| 
                        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
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: FEMALE REPRODUCTIVE SYSTEM INFECTIONS
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $5,553.07
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 5313 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $5,288.64 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $5,553.07 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $5,553.07
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $5,288.64
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $5,553.07
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $5,288.64
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $5,288.64
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: FEMALE REPRODUCTIVE SYSTEM INFECTIONS
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $10,064.94
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 5314 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $9,585.66 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $10,064.94 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $10,064.94
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $9,585.66
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $10,064.94
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $9,585.66
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $9,585.66
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: FEMALE REPRODUCTIVE SYSTEM INFECTIONS
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $4,222.65
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 5312 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $4,021.57 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $4,222.65 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $4,222.65
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $4,021.57
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $4,222.65
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $4,021.57
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $4,021.57
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: FEMALE REPRODUCTIVE SYSTEM INFECTIONS
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $3,297.14
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 5311 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | 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: FEMALE REPRODUCTIVE SYSTEM MALIGNANCY
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $4,974.63
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 5301 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $4,737.74 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $4,974.63 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $4,974.63
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $4,737.74
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $4,974.63
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $4,737.74
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $4,737.74
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: FEMALE REPRODUCTIVE SYSTEM MALIGNANCY
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $8,213.92
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 5303 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $7,822.78 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $8,213.92 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $8,213.92
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $7,822.78
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $8,213.92
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $7,822.78
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $7,822.78
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: FEMALE REPRODUCTIVE SYSTEM MALIGNANCY
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $13,709.15
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 5304 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $13,056.33 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $13,709.15 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $13,709.15
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $13,056.33
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $13,709.15
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $13,056.33
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $13,056.33
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: FEMALE REPRODUCTIVE SYSTEM MALIGNANCY
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $6,247.21
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 5302 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $5,949.72 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $6,247.21 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $6,247.21
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $5,949.72
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $6,247.21
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $5,949.72
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $5,949.72
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $12,378.72
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 5143 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $11,789.26 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $12,378.72 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $12,378.72
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $11,789.26
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $12,378.72
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $11,789.26
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $11,789.26
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $7,461.94
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 5141 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $7,106.61 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $7,461.94 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $7,461.94
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $7,106.61
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $7,461.94
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $7,106.61
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $7,106.61
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $26,030.02
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 5144 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $24,790.50 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $26,030.02 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $26,030.02
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $24,790.50
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $26,030.02
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $24,790.50
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $24,790.50
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $11,337.52
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 5142 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $10,797.64 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $11,337.52 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $11,337.52
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $10,797.64
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $11,337.52
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $10,797.64
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $10,797.64
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: FEVER AND INFLAMMATORY CONDITIONS
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $3,123.60
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 7222 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $2,974.86 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $3,123.60 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $3,123.60
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $2,974.86
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $3,123.60
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $2,974.86
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $2,974.86
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: FEVER AND INFLAMMATORY CONDITIONS
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $10,180.63
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 7224 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $9,695.84 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $10,180.63 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $10,180.63
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $9,695.84
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $10,180.63
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $9,695.84
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $9,695.84
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: FEVER AND INFLAMMATORY CONDITIONS
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $2,776.54
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 7221 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $2,644.32 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $2,776.54 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $2,776.54
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $2,644.32
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $2,776.54
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $2,644.32
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $2,644.32
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: FEVER AND INFLAMMATORY CONDITIONS
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $4,916.78
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 7223 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $4,682.65 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $4,916.78 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $4,916.78
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $4,682.65
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $4,916.78
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $4,682.65
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $4,682.65
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: FOOT AND TOE PROCEDURES
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $9,023.74
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 3142 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $8,594.04 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $9,023.74 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $9,023.74
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $8,594.04
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $9,023.74
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $8,594.04
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $8,594.04
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: FOOT AND TOE PROCEDURES
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $6,478.58
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 3141 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $6,170.08 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $6,478.58 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $6,478.58
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $6,170.08
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $6,478.58
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $6,170.08
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $6,170.08
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: FOOT AND TOE PROCEDURES
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $12,436.57
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 3143 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $11,844.35 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $12,436.57 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $12,436.57
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $11,844.35
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $12,436.57
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $11,844.35
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $11,844.35
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: FOOT AND TOE PROCEDURES
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $16,543.53
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 3144 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $15,755.74 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $16,543.53 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $16,543.53
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $15,755.74
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $16,543.53
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $15,755.74
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $15,755.74
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: FRACTURE OF FEMUR
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $4,338.34
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 3402 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $4,131.75 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $4,338.34 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $4,338.34
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $4,131.75
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $4,338.34
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $4,131.75
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $4,131.75
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: FRACTURE OF FEMUR
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $3,470.67
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 3401 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $3,305.40 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $3,470.67 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $3,470.67
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $3,305.40
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $3,470.67
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $3,305.40
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $3,305.40
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: FRACTURE OF FEMUR
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $11,915.97
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 3404 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $11,348.54 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $11,915.97 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $11,915.97
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $11,348.54
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $11,915.97
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $11,348.54
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $11,348.54
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        APR-DRG 42.00: FRACTURE OF FEMUR
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $7,982.54
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                APR-DRG 3403 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $7,602.42 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $7,982.54 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $7,982.54
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Mclaren Medicaid | 
                                            
                                                $7,602.42
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Meridian Medicaid | 
                                            
                                                $7,982.54
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Choice Medicaid | 
                                            
                                                $7,602.42
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UHCCP Medicaid | 
                                            
                                                $7,602.42
                                             | 
                                         
                                    
                                
                             
                         
                     |