|
HC KENTUCKY BLUE IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200090
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.95 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna American Axle |
$16.18
|
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.18
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$17.42
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health SBD |
$15.68
|
| Rate for Payer: UMR Bronson Commercial |
$10.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC KENTUCKY BLUE IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200090
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna American Axle |
$16.18
|
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.18
|
| 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 |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$4.70
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$17.42
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.16
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$5.73
|
| Rate for Payer: Priority Health SBD |
$15.68
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.26
|
| Rate for Payer: UHC Core |
$8.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: UMR Bronson Commercial |
$9.21
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC KETONES (ACETONE)
|
Facility
|
IP
|
$36.10
|
|
|
Service Code
|
CPT 82009
|
| Hospital Charge Code |
30100067
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.88 |
| Max. Negotiated Rate |
$32.49 |
| Rate for Payer: Aetna American Axle |
$23.46
|
| Rate for Payer: Aetna Commercial |
$30.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.46
|
| Rate for Payer: Cash Price |
$28.88
|
| Rate for Payer: Cofinity Commercial |
$25.27
|
| Rate for Payer: Cofinity Commercial |
$31.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.88
|
| Rate for Payer: Healthscope Commercial |
$32.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.68
|
| Rate for Payer: PHP Commercial |
$30.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.27
|
| Rate for Payer: Priority Health SBD |
$22.74
|
| Rate for Payer: UMR Bronson Commercial |
$15.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.08
|
|
|
HC KETONES (ACETONE)
|
Facility
|
OP
|
$36.10
|
|
|
Service Code
|
CPT 82009
|
| Hospital Charge Code |
30100067
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.47 |
| Max. Negotiated Rate |
$32.49 |
| Rate for Payer: Aetna American Axle |
$23.46
|
| Rate for Payer: Aetna Commercial |
$30.68
|
| Rate for Payer: Aetna Medicare |
$4.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.65
|
| Rate for Payer: BCBS Complete |
$2.60
|
| Rate for Payer: BCBS MAPPO |
$4.52
|
| Rate for Payer: BCBS Trust/PPO |
$4.06
|
| Rate for Payer: BCN Medicare Advantage |
$4.52
|
| Rate for Payer: Cash Price |
$28.88
|
| Rate for Payer: Cash Price |
$28.88
|
| Rate for Payer: Cofinity Commercial |
$25.27
|
| Rate for Payer: Cofinity Commercial |
$31.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.52
|
| Rate for Payer: Healthscope Commercial |
$32.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.08
|
| Rate for Payer: Mclaren Medicaid |
$2.47
|
| Rate for Payer: Mclaren Medicare |
$4.52
|
| Rate for Payer: Meridian Medicaid |
$2.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.68
|
| Rate for Payer: PACE Medicare |
$4.29
|
| Rate for Payer: PACE SWMI |
$4.52
|
| Rate for Payer: PHP Commercial |
$30.68
|
| Rate for Payer: PHP Medicare Advantage |
$4.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.33
|
| Rate for Payer: Priority Health Medicare |
$4.52
|
| Rate for Payer: Priority Health Narrow Network |
$3.46
|
| Rate for Payer: Priority Health SBD |
$22.74
|
| Rate for Payer: Railroad Medicare Medicare |
$4.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.42
|
| Rate for Payer: UHC Core |
$7.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.52
|
| Rate for Payer: UHC Exchange |
$4.52
|
| Rate for Payer: UHC Medicare Advantage |
$4.66
|
| Rate for Payer: UMR Bronson Commercial |
$13.36
|
| Rate for Payer: VA VA |
$4.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.08
|
|
|
HC KIDNEY ENDOSCOPY
|
Facility
|
IP
|
$5,852.76
|
|
|
Service Code
|
CPT 50551
|
| Hospital Charge Code |
76100307
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,575.21 |
| Max. Negotiated Rate |
$5,267.48 |
| Rate for Payer: Aetna American Axle |
$3,804.29
|
| Rate for Payer: Aetna Commercial |
$4,974.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,804.29
|
| Rate for Payer: Cash Price |
$4,682.21
|
| Rate for Payer: Cofinity Commercial |
$4,096.93
|
| Rate for Payer: Cofinity Commercial |
$5,033.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,682.21
|
| Rate for Payer: Healthscope Commercial |
$5,267.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,096.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,389.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,974.85
|
| Rate for Payer: PHP Commercial |
$4,974.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,096.93
|
| Rate for Payer: Priority Health SBD |
$3,687.24
|
| Rate for Payer: UMR Bronson Commercial |
$2,575.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,389.57
|
|
|
HC KIDNEY ENDOSCOPY
|
Facility
|
OP
|
$5,852.76
|
|
|
Service Code
|
CPT 50551
|
| Hospital Charge Code |
76100307
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$283.56 |
| Max. Negotiated Rate |
$14,479.04 |
| Rate for Payer: Aetna American Axle |
$3,804.29
|
| Rate for Payer: Aetna Commercial |
$4,974.85
|
| Rate for Payer: Aetna Medicare |
$4,783.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,804.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,749.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,749.21
|
| Rate for Payer: BCBS Complete |
$2,641.88
|
| Rate for Payer: BCBS MAPPO |
$4,599.37
|
| Rate for Payer: BCBS Trust/PPO |
$2,584.37
|
| Rate for Payer: BCN Medicare Advantage |
$4,599.37
|
| Rate for Payer: Cash Price |
$4,682.21
|
| Rate for Payer: Cash Price |
$4,682.21
|
| Rate for Payer: Cofinity Commercial |
$5,033.37
|
| Rate for Payer: Cofinity Commercial |
$4,096.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,682.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,599.37
|
| Rate for Payer: Healthscope Commercial |
$5,267.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,096.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,389.57
|
| Rate for Payer: Mclaren Medicaid |
$2,515.86
|
| Rate for Payer: Mclaren Medicare |
$4,599.37
|
| Rate for Payer: Meridian Medicaid |
$2,641.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4,829.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,289.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,974.85
|
| Rate for Payer: PACE Medicare |
$4,369.40
|
| Rate for Payer: PACE SWMI |
$4,599.37
|
| Rate for Payer: PHP Commercial |
$4,974.85
|
| Rate for Payer: PHP Medicare Advantage |
$4,599.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,515.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,096.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14,479.04
|
| Rate for Payer: Priority Health Medicare |
$4,599.37
|
| Rate for Payer: Priority Health Narrow Network |
$11,583.23
|
| Rate for Payer: Priority Health SBD |
$3,687.24
|
| Rate for Payer: Railroad Medicare Medicare |
$4,599.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$311.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,599.37
|
| Rate for Payer: UHC Exchange |
$283.56
|
| Rate for Payer: UHC Medicare Advantage |
$4,737.35
|
| Rate for Payer: UMR Bronson Commercial |
$2,165.52
|
| Rate for Payer: VA VA |
$4,599.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,389.57
|
|
|
HC KINEVAC 5 MCG IV
|
Facility
|
IP
|
$135.72
|
|
|
Service Code
|
HCPCS J2805
|
| Hospital Charge Code |
63600014
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$59.72 |
| Max. Negotiated Rate |
$122.15 |
| Rate for Payer: Aetna American Axle |
$88.22
|
| Rate for Payer: Aetna Commercial |
$115.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.22
|
| Rate for Payer: Cash Price |
$108.58
|
| Rate for Payer: Cofinity Commercial |
$116.72
|
| Rate for Payer: Cofinity Commercial |
$95.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.58
|
| Rate for Payer: Healthscope Commercial |
$122.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$95.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$115.36
|
| Rate for Payer: PHP Commercial |
$115.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$95.00
|
| Rate for Payer: Priority Health SBD |
$85.50
|
| Rate for Payer: UMR Bronson Commercial |
$59.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.79
|
|
|
HC KINEVAC 5 MCG IV
|
Facility
|
OP
|
$135.72
|
|
|
Service Code
|
HCPCS J2805
|
| Hospital Charge Code |
63600014
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$50.22 |
| Max. Negotiated Rate |
$430.11 |
| Rate for Payer: Aetna American Axle |
$88.22
|
| Rate for Payer: Aetna Commercial |
$115.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.22
|
| Rate for Payer: BCBS Complete |
$54.29
|
| Rate for Payer: BCBS Trust/PPO |
$430.11
|
| Rate for Payer: Cash Price |
$108.58
|
| Rate for Payer: Cash Price |
$108.58
|
| Rate for Payer: Cofinity Commercial |
$116.72
|
| Rate for Payer: Cofinity Commercial |
$95.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.58
|
| Rate for Payer: Healthscope Commercial |
$122.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$95.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$115.36
|
| Rate for Payer: PHP Commercial |
$115.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$95.00
|
| Rate for Payer: Priority Health SBD |
$85.50
|
| Rate for Payer: UMR Bronson Commercial |
$50.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.79
|
|
|
HC KIT ATS
|
Facility
|
OP
|
$150.00
|
|
| Hospital Charge Code |
27000666
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$55.50 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna American Axle |
$97.50
|
| Rate for Payer: Aetna Commercial |
$127.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.50
|
| Rate for Payer: BCBS Complete |
$60.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cofinity Commercial |
$105.00
|
| Rate for Payer: Cofinity Commercial |
$129.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.00
|
| Rate for Payer: Healthscope Commercial |
$135.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$105.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$127.50
|
| Rate for Payer: PHP Commercial |
$127.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.00
|
| Rate for Payer: Priority Health SBD |
$94.50
|
| Rate for Payer: UMR Bronson Commercial |
$55.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.50
|
|
|
HC KIT ATS
|
Facility
|
IP
|
$150.00
|
|
| Hospital Charge Code |
27000666
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$66.00 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna American Axle |
$97.50
|
| Rate for Payer: Aetna Commercial |
$127.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.50
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cofinity Commercial |
$105.00
|
| Rate for Payer: Cofinity Commercial |
$129.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.00
|
| Rate for Payer: Healthscope Commercial |
$135.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$105.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$127.50
|
| Rate for Payer: PHP Commercial |
$127.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.00
|
| Rate for Payer: Priority Health SBD |
$94.50
|
| Rate for Payer: UMR Bronson Commercial |
$66.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.50
|
|
|
HC KIT DILATOR VASC
|
Facility
|
OP
|
$525.00
|
|
| Hospital Charge Code |
27000101
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$194.25 |
| Max. Negotiated Rate |
$472.50 |
| Rate for Payer: Aetna American Axle |
$341.25
|
| Rate for Payer: Aetna Commercial |
$446.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$341.25
|
| Rate for Payer: BCBS Complete |
$210.00
|
| Rate for Payer: Cash Price |
$420.00
|
| Rate for Payer: Cofinity Commercial |
$367.50
|
| Rate for Payer: Cofinity Commercial |
$451.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$420.00
|
| Rate for Payer: Healthscope Commercial |
$472.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$367.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$393.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$446.25
|
| Rate for Payer: PHP Commercial |
$446.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$367.50
|
| Rate for Payer: Priority Health SBD |
$330.75
|
| Rate for Payer: UMR Bronson Commercial |
$194.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$393.75
|
|
|
HC KIT DILATOR VASC
|
Facility
|
IP
|
$525.00
|
|
| Hospital Charge Code |
27000101
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$231.00 |
| Max. Negotiated Rate |
$472.50 |
| Rate for Payer: Aetna American Axle |
$341.25
|
| Rate for Payer: Aetna Commercial |
$446.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$341.25
|
| Rate for Payer: Cash Price |
$420.00
|
| Rate for Payer: Cofinity Commercial |
$367.50
|
| Rate for Payer: Cofinity Commercial |
$451.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$420.00
|
| Rate for Payer: Healthscope Commercial |
$472.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$367.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$393.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$446.25
|
| Rate for Payer: PHP Commercial |
$446.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$367.50
|
| Rate for Payer: Priority Health SBD |
$330.75
|
| Rate for Payer: UMR Bronson Commercial |
$231.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$393.75
|
|
|
HC KLEIHAUER-BETKE STAIN
|
Facility
|
IP
|
$120.80
|
|
|
Service Code
|
CPT 85460
|
| Hospital Charge Code |
30500046
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$53.15 |
| Max. Negotiated Rate |
$108.72 |
| Rate for Payer: Aetna American Axle |
$78.52
|
| Rate for Payer: Aetna Commercial |
$102.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.52
|
| Rate for Payer: Cash Price |
$96.64
|
| Rate for Payer: Cofinity Commercial |
$103.89
|
| Rate for Payer: Cofinity Commercial |
$84.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.64
|
| Rate for Payer: Healthscope Commercial |
$108.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$84.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$102.68
|
| Rate for Payer: PHP Commercial |
$102.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.56
|
| Rate for Payer: Priority Health SBD |
$76.10
|
| Rate for Payer: UMR Bronson Commercial |
$53.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.60
|
|
|
HC KLEIHAUER-BETKE STAIN
|
Facility
|
OP
|
$120.80
|
|
|
Service Code
|
CPT 85460
|
| Hospital Charge Code |
30500046
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.23 |
| Max. Negotiated Rate |
$108.72 |
| Rate for Payer: Aetna American Axle |
$78.52
|
| Rate for Payer: Aetna Commercial |
$102.68
|
| Rate for Payer: Aetna Medicare |
$8.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.66
|
| Rate for Payer: BCBS Complete |
$4.44
|
| Rate for Payer: BCBS MAPPO |
$7.73
|
| Rate for Payer: BCBS Trust/PPO |
$6.95
|
| Rate for Payer: BCN Medicare Advantage |
$7.73
|
| Rate for Payer: Cash Price |
$96.64
|
| Rate for Payer: Cash Price |
$96.64
|
| Rate for Payer: Cofinity Commercial |
$103.89
|
| Rate for Payer: Cofinity Commercial |
$84.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.73
|
| Rate for Payer: Healthscope Commercial |
$108.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$84.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.60
|
| Rate for Payer: Mclaren Medicaid |
$4.23
|
| Rate for Payer: Mclaren Medicare |
$7.73
|
| Rate for Payer: Meridian Medicaid |
$4.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$102.68
|
| Rate for Payer: PACE Medicare |
$7.34
|
| Rate for Payer: PACE SWMI |
$7.73
|
| Rate for Payer: PHP Commercial |
$102.68
|
| Rate for Payer: PHP Medicare Advantage |
$7.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10.61
|
| Rate for Payer: Priority Health Medicare |
$7.73
|
| Rate for Payer: Priority Health Narrow Network |
$8.49
|
| Rate for Payer: Priority Health SBD |
$76.10
|
| Rate for Payer: Railroad Medicare Medicare |
$7.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.28
|
| Rate for Payer: UHC Core |
$12.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.73
|
| Rate for Payer: UHC Exchange |
$7.73
|
| Rate for Payer: UHC Medicare Advantage |
$7.96
|
| Rate for Payer: UMR Bronson Commercial |
$44.70
|
| Rate for Payer: VA VA |
$7.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.60
|
|
|
HC KOH PREPARATION
|
Facility
|
OP
|
$23.46
|
|
|
Service Code
|
CPT 87220
|
| Hospital Charge Code |
30600111
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.34 |
| Max. Negotiated Rate |
$21.11 |
| Rate for Payer: Aetna American Axle |
$15.25
|
| Rate for Payer: Aetna Commercial |
$19.94
|
| Rate for Payer: Aetna Medicare |
$4.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.34
|
| Rate for Payer: BCBS Complete |
$2.45
|
| Rate for Payer: BCBS MAPPO |
$4.27
|
| Rate for Payer: BCBS Trust/PPO |
$3.84
|
| Rate for Payer: BCN Medicare Advantage |
$4.27
|
| Rate for Payer: Cash Price |
$18.77
|
| Rate for Payer: Cash Price |
$18.77
|
| Rate for Payer: Cofinity Commercial |
$20.18
|
| Rate for Payer: Cofinity Commercial |
$16.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.27
|
| Rate for Payer: Healthscope Commercial |
$21.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.60
|
| Rate for Payer: Mclaren Medicaid |
$2.34
|
| Rate for Payer: Mclaren Medicare |
$4.27
|
| Rate for Payer: Meridian Medicaid |
$2.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.94
|
| Rate for Payer: PACE Medicare |
$4.06
|
| Rate for Payer: PACE SWMI |
$4.27
|
| Rate for Payer: PHP Commercial |
$19.94
|
| Rate for Payer: PHP Medicare Advantage |
$4.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.86
|
| Rate for Payer: Priority Health Medicare |
$4.27
|
| Rate for Payer: Priority Health Narrow Network |
$4.69
|
| Rate for Payer: Priority Health SBD |
$14.78
|
| Rate for Payer: Railroad Medicare Medicare |
$4.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.12
|
| Rate for Payer: UHC Core |
$7.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.27
|
| Rate for Payer: UHC Exchange |
$4.27
|
| Rate for Payer: UHC Medicare Advantage |
$4.40
|
| Rate for Payer: UMR Bronson Commercial |
$8.68
|
| Rate for Payer: VA VA |
$4.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.60
|
|
|
HC KOH PREPARATION
|
Facility
|
IP
|
$23.46
|
|
|
Service Code
|
CPT 87220
|
| Hospital Charge Code |
30600111
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.32 |
| Max. Negotiated Rate |
$21.11 |
| Rate for Payer: Aetna American Axle |
$15.25
|
| Rate for Payer: Aetna Commercial |
$19.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.25
|
| Rate for Payer: Cash Price |
$18.77
|
| Rate for Payer: Cofinity Commercial |
$16.42
|
| Rate for Payer: Cofinity Commercial |
$20.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.77
|
| Rate for Payer: Healthscope Commercial |
$21.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.94
|
| Rate for Payer: PHP Commercial |
$19.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.42
|
| Rate for Payer: Priority Health SBD |
$14.78
|
| Rate for Payer: UMR Bronson Commercial |
$10.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.60
|
|
|
HC KYLEENA 19.5MG
|
Facility
|
IP
|
$2,878.85
|
|
|
Service Code
|
CPT J7296
|
| Hospital Charge Code |
63600165
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,266.69 |
| Max. Negotiated Rate |
$2,590.96 |
| Rate for Payer: Aetna American Axle |
$1,871.25
|
| Rate for Payer: Aetna Commercial |
$2,447.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,871.25
|
| Rate for Payer: Cash Price |
$2,303.08
|
| Rate for Payer: Cofinity Commercial |
$2,015.20
|
| Rate for Payer: Cofinity Commercial |
$2,475.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,303.08
|
| Rate for Payer: Healthscope Commercial |
$2,590.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,015.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,159.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,447.02
|
| Rate for Payer: PHP Commercial |
$2,447.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,015.20
|
| Rate for Payer: Priority Health SBD |
$1,813.68
|
| Rate for Payer: UMR Bronson Commercial |
$1,266.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,159.14
|
|
|
HC KYLEENA 19.5MG
|
Facility
|
OP
|
$2,878.85
|
|
|
Service Code
|
CPT J7296
|
| Hospital Charge Code |
63600165
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$934.24 |
| Max. Negotiated Rate |
$3,547.36 |
| Rate for Payer: Aetna American Axle |
$1,871.25
|
| Rate for Payer: Aetna Commercial |
$2,447.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,871.25
|
| Rate for Payer: BCBS Complete |
$1,151.54
|
| Rate for Payer: BCBS Trust/PPO |
$3,547.36
|
| Rate for Payer: Cash Price |
$2,303.08
|
| Rate for Payer: Cash Price |
$2,303.08
|
| Rate for Payer: Cofinity Commercial |
$2,015.20
|
| Rate for Payer: Cofinity Commercial |
$2,475.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,303.08
|
| Rate for Payer: Healthscope Commercial |
$2,590.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,015.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,159.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,447.02
|
| Rate for Payer: PHP Commercial |
$2,447.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,015.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,167.80
|
| Rate for Payer: Priority Health Narrow Network |
$934.24
|
| Rate for Payer: Priority Health SBD |
$1,813.68
|
| Rate for Payer: UMR Bronson Commercial |
$1,065.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,159.14
|
|
|
HC LAAC IMPLANT
|
Facility
|
OP
|
$18,207.00
|
|
| Hospital Charge Code |
27800117
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,736.59 |
| Max. Negotiated Rate |
$16,386.30 |
| Rate for Payer: Aetna American Axle |
$11,834.55
|
| Rate for Payer: Aetna Commercial |
$15,475.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,834.55
|
| Rate for Payer: BCBS Complete |
$7,282.80
|
| Rate for Payer: Cash Price |
$14,565.60
|
| Rate for Payer: Cofinity Commercial |
$12,744.90
|
| Rate for Payer: Cofinity Commercial |
$15,658.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,565.60
|
| Rate for Payer: Healthscope Commercial |
$16,386.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12,744.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,655.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15,475.95
|
| Rate for Payer: PHP Commercial |
$15,475.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,744.90
|
| Rate for Payer: Priority Health SBD |
$11,470.41
|
| Rate for Payer: UMR Bronson Commercial |
$6,736.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,655.25
|
|
|
HC LAAC IMPLANT
|
Facility
|
IP
|
$18,207.00
|
|
| Hospital Charge Code |
27800117
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,011.08 |
| Max. Negotiated Rate |
$16,386.30 |
| Rate for Payer: Aetna American Axle |
$11,834.55
|
| Rate for Payer: Aetna Commercial |
$15,475.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,834.55
|
| Rate for Payer: Cash Price |
$14,565.60
|
| Rate for Payer: Cofinity Commercial |
$12,744.90
|
| Rate for Payer: Cofinity Commercial |
$15,658.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,565.60
|
| Rate for Payer: Healthscope Commercial |
$16,386.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12,744.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,655.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15,475.95
|
| Rate for Payer: PHP Commercial |
$15,475.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,744.90
|
| Rate for Payer: Priority Health SBD |
$11,470.41
|
| Rate for Payer: UMR Bronson Commercial |
$8,011.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,655.25
|
|
|
HC LABOR CAT (1) 0-2HRS
|
Facility
|
IP
|
$1,500.99
|
|
| Hospital Charge Code |
72000001
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$660.44 |
| Max. Negotiated Rate |
$1,350.89 |
| Rate for Payer: Aetna American Axle |
$975.64
|
| Rate for Payer: Aetna Commercial |
$1,275.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$975.64
|
| Rate for Payer: Cash Price |
$1,200.79
|
| Rate for Payer: Cofinity Commercial |
$1,050.69
|
| Rate for Payer: Cofinity Commercial |
$1,290.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,200.79
|
| Rate for Payer: Healthscope Commercial |
$1,350.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,050.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,125.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,275.84
|
| Rate for Payer: PHP Commercial |
$1,275.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,050.69
|
| Rate for Payer: Priority Health SBD |
$945.62
|
| Rate for Payer: UMR Bronson Commercial |
$660.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,125.74
|
|
|
HC LABOR CAT (1) 0-2HRS
|
Facility
|
OP
|
$1,500.99
|
|
| Hospital Charge Code |
72000001
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$555.37 |
| Max. Negotiated Rate |
$2,286.00 |
| Rate for Payer: Aetna American Axle |
$975.64
|
| Rate for Payer: Aetna Commercial |
$1,275.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$975.64
|
| Rate for Payer: BCBS Complete |
$600.40
|
| Rate for Payer: Cash Price |
$1,200.79
|
| Rate for Payer: Cash Price |
$1,200.79
|
| Rate for Payer: Cofinity Commercial |
$1,290.85
|
| Rate for Payer: Cofinity Commercial |
$1,050.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,200.79
|
| Rate for Payer: Healthscope Commercial |
$1,350.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,050.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,125.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,275.84
|
| Rate for Payer: PHP Commercial |
$1,275.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,050.69
|
| Rate for Payer: Priority Health SBD |
$945.62
|
| Rate for Payer: UHC Core |
$2,286.00
|
| Rate for Payer: UMR Bronson Commercial |
$555.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,125.74
|
|
|
HC LABOR CAT (2) 2-5HRS
|
Facility
|
IP
|
$2,001.38
|
|
| Hospital Charge Code |
72000002
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$880.61 |
| Max. Negotiated Rate |
$1,801.24 |
| Rate for Payer: Aetna American Axle |
$1,300.90
|
| Rate for Payer: Aetna Commercial |
$1,701.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,300.90
|
| Rate for Payer: Cash Price |
$1,601.10
|
| Rate for Payer: Cofinity Commercial |
$1,721.19
|
| Rate for Payer: Cofinity Commercial |
$1,400.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,601.10
|
| Rate for Payer: Healthscope Commercial |
$1,801.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,400.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,501.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,701.17
|
| Rate for Payer: PHP Commercial |
$1,701.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,400.97
|
| Rate for Payer: Priority Health SBD |
$1,260.87
|
| Rate for Payer: UMR Bronson Commercial |
$880.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,501.04
|
|
|
HC LABOR CAT (2) 2-5HRS
|
Facility
|
OP
|
$2,001.38
|
|
| Hospital Charge Code |
72000002
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$740.51 |
| Max. Negotiated Rate |
$2,286.00 |
| Rate for Payer: Aetna American Axle |
$1,300.90
|
| Rate for Payer: Aetna Commercial |
$1,701.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,300.90
|
| Rate for Payer: BCBS Complete |
$800.55
|
| Rate for Payer: Cash Price |
$1,601.10
|
| Rate for Payer: Cash Price |
$1,601.10
|
| Rate for Payer: Cofinity Commercial |
$1,721.19
|
| Rate for Payer: Cofinity Commercial |
$1,400.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,601.10
|
| Rate for Payer: Healthscope Commercial |
$1,801.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,400.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,501.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,701.17
|
| Rate for Payer: PHP Commercial |
$1,701.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,400.97
|
| Rate for Payer: Priority Health SBD |
$1,260.87
|
| Rate for Payer: UHC Core |
$2,286.00
|
| Rate for Payer: UMR Bronson Commercial |
$740.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,501.04
|
|
|
HC LABOR CAT (3) 5-8HRS
|
Facility
|
OP
|
$2,501.62
|
|
| Hospital Charge Code |
72000003
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$925.60 |
| Max. Negotiated Rate |
$2,286.00 |
| Rate for Payer: Aetna American Axle |
$1,626.05
|
| Rate for Payer: Aetna Commercial |
$2,126.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,626.05
|
| Rate for Payer: BCBS Complete |
$1,000.65
|
| Rate for Payer: Cash Price |
$2,001.30
|
| Rate for Payer: Cash Price |
$2,001.30
|
| Rate for Payer: Cofinity Commercial |
$2,151.39
|
| Rate for Payer: Cofinity Commercial |
$1,751.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,001.30
|
| Rate for Payer: Healthscope Commercial |
$2,251.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,751.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,876.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,126.38
|
| Rate for Payer: PHP Commercial |
$2,126.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,751.13
|
| Rate for Payer: Priority Health SBD |
$1,576.02
|
| Rate for Payer: UHC Core |
$2,286.00
|
| Rate for Payer: UMR Bronson Commercial |
$925.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,876.22
|
|
