Bronson Methodist Hospital

All Charges

Charge

Type

Setting

Price

PR ALBUTEROL IPRATROP NON-COMP

Professional

Both

$2.00

Service Code	HCPCS J7620
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$1.40
Rate for Payer: Aetna Commercial	$0.18
Rate for Payer: BCBS Complete	$0.80
Rate for Payer: Cash Price	$1.60
Rate for Payer: Cash Price	$1.60
Rate for Payer: Priority Health Cigna Priority Health	$1.40
Rate for Payer: UMR Bronson Commercial	$0.92

PR ALBUTEROL NON-COMP CON

Professional

Both

$2.00

Service Code	HCPCS J7611
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$1.40
Rate for Payer: Aetna Commercial	$0.15
Rate for Payer: BCBS Complete	$0.80
Rate for Payer: Cash Price	$1.60
Rate for Payer: Cash Price	$1.60
Rate for Payer: Priority Health Cigna Priority Health	$1.40
Rate for Payer: UMR Bronson Commercial	$0.92

PR ALBUTEROL NON-COMP UNIT

Professional

Both

$2.00

Service Code	HCPCS J7613
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$1.40
Rate for Payer: Aetna Commercial	$0.04
Rate for Payer: BCBS Complete	$0.80
Rate for Payer: Cash Price	$1.60
Rate for Payer: Cash Price	$1.60
Rate for Payer: Priority Health Cigna Priority Health	$1.40
Rate for Payer: UMR Bronson Commercial	$0.92

PR ALCOHOL AND/OR DRUG SERVICES

Professional

Both

$242.00

Service Code	HCPCS H0015
Min. Negotiated Rate	$96.80
Max. Negotiated Rate	$169.40
Rate for Payer: Aetna Commercial	$134.33
Rate for Payer: BCBS Complete	$96.80
Rate for Payer: Cash Price	$193.60
Rate for Payer: Cash Price	$193.60
Rate for Payer: Priority Health Cigna Priority Health	$169.40
Rate for Payer: UMR Bronson Commercial	$111.32

PR ALCOHOL/SUBSTANCE SCREEN & INTERVEN 15-30 MIN

Professional

Both

$53.00

Service Code	HCPCS 99408
Min. Negotiated Rate	$20.02
Max. Negotiated Rate	$1,099.92
Rate for Payer: Aetna Commercial	$33.63
Rate for Payer: BCBS Complete	$21.02
Rate for Payer: BCBS Trust/PPO	$1,099.92
Rate for Payer: Cash Price	$42.40
Rate for Payer: Cash Price	$42.40
Rate for Payer: Meridian Medicaid	$21.02
Rate for Payer: Priority Health Choice Medicaid	$20.02
Rate for Payer: Priority Health Cigna Priority Health	$37.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$40.26
Rate for Payer: Priority Health Narrow Network	$40.26
Rate for Payer: Priority Health SBD	$40.26
Rate for Payer: UMR Bronson Commercial	$24.38

PR ALCOHOL/SUBSTANCE SCREEN & INTERVENTION >30 MIN

Professional

Both

$102.00

Service Code	HCPCS 99409
Min. Negotiated Rate	$40.04
Max. Negotiated Rate	$1,109.43
Rate for Payer: Aetna Commercial	$67.61
Rate for Payer: BCBS Complete	$42.04
Rate for Payer: BCBS Trust/PPO	$1,109.43
Rate for Payer: Cash Price	$81.60
Rate for Payer: Cash Price	$81.60
Rate for Payer: Meridian Medicaid	$42.04
Rate for Payer: Priority Health Choice Medicaid	$40.04
Rate for Payer: Priority Health Cigna Priority Health	$71.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$80.53
Rate for Payer: Priority Health Narrow Network	$80.53
Rate for Payer: Priority Health SBD	$80.53
Rate for Payer: UMR Bronson Commercial	$46.92

PRALIDOXIME 1 GRAM SOLUTION FOR IM INJECTION

Facility

$286.25

Service Code	HCPCS J2730
Hospital Charge Code	151068
Hospital Revenue Code	636
Min. Negotiated Rate	$125.95
Max. Negotiated Rate	$257.62
Rate for Payer: Aetna American Axle	$186.06
Rate for Payer: Aetna Commercial	$243.31
Rate for Payer: Aetna New Business (MI Preferred)	$186.06
Rate for Payer: Cash Price	$229.00
Rate for Payer: Cofinity Commercial	$200.38
Rate for Payer: Cofinity Commercial	$246.18
Rate for Payer: Encore Health Key Benefits Commercial	$229.00
Rate for Payer: Healthscope Commercial	$257.62
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial	$200.38
Rate for Payer: Lakeland Regional Health Systems Commercial	$214.69
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$243.31
Rate for Payer: PHP Commercial	$243.31
Rate for Payer: Priority Health Cigna Priority Health	$200.38
Rate for Payer: Priority Health SBD	$180.34
Rate for Payer: UMR Bronson Commercial	$125.95
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$214.69

PRALIDOXIME 1 GRAM SOLUTION FOR INJECTION

Facility

$286.25

Service Code	HCPCS J2730
Hospital Charge Code	6462
Hospital Revenue Code	636
Min. Negotiated Rate	$125.95
Max. Negotiated Rate	$257.62
Rate for Payer: Aetna American Axle	$186.06
Rate for Payer: Aetna Commercial	$243.31
Rate for Payer: Aetna New Business (MI Preferred)	$186.06
Rate for Payer: Cash Price	$229.00
Rate for Payer: Cofinity Commercial	$200.38
Rate for Payer: Cofinity Commercial	$246.18
Rate for Payer: Encore Health Key Benefits Commercial	$229.00
Rate for Payer: Healthscope Commercial	$257.62
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial	$200.38
Rate for Payer: Lakeland Regional Health Systems Commercial	$214.69
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$243.31
Rate for Payer: PHP Commercial	$243.31
Rate for Payer: Priority Health Cigna Priority Health	$200.38
Rate for Payer: Priority Health SBD	$180.34
Rate for Payer: UMR Bronson Commercial	$125.95
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$214.69

PR ALLOGRAFT FOR SPINE SURGERY ONLY MORSELIZED

Professional

Both

$479.00

Service Code	HCPCS 20930
Min. Negotiated Rate	$155.86
Max. Negotiated Rate	$11,952.59
Rate for Payer: Aetna Commercial	$155.86
Rate for Payer: BCBS Complete	$191.60
Rate for Payer: BCBS Trust/PPO	$11,952.59
Rate for Payer: Cash Price	$383.20
Rate for Payer: Cash Price	$383.20
Rate for Payer: Priority Health Cigna Priority Health	$335.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$178.73
Rate for Payer: Priority Health Narrow Network	$178.73
Rate for Payer: Priority Health SBD	$178.73
Rate for Payer: UMR Bronson Commercial	$220.34

PR ALLOGRAFT FOR SPINE SURGERY ONLY STRUCTURAL

Professional

Both

$437.00

Service Code	HCPCS 20931
Min. Negotiated Rate	$70.29
Max. Negotiated Rate	$29,358.48
Rate for Payer: Aetna Commercial	$148.79
Rate for Payer: BCBS Complete	$73.80
Rate for Payer: BCBS Trust/PPO	$29,358.48
Rate for Payer: Cash Price	$349.60
Rate for Payer: Cash Price	$349.60
Rate for Payer: Meridian Medicaid	$73.80
Rate for Payer: Priority Health Choice Medicaid	$70.29
Rate for Payer: Priority Health Cigna Priority Health	$305.90
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$168.01
Rate for Payer: Priority Health Narrow Network	$168.01
Rate for Payer: Priority Health SBD	$168.01
Rate for Payer: UMR Bronson Commercial	$201.02

PR ALTEPLASE RECOMBINANT

Professional

Both

$89.00

Service Code	HCPCS J2997
Min. Negotiated Rate	$35.60
Max. Negotiated Rate	$91.64
Rate for Payer: Aetna Commercial	$91.64
Rate for Payer: BCBS Complete	$35.60
Rate for Payer: BCBS Trust/PPO	$88.53
Rate for Payer: Cash Price	$71.20
Rate for Payer: Cash Price	$71.20
Rate for Payer: Priority Health Cigna Priority Health	$62.30
Rate for Payer: UMR Bronson Commercial	$40.94

PR AMBULATORY BP MNTR W/SW 24 HR+ REC SCAN ALYS I&R

Professional

Both

$252.00

Service Code	HCPCS 93784
Min. Negotiated Rate	$37.78
Max. Negotiated Rate	$176.40
Rate for Payer: Aetna Commercial	$49.46
Rate for Payer: BCBS Complete	$100.80
Rate for Payer: BCBS Trust/PPO	$37.78
Rate for Payer: Cash Price	$201.60
Rate for Payer: Cash Price	$201.60
Rate for Payer: Priority Health Cigna Priority Health	$176.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$64.31
Rate for Payer: Priority Health Narrow Network	$64.31
Rate for Payer: Priority Health SBD	$64.31
Rate for Payer: UMR Bronson Commercial	$115.92

PR AMBULATORY BP MNTR W/SW 24 HR+ REVIEW W/I&R

Professional

Both

$35.00

Service Code	HCPCS 93790
Min. Negotiated Rate	$14.00
Max. Negotiated Rate	$31.84
Rate for Payer: Aetna Commercial	$20.22
Rate for Payer: BCBS Complete	$14.00
Rate for Payer: BCBS Trust/PPO	$31.84
Rate for Payer: Cash Price	$28.00
Rate for Payer: Cash Price	$28.00
Rate for Payer: Priority Health Cigna Priority Health	$24.50
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$25.06
Rate for Payer: Priority Health Narrow Network	$25.06
Rate for Payer: Priority Health SBD	$25.06
Rate for Payer: UMR Bronson Commercial	$16.10

PR AMBULATORY EEG MONITORING

Professional

Both

$573.00

Service Code	HCPCS 95950
Min. Negotiated Rate	$229.20
Max. Negotiated Rate	$401.10
Rate for Payer: BCBS Complete	$229.20
Rate for Payer: Cash Price	$458.40
Rate for Payer: Priority Health Cigna Priority Health	$401.10
Rate for Payer: UMR Bronson Commercial	$263.58

PR AMINOLEVULINIC ACID HCL TOP

Professional

Both

$174.00

Service Code	HCPCS J7308
Min. Negotiated Rate	$69.60
Max. Negotiated Rate	$404.09
Rate for Payer: Aetna Commercial	$404.09
Rate for Payer: BCBS Complete	$69.60
Rate for Payer: BCBS Trust/PPO	$399.72
Rate for Payer: Cash Price	$139.20
Rate for Payer: Cash Price	$139.20
Rate for Payer: Priority Health Cigna Priority Health	$121.80
Rate for Payer: UMR Bronson Commercial	$80.04

PRAMIPEXOLE 0.25 MG TABLET

Facility

$439.45

Service Code	NDC 60687-570-01
Hospital Charge Code	21290
Hospital Revenue Code	637
Min. Negotiated Rate	$193.36
Max. Negotiated Rate	$395.50
Rate for Payer: Aetna American Axle	$285.64
Rate for Payer: Aetna Commercial	$373.53
Rate for Payer: Aetna New Business (MI Preferred)	$285.64
Rate for Payer: Cash Price	$351.56
Rate for Payer: Cofinity Commercial	$307.62
Rate for Payer: Cofinity Commercial	$377.93
Rate for Payer: Encore Health Key Benefits Commercial	$351.56
Rate for Payer: Healthscope Commercial	$395.50
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial	$307.62
Rate for Payer: Lakeland Regional Health Systems Commercial	$329.59
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$373.53
Rate for Payer: PHP Commercial	$373.53
Rate for Payer: Priority Health Cigna Priority Health	$307.62
Rate for Payer: Priority Health SBD	$276.85
Rate for Payer: UMR Bronson Commercial	$193.36
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$329.59

PRAMIPEXOLE 0.25 MG TABLET

Facility

$2,550.78

Service Code	NDC 0597-0184-61
Hospital Charge Code	21290
Hospital Revenue Code	637
Min. Negotiated Rate	$1,122.34
Max. Negotiated Rate	$2,295.70
Rate for Payer: Aetna American Axle	$1,658.01
Rate for Payer: Aetna Commercial	$2,168.16
Rate for Payer: Aetna New Business (MI Preferred)	$1,658.01
Rate for Payer: Cash Price	$2,040.62
Rate for Payer: Cofinity Commercial	$1,785.55
Rate for Payer: Cofinity Commercial	$2,193.67
Rate for Payer: Encore Health Key Benefits Commercial	$2,040.62
Rate for Payer: Healthscope Commercial	$2,295.70
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial	$1,785.55
Rate for Payer: Lakeland Regional Health Systems Commercial	$1,913.08
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,168.16
Rate for Payer: PHP Commercial	$2,168.16
Rate for Payer: Priority Health Cigna Priority Health	$1,785.55
Rate for Payer: Priority Health SBD	$1,606.99
Rate for Payer: UMR Bronson Commercial	$1,122.34
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$1,913.08

PRAMIPEXOLE 0.25 MG TABLET

Facility

$217.85

Service Code	NDC 68462-331-90
Hospital Charge Code	21290
Hospital Revenue Code	637
Min. Negotiated Rate	$95.85
Max. Negotiated Rate	$196.06
Rate for Payer: Aetna American Axle	$141.60
Rate for Payer: Aetna Commercial	$185.17
Rate for Payer: Aetna New Business (MI Preferred)	$141.60
Rate for Payer: Cash Price	$174.28
Rate for Payer: Cofinity Commercial	$152.50
Rate for Payer: Cofinity Commercial	$187.35
Rate for Payer: Encore Health Key Benefits Commercial	$174.28
Rate for Payer: Healthscope Commercial	$196.06
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial	$152.50
Rate for Payer: Lakeland Regional Health Systems Commercial	$163.39
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$185.17
Rate for Payer: PHP Commercial	$185.17
Rate for Payer: Priority Health Cigna Priority Health	$152.50
Rate for Payer: Priority Health SBD	$137.25
Rate for Payer: UMR Bronson Commercial	$95.85
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$163.39

PRAMIPEXOLE 0.25 MG TABLET

Facility

$4.40

Service Code	NDC 60687-570-11
Hospital Charge Code	21290
Hospital Revenue Code	637
Min. Negotiated Rate	$1.94
Max. Negotiated Rate	$3.96
Rate for Payer: Aetna American Axle	$2.86
Rate for Payer: Aetna Commercial	$3.74
Rate for Payer: Aetna New Business (MI Preferred)	$2.86
Rate for Payer: Cash Price	$3.52
Rate for Payer: Cofinity Commercial	$3.08
Rate for Payer: Cofinity Commercial	$3.78
Rate for Payer: Encore Health Key Benefits Commercial	$3.52
Rate for Payer: Healthscope Commercial	$3.96
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial	$3.08
Rate for Payer: Lakeland Regional Health Systems Commercial	$3.30
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3.74
Rate for Payer: PHP Commercial	$3.74
Rate for Payer: Priority Health Cigna Priority Health	$3.08
Rate for Payer: Priority Health SBD	$2.77
Rate for Payer: UMR Bronson Commercial	$1.94
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$3.30

PRAMIPEXOLE 0.5 MG TABLET

Facility

$103.64

Service Code	NDC 13668-093-90
Hospital Charge Code	22719
Hospital Revenue Code	637
Min. Negotiated Rate	$45.60
Max. Negotiated Rate	$93.28
Rate for Payer: Aetna American Axle	$67.37
Rate for Payer: Aetna Commercial	$88.09
Rate for Payer: Aetna New Business (MI Preferred)	$67.37
Rate for Payer: Cash Price	$82.91
Rate for Payer: Cofinity Commercial	$72.55
Rate for Payer: Cofinity Commercial	$89.13
Rate for Payer: Encore Health Key Benefits Commercial	$82.91
Rate for Payer: Healthscope Commercial	$93.28
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial	$72.55
Rate for Payer: Lakeland Regional Health Systems Commercial	$77.73
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$88.09
Rate for Payer: PHP Commercial	$88.09
Rate for Payer: Priority Health Cigna Priority Health	$72.55
Rate for Payer: Priority Health SBD	$65.29
Rate for Payer: UMR Bronson Commercial	$45.60
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$77.73

PRAMIPEXOLE 0.5 MG TABLET

Facility

$2,186.82

Service Code	NDC 0597-0185-90
Hospital Charge Code	22719
Hospital Revenue Code	637
Min. Negotiated Rate	$962.20
Max. Negotiated Rate	$1,968.14
Rate for Payer: Aetna American Axle	$1,421.43
Rate for Payer: Aetna Commercial	$1,858.80
Rate for Payer: Aetna New Business (MI Preferred)	$1,421.43
Rate for Payer: Cash Price	$1,749.46
Rate for Payer: Cofinity Commercial	$1,530.77
Rate for Payer: Cofinity Commercial	$1,880.67
Rate for Payer: Encore Health Key Benefits Commercial	$1,749.46
Rate for Payer: Healthscope Commercial	$1,968.14
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial	$1,530.77
Rate for Payer: Lakeland Regional Health Systems Commercial	$1,640.12
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,858.80
Rate for Payer: PHP Commercial	$1,858.80
Rate for Payer: Priority Health Cigna Priority Health	$1,530.77
Rate for Payer: Priority Health SBD	$1,377.70
Rate for Payer: UMR Bronson Commercial	$962.20
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$1,640.12

PRAMIPEXOLE 0.5 MG TABLET

Facility

$217.85

Service Code	NDC 68462-332-90
Hospital Charge Code	22719
Hospital Revenue Code	637
Min. Negotiated Rate	$95.85
Max. Negotiated Rate	$196.06
Rate for Payer: Aetna American Axle	$141.60
Rate for Payer: Aetna Commercial	$185.17
Rate for Payer: Aetna New Business (MI Preferred)	$141.60
Rate for Payer: Cash Price	$174.28
Rate for Payer: Cofinity Commercial	$152.50
Rate for Payer: Cofinity Commercial	$187.35
Rate for Payer: Encore Health Key Benefits Commercial	$174.28
Rate for Payer: Healthscope Commercial	$196.06
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial	$152.50
Rate for Payer: Lakeland Regional Health Systems Commercial	$163.39
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$185.17
Rate for Payer: PHP Commercial	$185.17
Rate for Payer: Priority Health Cigna Priority Health	$152.50
Rate for Payer: Priority Health SBD	$137.25
Rate for Payer: UMR Bronson Commercial	$95.85
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$163.39

PRAMIPEXOLE 0.5 MG TABLET

Facility

$329.94

Service Code	NDC 42543-706-90
Hospital Charge Code	22719
Hospital Revenue Code	637
Min. Negotiated Rate	$145.17
Max. Negotiated Rate	$296.95
Rate for Payer: Aetna American Axle	$214.46
Rate for Payer: Aetna Commercial	$280.45
Rate for Payer: Aetna New Business (MI Preferred)	$214.46
Rate for Payer: Cash Price	$263.95
Rate for Payer: Cofinity Commercial	$230.96
Rate for Payer: Cofinity Commercial	$283.75
Rate for Payer: Encore Health Key Benefits Commercial	$263.95
Rate for Payer: Healthscope Commercial	$296.95
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial	$230.96
Rate for Payer: Lakeland Regional Health Systems Commercial	$247.46
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$280.45
Rate for Payer: PHP Commercial	$280.45
Rate for Payer: Priority Health Cigna Priority Health	$230.96
Rate for Payer: Priority Health SBD	$207.86
Rate for Payer: UMR Bronson Commercial	$145.17
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$247.46

PRAMIPEXOLE 1 MG TABLET

Facility

$217.85

Service Code	NDC 68462-333-90
Hospital Charge Code	21288
Hospital Revenue Code	637
Min. Negotiated Rate	$95.85
Max. Negotiated Rate	$196.06
Rate for Payer: Aetna American Axle	$141.60
Rate for Payer: Aetna Commercial	$185.17
Rate for Payer: Aetna New Business (MI Preferred)	$141.60
Rate for Payer: Cash Price	$174.28
Rate for Payer: Cofinity Commercial	$152.50
Rate for Payer: Cofinity Commercial	$187.35
Rate for Payer: Encore Health Key Benefits Commercial	$174.28
Rate for Payer: Healthscope Commercial	$196.06
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial	$152.50
Rate for Payer: Lakeland Regional Health Systems Commercial	$163.39
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$185.17
Rate for Payer: PHP Commercial	$185.17
Rate for Payer: Priority Health Cigna Priority Health	$152.50
Rate for Payer: Priority Health SBD	$137.25
Rate for Payer: UMR Bronson Commercial	$95.85
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$163.39

PRAMIPEXOLE 1 MG TABLET

Facility

$2,550.78

Service Code	NDC 0597-0190-61
Hospital Charge Code	21288
Hospital Revenue Code	637
Min. Negotiated Rate	$1,122.34
Max. Negotiated Rate	$2,295.70
Rate for Payer: Aetna American Axle	$1,658.01
Rate for Payer: Aetna Commercial	$2,168.16
Rate for Payer: Aetna New Business (MI Preferred)	$1,658.01
Rate for Payer: Cash Price	$2,040.62
Rate for Payer: Cofinity Commercial	$1,785.55
Rate for Payer: Cofinity Commercial	$2,193.67
Rate for Payer: Encore Health Key Benefits Commercial	$2,040.62
Rate for Payer: Healthscope Commercial	$2,295.70
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial	$1,785.55
Rate for Payer: Lakeland Regional Health Systems Commercial	$1,913.08
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,168.16
Rate for Payer: PHP Commercial	$2,168.16
Rate for Payer: Priority Health Cigna Priority Health	$1,785.55
Rate for Payer: Priority Health SBD	$1,606.99
Rate for Payer: UMR Bronson Commercial	$1,122.34
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$1,913.08

Know your out-of-pocket cost for care.

All Charges