|
LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$2.79
|
|
|
Service Code
|
NDC 68084065511
|
| Hospital Charge Code |
10455
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.23 |
| Max. Negotiated Rate |
$2.51 |
| Rate for Payer: Aetna American Axle |
$1.81
|
| Rate for Payer: Aetna Commercial |
$2.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.81
|
| Rate for Payer: Cash Price |
$2.23
|
| Rate for Payer: Cofinity Advantage |
$1.95
|
| Rate for Payer: Cofinity Commercial |
$2.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.23
|
| Rate for Payer: Healthscope Commercial |
$2.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.09
|
| Rate for Payer: PHP Commercial |
$2.37
|
| Rate for Payer: Priority Health SBD |
$1.76
|
| Rate for Payer: UMR Bronson Commercial |
$1.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.09
|
|
|
LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$272.65
|
|
|
Service Code
|
NDC 00054002025
|
| Hospital Charge Code |
10455
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$100.88 |
| Max. Negotiated Rate |
$245.38 |
| Rate for Payer: Aetna American Axle |
$177.22
|
| Rate for Payer: Aetna Commercial |
$231.75
|
| Rate for Payer: Aetna Medicare |
$136.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.22
|
| Rate for Payer: BCBS Complete |
$109.06
|
| Rate for Payer: Cash Price |
$218.12
|
| Rate for Payer: Cofinity Advantage |
$190.85
|
| Rate for Payer: Cofinity Commercial |
$234.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$218.12
|
| Rate for Payer: Healthscope Commercial |
$245.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$190.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$218.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$204.49
|
| Rate for Payer: PHP Commercial |
$231.75
|
| Rate for Payer: Priority Health SBD |
$171.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$177.22
|
| Rate for Payer: UHC Core |
$142.05
|
| Rate for Payer: UHC Exchange |
$107.15
|
| Rate for Payer: UMR Bronson Commercial |
$100.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.49
|
|
|
LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$372.40
|
|
|
Service Code
|
NDC 51079014220
|
| Hospital Charge Code |
10455
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$137.79 |
| Max. Negotiated Rate |
$335.16 |
| Rate for Payer: Aetna American Axle |
$242.06
|
| Rate for Payer: Aetna Commercial |
$316.54
|
| Rate for Payer: Aetna Medicare |
$186.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$242.06
|
| Rate for Payer: BCBS Complete |
$148.96
|
| Rate for Payer: Cash Price |
$297.92
|
| Rate for Payer: Cofinity Advantage |
$260.68
|
| Rate for Payer: Cofinity Commercial |
$320.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$297.92
|
| Rate for Payer: Healthscope Commercial |
$335.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$260.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$279.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$297.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$316.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$279.30
|
| Rate for Payer: PHP Commercial |
$316.54
|
| Rate for Payer: Priority Health SBD |
$234.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.06
|
| Rate for Payer: UHC Core |
$194.02
|
| Rate for Payer: UHC Exchange |
$146.35
|
| Rate for Payer: UMR Bronson Commercial |
$137.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$279.30
|
|
|
LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$272.65
|
|
|
Service Code
|
NDC 00054002025
|
| Hospital Charge Code |
10455
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$119.97 |
| Max. Negotiated Rate |
$245.38 |
| Rate for Payer: Aetna American Axle |
$177.22
|
| Rate for Payer: Aetna Commercial |
$231.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.22
|
| Rate for Payer: Cash Price |
$218.12
|
| Rate for Payer: Cofinity Advantage |
$190.85
|
| Rate for Payer: Cofinity Commercial |
$234.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$218.12
|
| Rate for Payer: Healthscope Commercial |
$245.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$190.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$204.49
|
| Rate for Payer: PHP Commercial |
$231.75
|
| Rate for Payer: Priority Health SBD |
$171.77
|
| Rate for Payer: UMR Bronson Commercial |
$119.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.49
|
|
|
LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$2.79
|
|
|
Service Code
|
NDC 68084065511
|
| Hospital Charge Code |
10455
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.03 |
| Max. Negotiated Rate |
$2.51 |
| Rate for Payer: Aetna American Axle |
$1.81
|
| Rate for Payer: Aetna Commercial |
$2.37
|
| Rate for Payer: Aetna Medicare |
$1.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.81
|
| Rate for Payer: BCBS Complete |
$1.12
|
| Rate for Payer: Cash Price |
$2.23
|
| Rate for Payer: Cofinity Advantage |
$1.95
|
| Rate for Payer: Cofinity Commercial |
$2.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.23
|
| Rate for Payer: Healthscope Commercial |
$2.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.09
|
| Rate for Payer: PHP Commercial |
$2.37
|
| Rate for Payer: Priority Health SBD |
$1.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.81
|
| Rate for Payer: UHC Core |
$1.45
|
| Rate for Payer: UHC Exchange |
$1.10
|
| Rate for Payer: UMR Bronson Commercial |
$1.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.09
|
|
|
LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$372.40
|
|
|
Service Code
|
NDC 51079014220
|
| Hospital Charge Code |
10455
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$163.86 |
| Max. Negotiated Rate |
$335.16 |
| Rate for Payer: Aetna American Axle |
$242.06
|
| Rate for Payer: Aetna Commercial |
$316.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$242.06
|
| Rate for Payer: Cash Price |
$297.92
|
| Rate for Payer: Cofinity Advantage |
$260.68
|
| Rate for Payer: Cofinity Commercial |
$320.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$297.92
|
| Rate for Payer: Healthscope Commercial |
$335.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$260.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$279.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$316.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$279.30
|
| Rate for Payer: PHP Commercial |
$316.54
|
| Rate for Payer: Priority Health SBD |
$234.61
|
| Rate for Payer: UMR Bronson Commercial |
$163.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$279.30
|
|
|
LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$278.40
|
|
|
Service Code
|
NDC 68084065501
|
| Hospital Charge Code |
10455
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$122.50 |
| Max. Negotiated Rate |
$250.56 |
| Rate for Payer: Aetna American Axle |
$180.96
|
| Rate for Payer: Aetna Commercial |
$236.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.96
|
| Rate for Payer: Cash Price |
$222.72
|
| Rate for Payer: Cofinity Advantage |
$194.88
|
| Rate for Payer: Cofinity Commercial |
$239.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$222.72
|
| Rate for Payer: Healthscope Commercial |
$250.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$194.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$208.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$236.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$208.80
|
| Rate for Payer: PHP Commercial |
$236.64
|
| Rate for Payer: Priority Health SBD |
$175.39
|
| Rate for Payer: UMR Bronson Commercial |
$122.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$208.80
|
|
|
LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$269.80
|
|
|
Service Code
|
NDC 00378145001
|
| Hospital Charge Code |
10455
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$99.83 |
| Max. Negotiated Rate |
$242.82 |
| Rate for Payer: Aetna American Axle |
$175.37
|
| Rate for Payer: Aetna Commercial |
$229.33
|
| Rate for Payer: Aetna Medicare |
$134.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.37
|
| Rate for Payer: BCBS Complete |
$107.92
|
| Rate for Payer: Cash Price |
$215.84
|
| Rate for Payer: Cofinity Advantage |
$188.86
|
| Rate for Payer: Cofinity Commercial |
$232.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$215.84
|
| Rate for Payer: Healthscope Commercial |
$242.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$188.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$202.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$215.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$229.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$202.35
|
| Rate for Payer: PHP Commercial |
$229.33
|
| Rate for Payer: Priority Health SBD |
$169.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.37
|
| Rate for Payer: UHC Core |
$140.57
|
| Rate for Payer: UHC Exchange |
$106.03
|
| Rate for Payer: UMR Bronson Commercial |
$99.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$202.35
|
|
|
LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$3.73
|
|
|
Service Code
|
NDC 51079014201
|
| Hospital Charge Code |
10455
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.38 |
| Max. Negotiated Rate |
$3.36 |
| Rate for Payer: Aetna American Axle |
$2.42
|
| Rate for Payer: Aetna Commercial |
$3.17
|
| Rate for Payer: Aetna Medicare |
$1.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.42
|
| Rate for Payer: BCBS Complete |
$1.49
|
| Rate for Payer: Cash Price |
$2.98
|
| Rate for Payer: Cofinity Advantage |
$2.61
|
| Rate for Payer: Cofinity Commercial |
$3.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.98
|
| Rate for Payer: Healthscope Commercial |
$3.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.80
|
| Rate for Payer: PHP Commercial |
$3.17
|
| Rate for Payer: Priority Health SBD |
$2.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.42
|
| Rate for Payer: UHC Core |
$1.94
|
| Rate for Payer: UHC Exchange |
$1.47
|
| Rate for Payer: UMR Bronson Commercial |
$1.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.80
|
|
|
LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$3.73
|
|
|
Service Code
|
NDC 51079014201
|
| Hospital Charge Code |
10455
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.64 |
| Max. Negotiated Rate |
$3.36 |
| Rate for Payer: Aetna American Axle |
$2.42
|
| Rate for Payer: Aetna Commercial |
$3.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.42
|
| Rate for Payer: Cash Price |
$2.98
|
| Rate for Payer: Cofinity Advantage |
$2.61
|
| Rate for Payer: Cofinity Commercial |
$3.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.98
|
| Rate for Payer: Healthscope Commercial |
$3.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.80
|
| Rate for Payer: PHP Commercial |
$3.17
|
| Rate for Payer: Priority Health SBD |
$2.35
|
| Rate for Payer: UMR Bronson Commercial |
$1.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.80
|
|
|
LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$269.80
|
|
|
Service Code
|
NDC 00378145001
|
| Hospital Charge Code |
10455
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$118.71 |
| Max. Negotiated Rate |
$242.82 |
| Rate for Payer: Aetna American Axle |
$175.37
|
| Rate for Payer: Aetna Commercial |
$229.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.37
|
| Rate for Payer: Cash Price |
$215.84
|
| Rate for Payer: Cofinity Advantage |
$188.86
|
| Rate for Payer: Cofinity Commercial |
$232.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$215.84
|
| Rate for Payer: Healthscope Commercial |
$242.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$188.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$202.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$229.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$202.35
|
| Rate for Payer: PHP Commercial |
$229.33
|
| Rate for Payer: Priority Health SBD |
$169.97
|
| Rate for Payer: UMR Bronson Commercial |
$118.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$202.35
|
|
|
LITHOLAPAXY: CRUSHING OR FRAGMENTATION OF CALCULUS BY ANY MEANS IN BLADDER AND REMOVAL OF FRAGMENTS; COMPLICATED OR LARGE (OVER 2.5 CM)
|
Facility
|
OP
|
$11,358.48
|
|
|
Service Code
|
CPT 52318
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,836.94 |
| Max. Negotiated Rate |
$11,358.48 |
| Rate for Payer: Aetna Medicare |
$3,652.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,390.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,390.39
|
| Rate for Payer: BCBS Complete |
$1,928.96
|
| Rate for Payer: BCBS MAPPO |
$3,512.31
|
| Rate for Payer: BCBS Trust/PPO |
$4,973.74
|
| Rate for Payer: BCN Commercial |
$4,973.74
|
| Rate for Payer: BCN Medicare Advantage |
$3,512.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,512.31
|
| Rate for Payer: Mclaren Medicaid |
$3,512.31
|
| Rate for Payer: Mclaren Medicare |
$3,512.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,687.93
|
| Rate for Payer: Meridian Medicaid |
$3,687.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,039.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,863.54
|
| Rate for Payer: Nomi Health Commercial |
$10,536.93
|
| Rate for Payer: PACE Medicare |
$3,336.69
|
| Rate for Payer: PACE SWMI |
$3,512.31
|
| Rate for Payer: PHP Medicare Advantage |
$3,512.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,836.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11,358.48
|
| Rate for Payer: Priority Health Medicare |
$3,512.31
|
| Rate for Payer: Priority Health Tiered Network |
$9,086.78
|
| Rate for Payer: Railroad Medicare Medicare |
$3,512.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,512.31
|
| Rate for Payer: UHC Medicaid |
$1,836.94
|
| Rate for Payer: UHCCP Medicaid |
$1,836.94
|
| Rate for Payer: VA VA |
$3,512.31
|
|
|
LITHOLAPAXY: CRUSHING OR FRAGMENTATION OF CALCULUS BY ANY MEANS IN BLADDER AND REMOVAL OF FRAGMENTS; SIMPLE OR SMALL (LESS THAN 2.5 CM)
|
Facility
|
OP
|
$11,358.48
|
|
|
Service Code
|
CPT 52317
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,836.94 |
| Max. Negotiated Rate |
$11,358.48 |
| Rate for Payer: Aetna Medicare |
$3,652.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,390.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,390.39
|
| Rate for Payer: BCBS Complete |
$1,928.96
|
| Rate for Payer: BCBS MAPPO |
$3,512.31
|
| Rate for Payer: BCBS Trust/PPO |
$4,035.64
|
| Rate for Payer: BCN Commercial |
$4,035.64
|
| Rate for Payer: BCN Medicare Advantage |
$3,512.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,512.31
|
| Rate for Payer: Mclaren Medicaid |
$3,512.31
|
| Rate for Payer: Mclaren Medicare |
$3,512.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,687.93
|
| Rate for Payer: Meridian Medicaid |
$3,687.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,039.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,863.54
|
| Rate for Payer: Nomi Health Commercial |
$10,536.93
|
| Rate for Payer: PACE Medicare |
$3,336.69
|
| Rate for Payer: PACE SWMI |
$3,512.31
|
| Rate for Payer: PHP Medicare Advantage |
$3,512.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,836.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11,358.48
|
| Rate for Payer: Priority Health Medicare |
$3,512.31
|
| Rate for Payer: Priority Health Tiered Network |
$9,086.78
|
| Rate for Payer: Railroad Medicare Medicare |
$3,512.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,512.31
|
| Rate for Payer: UHC Medicaid |
$1,836.94
|
| Rate for Payer: UHCCP Medicaid |
$1,836.94
|
| Rate for Payer: VA VA |
$3,512.31
|
|
|
LITHOTRIPSY, EXTRACORPOREAL SHOCK WAVE
|
Facility
|
OP
|
$11,358.48
|
|
|
Service Code
|
CPT 50590
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,836.94 |
| Max. Negotiated Rate |
$11,358.48 |
| Rate for Payer: Aetna Medicare |
$3,652.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,390.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,390.39
|
| Rate for Payer: BCBS Complete |
$1,928.96
|
| Rate for Payer: BCBS MAPPO |
$3,512.31
|
| Rate for Payer: BCBS Trust/PPO |
$3,526.10
|
| Rate for Payer: BCN Commercial |
$3,526.10
|
| Rate for Payer: BCN Medicare Advantage |
$3,512.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,512.31
|
| Rate for Payer: Mclaren Medicaid |
$3,512.31
|
| Rate for Payer: Mclaren Medicare |
$3,512.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,687.93
|
| Rate for Payer: Meridian Medicaid |
$3,687.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,039.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,863.54
|
| Rate for Payer: Nomi Health Commercial |
$10,536.93
|
| Rate for Payer: PACE Medicare |
$3,336.69
|
| Rate for Payer: PACE SWMI |
$3,512.31
|
| Rate for Payer: PHP Medicare Advantage |
$3,512.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,836.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11,358.48
|
| Rate for Payer: Priority Health Medicare |
$3,512.31
|
| Rate for Payer: Priority Health Tiered Network |
$9,086.78
|
| Rate for Payer: Railroad Medicare Medicare |
$3,512.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,512.31
|
| Rate for Payer: UHC Medicaid |
$1,836.94
|
| Rate for Payer: UHCCP Medicaid |
$1,836.94
|
| Rate for Payer: VA VA |
$3,512.31
|
|
|
LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT
|
Facility
|
IP
|
$254,366.46
|
|
|
Service Code
|
MSDRG 005
|
| Min. Negotiated Rate |
$82,475.70 |
| Max. Negotiated Rate |
$254,366.46 |
| Rate for Payer: Aetna Medicare |
$90,289.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108,520.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108,520.66
|
| Rate for Payer: BCBS MAPPO |
$86,816.53
|
| Rate for Payer: BCBS Trust/PPO |
$254,366.46
|
| Rate for Payer: BCN Commercial |
$254,366.46
|
| Rate for Payer: BCN Medicare Advantage |
$86,816.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86,816.53
|
| Rate for Payer: Mclaren Medicare |
$86,816.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91,157.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99,839.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$95,498.18
|
| Rate for Payer: Nomi Health Commercial |
$133,005.45
|
| Rate for Payer: PACE Medicare |
$82,475.70
|
| Rate for Payer: PACE SWMI |
$86,816.53
|
| Rate for Payer: PHP Medicare Advantage |
$86,816.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$166,227.32
|
| Rate for Payer: Priority Health Medicare |
$86,816.53
|
| Rate for Payer: Priority Health Tiered Network |
$132,981.84
|
| Rate for Payer: Railroad Medicare Medicare |
$86,816.53
|
| Rate for Payer: VA VA |
$86,816.53
|
|
|
LIVER TRANSPLANT WITHOUT MCC
|
Facility
|
IP
|
$97,854.58
|
|
|
Service Code
|
MSDRG 006
|
| Min. Negotiated Rate |
$37,402.23 |
| Max. Negotiated Rate |
$97,854.58 |
| Rate for Payer: Aetna Medicare |
$40,945.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49,213.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49,213.46
|
| Rate for Payer: BCBS MAPPO |
$39,370.77
|
| Rate for Payer: BCBS Trust/PPO |
$97,854.58
|
| Rate for Payer: BCN Commercial |
$97,854.58
|
| Rate for Payer: BCN Medicare Advantage |
$39,370.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39,370.77
|
| Rate for Payer: Mclaren Medicare |
$39,370.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41,339.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45,276.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$43,307.85
|
| Rate for Payer: Nomi Health Commercial |
$59,817.30
|
| Rate for Payer: PACE Medicare |
$37,402.23
|
| Rate for Payer: PACE SWMI |
$39,370.77
|
| Rate for Payer: PHP Medicare Advantage |
$39,370.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$74,758.36
|
| Rate for Payer: Priority Health Medicare |
$39,370.77
|
| Rate for Payer: Priority Health Tiered Network |
$59,806.68
|
| Rate for Payer: Railroad Medicare Medicare |
$39,370.77
|
| Rate for Payer: VA VA |
$39,370.77
|
|
|
LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC
|
Facility
|
IP
|
$46,337.29
|
|
|
Service Code
|
MSDRG 496
|
| Min. Negotiated Rate |
$14,894.49 |
| Max. Negotiated Rate |
$46,337.29 |
| Rate for Payer: Aetna Medicare |
$16,305.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,598.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,598.01
|
| Rate for Payer: BCBS MAPPO |
$15,678.41
|
| Rate for Payer: BCBS Trust/PPO |
$46,337.29
|
| Rate for Payer: BCN Commercial |
$46,337.29
|
| Rate for Payer: BCN Medicare Advantage |
$15,678.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,678.41
|
| Rate for Payer: Mclaren Medicare |
$15,678.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,462.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,030.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$17,246.25
|
| Rate for Payer: Nomi Health Commercial |
$23,270.31
|
| Rate for Payer: PACE Medicare |
$14,894.49
|
| Rate for Payer: PACE SWMI |
$15,678.41
|
| Rate for Payer: PHP Medicare Advantage |
$15,678.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$29,082.73
|
| Rate for Payer: Priority Health Medicare |
$15,678.41
|
| Rate for Payer: Priority Health Tiered Network |
$23,266.18
|
| Rate for Payer: Railroad Medicare Medicare |
$15,678.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29,403.57
|
| Rate for Payer: UHC Core |
$24,599.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15,678.41
|
| Rate for Payer: UHC Exchange |
$20,090.03
|
| Rate for Payer: VA VA |
$15,678.41
|
|
|
LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC
|
Facility
|
IP
|
$76,700.84
|
|
|
Service Code
|
MSDRG 495
|
| Min. Negotiated Rate |
$29,367.90 |
| Max. Negotiated Rate |
$76,700.84 |
| Rate for Payer: Aetna Medicare |
$32,150.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38,641.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38,641.97
|
| Rate for Payer: BCBS MAPPO |
$30,913.58
|
| Rate for Payer: BCBS Trust/PPO |
$76,700.84
|
| Rate for Payer: BCN Commercial |
$76,700.84
|
| Rate for Payer: BCN Medicare Advantage |
$30,913.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30,913.58
|
| Rate for Payer: Mclaren Medicare |
$30,913.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32,459.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35,550.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$34,004.94
|
| Rate for Payer: Nomi Health Commercial |
$46,771.53
|
| Rate for Payer: PACE Medicare |
$29,367.90
|
| Rate for Payer: PACE SWMI |
$30,913.58
|
| Rate for Payer: PHP Medicare Advantage |
$30,913.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$58,454.04
|
| Rate for Payer: Priority Health Medicare |
$30,913.58
|
| Rate for Payer: Priority Health Tiered Network |
$46,763.23
|
| Rate for Payer: Railroad Medicare Medicare |
$30,913.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59,098.91
|
| Rate for Payer: UHC Core |
$49,443.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$30,913.58
|
| Rate for Payer: UHC Exchange |
$40,379.42
|
| Rate for Payer: VA VA |
$30,913.58
|
|
|
LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CC/MCC
|
Facility
|
IP
|
$30,407.47
|
|
|
Service Code
|
MSDRG 497
|
| Min. Negotiated Rate |
$10,162.73 |
| Max. Negotiated Rate |
$30,407.47 |
| Rate for Payer: Aetna Medicare |
$11,125.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,372.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,372.01
|
| Rate for Payer: BCBS MAPPO |
$10,697.61
|
| Rate for Payer: BCBS Trust/PPO |
$30,407.47
|
| Rate for Payer: BCN Commercial |
$30,407.47
|
| Rate for Payer: BCN Medicare Advantage |
$10,697.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,697.61
|
| Rate for Payer: Mclaren Medicare |
$10,697.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,232.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,302.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$11,767.37
|
| Rate for Payer: Nomi Health Commercial |
$14,856.93
|
| Rate for Payer: PACE Medicare |
$10,162.73
|
| Rate for Payer: PACE SWMI |
$10,697.61
|
| Rate for Payer: PHP Medicare Advantage |
$10,697.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$19,480.38
|
| Rate for Payer: Priority Health Medicare |
$10,697.61
|
| Rate for Payer: Priority Health Tiered Network |
$15,584.30
|
| Rate for Payer: Railroad Medicare Medicare |
$10,697.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18,772.71
|
| Rate for Payer: UHC Core |
$15,705.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$10,697.61
|
| Rate for Payer: UHC Exchange |
$12,826.48
|
| Rate for Payer: VA VA |
$10,697.61
|
|
|
LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC
|
Facility
|
IP
|
$60,543.18
|
|
|
Service Code
|
MSDRG 498
|
| Min. Negotiated Rate |
$24,530.47 |
| Max. Negotiated Rate |
$60,543.18 |
| Rate for Payer: Aetna Medicare |
$26,854.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32,276.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32,276.94
|
| Rate for Payer: BCBS MAPPO |
$25,821.55
|
| Rate for Payer: BCBS Trust/PPO |
$60,543.18
|
| Rate for Payer: BCN Commercial |
$60,543.18
|
| Rate for Payer: BCN Medicare Advantage |
$25,821.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25,821.55
|
| Rate for Payer: Mclaren Medicare |
$25,821.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27,112.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29,694.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$28,403.71
|
| Rate for Payer: Nomi Health Commercial |
$38,916.72
|
| Rate for Payer: PACE Medicare |
$24,530.47
|
| Rate for Payer: PACE SWMI |
$25,821.55
|
| Rate for Payer: PHP Medicare Advantage |
$25,821.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$48,637.27
|
| Rate for Payer: Priority Health Medicare |
$25,821.55
|
| Rate for Payer: Priority Health Tiered Network |
$38,909.81
|
| Rate for Payer: Railroad Medicare Medicare |
$25,821.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49,173.84
|
| Rate for Payer: UHC Core |
$41,140.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$25,821.55
|
| Rate for Payer: UHC Exchange |
$33,598.10
|
| Rate for Payer: VA VA |
$25,821.55
|
|
|
LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CC/MCC
|
Facility
|
IP
|
$45,019.64
|
|
|
Service Code
|
MSDRG 499
|
| Min. Negotiated Rate |
$16,570.02 |
| Max. Negotiated Rate |
$45,019.64 |
| Rate for Payer: Aetna Medicare |
$18,139.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,802.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,802.66
|
| Rate for Payer: BCBS MAPPO |
$17,442.13
|
| Rate for Payer: BCBS Trust/PPO |
$45,019.64
|
| Rate for Payer: BCN Commercial |
$45,019.64
|
| Rate for Payer: BCN Medicare Advantage |
$17,442.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,442.13
|
| Rate for Payer: Mclaren Medicare |
$17,442.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,314.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,058.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$19,186.34
|
| Rate for Payer: Nomi Health Commercial |
$25,990.92
|
| Rate for Payer: PACE Medicare |
$16,570.02
|
| Rate for Payer: PACE SWMI |
$17,442.13
|
| Rate for Payer: PHP Medicare Advantage |
$17,442.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$32,482.89
|
| Rate for Payer: Priority Health Medicare |
$17,442.13
|
| Rate for Payer: Priority Health Tiered Network |
$25,986.31
|
| Rate for Payer: Railroad Medicare Medicare |
$17,442.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32,841.24
|
| Rate for Payer: UHC Core |
$27,475.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17,442.13
|
| Rate for Payer: UHC Exchange |
$22,438.83
|
| Rate for Payer: VA VA |
$17,442.13
|
|
|
LOMUSTINE 10 MG CAPSULE
|
Facility
|
OP
|
$2,191.37
|
|
|
Service Code
|
NDC 58181304005
|
| Hospital Charge Code |
10459
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$810.81 |
| Max. Negotiated Rate |
$1,972.23 |
| Rate for Payer: Aetna American Axle |
$1,424.39
|
| Rate for Payer: Aetna Commercial |
$1,862.66
|
| Rate for Payer: Aetna Medicare |
$1,095.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,424.39
|
| Rate for Payer: BCBS Complete |
$876.55
|
| Rate for Payer: Cash Price |
$1,753.10
|
| Rate for Payer: Cofinity Advantage |
$1,533.96
|
| Rate for Payer: Cofinity Commercial |
$1,884.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,753.10
|
| Rate for Payer: Healthscope Commercial |
$1,972.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,533.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,643.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,753.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,862.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,643.53
|
| Rate for Payer: PHP Commercial |
$1,862.66
|
| Rate for Payer: Priority Health SBD |
$1,380.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,424.39
|
| Rate for Payer: UHC Core |
$1,141.70
|
| Rate for Payer: UHC Exchange |
$861.21
|
| Rate for Payer: UMR Bronson Commercial |
$810.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,643.53
|
|
|
LOMUSTINE 10 MG CAPSULE
|
Facility
|
IP
|
$2,191.37
|
|
|
Service Code
|
NDC 58181304005
|
| Hospital Charge Code |
10459
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$964.20 |
| Max. Negotiated Rate |
$1,972.23 |
| Rate for Payer: Aetna American Axle |
$1,424.39
|
| Rate for Payer: Aetna Commercial |
$1,862.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,424.39
|
| Rate for Payer: Cash Price |
$1,753.10
|
| Rate for Payer: Cofinity Advantage |
$1,533.96
|
| Rate for Payer: Cofinity Commercial |
$1,884.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,753.10
|
| Rate for Payer: Healthscope Commercial |
$1,972.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,533.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,643.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,862.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,643.53
|
| Rate for Payer: PHP Commercial |
$1,862.66
|
| Rate for Payer: Priority Health SBD |
$1,380.56
|
| Rate for Payer: UMR Bronson Commercial |
$964.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,643.53
|
|
|
LONG CHAIN TRIGLYCERIDES 7.5 GRAM-67.5 KCAL/15 ML ORAL EMULSION
|
Facility
|
IP
|
$17.09
|
|
|
Service Code
|
NDC 41679008743
|
| Hospital Charge Code |
173669
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$7.52 |
| Max. Negotiated Rate |
$15.38 |
| Rate for Payer: Aetna American Axle |
$11.11
|
| Rate for Payer: Aetna Commercial |
$14.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.11
|
| Rate for Payer: Cash Price |
$13.67
|
| Rate for Payer: Cofinity Advantage |
$11.96
|
| Rate for Payer: Cofinity Commercial |
$14.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.67
|
| Rate for Payer: Healthscope Commercial |
$15.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.82
|
| Rate for Payer: PHP Commercial |
$14.53
|
| Rate for Payer: Priority Health SBD |
$10.77
|
| Rate for Payer: UMR Bronson Commercial |
$7.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.82
|
|
|
LONG CHAIN TRIGLYCERIDES 7.5 GRAM-67.5 KCAL/15 ML ORAL EMULSION
|
Facility
|
OP
|
$17.09
|
|
|
Service Code
|
NDC 41679008702
|
| Hospital Charge Code |
173669
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$6.32 |
| Max. Negotiated Rate |
$15.38 |
| Rate for Payer: Aetna American Axle |
$11.11
|
| Rate for Payer: Aetna Commercial |
$14.53
|
| Rate for Payer: Aetna Medicare |
$8.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.11
|
| Rate for Payer: BCBS Complete |
$6.84
|
| Rate for Payer: Cash Price |
$13.67
|
| Rate for Payer: Cofinity Advantage |
$11.96
|
| Rate for Payer: Cofinity Commercial |
$14.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.67
|
| Rate for Payer: Healthscope Commercial |
$15.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.82
|
| Rate for Payer: PHP Commercial |
$14.53
|
| Rate for Payer: Priority Health SBD |
$10.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.11
|
| Rate for Payer: UHC Core |
$8.90
|
| Rate for Payer: UHC Exchange |
$6.72
|
| Rate for Payer: UMR Bronson Commercial |
$6.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.82
|
|
