Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

CARVEDILOL 3.125 MG TABLET

Facility

$220.90

Service Code	NDC 43547025410
Hospital Charge Code	18551
Hospital Revenue Code	637
Min. Negotiated Rate	$88.36
Max. Negotiated Rate	$198.81
Rate for Payer: Aetna Commercial	$187.76
Rate for Payer: Aetna Medicare	$110.45
Rate for Payer: Aetna New Business (MI Preferred)	$143.59
Rate for Payer: BCBS Complete	$88.36
Rate for Payer: Cash Price	$176.72
Rate for Payer: Cofinity Commercial	$154.63
Rate for Payer: Cofinity Commercial	$189.97
Rate for Payer: Cofinity Medicare Advantage	$154.63
Rate for Payer: Encore Health Key Benefits Commercial	$176.72
Rate for Payer: Healthscope Commercial	$198.81
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$187.76
Rate for Payer: PHP Commercial	$187.76
Rate for Payer: Priority Health Cigna Priority Health	$143.59
Rate for Payer: Priority Health SBD	$139.17

CARVEDILOL 3.125 MG TABLET

Facility

$185.65

Service Code	NDC 51079077120
Hospital Charge Code	18551
Hospital Revenue Code	637
Min. Negotiated Rate	$74.26
Max. Negotiated Rate	$167.09
Rate for Payer: Aetna Commercial	$157.80
Rate for Payer: Aetna Medicare	$92.83
Rate for Payer: Aetna New Business (MI Preferred)	$120.67
Rate for Payer: BCBS Complete	$74.26
Rate for Payer: Cash Price	$148.52
Rate for Payer: Cofinity Commercial	$129.96
Rate for Payer: Cofinity Commercial	$159.66
Rate for Payer: Cofinity Medicare Advantage	$129.96
Rate for Payer: Encore Health Key Benefits Commercial	$148.52
Rate for Payer: Healthscope Commercial	$167.09
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$157.80
Rate for Payer: PHP Commercial	$157.80
Rate for Payer: Priority Health Cigna Priority Health	$120.67
Rate for Payer: Priority Health SBD	$116.96

CARVEDILOL 3.125 MG TABLET

Facility

$180.95

Service Code	NDC 00904730561
Hospital Charge Code	18551
Hospital Revenue Code	637
Min. Negotiated Rate	$72.38
Max. Negotiated Rate	$162.85
Rate for Payer: Aetna Commercial	$153.81
Rate for Payer: Aetna Medicare	$90.47
Rate for Payer: Aetna New Business (MI Preferred)	$117.62
Rate for Payer: BCBS Complete	$72.38
Rate for Payer: Cash Price	$144.76
Rate for Payer: Cofinity Commercial	$126.67
Rate for Payer: Cofinity Commercial	$155.62
Rate for Payer: Cofinity Medicare Advantage	$126.67
Rate for Payer: Encore Health Key Benefits Commercial	$144.76
Rate for Payer: Healthscope Commercial	$162.85
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$153.81
Rate for Payer: PHP Commercial	$153.81
Rate for Payer: Priority Health Cigna Priority Health	$117.62
Rate for Payer: Priority Health SBD	$114.00

CARVEDILOL 3.125 MG TABLET

Facility

$185.65

Service Code	NDC 51079077120
Hospital Charge Code	18551
Hospital Revenue Code	637
Min. Negotiated Rate	$116.96
Max. Negotiated Rate	$167.09
Rate for Payer: Aetna Commercial	$157.80
Rate for Payer: Aetna New Business (MI Preferred)	$120.67
Rate for Payer: Cash Price	$148.52
Rate for Payer: Cofinity Commercial	$129.96
Rate for Payer: Cofinity Commercial	$159.66
Rate for Payer: Cofinity Medicare Advantage	$129.96
Rate for Payer: Encore Health Key Benefits Commercial	$148.52
Rate for Payer: Healthscope Commercial	$167.09
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$157.80
Rate for Payer: PHP Commercial	$157.80
Rate for Payer: Priority Health Cigna Priority Health	$120.67
Rate for Payer: Priority Health SBD	$116.96

CARVEDILOL 3.125 MG TABLET

Facility

$1.86

Service Code	NDC 51079077101
Hospital Charge Code	18551
Hospital Revenue Code	637
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$1.67
Rate for Payer: Aetna Commercial	$1.58
Rate for Payer: Aetna New Business (MI Preferred)	$1.21
Rate for Payer: Cash Price	$1.49
Rate for Payer: Cofinity Commercial	$1.30
Rate for Payer: Cofinity Commercial	$1.60
Rate for Payer: Cofinity Medicare Advantage	$1.30
Rate for Payer: Encore Health Key Benefits Commercial	$1.49
Rate for Payer: Healthscope Commercial	$1.67
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1.58
Rate for Payer: PHP Commercial	$1.58
Rate for Payer: Priority Health Cigna Priority Health	$1.21
Rate for Payer: Priority Health SBD	$1.17

CARVEDILOL 3.125 MG TABLET

Facility

$180.95

Service Code	NDC 00904630061
Hospital Charge Code	18551
Hospital Revenue Code	637
Min. Negotiated Rate	$114.00
Max. Negotiated Rate	$162.85
Rate for Payer: Aetna Commercial	$153.81
Rate for Payer: Aetna New Business (MI Preferred)	$117.62
Rate for Payer: Cash Price	$144.76
Rate for Payer: Cofinity Commercial	$126.67
Rate for Payer: Cofinity Commercial	$155.62
Rate for Payer: Cofinity Medicare Advantage	$126.67
Rate for Payer: Encore Health Key Benefits Commercial	$144.76
Rate for Payer: Healthscope Commercial	$162.85
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$153.81
Rate for Payer: PHP Commercial	$153.81
Rate for Payer: Priority Health Cigna Priority Health	$117.62
Rate for Payer: Priority Health SBD	$114.00

CARVEDILOL 6.25 MG TABLET

Facility

$987.00

Service Code	NDC 43547025550
Hospital Charge Code	15747
Hospital Revenue Code	637
Min. Negotiated Rate	$621.81
Max. Negotiated Rate	$888.30
Rate for Payer: Aetna Commercial	$838.95
Rate for Payer: Aetna New Business (MI Preferred)	$641.55
Rate for Payer: Cash Price	$789.60
Rate for Payer: Cofinity Commercial	$690.90
Rate for Payer: Cofinity Commercial	$848.82
Rate for Payer: Cofinity Medicare Advantage	$690.90
Rate for Payer: Encore Health Key Benefits Commercial	$789.60
Rate for Payer: Healthscope Commercial	$888.30
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$838.95
Rate for Payer: PHP Commercial	$838.95
Rate for Payer: Priority Health Cigna Priority Health	$641.55
Rate for Payer: Priority Health SBD	$621.81

CARVEDILOL 6.25 MG TABLET

Facility

$188.00

Service Code	NDC 00904630161
Hospital Charge Code	15747
Hospital Revenue Code	637
Min. Negotiated Rate	$118.44
Max. Negotiated Rate	$169.20
Rate for Payer: Aetna Commercial	$159.80
Rate for Payer: Aetna New Business (MI Preferred)	$122.20
Rate for Payer: Cash Price	$150.40
Rate for Payer: Cofinity Commercial	$131.60
Rate for Payer: Cofinity Commercial	$161.68
Rate for Payer: Cofinity Medicare Advantage	$131.60
Rate for Payer: Encore Health Key Benefits Commercial	$150.40
Rate for Payer: Healthscope Commercial	$169.20
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$159.80
Rate for Payer: PHP Commercial	$159.80
Rate for Payer: Priority Health Cigna Priority Health	$122.20
Rate for Payer: Priority Health SBD	$118.44

CARVEDILOL 6.25 MG TABLET

Facility

$220.90

Service Code	NDC 43547025510
Hospital Charge Code	15747
Hospital Revenue Code	637
Min. Negotiated Rate	$88.36
Max. Negotiated Rate	$198.81
Rate for Payer: Aetna Commercial	$187.76
Rate for Payer: Aetna Medicare	$110.45
Rate for Payer: Aetna New Business (MI Preferred)	$143.59
Rate for Payer: BCBS Complete	$88.36
Rate for Payer: Cash Price	$176.72
Rate for Payer: Cofinity Commercial	$154.63
Rate for Payer: Cofinity Commercial	$189.97
Rate for Payer: Cofinity Medicare Advantage	$154.63
Rate for Payer: Encore Health Key Benefits Commercial	$176.72
Rate for Payer: Healthscope Commercial	$198.81
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$187.76
Rate for Payer: PHP Commercial	$187.76
Rate for Payer: Priority Health Cigna Priority Health	$143.59
Rate for Payer: Priority Health SBD	$139.17

CARVEDILOL 6.25 MG TABLET

Facility

$204.45

Service Code	NDC 00904730661
Hospital Charge Code	15747
Hospital Revenue Code	637
Min. Negotiated Rate	$81.78
Max. Negotiated Rate	$184.00
Rate for Payer: Aetna Commercial	$173.78
Rate for Payer: Aetna Medicare	$102.22
Rate for Payer: Aetna New Business (MI Preferred)	$132.89
Rate for Payer: BCBS Complete	$81.78
Rate for Payer: Cash Price	$163.56
Rate for Payer: Cofinity Commercial	$143.12
Rate for Payer: Cofinity Commercial	$175.83
Rate for Payer: Cofinity Medicare Advantage	$143.12
Rate for Payer: Encore Health Key Benefits Commercial	$163.56
Rate for Payer: Healthscope Commercial	$184.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$173.78
Rate for Payer: PHP Commercial	$173.78
Rate for Payer: Priority Health Cigna Priority Health	$132.89
Rate for Payer: Priority Health SBD	$128.80

CARVEDILOL 6.25 MG TABLET

Facility

$204.45

Service Code	NDC 00904730661
Hospital Charge Code	15747
Hospital Revenue Code	637
Min. Negotiated Rate	$128.80
Max. Negotiated Rate	$184.00
Rate for Payer: Aetna Commercial	$173.78
Rate for Payer: Aetna New Business (MI Preferred)	$132.89
Rate for Payer: Cash Price	$163.56
Rate for Payer: Cofinity Commercial	$143.12
Rate for Payer: Cofinity Commercial	$175.83
Rate for Payer: Cofinity Medicare Advantage	$143.12
Rate for Payer: Encore Health Key Benefits Commercial	$163.56
Rate for Payer: Healthscope Commercial	$184.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$173.78
Rate for Payer: PHP Commercial	$173.78
Rate for Payer: Priority Health Cigna Priority Health	$132.89
Rate for Payer: Priority Health SBD	$128.80

CARVEDILOL 6.25 MG TABLET

Facility

$188.00

Service Code	NDC 00904630161
Hospital Charge Code	15747
Hospital Revenue Code	637
Min. Negotiated Rate	$75.20
Max. Negotiated Rate	$169.20
Rate for Payer: Aetna Commercial	$159.80
Rate for Payer: Aetna Medicare	$94.00
Rate for Payer: Aetna New Business (MI Preferred)	$122.20
Rate for Payer: BCBS Complete	$75.20
Rate for Payer: Cash Price	$150.40
Rate for Payer: Cofinity Commercial	$131.60
Rate for Payer: Cofinity Commercial	$161.68
Rate for Payer: Cofinity Medicare Advantage	$131.60
Rate for Payer: Encore Health Key Benefits Commercial	$150.40
Rate for Payer: Healthscope Commercial	$169.20
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$159.80
Rate for Payer: PHP Commercial	$159.80
Rate for Payer: Priority Health Cigna Priority Health	$122.20
Rate for Payer: Priority Health SBD	$118.44

CARVEDILOL 6.25 MG TABLET

Facility

$220.90

Service Code	NDC 43547025510
Hospital Charge Code	15747
Hospital Revenue Code	637
Min. Negotiated Rate	$139.17
Max. Negotiated Rate	$198.81
Rate for Payer: Aetna Commercial	$187.76
Rate for Payer: Aetna New Business (MI Preferred)	$143.59
Rate for Payer: Cash Price	$176.72
Rate for Payer: Cofinity Commercial	$154.63
Rate for Payer: Cofinity Commercial	$189.97
Rate for Payer: Cofinity Medicare Advantage	$154.63
Rate for Payer: Encore Health Key Benefits Commercial	$176.72
Rate for Payer: Healthscope Commercial	$198.81
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$187.76
Rate for Payer: PHP Commercial	$187.76
Rate for Payer: Priority Health Cigna Priority Health	$143.59
Rate for Payer: Priority Health SBD	$139.17

CARVEDILOL 6.25 MG TABLET

Facility

$987.00

Service Code	NDC 43547025550
Hospital Charge Code	15747
Hospital Revenue Code	637
Min. Negotiated Rate	$394.80
Max. Negotiated Rate	$888.30
Rate for Payer: Aetna Commercial	$838.95
Rate for Payer: Aetna Medicare	$493.50
Rate for Payer: Aetna New Business (MI Preferred)	$641.55
Rate for Payer: BCBS Complete	$394.80
Rate for Payer: Cash Price	$789.60
Rate for Payer: Cofinity Commercial	$690.90
Rate for Payer: Cofinity Commercial	$848.82
Rate for Payer: Cofinity Medicare Advantage	$690.90
Rate for Payer: Encore Health Key Benefits Commercial	$789.60
Rate for Payer: Healthscope Commercial	$888.30
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$838.95
Rate for Payer: PHP Commercial	$838.95
Rate for Payer: Priority Health Cigna Priority Health	$641.55
Rate for Payer: Priority Health SBD	$621.81

CAUTERY OF CERVIX; ELECTRO OR THERMAL

Facility

$8,728.81

Service Code	CPT 57510
Hospital Revenue Code	360
Min. Negotiated Rate	$1,662.10
Max. Negotiated Rate	$8,728.81
Rate for Payer: Aetna Medicare	$3,224.97
Rate for Payer: Allen County Amish Medical Aid Commercial	$3,876.16
Rate for Payer: Amish Plain Church Group Commercial	$3,876.16
Rate for Payer: BCBS Complete	$1,745.20
Rate for Payer: BCBS MAPPO	$3,100.93
Rate for Payer: BCN Medicare Advantage	$3,100.93
Rate for Payer: Health Alliance Plan Medicare Advantage	$3,100.93
Rate for Payer: Mclaren Medicaid	$1,662.10
Rate for Payer: Mclaren Medicare	$3,100.93
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$3,255.98
Rate for Payer: Meridian Medicaid	$1,745.20
Rate for Payer: MI Amish Medical Board Commercial	$3,566.07
Rate for Payer: PACE Medicare	$2,945.88
Rate for Payer: PACE SWMI	$3,100.93
Rate for Payer: PHP Medicare Advantage	$3,100.93
Rate for Payer: Priority Health Choice Medicaid	$1,662.10
Rate for Payer: Priority Health Medicare	$3,100.93
Rate for Payer: Railroad Medicare Medicare	$3,100.93
Rate for Payer: UHC All Payor (Choice/PPO)	$8,728.81
Rate for Payer: UHC Dual Complete DSNP	$3,100.93
Rate for Payer: UHC Medicare Advantage	$3,100.93
Rate for Payer: UHCCP Medicaid	$1,745.82
Rate for Payer: VA VA	$3,100.93

CEFAZOLIN 100 GRAM SOLUTION FOR INJECTION

Facility

$301.75

Service Code	HCPCS J0690
Hospital Charge Code	31086
Hospital Revenue Code	636
Min. Negotiated Rate	$190.10
Max. Negotiated Rate	$271.57
Rate for Payer: Aetna Commercial	$256.49
Rate for Payer: Aetna New Business (MI Preferred)	$196.14
Rate for Payer: Cash Price	$241.40
Rate for Payer: Cofinity Commercial	$211.22
Rate for Payer: Cofinity Commercial	$259.50
Rate for Payer: Cofinity Medicare Advantage	$211.22
Rate for Payer: Encore Health Key Benefits Commercial	$241.40
Rate for Payer: Healthscope Commercial	$271.57
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$256.49
Rate for Payer: PHP Commercial	$256.49
Rate for Payer: Priority Health Cigna Priority Health	$196.14
Rate for Payer: Priority Health SBD	$190.10

CEFAZOLIN 100 GRAM SOLUTION FOR INJECTION

Facility

$301.75

Service Code	HCPCS J0690
Hospital Charge Code	31086
Hospital Revenue Code	636
Min. Negotiated Rate	$120.70
Max. Negotiated Rate	$271.57
Rate for Payer: Aetna Commercial	$256.49
Rate for Payer: Aetna Medicare	$150.88
Rate for Payer: Aetna New Business (MI Preferred)	$196.14
Rate for Payer: BCBS Complete	$120.70
Rate for Payer: Cash Price	$241.40
Rate for Payer: Cofinity Commercial	$211.22
Rate for Payer: Cofinity Commercial	$259.50
Rate for Payer: Cofinity Medicare Advantage	$211.22
Rate for Payer: Encore Health Key Benefits Commercial	$241.40
Rate for Payer: Healthscope Commercial	$271.57
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$256.49
Rate for Payer: PHP Commercial	$256.49
Rate for Payer: Priority Health Cigna Priority Health	$196.14
Rate for Payer: Priority Health SBD	$190.10

CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION

Facility

$49.67

Service Code	HCPCS J0690
Hospital Charge Code	1446
Hospital Revenue Code	636
Min. Negotiated Rate	$31.29
Max. Negotiated Rate	$44.70
Rate for Payer: Aetna Commercial	$42.22
Rate for Payer: Aetna Commercial	$24.71
Rate for Payer: Aetna New Business (MI Preferred)	$18.90
Rate for Payer: Aetna New Business (MI Preferred)	$32.29
Rate for Payer: Cash Price	$23.26
Rate for Payer: Cash Price	$39.74
Rate for Payer: Cofinity Commercial	$20.35
Rate for Payer: Cofinity Commercial	$34.77
Rate for Payer: Cofinity Commercial	$42.72
Rate for Payer: Cofinity Commercial	$25.00
Rate for Payer: Cofinity Medicare Advantage	$34.77
Rate for Payer: Cofinity Medicare Advantage	$20.35
Rate for Payer: Encore Health Key Benefits Commercial	$23.26
Rate for Payer: Encore Health Key Benefits Commercial	$39.74
Rate for Payer: Healthscope Commercial	$26.16
Rate for Payer: Healthscope Commercial	$44.70
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$24.71
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$42.22
Rate for Payer: PHP Commercial	$24.71
Rate for Payer: PHP Commercial	$42.22
Rate for Payer: Priority Health Cigna Priority Health	$32.29
Rate for Payer: Priority Health Cigna Priority Health	$18.90
Rate for Payer: Priority Health SBD	$31.29
Rate for Payer: Priority Health SBD	$18.31

CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION

Facility

$49.67

Service Code	HCPCS J0690
Hospital Charge Code	1446
Hospital Revenue Code	636
Min. Negotiated Rate	$19.87
Max. Negotiated Rate	$44.70
Rate for Payer: Aetna Commercial	$42.22
Rate for Payer: Aetna Commercial	$24.71
Rate for Payer: Aetna Medicare	$14.54
Rate for Payer: Aetna Medicare	$24.84
Rate for Payer: Aetna New Business (MI Preferred)	$18.90
Rate for Payer: Aetna New Business (MI Preferred)	$32.29
Rate for Payer: BCBS Complete	$19.87
Rate for Payer: BCBS Complete	$11.63
Rate for Payer: Cash Price	$23.26
Rate for Payer: Cash Price	$39.74
Rate for Payer: Cofinity Commercial	$20.35
Rate for Payer: Cofinity Commercial	$34.77
Rate for Payer: Cofinity Commercial	$42.72
Rate for Payer: Cofinity Commercial	$25.00
Rate for Payer: Cofinity Medicare Advantage	$34.77
Rate for Payer: Cofinity Medicare Advantage	$20.35
Rate for Payer: Encore Health Key Benefits Commercial	$23.26
Rate for Payer: Encore Health Key Benefits Commercial	$39.74
Rate for Payer: Healthscope Commercial	$26.16
Rate for Payer: Healthscope Commercial	$44.70
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$24.71
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$42.22
Rate for Payer: PHP Commercial	$42.22
Rate for Payer: PHP Commercial	$24.71
Rate for Payer: Priority Health Cigna Priority Health	$18.90
Rate for Payer: Priority Health Cigna Priority Health	$32.29
Rate for Payer: Priority Health SBD	$31.29
Rate for Payer: Priority Health SBD	$18.31

CEFAZOLIN 1 GRAM INTRAVENOUS SOLUTION

Facility

$15.83

Service Code	HCPCS J0690
Hospital Charge Code	27297
Hospital Revenue Code	636
Min. Negotiated Rate	$6.33
Max. Negotiated Rate	$14.25
Rate for Payer: Aetna Commercial	$13.46
Rate for Payer: Aetna Medicare	$7.92
Rate for Payer: Aetna New Business (MI Preferred)	$10.29
Rate for Payer: BCBS Complete	$6.33
Rate for Payer: Cash Price	$12.66
Rate for Payer: Cofinity Commercial	$11.08
Rate for Payer: Cofinity Commercial	$13.61
Rate for Payer: Cofinity Medicare Advantage	$11.08
Rate for Payer: Encore Health Key Benefits Commercial	$12.66
Rate for Payer: Healthscope Commercial	$14.25
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$13.46
Rate for Payer: PHP Commercial	$13.46
Rate for Payer: Priority Health Cigna Priority Health	$10.29
Rate for Payer: Priority Health SBD	$9.97

CEFAZOLIN 1 GRAM INTRAVENOUS SOLUTION

Facility

$15.83

Service Code	HCPCS J0690
Hospital Charge Code	27297
Hospital Revenue Code	636
Min. Negotiated Rate	$9.97
Max. Negotiated Rate	$14.25
Rate for Payer: Aetna Commercial	$13.46
Rate for Payer: Aetna New Business (MI Preferred)	$10.29
Rate for Payer: Cash Price	$12.66
Rate for Payer: Cofinity Commercial	$11.08
Rate for Payer: Cofinity Commercial	$13.61
Rate for Payer: Cofinity Medicare Advantage	$11.08
Rate for Payer: Encore Health Key Benefits Commercial	$12.66
Rate for Payer: Healthscope Commercial	$14.25
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$13.46
Rate for Payer: PHP Commercial	$13.46
Rate for Payer: Priority Health Cigna Priority Health	$10.29
Rate for Payer: Priority Health SBD	$9.97

CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION

Facility

$13.88

Service Code	HCPCS J0690
Hospital Charge Code	1445
Hospital Revenue Code	636
Min. Negotiated Rate	$5.55
Max. Negotiated Rate	$12.49
Rate for Payer: Aetna Commercial	$11.80
Rate for Payer: Aetna Commercial	$16.50
Rate for Payer: Aetna Commercial	$11.86
Rate for Payer: Aetna Medicare	$9.71
Rate for Payer: Aetna Medicare	$6.94
Rate for Payer: Aetna Medicare	$6.97
Rate for Payer: Aetna New Business (MI Preferred)	$12.62
Rate for Payer: Aetna New Business (MI Preferred)	$9.02
Rate for Payer: Aetna New Business (MI Preferred)	$9.07
Rate for Payer: BCBS Complete	$5.58
Rate for Payer: BCBS Complete	$5.55
Rate for Payer: BCBS Complete	$7.76
Rate for Payer: Cash Price	$15.53
Rate for Payer: Cash Price	$11.10
Rate for Payer: Cash Price	$11.16
Rate for Payer: Cofinity Commercial	$16.69
Rate for Payer: Cofinity Commercial	$9.72
Rate for Payer: Cofinity Commercial	$11.94
Rate for Payer: Cofinity Commercial	$9.77
Rate for Payer: Cofinity Commercial	$12.00
Rate for Payer: Cofinity Commercial	$13.59
Rate for Payer: Cofinity Medicare Advantage	$9.77
Rate for Payer: Cofinity Medicare Advantage	$9.72
Rate for Payer: Cofinity Medicare Advantage	$13.59
Rate for Payer: Encore Health Key Benefits Commercial	$11.16
Rate for Payer: Encore Health Key Benefits Commercial	$15.53
Rate for Payer: Encore Health Key Benefits Commercial	$11.10
Rate for Payer: Healthscope Commercial	$12.55
Rate for Payer: Healthscope Commercial	$12.49
Rate for Payer: Healthscope Commercial	$17.47
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$11.86
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$16.50
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$11.80
Rate for Payer: PHP Commercial	$11.86
Rate for Payer: PHP Commercial	$11.80
Rate for Payer: PHP Commercial	$16.50
Rate for Payer: Priority Health Cigna Priority Health	$9.02
Rate for Payer: Priority Health Cigna Priority Health	$12.62
Rate for Payer: Priority Health Cigna Priority Health	$9.07
Rate for Payer: Priority Health SBD	$12.23
Rate for Payer: Priority Health SBD	$8.79
Rate for Payer: Priority Health SBD	$8.74

CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION

Facility

$13.88

Service Code	HCPCS J0690
Hospital Charge Code	1445
Hospital Revenue Code	636
Min. Negotiated Rate	$8.74
Max. Negotiated Rate	$12.49
Rate for Payer: Aetna Commercial	$11.80
Rate for Payer: Aetna Commercial	$11.86
Rate for Payer: Aetna Commercial	$16.50
Rate for Payer: Aetna New Business (MI Preferred)	$9.07
Rate for Payer: Aetna New Business (MI Preferred)	$9.02
Rate for Payer: Aetna New Business (MI Preferred)	$12.62
Rate for Payer: Cash Price	$11.10
Rate for Payer: Cash Price	$11.16
Rate for Payer: Cash Price	$15.53
Rate for Payer: Cofinity Commercial	$13.59
Rate for Payer: Cofinity Commercial	$11.94
Rate for Payer: Cofinity Commercial	$9.72
Rate for Payer: Cofinity Commercial	$16.69
Rate for Payer: Cofinity Commercial	$12.00
Rate for Payer: Cofinity Commercial	$9.77
Rate for Payer: Cofinity Medicare Advantage	$9.77
Rate for Payer: Cofinity Medicare Advantage	$13.59
Rate for Payer: Cofinity Medicare Advantage	$9.72
Rate for Payer: Encore Health Key Benefits Commercial	$11.16
Rate for Payer: Encore Health Key Benefits Commercial	$11.10
Rate for Payer: Encore Health Key Benefits Commercial	$15.53
Rate for Payer: Healthscope Commercial	$12.55
Rate for Payer: Healthscope Commercial	$17.47
Rate for Payer: Healthscope Commercial	$12.49
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$11.86
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$11.80
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$16.50
Rate for Payer: PHP Commercial	$16.50
Rate for Payer: PHP Commercial	$11.80
Rate for Payer: PHP Commercial	$11.86
Rate for Payer: Priority Health Cigna Priority Health	$9.02
Rate for Payer: Priority Health Cigna Priority Health	$12.62
Rate for Payer: Priority Health Cigna Priority Health	$9.07
Rate for Payer: Priority Health SBD	$12.23
Rate for Payer: Priority Health SBD	$8.74
Rate for Payer: Priority Health SBD	$8.79

CEFAZOLIN 1 GRAM SOLUTION SOLID FORM MIXTURE COMPONENT CUSTOM

Facility

$13.95

Service Code	HCPCS J0690
Hospital Charge Code	301810
Hospital Revenue Code	636
Min. Negotiated Rate	$8.79
Max. Negotiated Rate	$12.55
Rate for Payer: Aetna Commercial	$11.86
Rate for Payer: Aetna New Business (MI Preferred)	$9.07
Rate for Payer: Cash Price	$11.16
Rate for Payer: Cofinity Commercial	$12.00
Rate for Payer: Cofinity Commercial	$9.77
Rate for Payer: Cofinity Medicare Advantage	$9.77
Rate for Payer: Encore Health Key Benefits Commercial	$11.16
Rate for Payer: Healthscope Commercial	$12.55
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$11.86
Rate for Payer: PHP Commercial	$11.86
Rate for Payer: Priority Health Cigna Priority Health	$9.07
Rate for Payer: Priority Health SBD	$8.79

CEFAZOLIN 1 GRAM SOLUTION SOLID FORM MIXTURE COMPONENT CUSTOM

Facility

$13.95

Service Code	HCPCS J0690
Hospital Charge Code	301810
Hospital Revenue Code	636
Min. Negotiated Rate	$5.58
Max. Negotiated Rate	$12.55
Rate for Payer: Aetna Commercial	$11.86
Rate for Payer: Aetna Medicare	$6.97
Rate for Payer: Aetna New Business (MI Preferred)	$9.07
Rate for Payer: BCBS Complete	$5.58
Rate for Payer: Cash Price	$11.16
Rate for Payer: Cofinity Commercial	$12.00
Rate for Payer: Cofinity Commercial	$9.77
Rate for Payer: Cofinity Medicare Advantage	$9.77
Rate for Payer: Encore Health Key Benefits Commercial	$11.16
Rate for Payer: Healthscope Commercial	$12.55
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$11.86
Rate for Payer: PHP Commercial	$11.86
Rate for Payer: Priority Health Cigna Priority Health	$9.07
Rate for Payer: Priority Health SBD	$8.79

Know your out-of-pocket cost for care.

All Charges