|
HC LEUKEMIA LYMPHOMA IMMUNOPH GLL
|
Facility
|
IP
|
$54.83
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100010
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$24.13 |
| Max. Negotiated Rate |
$49.35 |
| Rate for Payer: Aetna American Axle |
$35.64
|
| Rate for Payer: Aetna Commercial |
$46.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.64
|
| Rate for Payer: Cash Price |
$43.86
|
| Rate for Payer: Cofinity Commercial |
$38.38
|
| Rate for Payer: Cofinity Commercial |
$47.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$38.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.86
|
| Rate for Payer: Healthscope Commercial |
$49.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.61
|
| Rate for Payer: PHP Commercial |
$46.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.64
|
| Rate for Payer: Priority Health SBD |
$34.54
|
| Rate for Payer: UMR Bronson Commercial |
$24.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.12
|
|
|
HC LEUKEMIA LYMPHOMA IMMUNOPH TCR
|
Facility
|
IP
|
$52.24
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100009
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$22.99 |
| Max. Negotiated Rate |
$47.02 |
| Rate for Payer: Aetna American Axle |
$33.96
|
| Rate for Payer: Aetna Commercial |
$44.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.96
|
| Rate for Payer: Cash Price |
$41.79
|
| Rate for Payer: Cofinity Commercial |
$36.57
|
| Rate for Payer: Cofinity Commercial |
$44.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.79
|
| Rate for Payer: Healthscope Commercial |
$47.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.40
|
| Rate for Payer: PHP Commercial |
$44.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.96
|
| Rate for Payer: Priority Health SBD |
$32.91
|
| Rate for Payer: UMR Bronson Commercial |
$22.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.18
|
|
|
HC LEUKEMIA LYMPHOMA IMMUNOPH TCR
|
Facility
|
OP
|
$52.24
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100009
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$19.33 |
| Max. Negotiated Rate |
$47.02 |
| Rate for Payer: Aetna American Axle |
$33.96
|
| Rate for Payer: Aetna Commercial |
$44.40
|
| Rate for Payer: Aetna Medicare |
$26.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.96
|
| Rate for Payer: BCBS Complete |
$20.90
|
| Rate for Payer: BCBS Trust/PPO |
$36.43
|
| Rate for Payer: BCN Commercial |
$36.43
|
| Rate for Payer: Cash Price |
$41.79
|
| Rate for Payer: Cash Price |
$41.79
|
| Rate for Payer: Cofinity Commercial |
$36.57
|
| Rate for Payer: Cofinity Commercial |
$44.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.79
|
| Rate for Payer: Healthscope Commercial |
$47.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.40
|
| Rate for Payer: PHP Commercial |
$44.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.96
|
| Rate for Payer: Priority Health SBD |
$32.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.30
|
| Rate for Payer: UHC Exchange |
$21.18
|
| Rate for Payer: UMR Bronson Commercial |
$19.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.18
|
|
|
HC LEUKEMIA LYMPHOMA PLASMA CELL
|
Facility
|
IP
|
$52.24
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100013
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$22.99 |
| Max. Negotiated Rate |
$47.02 |
| Rate for Payer: Aetna American Axle |
$33.96
|
| Rate for Payer: Aetna Commercial |
$44.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.96
|
| Rate for Payer: Cash Price |
$41.79
|
| Rate for Payer: Cofinity Commercial |
$36.57
|
| Rate for Payer: Cofinity Commercial |
$44.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.79
|
| Rate for Payer: Healthscope Commercial |
$47.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.40
|
| Rate for Payer: PHP Commercial |
$44.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.96
|
| Rate for Payer: Priority Health SBD |
$32.91
|
| Rate for Payer: UMR Bronson Commercial |
$22.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.18
|
|
|
HC LEUKEMIA LYMPHOMA PLASMA CELL
|
Facility
|
OP
|
$52.24
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100013
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$19.33 |
| Max. Negotiated Rate |
$47.02 |
| Rate for Payer: Aetna American Axle |
$33.96
|
| Rate for Payer: Aetna Commercial |
$44.40
|
| Rate for Payer: Aetna Medicare |
$26.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.96
|
| Rate for Payer: BCBS Complete |
$20.90
|
| Rate for Payer: BCBS Trust/PPO |
$36.43
|
| Rate for Payer: BCN Commercial |
$36.43
|
| Rate for Payer: Cash Price |
$41.79
|
| Rate for Payer: Cash Price |
$41.79
|
| Rate for Payer: Cofinity Commercial |
$36.57
|
| Rate for Payer: Cofinity Commercial |
$44.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.79
|
| Rate for Payer: Healthscope Commercial |
$47.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.40
|
| Rate for Payer: PHP Commercial |
$44.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.96
|
| Rate for Payer: Priority Health SBD |
$32.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.30
|
| Rate for Payer: UHC Exchange |
$21.18
|
| Rate for Payer: UMR Bronson Commercial |
$19.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.18
|
|
|
HC LEUK/LYMPH IMMUNOPHENO CMPT B
|
Facility
|
IP
|
$52.24
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000008
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$22.99 |
| Max. Negotiated Rate |
$47.02 |
| Rate for Payer: Aetna American Axle |
$33.96
|
| Rate for Payer: Aetna Commercial |
$44.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.96
|
| Rate for Payer: Cash Price |
$41.79
|
| Rate for Payer: Cofinity Commercial |
$36.57
|
| Rate for Payer: Cofinity Commercial |
$44.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.79
|
| Rate for Payer: Healthscope Commercial |
$47.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.40
|
| Rate for Payer: PHP Commercial |
$44.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.96
|
| Rate for Payer: Priority Health SBD |
$32.91
|
| Rate for Payer: UMR Bronson Commercial |
$22.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.18
|
|
|
HC LEUK/LYMPH IMMUNOPHENO CMPT B
|
Facility
|
OP
|
$52.24
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000008
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$19.33 |
| Max. Negotiated Rate |
$47.02 |
| Rate for Payer: Aetna American Axle |
$33.96
|
| Rate for Payer: Aetna Commercial |
$44.40
|
| Rate for Payer: Aetna Medicare |
$26.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.96
|
| Rate for Payer: BCBS Complete |
$20.90
|
| Rate for Payer: BCBS Trust/PPO |
$36.43
|
| Rate for Payer: BCN Commercial |
$36.43
|
| Rate for Payer: Cash Price |
$41.79
|
| Rate for Payer: Cash Price |
$41.79
|
| Rate for Payer: Cofinity Commercial |
$36.57
|
| Rate for Payer: Cofinity Commercial |
$44.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.79
|
| Rate for Payer: Healthscope Commercial |
$47.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.40
|
| Rate for Payer: PHP Commercial |
$44.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.96
|
| Rate for Payer: Priority Health SBD |
$32.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.30
|
| Rate for Payer: UHC Exchange |
$21.18
|
| Rate for Payer: UMR Bronson Commercial |
$19.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.18
|
|
|
HC LEUK/LYMPH IMMUNOPHENO CMPT C
|
Facility
|
OP
|
$52.24
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000009
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$19.33 |
| Max. Negotiated Rate |
$47.02 |
| Rate for Payer: Aetna American Axle |
$33.96
|
| Rate for Payer: Aetna Commercial |
$44.40
|
| Rate for Payer: Aetna Medicare |
$26.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.96
|
| Rate for Payer: BCBS Complete |
$20.90
|
| Rate for Payer: BCBS Trust/PPO |
$36.43
|
| Rate for Payer: BCN Commercial |
$36.43
|
| Rate for Payer: Cash Price |
$41.79
|
| Rate for Payer: Cash Price |
$41.79
|
| Rate for Payer: Cofinity Commercial |
$36.57
|
| Rate for Payer: Cofinity Commercial |
$44.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.79
|
| Rate for Payer: Healthscope Commercial |
$47.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.40
|
| Rate for Payer: PHP Commercial |
$44.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.96
|
| Rate for Payer: Priority Health SBD |
$32.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.30
|
| Rate for Payer: UHC Exchange |
$21.18
|
| Rate for Payer: UMR Bronson Commercial |
$19.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.18
|
|
|
HC LEUK/LYMPH IMMUNOPHENO CMPT C
|
Facility
|
IP
|
$52.24
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000009
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$22.99 |
| Max. Negotiated Rate |
$47.02 |
| Rate for Payer: Aetna American Axle |
$33.96
|
| Rate for Payer: Aetna Commercial |
$44.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.96
|
| Rate for Payer: Cash Price |
$41.79
|
| Rate for Payer: Cofinity Commercial |
$36.57
|
| Rate for Payer: Cofinity Commercial |
$44.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.79
|
| Rate for Payer: Healthscope Commercial |
$47.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.40
|
| Rate for Payer: PHP Commercial |
$44.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.96
|
| Rate for Payer: Priority Health SBD |
$32.91
|
| Rate for Payer: UMR Bronson Commercial |
$22.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.18
|
|
|
HC LEUK/LYMPH IMMUNOPHENO CMPT D
|
Facility
|
IP
|
$54.83
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000010
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$24.13 |
| Max. Negotiated Rate |
$49.35 |
| Rate for Payer: Aetna American Axle |
$35.64
|
| Rate for Payer: Aetna Commercial |
$46.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.64
|
| Rate for Payer: Cash Price |
$43.86
|
| Rate for Payer: Cofinity Commercial |
$38.38
|
| Rate for Payer: Cofinity Commercial |
$47.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$38.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.86
|
| Rate for Payer: Healthscope Commercial |
$49.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.61
|
| Rate for Payer: PHP Commercial |
$46.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.64
|
| Rate for Payer: Priority Health SBD |
$34.54
|
| Rate for Payer: UMR Bronson Commercial |
$24.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.12
|
|
|
HC LEUK/LYMPH IMMUNOPHENO CMPT D
|
Facility
|
OP
|
$54.83
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000010
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$20.29 |
| Max. Negotiated Rate |
$49.35 |
| Rate for Payer: Aetna American Axle |
$35.64
|
| Rate for Payer: Aetna Commercial |
$46.61
|
| Rate for Payer: Aetna Medicare |
$27.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.64
|
| Rate for Payer: BCBS Complete |
$21.93
|
| Rate for Payer: BCBS Trust/PPO |
$36.43
|
| Rate for Payer: BCN Commercial |
$36.43
|
| Rate for Payer: Cash Price |
$43.86
|
| Rate for Payer: Cash Price |
$43.86
|
| Rate for Payer: Cofinity Commercial |
$38.38
|
| Rate for Payer: Cofinity Commercial |
$47.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$38.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.86
|
| Rate for Payer: Healthscope Commercial |
$49.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.61
|
| Rate for Payer: PHP Commercial |
$46.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.64
|
| Rate for Payer: Priority Health SBD |
$34.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.30
|
| Rate for Payer: UHC Exchange |
$21.18
|
| Rate for Payer: UMR Bronson Commercial |
$20.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.12
|
|
|
HC LEUK LYMPHOMA IMMUNOPHEN TISSUE
|
Facility
|
IP
|
$52.24
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100015
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$22.99 |
| Max. Negotiated Rate |
$47.02 |
| Rate for Payer: Aetna American Axle |
$33.96
|
| Rate for Payer: Aetna Commercial |
$44.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.96
|
| Rate for Payer: Cash Price |
$41.79
|
| Rate for Payer: Cofinity Commercial |
$36.57
|
| Rate for Payer: Cofinity Commercial |
$44.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.79
|
| Rate for Payer: Healthscope Commercial |
$47.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.40
|
| Rate for Payer: PHP Commercial |
$44.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.96
|
| Rate for Payer: Priority Health SBD |
$32.91
|
| Rate for Payer: UMR Bronson Commercial |
$22.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.18
|
|
|
HC LEUK LYMPHOMA IMMUNOPHEN TISSUE
|
Facility
|
OP
|
$52.24
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100015
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$19.33 |
| Max. Negotiated Rate |
$47.02 |
| Rate for Payer: Aetna American Axle |
$33.96
|
| Rate for Payer: Aetna Commercial |
$44.40
|
| Rate for Payer: Aetna Medicare |
$26.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.96
|
| Rate for Payer: BCBS Complete |
$20.90
|
| Rate for Payer: BCBS Trust/PPO |
$36.43
|
| Rate for Payer: BCN Commercial |
$36.43
|
| Rate for Payer: Cash Price |
$41.79
|
| Rate for Payer: Cash Price |
$41.79
|
| Rate for Payer: Cofinity Commercial |
$36.57
|
| Rate for Payer: Cofinity Commercial |
$44.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.79
|
| Rate for Payer: Healthscope Commercial |
$47.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.40
|
| Rate for Payer: PHP Commercial |
$44.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.96
|
| Rate for Payer: Priority Health SBD |
$32.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.30
|
| Rate for Payer: UHC Exchange |
$21.18
|
| Rate for Payer: UMR Bronson Commercial |
$19.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.18
|
|
|
HC LEUKOTRIENE E4, U
|
Facility
|
OP
|
$260.10
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100715
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.91 |
| Max. Negotiated Rate |
$234.09 |
| Rate for Payer: Aetna American Axle |
$169.06
|
| Rate for Payer: Aetna Commercial |
$221.08
|
| Rate for Payer: Aetna Medicare |
$25.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.11
|
| Rate for Payer: BCBS Complete |
$13.56
|
| Rate for Payer: BCBS MAPPO |
$24.09
|
| Rate for Payer: BCBS Trust/PPO |
$23.21
|
| Rate for Payer: BCN Commercial |
$23.21
|
| Rate for Payer: BCN Medicare Advantage |
$24.09
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cofinity Commercial |
$223.69
|
| Rate for Payer: Cofinity Commercial |
$182.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$182.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.09
|
| Rate for Payer: Healthscope Commercial |
$234.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$182.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.08
|
| Rate for Payer: Mclaren Medicaid |
$12.91
|
| Rate for Payer: Mclaren Medicare |
$24.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.29
|
| Rate for Payer: Meridian Medicaid |
$13.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.08
|
| Rate for Payer: Nomi Health Commercial |
$36.14
|
| Rate for Payer: PACE Medicare |
$22.89
|
| Rate for Payer: PACE SWMI |
$24.09
|
| Rate for Payer: PHP Commercial |
$221.08
|
| Rate for Payer: PHP Medicare Advantage |
$24.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.09
|
| Rate for Payer: Priority Health Medicare |
$24.09
|
| Rate for Payer: Priority Health Narrow Network |
$19.27
|
| Rate for Payer: Priority Health SBD |
$163.86
|
| Rate for Payer: Railroad Medicare Medicare |
$24.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.91
|
| Rate for Payer: UHC Core |
$16.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.09
|
| Rate for Payer: UHC Exchange |
$24.09
|
| Rate for Payer: UHC Medicare Advantage |
$24.09
|
| Rate for Payer: UHCCP Medicaid |
$12.91
|
| Rate for Payer: UMR Bronson Commercial |
$96.24
|
| Rate for Payer: VA VA |
$24.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.08
|
|
|
HC LEUKOTRIENE E4, U
|
Facility
|
IP
|
$260.10
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100715
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$114.44 |
| Max. Negotiated Rate |
$234.09 |
| Rate for Payer: Aetna American Axle |
$169.06
|
| Rate for Payer: Aetna Commercial |
$221.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.06
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cofinity Commercial |
$182.07
|
| Rate for Payer: Cofinity Commercial |
$223.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$182.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.08
|
| Rate for Payer: Healthscope Commercial |
$234.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$182.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.08
|
| Rate for Payer: PHP Commercial |
$221.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.06
|
| Rate for Payer: Priority Health SBD |
$163.86
|
| Rate for Payer: UMR Bronson Commercial |
$114.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.08
|
|
|
HC LEUPROLIDE ACETATE 3.75MG
|
Facility
|
IP
|
$1,031.14
|
|
|
Service Code
|
HCPCS J1950
|
| Hospital Charge Code |
63600142
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$453.70 |
| Max. Negotiated Rate |
$928.03 |
| Rate for Payer: Aetna American Axle |
$670.24
|
| Rate for Payer: Aetna Commercial |
$876.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$670.24
|
| Rate for Payer: Cash Price |
$824.91
|
| Rate for Payer: Cofinity Commercial |
$721.80
|
| Rate for Payer: Cofinity Commercial |
$886.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$721.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$824.91
|
| Rate for Payer: Healthscope Commercial |
$928.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$721.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$773.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$876.47
|
| Rate for Payer: PHP Commercial |
$876.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$670.24
|
| Rate for Payer: Priority Health SBD |
$649.62
|
| Rate for Payer: UMR Bronson Commercial |
$453.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$773.36
|
|
|
HC LEUPROLIDE ACETATE 3.75MG
|
Facility
|
OP
|
$1,031.14
|
|
|
Service Code
|
HCPCS J1950
|
| Hospital Charge Code |
63600142
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$381.52 |
| Max. Negotiated Rate |
$5,000.34 |
| Rate for Payer: Aetna American Axle |
$670.24
|
| Rate for Payer: Aetna Commercial |
$876.47
|
| Rate for Payer: Aetna Medicare |
$1,733.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$670.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,083.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,083.48
|
| Rate for Payer: BCBS Complete |
$938.06
|
| Rate for Payer: BCBS MAPPO |
$1,666.78
|
| Rate for Payer: BCBS Trust/PPO |
$4,361.69
|
| Rate for Payer: BCN Commercial |
$4,361.69
|
| Rate for Payer: BCN Medicare Advantage |
$1,666.78
|
| Rate for Payer: Cash Price |
$824.91
|
| Rate for Payer: Cash Price |
$824.91
|
| Rate for Payer: Cofinity Commercial |
$886.78
|
| Rate for Payer: Cofinity Commercial |
$721.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$721.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$824.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,666.78
|
| Rate for Payer: Healthscope Commercial |
$928.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$721.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$773.36
|
| Rate for Payer: Mclaren Medicaid |
$893.39
|
| Rate for Payer: Mclaren Medicare |
$1,666.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,750.12
|
| Rate for Payer: Meridian Medicaid |
$938.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,916.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$876.47
|
| Rate for Payer: Nomi Health Commercial |
$5,000.34
|
| Rate for Payer: PACE Medicare |
$1,583.44
|
| Rate for Payer: PACE SWMI |
$1,666.78
|
| Rate for Payer: PHP Commercial |
$876.47
|
| Rate for Payer: PHP Medicare Advantage |
$1,666.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$893.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$670.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,655.63
|
| Rate for Payer: Priority Health Medicare |
$1,666.78
|
| Rate for Payer: Priority Health Narrow Network |
$3,724.50
|
| Rate for Payer: Priority Health SBD |
$649.62
|
| Rate for Payer: Railroad Medicare Medicare |
$1,666.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,691.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,666.78
|
| Rate for Payer: UHC Exchange |
$3,185.38
|
| Rate for Payer: UHC Medicare Advantage |
$1,666.78
|
| Rate for Payer: UHCCP Medicaid |
$893.39
|
| Rate for Payer: UMR Bronson Commercial |
$381.52
|
| Rate for Payer: VA VA |
$1,666.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$773.36
|
|
|
HC LEUPROLIDE ACETATE SUSPNSION/ 7.5MG
|
Facility
|
IP
|
$461.04
|
|
|
Service Code
|
HCPCS J9217
|
| Hospital Charge Code |
63600147
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$202.86 |
| Max. Negotiated Rate |
$414.94 |
| Rate for Payer: Aetna American Axle |
$299.68
|
| Rate for Payer: Aetna Commercial |
$391.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$299.68
|
| Rate for Payer: Cash Price |
$368.83
|
| Rate for Payer: Cofinity Commercial |
$322.73
|
| Rate for Payer: Cofinity Commercial |
$396.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$322.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$368.83
|
| Rate for Payer: Healthscope Commercial |
$414.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$322.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$345.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$391.88
|
| Rate for Payer: PHP Commercial |
$391.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$299.68
|
| Rate for Payer: Priority Health SBD |
$290.46
|
| Rate for Payer: UMR Bronson Commercial |
$202.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$345.78
|
|
|
HC LEUPROLIDE ACETATE SUSPNSION/ 7.5MG
|
Facility
|
OP
|
$461.04
|
|
|
Service Code
|
HCPCS J9217
|
| Hospital Charge Code |
63600147
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$96.90 |
| Max. Negotiated Rate |
$542.37 |
| Rate for Payer: Aetna American Axle |
$299.68
|
| Rate for Payer: Aetna Commercial |
$391.88
|
| Rate for Payer: Aetna Medicare |
$188.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$299.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$225.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$225.99
|
| Rate for Payer: BCBS Complete |
$101.75
|
| Rate for Payer: BCBS MAPPO |
$180.79
|
| Rate for Payer: BCBS Trust/PPO |
$505.52
|
| Rate for Payer: BCN Commercial |
$505.52
|
| Rate for Payer: BCN Medicare Advantage |
$180.79
|
| Rate for Payer: Cash Price |
$368.83
|
| Rate for Payer: Cash Price |
$368.83
|
| Rate for Payer: Cofinity Commercial |
$396.49
|
| Rate for Payer: Cofinity Commercial |
$322.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$322.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$368.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$180.79
|
| Rate for Payer: Healthscope Commercial |
$414.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$322.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$345.78
|
| Rate for Payer: Mclaren Medicaid |
$96.90
|
| Rate for Payer: Mclaren Medicare |
$180.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$189.83
|
| Rate for Payer: Meridian Medicaid |
$101.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$207.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$391.88
|
| Rate for Payer: Nomi Health Commercial |
$542.37
|
| Rate for Payer: PACE Medicare |
$171.75
|
| Rate for Payer: PACE SWMI |
$180.79
|
| Rate for Payer: PHP Commercial |
$391.88
|
| Rate for Payer: PHP Medicare Advantage |
$180.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$299.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$508.00
|
| Rate for Payer: Priority Health Medicare |
$180.79
|
| Rate for Payer: Priority Health Narrow Network |
$406.40
|
| Rate for Payer: Priority Health SBD |
$290.46
|
| Rate for Payer: Railroad Medicare Medicare |
$180.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$508.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$180.79
|
| Rate for Payer: UHC Exchange |
$345.51
|
| Rate for Payer: UHC Medicare Advantage |
$180.79
|
| Rate for Payer: UHCCP Medicaid |
$96.90
|
| Rate for Payer: UMR Bronson Commercial |
$170.58
|
| Rate for Payer: VA VA |
$180.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$345.78
|
|
|
HC LEVEL 0.5 INIT 30 MIN
|
Facility
|
OP
|
$939.78
|
|
| Hospital Charge Code |
36000060
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$347.72 |
| Max. Negotiated Rate |
$845.80 |
| Rate for Payer: Aetna American Axle |
$610.86
|
| Rate for Payer: Aetna Commercial |
$798.81
|
| Rate for Payer: Aetna Medicare |
$469.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$610.86
|
| Rate for Payer: BCBS Complete |
$375.91
|
| Rate for Payer: Cash Price |
$751.82
|
| Rate for Payer: Cofinity Commercial |
$657.85
|
| Rate for Payer: Cofinity Commercial |
$808.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$657.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$751.82
|
| Rate for Payer: Healthscope Commercial |
$845.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$657.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$704.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$798.81
|
| Rate for Payer: PHP Commercial |
$798.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$610.86
|
| Rate for Payer: Priority Health SBD |
$592.06
|
| Rate for Payer: UMR Bronson Commercial |
$347.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$704.84
|
|
|
HC LEVEL 0.5 INIT 30 MIN
|
Facility
|
IP
|
$939.78
|
|
| Hospital Charge Code |
36000060
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$413.50 |
| Max. Negotiated Rate |
$845.80 |
| Rate for Payer: Aetna American Axle |
$610.86
|
| Rate for Payer: Aetna Commercial |
$798.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$610.86
|
| Rate for Payer: Cash Price |
$751.82
|
| Rate for Payer: Cofinity Commercial |
$657.85
|
| Rate for Payer: Cofinity Commercial |
$808.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$657.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$751.82
|
| Rate for Payer: Healthscope Commercial |
$845.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$657.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$704.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$798.81
|
| Rate for Payer: PHP Commercial |
$798.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$610.86
|
| Rate for Payer: Priority Health SBD |
$592.06
|
| Rate for Payer: UMR Bronson Commercial |
$413.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$704.84
|
|
|
HC LEVEL 0.5 SUBSQ 15 MIN
|
Facility
|
IP
|
$270.72
|
|
| Hospital Charge Code |
36000061
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$119.12 |
| Max. Negotiated Rate |
$243.65 |
| Rate for Payer: Aetna American Axle |
$175.97
|
| Rate for Payer: Aetna Commercial |
$230.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.97
|
| Rate for Payer: Cash Price |
$216.58
|
| Rate for Payer: Cofinity Commercial |
$189.50
|
| Rate for Payer: Cofinity Commercial |
$232.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$189.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.58
|
| Rate for Payer: Healthscope Commercial |
$243.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$189.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$203.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$230.11
|
| Rate for Payer: PHP Commercial |
$230.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$175.97
|
| Rate for Payer: Priority Health SBD |
$170.55
|
| Rate for Payer: UMR Bronson Commercial |
$119.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$203.04
|
|
|
HC LEVEL 0.5 SUBSQ 15 MIN
|
Facility
|
OP
|
$270.72
|
|
| Hospital Charge Code |
36000061
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$100.17 |
| Max. Negotiated Rate |
$243.65 |
| Rate for Payer: Aetna American Axle |
$175.97
|
| Rate for Payer: Aetna Commercial |
$230.11
|
| Rate for Payer: Aetna Medicare |
$135.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.97
|
| Rate for Payer: BCBS Complete |
$108.29
|
| Rate for Payer: Cash Price |
$216.58
|
| Rate for Payer: Cofinity Commercial |
$189.50
|
| Rate for Payer: Cofinity Commercial |
$232.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$189.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.58
|
| Rate for Payer: Healthscope Commercial |
$243.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$189.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$203.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$230.11
|
| Rate for Payer: PHP Commercial |
$230.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$175.97
|
| Rate for Payer: Priority Health SBD |
$170.55
|
| Rate for Payer: UMR Bronson Commercial |
$100.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$203.04
|
|
|
HC LEVEL 1 INIT 30 MIN
|
Facility
|
OP
|
$2,074.72
|
|
| Hospital Charge Code |
36000062
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$767.65 |
| Max. Negotiated Rate |
$1,867.25 |
| Rate for Payer: Aetna American Axle |
$1,348.57
|
| Rate for Payer: Aetna Commercial |
$1,763.51
|
| Rate for Payer: Aetna Medicare |
$1,037.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,348.57
|
| Rate for Payer: BCBS Complete |
$829.89
|
| Rate for Payer: Cash Price |
$1,659.78
|
| Rate for Payer: Cofinity Commercial |
$1,452.30
|
| Rate for Payer: Cofinity Commercial |
$1,784.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,452.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,659.78
|
| Rate for Payer: Healthscope Commercial |
$1,867.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,452.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,556.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,763.51
|
| Rate for Payer: PHP Commercial |
$1,763.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,348.57
|
| Rate for Payer: Priority Health SBD |
$1,307.07
|
| Rate for Payer: UMR Bronson Commercial |
$767.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,556.04
|
|
|
HC LEVEL 1 INIT 30 MIN
|
Facility
|
IP
|
$2,074.72
|
|
| Hospital Charge Code |
36000062
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$912.88 |
| Max. Negotiated Rate |
$1,867.25 |
| Rate for Payer: Aetna American Axle |
$1,348.57
|
| Rate for Payer: Aetna Commercial |
$1,763.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,348.57
|
| Rate for Payer: Cash Price |
$1,659.78
|
| Rate for Payer: Cofinity Commercial |
$1,452.30
|
| Rate for Payer: Cofinity Commercial |
$1,784.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,452.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,659.78
|
| Rate for Payer: Healthscope Commercial |
$1,867.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,452.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,556.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,763.51
|
| Rate for Payer: PHP Commercial |
$1,763.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,348.57
|
| Rate for Payer: Priority Health SBD |
$1,307.07
|
| Rate for Payer: UMR Bronson Commercial |
$912.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,556.04
|
|
