|
HC MED SURVEILLANCE SH
|
Facility
|
IP
|
$49.94
|
|
|
Service Code
|
HCPCS G0435
|
| Hospital Charge Code |
30200415
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.97 |
| Max. Negotiated Rate |
$44.95 |
| Rate for Payer: Aetna American Axle |
$32.46
|
| Rate for Payer: Aetna Commercial |
$42.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.46
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cofinity Advantage |
$34.96
|
| Rate for Payer: Cofinity Commercial |
$42.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.95
|
| Rate for Payer: Healthscope Commercial |
$44.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.45
|
| Rate for Payer: PHP Commercial |
$42.45
|
| Rate for Payer: Priority Health SBD |
$31.46
|
| Rate for Payer: UMR Bronson Commercial |
$21.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.45
|
|
|
HC MED SURVEILLANCE SH
|
Facility
|
OP
|
$49.94
|
|
|
Service Code
|
HCPCS G0435
|
| Hospital Charge Code |
30200415
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.27 |
| Max. Negotiated Rate |
$44.95 |
| Rate for Payer: Aetna American Axle |
$32.46
|
| Rate for Payer: Aetna Commercial |
$42.45
|
| Rate for Payer: Aetna Medicare |
$12.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.97
|
| Rate for Payer: BCBS Complete |
$6.58
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$13.86
|
| Rate for Payer: BCN Commercial |
$13.86
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cofinity Advantage |
$34.96
|
| Rate for Payer: Cofinity Commercial |
$42.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$44.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.45
|
| Rate for Payer: Mclaren Medicaid |
$11.98
|
| Rate for Payer: Mclaren Medicare |
$11.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.58
|
| Rate for Payer: Meridian Medicaid |
$12.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.45
|
| Rate for Payer: Nomi Health Commercial |
$35.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.45
|
| Rate for Payer: PACE Medicare |
$11.38
|
| Rate for Payer: PACE SWMI |
$11.98
|
| Rate for Payer: PHP Commercial |
$42.45
|
| Rate for Payer: PHP Medicare Advantage |
$11.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11.98
|
| Rate for Payer: Priority Health Medicare |
$11.98
|
| Rate for Payer: Priority Health SBD |
$31.46
|
| Rate for Payer: Priority Health Tiered Network |
$9.58
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.97
|
| Rate for Payer: UHC Core |
$17.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.98
|
| Rate for Payer: UHC Exchange |
$17.97
|
| Rate for Payer: UHC Medicaid |
$6.27
|
| Rate for Payer: UHCCP Medicaid |
$6.27
|
| Rate for Payer: UMR Bronson Commercial |
$18.48
|
| Rate for Payer: VA VA |
$11.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.45
|
|
|
HC MEDTRONIC CRT ICD
|
Facility
|
OP
|
$30,562.79
|
|
|
Service Code
|
HCPCS C1882
|
| Hospital Charge Code |
27500006
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$27,506.51 |
| Rate for Payer: Aetna American Axle |
$19,865.81
|
| Rate for Payer: Aetna Commercial |
$25,978.37
|
| Rate for Payer: Aetna Medicare |
$15,281.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19,865.81
|
| Rate for Payer: BCBS Complete |
$12,225.12
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$24,450.23
|
| Rate for Payer: Cash Price |
$24,450.23
|
| Rate for Payer: Cofinity Advantage |
$21,393.95
|
| Rate for Payer: Cofinity Commercial |
$26,284.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24,450.23
|
| Rate for Payer: Healthscope Commercial |
$27,506.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21,393.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,922.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24,450.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,978.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,922.09
|
| Rate for Payer: PHP Commercial |
$25,978.37
|
| Rate for Payer: Priority Health SBD |
$19,254.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19,865.81
|
| Rate for Payer: UHC Core |
$15,923.21
|
| Rate for Payer: UHC Exchange |
$12,011.18
|
| Rate for Payer: UMR Bronson Commercial |
$11,308.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,922.09
|
|
|
HC MEDTRONIC CRT ICD
|
Facility
|
IP
|
$30,562.79
|
|
|
Service Code
|
HCPCS C1882
|
| Hospital Charge Code |
27500006
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$13,447.63 |
| Max. Negotiated Rate |
$27,506.51 |
| Rate for Payer: Aetna American Axle |
$19,865.81
|
| Rate for Payer: Aetna Commercial |
$25,978.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19,865.81
|
| Rate for Payer: Cash Price |
$24,450.23
|
| Rate for Payer: Cofinity Advantage |
$21,393.95
|
| Rate for Payer: Cofinity Commercial |
$26,284.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24,450.23
|
| Rate for Payer: Healthscope Commercial |
$27,506.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21,393.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,922.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,978.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,922.09
|
| Rate for Payer: PHP Commercial |
$25,978.37
|
| Rate for Payer: Priority Health SBD |
$19,254.56
|
| Rate for Payer: UMR Bronson Commercial |
$13,447.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,922.09
|
|
|
HC MEDTRONIC CRT LEAD
|
Facility
|
OP
|
$6,331.69
|
|
|
Service Code
|
HCPCS C1900
|
| Hospital Charge Code |
27800018
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$5,698.52 |
| Rate for Payer: Aetna American Axle |
$4,115.60
|
| Rate for Payer: Aetna Commercial |
$5,381.94
|
| Rate for Payer: Aetna Medicare |
$3,165.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,115.60
|
| Rate for Payer: BCBS Complete |
$2,532.68
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$5,065.35
|
| Rate for Payer: Cash Price |
$5,065.35
|
| Rate for Payer: Cofinity Advantage |
$4,432.18
|
| Rate for Payer: Cofinity Commercial |
$5,445.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,065.35
|
| Rate for Payer: Healthscope Commercial |
$5,698.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,432.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,748.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,065.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,381.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,748.77
|
| Rate for Payer: PHP Commercial |
$5,381.94
|
| Rate for Payer: Priority Health SBD |
$3,988.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,115.60
|
| Rate for Payer: UHC Core |
$3,298.81
|
| Rate for Payer: UHC Exchange |
$2,488.35
|
| Rate for Payer: UMR Bronson Commercial |
$2,342.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,748.77
|
|
|
HC MEDTRONIC CRT LEAD
|
Facility
|
IP
|
$6,331.69
|
|
|
Service Code
|
HCPCS C1900
|
| Hospital Charge Code |
27800018
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,785.94 |
| Max. Negotiated Rate |
$5,698.52 |
| Rate for Payer: Aetna American Axle |
$4,115.60
|
| Rate for Payer: Aetna Commercial |
$5,381.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,115.60
|
| Rate for Payer: Cash Price |
$5,065.35
|
| Rate for Payer: Cofinity Advantage |
$4,432.18
|
| Rate for Payer: Cofinity Commercial |
$5,445.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,065.35
|
| Rate for Payer: Healthscope Commercial |
$5,698.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,432.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,748.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,381.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,748.77
|
| Rate for Payer: PHP Commercial |
$5,381.94
|
| Rate for Payer: Priority Health SBD |
$3,988.96
|
| Rate for Payer: UMR Bronson Commercial |
$2,785.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,748.77
|
|
|
HC MEDTRONIC DUAL PACEMAKER
|
Facility
|
OP
|
$9,020.27
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500007
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,337.50 |
| Max. Negotiated Rate |
$8,118.24 |
| Rate for Payer: Aetna American Axle |
$5,863.18
|
| Rate for Payer: Aetna Commercial |
$7,667.23
|
| Rate for Payer: Aetna Medicare |
$4,510.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,863.18
|
| Rate for Payer: BCBS Complete |
$3,608.11
|
| Rate for Payer: Cash Price |
$7,216.22
|
| Rate for Payer: Cofinity Advantage |
$6,314.19
|
| Rate for Payer: Cofinity Commercial |
$7,757.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,216.22
|
| Rate for Payer: Healthscope Commercial |
$8,118.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,314.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,765.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,216.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,667.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,765.20
|
| Rate for Payer: PHP Commercial |
$7,667.23
|
| Rate for Payer: Priority Health SBD |
$5,682.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,863.18
|
| Rate for Payer: UHC Core |
$4,699.56
|
| Rate for Payer: UHC Exchange |
$3,544.97
|
| Rate for Payer: UMR Bronson Commercial |
$3,337.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,765.20
|
|
|
HC MEDTRONIC DUAL PACEMAKER
|
Facility
|
IP
|
$9,020.27
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500007
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,968.92 |
| Max. Negotiated Rate |
$8,118.24 |
| Rate for Payer: Aetna American Axle |
$5,863.18
|
| Rate for Payer: Aetna Commercial |
$7,667.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,863.18
|
| Rate for Payer: Cash Price |
$7,216.22
|
| Rate for Payer: Cofinity Advantage |
$6,314.19
|
| Rate for Payer: Cofinity Commercial |
$7,757.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,216.22
|
| Rate for Payer: Healthscope Commercial |
$8,118.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,314.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,765.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,667.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,765.20
|
| Rate for Payer: PHP Commercial |
$7,667.23
|
| Rate for Payer: Priority Health SBD |
$5,682.77
|
| Rate for Payer: UMR Bronson Commercial |
$3,968.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,765.20
|
|
|
HC MEDTRONIC ICD DUAL
|
Facility
|
IP
|
$26,848.56
|
|
|
Service Code
|
HCPCS C1721
|
| Hospital Charge Code |
27800019
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11,813.37 |
| Max. Negotiated Rate |
$24,163.70 |
| Rate for Payer: Aetna American Axle |
$17,451.56
|
| Rate for Payer: Aetna Commercial |
$22,821.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17,451.56
|
| Rate for Payer: Cash Price |
$21,478.85
|
| Rate for Payer: Cofinity Advantage |
$18,793.99
|
| Rate for Payer: Cofinity Commercial |
$23,089.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21,478.85
|
| Rate for Payer: Healthscope Commercial |
$24,163.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18,793.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20,136.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,821.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20,136.42
|
| Rate for Payer: PHP Commercial |
$22,821.28
|
| Rate for Payer: Priority Health SBD |
$16,914.59
|
| Rate for Payer: UMR Bronson Commercial |
$11,813.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20,136.42
|
|
|
HC MEDTRONIC ICD DUAL
|
Facility
|
OP
|
$26,848.56
|
|
|
Service Code
|
HCPCS C1721
|
| Hospital Charge Code |
27800019
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,933.97 |
| Max. Negotiated Rate |
$24,163.70 |
| Rate for Payer: Aetna American Axle |
$17,451.56
|
| Rate for Payer: Aetna Commercial |
$22,821.28
|
| Rate for Payer: Aetna Medicare |
$13,424.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17,451.56
|
| Rate for Payer: BCBS Complete |
$10,739.42
|
| Rate for Payer: Cash Price |
$21,478.85
|
| Rate for Payer: Cofinity Advantage |
$18,793.99
|
| Rate for Payer: Cofinity Commercial |
$23,089.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21,478.85
|
| Rate for Payer: Healthscope Commercial |
$24,163.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18,793.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20,136.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,478.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,821.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20,136.42
|
| Rate for Payer: PHP Commercial |
$22,821.28
|
| Rate for Payer: Priority Health SBD |
$16,914.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,451.56
|
| Rate for Payer: UHC Core |
$13,988.10
|
| Rate for Payer: UHC Exchange |
$10,551.48
|
| Rate for Payer: UMR Bronson Commercial |
$9,933.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20,136.42
|
|
|
HC MEDTRONIC ICD SINGLE
|
Facility
|
OP
|
$24,301.66
|
|
|
Service Code
|
HCPCS C1722
|
| Hospital Charge Code |
27800020
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,991.61 |
| Max. Negotiated Rate |
$21,871.49 |
| Rate for Payer: Aetna American Axle |
$15,796.08
|
| Rate for Payer: Aetna Commercial |
$20,656.41
|
| Rate for Payer: Aetna Medicare |
$12,150.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15,796.08
|
| Rate for Payer: BCBS Complete |
$9,720.66
|
| Rate for Payer: Cash Price |
$19,441.33
|
| Rate for Payer: Cofinity Advantage |
$17,011.16
|
| Rate for Payer: Cofinity Commercial |
$20,899.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19,441.33
|
| Rate for Payer: Healthscope Commercial |
$21,871.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17,011.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18,226.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,441.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20,656.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18,226.24
|
| Rate for Payer: PHP Commercial |
$20,656.41
|
| Rate for Payer: Priority Health SBD |
$15,310.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,796.08
|
| Rate for Payer: UHC Core |
$12,661.16
|
| Rate for Payer: UHC Exchange |
$9,550.55
|
| Rate for Payer: UMR Bronson Commercial |
$8,991.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18,226.24
|
|
|
HC MEDTRONIC ICD SINGLE
|
Facility
|
IP
|
$24,301.66
|
|
|
Service Code
|
HCPCS C1722
|
| Hospital Charge Code |
27800020
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,692.73 |
| Max. Negotiated Rate |
$21,871.49 |
| Rate for Payer: Aetna American Axle |
$15,796.08
|
| Rate for Payer: Aetna Commercial |
$20,656.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15,796.08
|
| Rate for Payer: Cash Price |
$19,441.33
|
| Rate for Payer: Cofinity Advantage |
$17,011.16
|
| Rate for Payer: Cofinity Commercial |
$20,899.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19,441.33
|
| Rate for Payer: Healthscope Commercial |
$21,871.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17,011.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18,226.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20,656.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18,226.24
|
| Rate for Payer: PHP Commercial |
$20,656.41
|
| Rate for Payer: Priority Health SBD |
$15,310.05
|
| Rate for Payer: UMR Bronson Commercial |
$10,692.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18,226.24
|
|
|
HC MEDTRONIC SINGLE PACEMAKER
|
Facility
|
OP
|
$13,480.45
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500008
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$4,987.77 |
| Max. Negotiated Rate |
$12,132.41 |
| Rate for Payer: Aetna American Axle |
$8,762.29
|
| Rate for Payer: Aetna Commercial |
$11,458.38
|
| Rate for Payer: Aetna Medicare |
$6,740.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,762.29
|
| Rate for Payer: BCBS Complete |
$5,392.18
|
| Rate for Payer: Cash Price |
$10,784.36
|
| Rate for Payer: Cofinity Advantage |
$9,436.32
|
| Rate for Payer: Cofinity Commercial |
$11,593.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,784.36
|
| Rate for Payer: Healthscope Commercial |
$12,132.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,436.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,110.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,784.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,458.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,110.34
|
| Rate for Payer: PHP Commercial |
$11,458.38
|
| Rate for Payer: Priority Health SBD |
$8,492.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,762.29
|
| Rate for Payer: UHC Core |
$7,023.31
|
| Rate for Payer: UHC Exchange |
$5,297.82
|
| Rate for Payer: UMR Bronson Commercial |
$4,987.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,110.34
|
|
|
HC MEDTRONIC SINGLE PACEMAKER
|
Facility
|
IP
|
$13,480.45
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500008
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$5,931.40 |
| Max. Negotiated Rate |
$12,132.41 |
| Rate for Payer: Aetna American Axle |
$8,762.29
|
| Rate for Payer: Aetna Commercial |
$11,458.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,762.29
|
| Rate for Payer: Cash Price |
$10,784.36
|
| Rate for Payer: Cofinity Advantage |
$9,436.32
|
| Rate for Payer: Cofinity Commercial |
$11,593.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,784.36
|
| Rate for Payer: Healthscope Commercial |
$12,132.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,436.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,110.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,458.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,110.34
|
| Rate for Payer: PHP Commercial |
$11,458.38
|
| Rate for Payer: Priority Health SBD |
$8,492.68
|
| Rate for Payer: UMR Bronson Commercial |
$5,931.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,110.34
|
|
|
HC MEDTRONIC TACHY (ICD) LEAD
|
Facility
|
IP
|
$15,909.43
|
|
|
Service Code
|
HCPCS C1895
|
| Hospital Charge Code |
27800021
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,000.15 |
| Max. Negotiated Rate |
$14,318.49 |
| Rate for Payer: Aetna American Axle |
$10,341.13
|
| Rate for Payer: Aetna Commercial |
$13,523.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10,341.13
|
| Rate for Payer: Cash Price |
$12,727.54
|
| Rate for Payer: Cofinity Advantage |
$11,136.60
|
| Rate for Payer: Cofinity Commercial |
$13,682.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,727.54
|
| Rate for Payer: Healthscope Commercial |
$14,318.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11,136.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,932.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,523.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11,932.07
|
| Rate for Payer: PHP Commercial |
$13,523.02
|
| Rate for Payer: Priority Health SBD |
$10,022.94
|
| Rate for Payer: UMR Bronson Commercial |
$7,000.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,932.07
|
|
|
HC MEDTRONIC TACHY (ICD) LEAD
|
Facility
|
OP
|
$15,909.43
|
|
|
Service Code
|
HCPCS C1895
|
| Hospital Charge Code |
27800021
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,886.49 |
| Max. Negotiated Rate |
$14,318.49 |
| Rate for Payer: Aetna American Axle |
$10,341.13
|
| Rate for Payer: Aetna Commercial |
$13,523.02
|
| Rate for Payer: Aetna Medicare |
$7,954.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10,341.13
|
| Rate for Payer: BCBS Complete |
$6,363.77
|
| Rate for Payer: Cash Price |
$12,727.54
|
| Rate for Payer: Cofinity Advantage |
$11,136.60
|
| Rate for Payer: Cofinity Commercial |
$13,682.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,727.54
|
| Rate for Payer: Healthscope Commercial |
$14,318.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11,136.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,932.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,727.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,523.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11,932.07
|
| Rate for Payer: PHP Commercial |
$13,523.02
|
| Rate for Payer: Priority Health SBD |
$10,022.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,341.13
|
| Rate for Payer: UHC Core |
$8,288.81
|
| Rate for Payer: UHC Exchange |
$6,252.41
|
| Rate for Payer: UMR Bronson Commercial |
$5,886.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,932.07
|
|
|
HC MENACWY-TT VACCINE IM
|
Facility
|
OP
|
$191.02
|
|
|
Service Code
|
CPT 90619
|
| Hospital Charge Code |
63600210
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$70.68 |
| Max. Negotiated Rate |
$563.67 |
| Rate for Payer: Aetna American Axle |
$124.16
|
| Rate for Payer: Aetna Commercial |
$162.37
|
| Rate for Payer: Aetna Medicare |
$95.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$124.16
|
| Rate for Payer: BCBS Complete |
$76.41
|
| Rate for Payer: BCBS Trust/PPO |
$563.67
|
| Rate for Payer: BCN Commercial |
$563.67
|
| Rate for Payer: Cash Price |
$152.82
|
| Rate for Payer: Cash Price |
$152.82
|
| Rate for Payer: Cofinity Advantage |
$133.71
|
| Rate for Payer: Cofinity Commercial |
$164.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.82
|
| Rate for Payer: Healthscope Commercial |
$171.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$133.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$143.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$162.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$143.26
|
| Rate for Payer: PHP Commercial |
$162.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$201.76
|
| Rate for Payer: Priority Health SBD |
$120.34
|
| Rate for Payer: Priority Health Tiered Network |
$161.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$350.43
|
| Rate for Payer: UHC Core |
$350.43
|
| Rate for Payer: UHC Exchange |
$350.43
|
| Rate for Payer: UMR Bronson Commercial |
$70.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$143.26
|
|
|
HC MENACWY-TT VACCINE IM
|
Facility
|
IP
|
$191.02
|
|
|
Service Code
|
CPT 90619
|
| Hospital Charge Code |
63600210
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$84.05 |
| Max. Negotiated Rate |
$171.92 |
| Rate for Payer: Aetna American Axle |
$124.16
|
| Rate for Payer: Aetna Commercial |
$162.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$124.16
|
| Rate for Payer: Cash Price |
$152.82
|
| Rate for Payer: Cofinity Advantage |
$133.71
|
| Rate for Payer: Cofinity Commercial |
$164.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.82
|
| Rate for Payer: Healthscope Commercial |
$171.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$133.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$143.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$162.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$143.26
|
| Rate for Payer: PHP Commercial |
$162.37
|
| Rate for Payer: Priority Health SBD |
$120.34
|
| Rate for Payer: UMR Bronson Commercial |
$84.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$143.26
|
|
|
HC MENB-FHBP VACC 2/3 DOSE IM
|
Facility
|
OP
|
$537.45
|
|
|
Service Code
|
CPT 90621
|
| Hospital Charge Code |
63600187
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$188.96 |
| Max. Negotiated Rate |
$718.98 |
| Rate for Payer: Aetna American Axle |
$349.34
|
| Rate for Payer: Aetna Commercial |
$456.83
|
| Rate for Payer: Aetna Medicare |
$268.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$349.34
|
| Rate for Payer: BCBS Complete |
$214.98
|
| Rate for Payer: BCBS Trust/PPO |
$718.98
|
| Rate for Payer: BCN Commercial |
$718.98
|
| Rate for Payer: Cash Price |
$429.96
|
| Rate for Payer: Cash Price |
$429.96
|
| Rate for Payer: Cofinity Advantage |
$376.21
|
| Rate for Payer: Cofinity Commercial |
$462.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$429.96
|
| Rate for Payer: Healthscope Commercial |
$483.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$376.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$403.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$429.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$456.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$403.09
|
| Rate for Payer: PHP Commercial |
$456.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$236.20
|
| Rate for Payer: Priority Health SBD |
$338.59
|
| Rate for Payer: Priority Health Tiered Network |
$188.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$447.05
|
| Rate for Payer: UHC Core |
$447.05
|
| Rate for Payer: UHC Exchange |
$447.05
|
| Rate for Payer: UMR Bronson Commercial |
$198.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$403.09
|
|
|
HC MENB-FHBP VACC 2/3 DOSE IM
|
Facility
|
IP
|
$537.45
|
|
|
Service Code
|
CPT 90621
|
| Hospital Charge Code |
63600187
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$236.48 |
| Max. Negotiated Rate |
$483.70 |
| Rate for Payer: Aetna American Axle |
$349.34
|
| Rate for Payer: Aetna Commercial |
$456.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$349.34
|
| Rate for Payer: Cash Price |
$429.96
|
| Rate for Payer: Cofinity Advantage |
$376.21
|
| Rate for Payer: Cofinity Commercial |
$462.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$429.96
|
| Rate for Payer: Healthscope Commercial |
$483.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$376.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$403.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$456.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$403.09
|
| Rate for Payer: PHP Commercial |
$456.83
|
| Rate for Payer: Priority Health SBD |
$338.59
|
| Rate for Payer: UMR Bronson Commercial |
$236.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$403.09
|
|
|
HC MENB RECOMB PROT W/OUT MEMBR VESIC VACC IM
|
Facility
|
OP
|
$268.42
|
|
|
Service Code
|
CPT 90620
|
| Hospital Charge Code |
63600122
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$99.32 |
| Max. Negotiated Rate |
$754.69 |
| Rate for Payer: Aetna American Axle |
$174.47
|
| Rate for Payer: Aetna Commercial |
$228.16
|
| Rate for Payer: Aetna Medicare |
$134.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.47
|
| Rate for Payer: BCBS Complete |
$107.37
|
| Rate for Payer: BCBS Trust/PPO |
$754.69
|
| Rate for Payer: BCN Commercial |
$754.69
|
| Rate for Payer: Cash Price |
$214.74
|
| Rate for Payer: Cash Price |
$214.74
|
| Rate for Payer: Cofinity Advantage |
$187.89
|
| Rate for Payer: Cofinity Commercial |
$230.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.74
|
| Rate for Payer: Healthscope Commercial |
$241.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$187.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$201.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$214.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$201.31
|
| Rate for Payer: PHP Commercial |
$228.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$270.18
|
| Rate for Payer: Priority Health SBD |
$169.10
|
| Rate for Payer: Priority Health Tiered Network |
$216.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$497.34
|
| Rate for Payer: UHC Core |
$497.34
|
| Rate for Payer: UHC Exchange |
$497.34
|
| Rate for Payer: UMR Bronson Commercial |
$99.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$201.31
|
|
|
HC MENB RECOMB PROT W/OUT MEMBR VESIC VACC IM
|
Facility
|
IP
|
$268.42
|
|
|
Service Code
|
CPT 90620
|
| Hospital Charge Code |
63600122
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$118.10 |
| Max. Negotiated Rate |
$241.58 |
| Rate for Payer: Aetna American Axle |
$174.47
|
| Rate for Payer: Aetna Commercial |
$228.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.47
|
| Rate for Payer: Cash Price |
$214.74
|
| Rate for Payer: Cofinity Advantage |
$187.89
|
| Rate for Payer: Cofinity Commercial |
$230.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.74
|
| Rate for Payer: Healthscope Commercial |
$241.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$187.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$201.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$201.31
|
| Rate for Payer: PHP Commercial |
$228.16
|
| Rate for Payer: Priority Health SBD |
$169.10
|
| Rate for Payer: UMR Bronson Commercial |
$118.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$201.31
|
|
|
HC MENENCEPH CMPT 10
|
Facility
|
IP
|
$14.43
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
30200307
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.35 |
| Max. Negotiated Rate |
$12.99 |
| Rate for Payer: Aetna American Axle |
$9.38
|
| Rate for Payer: Aetna Commercial |
$12.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.38
|
| Rate for Payer: Cash Price |
$11.54
|
| Rate for Payer: Cofinity Advantage |
$10.10
|
| Rate for Payer: Cofinity Commercial |
$12.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.54
|
| Rate for Payer: Healthscope Commercial |
$12.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.82
|
| Rate for Payer: PHP Commercial |
$12.27
|
| Rate for Payer: Priority Health SBD |
$9.09
|
| Rate for Payer: UMR Bronson Commercial |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.82
|
|
|
HC MENENCEPH CMPT 10
|
Facility
|
OP
|
$14.43
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
30200307
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.34 |
| Max. Negotiated Rate |
$19.58 |
| Rate for Payer: Aetna American Axle |
$9.38
|
| Rate for Payer: Aetna Commercial |
$12.27
|
| Rate for Payer: Aetna Medicare |
$13.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.31
|
| Rate for Payer: BCBS Complete |
$7.17
|
| Rate for Payer: BCBS MAPPO |
$13.05
|
| Rate for Payer: BCBS Trust/PPO |
$15.09
|
| Rate for Payer: BCN Commercial |
$15.09
|
| Rate for Payer: BCN Medicare Advantage |
$13.05
|
| Rate for Payer: Cash Price |
$11.54
|
| Rate for Payer: Cash Price |
$11.54
|
| Rate for Payer: Cofinity Advantage |
$10.10
|
| Rate for Payer: Cofinity Commercial |
$12.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.05
|
| Rate for Payer: Healthscope Commercial |
$12.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.82
|
| Rate for Payer: Mclaren Medicaid |
$13.05
|
| Rate for Payer: Mclaren Medicare |
$13.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.70
|
| Rate for Payer: Meridian Medicaid |
$13.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.27
|
| Rate for Payer: Nomi Health Commercial |
$19.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.82
|
| Rate for Payer: PACE Medicare |
$12.40
|
| Rate for Payer: PACE SWMI |
$13.05
|
| Rate for Payer: PHP Commercial |
$12.27
|
| Rate for Payer: PHP Medicare Advantage |
$13.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13.05
|
| Rate for Payer: Priority Health Medicare |
$13.05
|
| Rate for Payer: Priority Health SBD |
$9.09
|
| Rate for Payer: Priority Health Tiered Network |
$10.44
|
| Rate for Payer: Railroad Medicare Medicare |
$13.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.58
|
| Rate for Payer: UHC Core |
$19.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.05
|
| Rate for Payer: UHC Exchange |
$19.58
|
| Rate for Payer: UHC Medicaid |
$6.83
|
| Rate for Payer: UHCCP Medicaid |
$6.83
|
| Rate for Payer: UMR Bronson Commercial |
$5.34
|
| Rate for Payer: VA VA |
$13.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.82
|
|
|
HC MENENCEPH CMPT 11
|
Facility
|
IP
|
$14.43
|
|
|
Service Code
|
CPT 86653
|
| Hospital Charge Code |
30200258
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.35 |
| Max. Negotiated Rate |
$12.99 |
| Rate for Payer: Aetna American Axle |
$9.38
|
| Rate for Payer: Aetna Commercial |
$12.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.38
|
| Rate for Payer: Cash Price |
$11.54
|
| Rate for Payer: Cofinity Advantage |
$10.10
|
| Rate for Payer: Cofinity Commercial |
$12.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.54
|
| Rate for Payer: Healthscope Commercial |
$12.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.82
|
| Rate for Payer: PHP Commercial |
$12.27
|
| Rate for Payer: Priority Health SBD |
$9.09
|
| Rate for Payer: UMR Bronson Commercial |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.82
|
|
