Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

THIORIDAZINE 25 MG TABLET

Facility

$264.00

Service Code	NDC 51079056620
Hospital Charge Code	7899
Hospital Revenue Code	637
Min. Negotiated Rate	$166.32
Max. Negotiated Rate	$237.60
Rate for Payer: Aetna Commercial	$224.40
Rate for Payer: Aetna New Business (MI Preferred)	$171.60
Rate for Payer: Cash Price	$211.20
Rate for Payer: Cofinity Advantage	$184.80
Rate for Payer: Cofinity Commercial	$227.04
Rate for Payer: Encore Health Key Benefits Commercial	$211.20
Rate for Payer: Healthscope Commercial	$237.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$224.40
Rate for Payer: Opus (Opus Packaging Group) HMA	$198.00
Rate for Payer: PHP Commercial	$224.40
Rate for Payer: Priority Health SBD	$166.32

THIORIDAZINE 25 MG TABLET

Facility

$2.64

Service Code	NDC 51079056601
Hospital Charge Code	7899
Hospital Revenue Code	637
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$2.38
Rate for Payer: Aetna Commercial	$2.24
Rate for Payer: Aetna Medicare	$1.32
Rate for Payer: Aetna New Business (MI Preferred)	$1.72
Rate for Payer: BCBS Complete	$1.06
Rate for Payer: Cash Price	$2.11
Rate for Payer: Cofinity Advantage	$1.85
Rate for Payer: Cofinity Commercial	$2.27
Rate for Payer: Encore Health Key Benefits Commercial	$2.11
Rate for Payer: Healthscope Commercial	$2.38
Rate for Payer: MI Amish Medical Board Commercial	$2.11
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2.24
Rate for Payer: Opus (Opus Packaging Group) HMA	$1.98
Rate for Payer: PHP Commercial	$2.24
Rate for Payer: Priority Health SBD	$1.66
Rate for Payer: UHC All Payor (Choice/PPO)	$1.72
Rate for Payer: UHC Core	$1.38
Rate for Payer: UHC Exchange	$1.04

THIORIDAZINE 25 MG TABLET

Facility

$264.00

Service Code	NDC 51079056620
Hospital Charge Code	7899
Hospital Revenue Code	637
Min. Negotiated Rate	$103.75
Max. Negotiated Rate	$237.60
Rate for Payer: Aetna Commercial	$224.40
Rate for Payer: Aetna Medicare	$132.00
Rate for Payer: Aetna New Business (MI Preferred)	$171.60
Rate for Payer: BCBS Complete	$105.60
Rate for Payer: Cash Price	$211.20
Rate for Payer: Cofinity Advantage	$184.80
Rate for Payer: Cofinity Commercial	$227.04
Rate for Payer: Encore Health Key Benefits Commercial	$211.20
Rate for Payer: Healthscope Commercial	$237.60
Rate for Payer: MI Amish Medical Board Commercial	$211.20
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$224.40
Rate for Payer: Opus (Opus Packaging Group) HMA	$198.00
Rate for Payer: PHP Commercial	$224.40
Rate for Payer: Priority Health SBD	$166.32
Rate for Payer: UHC All Payor (Choice/PPO)	$171.60
Rate for Payer: UHC Core	$137.54
Rate for Payer: UHC Exchange	$103.75

THIORIDAZINE 25 MG TABLET

Facility

$299.04

Service Code	NDC 00378061401
Hospital Charge Code	7899
Hospital Revenue Code	637
Min. Negotiated Rate	$188.40
Max. Negotiated Rate	$269.14
Rate for Payer: Aetna Commercial	$254.18
Rate for Payer: Aetna New Business (MI Preferred)	$194.38
Rate for Payer: Cash Price	$239.23
Rate for Payer: Cofinity Advantage	$209.33
Rate for Payer: Cofinity Commercial	$257.17
Rate for Payer: Encore Health Key Benefits Commercial	$239.23
Rate for Payer: Healthscope Commercial	$269.14
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$254.18
Rate for Payer: Opus (Opus Packaging Group) HMA	$224.28
Rate for Payer: PHP Commercial	$254.18
Rate for Payer: Priority Health SBD	$188.40

THIORIDAZINE 25 MG TABLET

Facility

$299.04

Service Code	NDC 00378061401
Hospital Charge Code	7899
Hospital Revenue Code	637
Min. Negotiated Rate	$117.52
Max. Negotiated Rate	$269.14
Rate for Payer: Aetna Commercial	$254.18
Rate for Payer: Aetna Medicare	$149.52
Rate for Payer: Aetna New Business (MI Preferred)	$194.38
Rate for Payer: BCBS Complete	$119.62
Rate for Payer: Cash Price	$239.23
Rate for Payer: Cofinity Advantage	$209.33
Rate for Payer: Cofinity Commercial	$257.17
Rate for Payer: Encore Health Key Benefits Commercial	$239.23
Rate for Payer: Healthscope Commercial	$269.14
Rate for Payer: MI Amish Medical Board Commercial	$239.23
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$254.18
Rate for Payer: Opus (Opus Packaging Group) HMA	$224.28
Rate for Payer: PHP Commercial	$254.18
Rate for Payer: Priority Health SBD	$188.40
Rate for Payer: UHC All Payor (Choice/PPO)	$194.38
Rate for Payer: UHC Core	$155.80
Rate for Payer: UHC Exchange	$117.52

THORACENTESIS, NEEDLE OR CATHETER, ASPIRATION OF THE PLEURAL SPACE; WITH IMAGING GUIDANCE

Facility

$2,021.35

Service Code	CPT 32555
Hospital Revenue Code	361
Min. Negotiated Rate	$326.90
Max. Negotiated Rate	$2,021.35
Rate for Payer: Aetna Medicare	$650.05
Rate for Payer: Allen County Amish Medical Aid Commercial	$781.31
Rate for Payer: Amish Plain Church Group Commercial	$781.31
Rate for Payer: BCBS Complete	$343.28
Rate for Payer: BCBS MAPPO	$625.05
Rate for Payer: BCBS Trust/PPO	$536.25
Rate for Payer: BCN Commercial	$536.25
Rate for Payer: BCN Medicare Advantage	$625.05
Rate for Payer: Health Alliance Plan Medicare Advantage	$625.05
Rate for Payer: Mclaren Medicaid	$326.90
Rate for Payer: Mclaren Medicare	$625.05
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$656.30
Rate for Payer: Meridian Medicaid	$656.30
Rate for Payer: MI Amish Medical Board Commercial	$718.81
Rate for Payer: Molina Medicare/Medicaid	$687.55
Rate for Payer: Nomi Health Commercial	$1,875.15
Rate for Payer: PACE Medicare	$593.80
Rate for Payer: PACE SWMI	$625.05
Rate for Payer: PHP Medicare Advantage	$625.05
Rate for Payer: Priority Health Choice Medicaid	$326.90
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$2,021.35
Rate for Payer: Priority Health Medicare	$625.05
Rate for Payer: Priority Health Tiered Network	$1,617.08
Rate for Payer: Railroad Medicare Medicare	$625.05
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$625.05
Rate for Payer: UHC Medicaid	$326.90
Rate for Payer: UHCCP Medicaid	$326.90
Rate for Payer: VA VA	$625.05

THROMBECTOMY, OPEN, ARTERIOVENOUS FISTULA WITHOUT REVISION, AUTOGENOUS OR NONAUTOGENOUS DIALYSIS GRAFT (SEPARATE PROCEDURE)

Facility

$17,930.33

Service Code	CPT 36831
Hospital Revenue Code	360
Min. Negotiated Rate	$2,157.03
Max. Negotiated Rate	$17,930.33
Rate for Payer: Aetna Medicare	$5,766.26
Rate for Payer: Allen County Amish Medical Aid Commercial	$6,930.60
Rate for Payer: Amish Plain Church Group Commercial	$6,930.60
Rate for Payer: BCBS Complete	$3,045.03
Rate for Payer: BCBS MAPPO	$5,544.48
Rate for Payer: BCBS Trust/PPO	$2,157.03
Rate for Payer: BCN Commercial	$2,157.03
Rate for Payer: BCN Medicare Advantage	$5,544.48
Rate for Payer: Health Alliance Plan Medicare Advantage	$5,544.48
Rate for Payer: Mclaren Medicaid	$2,899.76
Rate for Payer: Mclaren Medicare	$5,544.48
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$5,821.70
Rate for Payer: Meridian Medicaid	$5,821.70
Rate for Payer: MI Amish Medical Board Commercial	$6,376.15
Rate for Payer: Molina Medicare/Medicaid	$6,098.93
Rate for Payer: Nomi Health Commercial	$16,633.44
Rate for Payer: PACE Medicare	$5,267.26
Rate for Payer: PACE SWMI	$5,544.48
Rate for Payer: PHP Medicare Advantage	$5,544.48
Rate for Payer: Priority Health Choice Medicaid	$2,899.76
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$17,930.33
Rate for Payer: Priority Health Medicare	$5,544.48
Rate for Payer: Priority Health Tiered Network	$14,344.26
Rate for Payer: Railroad Medicare Medicare	$5,544.48
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$5,544.48
Rate for Payer: UHC Medicaid	$2,899.76
Rate for Payer: UHCCP Medicaid	$2,899.76
Rate for Payer: VA VA	$5,544.48

THROMBIN 5000UNITS/EPINEPHRINE TOPICAL 30ML/NS 1L

Facility

$218.05

Service Code	NDC 09900000200
Hospital Charge Code	500527
Hospital Revenue Code	250
Min. Negotiated Rate	$137.37
Max. Negotiated Rate	$196.25
Rate for Payer: Aetna Commercial	$185.34
Rate for Payer: Aetna New Business (MI Preferred)	$141.73
Rate for Payer: Cash Price	$174.44
Rate for Payer: Cofinity Advantage	$152.63
Rate for Payer: Cofinity Commercial	$187.52
Rate for Payer: Encore Health Key Benefits Commercial	$174.44
Rate for Payer: Healthscope Commercial	$196.25
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$185.34
Rate for Payer: Opus (Opus Packaging Group) HMA	$163.54
Rate for Payer: PHP Commercial	$185.34
Rate for Payer: Priority Health SBD	$137.37

THROMBIN 5000UNITS/EPINEPHRINE TOPICAL 30ML/NS 1L

Facility

$218.05

Service Code	NDC 09900000200
Hospital Charge Code	500527
Hospital Revenue Code	250
Min. Negotiated Rate	$85.69
Max. Negotiated Rate	$196.25
Rate for Payer: Aetna Commercial	$185.34
Rate for Payer: Aetna Medicare	$109.03
Rate for Payer: Aetna New Business (MI Preferred)	$141.73
Rate for Payer: BCBS Complete	$87.22
Rate for Payer: Cash Price	$174.44
Rate for Payer: Cofinity Advantage	$152.63
Rate for Payer: Cofinity Commercial	$187.52
Rate for Payer: Encore Health Key Benefits Commercial	$174.44
Rate for Payer: Healthscope Commercial	$196.25
Rate for Payer: MI Amish Medical Board Commercial	$174.44
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$185.34
Rate for Payer: Opus (Opus Packaging Group) HMA	$163.54
Rate for Payer: PHP Commercial	$185.34
Rate for Payer: Priority Health SBD	$137.37
Rate for Payer: UHC All Payor (Choice/PPO)	$141.73
Rate for Payer: UHC Core	$113.60
Rate for Payer: UHC Exchange	$85.69

THROMBIN (BOVINE) 20,000 UNIT TOPICAL SPRAY

Facility

$876.13

Service Code	NDC 60793021722
Hospital Charge Code	108841
Hospital Revenue Code	250
Min. Negotiated Rate	$551.96
Max. Negotiated Rate	$788.52
Rate for Payer: Aetna Commercial	$744.71
Rate for Payer: Aetna New Business (MI Preferred)	$569.48
Rate for Payer: Cash Price	$700.90
Rate for Payer: Cofinity Advantage	$613.29
Rate for Payer: Cofinity Commercial	$753.47
Rate for Payer: Encore Health Key Benefits Commercial	$700.90
Rate for Payer: Healthscope Commercial	$788.52
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$744.71
Rate for Payer: Opus (Opus Packaging Group) HMA	$657.10
Rate for Payer: PHP Commercial	$744.71
Rate for Payer: Priority Health SBD	$551.96

THROMBIN (BOVINE) 20,000 UNIT TOPICAL SPRAY

Facility

$876.13

Service Code	NDC 60793021722
Hospital Charge Code	108841
Hospital Revenue Code	250
Min. Negotiated Rate	$344.32
Max. Negotiated Rate	$788.52
Rate for Payer: Aetna Commercial	$744.71
Rate for Payer: Aetna Medicare	$438.06
Rate for Payer: Aetna New Business (MI Preferred)	$569.48
Rate for Payer: BCBS Complete	$350.45
Rate for Payer: Cash Price	$700.90
Rate for Payer: Cofinity Advantage	$613.29
Rate for Payer: Cofinity Commercial	$753.47
Rate for Payer: Encore Health Key Benefits Commercial	$700.90
Rate for Payer: Healthscope Commercial	$788.52
Rate for Payer: MI Amish Medical Board Commercial	$700.90
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$744.71
Rate for Payer: Opus (Opus Packaging Group) HMA	$657.10
Rate for Payer: PHP Commercial	$744.71
Rate for Payer: Priority Health SBD	$551.96
Rate for Payer: UHC All Payor (Choice/PPO)	$569.48
Rate for Payer: UHC Core	$456.46
Rate for Payer: UHC Exchange	$344.32

THROMBIN (BOVINE) 5,000 UNIT TOPICAL SOLUTION

Facility

$194.11

Service Code	NDC 60793021505
Hospital Charge Code	117741
Hospital Revenue Code	250
Min. Negotiated Rate	$76.29
Max. Negotiated Rate	$174.70
Rate for Payer: Aetna Commercial	$164.99
Rate for Payer: Aetna Medicare	$97.06
Rate for Payer: Aetna New Business (MI Preferred)	$126.17
Rate for Payer: BCBS Complete	$77.64
Rate for Payer: Cash Price	$155.29
Rate for Payer: Cofinity Advantage	$135.88
Rate for Payer: Cofinity Commercial	$166.93
Rate for Payer: Encore Health Key Benefits Commercial	$155.29
Rate for Payer: Healthscope Commercial	$174.70
Rate for Payer: MI Amish Medical Board Commercial	$155.29
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$164.99
Rate for Payer: Opus (Opus Packaging Group) HMA	$145.58
Rate for Payer: PHP Commercial	$164.99
Rate for Payer: Priority Health SBD	$122.29
Rate for Payer: UHC All Payor (Choice/PPO)	$126.17
Rate for Payer: UHC Core	$101.13
Rate for Payer: UHC Exchange	$76.29

THROMBIN (BOVINE) 5,000 UNIT TOPICAL SOLUTION

Facility

$194.11

Service Code	NDC 60793021505
Hospital Charge Code	117741
Hospital Revenue Code	250
Min. Negotiated Rate	$122.29
Max. Negotiated Rate	$174.70
Rate for Payer: Aetna Commercial	$164.99
Rate for Payer: Aetna New Business (MI Preferred)	$126.17
Rate for Payer: Cash Price	$155.29
Rate for Payer: Cofinity Advantage	$135.88
Rate for Payer: Cofinity Commercial	$166.93
Rate for Payer: Encore Health Key Benefits Commercial	$155.29
Rate for Payer: Healthscope Commercial	$174.70
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$164.99
Rate for Payer: Opus (Opus Packaging Group) HMA	$145.58
Rate for Payer: PHP Commercial	$164.99
Rate for Payer: Priority Health SBD	$122.29

THYROID DISORDERS

Facility

$3,334.31

Service Code	APR-DRG 4271
Min. Negotiated Rate	$3,175.54
Max. Negotiated Rate	$3,334.31
Rate for Payer: BCBS Complete	$3,334.31
Rate for Payer: Mclaren Medicaid	$3,175.54
Rate for Payer: Meridian Medicaid	$3,334.31
Rate for Payer: Priority Health Choice Medicaid	$3,175.54
Rate for Payer: UHC Medicaid	$3,175.54
Rate for Payer: UHCCP Medicaid	$3,175.54

THYROID DISORDERS

Facility

$4,830.05

Service Code	APR-DRG 4272
Min. Negotiated Rate	$4,600.05
Max. Negotiated Rate	$4,830.05
Rate for Payer: BCBS Complete	$4,830.05
Rate for Payer: Mclaren Medicaid	$4,600.05
Rate for Payer: Meridian Medicaid	$4,830.05
Rate for Payer: Priority Health Choice Medicaid	$4,600.05
Rate for Payer: UHC Medicaid	$4,600.05
Rate for Payer: UHCCP Medicaid	$4,600.05

THYROID DISORDERS

Facility

$13,619.89

Service Code	APR-DRG 4274
Min. Negotiated Rate	$12,971.32
Max. Negotiated Rate	$13,619.89
Rate for Payer: BCBS Complete	$13,619.89
Rate for Payer: Mclaren Medicaid	$12,971.32
Rate for Payer: Meridian Medicaid	$13,619.89
Rate for Payer: Priority Health Choice Medicaid	$12,971.32
Rate for Payer: UHC Medicaid	$12,971.32
Rate for Payer: UHCCP Medicaid	$12,971.32

THYROID DISORDERS

Facility

$7,760.19

Service Code	APR-DRG 4273
Min. Negotiated Rate	$7,390.66
Max. Negotiated Rate	$7,760.19
Rate for Payer: BCBS Complete	$7,760.19
Rate for Payer: Mclaren Medicaid	$7,390.66
Rate for Payer: Meridian Medicaid	$7,760.19
Rate for Payer: Priority Health Choice Medicaid	$7,390.66
Rate for Payer: UHC Medicaid	$7,390.66
Rate for Payer: UHCCP Medicaid	$7,390.66

THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES

Facility

$7,268.30

Service Code	APR-DRG 4041
Min. Negotiated Rate	$6,922.19
Max. Negotiated Rate	$7,268.30
Rate for Payer: BCBS Complete	$7,268.30
Rate for Payer: Mclaren Medicaid	$6,922.19
Rate for Payer: Meridian Medicaid	$7,268.30
Rate for Payer: Priority Health Choice Medicaid	$6,922.19
Rate for Payer: UHC Medicaid	$6,922.19
Rate for Payer: UHCCP Medicaid	$6,922.19

THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES

Facility

$12,498.51

Service Code	APR-DRG 4043
Min. Negotiated Rate	$11,903.35
Max. Negotiated Rate	$12,498.51
Rate for Payer: BCBS Complete	$12,498.51
Rate for Payer: Mclaren Medicaid	$11,903.35
Rate for Payer: Meridian Medicaid	$12,498.51
Rate for Payer: Priority Health Choice Medicaid	$11,903.35
Rate for Payer: UHC Medicaid	$11,903.35
Rate for Payer: UHCCP Medicaid	$11,903.35

THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES

Facility

$10,513.75

Service Code	APR-DRG 4042
Min. Negotiated Rate	$10,013.09
Max. Negotiated Rate	$10,513.75
Rate for Payer: BCBS Complete	$10,513.75
Rate for Payer: Mclaren Medicaid	$10,013.09
Rate for Payer: Meridian Medicaid	$10,513.75
Rate for Payer: Priority Health Choice Medicaid	$10,013.09
Rate for Payer: UHC Medicaid	$10,013.09
Rate for Payer: UHCCP Medicaid	$10,013.09

THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES

Facility

$25,346.74

Service Code	APR-DRG 4044
Min. Negotiated Rate	$24,139.75
Max. Negotiated Rate	$25,346.74
Rate for Payer: BCBS Complete	$25,346.74
Rate for Payer: Mclaren Medicaid	$24,139.75
Rate for Payer: Meridian Medicaid	$25,346.74
Rate for Payer: Priority Health Choice Medicaid	$24,139.75
Rate for Payer: UHC Medicaid	$24,139.75
Rate for Payer: UHCCP Medicaid	$24,139.75

THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC

Facility

$31,263.72

Service Code	MSDRG 626
Min. Negotiated Rate	$11,558.36
Max. Negotiated Rate	$31,263.72
Rate for Payer: Aetna Medicare	$12,653.36
Rate for Payer: Allen County Amish Medical Aid Commercial	$15,208.36
Rate for Payer: Amish Plain Church Group Commercial	$15,208.36
Rate for Payer: BCBS MAPPO	$12,166.69
Rate for Payer: BCBS Trust/PPO	$31,263.72
Rate for Payer: BCN Commercial	$31,263.72
Rate for Payer: BCN Medicare Advantage	$12,166.69
Rate for Payer: Health Alliance Plan Medicare Advantage	$12,166.69
Rate for Payer: Mclaren Medicare	$12,166.69
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$12,775.02
Rate for Payer: MI Amish Medical Board Commercial	$13,991.69
Rate for Payer: Molina Medicare/Medicaid	$13,383.36
Rate for Payer: Nomi Health Commercial	$19,342.26
Rate for Payer: PACE Medicare	$11,558.36
Rate for Payer: PACE SWMI	$12,166.69
Rate for Payer: PHP Medicare Advantage	$12,166.69
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$24,173.54
Rate for Payer: Priority Health Medicare	$12,166.69
Rate for Payer: Priority Health Tiered Network	$19,338.83
Rate for Payer: Railroad Medicare Medicare	$12,166.69
Rate for Payer: UHC All Payor (Choice/PPO)	$24,440.22
Rate for Payer: UHC Core	$20,447.32
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$12,166.69
Rate for Payer: UHC Exchange	$16,698.82
Rate for Payer: VA VA	$12,166.69

THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC

Facility

$49,227.63

Service Code	MSDRG 625
Min. Negotiated Rate	$22,723.06
Max. Negotiated Rate	$49,227.63
Rate for Payer: Aetna Medicare	$24,875.77
Rate for Payer: Allen County Amish Medical Aid Commercial	$29,898.76
Rate for Payer: Amish Plain Church Group Commercial	$29,898.76
Rate for Payer: BCBS MAPPO	$23,919.01
Rate for Payer: BCBS Trust/PPO	$42,115.67
Rate for Payer: BCN Commercial	$42,115.67
Rate for Payer: BCN Medicare Advantage	$23,919.01
Rate for Payer: Health Alliance Plan Medicare Advantage	$23,919.01
Rate for Payer: Mclaren Medicare	$23,919.01
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$25,114.96
Rate for Payer: MI Amish Medical Board Commercial	$27,506.86
Rate for Payer: Molina Medicare/Medicaid	$26,310.91
Rate for Payer: Nomi Health Commercial	$38,959.29
Rate for Payer: PACE Medicare	$22,723.06
Rate for Payer: PACE SWMI	$23,919.01
Rate for Payer: PHP Medicare Advantage	$23,919.01
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$48,690.48
Rate for Payer: Priority Health Medicare	$23,919.01
Rate for Payer: Priority Health Tiered Network	$38,952.37
Rate for Payer: Railroad Medicare Medicare	$23,919.01
Rate for Payer: UHC All Payor (Choice/PPO)	$49,227.63
Rate for Payer: UHC Core	$41,185.10
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$23,919.01
Rate for Payer: UHC Exchange	$33,634.85
Rate for Payer: VA VA	$23,919.01

THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC

Facility

$25,900.95

Service Code	MSDRG 627
Min. Negotiated Rate	$10,302.19
Max. Negotiated Rate	$25,900.95
Rate for Payer: Aetna Medicare	$11,278.19
Rate for Payer: Allen County Amish Medical Aid Commercial	$13,555.51
Rate for Payer: Amish Plain Church Group Commercial	$13,555.51
Rate for Payer: BCBS MAPPO	$10,844.41
Rate for Payer: BCBS Trust/PPO	$25,900.95
Rate for Payer: BCN Commercial	$25,900.95
Rate for Payer: BCN Medicare Advantage	$10,844.41
Rate for Payer: Health Alliance Plan Medicare Advantage	$10,844.41
Rate for Payer: Mclaren Medicare	$10,844.41
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$11,386.63
Rate for Payer: MI Amish Medical Board Commercial	$12,471.07
Rate for Payer: Molina Medicare/Medicaid	$11,928.85
Rate for Payer: Nomi Health Commercial	$17,135.07
Rate for Payer: PACE Medicare	$10,302.19
Rate for Payer: PACE SWMI	$10,844.41
Rate for Payer: PHP Medicare Advantage	$10,844.41
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$21,415.04
Rate for Payer: Priority Health Medicare	$10,844.41
Rate for Payer: Priority Health Tiered Network	$17,132.03
Rate for Payer: Railroad Medicare Medicare	$10,844.41
Rate for Payer: UHC All Payor (Choice/PPO)	$21,651.29
Rate for Payer: UHC Core	$18,114.03
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$10,844.41
Rate for Payer: UHC Exchange	$14,793.28
Rate for Payer: VA VA	$10,844.41

THYROID (PORK) 30 MG TABLET

Facility

$307.20

Service Code	NDC 42192032901
Hospital Charge Code	119104
Hospital Revenue Code	637
Min. Negotiated Rate	$193.54
Max. Negotiated Rate	$276.48
Rate for Payer: Aetna Commercial	$261.12
Rate for Payer: Aetna New Business (MI Preferred)	$199.68
Rate for Payer: Cash Price	$245.76
Rate for Payer: Cofinity Advantage	$215.04
Rate for Payer: Cofinity Commercial	$264.19
Rate for Payer: Encore Health Key Benefits Commercial	$245.76
Rate for Payer: Healthscope Commercial	$276.48
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$261.12
Rate for Payer: Opus (Opus Packaging Group) HMA	$230.40
Rate for Payer: PHP Commercial	$261.12
Rate for Payer: Priority Health SBD	$193.54

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