Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

MOUTH PROCEDURES WITH CC/MCC

Facility

$24,339.16

Service Code	MSDRG 137
Min. Negotiated Rate	$11,512.85
Max. Negotiated Rate	$24,339.16
Rate for Payer: Aetna Medicare	$12,603.54
Rate for Payer: Allen County Amish Medical Aid Commercial	$15,148.49
Rate for Payer: Amish Plain Church Group Commercial	$15,148.49
Rate for Payer: BCBS MAPPO	$12,118.79
Rate for Payer: BCBS Trust/PPO	$22,871.96
Rate for Payer: BCN Commercial	$22,871.96
Rate for Payer: BCN Medicare Advantage	$12,118.79
Rate for Payer: Health Alliance Plan Medicare Advantage	$12,118.79
Rate for Payer: Mclaren Medicare	$12,118.79
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$12,724.73
Rate for Payer: MI Amish Medical Board Commercial	$13,936.61
Rate for Payer: Molina Medicare/Medicaid	$13,330.67
Rate for Payer: Nomi Health Commercial	$19,262.28
Rate for Payer: PACE Medicare	$11,512.85
Rate for Payer: PACE SWMI	$12,118.79
Rate for Payer: PHP Medicare Advantage	$12,118.79
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$24,073.58
Rate for Payer: Priority Health Medicare	$12,118.79
Rate for Payer: Priority Health Tiered Network	$19,258.86
Rate for Payer: Railroad Medicare Medicare	$12,118.79
Rate for Payer: UHC All Payor (Choice/PPO)	$24,339.16
Rate for Payer: UHC Core	$20,362.77
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$12,118.79
Rate for Payer: UHC Exchange	$16,629.77
Rate for Payer: VA VA	$12,118.79

MOUTH PROCEDURES WITHOUT CC/MCC

Facility

$14,445.06

Service Code	MSDRG 138
Min. Negotiated Rate	$7,056.37
Max. Negotiated Rate	$14,445.06
Rate for Payer: Aetna Medicare	$7,724.87
Rate for Payer: Allen County Amish Medical Aid Commercial	$9,284.70
Rate for Payer: Amish Plain Church Group Commercial	$9,284.70
Rate for Payer: BCBS MAPPO	$7,427.76
Rate for Payer: BCBS Trust/PPO	$13,574.30
Rate for Payer: BCN Commercial	$13,574.30
Rate for Payer: BCN Medicare Advantage	$7,427.76
Rate for Payer: Health Alliance Plan Medicare Advantage	$7,427.76
Rate for Payer: Mclaren Medicare	$7,427.76
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$7,799.15
Rate for Payer: MI Amish Medical Board Commercial	$8,541.92
Rate for Payer: Molina Medicare/Medicaid	$8,170.54
Rate for Payer: Nomi Health Commercial	$11,431.98
Rate for Payer: PACE Medicare	$7,056.37
Rate for Payer: PACE SWMI	$7,427.76
Rate for Payer: PHP Medicare Advantage	$7,427.76
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$14,287.44
Rate for Payer: Priority Health Medicare	$7,427.76
Rate for Payer: Priority Health Tiered Network	$11,429.95
Rate for Payer: Railroad Medicare Medicare	$7,427.76
Rate for Payer: UHC All Payor (Choice/PPO)	$14,445.06
Rate for Payer: UHC Core	$12,085.11
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$7,427.76
Rate for Payer: UHC Exchange	$9,869.61
Rate for Payer: VA VA	$7,427.76

MOXIFLOXACIN 0.5 % EYE DROPS

Facility

$13.60

Service Code	NDC 70069008101
Hospital Charge Code	35699
Hospital Revenue Code	637
Min. Negotiated Rate	$8.57
Max. Negotiated Rate	$12.24
Rate for Payer: Aetna Commercial	$11.56
Rate for Payer: Aetna New Business (MI Preferred)	$8.84
Rate for Payer: Cash Price	$10.88
Rate for Payer: Cofinity Advantage	$9.52
Rate for Payer: Cofinity Commercial	$11.70
Rate for Payer: Encore Health Key Benefits Commercial	$10.88
Rate for Payer: Healthscope Commercial	$12.24
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$11.56
Rate for Payer: Opus (Opus Packaging Group) HMA	$10.20
Rate for Payer: PHP Commercial	$11.56
Rate for Payer: Priority Health SBD	$8.57

MOXIFLOXACIN 0.5 % EYE DROPS

Facility

$13.60

Service Code	NDC 70069008101
Hospital Charge Code	35699
Hospital Revenue Code	637
Min. Negotiated Rate	$5.34
Max. Negotiated Rate	$12.24
Rate for Payer: Aetna Commercial	$11.56
Rate for Payer: Aetna Medicare	$6.80
Rate for Payer: Aetna New Business (MI Preferred)	$8.84
Rate for Payer: BCBS Complete	$5.44
Rate for Payer: Cash Price	$10.88
Rate for Payer: Cofinity Advantage	$9.52
Rate for Payer: Cofinity Commercial	$11.70
Rate for Payer: Encore Health Key Benefits Commercial	$10.88
Rate for Payer: Healthscope Commercial	$12.24
Rate for Payer: MI Amish Medical Board Commercial	$10.88
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$11.56
Rate for Payer: Opus (Opus Packaging Group) HMA	$10.20
Rate for Payer: PHP Commercial	$11.56
Rate for Payer: Priority Health SBD	$8.57
Rate for Payer: UHC All Payor (Choice/PPO)	$8.84
Rate for Payer: UHC Core	$7.09
Rate for Payer: UHC Exchange	$5.34

MOXIFLOXACIN 400 MG/250 ML-SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK

Facility

$190.24

Service Code	HCPCS J2280
Hospital Charge Code	31906
Hospital Revenue Code	636
Min. Negotiated Rate	$15.11
Max. Negotiated Rate	$171.22
Rate for Payer: Aetna Commercial	$161.70
Rate for Payer: Aetna Medicare	$95.12
Rate for Payer: Aetna New Business (MI Preferred)	$123.66
Rate for Payer: BCBS Complete	$76.10
Rate for Payer: BCBS Trust/PPO	$22.95
Rate for Payer: BCN Commercial	$22.95
Rate for Payer: Cash Price	$152.19
Rate for Payer: Cash Price	$152.19
Rate for Payer: Cofinity Advantage	$133.17
Rate for Payer: Cofinity Commercial	$163.61
Rate for Payer: Encore Health Key Benefits Commercial	$152.19
Rate for Payer: Healthscope Commercial	$171.22
Rate for Payer: MI Amish Medical Board Commercial	$152.19
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$161.70
Rate for Payer: Opus (Opus Packaging Group) HMA	$142.68
Rate for Payer: PHP Commercial	$161.70
Rate for Payer: Priority Health SBD	$119.85
Rate for Payer: UHC All Payor (Choice/PPO)	$15.11
Rate for Payer: UHC Core	$15.11
Rate for Payer: UHC Exchange	$15.11

MOXIFLOXACIN 400 MG/250 ML-SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK

Facility

$190.24

Service Code	HCPCS J2280
Hospital Charge Code	31906
Hospital Revenue Code	636
Min. Negotiated Rate	$119.85
Max. Negotiated Rate	$171.22
Rate for Payer: Aetna Commercial	$161.70
Rate for Payer: Aetna New Business (MI Preferred)	$123.66
Rate for Payer: Cash Price	$152.19
Rate for Payer: Cofinity Advantage	$133.17
Rate for Payer: Cofinity Commercial	$163.61
Rate for Payer: Encore Health Key Benefits Commercial	$152.19
Rate for Payer: Healthscope Commercial	$171.22
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$161.70
Rate for Payer: Opus (Opus Packaging Group) HMA	$142.68
Rate for Payer: PHP Commercial	$161.70
Rate for Payer: Priority Health SBD	$119.85

MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL

Facility

$18,422.42

Service Code	APR-DRG 2991
Min. Negotiated Rate	$17,545.16
Max. Negotiated Rate	$18,422.42
Rate for Payer: BCBS Complete	$18,422.42
Rate for Payer: Mclaren Medicaid	$17,545.16
Rate for Payer: Meridian Medicaid	$18,422.42
Rate for Payer: Priority Health Choice Medicaid	$17,545.16
Rate for Payer: UHC Medicaid	$17,545.16
Rate for Payer: UHCCP Medicaid	$17,545.16

MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL

Facility

$40,427.97

Service Code	APR-DRG 2994
Min. Negotiated Rate	$38,502.83
Max. Negotiated Rate	$40,427.97
Rate for Payer: BCBS Complete	$40,427.97
Rate for Payer: Mclaren Medicaid	$38,502.83
Rate for Payer: Meridian Medicaid	$40,427.97
Rate for Payer: Priority Health Choice Medicaid	$38,502.83
Rate for Payer: UHC Medicaid	$38,502.83
Rate for Payer: UHCCP Medicaid	$38,502.83

MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL

Facility

$22,242.32

Service Code	APR-DRG 2992
Min. Negotiated Rate	$21,183.16
Max. Negotiated Rate	$22,242.32
Rate for Payer: BCBS Complete	$22,242.32
Rate for Payer: Mclaren Medicaid	$21,183.16
Rate for Payer: Meridian Medicaid	$22,242.32
Rate for Payer: Priority Health Choice Medicaid	$21,183.16
Rate for Payer: UHC Medicaid	$21,183.16
Rate for Payer: UHCCP Medicaid	$21,183.16

MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL

Facility

$30,699.07

Service Code	APR-DRG 2993
Min. Negotiated Rate	$29,237.21
Max. Negotiated Rate	$30,699.07
Rate for Payer: BCBS Complete	$30,699.07
Rate for Payer: Mclaren Medicaid	$29,237.21
Rate for Payer: Meridian Medicaid	$30,699.07
Rate for Payer: Priority Health Choice Medicaid	$29,237.21
Rate for Payer: UHC Medicaid	$29,237.21
Rate for Payer: UHCCP Medicaid	$29,237.21

MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH CC

Facility

$117,663.18

Service Code	MSDRG 427
Min. Negotiated Rate	$53,547.68
Max. Negotiated Rate	$117,663.18
Rate for Payer: Aetna Medicare	$58,620.62
Rate for Payer: Allen County Amish Medical Aid Commercial	$70,457.48
Rate for Payer: Amish Plain Church Group Commercial	$70,457.48
Rate for Payer: BCBS MAPPO	$56,365.98
Rate for Payer: BCBS Trust/PPO	$90,565.55
Rate for Payer: BCN Commercial	$90,565.55
Rate for Payer: BCN Medicare Advantage	$56,365.98
Rate for Payer: Health Alliance Plan Medicare Advantage	$56,365.98
Rate for Payer: Mclaren Medicare	$56,365.98
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$59,184.28
Rate for Payer: MI Amish Medical Board Commercial	$64,820.88
Rate for Payer: Molina Medicare/Medicaid	$62,002.58
Rate for Payer: Nomi Health Commercial	$93,119.94
Rate for Payer: PACE Medicare	$53,547.68
Rate for Payer: PACE SWMI	$56,365.98
Rate for Payer: PHP Medicare Advantage	$56,365.98
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$116,379.28
Rate for Payer: Priority Health Medicare	$56,365.98
Rate for Payer: Priority Health Tiered Network	$93,103.41
Rate for Payer: Railroad Medicare Medicare	$56,365.98
Rate for Payer: UHC All Payor (Choice/PPO)	$117,663.18
Rate for Payer: UHC Core	$98,440.05
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$56,365.98
Rate for Payer: UHC Exchange	$80,393.55
Rate for Payer: VA VA	$56,365.98

MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE

Facility

$179,645.56

Service Code	MSDRG 426
Min. Negotiated Rate	$81,465.67
Max. Negotiated Rate	$179,645.56
Rate for Payer: Aetna Medicare	$89,183.47
Rate for Payer: Allen County Amish Medical Aid Commercial	$107,191.68
Rate for Payer: Amish Plain Church Group Commercial	$107,191.68
Rate for Payer: BCBS MAPPO	$85,753.34
Rate for Payer: BCBS Trust/PPO	$135,466.78
Rate for Payer: BCN Commercial	$135,466.78
Rate for Payer: BCN Medicare Advantage	$85,753.34
Rate for Payer: Health Alliance Plan Medicare Advantage	$85,753.34
Rate for Payer: Mclaren Medicare	$85,753.34
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$90,041.01
Rate for Payer: MI Amish Medical Board Commercial	$98,616.34
Rate for Payer: Molina Medicare/Medicaid	$94,328.67
Rate for Payer: Nomi Health Commercial	$142,173.48
Rate for Payer: PACE Medicare	$81,465.67
Rate for Payer: PACE SWMI	$85,753.34
Rate for Payer: PHP Medicare Advantage	$85,753.34
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$177,685.33
Rate for Payer: Priority Health Medicare	$85,753.34
Rate for Payer: Priority Health Tiered Network	$142,148.24
Rate for Payer: Railroad Medicare Medicare	$85,753.34
Rate for Payer: UHC All Payor (Choice/PPO)	$179,645.56
Rate for Payer: UHC Core	$150,296.10
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$85,753.34
Rate for Payer: UHC Exchange	$122,743.10
Rate for Payer: VA VA	$85,753.34

MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITHOUT CC/MCC

Facility

$91,638.60

Service Code	MSDRG 428
Min. Negotiated Rate	$41,825.73
Max. Negotiated Rate	$91,638.60
Rate for Payer: Aetna Medicare	$45,788.16
Rate for Payer: Allen County Amish Medical Aid Commercial	$55,033.85
Rate for Payer: Amish Plain Church Group Commercial	$55,033.85
Rate for Payer: BCBS MAPPO	$44,027.08
Rate for Payer: BCBS Trust/PPO	$76,200.06
Rate for Payer: BCN Commercial	$76,200.06
Rate for Payer: BCN Medicare Advantage	$44,027.08
Rate for Payer: Health Alliance Plan Medicare Advantage	$44,027.08
Rate for Payer: Mclaren Medicare	$44,027.08
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$46,228.43
Rate for Payer: MI Amish Medical Board Commercial	$50,631.14
Rate for Payer: Molina Medicare/Medicaid	$48,429.79
Rate for Payer: Nomi Health Commercial	$72,523.80
Rate for Payer: PACE Medicare	$41,825.73
Rate for Payer: PACE SWMI	$44,027.08
Rate for Payer: PHP Medicare Advantage	$44,027.08
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$90,638.67
Rate for Payer: Priority Health Medicare	$44,027.08
Rate for Payer: Priority Health Tiered Network	$72,510.93
Rate for Payer: Railroad Medicare Medicare	$44,027.08
Rate for Payer: UHC All Payor (Choice/PPO)	$91,638.60
Rate for Payer: UHC Core	$76,667.21
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$44,027.08
Rate for Payer: UHC Exchange	$62,612.21
Rate for Payer: VA VA	$44,027.08

MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE

Facility

$108,910.08

Service Code	MSDRG 447
Min. Negotiated Rate	$49,605.14
Max. Negotiated Rate	$108,910.08
Rate for Payer: Aetna Medicare	$54,304.58
Rate for Payer: Allen County Amish Medical Aid Commercial	$65,269.93
Rate for Payer: Amish Plain Church Group Commercial	$65,269.93
Rate for Payer: BCBS MAPPO	$52,215.94
Rate for Payer: BCBS Trust/PPO	$97,199.38
Rate for Payer: BCN Commercial	$97,199.38
Rate for Payer: BCN Medicare Advantage	$52,215.94
Rate for Payer: Health Alliance Plan Medicare Advantage	$52,215.94
Rate for Payer: Mclaren Medicare	$52,215.94
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$54,826.74
Rate for Payer: MI Amish Medical Board Commercial	$60,048.33
Rate for Payer: Molina Medicare/Medicaid	$57,437.53
Rate for Payer: Nomi Health Commercial	$86,192.64
Rate for Payer: PACE Medicare	$49,605.14
Rate for Payer: PACE SWMI	$52,215.94
Rate for Payer: PHP Medicare Advantage	$52,215.94
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$107,721.69
Rate for Payer: Priority Health Medicare	$52,215.94
Rate for Payer: Priority Health Tiered Network	$86,177.34
Rate for Payer: Railroad Medicare Medicare	$52,215.94
Rate for Payer: UHC All Payor (Choice/PPO)	$108,910.08
Rate for Payer: UHC Core	$91,116.98
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$52,215.94
Rate for Payer: UHC Exchange	$74,412.98
Rate for Payer: VA VA	$52,215.94

MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC

Facility

$69,125.04

Service Code	MSDRG 448
Min. Negotiated Rate	$31,685.22
Max. Negotiated Rate	$69,125.04
Rate for Payer: Aetna Medicare	$34,686.97
Rate for Payer: Allen County Amish Medical Aid Commercial	$41,691.07
Rate for Payer: Amish Plain Church Group Commercial	$41,691.07
Rate for Payer: BCBS MAPPO	$33,352.86
Rate for Payer: BCBS Trust/PPO	$61,698.81
Rate for Payer: BCN Commercial	$61,698.81
Rate for Payer: BCN Medicare Advantage	$33,352.86
Rate for Payer: Health Alliance Plan Medicare Advantage	$33,352.86
Rate for Payer: Mclaren Medicare	$33,352.86
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$35,020.50
Rate for Payer: MI Amish Medical Board Commercial	$38,355.79
Rate for Payer: Molina Medicare/Medicaid	$36,688.15
Rate for Payer: Nomi Health Commercial	$54,706.32
Rate for Payer: PACE Medicare	$31,685.22
Rate for Payer: PACE SWMI	$33,352.86
Rate for Payer: PHP Medicare Advantage	$33,352.86
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$68,370.77
Rate for Payer: Priority Health Medicare	$33,352.86
Rate for Payer: Priority Health Tiered Network	$54,696.61
Rate for Payer: Railroad Medicare Medicare	$33,352.86
Rate for Payer: UHC All Payor (Choice/PPO)	$69,125.04
Rate for Payer: UHC Core	$57,831.79
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$33,352.86
Rate for Payer: UHC Exchange	$47,229.79
Rate for Payer: VA VA	$33,352.86

MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC

Facility

$27,139.24

Service Code	MSDRG 059
Min. Negotiated Rate	$9,660.51
Max. Negotiated Rate	$27,139.24
Rate for Payer: Aetna Medicare	$10,575.72
Rate for Payer: Allen County Amish Medical Aid Commercial	$12,711.20
Rate for Payer: Amish Plain Church Group Commercial	$12,711.20
Rate for Payer: BCBS MAPPO	$10,168.96
Rate for Payer: BCBS Trust/PPO	$27,139.24
Rate for Payer: BCN Commercial	$27,139.24
Rate for Payer: BCN Medicare Advantage	$10,168.96
Rate for Payer: Health Alliance Plan Medicare Advantage	$10,168.96
Rate for Payer: Mclaren Medicare	$10,168.96
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$10,677.41
Rate for Payer: MI Amish Medical Board Commercial	$11,694.30
Rate for Payer: Molina Medicare/Medicaid	$11,185.86
Rate for Payer: Nomi Health Commercial	$16,007.61
Rate for Payer: PACE Medicare	$9,660.51
Rate for Payer: PACE SWMI	$10,168.96
Rate for Payer: PHP Medicare Advantage	$10,168.96
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$20,005.96
Rate for Payer: Priority Health Medicare	$10,168.96
Rate for Payer: Priority Health Tiered Network	$16,004.77
Rate for Payer: Railroad Medicare Medicare	$10,168.96
Rate for Payer: UHC All Payor (Choice/PPO)	$20,226.67
Rate for Payer: UHC Core	$16,922.15
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$10,168.96
Rate for Payer: UHC Exchange	$13,819.90
Rate for Payer: VA VA	$10,168.96

MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC

Facility

$28,323.68

Service Code	MSDRG 058
Min. Negotiated Rate	$13,100.89
Max. Negotiated Rate	$28,323.68
Rate for Payer: Aetna Medicare	$14,342.03
Rate for Payer: Allen County Amish Medical Aid Commercial	$17,238.01
Rate for Payer: Amish Plain Church Group Commercial	$17,238.01
Rate for Payer: BCBS MAPPO	$13,790.41
Rate for Payer: BCBS Trust/PPO	$28,323.68
Rate for Payer: BCN Commercial	$28,323.68
Rate for Payer: BCN Medicare Advantage	$13,790.41
Rate for Payer: Health Alliance Plan Medicare Advantage	$13,790.41
Rate for Payer: Mclaren Medicare	$13,790.41
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$14,479.93
Rate for Payer: MI Amish Medical Board Commercial	$15,858.97
Rate for Payer: Molina Medicare/Medicaid	$15,169.45
Rate for Payer: Nomi Health Commercial	$22,052.55
Rate for Payer: PACE Medicare	$13,100.89
Rate for Payer: PACE SWMI	$13,790.41
Rate for Payer: PHP Medicare Advantage	$13,790.41
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$27,560.80
Rate for Payer: Priority Health Medicare	$13,790.41
Rate for Payer: Priority Health Tiered Network	$22,048.64
Rate for Payer: Railroad Medicare Medicare	$13,790.41
Rate for Payer: UHC All Payor (Choice/PPO)	$27,864.85
Rate for Payer: UHC Core	$23,312.45
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$13,790.41
Rate for Payer: UHC Exchange	$19,038.70
Rate for Payer: VA VA	$13,790.41

MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC

Facility

$17,895.42

Service Code	MSDRG 060
Min. Negotiated Rate	$7,303.06
Max. Negotiated Rate	$17,895.42
Rate for Payer: Aetna Medicare	$7,994.93
Rate for Payer: Allen County Amish Medical Aid Commercial	$9,609.29
Rate for Payer: Amish Plain Church Group Commercial	$9,609.29
Rate for Payer: BCBS MAPPO	$7,687.43
Rate for Payer: BCBS Trust/PPO	$17,895.42
Rate for Payer: BCN Commercial	$17,895.42
Rate for Payer: BCN Medicare Advantage	$7,687.43
Rate for Payer: Health Alliance Plan Medicare Advantage	$7,687.43
Rate for Payer: Mclaren Medicare	$7,687.43
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$8,071.80
Rate for Payer: MI Amish Medical Board Commercial	$8,840.54
Rate for Payer: Molina Medicare/Medicaid	$8,456.17
Rate for Payer: Nomi Health Commercial	$11,865.42
Rate for Payer: PACE Medicare	$7,303.06
Rate for Payer: PACE SWMI	$7,687.43
Rate for Payer: PHP Medicare Advantage	$7,687.43
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$14,829.14
Rate for Payer: Priority Health Medicare	$7,687.43
Rate for Payer: Priority Health Tiered Network	$11,863.31
Rate for Payer: Railroad Medicare Medicare	$7,687.43
Rate for Payer: UHC All Payor (Choice/PPO)	$14,992.74
Rate for Payer: UHC Core	$12,543.31
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$7,687.43
Rate for Payer: UHC Exchange	$10,243.81
Rate for Payer: VA VA	$7,687.43

MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES

Facility

$5,366.09

Service Code	APR-DRG 0432
Min. Negotiated Rate	$5,110.56
Max. Negotiated Rate	$5,366.09
Rate for Payer: BCBS Complete	$5,366.09
Rate for Payer: Mclaren Medicaid	$5,110.56
Rate for Payer: Meridian Medicaid	$5,366.09
Rate for Payer: Priority Health Choice Medicaid	$5,110.56
Rate for Payer: UHC Medicaid	$5,110.56
Rate for Payer: UHCCP Medicaid	$5,110.56

MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES

Facility

$13,328.08

Service Code	APR-DRG 0433
Min. Negotiated Rate	$12,693.41
Max. Negotiated Rate	$13,328.08
Rate for Payer: BCBS Complete	$13,328.08
Rate for Payer: Mclaren Medicaid	$12,693.41
Rate for Payer: Meridian Medicaid	$13,328.08
Rate for Payer: Priority Health Choice Medicaid	$12,693.41
Rate for Payer: UHC Medicaid	$12,693.41
Rate for Payer: UHCCP Medicaid	$12,693.41

MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES

Facility

$4,440.78

Service Code	APR-DRG 0431
Min. Negotiated Rate	$4,229.32
Max. Negotiated Rate	$4,440.78
Rate for Payer: BCBS Complete	$4,440.78
Rate for Payer: Mclaren Medicaid	$4,229.32
Rate for Payer: Meridian Medicaid	$4,440.78
Rate for Payer: Priority Health Choice Medicaid	$4,229.32
Rate for Payer: UHC Medicaid	$4,229.32
Rate for Payer: UHCCP Medicaid	$4,229.32

MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES

Facility

$26,964.59

Service Code	APR-DRG 0434
Min. Negotiated Rate	$25,680.56
Max. Negotiated Rate	$26,964.59
Rate for Payer: BCBS Complete	$26,964.59
Rate for Payer: Mclaren Medicaid	$25,680.56
Rate for Payer: Meridian Medicaid	$26,964.59
Rate for Payer: Priority Health Choice Medicaid	$25,680.56
Rate for Payer: UHC Medicaid	$25,680.56
Rate for Payer: UHCCP Medicaid	$25,680.56

MULTIPLE SIGNIFICANT TRAUMA WITHOUT O.R. PROCEDURE

Facility

$6,033.41

Service Code	APR-DRG 9302
Min. Negotiated Rate	$5,746.10
Max. Negotiated Rate	$6,033.41
Rate for Payer: BCBS Complete	$6,033.41
Rate for Payer: Mclaren Medicaid	$5,746.10
Rate for Payer: Meridian Medicaid	$6,033.41
Rate for Payer: Priority Health Choice Medicaid	$5,746.10
Rate for Payer: UHC Medicaid	$5,746.10
Rate for Payer: UHCCP Medicaid	$5,746.10

MULTIPLE SIGNIFICANT TRAUMA WITHOUT O.R. PROCEDURE

Facility

$4,764.12

Service Code	APR-DRG 9301
Min. Negotiated Rate	$4,537.26
Max. Negotiated Rate	$4,764.12
Rate for Payer: BCBS Complete	$4,764.12
Rate for Payer: Mclaren Medicaid	$4,537.26
Rate for Payer: Meridian Medicaid	$4,764.12
Rate for Payer: Priority Health Choice Medicaid	$4,537.26
Rate for Payer: UHC Medicaid	$4,537.26
Rate for Payer: UHCCP Medicaid	$4,537.26

MULTIPLE SIGNIFICANT TRAUMA WITHOUT O.R. PROCEDURE

Facility

$14,915.55

Service Code	APR-DRG 9304
Min. Negotiated Rate	$14,205.28
Max. Negotiated Rate	$14,915.55
Rate for Payer: BCBS Complete	$14,915.55
Rate for Payer: Mclaren Medicaid	$14,205.28
Rate for Payer: Meridian Medicaid	$14,915.55
Rate for Payer: Priority Health Choice Medicaid	$14,205.28
Rate for Payer: UHC Medicaid	$14,205.28
Rate for Payer: UHCCP Medicaid	$14,205.28

Know your out-of-pocket cost for care.

All Charges