|
CARBOXYMETHYLCELLULOSE SODIUM 1 % EYE LIQUID GEL DROPS
|
Facility
|
IP
|
$28.25
|
|
|
Service Code
|
NDC 0023-9205-15
|
| Hospital Charge Code |
27992
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$12.43 |
| Max. Negotiated Rate |
$25.42 |
| Rate for Payer: Aetna American Axle |
$18.36
|
| Rate for Payer: Aetna Commercial |
$24.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.36
|
| Rate for Payer: Cash Price |
$22.60
|
| Rate for Payer: Cofinity Commercial |
$19.78
|
| Rate for Payer: Cofinity Commercial |
$24.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.60
|
| Rate for Payer: Healthscope Commercial |
$25.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24.01
|
| Rate for Payer: PHP Commercial |
$24.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.78
|
| Rate for Payer: Priority Health SBD |
$17.80
|
| Rate for Payer: UMR Bronson Commercial |
$12.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.19
|
|
|
CARBOXYMETHYLCELLULOSE SODIUM EYE DROPS
|
Facility
|
IP
|
$21.77
|
|
|
Service Code
|
NDC 23182212
|
| Hospital Charge Code |
118076
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$9.58 |
| Max. Negotiated Rate |
$19.59 |
| Rate for Payer: Aetna American Axle |
$14.15
|
| Rate for Payer: Aetna Commercial |
$18.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.15
|
| Rate for Payer: Cash Price |
$17.42
|
| Rate for Payer: Cofinity Commercial |
$15.24
|
| Rate for Payer: Cofinity Commercial |
$18.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.42
|
| Rate for Payer: Healthscope Commercial |
$19.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.50
|
| Rate for Payer: PHP Commercial |
$18.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.24
|
| Rate for Payer: Priority Health SBD |
$13.72
|
| Rate for Payer: UMR Bronson Commercial |
$9.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.33
|
|
|
CARDIAC ARREST, UNEXPLAINED WITH CC
|
Facility
|
IP
|
$11,906.12
|
|
|
Service Code
|
MS-DRG 297
|
| Min. Negotiated Rate |
$5,820.61 |
| Max. Negotiated Rate |
$11,906.12 |
| Rate for Payer: Aetna Medicare |
$6,372.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,658.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,658.70
|
| Rate for Payer: BCBS MAPPO |
$6,126.96
|
| Rate for Payer: BCBS Trust/PPO |
$11,906.12
|
| Rate for Payer: BCN Medicare Advantage |
$6,126.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,126.96
|
| Rate for Payer: Mclaren Medicare |
$6,126.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,433.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,046.00
|
| Rate for Payer: PACE Medicare |
$5,820.61
|
| Rate for Payer: PACE SWMI |
$6,126.96
|
| Rate for Payer: PHP Medicare Advantage |
$6,126.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,455.35
|
| Rate for Payer: Priority Health Medicare |
$6,126.96
|
| Rate for Payer: Priority Health Narrow Network |
$8,364.28
|
| Rate for Payer: Railroad Medicare Medicare |
$6,126.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,114.06
|
| Rate for Payer: UHC Core |
$9,113.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,126.96
|
| Rate for Payer: UHC Exchange |
$7,245.20
|
| Rate for Payer: UHC Medicare Advantage |
$6,310.77
|
| Rate for Payer: VA VA |
$6,126.96
|
|
|
CARDIAC ARREST, UNEXPLAINED WITH MCC
|
Facility
|
IP
|
$35,273.58
|
|
|
Service Code
|
MS-DRG 296
|
| Min. Negotiated Rate |
$12,223.32 |
| Max. Negotiated Rate |
$35,273.58 |
| Rate for Payer: Aetna Medicare |
$13,381.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,083.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,083.31
|
| Rate for Payer: BCBS MAPPO |
$12,866.65
|
| Rate for Payer: BCBS Trust/PPO |
$35,273.58
|
| Rate for Payer: BCN Medicare Advantage |
$12,866.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,866.65
|
| Rate for Payer: Mclaren Medicare |
$12,866.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13,509.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,796.65
|
| Rate for Payer: PACE Medicare |
$12,223.32
|
| Rate for Payer: PACE SWMI |
$12,866.65
|
| Rate for Payer: PHP Medicare Advantage |
$12,866.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23,005.79
|
| Rate for Payer: Priority Health Medicare |
$12,866.65
|
| Rate for Payer: Priority Health Narrow Network |
$18,404.63
|
| Rate for Payer: Railroad Medicare Medicare |
$12,866.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24,455.21
|
| Rate for Payer: UHC Core |
$20,052.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,866.65
|
| Rate for Payer: UHC Exchange |
$15,942.22
|
| Rate for Payer: UHC Medicare Advantage |
$13,252.65
|
| Rate for Payer: VA VA |
$12,866.65
|
|
|
CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC
|
Facility
|
IP
|
$10,933.63
|
|
|
Service Code
|
MS-DRG 298
|
| Min. Negotiated Rate |
$3,705.66 |
| Max. Negotiated Rate |
$10,933.63 |
| Rate for Payer: Aetna Medicare |
$4,056.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,875.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,875.86
|
| Rate for Payer: BCBS MAPPO |
$3,900.69
|
| Rate for Payer: BCBS Trust/PPO |
$10,933.63
|
| Rate for Payer: BCN Medicare Advantage |
$3,900.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,900.69
|
| Rate for Payer: Mclaren Medicare |
$3,900.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4,095.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,485.79
|
| Rate for Payer: PACE Medicare |
$3,705.66
|
| Rate for Payer: PACE SWMI |
$3,900.69
|
| Rate for Payer: PHP Medicare Advantage |
$3,900.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,298.18
|
| Rate for Payer: Priority Health Medicare |
$3,900.69
|
| Rate for Payer: Priority Health Narrow Network |
$5,038.54
|
| Rate for Payer: Railroad Medicare Medicare |
$3,900.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,694.98
|
| Rate for Payer: UHC Core |
$5,489.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,900.69
|
| Rate for Payer: UHC Exchange |
$4,364.42
|
| Rate for Payer: UHC Medicare Advantage |
$4,017.71
|
| Rate for Payer: VA VA |
$3,900.69
|
|
|
CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC
|
Facility
|
IP
|
$13,969.21
|
|
|
Service Code
|
MS-DRG 309
|
| Min. Negotiated Rate |
$5,938.49 |
| Max. Negotiated Rate |
$13,969.21 |
| Rate for Payer: Aetna Medicare |
$6,501.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,813.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,813.80
|
| Rate for Payer: BCBS MAPPO |
$6,251.04
|
| Rate for Payer: BCBS Trust/PPO |
$13,969.21
|
| Rate for Payer: BCN Medicare Advantage |
$6,251.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,251.04
|
| Rate for Payer: Mclaren Medicare |
$6,251.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,563.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,188.70
|
| Rate for Payer: PACE Medicare |
$5,938.49
|
| Rate for Payer: PACE SWMI |
$6,251.04
|
| Rate for Payer: PHP Medicare Advantage |
$6,251.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,686.39
|
| Rate for Payer: Priority Health Medicare |
$6,251.04
|
| Rate for Payer: Priority Health Narrow Network |
$8,549.11
|
| Rate for Payer: Railroad Medicare Medicare |
$6,251.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,359.65
|
| Rate for Payer: UHC Core |
$9,314.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,251.04
|
| Rate for Payer: UHC Exchange |
$7,405.30
|
| Rate for Payer: UHC Medicare Advantage |
$6,438.57
|
| Rate for Payer: VA VA |
$6,251.04
|
|
|
CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC
|
Facility
|
IP
|
$21,276.72
|
|
|
Service Code
|
MS-DRG 308
|
| Min. Negotiated Rate |
$9,287.70 |
| Max. Negotiated Rate |
$21,276.72 |
| Rate for Payer: Aetna Medicare |
$10,167.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,220.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,220.66
|
| Rate for Payer: BCBS MAPPO |
$9,776.53
|
| Rate for Payer: BCBS Trust/PPO |
$21,276.72
|
| Rate for Payer: BCN Medicare Advantage |
$9,776.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,776.53
|
| Rate for Payer: Mclaren Medicare |
$9,776.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10,265.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,243.01
|
| Rate for Payer: PACE Medicare |
$9,287.70
|
| Rate for Payer: PACE SWMI |
$9,776.53
|
| Rate for Payer: PHP Medicare Advantage |
$9,776.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17,251.47
|
| Rate for Payer: Priority Health Medicare |
$9,776.53
|
| Rate for Payer: Priority Health Narrow Network |
$13,801.18
|
| Rate for Payer: Railroad Medicare Medicare |
$9,776.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18,338.36
|
| Rate for Payer: UHC Core |
$15,037.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,776.53
|
| Rate for Payer: UHC Exchange |
$11,954.68
|
| Rate for Payer: UHC Medicare Advantage |
$10,069.83
|
| Rate for Payer: VA VA |
$9,776.53
|
|
|
CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$10,740.13
|
|
|
Service Code
|
MS-DRG 310
|
| Min. Negotiated Rate |
$4,535.11 |
| Max. Negotiated Rate |
$10,740.13 |
| Rate for Payer: Aetna Medicare |
$4,964.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,967.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,967.25
|
| Rate for Payer: BCBS MAPPO |
$4,773.80
|
| Rate for Payer: BCBS Trust/PPO |
$10,740.13
|
| Rate for Payer: BCN Medicare Advantage |
$4,773.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,773.80
|
| Rate for Payer: Mclaren Medicare |
$4,773.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,012.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,489.87
|
| Rate for Payer: PACE Medicare |
$4,535.11
|
| Rate for Payer: PACE SWMI |
$4,773.80
|
| Rate for Payer: PHP Medicare Advantage |
$4,773.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,935.51
|
| Rate for Payer: Priority Health Medicare |
$4,773.80
|
| Rate for Payer: Priority Health Narrow Network |
$6,348.41
|
| Rate for Payer: Railroad Medicare Medicare |
$4,773.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,435.46
|
| Rate for Payer: UHC Core |
$6,916.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,773.80
|
| Rate for Payer: UHC Exchange |
$5,499.03
|
| Rate for Payer: UHC Medicare Advantage |
$4,917.01
|
| Rate for Payer: VA VA |
$4,773.80
|
|
|
CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC
|
Facility
|
IP
|
$38,927.33
|
|
|
Service Code
|
MS-DRG 306
|
| Min. Negotiated Rate |
$11,737.24 |
| Max. Negotiated Rate |
$38,927.33 |
| Rate for Payer: Aetna Medicare |
$12,849.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,443.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,443.74
|
| Rate for Payer: BCBS MAPPO |
$12,354.99
|
| Rate for Payer: BCBS Trust/PPO |
$38,927.33
|
| Rate for Payer: BCN Medicare Advantage |
$12,354.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,354.99
|
| Rate for Payer: Mclaren Medicare |
$12,354.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12,972.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,208.24
|
| Rate for Payer: PACE Medicare |
$11,737.24
|
| Rate for Payer: PACE SWMI |
$12,354.99
|
| Rate for Payer: PHP Medicare Advantage |
$12,354.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22,052.96
|
| Rate for Payer: Priority Health Medicare |
$12,354.99
|
| Rate for Payer: Priority Health Narrow Network |
$17,642.37
|
| Rate for Payer: Railroad Medicare Medicare |
$12,354.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23,442.35
|
| Rate for Payer: UHC Core |
$19,222.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,354.99
|
| Rate for Payer: UHC Exchange |
$15,281.94
|
| Rate for Payer: UHC Medicare Advantage |
$12,725.64
|
| Rate for Payer: VA VA |
$12,354.99
|
|
|
CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC
|
Facility
|
IP
|
$21,171.18
|
|
|
Service Code
|
MS-DRG 307
|
| Min. Negotiated Rate |
$7,387.26 |
| Max. Negotiated Rate |
$21,171.18 |
| Rate for Payer: Aetna Medicare |
$8,087.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,720.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,720.08
|
| Rate for Payer: BCBS MAPPO |
$7,776.06
|
| Rate for Payer: BCBS Trust/PPO |
$21,171.18
|
| Rate for Payer: BCN Medicare Advantage |
$7,776.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,776.06
|
| Rate for Payer: Mclaren Medicare |
$7,776.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8,164.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,942.47
|
| Rate for Payer: PACE Medicare |
$7,387.26
|
| Rate for Payer: PACE SWMI |
$7,776.06
|
| Rate for Payer: PHP Medicare Advantage |
$7,776.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13,526.23
|
| Rate for Payer: Priority Health Medicare |
$7,776.06
|
| Rate for Payer: Priority Health Narrow Network |
$10,820.98
|
| Rate for Payer: Railroad Medicare Medicare |
$7,776.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,378.42
|
| Rate for Payer: UHC Core |
$11,790.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,776.06
|
| Rate for Payer: UHC Exchange |
$9,373.21
|
| Rate for Payer: UHC Medicare Advantage |
$8,009.34
|
| Rate for Payer: VA VA |
$7,776.06
|
|
|
CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC
|
Facility
|
IP
|
$143,579.57
|
|
|
Service Code
|
MS-DRG 275
|
| Min. Negotiated Rate |
$51,993.95 |
| Max. Negotiated Rate |
$143,579.57 |
| Rate for Payer: Aetna Medicare |
$56,919.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$68,413.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$68,413.09
|
| Rate for Payer: BCBS MAPPO |
$54,730.47
|
| Rate for Payer: BCBS Trust/PPO |
$143,579.57
|
| Rate for Payer: BCN Medicare Advantage |
$54,730.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54,730.47
|
| Rate for Payer: Mclaren Medicare |
$54,730.47
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$57,466.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62,940.04
|
| Rate for Payer: PACE Medicare |
$51,993.95
|
| Rate for Payer: PACE SWMI |
$54,730.47
|
| Rate for Payer: PHP Medicare Advantage |
$54,730.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$100,963.17
|
| Rate for Payer: Priority Health Medicare |
$54,730.47
|
| Rate for Payer: Priority Health Narrow Network |
$80,770.54
|
| Rate for Payer: Railroad Medicare Medicare |
$54,730.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107,324.09
|
| Rate for Payer: UHC Core |
$88,003.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$54,730.47
|
| Rate for Payer: UHC Exchange |
$69,964.00
|
| Rate for Payer: UHC Medicare Advantage |
$56,372.38
|
| Rate for Payer: VA VA |
$54,730.47
|
|
|
CARDIAC DEFIBRILLATOR IMPLANT WITH MCC
|
Facility
|
IP
|
$141,526.53
|
|
|
Service Code
|
MS-DRG 276
|
| Min. Negotiated Rate |
$45,949.94 |
| Max. Negotiated Rate |
$141,526.53 |
| Rate for Payer: Aetna Medicare |
$50,303.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$60,460.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$60,460.45
|
| Rate for Payer: BCBS MAPPO |
$48,368.36
|
| Rate for Payer: BCBS Trust/PPO |
$141,526.53
|
| Rate for Payer: BCN Medicare Advantage |
$48,368.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48,368.36
|
| Rate for Payer: Mclaren Medicare |
$48,368.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$50,786.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55,623.61
|
| Rate for Payer: PACE Medicare |
$45,949.94
|
| Rate for Payer: PACE SWMI |
$48,368.36
|
| Rate for Payer: PHP Medicare Advantage |
$48,368.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$89,115.87
|
| Rate for Payer: Priority Health Medicare |
$48,368.36
|
| Rate for Payer: Priority Health Narrow Network |
$71,292.70
|
| Rate for Payer: Railroad Medicare Medicare |
$48,368.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94,730.39
|
| Rate for Payer: UHC Core |
$77,677.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$48,368.36
|
| Rate for Payer: UHC Exchange |
$61,754.23
|
| Rate for Payer: UHC Medicare Advantage |
$49,819.41
|
| Rate for Payer: VA VA |
$48,368.36
|
|
|
CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC
|
Facility
|
IP
|
$113,181.02
|
|
|
Service Code
|
MS-DRG 277
|
| Min. Negotiated Rate |
$35,497.41 |
| Max. Negotiated Rate |
$113,181.02 |
| Rate for Payer: Aetna Medicare |
$38,860.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46,707.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46,707.11
|
| Rate for Payer: BCBS MAPPO |
$37,365.69
|
| Rate for Payer: BCBS Trust/PPO |
$113,181.02
|
| Rate for Payer: BCN Medicare Advantage |
$37,365.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37,365.69
|
| Rate for Payer: Mclaren Medicare |
$37,365.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$39,233.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42,970.54
|
| Rate for Payer: PACE Medicare |
$35,497.41
|
| Rate for Payer: PACE SWMI |
$37,365.69
|
| Rate for Payer: PHP Medicare Advantage |
$37,365.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68,627.06
|
| Rate for Payer: Priority Health Medicare |
$37,365.69
|
| Rate for Payer: Priority Health Narrow Network |
$54,901.65
|
| Rate for Payer: Railroad Medicare Medicare |
$37,365.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72,950.73
|
| Rate for Payer: UHC Core |
$59,818.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$37,365.69
|
| Rate for Payer: UHC Exchange |
$47,556.19
|
| Rate for Payer: UHC Medicare Advantage |
$38,486.66
|
| Rate for Payer: VA VA |
$37,365.69
|
|
|
CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC
|
Facility
|
IP
|
$54,587.73
|
|
|
Service Code
|
MS-DRG 258
|
| Min. Negotiated Rate |
$20,315.67 |
| Max. Negotiated Rate |
$54,587.73 |
| Rate for Payer: Aetna Medicare |
$22,240.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26,731.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26,731.15
|
| Rate for Payer: BCBS MAPPO |
$21,384.92
|
| Rate for Payer: BCBS Trust/PPO |
$54,587.73
|
| Rate for Payer: BCN Medicare Advantage |
$21,384.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21,384.92
|
| Rate for Payer: Mclaren Medicare |
$21,384.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22,454.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24,592.66
|
| Rate for Payer: PACE Medicare |
$20,315.67
|
| Rate for Payer: PACE SWMI |
$21,384.92
|
| Rate for Payer: PHP Medicare Advantage |
$21,384.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38,868.19
|
| Rate for Payer: Priority Health Medicare |
$21,384.92
|
| Rate for Payer: Priority Health Narrow Network |
$31,094.55
|
| Rate for Payer: Railroad Medicare Medicare |
$21,384.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41,316.98
|
| Rate for Payer: UHC Core |
$33,879.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$21,384.92
|
| Rate for Payer: UHC Exchange |
$26,934.32
|
| Rate for Payer: UHC Medicare Advantage |
$22,026.47
|
| Rate for Payer: VA VA |
$21,384.92
|
|
|
CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC
|
Facility
|
IP
|
$35,585.18
|
|
|
Service Code
|
MS-DRG 259
|
| Min. Negotiated Rate |
$14,151.60 |
| Max. Negotiated Rate |
$35,585.18 |
| Rate for Payer: Aetna Medicare |
$15,492.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18,620.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18,620.52
|
| Rate for Payer: BCBS MAPPO |
$14,896.42
|
| Rate for Payer: BCBS Trust/PPO |
$35,585.18
|
| Rate for Payer: BCN Medicare Advantage |
$14,896.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,896.42
|
| Rate for Payer: Mclaren Medicare |
$14,896.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15,641.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,130.88
|
| Rate for Payer: PACE Medicare |
$14,151.60
|
| Rate for Payer: PACE SWMI |
$14,896.42
|
| Rate for Payer: PHP Medicare Advantage |
$14,896.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26,785.56
|
| Rate for Payer: Priority Health Medicare |
$14,896.42
|
| Rate for Payer: Priority Health Narrow Network |
$21,428.45
|
| Rate for Payer: Railroad Medicare Medicare |
$14,896.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28,473.12
|
| Rate for Payer: UHC Core |
$23,347.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$14,896.42
|
| Rate for Payer: UHC Exchange |
$18,561.47
|
| Rate for Payer: UHC Medicare Advantage |
$15,343.31
|
| Rate for Payer: VA VA |
$14,896.42
|
|
|
CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC
|
Facility
|
IP
|
$44,485.87
|
|
|
Service Code
|
MS-DRG 261
|
| Min. Negotiated Rate |
$14,262.89 |
| Max. Negotiated Rate |
$44,485.87 |
| Rate for Payer: Aetna Medicare |
$15,614.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18,766.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18,766.96
|
| Rate for Payer: BCBS MAPPO |
$15,013.57
|
| Rate for Payer: BCBS Trust/PPO |
$44,485.87
|
| Rate for Payer: BCN Medicare Advantage |
$15,013.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,013.57
|
| Rate for Payer: Mclaren Medicare |
$15,013.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15,764.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,265.61
|
| Rate for Payer: PACE Medicare |
$14,262.89
|
| Rate for Payer: PACE SWMI |
$15,013.57
|
| Rate for Payer: PHP Medicare Advantage |
$15,013.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27,003.68
|
| Rate for Payer: Priority Health Medicare |
$15,013.57
|
| Rate for Payer: Priority Health Narrow Network |
$21,602.94
|
| Rate for Payer: Railroad Medicare Medicare |
$15,013.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28,704.98
|
| Rate for Payer: UHC Core |
$23,537.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,013.57
|
| Rate for Payer: UHC Exchange |
$18,712.62
|
| Rate for Payer: UHC Medicare Advantage |
$15,463.98
|
| Rate for Payer: VA VA |
$15,013.57
|
|
|
CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC
|
Facility
|
IP
|
$83,199.61
|
|
|
Service Code
|
MS-DRG 260
|
| Min. Negotiated Rate |
$24,756.44 |
| Max. Negotiated Rate |
$83,199.61 |
| Rate for Payer: Aetna Medicare |
$27,101.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32,574.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32,574.26
|
| Rate for Payer: BCBS MAPPO |
$26,059.41
|
| Rate for Payer: BCBS Trust/PPO |
$83,199.61
|
| Rate for Payer: BCN Medicare Advantage |
$26,059.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26,059.41
|
| Rate for Payer: Mclaren Medicare |
$26,059.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$27,362.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29,968.32
|
| Rate for Payer: PACE Medicare |
$24,756.44
|
| Rate for Payer: PACE SWMI |
$26,059.41
|
| Rate for Payer: PHP Medicare Advantage |
$26,059.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47,572.85
|
| Rate for Payer: Priority Health Medicare |
$26,059.41
|
| Rate for Payer: Priority Health Narrow Network |
$38,058.28
|
| Rate for Payer: Railroad Medicare Medicare |
$26,059.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50,570.06
|
| Rate for Payer: UHC Core |
$41,466.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$26,059.41
|
| Rate for Payer: UHC Exchange |
$32,966.35
|
| Rate for Payer: UHC Medicare Advantage |
$26,841.19
|
| Rate for Payer: VA VA |
$26,059.41
|
|
|
CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC
|
Facility
|
IP
|
$38,894.67
|
|
|
Service Code
|
MS-DRG 262
|
| Min. Negotiated Rate |
$12,531.54 |
| Max. Negotiated Rate |
$38,894.67 |
| Rate for Payer: Aetna Medicare |
$13,718.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,488.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,488.88
|
| Rate for Payer: BCBS MAPPO |
$13,191.10
|
| Rate for Payer: BCBS Trust/PPO |
$38,894.67
|
| Rate for Payer: BCN Medicare Advantage |
$13,191.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,191.10
|
| Rate for Payer: Mclaren Medicare |
$13,191.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13,850.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,169.76
|
| Rate for Payer: PACE Medicare |
$12,531.54
|
| Rate for Payer: PACE SWMI |
$13,191.10
|
| Rate for Payer: PHP Medicare Advantage |
$13,191.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23,609.92
|
| Rate for Payer: Priority Health Medicare |
$13,191.10
|
| Rate for Payer: Priority Health Narrow Network |
$18,887.94
|
| Rate for Payer: Railroad Medicare Medicare |
$13,191.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,097.41
|
| Rate for Payer: UHC Core |
$20,579.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,191.10
|
| Rate for Payer: UHC Exchange |
$16,360.86
|
| Rate for Payer: UHC Medicare Advantage |
$13,586.83
|
| Rate for Payer: VA VA |
$13,191.10
|
|
|
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC
|
Facility
|
IP
|
$138,171.81
|
|
|
Service Code
|
MS-DRG 217
|
| Min. Negotiated Rate |
$47,085.38 |
| Max. Negotiated Rate |
$138,171.81 |
| Rate for Payer: Aetna Medicare |
$51,546.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$61,954.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$61,954.45
|
| Rate for Payer: BCBS MAPPO |
$49,563.56
|
| Rate for Payer: BCBS Trust/PPO |
$138,171.81
|
| Rate for Payer: BCN Medicare Advantage |
$49,563.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49,563.56
|
| Rate for Payer: Mclaren Medicare |
$49,563.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$52,041.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56,998.09
|
| Rate for Payer: PACE Medicare |
$47,085.38
|
| Rate for Payer: PACE SWMI |
$49,563.56
|
| Rate for Payer: PHP Medicare Advantage |
$49,563.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$91,341.55
|
| Rate for Payer: Priority Health Medicare |
$49,563.56
|
| Rate for Payer: Priority Health Narrow Network |
$73,073.24
|
| Rate for Payer: Railroad Medicare Medicare |
$49,563.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97,096.29
|
| Rate for Payer: UHC Core |
$79,617.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$49,563.56
|
| Rate for Payer: UHC Exchange |
$63,296.54
|
| Rate for Payer: UHC Medicare Advantage |
$51,050.47
|
| Rate for Payer: VA VA |
$49,563.56
|
|
|
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC
|
Facility
|
IP
|
$206,211.09
|
|
|
Service Code
|
MS-DRG 216
|
| Min. Negotiated Rate |
$71,536.63 |
| Max. Negotiated Rate |
$206,211.09 |
| Rate for Payer: Aetna Medicare |
$78,313.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$94,127.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$94,127.15
|
| Rate for Payer: BCBS MAPPO |
$75,301.72
|
| Rate for Payer: BCBS Trust/PPO |
$206,211.09
|
| Rate for Payer: BCN Medicare Advantage |
$75,301.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75,301.72
|
| Rate for Payer: Mclaren Medicare |
$75,301.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$79,066.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$86,596.98
|
| Rate for Payer: PACE Medicare |
$71,536.63
|
| Rate for Payer: PACE SWMI |
$75,301.72
|
| Rate for Payer: PHP Medicare Advantage |
$75,301.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$139,270.28
|
| Rate for Payer: Priority Health Medicare |
$75,301.72
|
| Rate for Payer: Priority Health Narrow Network |
$111,416.22
|
| Rate for Payer: Railroad Medicare Medicare |
$75,301.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$148,044.65
|
| Rate for Payer: UHC Core |
$121,393.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$75,301.72
|
| Rate for Payer: UHC Exchange |
$96,509.50
|
| Rate for Payer: UHC Medicare Advantage |
$77,560.77
|
| Rate for Payer: VA VA |
$75,301.72
|
|
|
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CC/MCC
|
Facility
|
IP
|
$111,127.98
|
|
|
Service Code
|
MS-DRG 218
|
| Min. Negotiated Rate |
$42,190.76 |
| Max. Negotiated Rate |
$111,127.98 |
| Rate for Payer: Aetna Medicare |
$46,187.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$55,514.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$55,514.16
|
| Rate for Payer: BCBS MAPPO |
$44,411.33
|
| Rate for Payer: BCBS Trust/PPO |
$111,127.98
|
| Rate for Payer: BCN Medicare Advantage |
$44,411.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44,411.33
|
| Rate for Payer: Mclaren Medicare |
$44,411.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$46,631.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51,073.03
|
| Rate for Payer: PACE Medicare |
$42,190.76
|
| Rate for Payer: PACE SWMI |
$44,411.33
|
| Rate for Payer: PHP Medicare Advantage |
$44,411.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$81,747.19
|
| Rate for Payer: Priority Health Medicare |
$44,411.33
|
| Rate for Payer: Priority Health Narrow Network |
$65,397.75
|
| Rate for Payer: Railroad Medicare Medicare |
$44,411.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86,897.46
|
| Rate for Payer: UHC Core |
$71,254.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$44,411.33
|
| Rate for Payer: UHC Exchange |
$56,647.98
|
| Rate for Payer: UHC Medicare Advantage |
$45,743.67
|
| Rate for Payer: VA VA |
$44,411.33
|
|
|
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC
|
Facility
|
IP
|
$111,763.74
|
|
|
Service Code
|
MS-DRG 220
|
| Min. Negotiated Rate |
$38,881.05 |
| Max. Negotiated Rate |
$111,763.74 |
| Rate for Payer: Aetna Medicare |
$42,564.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$51,159.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$51,159.28
|
| Rate for Payer: BCBS MAPPO |
$40,927.42
|
| Rate for Payer: BCBS Trust/PPO |
$111,763.74
|
| Rate for Payer: BCN Medicare Advantage |
$40,927.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40,927.42
|
| Rate for Payer: Mclaren Medicare |
$40,927.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$42,973.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47,066.53
|
| Rate for Payer: PACE Medicare |
$38,881.05
|
| Rate for Payer: PACE SWMI |
$40,927.42
|
| Rate for Payer: PHP Medicare Advantage |
$40,927.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$75,259.59
|
| Rate for Payer: Priority Health Medicare |
$40,927.42
|
| Rate for Payer: Priority Health Narrow Network |
$60,207.67
|
| Rate for Payer: Railroad Medicare Medicare |
$40,927.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80,001.13
|
| Rate for Payer: UHC Core |
$65,599.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$40,927.42
|
| Rate for Payer: UHC Exchange |
$52,152.30
|
| Rate for Payer: UHC Medicare Advantage |
$42,155.24
|
| Rate for Payer: VA VA |
$40,927.42
|
|
|
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC
|
Facility
|
IP
|
$149,711.04
|
|
|
Service Code
|
MS-DRG 219
|
| Min. Negotiated Rate |
$56,938.36 |
| Max. Negotiated Rate |
$149,711.04 |
| Rate for Payer: Aetna Medicare |
$62,332.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$74,918.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$74,918.90
|
| Rate for Payer: BCBS MAPPO |
$59,935.12
|
| Rate for Payer: BCBS Trust/PPO |
$149,711.04
|
| Rate for Payer: BCN Medicare Advantage |
$59,935.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59,935.12
|
| Rate for Payer: Mclaren Medicare |
$59,935.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$62,931.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$68,925.39
|
| Rate for Payer: PACE Medicare |
$56,938.36
|
| Rate for Payer: PACE SWMI |
$59,935.12
|
| Rate for Payer: PHP Medicare Advantage |
$59,935.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$110,655.10
|
| Rate for Payer: Priority Health Medicare |
$59,935.12
|
| Rate for Payer: Priority Health Narrow Network |
$88,524.08
|
| Rate for Payer: Railroad Medicare Medicare |
$59,935.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117,626.64
|
| Rate for Payer: UHC Core |
$96,451.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$59,935.12
|
| Rate for Payer: UHC Exchange |
$76,680.17
|
| Rate for Payer: UHC Medicare Advantage |
$61,733.17
|
| Rate for Payer: VA VA |
$59,935.12
|
|
|
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC
|
Facility
|
IP
|
$99,344.99
|
|
|
Service Code
|
MS-DRG 221
|
| Min. Negotiated Rate |
$34,517.89 |
| Max. Negotiated Rate |
$99,344.99 |
| Rate for Payer: Aetna Medicare |
$37,788.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45,418.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45,418.28
|
| Rate for Payer: BCBS MAPPO |
$36,334.62
|
| Rate for Payer: BCBS Trust/PPO |
$99,344.99
|
| Rate for Payer: BCN Medicare Advantage |
$36,334.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36,334.62
|
| Rate for Payer: Mclaren Medicare |
$36,334.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$38,151.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41,784.81
|
| Rate for Payer: PACE Medicare |
$34,517.89
|
| Rate for Payer: PACE SWMI |
$36,334.62
|
| Rate for Payer: PHP Medicare Advantage |
$36,334.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66,707.04
|
| Rate for Payer: Priority Health Medicare |
$36,334.62
|
| Rate for Payer: Priority Health Narrow Network |
$53,365.63
|
| Rate for Payer: Railroad Medicare Medicare |
$36,334.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70,909.74
|
| Rate for Payer: UHC Core |
$58,144.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$36,334.62
|
| Rate for Payer: UHC Exchange |
$46,225.68
|
| Rate for Payer: UHC Medicare Advantage |
$37,424.66
|
| Rate for Payer: VA VA |
$36,334.62
|
|
|
CARDIOPLEGIC SOLUTION 16 MEQ/L (POTASSIUM) FOR PERFUSION
|
Facility
|
IP
|
$180.96
|
|
|
Service Code
|
NDC 0338-0341-04
|
| Hospital Charge Code |
30275
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$79.62 |
| Max. Negotiated Rate |
$162.86 |
| Rate for Payer: Aetna American Axle |
$117.62
|
| Rate for Payer: Aetna Commercial |
$153.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.62
|
| Rate for Payer: Cash Price |
$144.77
|
| Rate for Payer: Cofinity Commercial |
$126.67
|
| Rate for Payer: Cofinity Commercial |
$155.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.77
|
| Rate for Payer: Healthscope Commercial |
$162.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$126.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$153.82
|
| Rate for Payer: PHP Commercial |
$153.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.67
|
| Rate for Payer: Priority Health SBD |
$114.00
|
| Rate for Payer: UMR Bronson Commercial |
$79.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.72
|
|
