| 
                        APR-DRG 42.00: EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $18,799.46
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 9503 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $17,904.25 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $18,799.46 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $18,799.46
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $17,904.25
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $18,799.46
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $17,904.25
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $17,904.25
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $13,015.01
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 9502 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $12,395.25 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $13,015.01 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $13,015.01
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $12,395.25
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $13,015.01
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $12,395.25
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $12,395.25
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $5,784.45
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 8432 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $5,509.00 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $5,784.45 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $5,784.45
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $5,509.00
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $5,784.45
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $5,509.00
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $5,509.00
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $3,586.36
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 8431 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $3,415.58 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $3,586.36 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $3,586.36
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $3,415.58
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $3,586.36
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $3,415.58
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $3,415.58
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $25,451.58
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 8434 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $24,239.60 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $25,451.58 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $25,451.58
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $24,239.60
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $25,451.58
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $24,239.60
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $24,239.60
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $17,700.42
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 8433 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $16,857.54 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $17,700.42 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $17,700.42
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $16,857.54
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $17,700.42
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $16,857.54
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $16,857.54
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $28,170.27
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 8411 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $26,828.83 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $28,170.27 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $28,170.27
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $26,828.83
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $28,170.27
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $26,828.83
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $26,828.83
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $41,590.20
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 8413 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $39,609.71 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $41,590.20 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $41,590.20
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $39,609.71
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $41,590.20
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $39,609.71
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $39,609.71
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $28,575.18
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 8412 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $27,214.46 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $28,575.18 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $28,575.18
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $27,214.46
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $28,575.18
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $27,214.46
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $27,214.46
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $132,348.22
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 8414 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $126,045.92 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $132,348.22 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $132,348.22
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $126,045.92
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $132,348.22
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $126,045.92
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $126,045.92
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: EXTERNAL HEART ASSIST DEVICES
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $25,567.27
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 1782 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $24,349.78 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $25,567.27 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $25,567.27
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $24,349.78
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $25,567.27
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $24,349.78
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $24,349.78
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: EXTERNAL HEART ASSIST DEVICES
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $23,022.11
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 1781 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $21,925.82 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $23,022.11 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $23,022.11
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $21,925.82
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $23,022.11
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $21,925.82
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $21,925.82
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: EXTERNAL HEART ASSIST DEVICES
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $38,929.35
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 1784 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $37,075.57 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $38,929.35 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $38,929.35
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $37,075.57
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $38,929.35
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $37,075.57
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $37,075.57
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: EXTERNAL HEART ASSIST DEVICES
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $31,409.56
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 1783 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $29,913.87 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $31,409.56 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $31,409.56
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $29,913.87
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $31,409.56
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $29,913.87
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $29,913.87
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $52,464.96
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 0092 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $49,966.63 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $52,464.96 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $52,464.96
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $49,966.63
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $52,464.96
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $49,966.63
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $49,966.63
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $120,895.00
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 0094 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $115,138.10 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $120,895.00 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $120,895.00
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $115,138.10
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $120,895.00
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $115,138.10
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $115,138.10
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $37,541.08
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 0091 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $35,753.41 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $37,541.08 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $37,541.08
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $35,753.41
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $37,541.08
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $35,753.41
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $35,753.41
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $86,998.13
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 0093 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $82,855.36 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $86,998.13 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $86,998.13
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $82,855.36
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $86,998.13
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $82,855.36
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $82,855.36
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: EYE INFECTIONS AND OTHER EYE DISORDERS
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $10,238.48
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 0823 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $9,750.93 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $10,238.48 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $10,238.48
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $9,750.93
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $10,238.48
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $9,750.93
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $9,750.93
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: EYE INFECTIONS AND OTHER EYE DISORDERS
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $14,692.50
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 0824 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $13,992.86 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $14,692.50 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $14,692.50
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $13,992.86
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $14,692.50
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $13,992.86
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $13,992.86
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: EYE INFECTIONS AND OTHER EYE DISORDERS
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $5,495.23
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 0822 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $5,233.55 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $5,495.23 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $5,495.23
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $5,233.55
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $5,495.23
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $5,233.55
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $5,233.55
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: EYE INFECTIONS AND OTHER EYE DISORDERS
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $3,412.83
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 0821 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $3,250.31 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $3,412.83 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $3,412.83
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $3,250.31
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $3,412.83
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $3,250.31
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $3,250.31
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $11,279.68
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 0921 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $10,742.55 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $11,279.68 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $11,279.68
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $10,742.55
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $11,279.68
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $10,742.55
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $10,742.55
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $34,417.48
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 0924 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $32,778.55 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $34,417.48 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $34,417.48
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $32,778.55
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $34,417.48
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $32,778.55
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $32,778.55
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $12,667.95
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 0922 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $12,064.71 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $12,667.95 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $12,667.95
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $12,064.71
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $12,667.95
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $12,064.71
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $12,064.71
                                             | 
                                         
                                    
                                
                             
                         
                     |