| 
                        APR-DRG 42.00: DISORDERS OF GALLBLADDER AND BILIARY TRACT
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $4,454.03
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 2841 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $4,241.93 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $4,454.03 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $4,454.03
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $4,241.93
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $4,454.03
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $4,241.93
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $4,241.93
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: DISORDERS OF GALLBLADDER AND BILIARY TRACT
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $7,230.56
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 2843 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $6,886.25 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $7,230.56 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $7,230.56
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $6,886.25
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $7,230.56
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $6,886.25
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $6,886.25
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: DISORDERS OF GALLBLADDER AND BILIARY TRACT
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $5,726.61
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 2842 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $5,453.91 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $5,726.61 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $5,726.61
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $5,453.91
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $5,726.61
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $5,453.91
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $5,453.91
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: DISORDERS OF GALLBLADDER AND BILIARY TRACT
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $9,660.03
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 2844 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $9,200.03 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $9,660.03 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $9,660.03
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $9,200.03
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $9,660.03
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $9,200.03
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $9,200.03
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: DISORDERS OF PANCREAS EXCEPT MALIGNANCY
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $6,709.96
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 2823 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $6,390.44 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $6,709.96 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $6,709.96
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $6,390.44
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $6,709.96
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $6,390.44
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $6,390.44
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: DISORDERS OF PANCREAS EXCEPT MALIGNANCY
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $3,354.98
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 2821 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $3,195.22 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $3,354.98 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $3,354.98
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $3,195.22
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $3,354.98
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $3,195.22
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $3,195.22
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: DISORDERS OF PANCREAS EXCEPT MALIGNANCY
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $4,627.56
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 2822 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $4,407.20 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $4,627.56 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $4,627.56
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $4,407.20
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $4,627.56
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $4,407.20
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $4,407.20
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: DISORDERS OF PANCREAS EXCEPT MALIGNANCY
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $13,824.84
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 2824 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $13,166.51 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $13,824.84 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $13,824.84
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $13,166.51
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $13,824.84
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $13,166.51
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $13,166.51
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: DIVERTICULITIS AND DIVERTICULOSIS
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $7,230.56
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 2443 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $6,886.25 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $7,230.56 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $7,230.56
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $6,886.25
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $7,230.56
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $6,886.25
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $6,886.25
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: DIVERTICULITIS AND DIVERTICULOSIS
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $12,089.50
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 2444 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $11,513.81 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $12,089.50 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $12,089.50
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $11,513.81
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $12,089.50
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $11,513.81
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $11,513.81
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: DIVERTICULITIS AND DIVERTICULOSIS
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $4,396.18
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 2442 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $4,186.84 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $4,396.18 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $4,396.18
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $4,186.84
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $4,396.18
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $4,186.84
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $4,186.84
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: DIVERTICULITIS AND DIVERTICULOSIS
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $3,354.98
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 2441 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $3,195.22 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $3,354.98 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $3,354.98
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $3,195.22
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $3,354.98
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $3,195.22
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $3,195.22
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: DORSAL AND LUMBAR FUSION PROCEDURE EXCEPT FOR CURVATURE OF BACK
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $31,930.16
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 3044 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $30,409.68 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $31,930.16 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $31,930.16
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $30,409.68
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $31,930.16
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $30,409.68
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $30,409.68
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: DORSAL AND LUMBAR FUSION PROCEDURE EXCEPT FOR CURVATURE OF BACK
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $13,766.99
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 3041 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $13,111.42 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $13,766.99 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $13,766.99
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $13,111.42
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $13,766.99
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $13,111.42
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $13,111.42
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: DORSAL AND LUMBAR FUSION PROCEDURE EXCEPT FOR CURVATURE OF BACK
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $25,682.96
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 3043 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $24,459.96 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $25,682.96 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $25,682.96
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $24,459.96
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $25,682.96
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $24,459.96
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $24,459.96
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: DORSAL AND LUMBAR FUSION PROCEDURE EXCEPT FOR CURVATURE OF BACK
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $17,642.57
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 3042 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $16,802.45 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $17,642.57 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $17,642.57
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $16,802.45
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $17,642.57
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $16,802.45
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $16,802.45
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: DORSAL AND LUMBAR FUSION PROCEDURE FOR CURVATURE OF BACK
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $39,854.86
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 3033 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $37,957.01 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $39,854.86 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $39,854.86
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $37,957.01
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $39,854.86
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $37,957.01
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $37,957.01
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: DORSAL AND LUMBAR FUSION PROCEDURE FOR CURVATURE OF BACK
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $57,497.43
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 3034 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $54,759.46 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $57,497.43 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $57,497.43
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $54,759.46
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $57,497.43
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $54,759.46
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $54,759.46
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: DORSAL AND LUMBAR FUSION PROCEDURE FOR CURVATURE OF BACK
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $24,526.07
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 3031 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $23,358.16 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $24,526.07 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $24,526.07
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $23,358.16
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $24,526.07
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $23,358.16
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $23,358.16
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: DORSAL AND LUMBAR FUSION PROCEDURE FOR CURVATURE OF BACK
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $26,666.31
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 3032 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $25,396.49 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $26,666.31 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $26,666.31
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $25,396.49
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $26,666.31
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $25,396.49
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $25,396.49
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $2,371.62
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 7702 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $2,258.69 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $2,371.62 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $2,371.62
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $2,258.69
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $2,371.62
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $2,258.69
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $2,258.69
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $3,297.14
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 7703 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $3,140.13 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $3,297.14 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $3,297.14
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $3,140.13
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $3,297.14
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $3,140.13
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $3,140.13
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $9,544.34
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 7704 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $9,089.85 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $9,544.34 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $9,544.34
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $9,089.85
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $9,544.34
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $9,089.85
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $9,089.85
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $1,966.71
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 7701 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $1,873.06 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $1,966.71 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $1,966.71
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $1,873.06
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $1,966.71
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $1,873.06
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $1,873.06
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL MALIGNANCIES
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $5,321.69
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 1101 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $5,068.28 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $5,321.69 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $5,321.69
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $5,068.28
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $5,321.69
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $5,068.28
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $5,068.28
                                             | 
                                         
                                    
                                
                             
                         
                     |