Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET

Facility

$145.20

Service Code	NDC 00904744061
Hospital Charge Code	24216
Hospital Revenue Code	637
Min. Negotiated Rate	$57.06
Max. Negotiated Rate	$130.68
Rate for Payer: Aetna Commercial	$123.42
Rate for Payer: Aetna Medicare	$72.60
Rate for Payer: Aetna New Business (MI Preferred)	$94.38
Rate for Payer: BCBS Complete	$58.08
Rate for Payer: Cash Price	$116.16
Rate for Payer: Cofinity Advantage	$101.64
Rate for Payer: Cofinity Commercial	$124.87
Rate for Payer: Encore Health Key Benefits Commercial	$116.16
Rate for Payer: Healthscope Commercial	$130.68
Rate for Payer: MI Amish Medical Board Commercial	$116.16
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$123.42
Rate for Payer: Opus (Opus Packaging Group) HMA	$108.90
Rate for Payer: PHP Commercial	$123.42
Rate for Payer: Priority Health SBD	$91.48
Rate for Payer: UHC All Payor (Choice/PPO)	$94.38
Rate for Payer: UHC Core	$75.65
Rate for Payer: UHC Exchange	$57.06

SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET

Facility

$159.50

Service Code	NDC 60687062201
Hospital Charge Code	24216
Hospital Revenue Code	637
Min. Negotiated Rate	$62.68
Max. Negotiated Rate	$143.55
Rate for Payer: Aetna Commercial	$135.57
Rate for Payer: Aetna Medicare	$79.75
Rate for Payer: Aetna New Business (MI Preferred)	$103.67
Rate for Payer: BCBS Complete	$63.80
Rate for Payer: Cash Price	$127.60
Rate for Payer: Cofinity Advantage	$111.65
Rate for Payer: Cofinity Commercial	$137.17
Rate for Payer: Encore Health Key Benefits Commercial	$127.60
Rate for Payer: Healthscope Commercial	$143.55
Rate for Payer: MI Amish Medical Board Commercial	$127.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$135.57
Rate for Payer: Opus (Opus Packaging Group) HMA	$119.62
Rate for Payer: PHP Commercial	$135.57
Rate for Payer: Priority Health SBD	$100.48
Rate for Payer: UHC All Payor (Choice/PPO)	$103.67
Rate for Payer: UHC Core	$83.10
Rate for Payer: UHC Exchange	$62.68

SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET

Facility

$101.20

Service Code	NDC 51645085099
Hospital Charge Code	24216
Hospital Revenue Code	637
Min. Negotiated Rate	$63.76
Max. Negotiated Rate	$91.08
Rate for Payer: Aetna Commercial	$86.02
Rate for Payer: Aetna New Business (MI Preferred)	$65.78
Rate for Payer: Cash Price	$80.96
Rate for Payer: Cofinity Advantage	$70.84
Rate for Payer: Cofinity Commercial	$87.03
Rate for Payer: Encore Health Key Benefits Commercial	$80.96
Rate for Payer: Healthscope Commercial	$91.08
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$86.02
Rate for Payer: Opus (Opus Packaging Group) HMA	$75.90
Rate for Payer: PHP Commercial	$86.02
Rate for Payer: Priority Health SBD	$63.76

SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET

Facility

$88.20

Service Code	NDC 09629513881
Hospital Charge Code	24216
Hospital Revenue Code	637
Min. Negotiated Rate	$34.66
Max. Negotiated Rate	$79.38
Rate for Payer: Aetna Commercial	$74.97
Rate for Payer: Aetna Medicare	$44.10
Rate for Payer: Aetna New Business (MI Preferred)	$57.33
Rate for Payer: BCBS Complete	$35.28
Rate for Payer: Cash Price	$70.56
Rate for Payer: Cofinity Advantage	$61.74
Rate for Payer: Cofinity Commercial	$75.85
Rate for Payer: Encore Health Key Benefits Commercial	$70.56
Rate for Payer: Healthscope Commercial	$79.38
Rate for Payer: MI Amish Medical Board Commercial	$70.56
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$74.97
Rate for Payer: Opus (Opus Packaging Group) HMA	$66.15
Rate for Payer: PHP Commercial	$74.97
Rate for Payer: Priority Health SBD	$55.57
Rate for Payer: UHC All Payor (Choice/PPO)	$57.33
Rate for Payer: UHC Core	$45.95
Rate for Payer: UHC Exchange	$34.66

SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET

Facility

$191.10

Service Code	NDC 67618031060
Hospital Charge Code	24216
Hospital Revenue Code	637
Min. Negotiated Rate	$120.39
Max. Negotiated Rate	$171.99
Rate for Payer: Aetna Commercial	$162.44
Rate for Payer: Aetna New Business (MI Preferred)	$124.22
Rate for Payer: Cash Price	$152.88
Rate for Payer: Cofinity Advantage	$133.77
Rate for Payer: Cofinity Commercial	$164.35
Rate for Payer: Encore Health Key Benefits Commercial	$152.88
Rate for Payer: Healthscope Commercial	$171.99
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$162.44
Rate for Payer: Opus (Opus Packaging Group) HMA	$143.32
Rate for Payer: PHP Commercial	$162.44
Rate for Payer: Priority Health SBD	$120.39

SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET

Facility

$94.50

Service Code	NDC 70000052601
Hospital Charge Code	24216
Hospital Revenue Code	637
Min. Negotiated Rate	$59.53
Max. Negotiated Rate	$85.05
Rate for Payer: Aetna Commercial	$80.33
Rate for Payer: Aetna New Business (MI Preferred)	$61.42
Rate for Payer: Cash Price	$75.60
Rate for Payer: Cofinity Advantage	$66.15
Rate for Payer: Cofinity Commercial	$81.27
Rate for Payer: Encore Health Key Benefits Commercial	$75.60
Rate for Payer: Healthscope Commercial	$85.05
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$80.33
Rate for Payer: Opus (Opus Packaging Group) HMA	$70.88
Rate for Payer: PHP Commercial	$80.33
Rate for Payer: Priority Health SBD	$59.53

SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET

Facility

$159.50

Service Code	NDC 60687062201
Hospital Charge Code	24216
Hospital Revenue Code	637
Min. Negotiated Rate	$100.48
Max. Negotiated Rate	$143.55
Rate for Payer: Aetna Commercial	$135.57
Rate for Payer: Aetna New Business (MI Preferred)	$103.67
Rate for Payer: Cash Price	$127.60
Rate for Payer: Cofinity Advantage	$111.65
Rate for Payer: Cofinity Commercial	$137.17
Rate for Payer: Encore Health Key Benefits Commercial	$127.60
Rate for Payer: Healthscope Commercial	$143.55
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$135.57
Rate for Payer: Opus (Opus Packaging Group) HMA	$119.62
Rate for Payer: PHP Commercial	$135.57
Rate for Payer: Priority Health SBD	$100.48

SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET

Facility

$191.10

Service Code	NDC 67618031060
Hospital Charge Code	24216
Hospital Revenue Code	637
Min. Negotiated Rate	$75.10
Max. Negotiated Rate	$171.99
Rate for Payer: Aetna Commercial	$162.44
Rate for Payer: Aetna Medicare	$95.55
Rate for Payer: Aetna New Business (MI Preferred)	$124.22
Rate for Payer: BCBS Complete	$76.44
Rate for Payer: Cash Price	$152.88
Rate for Payer: Cofinity Advantage	$133.77
Rate for Payer: Cofinity Commercial	$164.35
Rate for Payer: Encore Health Key Benefits Commercial	$152.88
Rate for Payer: Healthscope Commercial	$171.99
Rate for Payer: MI Amish Medical Board Commercial	$152.88
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$162.44
Rate for Payer: Opus (Opus Packaging Group) HMA	$143.32
Rate for Payer: PHP Commercial	$162.44
Rate for Payer: Priority Health SBD	$120.39
Rate for Payer: UHC All Payor (Choice/PPO)	$124.22
Rate for Payer: UHC Core	$99.56
Rate for Payer: UHC Exchange	$75.10

SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET

Facility

$1.60

Service Code	NDC 60687062211
Hospital Charge Code	24216
Hospital Revenue Code	637
Min. Negotiated Rate	$0.63
Max. Negotiated Rate	$1.44
Rate for Payer: Aetna Commercial	$1.36
Rate for Payer: Aetna Medicare	$0.80
Rate for Payer: Aetna New Business (MI Preferred)	$1.04
Rate for Payer: BCBS Complete	$0.64
Rate for Payer: Cash Price	$1.28
Rate for Payer: Cofinity Advantage	$1.12
Rate for Payer: Cofinity Commercial	$1.38
Rate for Payer: Encore Health Key Benefits Commercial	$1.28
Rate for Payer: Healthscope Commercial	$1.44
Rate for Payer: MI Amish Medical Board Commercial	$1.28
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1.36
Rate for Payer: Opus (Opus Packaging Group) HMA	$1.20
Rate for Payer: PHP Commercial	$1.36
Rate for Payer: Priority Health SBD	$1.01
Rate for Payer: UHC All Payor (Choice/PPO)	$1.04
Rate for Payer: UHC Core	$0.83
Rate for Payer: UHC Exchange	$0.63

SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET

Facility

$44.52

Service Code	NDC 67618031030
Hospital Charge Code	24216
Hospital Revenue Code	637
Min. Negotiated Rate	$17.50
Max. Negotiated Rate	$40.07
Rate for Payer: Aetna Commercial	$37.84
Rate for Payer: Aetna Medicare	$22.26
Rate for Payer: Aetna New Business (MI Preferred)	$28.94
Rate for Payer: BCBS Complete	$17.81
Rate for Payer: Cash Price	$35.62
Rate for Payer: Cofinity Advantage	$31.16
Rate for Payer: Cofinity Commercial	$38.29
Rate for Payer: Encore Health Key Benefits Commercial	$35.62
Rate for Payer: Healthscope Commercial	$40.07
Rate for Payer: MI Amish Medical Board Commercial	$35.62
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$37.84
Rate for Payer: Opus (Opus Packaging Group) HMA	$33.39
Rate for Payer: PHP Commercial	$37.84
Rate for Payer: Priority Health SBD	$28.05
Rate for Payer: UHC All Payor (Choice/PPO)	$28.94
Rate for Payer: UHC Core	$23.19
Rate for Payer: UHC Exchange	$17.50

SENNOSIDES 8.6 MG TABLET

Facility

$107.10

Service Code	NDC 57896045401
Hospital Charge Code	11349
Hospital Revenue Code	637
Min. Negotiated Rate	$42.09
Max. Negotiated Rate	$96.39
Rate for Payer: Aetna Commercial	$91.03
Rate for Payer: Aetna Medicare	$53.55
Rate for Payer: Aetna New Business (MI Preferred)	$69.61
Rate for Payer: BCBS Complete	$42.84
Rate for Payer: Cash Price	$85.68
Rate for Payer: Cofinity Advantage	$74.97
Rate for Payer: Cofinity Commercial	$92.11
Rate for Payer: Encore Health Key Benefits Commercial	$85.68
Rate for Payer: Healthscope Commercial	$96.39
Rate for Payer: MI Amish Medical Board Commercial	$85.68
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$91.03
Rate for Payer: Opus (Opus Packaging Group) HMA	$80.33
Rate for Payer: PHP Commercial	$91.03
Rate for Payer: Priority Health SBD	$67.47
Rate for Payer: UHC All Payor (Choice/PPO)	$69.61
Rate for Payer: UHC Core	$55.80
Rate for Payer: UHC Exchange	$42.09

SENNOSIDES 8.6 MG TABLET

Facility

$44.52

Service Code	NDC 67618030020
Hospital Charge Code	11349
Hospital Revenue Code	637
Min. Negotiated Rate	$28.05
Max. Negotiated Rate	$40.07
Rate for Payer: Aetna Commercial	$37.84
Rate for Payer: Aetna New Business (MI Preferred)	$28.94
Rate for Payer: Cash Price	$35.62
Rate for Payer: Cofinity Advantage	$31.16
Rate for Payer: Cofinity Commercial	$38.29
Rate for Payer: Encore Health Key Benefits Commercial	$35.62
Rate for Payer: Healthscope Commercial	$40.07
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$37.84
Rate for Payer: Opus (Opus Packaging Group) HMA	$33.39
Rate for Payer: PHP Commercial	$37.84
Rate for Payer: Priority Health SBD	$28.05

SENNOSIDES 8.6 MG TABLET

Facility

$94.50

Service Code	NDC 00904725260
Hospital Charge Code	11349
Hospital Revenue Code	637
Min. Negotiated Rate	$59.53
Max. Negotiated Rate	$85.05
Rate for Payer: Aetna Commercial	$80.33
Rate for Payer: Aetna New Business (MI Preferred)	$61.42
Rate for Payer: Cash Price	$75.60
Rate for Payer: Cofinity Advantage	$66.15
Rate for Payer: Cofinity Commercial	$81.27
Rate for Payer: Encore Health Key Benefits Commercial	$75.60
Rate for Payer: Healthscope Commercial	$85.05
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$80.33
Rate for Payer: Opus (Opus Packaging Group) HMA	$70.88
Rate for Payer: PHP Commercial	$80.33
Rate for Payer: Priority Health SBD	$59.53

SENNOSIDES 8.6 MG TABLET

Facility

$132.30

Service Code	NDC 00904672559
Hospital Charge Code	11349
Hospital Revenue Code	637
Min. Negotiated Rate	$51.99
Max. Negotiated Rate	$119.07
Rate for Payer: Aetna Commercial	$112.45
Rate for Payer: Aetna Medicare	$66.15
Rate for Payer: Aetna New Business (MI Preferred)	$86.00
Rate for Payer: BCBS Complete	$52.92
Rate for Payer: Cash Price	$105.84
Rate for Payer: Cofinity Advantage	$92.61
Rate for Payer: Cofinity Commercial	$113.78
Rate for Payer: Encore Health Key Benefits Commercial	$105.84
Rate for Payer: Healthscope Commercial	$119.07
Rate for Payer: MI Amish Medical Board Commercial	$105.84
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$112.45
Rate for Payer: Opus (Opus Packaging Group) HMA	$99.22
Rate for Payer: PHP Commercial	$112.45
Rate for Payer: Priority Health SBD	$83.35
Rate for Payer: UHC All Payor (Choice/PPO)	$86.00
Rate for Payer: UHC Core	$68.93
Rate for Payer: UHC Exchange	$51.99

SENNOSIDES 8.6 MG TABLET

Facility

$148.00

Service Code	NDC 00904725261
Hospital Charge Code	11349
Hospital Revenue Code	637
Min. Negotiated Rate	$58.16
Max. Negotiated Rate	$133.20
Rate for Payer: Aetna Commercial	$125.80
Rate for Payer: Aetna Medicare	$74.00
Rate for Payer: Aetna New Business (MI Preferred)	$96.20
Rate for Payer: BCBS Complete	$59.20
Rate for Payer: Cash Price	$118.40
Rate for Payer: Cofinity Advantage	$103.60
Rate for Payer: Cofinity Commercial	$127.28
Rate for Payer: Encore Health Key Benefits Commercial	$118.40
Rate for Payer: Healthscope Commercial	$133.20
Rate for Payer: MI Amish Medical Board Commercial	$118.40
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$125.80
Rate for Payer: Opus (Opus Packaging Group) HMA	$111.00
Rate for Payer: PHP Commercial	$125.80
Rate for Payer: Priority Health SBD	$93.24
Rate for Payer: UHC All Payor (Choice/PPO)	$96.20
Rate for Payer: UHC Core	$77.11
Rate for Payer: UHC Exchange	$58.16

SENNOSIDES 8.6 MG TABLET

Facility

$132.00

Service Code	NDC 00904652261
Hospital Charge Code	11349
Hospital Revenue Code	637
Min. Negotiated Rate	$51.88
Max. Negotiated Rate	$118.80
Rate for Payer: Aetna Commercial	$112.20
Rate for Payer: Aetna Medicare	$66.00
Rate for Payer: Aetna New Business (MI Preferred)	$85.80
Rate for Payer: BCBS Complete	$52.80
Rate for Payer: Cash Price	$105.60
Rate for Payer: Cofinity Advantage	$92.40
Rate for Payer: Cofinity Commercial	$113.52
Rate for Payer: Encore Health Key Benefits Commercial	$105.60
Rate for Payer: Healthscope Commercial	$118.80
Rate for Payer: MI Amish Medical Board Commercial	$105.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$112.20
Rate for Payer: Opus (Opus Packaging Group) HMA	$99.00
Rate for Payer: PHP Commercial	$112.20
Rate for Payer: Priority Health SBD	$83.16
Rate for Payer: UHC All Payor (Choice/PPO)	$85.80
Rate for Payer: UHC Core	$68.77
Rate for Payer: UHC Exchange	$51.88

SENNOSIDES 8.6 MG TABLET

Facility

$107.10

Service Code	NDC 57896043401
Hospital Charge Code	11349
Hospital Revenue Code	637
Min. Negotiated Rate	$42.09
Max. Negotiated Rate	$96.39
Rate for Payer: Aetna Commercial	$91.03
Rate for Payer: Aetna Medicare	$53.55
Rate for Payer: Aetna New Business (MI Preferred)	$69.61
Rate for Payer: BCBS Complete	$42.84
Rate for Payer: Cash Price	$85.68
Rate for Payer: Cofinity Advantage	$74.97
Rate for Payer: Cofinity Commercial	$92.11
Rate for Payer: Encore Health Key Benefits Commercial	$85.68
Rate for Payer: Healthscope Commercial	$96.39
Rate for Payer: MI Amish Medical Board Commercial	$85.68
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$91.03
Rate for Payer: Opus (Opus Packaging Group) HMA	$80.33
Rate for Payer: PHP Commercial	$91.03
Rate for Payer: Priority Health SBD	$67.47
Rate for Payer: UHC All Payor (Choice/PPO)	$69.61
Rate for Payer: UHC Core	$55.80
Rate for Payer: UHC Exchange	$42.09

SENNOSIDES 8.6 MG TABLET

Facility

$756.00

Service Code	NDC 49483008010
Hospital Charge Code	11349
Hospital Revenue Code	637
Min. Negotiated Rate	$476.28
Max. Negotiated Rate	$680.40
Rate for Payer: Aetna Commercial	$642.60
Rate for Payer: Aetna New Business (MI Preferred)	$491.40
Rate for Payer: Cash Price	$604.80
Rate for Payer: Cofinity Advantage	$529.20
Rate for Payer: Cofinity Commercial	$650.16
Rate for Payer: Encore Health Key Benefits Commercial	$604.80
Rate for Payer: Healthscope Commercial	$680.40
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$642.60
Rate for Payer: Opus (Opus Packaging Group) HMA	$567.00
Rate for Payer: PHP Commercial	$642.60
Rate for Payer: Priority Health SBD	$476.28

SENNOSIDES 8.6 MG TABLET

Facility

$88.20

Service Code	NDC 96295013956
Hospital Charge Code	11349
Hospital Revenue Code	637
Min. Negotiated Rate	$55.57
Max. Negotiated Rate	$79.38
Rate for Payer: Aetna Commercial	$74.97
Rate for Payer: Aetna New Business (MI Preferred)	$57.33
Rate for Payer: Cash Price	$70.56
Rate for Payer: Cofinity Advantage	$61.74
Rate for Payer: Cofinity Commercial	$75.85
Rate for Payer: Encore Health Key Benefits Commercial	$70.56
Rate for Payer: Healthscope Commercial	$79.38
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$74.97
Rate for Payer: Opus (Opus Packaging Group) HMA	$66.15
Rate for Payer: PHP Commercial	$74.97
Rate for Payer: Priority Health SBD	$55.57

SENNOSIDES 8.6 MG TABLET

Facility

$122.00

Service Code	NDC 96295013289
Hospital Charge Code	11349
Hospital Revenue Code	637
Min. Negotiated Rate	$76.86
Max. Negotiated Rate	$109.80
Rate for Payer: Aetna Commercial	$103.70
Rate for Payer: Aetna New Business (MI Preferred)	$79.30
Rate for Payer: Cash Price	$97.60
Rate for Payer: Cofinity Advantage	$85.40
Rate for Payer: Cofinity Commercial	$104.92
Rate for Payer: Encore Health Key Benefits Commercial	$97.60
Rate for Payer: Healthscope Commercial	$109.80
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$103.70
Rate for Payer: Opus (Opus Packaging Group) HMA	$91.50
Rate for Payer: PHP Commercial	$103.70
Rate for Payer: Priority Health SBD	$76.86

SENNOSIDES 8.6 MG TABLET

Facility

$88.20

Service Code	NDC 96295013956
Hospital Charge Code	11349
Hospital Revenue Code	637
Min. Negotiated Rate	$34.66
Max. Negotiated Rate	$79.38
Rate for Payer: Aetna Commercial	$74.97
Rate for Payer: Aetna Medicare	$44.10
Rate for Payer: Aetna New Business (MI Preferred)	$57.33
Rate for Payer: BCBS Complete	$35.28
Rate for Payer: Cash Price	$70.56
Rate for Payer: Cofinity Advantage	$61.74
Rate for Payer: Cofinity Commercial	$75.85
Rate for Payer: Encore Health Key Benefits Commercial	$70.56
Rate for Payer: Healthscope Commercial	$79.38
Rate for Payer: MI Amish Medical Board Commercial	$70.56
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$74.97
Rate for Payer: Opus (Opus Packaging Group) HMA	$66.15
Rate for Payer: PHP Commercial	$74.97
Rate for Payer: Priority Health SBD	$55.57
Rate for Payer: UHC All Payor (Choice/PPO)	$57.33
Rate for Payer: UHC Core	$45.95
Rate for Payer: UHC Exchange	$34.66

SENNOSIDES 8.6 MG TABLET

Facility

$132.30

Service Code	NDC 49483008001
Hospital Charge Code	11349
Hospital Revenue Code	637
Min. Negotiated Rate	$51.99
Max. Negotiated Rate	$119.07
Rate for Payer: Aetna Commercial	$112.45
Rate for Payer: Aetna Medicare	$66.15
Rate for Payer: Aetna New Business (MI Preferred)	$86.00
Rate for Payer: BCBS Complete	$52.92
Rate for Payer: Cash Price	$105.84
Rate for Payer: Cofinity Advantage	$92.61
Rate for Payer: Cofinity Commercial	$113.78
Rate for Payer: Encore Health Key Benefits Commercial	$105.84
Rate for Payer: Healthscope Commercial	$119.07
Rate for Payer: MI Amish Medical Board Commercial	$105.84
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$112.45
Rate for Payer: Opus (Opus Packaging Group) HMA	$99.22
Rate for Payer: PHP Commercial	$112.45
Rate for Payer: Priority Health SBD	$83.35
Rate for Payer: UHC All Payor (Choice/PPO)	$86.00
Rate for Payer: UHC Core	$68.93
Rate for Payer: UHC Exchange	$51.99

SENNOSIDES 8.6 MG TABLET

Facility

$149.10

Service Code	NDC 67618030010
Hospital Charge Code	11349
Hospital Revenue Code	637
Min. Negotiated Rate	$93.93
Max. Negotiated Rate	$134.19
Rate for Payer: Aetna Commercial	$126.73
Rate for Payer: Aetna New Business (MI Preferred)	$96.92
Rate for Payer: Cash Price	$119.28
Rate for Payer: Cofinity Advantage	$104.37
Rate for Payer: Cofinity Commercial	$128.23
Rate for Payer: Encore Health Key Benefits Commercial	$119.28
Rate for Payer: Healthscope Commercial	$134.19
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$126.73
Rate for Payer: Opus (Opus Packaging Group) HMA	$111.83
Rate for Payer: PHP Commercial	$126.73
Rate for Payer: Priority Health SBD	$93.93

SENNOSIDES 8.6 MG TABLET

Facility

$56.70

Service Code	NDC 70000044703
Hospital Charge Code	11349
Hospital Revenue Code	637
Min. Negotiated Rate	$22.28
Max. Negotiated Rate	$51.03
Rate for Payer: Aetna Commercial	$48.20
Rate for Payer: Aetna Medicare	$28.35
Rate for Payer: Aetna New Business (MI Preferred)	$36.85
Rate for Payer: BCBS Complete	$22.68
Rate for Payer: Cash Price	$45.36
Rate for Payer: Cofinity Advantage	$39.69
Rate for Payer: Cofinity Commercial	$48.76
Rate for Payer: Encore Health Key Benefits Commercial	$45.36
Rate for Payer: Healthscope Commercial	$51.03
Rate for Payer: MI Amish Medical Board Commercial	$45.36
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$48.20
Rate for Payer: Opus (Opus Packaging Group) HMA	$42.52
Rate for Payer: PHP Commercial	$48.20
Rate for Payer: Priority Health SBD	$35.72
Rate for Payer: UHC All Payor (Choice/PPO)	$36.85
Rate for Payer: UHC Core	$29.54
Rate for Payer: UHC Exchange	$22.28

SENNOSIDES 8.6 MG TABLET

Facility

$132.30

Service Code	NDC 00904672559
Hospital Charge Code	11349
Hospital Revenue Code	637
Min. Negotiated Rate	$83.35
Max. Negotiated Rate	$119.07
Rate for Payer: Aetna Commercial	$112.45
Rate for Payer: Aetna New Business (MI Preferred)	$86.00
Rate for Payer: Cash Price	$105.84
Rate for Payer: Cofinity Advantage	$92.61
Rate for Payer: Cofinity Commercial	$113.78
Rate for Payer: Encore Health Key Benefits Commercial	$105.84
Rate for Payer: Healthscope Commercial	$119.07
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$112.45
Rate for Payer: Opus (Opus Packaging Group) HMA	$99.22
Rate for Payer: PHP Commercial	$112.45
Rate for Payer: Priority Health SBD	$83.35

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