Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

WATER FOR INJECTION, STERILE INJECTION SOLUTION

Facility

$13.75

Service Code	NDC 0409-4887-10
Hospital Charge Code	11671
Hospital Revenue Code	250
Min. Negotiated Rate	$5.50
Max. Negotiated Rate	$12.38
Rate for Payer: Aetna Commercial	$11.69
Rate for Payer: Aetna New Business (MI Preferred)	$8.94
Rate for Payer: BCBS Complete	$5.50
Rate for Payer: Cash Price	$11.00
Rate for Payer: Cofinity Commercial	$11.82
Rate for Payer: Cofinity Commercial	$9.62
Rate for Payer: Healthscope Commercial	$12.38
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$11.69
Rate for Payer: PHP Commercial	$11.69
Rate for Payer: Priority Health Cigna Priority Health	$9.62
Rate for Payer: Priority Health SBD	$8.66

WATER FOR INJECTION, STERILE INJECTION SOLUTION

Facility

$27.38

Service Code	NDC 0409-4887-99
Hospital Charge Code	11671
Hospital Revenue Code	250
Min. Negotiated Rate	$10.95
Max. Negotiated Rate	$24.64
Rate for Payer: Aetna Commercial	$23.27
Rate for Payer: Aetna New Business (MI Preferred)	$17.80
Rate for Payer: BCBS Complete	$10.95
Rate for Payer: Cash Price	$21.90
Rate for Payer: Cofinity Commercial	$19.17
Rate for Payer: Cofinity Commercial	$23.55
Rate for Payer: Healthscope Commercial	$24.64
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$23.27
Rate for Payer: PHP Commercial	$23.27
Rate for Payer: Priority Health Cigna Priority Health	$19.17
Rate for Payer: Priority Health SBD	$17.25

WATER FOR INJECTION, STERILE INJECTION SOLUTION

Facility

$27.38

Service Code	NDC 0409-4887-25
Hospital Charge Code	11671
Hospital Revenue Code	250
Min. Negotiated Rate	$17.25
Max. Negotiated Rate	$24.64
Rate for Payer: Aetna Commercial	$23.27
Rate for Payer: Aetna New Business (MI Preferred)	$17.80
Rate for Payer: Cash Price	$21.90
Rate for Payer: Cofinity Commercial	$19.17
Rate for Payer: Cofinity Commercial	$23.55
Rate for Payer: Healthscope Commercial	$24.64
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$23.27
Rate for Payer: PHP Commercial	$23.27
Rate for Payer: Priority Health Cigna Priority Health	$19.17
Rate for Payer: Priority Health SBD	$17.25

WATER FOR INJECTION, STERILE INJECTION SOLUTION

Facility

$13.75

Service Code	NDC 0409-4887-17
Hospital Charge Code	11671
Hospital Revenue Code	250
Min. Negotiated Rate	$5.50
Max. Negotiated Rate	$12.38
Rate for Payer: Aetna Commercial	$11.69
Rate for Payer: Aetna New Business (MI Preferred)	$8.94
Rate for Payer: BCBS Complete	$5.50
Rate for Payer: Cash Price	$11.00
Rate for Payer: Cofinity Commercial	$11.82
Rate for Payer: Cofinity Commercial	$9.62
Rate for Payer: Healthscope Commercial	$12.38
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$11.69
Rate for Payer: PHP Commercial	$11.69
Rate for Payer: Priority Health Cigna Priority Health	$9.62
Rate for Payer: Priority Health SBD	$8.66

WATER FOR INJECTION, STERILE INJECTION SOLUTION

Facility

$14.79

Service Code	NDC 0409-4887-20
Hospital Charge Code	11671
Hospital Revenue Code	250
Min. Negotiated Rate	$9.32
Max. Negotiated Rate	$13.31
Rate for Payer: Aetna Commercial	$12.57
Rate for Payer: Aetna New Business (MI Preferred)	$9.61
Rate for Payer: Cash Price	$11.83
Rate for Payer: Cofinity Commercial	$10.35
Rate for Payer: Cofinity Commercial	$12.72
Rate for Payer: Healthscope Commercial	$13.31
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$12.57
Rate for Payer: PHP Commercial	$12.57
Rate for Payer: Priority Health Cigna Priority Health	$10.35
Rate for Payer: Priority Health SBD	$9.32

WATER FOR INJECTION, STERILE INJECTION SOLUTION

Facility

$14.79

Service Code	NDC 0409-4887-23
Hospital Charge Code	11671
Hospital Revenue Code	250
Min. Negotiated Rate	$9.32
Max. Negotiated Rate	$13.31
Rate for Payer: Aetna Commercial	$12.57
Rate for Payer: Aetna New Business (MI Preferred)	$9.61
Rate for Payer: Cash Price	$11.83
Rate for Payer: Cofinity Commercial	$10.35
Rate for Payer: Cofinity Commercial	$12.72
Rate for Payer: Healthscope Commercial	$13.31
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$12.57
Rate for Payer: PHP Commercial	$12.57
Rate for Payer: Priority Health Cigna Priority Health	$10.35
Rate for Payer: Priority Health SBD	$9.32

WATER FOR INJECTION, STERILE INJECTION SOLUTION

Facility

$13.75

Service Code	NDC 0409-4887-17
Hospital Charge Code	11671
Hospital Revenue Code	250
Min. Negotiated Rate	$8.66
Max. Negotiated Rate	$12.38
Rate for Payer: Aetna Commercial	$11.69
Rate for Payer: Aetna New Business (MI Preferred)	$8.94
Rate for Payer: Cash Price	$11.00
Rate for Payer: Cofinity Commercial	$11.82
Rate for Payer: Cofinity Commercial	$9.62
Rate for Payer: Healthscope Commercial	$12.38
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$11.69
Rate for Payer: PHP Commercial	$11.69
Rate for Payer: Priority Health Cigna Priority Health	$9.62
Rate for Payer: Priority Health SBD	$8.66

WATER FOR INJECTION, STERILE INJECTION SOLUTION

Facility

$27.38

Service Code	NDC 0409-4887-25
Hospital Charge Code	11671
Hospital Revenue Code	250
Min. Negotiated Rate	$10.95
Max. Negotiated Rate	$24.64
Rate for Payer: Aetna Commercial	$23.27
Rate for Payer: Aetna New Business (MI Preferred)	$17.80
Rate for Payer: BCBS Complete	$10.95
Rate for Payer: Cash Price	$21.90
Rate for Payer: Cofinity Commercial	$23.55
Rate for Payer: Cofinity Commercial	$19.17
Rate for Payer: Healthscope Commercial	$24.64
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$23.27
Rate for Payer: PHP Commercial	$23.27
Rate for Payer: Priority Health Cigna Priority Health	$19.17
Rate for Payer: Priority Health SBD	$17.25

WATER FOR INJECTION, STERILE INTRAVENOUS SOLUTION

Facility

$47.85

Service Code	NDC 0338-0013-04
Hospital Charge Code	28400
Hospital Revenue Code	250
Min. Negotiated Rate	$19.14
Max. Negotiated Rate	$43.06
Rate for Payer: Aetna Commercial	$40.67
Rate for Payer: Aetna New Business (MI Preferred)	$31.10
Rate for Payer: BCBS Complete	$19.14
Rate for Payer: Cash Price	$38.28
Rate for Payer: Cofinity Commercial	$33.50
Rate for Payer: Cofinity Commercial	$41.15
Rate for Payer: Healthscope Commercial	$43.06
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$40.67
Rate for Payer: PHP Commercial	$40.67
Rate for Payer: Priority Health Cigna Priority Health	$33.50
Rate for Payer: Priority Health SBD	$30.15

WATER FOR INJECTION, STERILE INTRAVENOUS SOLUTION

Facility

$47.85

Service Code	NDC 0338-0013-04
Hospital Charge Code	28400
Hospital Revenue Code	250
Min. Negotiated Rate	$30.15
Max. Negotiated Rate	$43.06
Rate for Payer: Aetna Commercial	$40.67
Rate for Payer: Aetna New Business (MI Preferred)	$31.10
Rate for Payer: Cash Price	$38.28
Rate for Payer: Cofinity Commercial	$33.50
Rate for Payer: Cofinity Commercial	$41.15
Rate for Payer: Healthscope Commercial	$43.06
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$40.67
Rate for Payer: PHP Commercial	$40.67
Rate for Payer: Priority Health Cigna Priority Health	$33.50
Rate for Payer: Priority Health SBD	$30.15

WATER FOR IRRIGATION, STERILE SOLUTION

Facility

$69.92

Service Code	NDC 0338-0004-04
Hospital Charge Code	7485
Hospital Revenue Code	250
Min. Negotiated Rate	$44.05
Max. Negotiated Rate	$62.93
Rate for Payer: Aetna Commercial	$59.43
Rate for Payer: Aetna New Business (MI Preferred)	$45.45
Rate for Payer: Cash Price	$55.94
Rate for Payer: Cofinity Commercial	$48.94
Rate for Payer: Cofinity Commercial	$60.13
Rate for Payer: Healthscope Commercial	$62.93
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$59.43
Rate for Payer: PHP Commercial	$59.43
Rate for Payer: Priority Health Cigna Priority Health	$48.94
Rate for Payer: Priority Health SBD	$44.05

WATER FOR IRRIGATION, STERILE SOLUTION

Facility

$47.85

Service Code	NDC 0338-0004-05
Hospital Charge Code	7485
Hospital Revenue Code	250
Min. Negotiated Rate	$30.15
Max. Negotiated Rate	$43.06
Rate for Payer: Aetna Commercial	$40.67
Rate for Payer: Aetna New Business (MI Preferred)	$31.10
Rate for Payer: Cash Price	$38.28
Rate for Payer: Cofinity Commercial	$33.50
Rate for Payer: Cofinity Commercial	$41.15
Rate for Payer: Healthscope Commercial	$43.06
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$40.67
Rate for Payer: PHP Commercial	$40.67
Rate for Payer: Priority Health Cigna Priority Health	$33.50
Rate for Payer: Priority Health SBD	$30.15

WATER FOR IRRIGATION, STERILE SOLUTION

Facility

$95.70

Service Code	NDC 0338-0003-47
Hospital Charge Code	7485
Hospital Revenue Code	250
Min. Negotiated Rate	$60.29
Max. Negotiated Rate	$86.13
Rate for Payer: Aetna Commercial	$81.34
Rate for Payer: Aetna New Business (MI Preferred)	$62.20
Rate for Payer: Cash Price	$76.56
Rate for Payer: Cofinity Commercial	$66.99
Rate for Payer: Cofinity Commercial	$82.30
Rate for Payer: Healthscope Commercial	$86.13
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$81.34
Rate for Payer: PHP Commercial	$81.34
Rate for Payer: Priority Health Cigna Priority Health	$66.99
Rate for Payer: Priority Health SBD	$60.29

WATER FOR IRRIGATION, STERILE SOLUTION

Facility

$63.80

Service Code	NDC 0338-0004-03
Hospital Charge Code	7485
Hospital Revenue Code	250
Min. Negotiated Rate	$40.19
Max. Negotiated Rate	$57.42
Rate for Payer: Aetna Commercial	$54.23
Rate for Payer: Aetna New Business (MI Preferred)	$41.47
Rate for Payer: Cash Price	$51.04
Rate for Payer: Cofinity Commercial	$44.66
Rate for Payer: Cofinity Commercial	$54.87
Rate for Payer: Healthscope Commercial	$57.42
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$54.23
Rate for Payer: PHP Commercial	$54.23
Rate for Payer: Priority Health Cigna Priority Health	$44.66
Rate for Payer: Priority Health SBD	$40.19

WHITE PETROLATUM 43 % TOPICAL OINTMENT

Facility

$31.64

Service Code	NDC 53329-077-31
Hospital Charge Code	118982
Hospital Revenue Code	637
Min. Negotiated Rate	$19.93
Max. Negotiated Rate	$28.48
Rate for Payer: Aetna Commercial	$26.89
Rate for Payer: Aetna New Business (MI Preferred)	$20.57
Rate for Payer: Cash Price	$25.31
Rate for Payer: Cofinity Commercial	$22.15
Rate for Payer: Cofinity Commercial	$27.21
Rate for Payer: Healthscope Commercial	$28.48
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$26.89
Rate for Payer: PHP Commercial	$26.89
Rate for Payer: Priority Health Cigna Priority Health	$22.15
Rate for Payer: Priority Health SBD	$19.93

WHITE PETROLATUM 43 % TOPICAL OINTMENT

Facility

$14.87

Service Code	NDC 53329-773-14
Hospital Charge Code	118982
Hospital Revenue Code	637
Min. Negotiated Rate	$9.37
Max. Negotiated Rate	$13.38
Rate for Payer: Aetna Commercial	$12.64
Rate for Payer: Aetna New Business (MI Preferred)	$9.67
Rate for Payer: Cash Price	$11.90
Rate for Payer: Cofinity Commercial	$10.41
Rate for Payer: Cofinity Commercial	$12.79
Rate for Payer: Healthscope Commercial	$13.38
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$12.64
Rate for Payer: PHP Commercial	$12.64
Rate for Payer: Priority Health Cigna Priority Health	$10.41
Rate for Payer: Priority Health SBD	$9.37

WHITE PETROLATUM 57.7 %-MINERAL OIL 31.9 % EYE OINTMENT

Facility

$24.64

Service Code	NDC 6373614308
Hospital Charge Code	175688
Hospital Revenue Code	637
Min. Negotiated Rate	$15.52
Max. Negotiated Rate	$22.18
Rate for Payer: Aetna Commercial	$20.94
Rate for Payer: Aetna New Business (MI Preferred)	$16.02
Rate for Payer: Cash Price	$19.71
Rate for Payer: Cofinity Commercial	$17.25
Rate for Payer: Cofinity Commercial	$21.19
Rate for Payer: Healthscope Commercial	$22.18
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$20.94
Rate for Payer: PHP Commercial	$20.94
Rate for Payer: Priority Health Cigna Priority Health	$17.25
Rate for Payer: Priority Health SBD	$15.52

WHITE PETROLATUM EYE OINTMENT WRAPPER

Facility

$24.64

Service Code	NDC 6373614308
Hospital Charge Code	301577
Hospital Revenue Code	637
Min. Negotiated Rate	$15.52
Max. Negotiated Rate	$22.18
Rate for Payer: Aetna Commercial	$20.94
Rate for Payer: Aetna New Business (MI Preferred)	$16.02
Rate for Payer: Cash Price	$19.71
Rate for Payer: Cofinity Commercial	$17.25
Rate for Payer: Cofinity Commercial	$21.19
Rate for Payer: Healthscope Commercial	$22.18
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$20.94
Rate for Payer: PHP Commercial	$20.94
Rate for Payer: Priority Health Cigna Priority Health	$17.25
Rate for Payer: Priority Health SBD	$15.52

WHITE PETROLATUM-MINERAL OIL TOPICAL CREAM

Facility

$12.88

Service Code	NDC 6192417804
Hospital Charge Code	11371
Hospital Revenue Code	637
Min. Negotiated Rate	$8.11
Max. Negotiated Rate	$11.59
Rate for Payer: Aetna Commercial	$10.95
Rate for Payer: Aetna New Business (MI Preferred)	$8.37
Rate for Payer: Cash Price	$10.30
Rate for Payer: Cofinity Commercial	$11.08
Rate for Payer: Cofinity Commercial	$9.02
Rate for Payer: Healthscope Commercial	$11.59
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$10.95
Rate for Payer: PHP Commercial	$10.95
Rate for Payer: Priority Health Cigna Priority Health	$9.02
Rate for Payer: Priority Health SBD	$8.11

WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC

Facility

$52,332.69

Service Code	MS-DRG 464
Min. Negotiated Rate	$21,002.78
Max. Negotiated Rate	$52,332.69
Rate for Payer: Aetna Medicare	$22,992.52
Rate for Payer: Allen County Amish Medical Aid Commercial	$27,635.24
Rate for Payer: Amish Plain Church Group Commercial	$27,635.24
Rate for Payer: BCBS MAPPO	$22,108.19
Rate for Payer: BCBS Trust/PPO	$52,332.69
Rate for Payer: BCN Medicare Advantage	$22,108.19
Rate for Payer: Health Alliance Plan Medicare Advantage	$22,108.19
Rate for Payer: Mclaren Medicare	$22,108.19
Rate for Payer: Meridian Wellcare - Medicare Advantage	$23,213.60
Rate for Payer: MI Amish Medical Board Commercial	$25,424.42
Rate for Payer: PACE Medicare	$21,002.78
Rate for Payer: PACE SWMI	$22,108.19
Rate for Payer: PHP Medicare Advantage	$22,108.19
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$43,069.85
Rate for Payer: Priority Health Medicare	$22,108.19
Rate for Payer: Priority Health Narrow Network	$34,455.88
Rate for Payer: Railroad Medicare Medicare	$22,108.19
Rate for Payer: UHC All Payor (Choice/PPO)	$45,783.36
Rate for Payer: UHC Core	$28,093.10
Rate for Payer: UHC Dual Complete DSNP	$22,108.19
Rate for Payer: UHC Exchange	$30,089.04
Rate for Payer: UHC Medicare Advantage	$22,771.44
Rate for Payer: VA VA	$22,108.19

WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC

Facility

$95,482.12

Service Code	MS-DRG 463
Min. Negotiated Rate	$39,217.45
Max. Negotiated Rate	$95,482.12
Rate for Payer: Aetna Medicare	$42,932.79
Rate for Payer: Allen County Amish Medical Aid Commercial	$51,601.91
Rate for Payer: Amish Plain Church Group Commercial	$51,601.91
Rate for Payer: BCBS MAPPO	$41,281.53
Rate for Payer: BCBS Trust/PPO	$95,482.12
Rate for Payer: BCN Medicare Advantage	$41,281.53
Rate for Payer: Health Alliance Plan Medicare Advantage	$41,281.53
Rate for Payer: Mclaren Medicare	$41,281.53
Rate for Payer: Meridian Wellcare - Medicare Advantage	$43,345.61
Rate for Payer: MI Amish Medical Board Commercial	$47,473.76
Rate for Payer: PACE Medicare	$39,217.45
Rate for Payer: PACE SWMI	$41,281.53
Rate for Payer: PHP Medicare Advantage	$41,281.53
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$81,273.64
Rate for Payer: Priority Health Medicare	$41,281.53
Rate for Payer: Priority Health Narrow Network	$65,018.91
Rate for Payer: Railroad Medicare Medicare	$41,281.53
Rate for Payer: UHC All Payor (Choice/PPO)	$86,394.08
Rate for Payer: UHC Core	$53,012.23
Rate for Payer: UHC Dual Complete DSNP	$41,281.53
Rate for Payer: UHC Exchange	$56,778.59
Rate for Payer: UHC Medicare Advantage	$42,519.98
Rate for Payer: VA VA	$41,281.53

WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC

Facility

$29,761.03

Service Code	MS-DRG 465
Min. Negotiated Rate	$13,267.55
Max. Negotiated Rate	$29,761.03
Rate for Payer: Aetna Medicare	$14,524.47
Rate for Payer: Allen County Amish Medical Aid Commercial	$17,457.30
Rate for Payer: Amish Plain Church Group Commercial	$17,457.30
Rate for Payer: BCBS MAPPO	$13,965.84
Rate for Payer: BCBS Trust/PPO	$29,761.03
Rate for Payer: BCN Medicare Advantage	$13,965.84
Rate for Payer: Health Alliance Plan Medicare Advantage	$13,965.84
Rate for Payer: Mclaren Medicare	$13,965.84
Rate for Payer: Meridian Wellcare - Medicare Advantage	$14,664.13
Rate for Payer: MI Amish Medical Board Commercial	$16,060.72
Rate for Payer: PACE Medicare	$13,267.55
Rate for Payer: PACE SWMI	$13,965.84
Rate for Payer: PHP Medicare Advantage	$13,965.84
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$26,845.83
Rate for Payer: Priority Health Medicare	$13,965.84
Rate for Payer: Priority Health Narrow Network	$21,476.66
Rate for Payer: Railroad Medicare Medicare	$13,965.84
Rate for Payer: UHC All Payor (Choice/PPO)	$28,537.18
Rate for Payer: UHC Core	$17,510.69
Rate for Payer: UHC Dual Complete DSNP	$13,965.84
Rate for Payer: UHC Exchange	$18,754.77
Rate for Payer: UHC Medicare Advantage	$14,384.82
Rate for Payer: VA VA	$13,965.84

WOUND DEBRIDEMENTS FOR INJURIES WITH CC

Facility

$40,376.01

Service Code	MS-DRG 902
Min. Negotiated Rate	$13,362.65
Max. Negotiated Rate	$40,376.01
Rate for Payer: Aetna Medicare	$14,628.59
Rate for Payer: Allen County Amish Medical Aid Commercial	$17,582.44
Rate for Payer: Amish Plain Church Group Commercial	$17,582.44
Rate for Payer: BCBS MAPPO	$14,065.95
Rate for Payer: BCBS Trust/PPO	$40,376.01
Rate for Payer: BCN Medicare Advantage	$14,065.95
Rate for Payer: Health Alliance Plan Medicare Advantage	$14,065.95
Rate for Payer: Mclaren Medicare	$14,065.95
Rate for Payer: Meridian Wellcare - Medicare Advantage	$14,769.25
Rate for Payer: MI Amish Medical Board Commercial	$16,175.84
Rate for Payer: PACE Medicare	$13,362.65
Rate for Payer: PACE SWMI	$14,065.95
Rate for Payer: PHP Medicare Advantage	$14,065.95
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$27,045.29
Rate for Payer: Priority Health Medicare	$14,065.95
Rate for Payer: Priority Health Narrow Network	$21,636.23
Rate for Payer: Railroad Medicare Medicare	$14,065.95
Rate for Payer: UHC All Payor (Choice/PPO)	$28,749.21
Rate for Payer: UHC Core	$17,640.79
Rate for Payer: UHC Dual Complete DSNP	$14,065.95
Rate for Payer: UHC Exchange	$18,894.12
Rate for Payer: UHC Medicare Advantage	$14,487.93
Rate for Payer: VA VA	$14,065.95

WOUND DEBRIDEMENTS FOR INJURIES WITH MCC

Facility

$66,016.26

Service Code	MS-DRG 901
Min. Negotiated Rate	$30,077.62
Max. Negotiated Rate	$66,016.26
Rate for Payer: Aetna Medicare	$32,927.08
Rate for Payer: Allen County Amish Medical Aid Commercial	$39,575.81
Rate for Payer: Amish Plain Church Group Commercial	$39,575.81
Rate for Payer: BCBS MAPPO	$31,660.65
Rate for Payer: BCBS Trust/PPO	$62,007.82
Rate for Payer: BCN Medicare Advantage	$31,660.65
Rate for Payer: Health Alliance Plan Medicare Advantage	$31,660.65
Rate for Payer: Mclaren Medicare	$31,660.65
Rate for Payer: Meridian Wellcare - Medicare Advantage	$33,243.68
Rate for Payer: MI Amish Medical Board Commercial	$36,409.75
Rate for Payer: PACE Medicare	$30,077.62
Rate for Payer: PACE SWMI	$31,660.65
Rate for Payer: PHP Medicare Advantage	$31,660.65
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$62,103.58
Rate for Payer: Priority Health Medicare	$31,660.65
Rate for Payer: Priority Health Narrow Network	$49,682.86
Rate for Payer: Railroad Medicare Medicare	$31,660.65
Rate for Payer: UHC All Payor (Choice/PPO)	$66,016.26
Rate for Payer: UHC Core	$40,508.21
Rate for Payer: UHC Dual Complete DSNP	$31,660.65
Rate for Payer: UHC Exchange	$43,386.20
Rate for Payer: UHC Medicare Advantage	$32,610.47
Rate for Payer: VA VA	$31,660.65

WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC

Facility

$22,433.31

Service Code	MS-DRG 903
Min. Negotiated Rate	$8,962.07
Max. Negotiated Rate	$22,433.31
Rate for Payer: Aetna Medicare	$9,811.11
Rate for Payer: Allen County Amish Medical Aid Commercial	$11,792.20
Rate for Payer: Amish Plain Church Group Commercial	$11,792.20
Rate for Payer: BCBS MAPPO	$9,433.76
Rate for Payer: BCBS Trust/PPO	$22,433.31
Rate for Payer: BCN Medicare Advantage	$9,433.76
Rate for Payer: Health Alliance Plan Medicare Advantage	$9,433.76
Rate for Payer: Mclaren Medicare	$9,433.76
Rate for Payer: Meridian Wellcare - Medicare Advantage	$9,905.45
Rate for Payer: MI Amish Medical Board Commercial	$10,848.82
Rate for Payer: PACE Medicare	$8,962.07
Rate for Payer: PACE SWMI	$9,433.76
Rate for Payer: PHP Medicare Advantage	$9,433.76
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$17,815.43
Rate for Payer: Priority Health Medicare	$9,433.76
Rate for Payer: Priority Health Narrow Network	$14,252.34
Rate for Payer: Railroad Medicare Medicare	$9,433.76
Rate for Payer: UHC All Payor (Choice/PPO)	$18,937.84
Rate for Payer: UHC Core	$11,620.44
Rate for Payer: UHC Dual Complete DSNP	$9,433.76
Rate for Payer: UHC Exchange	$12,446.04
Rate for Payer: UHC Medicare Advantage	$9,716.77
Rate for Payer: VA VA	$9,433.76

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