|
HC BOTRYTIS CINEREA IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200075
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$5.04
|
| Rate for Payer: BCN Commercial |
$5.04
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.37
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$4.30
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: UMR Bronson Commercial |
$9.39
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC BOTRYTIS CINEREA IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200075
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.17 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: UMR Bronson Commercial |
$11.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC BOTTLE A/B CDI 500
|
Facility
|
IP
|
$201.96
|
|
| Hospital Charge Code |
27000684
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$88.86 |
| Max. Negotiated Rate |
$181.76 |
| Rate for Payer: Aetna American Axle |
$131.27
|
| Rate for Payer: Aetna Commercial |
$171.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$131.27
|
| Rate for Payer: Cash Price |
$161.57
|
| Rate for Payer: Cofinity Commercial |
$141.37
|
| Rate for Payer: Cofinity Commercial |
$173.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$141.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$161.57
|
| Rate for Payer: Healthscope Commercial |
$181.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$141.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$151.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$171.67
|
| Rate for Payer: PHP Commercial |
$171.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$131.27
|
| Rate for Payer: Priority Health SBD |
$127.23
|
| Rate for Payer: UMR Bronson Commercial |
$88.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$151.47
|
|
|
HC BOTTLE A/B CDI 500
|
Facility
|
OP
|
$201.96
|
|
| Hospital Charge Code |
27000684
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$74.73 |
| Max. Negotiated Rate |
$181.76 |
| Rate for Payer: Aetna American Axle |
$131.27
|
| Rate for Payer: Aetna Commercial |
$171.67
|
| Rate for Payer: Aetna Medicare |
$100.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$131.27
|
| Rate for Payer: BCBS Complete |
$80.78
|
| Rate for Payer: Cash Price |
$161.57
|
| Rate for Payer: Cofinity Commercial |
$141.37
|
| Rate for Payer: Cofinity Commercial |
$173.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$141.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$161.57
|
| Rate for Payer: Healthscope Commercial |
$181.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$141.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$151.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$171.67
|
| Rate for Payer: PHP Commercial |
$171.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$131.27
|
| Rate for Payer: Priority Health SBD |
$127.23
|
| Rate for Payer: UMR Bronson Commercial |
$74.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$151.47
|
|
|
HC BOWL
|
Facility
|
OP
|
$229.50
|
|
| Hospital Charge Code |
27000091
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$84.92 |
| Max. Negotiated Rate |
$206.55 |
| Rate for Payer: Aetna American Axle |
$149.18
|
| Rate for Payer: Aetna Commercial |
$195.08
|
| Rate for Payer: Aetna Medicare |
$114.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$149.18
|
| Rate for Payer: BCBS Complete |
$91.80
|
| Rate for Payer: Cash Price |
$183.60
|
| Rate for Payer: Cofinity Commercial |
$160.65
|
| Rate for Payer: Cofinity Commercial |
$197.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$160.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$183.60
|
| Rate for Payer: Healthscope Commercial |
$206.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$160.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$172.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$195.08
|
| Rate for Payer: PHP Commercial |
$195.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.18
|
| Rate for Payer: Priority Health SBD |
$144.58
|
| Rate for Payer: UMR Bronson Commercial |
$84.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$172.12
|
|
|
HC BOWL
|
Facility
|
IP
|
$229.50
|
|
| Hospital Charge Code |
27000091
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$100.98 |
| Max. Negotiated Rate |
$206.55 |
| Rate for Payer: PHP Commercial |
$195.08
|
| Rate for Payer: Aetna American Axle |
$149.18
|
| Rate for Payer: Aetna Commercial |
$195.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$149.18
|
| Rate for Payer: Cash Price |
$183.60
|
| Rate for Payer: Cofinity Commercial |
$160.65
|
| Rate for Payer: Cofinity Commercial |
$197.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$160.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$183.60
|
| Rate for Payer: Healthscope Commercial |
$206.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$160.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$172.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$195.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.18
|
| Rate for Payer: Priority Health SBD |
$144.58
|
| Rate for Payer: UMR Bronson Commercial |
$100.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$172.12
|
|
|
HC BOWL ATS 55 ML
|
Facility
|
IP
|
$253.47
|
|
| Hospital Charge Code |
27000283
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$111.53 |
| Max. Negotiated Rate |
$228.12 |
| Rate for Payer: Aetna American Axle |
$164.76
|
| Rate for Payer: Aetna Commercial |
$215.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.76
|
| Rate for Payer: Cash Price |
$202.78
|
| Rate for Payer: Cofinity Commercial |
$177.43
|
| Rate for Payer: Cofinity Commercial |
$217.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$177.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$202.78
|
| Rate for Payer: Healthscope Commercial |
$228.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$177.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$190.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.45
|
| Rate for Payer: PHP Commercial |
$215.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.76
|
| Rate for Payer: Priority Health SBD |
$159.69
|
| Rate for Payer: UMR Bronson Commercial |
$111.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$190.10
|
|
|
HC BOWL ATS 55 ML
|
Facility
|
OP
|
$253.47
|
|
| Hospital Charge Code |
27000283
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$93.78 |
| Max. Negotiated Rate |
$228.12 |
| Rate for Payer: Aetna American Axle |
$164.76
|
| Rate for Payer: Aetna Commercial |
$215.45
|
| Rate for Payer: Aetna Medicare |
$126.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.76
|
| Rate for Payer: BCBS Complete |
$101.39
|
| Rate for Payer: Cash Price |
$202.78
|
| Rate for Payer: Cofinity Commercial |
$177.43
|
| Rate for Payer: Cofinity Commercial |
$217.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$177.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$202.78
|
| Rate for Payer: Healthscope Commercial |
$228.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$177.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$190.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.45
|
| Rate for Payer: PHP Commercial |
$215.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.76
|
| Rate for Payer: Priority Health SBD |
$159.69
|
| Rate for Payer: UMR Bronson Commercial |
$93.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$190.10
|
|
|
HC B. PARAPERTUSSIS BY PCR CMPT
|
Facility
|
IP
|
$52.44
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600219
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$23.07 |
| Max. Negotiated Rate |
$47.20 |
| Rate for Payer: Aetna American Axle |
$34.09
|
| Rate for Payer: Aetna Commercial |
$44.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.09
|
| Rate for Payer: Cash Price |
$41.95
|
| Rate for Payer: Cofinity Commercial |
$36.71
|
| Rate for Payer: Cofinity Commercial |
$45.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.95
|
| Rate for Payer: Healthscope Commercial |
$47.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.57
|
| Rate for Payer: PHP Commercial |
$44.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.09
|
| Rate for Payer: Priority Health SBD |
$33.04
|
| Rate for Payer: UMR Bronson Commercial |
$23.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.33
|
|
|
HC B. PARAPERTUSSIS BY PCR CMPT
|
Facility
|
OP
|
$52.44
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600219
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$52.64 |
| Rate for Payer: Aetna American Axle |
$34.09
|
| Rate for Payer: Aetna Commercial |
$44.57
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$33.81
|
| Rate for Payer: BCN Commercial |
$33.81
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$41.95
|
| Rate for Payer: Cash Price |
$41.95
|
| Rate for Payer: Cofinity Commercial |
$45.10
|
| Rate for Payer: Cofinity Commercial |
$36.71
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$47.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.33
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.57
|
| Rate for Payer: Nomi Health Commercial |
$52.64
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$44.57
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.09
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$33.04
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: UMR Bronson Commercial |
$19.40
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.33
|
|
|
HC B.PERTUSSIS BY PCR
|
Facility
|
IP
|
$57.40
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600218
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$25.26 |
| Max. Negotiated Rate |
$51.66 |
| Rate for Payer: Aetna American Axle |
$37.31
|
| Rate for Payer: Aetna Commercial |
$48.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.31
|
| Rate for Payer: Cash Price |
$45.92
|
| Rate for Payer: Cofinity Commercial |
$40.18
|
| Rate for Payer: Cofinity Commercial |
$49.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$40.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.92
|
| Rate for Payer: Healthscope Commercial |
$51.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.79
|
| Rate for Payer: PHP Commercial |
$48.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.31
|
| Rate for Payer: Priority Health SBD |
$36.16
|
| Rate for Payer: UMR Bronson Commercial |
$25.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.05
|
|
|
HC B.PERTUSSIS BY PCR
|
Facility
|
OP
|
$57.40
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600218
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$52.64 |
| Rate for Payer: Aetna American Axle |
$37.31
|
| Rate for Payer: Aetna Commercial |
$48.79
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$33.81
|
| Rate for Payer: BCN Commercial |
$33.81
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$45.92
|
| Rate for Payer: Cash Price |
$45.92
|
| Rate for Payer: Cofinity Commercial |
$49.36
|
| Rate for Payer: Cofinity Commercial |
$40.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$40.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$51.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.05
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.79
|
| Rate for Payer: Nomi Health Commercial |
$52.64
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$48.79
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.31
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$36.16
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: UMR Bronson Commercial |
$21.24
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.05
|
|
|
HC BRACE ADD TO LE PELVIC CONTROL HIP JOINT
|
Facility
|
OP
|
$972.10
|
|
|
Service Code
|
HCPCS L2624
|
| Hospital Charge Code |
27400039
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$359.68 |
| Max. Negotiated Rate |
$1,214.96 |
| Rate for Payer: Aetna American Axle |
$631.86
|
| Rate for Payer: Aetna Commercial |
$826.28
|
| Rate for Payer: Aetna Medicare |
$486.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$631.86
|
| Rate for Payer: BCBS Complete |
$388.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,214.96
|
| Rate for Payer: BCN Commercial |
$1,214.96
|
| Rate for Payer: Cash Price |
$777.68
|
| Rate for Payer: Cash Price |
$777.68
|
| Rate for Payer: Cofinity Commercial |
$680.47
|
| Rate for Payer: Cofinity Commercial |
$836.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$680.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$777.68
|
| Rate for Payer: Healthscope Commercial |
$874.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$680.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$729.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$826.28
|
| Rate for Payer: PHP Commercial |
$826.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$631.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$470.12
|
| Rate for Payer: Priority Health Narrow Network |
$376.10
|
| Rate for Payer: Priority Health SBD |
$612.42
|
| Rate for Payer: UMR Bronson Commercial |
$359.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$729.08
|
|
|
HC BRACE ADD TO LE PELVIC CONTROL HIP JOINT
|
Facility
|
IP
|
$972.10
|
|
|
Service Code
|
HCPCS L2624
|
| Hospital Charge Code |
27400039
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$427.72 |
| Max. Negotiated Rate |
$874.89 |
| Rate for Payer: Aetna American Axle |
$631.86
|
| Rate for Payer: Aetna Commercial |
$826.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$631.86
|
| Rate for Payer: Cash Price |
$777.68
|
| Rate for Payer: Cofinity Commercial |
$680.47
|
| Rate for Payer: Cofinity Commercial |
$836.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$680.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$777.68
|
| Rate for Payer: Healthscope Commercial |
$874.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$680.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$729.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$826.28
|
| Rate for Payer: PHP Commercial |
$826.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$631.86
|
| Rate for Payer: Priority Health SBD |
$612.42
|
| Rate for Payer: UMR Bronson Commercial |
$427.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$729.08
|
|
|
HC BRACE AFO
|
Facility
|
IP
|
$596.14
|
|
|
Service Code
|
HCPCS L1930
|
| Hospital Charge Code |
27000002
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$262.30 |
| Max. Negotiated Rate |
$536.53 |
| Rate for Payer: Aetna American Axle |
$387.49
|
| Rate for Payer: Aetna Commercial |
$506.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$387.49
|
| Rate for Payer: Cash Price |
$476.91
|
| Rate for Payer: Cofinity Commercial |
$417.30
|
| Rate for Payer: Cofinity Commercial |
$512.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$417.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$476.91
|
| Rate for Payer: Healthscope Commercial |
$536.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$417.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$447.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$506.72
|
| Rate for Payer: PHP Commercial |
$506.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.49
|
| Rate for Payer: Priority Health SBD |
$375.57
|
| Rate for Payer: UMR Bronson Commercial |
$262.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$447.10
|
|
|
HC BRACE AFO
|
Facility
|
OP
|
$596.14
|
|
|
Service Code
|
HCPCS L1930
|
| Hospital Charge Code |
27000002
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$220.57 |
| Max. Negotiated Rate |
$784.45 |
| Rate for Payer: Priority Health SBD |
$375.57
|
| Rate for Payer: UMR Bronson Commercial |
$220.57
|
| Rate for Payer: Aetna American Axle |
$387.49
|
| Rate for Payer: Aetna Commercial |
$506.72
|
| Rate for Payer: Aetna Medicare |
$298.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$387.49
|
| Rate for Payer: BCBS Complete |
$238.46
|
| Rate for Payer: BCBS Trust/PPO |
$784.45
|
| Rate for Payer: BCN Commercial |
$784.45
|
| Rate for Payer: Cash Price |
$476.91
|
| Rate for Payer: Cash Price |
$476.91
|
| Rate for Payer: Cofinity Commercial |
$417.30
|
| Rate for Payer: Cofinity Commercial |
$512.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$417.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$476.91
|
| Rate for Payer: Healthscope Commercial |
$536.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$417.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$447.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$506.72
|
| Rate for Payer: PHP Commercial |
$506.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$303.53
|
| Rate for Payer: Priority Health Narrow Network |
$242.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$447.10
|
|
|
HC BRACE AFO WITH INTERFACE
|
Facility
|
OP
|
$1,466.73
|
|
|
Service Code
|
HCPCS L1960
|
| Hospital Charge Code |
27000003
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$542.69 |
| Max. Negotiated Rate |
$1,930.18 |
| Rate for Payer: Aetna American Axle |
$953.37
|
| Rate for Payer: Aetna Commercial |
$1,246.72
|
| Rate for Payer: Aetna Medicare |
$733.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$953.37
|
| Rate for Payer: BCBS Complete |
$586.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,930.18
|
| Rate for Payer: BCN Commercial |
$1,930.18
|
| Rate for Payer: Cash Price |
$1,173.38
|
| Rate for Payer: Cash Price |
$1,173.38
|
| Rate for Payer: Cofinity Commercial |
$1,026.71
|
| Rate for Payer: Cofinity Commercial |
$1,261.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,026.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,173.38
|
| Rate for Payer: Healthscope Commercial |
$1,320.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,026.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,100.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,246.72
|
| Rate for Payer: PHP Commercial |
$1,246.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$953.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$746.86
|
| Rate for Payer: Priority Health Narrow Network |
$597.49
|
| Rate for Payer: Priority Health SBD |
$924.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$875.23
|
| Rate for Payer: UHC Exchange |
$729.36
|
| Rate for Payer: UMR Bronson Commercial |
$542.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,100.05
|
|
|
HC BRACE AFO WITH INTERFACE
|
Facility
|
IP
|
$1,466.73
|
|
|
Service Code
|
HCPCS L1960
|
| Hospital Charge Code |
27000003
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$645.36 |
| Max. Negotiated Rate |
$1,320.06 |
| Rate for Payer: Aetna American Axle |
$953.37
|
| Rate for Payer: Aetna Commercial |
$1,246.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$953.37
|
| Rate for Payer: Cash Price |
$1,173.38
|
| Rate for Payer: Cofinity Commercial |
$1,026.71
|
| Rate for Payer: Cofinity Commercial |
$1,261.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,026.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,173.38
|
| Rate for Payer: Healthscope Commercial |
$1,320.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,026.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,100.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,246.72
|
| Rate for Payer: PHP Commercial |
$1,246.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$953.37
|
| Rate for Payer: Priority Health SBD |
$924.04
|
| Rate for Payer: UMR Bronson Commercial |
$645.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,100.05
|
|
|
HC BRACE AK PELVIC CONTROL BELT LIGHT
|
Facility
|
IP
|
$329.81
|
|
|
Service Code
|
HCPCS L5692
|
| Hospital Charge Code |
27400038
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$145.12 |
| Max. Negotiated Rate |
$296.83 |
| Rate for Payer: Aetna American Axle |
$214.38
|
| Rate for Payer: Aetna Commercial |
$280.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$214.38
|
| Rate for Payer: Cash Price |
$263.85
|
| Rate for Payer: Cofinity Commercial |
$230.87
|
| Rate for Payer: Cofinity Commercial |
$283.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$230.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.85
|
| Rate for Payer: Healthscope Commercial |
$296.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$230.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$280.34
|
| Rate for Payer: PHP Commercial |
$280.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.38
|
| Rate for Payer: Priority Health SBD |
$207.78
|
| Rate for Payer: UMR Bronson Commercial |
$145.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.36
|
|
|
HC BRACE AK PELVIC CONTROL BELT LIGHT
|
Facility
|
OP
|
$329.81
|
|
|
Service Code
|
HCPCS L5692
|
| Hospital Charge Code |
27400038
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$122.03 |
| Max. Negotiated Rate |
$412.18 |
| Rate for Payer: Aetna American Axle |
$214.38
|
| Rate for Payer: Aetna Commercial |
$280.34
|
| Rate for Payer: Aetna Medicare |
$164.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$214.38
|
| Rate for Payer: BCBS Complete |
$131.92
|
| Rate for Payer: BCBS Trust/PPO |
$412.18
|
| Rate for Payer: BCN Commercial |
$412.18
|
| Rate for Payer: Cash Price |
$263.85
|
| Rate for Payer: Cash Price |
$263.85
|
| Rate for Payer: Cofinity Commercial |
$230.87
|
| Rate for Payer: Cofinity Commercial |
$283.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$230.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.85
|
| Rate for Payer: Healthscope Commercial |
$296.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$230.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$280.34
|
| Rate for Payer: PHP Commercial |
$280.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$159.48
|
| Rate for Payer: Priority Health Narrow Network |
$127.58
|
| Rate for Payer: Priority Health SBD |
$207.78
|
| Rate for Payer: UMR Bronson Commercial |
$122.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.36
|
|
|
HC BRACE AK PROSTH SOCK SINGLE-PLY/6
|
Facility
|
OP
|
$132.50
|
|
|
Service Code
|
HCPCS L8480
|
| Hospital Charge Code |
27400034
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$8.84 |
| Max. Negotiated Rate |
$119.25 |
| Rate for Payer: Aetna American Axle |
$86.12
|
| Rate for Payer: Aetna Commercial |
$112.62
|
| Rate for Payer: Aetna Medicare |
$66.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.12
|
| Rate for Payer: BCBS Complete |
$53.00
|
| Rate for Payer: BCBS Trust/PPO |
$28.55
|
| Rate for Payer: BCN Commercial |
$28.55
|
| Rate for Payer: Cash Price |
$106.00
|
| Rate for Payer: Cash Price |
$106.00
|
| Rate for Payer: Cofinity Commercial |
$113.95
|
| Rate for Payer: Cofinity Commercial |
$92.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$92.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.00
|
| Rate for Payer: Healthscope Commercial |
$119.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$92.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.62
|
| Rate for Payer: PHP Commercial |
$112.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.05
|
| Rate for Payer: Priority Health Narrow Network |
$8.84
|
| Rate for Payer: Priority Health SBD |
$83.48
|
| Rate for Payer: UMR Bronson Commercial |
$49.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.38
|
|
|
HC BRACE AK PROSTH SOCK SINGLE-PLY/6
|
Facility
|
IP
|
$132.50
|
|
|
Service Code
|
HCPCS L8480
|
| Hospital Charge Code |
27400034
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$58.30 |
| Max. Negotiated Rate |
$119.25 |
| Rate for Payer: Aetna American Axle |
$86.12
|
| Rate for Payer: Aetna Commercial |
$112.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.12
|
| Rate for Payer: Cash Price |
$106.00
|
| Rate for Payer: Cofinity Commercial |
$113.95
|
| Rate for Payer: Cofinity Commercial |
$92.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$92.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.00
|
| Rate for Payer: Healthscope Commercial |
$119.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$92.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.62
|
| Rate for Payer: PHP Commercial |
$112.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.12
|
| Rate for Payer: Priority Health SBD |
$83.48
|
| Rate for Payer: UMR Bronson Commercial |
$58.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.38
|
|
|
HC BRACE AK RIGID DRESSING NWB
|
Facility
|
IP
|
$1,497.14
|
|
|
Service Code
|
HCPCS L5460
|
| Hospital Charge Code |
27400033
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$658.74 |
| Max. Negotiated Rate |
$1,347.43 |
| Rate for Payer: Aetna American Axle |
$973.14
|
| Rate for Payer: Aetna Commercial |
$1,272.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$973.14
|
| Rate for Payer: Cash Price |
$1,197.71
|
| Rate for Payer: Cofinity Commercial |
$1,048.00
|
| Rate for Payer: Cofinity Commercial |
$1,287.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,048.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,197.71
|
| Rate for Payer: Healthscope Commercial |
$1,347.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,048.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,122.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,272.57
|
| Rate for Payer: PHP Commercial |
$1,272.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$973.14
|
| Rate for Payer: Priority Health SBD |
$943.20
|
| Rate for Payer: UMR Bronson Commercial |
$658.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,122.86
|
|
|
HC BRACE AK RIGID DRESSING NWB
|
Facility
|
OP
|
$1,497.14
|
|
|
Service Code
|
HCPCS L5460
|
| Hospital Charge Code |
27400033
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$553.94 |
| Max. Negotiated Rate |
$1,935.29 |
| Rate for Payer: Aetna American Axle |
$973.14
|
| Rate for Payer: Aetna Commercial |
$1,272.57
|
| Rate for Payer: Aetna Medicare |
$748.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$973.14
|
| Rate for Payer: BCBS Complete |
$598.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,935.29
|
| Rate for Payer: BCN Commercial |
$1,935.29
|
| Rate for Payer: Cash Price |
$1,197.71
|
| Rate for Payer: Cash Price |
$1,197.71
|
| Rate for Payer: Cofinity Commercial |
$1,048.00
|
| Rate for Payer: Cofinity Commercial |
$1,287.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,048.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,197.71
|
| Rate for Payer: Healthscope Commercial |
$1,347.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,048.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,122.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,272.57
|
| Rate for Payer: PHP Commercial |
$1,272.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$973.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$748.84
|
| Rate for Payer: Priority Health Narrow Network |
$599.07
|
| Rate for Payer: Priority Health SBD |
$943.20
|
| Rate for Payer: UMR Bronson Commercial |
$553.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,122.86
|
|
|
HC BRACE ANKLE STIRRUP SPLINT
|
Facility
|
OP
|
$147.44
|
|
|
Service Code
|
HCPCS L4350
|
| Hospital Charge Code |
27400001
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$54.55 |
| Max. Negotiated Rate |
$301.27 |
| Rate for Payer: Aetna American Axle |
$95.84
|
| Rate for Payer: Aetna Commercial |
$125.32
|
| Rate for Payer: Aetna Medicare |
$73.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.84
|
| Rate for Payer: BCBS Complete |
$58.98
|
| Rate for Payer: BCBS Trust/PPO |
$301.27
|
| Rate for Payer: BCN Commercial |
$301.27
|
| Rate for Payer: Cash Price |
$117.95
|
| Rate for Payer: Cash Price |
$117.95
|
| Rate for Payer: Cofinity Commercial |
$103.21
|
| Rate for Payer: Cofinity Commercial |
$126.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$103.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$117.95
|
| Rate for Payer: Healthscope Commercial |
$132.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$103.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125.32
|
| Rate for Payer: PHP Commercial |
$125.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$95.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$116.57
|
| Rate for Payer: Priority Health Narrow Network |
$93.26
|
| Rate for Payer: Priority Health SBD |
$92.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$136.61
|
| Rate for Payer: UHC Exchange |
$113.84
|
| Rate for Payer: UMR Bronson Commercial |
$54.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.58
|
|
