|
HC PACEMAKER DUAL CHAMBER LVL 7
|
Facility
|
IP
|
$7,952.00
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500354
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,498.88 |
| Max. Negotiated Rate |
$7,156.80 |
| Rate for Payer: Aetna American Axle |
$5,168.80
|
| Rate for Payer: Aetna Commercial |
$6,759.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,168.80
|
| Rate for Payer: Cash Price |
$6,361.60
|
| Rate for Payer: Cofinity Commercial |
$5,566.40
|
| Rate for Payer: Cofinity Commercial |
$6,838.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,566.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,361.60
|
| Rate for Payer: Healthscope Commercial |
$7,156.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,566.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,964.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,759.20
|
| Rate for Payer: PHP Commercial |
$6,759.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,168.80
|
| Rate for Payer: Priority Health SBD |
$5,009.76
|
| Rate for Payer: UMR Bronson Commercial |
$3,498.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,964.00
|
|
|
HC PACEMAKER DUAL CHAMBER LVL 9
|
Facility
|
OP
|
$9,233.04
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500349
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,416.22 |
| Max. Negotiated Rate |
$8,309.74 |
| Rate for Payer: Aetna American Axle |
$6,001.48
|
| Rate for Payer: Aetna Commercial |
$7,848.08
|
| Rate for Payer: Aetna Medicare |
$4,616.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,001.48
|
| Rate for Payer: BCBS Complete |
$3,693.22
|
| Rate for Payer: Cash Price |
$7,386.43
|
| Rate for Payer: Cofinity Commercial |
$6,463.13
|
| Rate for Payer: Cofinity Commercial |
$7,940.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,463.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,386.43
|
| Rate for Payer: Healthscope Commercial |
$8,309.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,463.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,924.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,848.08
|
| Rate for Payer: PHP Commercial |
$7,848.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,001.48
|
| Rate for Payer: Priority Health SBD |
$5,816.82
|
| Rate for Payer: UMR Bronson Commercial |
$3,416.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,924.78
|
|
|
HC PACEMAKER DUAL CHAMBER LVL 9
|
Facility
|
IP
|
$9,233.04
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500349
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$4,062.54 |
| Max. Negotiated Rate |
$8,309.74 |
| Rate for Payer: Aetna Commercial |
$7,848.08
|
| Rate for Payer: Aetna American Axle |
$6,001.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,001.48
|
| Rate for Payer: Cash Price |
$7,386.43
|
| Rate for Payer: Cofinity Commercial |
$6,463.13
|
| Rate for Payer: Cofinity Commercial |
$7,940.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,463.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,386.43
|
| Rate for Payer: Healthscope Commercial |
$8,309.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,463.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,924.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,848.08
|
| Rate for Payer: PHP Commercial |
$7,848.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,001.48
|
| Rate for Payer: Priority Health SBD |
$5,816.82
|
| Rate for Payer: UMR Bronson Commercial |
$4,062.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,924.78
|
|
|
HC PACEMAKER IMPLANT, DUAL
|
Facility
|
IP
|
$19,347.05
|
|
|
Service Code
|
CPT 33208
|
| Hospital Charge Code |
36100059
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,512.70 |
| Max. Negotiated Rate |
$17,412.34 |
| Rate for Payer: Aetna American Axle |
$12,575.58
|
| Rate for Payer: Aetna Commercial |
$16,444.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,575.58
|
| Rate for Payer: Cash Price |
$15,477.64
|
| Rate for Payer: Cofinity Commercial |
$13,542.94
|
| Rate for Payer: Cofinity Commercial |
$16,638.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$13,542.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,477.64
|
| Rate for Payer: Healthscope Commercial |
$17,412.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13,542.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,510.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,444.99
|
| Rate for Payer: PHP Commercial |
$16,444.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,575.58
|
| Rate for Payer: Priority Health SBD |
$12,188.64
|
| Rate for Payer: UMR Bronson Commercial |
$8,512.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,510.29
|
|
|
HC PACEMAKER IMPLANT, DUAL
|
Facility
|
OP
|
$19,347.05
|
|
|
Service Code
|
CPT 33208
|
| Hospital Charge Code |
36100059
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$496.29 |
| Max. Negotiated Rate |
$32,227.28 |
| Rate for Payer: Aetna American Axle |
$12,575.58
|
| Rate for Payer: Aetna Commercial |
$16,444.99
|
| Rate for Payer: Aetna Medicare |
$10,663.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,575.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,817.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,817.15
|
| Rate for Payer: BCBS Complete |
$5,770.79
|
| Rate for Payer: BCBS MAPPO |
$10,253.72
|
| Rate for Payer: BCBS Trust/PPO |
$13,722.42
|
| Rate for Payer: BCN Commercial |
$13,722.42
|
| Rate for Payer: BCN Medicare Advantage |
$10,253.72
|
| Rate for Payer: Cash Price |
$15,477.64
|
| Rate for Payer: Cash Price |
$15,477.64
|
| Rate for Payer: Cash Price |
$15,477.64
|
| Rate for Payer: Cofinity Commercial |
$16,638.46
|
| Rate for Payer: Cofinity Commercial |
$13,542.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$13,542.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,477.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,253.72
|
| Rate for Payer: Healthscope Commercial |
$17,412.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13,542.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,510.29
|
| Rate for Payer: Mclaren Medicaid |
$5,495.99
|
| Rate for Payer: Mclaren Medicare |
$10,253.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,766.41
|
| Rate for Payer: Meridian Medicaid |
$5,770.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,791.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,444.99
|
| Rate for Payer: Nomi Health Commercial |
$21,532.81
|
| Rate for Payer: PACE Medicare |
$9,741.03
|
| Rate for Payer: PACE SWMI |
$10,253.72
|
| Rate for Payer: PHP Commercial |
$16,444.99
|
| Rate for Payer: PHP Medicare Advantage |
$10,253.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,495.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,575.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32,227.28
|
| Rate for Payer: Priority Health Medicare |
$10,253.72
|
| Rate for Payer: Priority Health Narrow Network |
$25,781.82
|
| Rate for Payer: Priority Health SBD |
$12,188.64
|
| Rate for Payer: Railroad Medicare Medicare |
$10,253.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$545.92
|
| Rate for Payer: UHC Core |
$18,337.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,253.72
|
| Rate for Payer: UHC Exchange |
$496.29
|
| Rate for Payer: UHC Medicare Advantage |
$10,253.72
|
| Rate for Payer: UHCCP Medicaid |
$5,495.99
|
| Rate for Payer: UMR Bronson Commercial |
$7,158.41
|
| Rate for Payer: VA VA |
$10,253.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,510.29
|
|
|
HC PACEMAKER LEAD
|
Facility
|
OP
|
$1,949.22
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27800024
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$721.21 |
| Max. Negotiated Rate |
$1,754.30 |
| Rate for Payer: Aetna American Axle |
$1,266.99
|
| Rate for Payer: Aetna Commercial |
$1,656.84
|
| Rate for Payer: Aetna Medicare |
$974.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,266.99
|
| Rate for Payer: BCBS Complete |
$779.69
|
| Rate for Payer: Cash Price |
$1,559.38
|
| Rate for Payer: Cofinity Commercial |
$1,364.45
|
| Rate for Payer: Cofinity Commercial |
$1,676.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,364.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,559.38
|
| Rate for Payer: Healthscope Commercial |
$1,754.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,364.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,461.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,656.84
|
| Rate for Payer: PHP Commercial |
$1,656.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,266.99
|
| Rate for Payer: Priority Health SBD |
$1,228.01
|
| Rate for Payer: UMR Bronson Commercial |
$721.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,461.92
|
|
|
HC PACEMAKER LEAD
|
Facility
|
IP
|
$1,949.22
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27800024
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$857.66 |
| Max. Negotiated Rate |
$1,754.30 |
| Rate for Payer: Aetna American Axle |
$1,266.99
|
| Rate for Payer: Aetna Commercial |
$1,656.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,266.99
|
| Rate for Payer: Cash Price |
$1,559.38
|
| Rate for Payer: Cofinity Commercial |
$1,364.45
|
| Rate for Payer: Cofinity Commercial |
$1,676.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,364.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,559.38
|
| Rate for Payer: Healthscope Commercial |
$1,754.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,364.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,461.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,656.84
|
| Rate for Payer: PHP Commercial |
$1,656.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,266.99
|
| Rate for Payer: Priority Health SBD |
$1,228.01
|
| Rate for Payer: UMR Bronson Commercial |
$857.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,461.92
|
|
|
HC PACEMAKER OTHER SINGLE OR DUAL LVL 11
|
Facility
|
IP
|
$11,889.00
|
|
|
Service Code
|
HCPCS C2621
|
| Hospital Charge Code |
27500348
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$5,231.16 |
| Max. Negotiated Rate |
$10,700.10 |
| Rate for Payer: Aetna American Axle |
$7,727.85
|
| Rate for Payer: Aetna Commercial |
$10,105.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,727.85
|
| Rate for Payer: Cash Price |
$9,511.20
|
| Rate for Payer: Cofinity Commercial |
$10,224.54
|
| Rate for Payer: Cofinity Commercial |
$8,322.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,322.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,511.20
|
| Rate for Payer: Healthscope Commercial |
$10,700.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,322.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,916.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,105.65
|
| Rate for Payer: PHP Commercial |
$10,105.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,727.85
|
| Rate for Payer: Priority Health SBD |
$7,490.07
|
| Rate for Payer: UMR Bronson Commercial |
$5,231.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,916.75
|
|
|
HC PACEMAKER OTHER SINGLE OR DUAL LVL 11
|
Facility
|
OP
|
$11,889.00
|
|
|
Service Code
|
HCPCS C2621
|
| Hospital Charge Code |
27500348
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$4,398.93 |
| Max. Negotiated Rate |
$10,700.10 |
| Rate for Payer: Aetna American Axle |
$7,727.85
|
| Rate for Payer: Aetna Commercial |
$10,105.65
|
| Rate for Payer: Aetna Medicare |
$5,944.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,727.85
|
| Rate for Payer: BCBS Complete |
$4,755.60
|
| Rate for Payer: Cash Price |
$9,511.20
|
| Rate for Payer: Cofinity Commercial |
$10,224.54
|
| Rate for Payer: Cofinity Commercial |
$8,322.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,322.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,511.20
|
| Rate for Payer: Healthscope Commercial |
$10,700.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,322.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,916.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,105.65
|
| Rate for Payer: PHP Commercial |
$10,105.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,727.85
|
| Rate for Payer: Priority Health SBD |
$7,490.07
|
| Rate for Payer: UMR Bronson Commercial |
$4,398.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,916.75
|
|
|
HC PACEMAKER SINGLE CHAMBER LVL 13
|
Facility
|
OP
|
$13,770.00
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500351
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$5,094.90 |
| Max. Negotiated Rate |
$12,393.00 |
| Rate for Payer: Aetna American Axle |
$8,950.50
|
| Rate for Payer: Aetna Commercial |
$11,704.50
|
| Rate for Payer: Aetna Medicare |
$6,885.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,950.50
|
| Rate for Payer: BCBS Complete |
$5,508.00
|
| Rate for Payer: Cash Price |
$11,016.00
|
| Rate for Payer: Cofinity Commercial |
$11,842.20
|
| Rate for Payer: Cofinity Commercial |
$9,639.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$9,639.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,016.00
|
| Rate for Payer: Healthscope Commercial |
$12,393.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,639.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,327.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,704.50
|
| Rate for Payer: PHP Commercial |
$11,704.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,950.50
|
| Rate for Payer: Priority Health SBD |
$8,675.10
|
| Rate for Payer: UMR Bronson Commercial |
$5,094.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,327.50
|
|
|
HC PACEMAKER SINGLE CHAMBER LVL 13
|
Facility
|
IP
|
$13,770.00
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500351
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$6,058.80 |
| Max. Negotiated Rate |
$12,393.00 |
| Rate for Payer: Aetna American Axle |
$8,950.50
|
| Rate for Payer: Aetna Commercial |
$11,704.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,950.50
|
| Rate for Payer: Cash Price |
$11,016.00
|
| Rate for Payer: Cofinity Commercial |
$11,842.20
|
| Rate for Payer: Cofinity Commercial |
$9,639.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$9,639.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,016.00
|
| Rate for Payer: Healthscope Commercial |
$12,393.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,639.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,327.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,704.50
|
| Rate for Payer: PHP Commercial |
$11,704.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,950.50
|
| Rate for Payer: Priority Health SBD |
$8,675.10
|
| Rate for Payer: UMR Bronson Commercial |
$6,058.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,327.50
|
|
|
HC PACEMAKER SINGLE CHAMBER LVL 16
|
Facility
|
OP
|
$16,863.15
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500350
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$6,239.37 |
| Max. Negotiated Rate |
$15,176.84 |
| Rate for Payer: Aetna American Axle |
$10,961.05
|
| Rate for Payer: Aetna Commercial |
$14,333.68
|
| Rate for Payer: Aetna Medicare |
$8,431.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10,961.05
|
| Rate for Payer: BCBS Complete |
$6,745.26
|
| Rate for Payer: Cash Price |
$13,490.52
|
| Rate for Payer: Cofinity Commercial |
$11,804.20
|
| Rate for Payer: Cofinity Commercial |
$14,502.31
|
| Rate for Payer: Cofinity Medicare Advantage |
$11,804.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,490.52
|
| Rate for Payer: Healthscope Commercial |
$15,176.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11,804.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,647.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,333.68
|
| Rate for Payer: PHP Commercial |
$14,333.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,961.05
|
| Rate for Payer: Priority Health SBD |
$10,623.78
|
| Rate for Payer: UMR Bronson Commercial |
$6,239.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,647.36
|
|
|
HC PACEMAKER SINGLE CHAMBER LVL 16
|
Facility
|
IP
|
$16,863.15
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500350
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$7,419.79 |
| Max. Negotiated Rate |
$15,176.84 |
| Rate for Payer: Aetna American Axle |
$10,961.05
|
| Rate for Payer: Aetna Commercial |
$14,333.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10,961.05
|
| Rate for Payer: Cash Price |
$13,490.52
|
| Rate for Payer: Cofinity Commercial |
$11,804.20
|
| Rate for Payer: Cofinity Commercial |
$14,502.31
|
| Rate for Payer: Cofinity Medicare Advantage |
$11,804.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,490.52
|
| Rate for Payer: Healthscope Commercial |
$15,176.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11,804.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,647.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,333.68
|
| Rate for Payer: PHP Commercial |
$14,333.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,961.05
|
| Rate for Payer: Priority Health SBD |
$10,623.78
|
| Rate for Payer: UMR Bronson Commercial |
$7,419.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,647.36
|
|
|
HC PACEMAKER SINGLE CHAMBER LVL 6
|
Facility
|
OP
|
$6,319.92
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500352
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,338.37 |
| Max. Negotiated Rate |
$5,687.93 |
| Rate for Payer: Aetna American Axle |
$4,107.95
|
| Rate for Payer: Aetna Commercial |
$5,371.93
|
| Rate for Payer: Aetna Medicare |
$3,159.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,107.95
|
| Rate for Payer: BCBS Complete |
$2,527.97
|
| Rate for Payer: Cash Price |
$5,055.94
|
| Rate for Payer: Cofinity Commercial |
$4,423.94
|
| Rate for Payer: Cofinity Commercial |
$5,435.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,423.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,055.94
|
| Rate for Payer: Healthscope Commercial |
$5,687.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,423.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,739.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,371.93
|
| Rate for Payer: PHP Commercial |
$5,371.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,107.95
|
| Rate for Payer: Priority Health SBD |
$3,981.55
|
| Rate for Payer: UMR Bronson Commercial |
$2,338.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,739.94
|
|
|
HC PACEMAKER SINGLE CHAMBER LVL 6
|
Facility
|
IP
|
$6,319.92
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500352
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,780.76 |
| Max. Negotiated Rate |
$5,687.93 |
| Rate for Payer: Aetna American Axle |
$4,107.95
|
| Rate for Payer: Aetna Commercial |
$5,371.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,107.95
|
| Rate for Payer: Cash Price |
$5,055.94
|
| Rate for Payer: Cofinity Commercial |
$4,423.94
|
| Rate for Payer: Cofinity Commercial |
$5,435.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,423.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,055.94
|
| Rate for Payer: Healthscope Commercial |
$5,687.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,423.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,739.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,371.93
|
| Rate for Payer: PHP Commercial |
$5,371.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,107.95
|
| Rate for Payer: Priority Health SBD |
$3,981.55
|
| Rate for Payer: UMR Bronson Commercial |
$2,780.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,739.94
|
|
|
HC PACEMAKER SINGLE CHAMBER LVL 8
|
Facility
|
OP
|
$8,315.04
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500353
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,076.56 |
| Max. Negotiated Rate |
$7,483.54 |
| Rate for Payer: Aetna American Axle |
$5,404.78
|
| Rate for Payer: Aetna Commercial |
$7,067.78
|
| Rate for Payer: Aetna Medicare |
$4,157.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,404.78
|
| Rate for Payer: BCBS Complete |
$3,326.02
|
| Rate for Payer: Cash Price |
$6,652.03
|
| Rate for Payer: Cofinity Commercial |
$5,820.53
|
| Rate for Payer: Cofinity Commercial |
$7,150.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,820.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,652.03
|
| Rate for Payer: Healthscope Commercial |
$7,483.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,820.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,236.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,067.78
|
| Rate for Payer: PHP Commercial |
$7,067.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,404.78
|
| Rate for Payer: Priority Health SBD |
$5,238.48
|
| Rate for Payer: UMR Bronson Commercial |
$3,076.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,236.28
|
|
|
HC PACEMAKER SINGLE CHAMBER LVL 8
|
Facility
|
IP
|
$8,315.04
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500353
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,658.62 |
| Max. Negotiated Rate |
$7,483.54 |
| Rate for Payer: Aetna American Axle |
$5,404.78
|
| Rate for Payer: Aetna Commercial |
$7,067.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,404.78
|
| Rate for Payer: Cash Price |
$6,652.03
|
| Rate for Payer: Cofinity Commercial |
$5,820.53
|
| Rate for Payer: Cofinity Commercial |
$7,150.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,820.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,652.03
|
| Rate for Payer: Healthscope Commercial |
$7,483.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,820.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,236.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,067.78
|
| Rate for Payer: PHP Commercial |
$7,067.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,404.78
|
| Rate for Payer: Priority Health SBD |
$5,238.48
|
| Rate for Payer: UMR Bronson Commercial |
$3,658.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,236.28
|
|
|
HC PACEMAKER TESTING CABLE
|
Facility
|
OP
|
$114.69
|
|
| Hospital Charge Code |
27200143
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.44 |
| Max. Negotiated Rate |
$103.22 |
| Rate for Payer: Aetna American Axle |
$74.55
|
| Rate for Payer: Aetna Commercial |
$97.49
|
| Rate for Payer: Aetna Medicare |
$57.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.55
|
| Rate for Payer: BCBS Complete |
$45.88
|
| Rate for Payer: Cash Price |
$91.75
|
| Rate for Payer: Cofinity Commercial |
$80.28
|
| Rate for Payer: Cofinity Commercial |
$98.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$80.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.75
|
| Rate for Payer: Healthscope Commercial |
$103.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$80.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.49
|
| Rate for Payer: PHP Commercial |
$97.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.55
|
| Rate for Payer: Priority Health SBD |
$72.25
|
| Rate for Payer: UMR Bronson Commercial |
$42.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.02
|
|
|
HC PACEMAKER TESTING CABLE
|
Facility
|
IP
|
$114.69
|
|
| Hospital Charge Code |
27200143
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$50.46 |
| Max. Negotiated Rate |
$103.22 |
| Rate for Payer: Aetna American Axle |
$74.55
|
| Rate for Payer: Aetna Commercial |
$97.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.55
|
| Rate for Payer: Cash Price |
$91.75
|
| Rate for Payer: Cofinity Commercial |
$80.28
|
| Rate for Payer: Cofinity Commercial |
$98.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$80.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.75
|
| Rate for Payer: Healthscope Commercial |
$103.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$80.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.49
|
| Rate for Payer: PHP Commercial |
$97.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.55
|
| Rate for Payer: Priority Health SBD |
$72.25
|
| Rate for Payer: UMR Bronson Commercial |
$50.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.02
|
|
|
HC PACER POCKET REVISION
|
Facility
|
OP
|
$2,755.73
|
|
|
Service Code
|
CPT 33222
|
| Hospital Charge Code |
36100067
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$327.41 |
| Max. Negotiated Rate |
$5,632.99 |
| Rate for Payer: Aetna American Axle |
$1,791.22
|
| Rate for Payer: Aetna Commercial |
$2,342.37
|
| Rate for Payer: Aetna Medicare |
$1,863.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,791.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,240.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,240.30
|
| Rate for Payer: BCBS Complete |
$1,008.67
|
| Rate for Payer: BCBS MAPPO |
$1,792.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,401.99
|
| Rate for Payer: BCN Commercial |
$1,401.99
|
| Rate for Payer: BCN Medicare Advantage |
$1,792.24
|
| Rate for Payer: Cash Price |
$2,204.58
|
| Rate for Payer: Cash Price |
$2,204.58
|
| Rate for Payer: Cash Price |
$2,204.58
|
| Rate for Payer: Cofinity Commercial |
$2,369.93
|
| Rate for Payer: Cofinity Commercial |
$1,929.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,929.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,204.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,792.24
|
| Rate for Payer: Healthscope Commercial |
$2,480.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,929.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,066.80
|
| Rate for Payer: Mclaren Medicaid |
$960.64
|
| Rate for Payer: Mclaren Medicare |
$1,792.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,881.85
|
| Rate for Payer: Meridian Medicaid |
$1,008.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,061.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,342.37
|
| Rate for Payer: Nomi Health Commercial |
$3,763.70
|
| Rate for Payer: PACE Medicare |
$1,702.63
|
| Rate for Payer: PACE SWMI |
$1,792.24
|
| Rate for Payer: PHP Commercial |
$2,342.37
|
| Rate for Payer: PHP Medicare Advantage |
$1,792.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$960.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,791.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,632.99
|
| Rate for Payer: Priority Health Medicare |
$1,792.24
|
| Rate for Payer: Priority Health Narrow Network |
$4,506.39
|
| Rate for Payer: Priority Health SBD |
$1,736.11
|
| Rate for Payer: Railroad Medicare Medicare |
$1,792.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$360.15
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,792.24
|
| Rate for Payer: UHC Exchange |
$327.41
|
| Rate for Payer: UHC Medicare Advantage |
$1,792.24
|
| Rate for Payer: UHCCP Medicaid |
$960.64
|
| Rate for Payer: UMR Bronson Commercial |
$1,019.62
|
| Rate for Payer: VA VA |
$1,792.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,066.80
|
|
|
HC PACER POCKET REVISION
|
Facility
|
IP
|
$2,755.73
|
|
|
Service Code
|
CPT 33222
|
| Hospital Charge Code |
36100067
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,212.52 |
| Max. Negotiated Rate |
$2,480.16 |
| Rate for Payer: Aetna American Axle |
$1,791.22
|
| Rate for Payer: Aetna Commercial |
$2,342.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,791.22
|
| Rate for Payer: Cash Price |
$2,204.58
|
| Rate for Payer: Cofinity Commercial |
$1,929.01
|
| Rate for Payer: Cofinity Commercial |
$2,369.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,929.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,204.58
|
| Rate for Payer: Healthscope Commercial |
$2,480.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,929.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,066.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,342.37
|
| Rate for Payer: PHP Commercial |
$2,342.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,791.22
|
| Rate for Payer: Priority Health SBD |
$1,736.11
|
| Rate for Payer: UMR Bronson Commercial |
$1,212.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,066.80
|
|
|
HC PACK CCS BRONSON FX XC BASE
|
Facility
|
IP
|
$765.00
|
|
| Hospital Charge Code |
27000682
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$336.60 |
| Max. Negotiated Rate |
$688.50 |
| Rate for Payer: Aetna American Axle |
$497.25
|
| Rate for Payer: Aetna Commercial |
$650.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$497.25
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Cofinity Commercial |
$535.50
|
| Rate for Payer: Cofinity Commercial |
$657.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$535.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$612.00
|
| Rate for Payer: Healthscope Commercial |
$688.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$535.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$573.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$650.25
|
| Rate for Payer: PHP Commercial |
$650.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$497.25
|
| Rate for Payer: Priority Health SBD |
$481.95
|
| Rate for Payer: UMR Bronson Commercial |
$336.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$573.75
|
|
|
HC PACK CCS BRONSON FX XC BASE
|
Facility
|
OP
|
$765.00
|
|
| Hospital Charge Code |
27000682
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$283.05 |
| Max. Negotiated Rate |
$688.50 |
| Rate for Payer: Cofinity Commercial |
$657.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$535.50
|
| Rate for Payer: Aetna American Axle |
$497.25
|
| Rate for Payer: Aetna Commercial |
$650.25
|
| Rate for Payer: Aetna Medicare |
$382.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$497.25
|
| Rate for Payer: BCBS Complete |
$306.00
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Cofinity Commercial |
$535.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$612.00
|
| Rate for Payer: Healthscope Commercial |
$688.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$535.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$573.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$650.25
|
| Rate for Payer: PHP Commercial |
$650.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$497.25
|
| Rate for Payer: Priority Health SBD |
$481.95
|
| Rate for Payer: UMR Bronson Commercial |
$283.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$573.75
|
|
|
HC PACKED CELLS DIRECT
|
Facility
|
OP
|
$825.28
|
|
|
Service Code
|
HCPCS P9016
|
| Hospital Charge Code |
39000058
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$95.58 |
| Max. Negotiated Rate |
$742.75 |
| Rate for Payer: Aetna American Axle |
$536.43
|
| Rate for Payer: Aetna Commercial |
$701.49
|
| Rate for Payer: Aetna Medicare |
$185.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$536.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$222.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$222.90
|
| Rate for Payer: BCBS Complete |
$100.36
|
| Rate for Payer: BCBS MAPPO |
$178.32
|
| Rate for Payer: BCBS Trust/PPO |
$478.52
|
| Rate for Payer: BCN Commercial |
$478.52
|
| Rate for Payer: BCN Medicare Advantage |
$178.32
|
| Rate for Payer: Cash Price |
$660.22
|
| Rate for Payer: Cash Price |
$660.22
|
| Rate for Payer: Cash Price |
$660.22
|
| Rate for Payer: Cofinity Commercial |
$577.70
|
| Rate for Payer: Cofinity Commercial |
$709.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$577.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$660.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$178.32
|
| Rate for Payer: Healthscope Commercial |
$742.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$577.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$618.96
|
| Rate for Payer: Mclaren Medicaid |
$95.58
|
| Rate for Payer: Mclaren Medicare |
$178.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$187.24
|
| Rate for Payer: Meridian Medicaid |
$100.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$205.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$701.49
|
| Rate for Payer: Nomi Health Commercial |
$534.96
|
| Rate for Payer: PACE Medicare |
$169.40
|
| Rate for Payer: PACE SWMI |
$178.32
|
| Rate for Payer: PHP Commercial |
$701.49
|
| Rate for Payer: PHP Medicare Advantage |
$178.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$95.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$536.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$560.47
|
| Rate for Payer: Priority Health Medicare |
$178.32
|
| Rate for Payer: Priority Health Narrow Network |
$448.38
|
| Rate for Payer: Priority Health SBD |
$519.93
|
| Rate for Payer: Railroad Medicare Medicare |
$178.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$501.95
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$178.32
|
| Rate for Payer: UHC Exchange |
$340.79
|
| Rate for Payer: UHC Medicare Advantage |
$178.32
|
| Rate for Payer: UHCCP Medicaid |
$95.58
|
| Rate for Payer: UMR Bronson Commercial |
$305.35
|
| Rate for Payer: VA VA |
$178.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$618.96
|
|
|
HC PACKED CELLS DIRECT
|
Facility
|
IP
|
$825.28
|
|
|
Service Code
|
HCPCS P9016
|
| Hospital Charge Code |
39000058
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$363.12 |
| Max. Negotiated Rate |
$742.75 |
| Rate for Payer: Aetna American Axle |
$536.43
|
| Rate for Payer: Aetna Commercial |
$701.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$536.43
|
| Rate for Payer: Cash Price |
$660.22
|
| Rate for Payer: Cofinity Commercial |
$577.70
|
| Rate for Payer: Cofinity Commercial |
$709.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$577.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$660.22
|
| Rate for Payer: Healthscope Commercial |
$742.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$577.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$618.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$701.49
|
| Rate for Payer: PHP Commercial |
$701.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$536.43
|
| Rate for Payer: Priority Health SBD |
$519.93
|
| Rate for Payer: UMR Bronson Commercial |
$363.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$618.96
|
|
