Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

CEPHALEXIN 500 MG CAPSULE

Facility

$129.20

Service Code	NDC 50268015215
Hospital Charge Code	9500
Hospital Revenue Code	637
Min. Negotiated Rate	$81.40
Max. Negotiated Rate	$116.28
Rate for Payer: Aetna Commercial	$109.82
Rate for Payer: Aetna New Business (MI Preferred)	$83.98
Rate for Payer: Cash Price	$103.36
Rate for Payer: Cofinity Advantage	$90.44
Rate for Payer: Cofinity Commercial	$111.11
Rate for Payer: Encore Health Key Benefits Commercial	$103.36
Rate for Payer: Healthscope Commercial	$116.28
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$109.82
Rate for Payer: Opus (Opus Packaging Group) HMA	$96.90
Rate for Payer: PHP Commercial	$109.82
Rate for Payer: Priority Health SBD	$81.40

CEPHALEXIN 500 MG CAPSULE

Facility

$192.85

Service Code	NDC 00093314701
Hospital Charge Code	9500
Hospital Revenue Code	637
Min. Negotiated Rate	$75.79
Max. Negotiated Rate	$173.56
Rate for Payer: Aetna Commercial	$163.92
Rate for Payer: Aetna Medicare	$96.42
Rate for Payer: Aetna New Business (MI Preferred)	$125.35
Rate for Payer: BCBS Complete	$77.14
Rate for Payer: Cash Price	$154.28
Rate for Payer: Cofinity Advantage	$135.00
Rate for Payer: Cofinity Commercial	$165.85
Rate for Payer: Encore Health Key Benefits Commercial	$154.28
Rate for Payer: Healthscope Commercial	$173.56
Rate for Payer: MI Amish Medical Board Commercial	$154.28
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$163.92
Rate for Payer: Opus (Opus Packaging Group) HMA	$144.64
Rate for Payer: PHP Commercial	$163.92
Rate for Payer: Priority Health SBD	$121.50
Rate for Payer: UHC All Payor (Choice/PPO)	$125.35
Rate for Payer: UHC Core	$100.47
Rate for Payer: UHC Exchange	$75.79

CEPHALEXIN 500 MG CAPSULE

Facility

$334.40

Service Code	NDC 00904733761
Hospital Charge Code	9500
Hospital Revenue Code	637
Min. Negotiated Rate	$210.67
Max. Negotiated Rate	$300.96
Rate for Payer: Aetna Commercial	$284.24
Rate for Payer: Aetna New Business (MI Preferred)	$217.36
Rate for Payer: Cash Price	$267.52
Rate for Payer: Cofinity Advantage	$234.08
Rate for Payer: Cofinity Commercial	$287.58
Rate for Payer: Encore Health Key Benefits Commercial	$267.52
Rate for Payer: Healthscope Commercial	$300.96
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$284.24
Rate for Payer: Opus (Opus Packaging Group) HMA	$250.80
Rate for Payer: PHP Commercial	$284.24
Rate for Payer: Priority Health SBD	$210.67

CERTOLIZUMAB PEGOL 400 MG (200 MG X 2 VIALS) SUBCUTANEOUS KIT

Facility

$6,158.53

Service Code	HCPCS J0717
Hospital Charge Code	91495
Hospital Revenue Code	636
Min. Negotiated Rate	$1.98
Max. Negotiated Rate	$5,542.68
Rate for Payer: Aetna Commercial	$5,234.75
Rate for Payer: Aetna Medicare	$3.94
Rate for Payer: Aetna New Business (MI Preferred)	$4,003.04
Rate for Payer: Allen County Amish Medical Aid Commercial	$4.74
Rate for Payer: Amish Plain Church Group Commercial	$4.74
Rate for Payer: BCBS Complete	$2.08
Rate for Payer: BCBS MAPPO	$3.79
Rate for Payer: BCBS Trust/PPO	$9.68
Rate for Payer: BCN Commercial	$9.68
Rate for Payer: BCN Medicare Advantage	$3.79
Rate for Payer: Cash Price	$4,926.82
Rate for Payer: Cash Price	$4,926.82
Rate for Payer: Cofinity Advantage	$4,310.97
Rate for Payer: Cofinity Commercial	$5,296.34
Rate for Payer: Encore Health Key Benefits Commercial	$4,926.82
Rate for Payer: Health Alliance Plan Medicare Advantage	$3.79
Rate for Payer: Healthscope Commercial	$5,542.68
Rate for Payer: Mclaren Medicaid	$1.98
Rate for Payer: Mclaren Medicare	$3.79
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$3.98
Rate for Payer: Meridian Medicaid	$3.98
Rate for Payer: MI Amish Medical Board Commercial	$4.36
Rate for Payer: Molina Medicare/Medicaid	$4.17
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$5,234.75
Rate for Payer: Nomi Health Commercial	$11.37
Rate for Payer: Opus (Opus Packaging Group) HMA	$4,618.90
Rate for Payer: PACE Medicare	$3.60
Rate for Payer: PACE SWMI	$3.79
Rate for Payer: PHP Commercial	$5,234.75
Rate for Payer: PHP Medicare Advantage	$3.79
Rate for Payer: Priority Health Choice Medicaid	$1.98
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$12.34
Rate for Payer: Priority Health Medicare	$3.79
Rate for Payer: Priority Health SBD	$3,879.87
Rate for Payer: Priority Health Tiered Network	$9.87
Rate for Payer: Railroad Medicare Medicare	$3.79
Rate for Payer: UHC All Payor (Choice/PPO)	$6.39
Rate for Payer: UHC Core	$6.39
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$3.79
Rate for Payer: UHC Exchange	$6.39
Rate for Payer: UHC Medicaid	$1.98
Rate for Payer: UHCCP Medicaid	$1.98
Rate for Payer: VA VA	$3.79

CERTOLIZUMAB PEGOL 400 MG (200 MG X 2 VIALS) SUBCUTANEOUS KIT

Facility

$6,158.53

Service Code	HCPCS J0717
Hospital Charge Code	91495
Hospital Revenue Code	636
Min. Negotiated Rate	$3,879.87
Max. Negotiated Rate	$5,542.68
Rate for Payer: Aetna Commercial	$5,234.75
Rate for Payer: Aetna New Business (MI Preferred)	$4,003.04
Rate for Payer: Cash Price	$4,926.82
Rate for Payer: Cofinity Advantage	$4,310.97
Rate for Payer: Cofinity Commercial	$5,296.34
Rate for Payer: Encore Health Key Benefits Commercial	$4,926.82
Rate for Payer: Healthscope Commercial	$5,542.68
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$5,234.75
Rate for Payer: Opus (Opus Packaging Group) HMA	$4,618.90
Rate for Payer: PHP Commercial	$5,234.75
Rate for Payer: Priority Health SBD	$3,879.87

CERVICAL SPINAL FUSION WITH CC

Facility

$48,021.43

Service Code	MSDRG 472
Min. Negotiated Rate	$22,179.76
Max. Negotiated Rate	$48,021.43
Rate for Payer: Aetna Medicare	$24,281.00
Rate for Payer: Allen County Amish Medical Aid Commercial	$29,183.90
Rate for Payer: Amish Plain Church Group Commercial	$29,183.90
Rate for Payer: BCBS MAPPO	$23,347.12
Rate for Payer: BCBS Trust/PPO	$45,678.37
Rate for Payer: BCN Commercial	$45,678.37
Rate for Payer: BCN Medicare Advantage	$23,347.12
Rate for Payer: Health Alliance Plan Medicare Advantage	$23,347.12
Rate for Payer: Mclaren Medicare	$23,347.12
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$24,514.48
Rate for Payer: MI Amish Medical Board Commercial	$26,849.19
Rate for Payer: Molina Medicare/Medicaid	$25,681.83
Rate for Payer: Nomi Health Commercial	$38,004.69
Rate for Payer: PACE Medicare	$22,179.76
Rate for Payer: PACE SWMI	$23,347.12
Rate for Payer: PHP Medicare Advantage	$23,347.12
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$47,497.44
Rate for Payer: Priority Health Medicare	$23,347.12
Rate for Payer: Priority Health Tiered Network	$37,997.94
Rate for Payer: Railroad Medicare Medicare	$23,347.12
Rate for Payer: UHC All Payor (Choice/PPO)	$48,021.43
Rate for Payer: UHC Core	$40,175.97
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$23,347.12
Rate for Payer: UHC Exchange	$32,810.72
Rate for Payer: VA VA	$23,347.12

CERVICAL SPINAL FUSION WITH MCC

Facility

$78,707.81

Service Code	MSDRG 471
Min. Negotiated Rate	$36,001.49
Max. Negotiated Rate	$78,707.81
Rate for Payer: Aetna Medicare	$39,412.15
Rate for Payer: Allen County Amish Medical Aid Commercial	$47,370.38
Rate for Payer: Amish Plain Church Group Commercial	$47,370.38
Rate for Payer: BCBS MAPPO	$37,896.30
Rate for Payer: BCBS Trust/PPO	$60,497.98
Rate for Payer: BCN Commercial	$60,497.98
Rate for Payer: BCN Medicare Advantage	$37,896.30
Rate for Payer: Health Alliance Plan Medicare Advantage	$37,896.30
Rate for Payer: Mclaren Medicare	$37,896.30
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$39,791.11
Rate for Payer: MI Amish Medical Board Commercial	$43,580.75
Rate for Payer: Molina Medicare/Medicaid	$41,685.93
Rate for Payer: Nomi Health Commercial	$62,290.23
Rate for Payer: PACE Medicare	$36,001.49
Rate for Payer: PACE SWMI	$37,896.30
Rate for Payer: PHP Medicare Advantage	$37,896.30
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$77,848.98
Rate for Payer: Priority Health Medicare	$37,896.30
Rate for Payer: Priority Health Tiered Network	$62,279.17
Rate for Payer: Railroad Medicare Medicare	$37,896.30
Rate for Payer: UHC All Payor (Choice/PPO)	$78,707.81
Rate for Payer: UHC Core	$65,848.98
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$37,896.30
Rate for Payer: UHC Exchange	$53,777.23
Rate for Payer: VA VA	$37,896.30

CERVICAL SPINAL FUSION WITHOUT CC/MCC

Facility

$39,793.19

Service Code	MSDRG 473
Min. Negotiated Rate	$18,473.63
Max. Negotiated Rate	$39,793.19
Rate for Payer: Aetna Medicare	$20,223.77
Rate for Payer: Allen County Amish Medical Aid Commercial	$24,307.41
Rate for Payer: Amish Plain Church Group Commercial	$24,307.41
Rate for Payer: BCBS MAPPO	$19,445.93
Rate for Payer: BCBS Trust/PPO	$37,349.80
Rate for Payer: BCN Commercial	$37,349.80
Rate for Payer: BCN Medicare Advantage	$19,445.93
Rate for Payer: Health Alliance Plan Medicare Advantage	$19,445.93
Rate for Payer: Mclaren Medicare	$19,445.93
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$20,418.23
Rate for Payer: MI Amish Medical Board Commercial	$22,362.82
Rate for Payer: Molina Medicare/Medicaid	$21,390.52
Rate for Payer: Nomi Health Commercial	$31,492.77
Rate for Payer: PACE Medicare	$18,473.63
Rate for Payer: PACE SWMI	$19,445.93
Rate for Payer: PHP Medicare Advantage	$19,445.93
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$39,358.98
Rate for Payer: Priority Health Medicare	$19,445.93
Rate for Payer: Priority Health Tiered Network	$31,487.18
Rate for Payer: Railroad Medicare Medicare	$19,445.93
Rate for Payer: UHC All Payor (Choice/PPO)	$39,793.19
Rate for Payer: UHC Core	$33,292.01
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$19,445.93
Rate for Payer: UHC Exchange	$27,188.76
Rate for Payer: VA VA	$19,445.93

CESAREAN SECTION WITHOUT STERILIZATION

Facility

$17,119.31

Service Code	APR-DRG 5404
Min. Negotiated Rate	$2,100.00
Max. Negotiated Rate	$17,119.31
Rate for Payer: BCBS Complete	$17,119.31
Rate for Payer: Mclaren Medicaid	$16,304.11
Rate for Payer: Meridian Medicaid	$2,100.00
Rate for Payer: Priority Health Choice Medicaid	$16,304.11
Rate for Payer: UHC Medicaid	$16,304.11
Rate for Payer: UHCCP Medicaid	$16,304.11

CESAREAN SECTION WITHOUT STERILIZATION

Facility

$7,036.11

Service Code	APR-DRG 5403
Min. Negotiated Rate	$2,100.00
Max. Negotiated Rate	$7,036.11
Rate for Payer: BCBS Complete	$7,036.11
Rate for Payer: Mclaren Medicaid	$6,701.06
Rate for Payer: Meridian Medicaid	$2,100.00
Rate for Payer: Priority Health Choice Medicaid	$6,701.06
Rate for Payer: UHC Medicaid	$6,701.06
Rate for Payer: UHCCP Medicaid	$6,701.06

CESAREAN SECTION WITHOUT STERILIZATION

Facility

$5,893.52

Service Code	APR-DRG 5402
Min. Negotiated Rate	$2,100.00
Max. Negotiated Rate	$5,893.52
Rate for Payer: BCBS Complete	$5,893.52
Rate for Payer: Mclaren Medicaid	$5,612.88
Rate for Payer: Meridian Medicaid	$2,100.00
Rate for Payer: Priority Health Choice Medicaid	$5,612.88
Rate for Payer: UHC Medicaid	$5,612.88
Rate for Payer: UHCCP Medicaid	$5,612.88

CESAREAN SECTION WITHOUT STERILIZATION

Facility

$4,562.89

Service Code	APR-DRG 5401
Min. Negotiated Rate	$2,100.00
Max. Negotiated Rate	$4,562.89
Rate for Payer: BCBS Complete	$4,562.89
Rate for Payer: Mclaren Medicaid	$4,345.61
Rate for Payer: Meridian Medicaid	$2,100.00
Rate for Payer: Priority Health Choice Medicaid	$4,345.61
Rate for Payer: UHC Medicaid	$4,345.61
Rate for Payer: UHCCP Medicaid	$4,345.61

CESAREAN SECTION WITHOUT STERILIZATION WITH CC

Facility

$18,203.84

Service Code	MSDRG 787
Min. Negotiated Rate	$8,749.39
Max. Negotiated Rate	$18,203.84
Rate for Payer: Aetna Medicare	$9,578.28
Rate for Payer: Allen County Amish Medical Aid Commercial	$11,512.35
Rate for Payer: Amish Plain Church Group Commercial	$11,512.35
Rate for Payer: BCBS MAPPO	$9,209.88
Rate for Payer: BCBS Trust/PPO	$14,866.42
Rate for Payer: BCN Commercial	$14,866.42
Rate for Payer: BCN Medicare Advantage	$9,209.88
Rate for Payer: Health Alliance Plan Medicare Advantage	$9,209.88
Rate for Payer: Mclaren Medicare	$9,209.88
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$9,670.37
Rate for Payer: MI Amish Medical Board Commercial	$10,591.36
Rate for Payer: Molina Medicare/Medicaid	$10,130.87
Rate for Payer: Nomi Health Commercial	$14,406.72
Rate for Payer: PACE Medicare	$8,749.39
Rate for Payer: PACE SWMI	$9,209.88
Rate for Payer: PHP Medicare Advantage	$9,209.88
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$14,632.45
Rate for Payer: Priority Health Medicare	$9,209.88
Rate for Payer: Priority Health Tiered Network	$11,705.96
Rate for Payer: Railroad Medicare Medicare	$9,209.88
Rate for Payer: UHC All Payor (Choice/PPO)	$18,203.84
Rate for Payer: UHC Core	$15,229.80
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$9,209.88
Rate for Payer: UHC Exchange	$12,437.80
Rate for Payer: VA VA	$9,209.88

CESAREAN SECTION WITHOUT STERILIZATION WITH MCC

Facility

$26,886.85

Service Code	MSDRG 786
Min. Negotiated Rate	$12,660.36
Max. Negotiated Rate	$26,886.85
Rate for Payer: Aetna Medicare	$13,859.77
Rate for Payer: Allen County Amish Medical Aid Commercial	$16,658.38
Rate for Payer: Amish Plain Church Group Commercial	$16,658.38
Rate for Payer: BCBS MAPPO	$13,326.70
Rate for Payer: BCBS Trust/PPO	$20,498.39
Rate for Payer: BCN Commercial	$20,498.39
Rate for Payer: BCN Medicare Advantage	$13,326.70
Rate for Payer: Health Alliance Plan Medicare Advantage	$13,326.70
Rate for Payer: Mclaren Medicare	$13,326.70
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$13,993.03
Rate for Payer: MI Amish Medical Board Commercial	$15,325.70
Rate for Payer: Molina Medicare/Medicaid	$14,659.37
Rate for Payer: Nomi Health Commercial	$21,278.55
Rate for Payer: PACE Medicare	$12,660.36
Rate for Payer: PACE SWMI	$13,326.70
Rate for Payer: PHP Medicare Advantage	$13,326.70
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$21,044.23
Rate for Payer: Priority Health Medicare	$13,326.70
Rate for Payer: Priority Health Tiered Network	$16,835.38
Rate for Payer: Railroad Medicare Medicare	$13,326.70
Rate for Payer: UHC All Payor (Choice/PPO)	$26,886.85
Rate for Payer: UHC Core	$22,494.23
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$13,326.70
Rate for Payer: UHC Exchange	$18,370.48
Rate for Payer: VA VA	$13,326.70

CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC

Facility

$15,628.44

Service Code	MSDRG 788
Min. Negotiated Rate	$7,589.39
Max. Negotiated Rate	$15,628.44
Rate for Payer: Aetna Medicare	$8,308.38
Rate for Payer: Allen County Amish Medical Aid Commercial	$9,986.04
Rate for Payer: Amish Plain Church Group Commercial	$9,986.04
Rate for Payer: BCBS MAPPO	$7,988.83
Rate for Payer: BCBS Trust/PPO	$13,590.68
Rate for Payer: BCN Commercial	$13,590.68
Rate for Payer: BCN Medicare Advantage	$7,988.83
Rate for Payer: Health Alliance Plan Medicare Advantage	$7,988.83
Rate for Payer: Mclaren Medicare	$7,988.83
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$8,388.27
Rate for Payer: MI Amish Medical Board Commercial	$9,187.15
Rate for Payer: Molina Medicare/Medicaid	$8,787.71
Rate for Payer: Nomi Health Commercial	$12,368.52
Rate for Payer: PACE Medicare	$7,589.39
Rate for Payer: PACE SWMI	$7,988.83
Rate for Payer: PHP Medicare Advantage	$7,988.83
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$13,099.24
Rate for Payer: Priority Health Medicare	$7,988.83
Rate for Payer: Priority Health Tiered Network	$10,479.39
Rate for Payer: Railroad Medicare Medicare	$7,988.83
Rate for Payer: UHC All Payor (Choice/PPO)	$15,628.44
Rate for Payer: UHC Core	$13,075.16
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$7,988.83
Rate for Payer: UHC Exchange	$10,678.16
Rate for Payer: VA VA	$7,988.83

CESAREAN SECTION WITH STERILIZATION

Facility

$2,915.80

Service Code	APR-DRG 5391
Min. Negotiated Rate	$2,100.00
Max. Negotiated Rate	$2,915.80
Rate for Payer: BCBS Complete	$2,915.80
Rate for Payer: Mclaren Medicaid	$2,776.96
Rate for Payer: Meridian Medicaid	$2,100.00
Rate for Payer: Priority Health Choice Medicaid	$2,776.96
Rate for Payer: UHC Medicaid	$2,776.96
Rate for Payer: UHCCP Medicaid	$2,776.96

CESAREAN SECTION WITH STERILIZATION

Facility

$7,334.23

Service Code	APR-DRG 5393
Min. Negotiated Rate	$2,100.00
Max. Negotiated Rate	$7,334.23
Rate for Payer: BCBS Complete	$7,334.23
Rate for Payer: Mclaren Medicaid	$6,984.98
Rate for Payer: Meridian Medicaid	$2,100.00
Rate for Payer: Priority Health Choice Medicaid	$6,984.98
Rate for Payer: UHC Medicaid	$6,984.98
Rate for Payer: UHCCP Medicaid	$6,984.98

CESAREAN SECTION WITH STERILIZATION

Facility

$15,723.90

Service Code	APR-DRG 5394
Min. Negotiated Rate	$2,100.00
Max. Negotiated Rate	$15,723.90
Rate for Payer: BCBS Complete	$15,723.90
Rate for Payer: Mclaren Medicaid	$14,975.14
Rate for Payer: Meridian Medicaid	$2,100.00
Rate for Payer: Priority Health Choice Medicaid	$14,975.14
Rate for Payer: UHC Medicaid	$14,975.14
Rate for Payer: UHCCP Medicaid	$14,975.14

CESAREAN SECTION WITH STERILIZATION

Facility

$3,802.70

Service Code	APR-DRG 5392
Min. Negotiated Rate	$2,100.00
Max. Negotiated Rate	$3,802.70
Rate for Payer: BCBS Complete	$3,802.70
Rate for Payer: Mclaren Medicaid	$3,621.62
Rate for Payer: Meridian Medicaid	$2,100.00
Rate for Payer: Priority Health Choice Medicaid	$3,621.62
Rate for Payer: UHC Medicaid	$3,621.62
Rate for Payer: UHCCP Medicaid	$3,621.62

CESAREAN SECTION WITH STERILIZATION WITH CC

Facility

$17,279.63

Service Code	MSDRG 784
Min. Negotiated Rate	$8,333.12
Max. Negotiated Rate	$17,279.63
Rate for Payer: Aetna Medicare	$9,122.58
Rate for Payer: Allen County Amish Medical Aid Commercial	$10,964.64
Rate for Payer: Amish Plain Church Group Commercial	$10,964.64
Rate for Payer: BCBS MAPPO	$8,771.71
Rate for Payer: BCBS Trust/PPO	$15,613.14
Rate for Payer: BCN Commercial	$15,613.14
Rate for Payer: BCN Medicare Advantage	$8,771.71
Rate for Payer: Health Alliance Plan Medicare Advantage	$8,771.71
Rate for Payer: Mclaren Medicare	$8,771.71
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$9,210.30
Rate for Payer: MI Amish Medical Board Commercial	$10,087.47
Rate for Payer: Molina Medicare/Medicaid	$9,648.88
Rate for Payer: Nomi Health Commercial	$13,675.29
Rate for Payer: PACE Medicare	$8,333.12
Rate for Payer: PACE SWMI	$8,771.71
Rate for Payer: PHP Medicare Advantage	$8,771.71
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$14,916.20
Rate for Payer: Priority Health Medicare	$8,771.71
Rate for Payer: Priority Health Tiered Network	$11,932.96
Rate for Payer: Railroad Medicare Medicare	$8,771.71
Rate for Payer: UHC All Payor (Choice/PPO)	$17,279.63
Rate for Payer: UHC Core	$14,456.58
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$8,771.71
Rate for Payer: UHC Exchange	$11,806.33
Rate for Payer: VA VA	$8,771.71

CESAREAN SECTION WITH STERILIZATION WITH MCC

Facility

$40,018.13

Service Code	MSDRG 783
Min. Negotiated Rate	$18,574.94
Max. Negotiated Rate	$40,018.13
Rate for Payer: Aetna Medicare	$20,334.67
Rate for Payer: Allen County Amish Medical Aid Commercial	$24,440.71
Rate for Payer: Amish Plain Church Group Commercial	$24,440.71
Rate for Payer: BCBS MAPPO	$19,552.57
Rate for Payer: BCBS Trust/PPO	$22,661.28
Rate for Payer: BCN Commercial	$22,661.28
Rate for Payer: BCN Medicare Advantage	$19,552.57
Rate for Payer: Health Alliance Plan Medicare Advantage	$19,552.57
Rate for Payer: Mclaren Medicare	$19,552.57
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$20,530.20
Rate for Payer: MI Amish Medical Board Commercial	$22,485.46
Rate for Payer: Molina Medicare/Medicaid	$21,507.83
Rate for Payer: Nomi Health Commercial	$31,670.79
Rate for Payer: PACE Medicare	$18,574.94
Rate for Payer: PACE SWMI	$19,552.57
Rate for Payer: PHP Medicare Advantage	$19,552.57
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$23,625.38
Rate for Payer: Priority Health Medicare	$19,552.57
Rate for Payer: Priority Health Tiered Network	$18,900.30
Rate for Payer: Railroad Medicare Medicare	$19,552.57
Rate for Payer: UHC All Payor (Choice/PPO)	$40,018.13
Rate for Payer: UHC Core	$33,480.20
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$19,552.57
Rate for Payer: UHC Exchange	$27,342.45
Rate for Payer: VA VA	$19,552.57

CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC

Facility

$15,612.14

Service Code	MSDRG 785
Min. Negotiated Rate	$7,582.04
Max. Negotiated Rate	$15,612.14
Rate for Payer: Aetna Medicare	$8,300.33
Rate for Payer: Allen County Amish Medical Aid Commercial	$9,976.36
Rate for Payer: Amish Plain Church Group Commercial	$9,976.36
Rate for Payer: BCBS MAPPO	$7,981.09
Rate for Payer: BCBS Trust/PPO	$13,347.24
Rate for Payer: BCN Commercial	$13,347.24
Rate for Payer: BCN Medicare Advantage	$7,981.09
Rate for Payer: Health Alliance Plan Medicare Advantage	$7,981.09
Rate for Payer: Mclaren Medicare	$7,981.09
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$8,380.14
Rate for Payer: MI Amish Medical Board Commercial	$9,178.25
Rate for Payer: Molina Medicare/Medicaid	$8,779.20
Rate for Payer: Nomi Health Commercial	$12,355.62
Rate for Payer: PACE Medicare	$7,582.04
Rate for Payer: PACE SWMI	$7,981.09
Rate for Payer: PHP Medicare Advantage	$7,981.09
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$12,296.36
Rate for Payer: Priority Health Medicare	$7,981.09
Rate for Payer: Priority Health Tiered Network	$9,837.08
Rate for Payer: Railroad Medicare Medicare	$7,981.09
Rate for Payer: UHC All Payor (Choice/PPO)	$15,612.14
Rate for Payer: UHC Core	$13,061.52
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$7,981.09
Rate for Payer: UHC Exchange	$10,667.02
Rate for Payer: VA VA	$7,981.09

CETUXIMAB 100 MG/50 ML INTRAVENOUS SOLUTION

Facility

$3,716.83

Service Code	HCPCS J9055
Hospital Charge Code	37989
Hospital Revenue Code	636
Min. Negotiated Rate	$2,341.60
Max. Negotiated Rate	$3,345.15
Rate for Payer: Aetna Commercial	$3,159.31
Rate for Payer: Aetna New Business (MI Preferred)	$2,415.94
Rate for Payer: Cash Price	$2,973.46
Rate for Payer: Cofinity Advantage	$2,601.78
Rate for Payer: Cofinity Commercial	$3,196.47
Rate for Payer: Encore Health Key Benefits Commercial	$2,973.46
Rate for Payer: Healthscope Commercial	$3,345.15
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3,159.31
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,787.62
Rate for Payer: PHP Commercial	$3,159.31
Rate for Payer: Priority Health SBD	$2,341.60

CETUXIMAB 100 MG/50 ML INTRAVENOUS SOLUTION

Facility

$3,716.83

Service Code	HCPCS J9055
Hospital Charge Code	37989
Hospital Revenue Code	636
Min. Negotiated Rate	$42.08
Max. Negotiated Rate	$3,345.15
Rate for Payer: Aetna Commercial	$3,159.31
Rate for Payer: Aetna Medicare	$83.68
Rate for Payer: Aetna New Business (MI Preferred)	$2,415.94
Rate for Payer: Allen County Amish Medical Aid Commercial	$100.58
Rate for Payer: Amish Plain Church Group Commercial	$100.58
Rate for Payer: BCBS Complete	$44.19
Rate for Payer: BCBS MAPPO	$80.46
Rate for Payer: BCBS Trust/PPO	$197.83
Rate for Payer: BCN Commercial	$197.83
Rate for Payer: BCN Medicare Advantage	$80.46
Rate for Payer: Cash Price	$2,973.46
Rate for Payer: Cash Price	$2,973.46
Rate for Payer: Cofinity Advantage	$2,601.78
Rate for Payer: Cofinity Commercial	$3,196.47
Rate for Payer: Encore Health Key Benefits Commercial	$2,973.46
Rate for Payer: Health Alliance Plan Medicare Advantage	$80.46
Rate for Payer: Healthscope Commercial	$3,345.15
Rate for Payer: Mclaren Medicaid	$42.08
Rate for Payer: Mclaren Medicare	$80.46
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$84.48
Rate for Payer: Meridian Medicaid	$84.48
Rate for Payer: MI Amish Medical Board Commercial	$92.53
Rate for Payer: Molina Medicare/Medicaid	$88.51
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3,159.31
Rate for Payer: Nomi Health Commercial	$241.38
Rate for Payer: Opus (Opus Packaging Group) HMA	$2,787.62
Rate for Payer: PACE Medicare	$76.44
Rate for Payer: PACE SWMI	$80.46
Rate for Payer: PHP Commercial	$3,159.31
Rate for Payer: PHP Medicare Advantage	$80.46
Rate for Payer: Priority Health Choice Medicaid	$42.08
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$247.18
Rate for Payer: Priority Health Medicare	$80.46
Rate for Payer: Priority Health SBD	$2,341.60
Rate for Payer: Priority Health Tiered Network	$197.74
Rate for Payer: Railroad Medicare Medicare	$80.46
Rate for Payer: UHC All Payor (Choice/PPO)	$132.56
Rate for Payer: UHC Core	$132.56
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$80.46
Rate for Payer: UHC Exchange	$132.56
Rate for Payer: UHC Medicaid	$42.08
Rate for Payer: UHCCP Medicaid	$42.08
Rate for Payer: VA VA	$80.46

CETUXIMAB 200 MG/100 ML INTRAVENOUS SOLUTION

Facility

$7,433.65

Service Code	HCPCS J9055
Hospital Charge Code	118617
Hospital Revenue Code	636
Min. Negotiated Rate	$4,683.20
Max. Negotiated Rate	$6,690.28
Rate for Payer: Aetna Commercial	$6,318.60
Rate for Payer: Aetna New Business (MI Preferred)	$4,831.87
Rate for Payer: Cash Price	$5,946.92
Rate for Payer: Cofinity Advantage	$5,203.56
Rate for Payer: Cofinity Commercial	$6,392.94
Rate for Payer: Encore Health Key Benefits Commercial	$5,946.92
Rate for Payer: Healthscope Commercial	$6,690.28
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$6,318.60
Rate for Payer: Opus (Opus Packaging Group) HMA	$5,575.24
Rate for Payer: PHP Commercial	$6,318.60
Rate for Payer: Priority Health SBD	$4,683.20

Know your out-of-pocket cost for care.

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