotiated Rate	$4.39
Rate for Payer: Aetna Commercial	$4.15
Rate for Payer: Aetna Medicare	$2.44
Rate for Payer: Aetna New Business (MI Preferred)	$3.17
Rate for Payer: BCBS Complete	$1.95
Rate for Payer: Cash Price	$3.90
Rate for Payer: Cofinity Advantage	$3.42
Rate for Payer: Cofinity Commercial	$4.20
Rate for Payer: Encore Health Key Benefits Commercial	$3.90
Rate for Payer: Healthscope Commercial	$4.39
Rate for Payer: MI Amish Medical Board Commercial	$3.90
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4.15
Rate for Payer: Opus (Opus Packaging Group) HMA	$3.66
Rate for Payer: PHP Commercial	$4.15
Rate for Payer: Priority Health SBD	$3.07
Rate for Payer: UHC All Payor (Choice/PPO)	$3.17
Rate for Payer: UHC Core	$2.54
Rate for Payer: UHC Exchange	$1.92

SOTALOL 80 MG TABLET

Facility

$444.00

Service Code	NDC 00245001201
Hospital Charge Code	11421
Hospital Revenue Code	637
Min. Negotiated Rate	$279.72
Max. Negotiated Rate	$399.60
Rate for Payer: Aetna Commercial	$377.40
Rate for Payer: Aetna New Business (MI Preferred)	$288.60
Rate for Payer: Cash Price	$355.20
Rate for Payer: Cofinity Advantage	$310.80
Rate for Payer: Cofinity Commercial	$381.84
Rate for Payer: Encore Health Key Benefits Commercial	$355.20
Rate for Payer: Healthscope Commercial	$399.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$377.40
Rate for Payer: Opus (Opus Packaging Group) HMA	$333.00
Rate for Payer: PHP Commercial	$377.40
Rate for Payer: Priority Health SBD	$279.72

SOTALOL 80 MG TABLET

Facility

$444.00

Service Code	NDC 00245001201
Hospital Charge Code	11421
Hospital Revenue Code	637
Min. Negotiated Rate	$174.49
Max. Negotiated Rate	$399.60
Rate for Payer: Aetna Commercial	$377.40
Rate for Payer: Aetna Medicare	$222.00
Rate for Payer: Aetna New Business (MI Preferred)	$288.60
Rate for Payer: BCBS Complete	$177.60
Rate for Payer: Cash Price	$355.20
Rate for Payer: Cofinity Advantage	$310.80
Rate for Payer: Cofinity Commercial	$381.84
Rate for Payer: Encore Health Key Benefits Commercial	$355.20
Rate for Payer: Healthscope Commercial	$399.60
Rate for Payer: MI Amish Medical Board Commercial	$355.20
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$377.40
Rate for Payer: Opus (Opus Packaging Group) HMA	$333.00
Rate for Payer: PHP Commercial	$377.40
Rate for Payer: Priority Health SBD	$279.72
Rate for Payer: UHC All Payor (Choice/PPO)	$288.60
Rate for Payer: UHC Core	$231.32
Rate for Payer: UHC Exchange	$174.49

SOTALOL 80 MG TABLET

Facility

$4.44

Service Code	NDC 00245001289
Hospital Charge Code	11421
Hospital Revenue Code	637
Min. Negotiated Rate	$1.74
Max. Negotiated Rate	$4.00
Rate for Payer: Aetna Commercial	$3.77
Rate for Payer: Aetna Medicare	$2.22
Rate for Payer: Aetna New Business (MI Preferred)	$2.89
Rate for Payer: BCBS Complete	$1.78
Rate for Payer: Cash Price	$3.55
Rate for Payer: Cofinity Advantage	$3.11
Rate for Payer: Cofinity Commercial	$3.82
Rate for Payer: Encore Health Key Benefits Commercial	$3.55
Rate for Payer: Healthscope Commercial	$4.00
Rate for Payer: MI Amish Medical Board Commercial	$3.55
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3.77
Rate for Payer: Opus (Opus Packaging Group) HMA	$3.33
Rate for Payer: PHP Commercial	$3.77
Rate for Payer: Priority Health SBD	$2.80
Rate for Payer: UHC All Payor (Choice/PPO)	$2.89
Rate for Payer: UHC Core	$2.31
Rate for Payer: UHC Exchange	$1.74

SOTALOL 80 MG TABLET

Facility

$143.35

Service Code	NDC 60505008000
Hospital Charge Code	11421
Hospital Revenue Code	637
Min. Negotiated Rate	$56.34
Max. Negotiated Rate	$129.01
Rate for Payer: Aetna Commercial	$121.85
Rate for Payer: Aetna Medicare	$71.67
Rate for Payer: Aetna New Business (MI Preferred)	$93.18
Rate for Payer: BCBS Complete	$57.34
Rate for Payer: Cash Price	$114.68
Rate for Payer: Cofinity Advantage	$100.34
Rate for Payer: Cofinity Commercial	$123.28
Rate for Payer: Encore Health Key Benefits Commercial	$114.68
Rate for Payer: Healthscope Commercial	$129.01
Rate for Payer: MI Amish Medical Board Commercial	$114.68
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$121.85
Rate for Payer: Opus (Opus Packaging Group) HMA	$107.51
Rate for Payer: PHP Commercial	$121.85
Rate for Payer: Priority Health SBD	$90.31
Rate for Payer: UHC All Payor (Choice/PPO)	$93.18
Rate for Payer: UHC Core	$74.69
Rate for Payer: UHC Exchange	$56.34

SPHINCTEROTOMY, ANAL, DIVISION OF SPHINCTER (SEPARATE PROCEDURE)

Facility

$8,943.95

Service Code	CPT 46080
Hospital Revenue Code	360
Min. Negotiated Rate	$1,446.45
Max. Negotiated Rate	$8,943.95
Rate for Payer: Aetna Medicare	$2,876.31
Rate for Payer: Allen County Amish Medical Aid Commercial	$3,457.10
Rate for Payer: Amish Plain Church Group Commercial	$3,457.10
Rate for Payer: BCBS Complete	$1,518.91
Rate for Payer: BCBS MAPPO	$2,765.68
Rate for Payer: BCBS Trust/PPO	$1,645.42
Rate for Payer: BCN Commercial	$1,645.42
Rate for Payer: BCN Medicare Advantage	$2,765.68
Rate for Payer: Health Alliance Plan Medicare Advantage	$2,765.68
Rate for Payer: Mclaren Medicaid	$1,446.45
Rate for Payer: Mclaren Medicare	$2,765.68
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$2,903.96
Rate for Payer: Meridian Medicaid	$2,903.96
Rate for Payer: MI Amish Medical Board Commercial	$3,180.53
Rate for Payer: Molina Medicare/Medicaid	$3,042.25
Rate for Payer: Nomi Health Commercial	$8,297.04
Rate for Payer: PACE Medicare	$2,627.40
Rate for Payer: PACE SWMI	$2,765.68
Rate for Payer: PHP Medicare Advantage	$2,765.68
Rate for Payer: Priority Health Choice Medicaid	$1,446.45
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$8,943.95
Rate for Payer: Priority Health Medicare	$2,765.68
Rate for Payer: Priority Health Tiered Network	$7,155.16
Rate for Payer: Railroad Medicare Medicare	$2,765.68
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$2,765.68
Rate for Payer: UHC Medicaid	$1,446.45
Rate for Payer: UHCCP Medicaid	$1,446.45
Rate for Payer: VA VA	$2,765.68

SPINAL DISORDERS AND INJURIES

Facility

$14,592.78

Service Code	APR-DRG 0404
Min. Negotiated Rate	$13,897.88
Max. Negotiated Rate	$14,592.78
Rate for Payer: BCBS Complete	$14,592.78
Rate for Payer: Mclaren Medicaid	$13,897.88
Rate for Payer: Meridian Medicaid	$14,592.78
Rate for Payer: Priority Health Choice Medicaid	$13,897.88
Rate for Payer: UHC Medicaid	$13,897.88
Rate for Payer: UHCCP Medicaid	$13,897.88

SPINAL DISORDERS AND INJURIES

Facility

$7,215.55

Service Code	APR-DRG 0401
Min. Negotiated Rate	$6,871.96
Max. Negotiated Rate	$7,215.55
Rate for Payer: BCBS Complete	$7,215.55
Rate for Payer: Mclaren Medicaid	$6,871.96
Rate for Payer: Meridian Medicaid	$7,215.55
Rate for Payer: Priority Health Choice Medicaid	$6,871.96
Rate for Payer: UHC Medicaid	$6,871.96
Rate for Payer: UHCCP Medicaid	$6,871.96

SPINAL DISORDERS AND INJURIES

Facility

$11,013.67

Service Code	APR-DRG 0403
Min. Negotiated Rate	$10,489.21
Max. Negotiated Rate	$11,013.67
Rate for Payer: BCBS Complete	$11,013.67
Rate for Payer: Mclaren Medicaid	$10,489.21
Rate for Payer: Meridian Medicaid	$11,013.67
Rate for Payer: Priority Health Choice Medicaid	$10,489.21
Rate for Payer: UHC Medicaid	$10,489.21
Rate for Payer: UHCCP Medicaid	$10,489.21

SPINAL DISORDERS AND INJURIES

Facility

$9,368.30

Service Code	APR-DRG 0402
Min. Negotiated Rate	$8,922.19
Max. Negotiated Rate	$9,368.30
Rate for Payer: BCBS Complete	$9,368.30
Rate for Payer: Mclaren Medicaid	$8,922.19
Rate for Payer: Meridian Medicaid	$9,368.30
Rate for Payer: Priority Health Choice Medicaid	$8,922.19
Rate for Payer: UHC Medicaid	$8,922.19
Rate for Payer: UHCCP Medicaid	$8,922.19

SPINAL DISORDERS AND INJURIES WITH CC/MCC

Facility

$29,202.03

Service Code	MSDRG 052
Min. Negotiated Rate	$13,848.27
Max. Negotiated Rate	$29,202.03
Rate for Payer: Aetna Medicare	$15,160.22
Rate for Payer: Allen County Amish Medical Aid Commercial	$18,221.41
Rate for Payer: Amish Plain Church Group Commercial	$18,221.41
Rate for Payer: BCBS MAPPO	$14,577.13
Rate for Payer: BCBS Trust/PPO	$28,283.89
Rate for Payer: BCN Commercial	$28,283.89
Rate for Payer: BCN Medicare Advantage	$14,577.13
Rate for Payer: Health Alliance Plan Medicare Advantage	$14,577.13
Rate for Payer: Mclaren Medicare	$14,577.13
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$15,305.99
Rate for Payer: MI Amish Medical Board Commercial	$16,763.70
Rate for Payer: Molina Medicare/Medicaid	$16,034.84
Rate for Payer: Nomi Health Commercial	$22,972.32
Rate for Payer: PACE Medicare	$13,848.27
Rate for Payer: PACE SWMI	$14,577.13
Rate for Payer: PHP Medicare Advantage	$14,577.13
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$29,202.03
Rate for Payer: Priority Health Medicare	$14,577.13
Rate for Payer: Priority Health Tiered Network	$23,361.62
Rate for Payer: Railroad Medicare Medicare	$14,577.13
Rate for Payer: UHC All Payor (Choice/PPO)	$29,027.04
Rate for Payer: UHC Core	$24,284.77
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$14,577.13
Rate for Payer: UHC Exchange	$19,832.77
Rate for Payer: VA VA	$14,577.13

SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC

Facility

$20,402.41

Service Code	MSDRG 053
Min. Negotiated Rate	$7,739.15
Max. Negotiated Rate	$20,402.41
Rate for Payer: Aetna Medicare	$8,472.33
Rate for Payer: Allen County Amish Medical Aid Commercial	$10,183.09
Rate for Payer: Amish Plain Church Group Commercial	$10,183.09
Rate for Payer: BCBS MAPPO	$8,146.47
Rate for Payer: BCBS Trust/PPO	$20,402.41
Rate for Payer: BCN Commercial	$20,402.41
Rate for Payer: BCN Medicare Advantage	$8,146.47
Rate for Payer: Health Alliance Plan Medicare Advantage	$8,146.47
Rate for Payer: Mclaren Medicare	$8,146.47
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$8,553.79
Rate for Payer: MI Amish Medical Board Commercial	$9,368.44
Rate for Payer: Molina Medicare/Medicaid	$8,961.12
Rate for Payer: Nomi Health Commercial	$12,631.68
Rate for Payer: PACE Medicare	$7,739.15
Rate for Payer: PACE SWMI	$8,146.47
Rate for Payer: PHP Medicare Advantage	$8,146.47
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$15,786.80
Rate for Payer: Priority Health Medicare	$8,146.47
Rate for Payer: Priority Health Tiered Network	$12,629.44
Rate for Payer: Railroad Medicare Medicare	$8,146.47
Rate for Payer: UHC All Payor (Choice/PPO)	$15,960.96
Rate for Payer: UHC Core	$13,353.35
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$8,146.47
Rate for Payer: UHC Exchange	$10,905.35
Rate for Payer: VA VA	$8,146.47

SPINAL FUSION AND OTHER BACK AND NECK PROCEDURES EXCEPT FOR DISC PROCEDURES

Facility

$10,150.28

Service Code	APR-DRG 3211
Min. Negotiated Rate	$9,666.93
Max. Negotiated Rate	$10,150.28
Rate for Payer: BCBS Complete	$10,150.28
Rate for Payer: Mclaren Medicaid	$9,666.93
Rate for Payer: Meridian Medicaid	$10,150.28
Rate for Payer: Priority Health Choice Medicaid	$9,666.93
Rate for Payer: UHC Medicaid	$9,666.93
Rate for Payer: UHCCP Medicaid	$9,666.93

SPINAL FUSION AND OTHER BACK AND NECK PROCEDURES EXCEPT FOR DISC PROCEDURES

Facility

$26,437.73

Service Code	APR-DRG 3214
Min. Negotiated Rate	$25,178.79
Max. Negotiated Rate	$26,437.73
Rate for Payer: BCBS Complete	$26,437.73
Rate for Payer: Mclaren Medicaid	$25,178.79
Rate for Payer: Meridian Medicaid	$26,437.73
Rate for Payer: Priority Health Choice Medicaid	$25,178.79
Rate for Payer: UHC Medicaid	$25,178.79
Rate for Payer: UHCCP Medicaid	$25,178.79

SPINAL FUSION AND OTHER BACK AND NECK PROCEDURES EXCEPT FOR DISC PROCEDURES

Facility

$13,302.85

Service Code	APR-DRG 3212
Min. Negotiated Rate	$12,669.38
Max. Negotiated Rate	$13,302.85
Rate for Payer: BCBS Complete	$13,302.85
Rate for Payer: Mclaren Medicaid	$12,669.38
Rate for Payer: Meridian Medicaid	$13,302.85
Rate for Payer: Priority Health Choice Medicaid	$12,669.38
Rate for Payer: UHC Medicaid	$12,669.38
Rate for Payer: UHCCP Medicaid	$12,669.38

SPINAL FUSION AND OTHER BACK AND NECK PROCEDURES EXCEPT FOR DISC PROCEDURES

Facility

$21,892.03

Service Code	APR-DRG 3213
Min. Negotiated Rate	$20,849.56
Max. Negotiated Rate	$21,892.03
Rate for Payer: BCBS Complete	$21,892.03
Rate for Payer: Mclaren Medicaid	$20,849.56
Rate for Payer: Meridian Medicaid	$21,892.03
Rate for Payer: Priority Health Choice Medicaid	$20,849.56
Rate for Payer: UHC Medicaid	$20,849.56
Rate for Payer: UHCCP Medicaid	$20,849.56

SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC

Facility

$101,160.01

Service Code	MSDRG 457
Min. Negotiated Rate	$44,330.04
Max. Negotiated Rate	$101,160.01
Rate for Payer: Aetna Medicare	$48,529.73
Rate for Payer: Allen County Amish Medical Aid Commercial	$58,329.00
Rate for Payer: Amish Plain Church Group Commercial	$58,329.00
Rate for Payer: BCBS MAPPO	$46,663.20
Rate for Payer: BCBS Trust/PPO	$101,160.01
Rate for Payer: BCN Commercial	$101,160.01
Rate for Payer: BCN Medicare Advantage	$46,663.20
Rate for Payer: Health Alliance Plan Medicare Advantage	$46,663.20
Rate for Payer: Mclaren Medicare	$46,663.20
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$48,996.36
Rate for Payer: MI Amish Medical Board Commercial	$53,662.68
Rate for Payer: Molina Medicare/Medicaid	$51,329.52
Rate for Payer: Nomi Health Commercial	$76,923.99
Rate for Payer: PACE Medicare	$44,330.04
Rate for Payer: PACE SWMI	$46,663.20
Rate for Payer: PHP Medicare Advantage	$46,663.20
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$96,137.93
Rate for Payer: Priority Health Medicare	$46,663.20
Rate for Payer: Priority Health Tiered Network	$76,910.33
Rate for Payer: Railroad Medicare Medicare	$46,663.20
Rate for Payer: UHC All Payor (Choice/PPO)	$97,198.53
Rate for Payer: UHC Core	$81,318.79
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$46,663.20
Rate for Payer: UHC Exchange	$66,411.04
Rate for Payer: VA VA	$46,663.20

SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC

Facility

$136,975.42

Service Code	MSDRG 456
Min. Negotiated Rate	$62,246.28
Max. Negotiated Rate	$136,975.42
Rate for Payer: Aetna Medicare	$68,143.30
Rate for Payer: Allen County Amish Medical Aid Commercial	$81,903.00
Rate for Payer: Amish Plain Church Group Commercial	$81,903.00
Rate for Payer: BCBS MAPPO	$65,522.40
Rate for Payer: BCBS Trust/PPO	$125,284.30
Rate for Payer: BCN Commercial	$125,284.30
Rate for Payer: BCN Medicare Advantage	$65,522.40
Rate for Payer: Health Alliance Plan Medicare Advantage	$65,522.40
Rate for Payer: Mclaren Medicare	$65,522.40
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$68,798.52
Rate for Payer: MI Amish Medical Board Commercial	$75,350.76
Rate for Payer: Molina Medicare/Medicaid	$72,074.64
Rate for Payer: Nomi Health Commercial	$108,403.86
Rate for Payer: PACE Medicare	$62,246.28
Rate for Payer: PACE SWMI	$65,522.40
Rate for Payer: PHP Medicare Advantage	$65,522.40
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$135,480.79
Rate for Payer: Priority Health Medicare	$65,522.40
Rate for Payer: Priority Health Tiered Network	$108,384.62
Rate for Payer: Railroad Medicare Medicare	$65,522.40
Rate for Payer: UHC All Payor (Choice/PPO)	$136,975.42
Rate for Payer: UHC Core	$114,597.17
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$65,522.40
Rate for Payer: UHC Exchange	$93,588.67
Rate for Payer: VA VA	$65,522.40

SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITHOUT CC/MCC

Facility

$96,249.01

Service Code	MSDRG 458
Min. Negotiated Rate	$31,184.52
Max. Negotiated Rate	$96,249.01
Rate for Payer: Aetna Medicare	$34,138.84
Rate for Payer: Allen County Amish Medical Aid Commercial	$41,032.26
Rate for Payer: Amish Plain Church Group Commercial	$41,032.26
Rate for Payer: BCBS MAPPO	$32,825.81
Rate for Payer: BCBS Trust/PPO	$96,249.01
Rate for Payer: BCN Commercial	$96,249.01
Rate for Payer: BCN Medicare Advantage	$32,825.81
Rate for Payer: Health Alliance Plan Medicare Advantage	$32,825.81
Rate for Payer: Mclaren Medicare	$32,825.81
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$34,467.10
Rate for Payer: MI Amish Medical Board Commercial	$37,749.68
Rate for Payer: Molina Medicare/Medicaid	$36,108.39
Rate for Payer: Nomi Health Commercial	$53,826.54
Rate for Payer: PACE Medicare	$31,184.52
Rate for Payer: PACE SWMI	$32,825.81
Rate for Payer: PHP Medicare Advantage	$32,825.81
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$67,271.24
Rate for Payer: Priority Health Medicare	$32,825.81
Rate for Payer: Priority Health Tiered Network	$53,816.98
Rate for Payer: Railroad Medicare Medicare	$32,825.81
Rate for Payer: UHC All Payor (Choice/PPO)	$68,013.38
Rate for Payer: UHC Core	$56,901.75
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$32,825.81
Rate for Payer: UHC Exchange	$46,470.25
Rate for Payer: VA VA	$32,825.81

SPINAL PROCEDURES

Facility

$23,071.89

Service Code	APR-DRG 0233
Min. Negotiated Rate	$21,973.22
Max. Negotiated Rate	$23,071.89
Rate for Payer: BCBS Complete	$23,071.89
Rate for Payer: Mclaren Medicaid	$21,973.22
Rate for Payer: Meridian Medicaid	$23,071.89
Rate for Payer: Priority Health Choice Medicaid	$21,973.22
Rate for Payer: UHC Medicaid	$21,973.22
Rate for Payer: UHCCP Medicaid	$21,973.22

SPINAL PROCEDURES

Facility

$9,754.13

Service Code	APR-DRG 0231
Min. Negotiated Rate	$9,289.64
Max. Negotiated Rate	$9,754.13
Rate for Payer: BCBS Complete	$9,754.13
Rate for Payer: Mclaren Medicaid	$9,289.64
Rate for Payer: Meridian Medicaid	$9,754.13
Rate for Payer: Priority Health Choice Medicaid	$9,289.64
Rate for Payer: UHC Medicaid	$9,289.64
Rate for Payer: UHCCP Medicaid	$9,289.64

SPINAL PROCEDURES

Facility

$14,778.53

Service Code	APR-DRG 0232
Min. Negotiated Rate	$14,074.79
Max. Negotiated Rate	$14,778.53
Rate for Payer: BCBS Complete	$14,778.53
Rate for Payer: Mclaren Medicaid	$14,074.79
Rate for Payer: Meridian Medicaid	$14,778.53
Rate for Payer: Priority Health Choice Medicaid	$14,074.79
Rate for Payer: UHC Medicaid	$14,074.79
Rate for Payer: UHCCP Medicaid	$14,074.79

SPINAL PROCEDURES

Facility

$29,447.55

Service Code	APR-DRG 0234
Min. Negotiated Rate	$28,045.29
Max. Negotiated Rate	$29,447.55
Rate for Payer: BCBS Complete	$29,447.55
Rate for Payer: Mclaren Medicaid	$28,045.29
Rate for Payer: Meridian Medicaid	$29,447.55
Rate for Payer: Priority Health Choice Medicaid	$28,045.29
Rate for Payer: UHC Medicaid	$28,045.29
Rate for Payer: UHCCP Medicaid	$28,045.29

SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS

Facility

$59,961.93

Service Code	MSDRG 029
Min. Negotiated Rate	$25,597.39
Max. Negotiated Rate	$59,961.93
Rate for Payer: Aetna Medicare	$28,022.40
Rate for Payer: Allen County Amish Medical Aid Commercial	$33,680.78
Rate for Payer: Amish Plain Church Group Commercial	$33,680.78
Rate for Payer: BCBS MAPPO	$26,944.62
Rate for Payer: BCBS Trust/PPO	$59,961.93
Rate for Payer: BCN Commercial	$59,961.93
Rate for Payer: BCN Medicare Advantage	$26,944.62
Rate for Payer: Health Alliance Plan Medicare Advantage	$26,944.62
Rate for Payer: Mclaren Medicare	$26,944.62
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$28,291.85
Rate for Payer: MI Amish Medical Board Commercial	$30,986.31
Rate for Payer: Molina Medicare/Medicaid	$29,639.08
Rate for Payer: Nomi Health Commercial	$44,009.64
Rate for Payer: PACE Medicare	$25,597.39
Rate for Payer: PACE SWMI	$26,944.62
Rate for Payer: PHP Medicare Advantage	$26,944.62
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$55,002.29
Rate for Payer: Priority Health Medicare	$26,944.62
Rate for Payer: Priority Health Tiered Network	$44,001.83
Rate for Payer: Railroad Medicare Medicare	$26,944.62
Rate for Payer: UHC All Payor (Choice/PPO)	$55,609.08
Rate for Payer: UHC Core	$46,523.99
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$26,944.62
Rate for Payer: UHC Exchange	$37,994.99
Rate for Payer: VA VA	$26,944.62

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