Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PR XTRORAL I&D ABSC CST/HMTMA FLOOR MOUTH SUBLNGL

Professional

Both

$608.00

Service Code	HCPCS 41015
Min. Negotiated Rate	$194.90
Max. Negotiated Rate	$52,043.00
Rate for Payer: Aetna Commercial	$381.47
Rate for Payer: Aetna Medicare	$296.07
Rate for Payer: Aetna New Business (MI Preferred)	$381.47
Rate for Payer: Aetna New Business (MI Preferred)	$409.94
Rate for Payer: BCBS Complete	$204.64
Rate for Payer: BCBS MAPPO	$284.68
Rate for Payer: BCBS Trust/PPO	$1,058.71
Rate for Payer: BCN Commercial	$583.48
Rate for Payer: BCN Medicare Advantage	$284.68
Rate for Payer: Cash Price	$486.40
Rate for Payer: Cash Price	$486.40
Rate for Payer: Cofinity Commercial	$409.94
Rate for Payer: Cofinity Commercial	$381.47
Rate for Payer: Health Alliance Plan Medicare Advantage	$284.68
Rate for Payer: Healthscope Commercial	$526.66
Rate for Payer: Healthscope Commercial	$455.49
Rate for Payer: Mclaren Medicaid	$194.90
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$298.91
Rate for Payer: Meridian Medicaid	$204.64
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$52,043.00
Rate for Payer: Nomi Health Commercial	$341.62
Rate for Payer: PACE SWMI	$284.68
Rate for Payer: PHP Medicare Advantage	$284.68
Rate for Payer: Priority Health Choice Medicaid	$194.90
Rate for Payer: Priority Health Cigna Priority Health	$395.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$535.74
Rate for Payer: Priority Health Medicare	$284.68
Rate for Payer: Priority Health Narrow Network	$535.74
Rate for Payer: Priority Health SBD	$535.74
Rate for Payer: UHC All Payor (Choice/PPO)	$382.32
Rate for Payer: UHC Dual Complete DSNP	$284.68
Rate for Payer: UHC Exchange	$382.32
Rate for Payer: UHC Medicare Advantage	$284.68
Rate for Payer: UHCCP Medicaid	$194.90

PR XTRORAL I&D ABSC CST/HMTMA FLOOR MOUTH SUBMNDB

Professional

Both

$902.00

Service Code	HCPCS 41017
Min. Negotiated Rate	$221.31
Max. Negotiated Rate	$59,841.00
Rate for Payer: Aetna Commercial	$431.88
Rate for Payer: Aetna Medicare	$335.19
Rate for Payer: Aetna New Business (MI Preferred)	$431.88
Rate for Payer: Aetna New Business (MI Preferred)	$464.11
Rate for Payer: BCBS Complete	$232.38
Rate for Payer: BCBS MAPPO	$322.30
Rate for Payer: BCBS Trust/PPO	$640.30
Rate for Payer: BCN Commercial	$686.10
Rate for Payer: BCN Medicare Advantage	$322.30
Rate for Payer: Cash Price	$721.60
Rate for Payer: Cash Price	$721.60
Rate for Payer: Cofinity Commercial	$464.11
Rate for Payer: Cofinity Commercial	$431.88
Rate for Payer: Health Alliance Plan Medicare Advantage	$322.30
Rate for Payer: Healthscope Commercial	$596.26
Rate for Payer: Healthscope Commercial	$515.68
Rate for Payer: Mclaren Medicaid	$221.31
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$338.42
Rate for Payer: Meridian Medicaid	$232.38
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$59,841.00
Rate for Payer: Nomi Health Commercial	$386.76
Rate for Payer: PACE SWMI	$322.30
Rate for Payer: PHP Medicare Advantage	$322.30
Rate for Payer: Priority Health Choice Medicaid	$221.31
Rate for Payer: Priority Health Cigna Priority Health	$586.30
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$614.49
Rate for Payer: Priority Health Medicare	$322.30
Rate for Payer: Priority Health Narrow Network	$614.49
Rate for Payer: Priority Health SBD	$614.49
Rate for Payer: UHC All Payor (Choice/PPO)	$388.26
Rate for Payer: UHC Dual Complete DSNP	$322.30
Rate for Payer: UHC Exchange	$388.26
Rate for Payer: UHC Medicare Advantage	$322.30
Rate for Payer: UHCCP Medicaid	$221.31

PR ZINC PASTE BAND W >=3""<5""/YD

Professional

Both

$18.00

Service Code	HCPCS A6456
Min. Negotiated Rate	$1.39
Max. Negotiated Rate	$167.00
Rate for Payer: BCBS Complete	$7.20
Rate for Payer: BCN Commercial	$1.39
Rate for Payer: Cash Price	$14.40
Rate for Payer: Cash Price	$14.40
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$167.00
Rate for Payer: Priority Health Cigna Priority Health	$11.70

PR ZOSTER VACCINE HZV LIVE FOR SUBCUTANEOUS USE

Professional

Both

$247.00

Service Code	HCPCS 90736
Min. Negotiated Rate	$98.80
Max. Negotiated Rate	$18,848.00
Rate for Payer: Aetna Commercial	$216.92
Rate for Payer: Aetna Medicare	$123.50
Rate for Payer: Aetna New Business (MI Preferred)	$216.92
Rate for Payer: BCBS Complete	$98.80
Rate for Payer: BCBS Trust/PPO	$221.01
Rate for Payer: BCN Commercial	$216.92
Rate for Payer: Cash Price	$197.60
Rate for Payer: Cash Price	$197.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$18,848.00
Rate for Payer: Priority Health Cigna Priority Health	$160.55
Rate for Payer: UHC All Payor (Choice/PPO)	$232.19
Rate for Payer: UHC Exchange	$232.19

PSEUDOEPHEDRINE 30 MG TABLET

Facility

$72.85

Service Code	NDC 00904699061
Hospital Charge Code	6714
Hospital Revenue Code	637
Min. Negotiated Rate	$29.14
Max. Negotiated Rate	$65.56
Rate for Payer: Aetna Commercial	$61.92
Rate for Payer: Aetna Medicare	$36.42
Rate for Payer: Aetna New Business (MI Preferred)	$47.35
Rate for Payer: BCBS Complete	$29.14
Rate for Payer: Cash Price	$58.28
Rate for Payer: Cofinity Commercial	$51.00
Rate for Payer: Cofinity Commercial	$62.65
Rate for Payer: Cofinity Medicare Advantage	$51.00
Rate for Payer: Encore Health Key Benefits Commercial	$58.28
Rate for Payer: Healthscope Commercial	$65.56
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$61.92
Rate for Payer: PHP Commercial	$61.92
Rate for Payer: Priority Health Cigna Priority Health	$47.35
Rate for Payer: Priority Health SBD	$45.90

PSEUDOEPHEDRINE 30 MG TABLET

Facility

$72.85

Service Code	NDC 00904699061
Hospital Charge Code	6714
Hospital Revenue Code	637
Min. Negotiated Rate	$45.90
Max. Negotiated Rate	$65.56
Rate for Payer: Aetna Commercial	$61.92
Rate for Payer: Aetna New Business (MI Preferred)	$47.35
Rate for Payer: Cash Price	$58.28
Rate for Payer: Cofinity Commercial	$51.00
Rate for Payer: Cofinity Commercial	$62.65
Rate for Payer: Cofinity Medicare Advantage	$51.00
Rate for Payer: Encore Health Key Benefits Commercial	$58.28
Rate for Payer: Healthscope Commercial	$65.56
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$61.92
Rate for Payer: PHP Commercial	$61.92
Rate for Payer: Priority Health Cigna Priority Health	$47.35
Rate for Payer: Priority Health SBD	$45.90

PSEUDOEPHEDRINE 30 MG TABLET

Facility

$44.65

Service Code	NDC 00904505359
Hospital Charge Code	6714
Hospital Revenue Code	637
Min. Negotiated Rate	$17.86
Max. Negotiated Rate	$40.18
Rate for Payer: Aetna Commercial	$37.95
Rate for Payer: Aetna Medicare	$22.32
Rate for Payer: Aetna New Business (MI Preferred)	$29.02
Rate for Payer: BCBS Complete	$17.86
Rate for Payer: Cash Price	$35.72
Rate for Payer: Cofinity Commercial	$31.26
Rate for Payer: Cofinity Commercial	$38.40
Rate for Payer: Cofinity Medicare Advantage	$31.26
Rate for Payer: Encore Health Key Benefits Commercial	$35.72
Rate for Payer: Healthscope Commercial	$40.18
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$37.95
Rate for Payer: PHP Commercial	$37.95
Rate for Payer: Priority Health Cigna Priority Health	$29.02
Rate for Payer: Priority Health SBD	$28.13

PSEUDOEPHEDRINE 30 MG TABLET

Facility

$44.65

Service Code	NDC 00904505359
Hospital Charge Code	6714
Hospital Revenue Code	637
Min. Negotiated Rate	$28.13
Max. Negotiated Rate	$40.18
Rate for Payer: Aetna Commercial	$37.95
Rate for Payer: Aetna New Business (MI Preferred)	$29.02
Rate for Payer: Cash Price	$35.72
Rate for Payer: Cofinity Commercial	$31.26
Rate for Payer: Cofinity Commercial	$38.40
Rate for Payer: Cofinity Medicare Advantage	$31.26
Rate for Payer: Encore Health Key Benefits Commercial	$35.72
Rate for Payer: Healthscope Commercial	$40.18
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$37.95
Rate for Payer: PHP Commercial	$37.95
Rate for Payer: Priority Health Cigna Priority Health	$29.02
Rate for Payer: Priority Health SBD	$28.13

PSEUDOEPHEDRINE 30 MG TABLET

Facility

$61.10

Service Code	NDC 00904672760
Hospital Charge Code	6714
Hospital Revenue Code	637
Min. Negotiated Rate	$38.49
Max. Negotiated Rate	$54.99
Rate for Payer: Aetna Commercial	$51.94
Rate for Payer: Aetna New Business (MI Preferred)	$39.72
Rate for Payer: Cash Price	$48.88
Rate for Payer: Cofinity Commercial	$42.77
Rate for Payer: Cofinity Commercial	$52.55
Rate for Payer: Cofinity Medicare Advantage	$42.77
Rate for Payer: Encore Health Key Benefits Commercial	$48.88
Rate for Payer: Healthscope Commercial	$54.99
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$51.94
Rate for Payer: PHP Commercial	$51.94
Rate for Payer: Priority Health Cigna Priority Health	$39.72
Rate for Payer: Priority Health SBD	$38.49

PSEUDOEPHEDRINE 30 MG TABLET

Facility

$61.10

Service Code	NDC 00904672760
Hospital Charge Code	6714
Hospital Revenue Code	637
Min. Negotiated Rate	$24.44
Max. Negotiated Rate	$54.99
Rate for Payer: Aetna Commercial	$51.94
Rate for Payer: Aetna Medicare	$30.55
Rate for Payer: Aetna New Business (MI Preferred)	$39.72
Rate for Payer: BCBS Complete	$24.44
Rate for Payer: Cash Price	$48.88
Rate for Payer: Cofinity Commercial	$42.77
Rate for Payer: Cofinity Commercial	$52.55
Rate for Payer: Cofinity Medicare Advantage	$42.77
Rate for Payer: Encore Health Key Benefits Commercial	$48.88
Rate for Payer: Healthscope Commercial	$54.99
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$51.94
Rate for Payer: PHP Commercial	$51.94
Rate for Payer: Priority Health Cigna Priority Health	$39.72
Rate for Payer: Priority Health SBD	$38.49

PSEUDOEPHEDRINE ER 120 MG TABLET,EXTENDED RELEASE

Facility

$31.83

Service Code	NDC 00904675415
Hospital Charge Code	6716
Hospital Revenue Code	637
Min. Negotiated Rate	$12.73
Max. Negotiated Rate	$28.65
Rate for Payer: Aetna Commercial	$27.06
Rate for Payer: Aetna Medicare	$15.92
Rate for Payer: Aetna New Business (MI Preferred)	$20.69
Rate for Payer: BCBS Complete	$12.73
Rate for Payer: Cash Price	$25.46
Rate for Payer: Cofinity Commercial	$22.28
Rate for Payer: Cofinity Commercial	$27.37
Rate for Payer: Cofinity Medicare Advantage	$22.28
Rate for Payer: Encore Health Key Benefits Commercial	$25.46
Rate for Payer: Healthscope Commercial	$28.65
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$27.06
Rate for Payer: PHP Commercial	$27.06
Rate for Payer: Priority Health Cigna Priority Health	$20.69
Rate for Payer: Priority Health SBD	$20.05

PSEUDOEPHEDRINE ER 120 MG TABLET,EXTENDED RELEASE

Facility

$31.83

Service Code	NDC 00904675415
Hospital Charge Code	6716
Hospital Revenue Code	637
Min. Negotiated Rate	$20.05
Max. Negotiated Rate	$28.65
Rate for Payer: Aetna Commercial	$27.06
Rate for Payer: Aetna New Business (MI Preferred)	$20.69
Rate for Payer: Cash Price	$25.46
Rate for Payer: Cofinity Commercial	$22.28
Rate for Payer: Cofinity Commercial	$27.37
Rate for Payer: Cofinity Medicare Advantage	$22.28
Rate for Payer: Encore Health Key Benefits Commercial	$25.46
Rate for Payer: Healthscope Commercial	$28.65
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$27.06
Rate for Payer: PHP Commercial	$27.06
Rate for Payer: Priority Health Cigna Priority Health	$20.69
Rate for Payer: Priority Health SBD	$20.05

PSYLLIUM ORAL PACKET

Facility

$42.68

Service Code	NDC 38485080857
Hospital Charge Code	11218
Hospital Revenue Code	637
Min. Negotiated Rate	$26.89
Max. Negotiated Rate	$38.41
Rate for Payer: Aetna Commercial	$36.28
Rate for Payer: Aetna New Business (MI Preferred)	$27.74
Rate for Payer: Cash Price	$34.14
Rate for Payer: Cofinity Commercial	$29.88
Rate for Payer: Cofinity Commercial	$36.70
Rate for Payer: Cofinity Medicare Advantage	$29.88
Rate for Payer: Encore Health Key Benefits Commercial	$34.14
Rate for Payer: Healthscope Commercial	$38.41
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$36.28
Rate for Payer: PHP Commercial	$36.28
Rate for Payer: Priority Health Cigna Priority Health	$27.74
Rate for Payer: Priority Health SBD	$26.89

PSYLLIUM ORAL PACKET

Facility

$42.68

Service Code	NDC 38485080857
Hospital Charge Code	11218
Hospital Revenue Code	637
Min. Negotiated Rate	$17.07
Max. Negotiated Rate	$38.41
Rate for Payer: Aetna Commercial	$36.28
Rate for Payer: Aetna Medicare	$21.34
Rate for Payer: Aetna New Business (MI Preferred)	$27.74
Rate for Payer: BCBS Complete	$17.07
Rate for Payer: Cash Price	$34.14
Rate for Payer: Cofinity Commercial	$29.88
Rate for Payer: Cofinity Commercial	$36.70
Rate for Payer: Cofinity Medicare Advantage	$29.88
Rate for Payer: Encore Health Key Benefits Commercial	$34.14
Rate for Payer: Healthscope Commercial	$38.41
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$36.28
Rate for Payer: PHP Commercial	$36.28
Rate for Payer: Priority Health Cigna Priority Health	$27.74
Rate for Payer: Priority Health SBD	$26.89

PUNCH BIOPSY OF SKIN (INCLUDING SIMPLE CLOSURE, WHEN PERFORMED); SINGLE LESION

Facility

$1,230.33

Service Code	CPT 11104
Hospital Revenue Code	360
Min. Negotiated Rate	$49.21
Max. Negotiated Rate	$1,230.33
Rate for Payer: Aetna Medicare	$407.11
Rate for Payer: Allen County Amish Medical Aid Commercial	$489.31
Rate for Payer: Amish Plain Church Group Commercial	$489.31
Rate for Payer: BCBS Complete	$220.31
Rate for Payer: BCBS MAPPO	$391.45
Rate for Payer: BCBS Trust/PPO	$172.70
Rate for Payer: BCN Commercial	$172.70
Rate for Payer: BCN Medicare Advantage	$391.45
Rate for Payer: Health Alliance Plan Medicare Advantage	$391.45
Rate for Payer: Mclaren Medicaid	$209.82
Rate for Payer: Mclaren Medicare	$391.45
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$411.02
Rate for Payer: Meridian Medicaid	$220.31
Rate for Payer: MI Amish Medical Board Commercial	$450.17
Rate for Payer: Nomi Health Commercial	$822.04
Rate for Payer: PACE Medicare	$371.88
Rate for Payer: PACE SWMI	$391.45
Rate for Payer: PHP Medicare Advantage	$391.45
Rate for Payer: Priority Health Choice Medicaid	$209.82
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,230.33
Rate for Payer: Priority Health Medicare	$391.45
Rate for Payer: Priority Health Narrow Network	$984.26
Rate for Payer: Railroad Medicare Medicare	$391.45
Rate for Payer: UHC All Payor (Choice/PPO)	$49.21
Rate for Payer: UHC Core	$878.00
Rate for Payer: UHC Dual Complete DSNP	$391.45
Rate for Payer: UHC Exchange	$940.00
Rate for Payer: UHC Medicare Advantage	$391.45
Rate for Payer: UHCCP Medicaid	$220.39
Rate for Payer: VA VA	$391.45

PUNCTURE ASPIRATION OF ABSCESS, HEMATOMA, BULLA, OR CYST

Facility

$1,230.33

Service Code	CPT 10160
Hospital Revenue Code	361
Min. Negotiated Rate	$101.00
Max. Negotiated Rate	$1,230.33
Rate for Payer: Aetna Medicare	$407.11
Rate for Payer: Allen County Amish Medical Aid Commercial	$489.31
Rate for Payer: Amish Plain Church Group Commercial	$489.31
Rate for Payer: BCBS Complete	$220.31
Rate for Payer: BCBS MAPPO	$391.45
Rate for Payer: BCBS Trust/PPO	$167.11
Rate for Payer: BCN Commercial	$167.11
Rate for Payer: BCN Medicare Advantage	$391.45
Rate for Payer: Health Alliance Plan Medicare Advantage	$391.45
Rate for Payer: Mclaren Medicaid	$209.82
Rate for Payer: Mclaren Medicare	$391.45
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$411.02
Rate for Payer: Meridian Medicaid	$220.31
Rate for Payer: MI Amish Medical Board Commercial	$450.17
Rate for Payer: Nomi Health Commercial	$822.04
Rate for Payer: PACE Medicare	$371.88
Rate for Payer: PACE SWMI	$391.45
Rate for Payer: PHP Medicare Advantage	$391.45
Rate for Payer: Priority Health Choice Medicaid	$209.82
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,230.33
Rate for Payer: Priority Health Medicare	$391.45
Rate for Payer: Priority Health Narrow Network	$984.26
Rate for Payer: Railroad Medicare Medicare	$391.45
Rate for Payer: UHC All Payor (Choice/PPO)	$101.00
Rate for Payer: UHC Core	$878.00
Rate for Payer: UHC Dual Complete DSNP	$391.45
Rate for Payer: UHC Exchange	$940.00
Rate for Payer: UHC Medicare Advantage	$391.45
Rate for Payer: UHCCP Medicaid	$220.39
Rate for Payer: VA VA	$391.45

PYRAZINAMIDE 500 MG TABLET

Facility

$948.17

Service Code	NDC 61748001206
Hospital Charge Code	6738
Hospital Revenue Code	637
Min. Negotiated Rate	$379.27
Max. Negotiated Rate	$853.35
Rate for Payer: Aetna Commercial	$805.94
Rate for Payer: Aetna Medicare	$474.08
Rate for Payer: Aetna New Business (MI Preferred)	$616.31
Rate for Payer: BCBS Complete	$379.27
Rate for Payer: Cash Price	$758.54
Rate for Payer: Cofinity Commercial	$663.72
Rate for Payer: Cofinity Commercial	$815.43
Rate for Payer: Cofinity Medicare Advantage	$663.72
Rate for Payer: Encore Health Key Benefits Commercial	$758.54
Rate for Payer: Healthscope Commercial	$853.35
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$805.94
Rate for Payer: PHP Commercial	$805.94
Rate for Payer: Priority Health Cigna Priority Health	$616.31
Rate for Payer: Priority Health SBD	$597.35

PYRAZINAMIDE 500 MG TABLET

Facility

$948.17

Service Code	NDC 61748001206
Hospital Charge Code	6738
Hospital Revenue Code	637
Min. Negotiated Rate	$597.35
Max. Negotiated Rate	$853.35
Rate for Payer: Aetna Commercial	$805.94
Rate for Payer: Aetna New Business (MI Preferred)	$616.31
Rate for Payer: Cash Price	$758.54
Rate for Payer: Cofinity Commercial	$663.72
Rate for Payer: Cofinity Commercial	$815.43
Rate for Payer: Cofinity Medicare Advantage	$663.72
Rate for Payer: Encore Health Key Benefits Commercial	$758.54
Rate for Payer: Healthscope Commercial	$853.35
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$805.94
Rate for Payer: PHP Commercial	$805.94
Rate for Payer: Priority Health Cigna Priority Health	$616.31
Rate for Payer: Priority Health SBD	$597.35

PYRAZINAMIDE 500 MG TABLET

Facility

$1,368.63

Service Code	NDC 70954048430
Hospital Charge Code	6738
Hospital Revenue Code	637
Min. Negotiated Rate	$547.45
Max. Negotiated Rate	$1,231.77
Rate for Payer: Aetna Commercial	$1,163.34
Rate for Payer: Aetna Medicare	$684.32
Rate for Payer: Aetna New Business (MI Preferred)	$889.61
Rate for Payer: BCBS Complete	$547.45
Rate for Payer: Cash Price	$1,094.90
Rate for Payer: Cofinity Commercial	$1,177.02
Rate for Payer: Cofinity Commercial	$958.04
Rate for Payer: Cofinity Medicare Advantage	$958.04
Rate for Payer: Encore Health Key Benefits Commercial	$1,094.90
Rate for Payer: Healthscope Commercial	$1,231.77
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,163.34
Rate for Payer: PHP Commercial	$1,163.34
Rate for Payer: Priority Health Cigna Priority Health	$889.61
Rate for Payer: Priority Health SBD	$862.24

PYRAZINAMIDE 500 MG TABLET

Facility

$894.72

Service Code	NDC 61748001211
Hospital Charge Code	6738
Hospital Revenue Code	637
Min. Negotiated Rate	$357.89
Max. Negotiated Rate	$805.25
Rate for Payer: Aetna Commercial	$760.51
Rate for Payer: Aetna Medicare	$447.36
Rate for Payer: Aetna New Business (MI Preferred)	$581.57
Rate for Payer: BCBS Complete	$357.89
Rate for Payer: Cash Price	$715.78
Rate for Payer: Cofinity Commercial	$626.30
Rate for Payer: Cofinity Commercial	$769.46
Rate for Payer: Cofinity Medicare Advantage	$626.30
Rate for Payer: Encore Health Key Benefits Commercial	$715.78
Rate for Payer: Healthscope Commercial	$805.25
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$760.51
Rate for Payer: PHP Commercial	$760.51
Rate for Payer: Priority Health Cigna Priority Health	$581.57
Rate for Payer: Priority Health SBD	$563.67

PYRAZINAMIDE 500 MG TABLET

Facility

$1,368.63

Service Code	NDC 70954048430
Hospital Charge Code	6738
Hospital Revenue Code	637
Min. Negotiated Rate	$862.24
Max. Negotiated Rate	$1,231.77
Rate for Payer: Aetna Commercial	$1,163.34
Rate for Payer: Aetna New Business (MI Preferred)	$889.61
Rate for Payer: Cash Price	$1,094.90
Rate for Payer: Cofinity Commercial	$1,177.02
Rate for Payer: Cofinity Commercial	$958.04
Rate for Payer: Cofinity Medicare Advantage	$958.04
Rate for Payer: Encore Health Key Benefits Commercial	$1,094.90
Rate for Payer: Healthscope Commercial	$1,231.77
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,163.34
Rate for Payer: PHP Commercial	$1,163.34
Rate for Payer: Priority Health Cigna Priority Health	$889.61
Rate for Payer: Priority Health SBD	$862.24

PYRAZINAMIDE 500 MG TABLET

Facility

$1,540.31

Service Code	NDC 61748001201
Hospital Charge Code	6738
Hospital Revenue Code	637
Min. Negotiated Rate	$970.40
Max. Negotiated Rate	$1,386.28
Rate for Payer: Aetna Commercial	$1,309.26
Rate for Payer: Aetna New Business (MI Preferred)	$1,001.20
Rate for Payer: Cash Price	$1,232.25
Rate for Payer: Cofinity Commercial	$1,078.22
Rate for Payer: Cofinity Commercial	$1,324.67
Rate for Payer: Cofinity Medicare Advantage	$1,078.22
Rate for Payer: Encore Health Key Benefits Commercial	$1,232.25
Rate for Payer: Healthscope Commercial	$1,386.28
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,309.26
Rate for Payer: PHP Commercial	$1,309.26
Rate for Payer: Priority Health Cigna Priority Health	$1,001.20
Rate for Payer: Priority Health SBD	$970.40

PYRAZINAMIDE 500 MG TABLET

Facility

$894.72

Service Code	NDC 61748001211
Hospital Charge Code	6738
Hospital Revenue Code	637
Min. Negotiated Rate	$563.67
Max. Negotiated Rate	$805.25
Rate for Payer: Aetna Commercial	$760.51
Rate for Payer: Aetna New Business (MI Preferred)	$581.57
Rate for Payer: Cash Price	$715.78
Rate for Payer: Cofinity Commercial	$626.30
Rate for Payer: Cofinity Commercial	$769.46
Rate for Payer: Cofinity Medicare Advantage	$626.30
Rate for Payer: Encore Health Key Benefits Commercial	$715.78
Rate for Payer: Healthscope Commercial	$805.25
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$760.51
Rate for Payer: PHP Commercial	$760.51
Rate for Payer: Priority Health Cigna Priority Health	$581.57
Rate for Payer: Priority Health SBD	$563.67

PYRAZINAMIDE 500 MG TABLET

Facility

$1,540.31

Service Code	NDC 61748001201
Hospital Charge Code	6738
Hospital Revenue Code	637
Min. Negotiated Rate	$616.12
Max. Negotiated Rate	$1,386.28
Rate for Payer: Aetna Commercial	$1,309.26
Rate for Payer: Aetna Medicare	$770.16
Rate for Payer: Aetna New Business (MI Preferred)	$1,001.20
Rate for Payer: BCBS Complete	$616.12
Rate for Payer: Cash Price	$1,232.25
Rate for Payer: Cofinity Commercial	$1,078.22
Rate for Payer: Cofinity Commercial	$1,324.67
Rate for Payer: Cofinity Medicare Advantage	$1,078.22
Rate for Payer: Encore Health Key Benefits Commercial	$1,232.25
Rate for Payer: Healthscope Commercial	$1,386.28
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,309.26
Rate for Payer: PHP Commercial	$1,309.26
Rate for Payer: Priority Health Cigna Priority Health	$1,001.20
Rate for Payer: Priority Health SBD	$970.40

PYRIDOSTIGMINE BROMIDE 5 MG/ML INJECTION SOLUTION

Facility

$124.60

Service Code	NDC 00781304072
Hospital Charge Code	11237
Hospital Revenue Code	250
Min. Negotiated Rate	$49.84
Max. Negotiated Rate	$112.14
Rate for Payer: Aetna Commercial	$105.91
Rate for Payer: Aetna Medicare	$62.30
Rate for Payer: Aetna New Business (MI Preferred)	$80.99
Rate for Payer: BCBS Complete	$49.84
Rate for Payer: Cash Price	$99.68
Rate for Payer: Cofinity Commercial	$107.16
Rate for Payer: Cofinity Commercial	$87.22
Rate for Payer: Cofinity Medicare Advantage	$87.22
Rate for Payer: Encore Health Key Benefits Commercial	$99.68
Rate for Payer: Healthscope Commercial	$112.14
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$105.91
Rate for Payer: PHP Commercial	$105.91
Rate for Payer: Priority Health Cigna Priority Health	$80.99
Rate for Payer: Priority Health SBD	$78.50

Know your out-of-pocket cost for care.

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