Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

RIFABUTIN 150 MG CAPSULE

Facility

$4,052.98

Service Code	NDC 59762135001
Hospital Charge Code	11290
Hospital Revenue Code	637
Min. Negotiated Rate	$1,621.19
Max. Negotiated Rate	$3,647.68
Rate for Payer: Aetna Commercial	$3,445.03
Rate for Payer: Aetna Medicare	$2,026.49
Rate for Payer: Aetna New Business (MI Preferred)	$2,634.44
Rate for Payer: BCBS Complete	$1,621.19
Rate for Payer: Cash Price	$3,242.38
Rate for Payer: Cofinity Commercial	$2,837.09
Rate for Payer: Cofinity Commercial	$3,485.56
Rate for Payer: Cofinity Medicare Advantage	$2,837.09
Rate for Payer: Encore Health Key Benefits Commercial	$3,242.38
Rate for Payer: Healthscope Commercial	$3,647.68
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3,445.03
Rate for Payer: PHP Commercial	$3,445.03
Rate for Payer: Priority Health Cigna Priority Health	$2,634.44
Rate for Payer: Priority Health SBD	$2,553.38

RIFABUTIN 150 MG CAPSULE

Facility

$4,334.18

Service Code	NDC 70954004110
Hospital Charge Code	11290
Hospital Revenue Code	637
Min. Negotiated Rate	$2,730.53
Max. Negotiated Rate	$3,900.76
Rate for Payer: Aetna Commercial	$3,684.05
Rate for Payer: Aetna New Business (MI Preferred)	$2,817.22
Rate for Payer: Cash Price	$3,467.34
Rate for Payer: Cofinity Commercial	$3,033.93
Rate for Payer: Cofinity Commercial	$3,727.39
Rate for Payer: Cofinity Medicare Advantage	$3,033.93
Rate for Payer: Encore Health Key Benefits Commercial	$3,467.34
Rate for Payer: Healthscope Commercial	$3,900.76
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3,684.05
Rate for Payer: PHP Commercial	$3,684.05
Rate for Payer: Priority Health Cigna Priority Health	$2,817.22
Rate for Payer: Priority Health SBD	$2,730.53

RIFABUTIN 150 MG CAPSULE

Facility

$4,334.18

Service Code	NDC 70954004110
Hospital Charge Code	11290
Hospital Revenue Code	637
Min. Negotiated Rate	$1,733.67
Max. Negotiated Rate	$3,900.76
Rate for Payer: Aetna Commercial	$3,684.05
Rate for Payer: Aetna Medicare	$2,167.09
Rate for Payer: Aetna New Business (MI Preferred)	$2,817.22
Rate for Payer: BCBS Complete	$1,733.67
Rate for Payer: Cash Price	$3,467.34
Rate for Payer: Cofinity Commercial	$3,033.93
Rate for Payer: Cofinity Commercial	$3,727.39
Rate for Payer: Cofinity Medicare Advantage	$3,033.93
Rate for Payer: Encore Health Key Benefits Commercial	$3,467.34
Rate for Payer: Healthscope Commercial	$3,900.76
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3,684.05
Rate for Payer: PHP Commercial	$3,684.05
Rate for Payer: Priority Health Cigna Priority Health	$2,817.22
Rate for Payer: Priority Health SBD	$2,730.53

RIFAMPIN 150 MG CAPSULE

Facility

$10.82

Service Code	NDC 60687057511
Hospital Charge Code	11292
Hospital Revenue Code	637
Min. Negotiated Rate	$4.33
Max. Negotiated Rate	$9.74
Rate for Payer: Aetna Commercial	$9.20
Rate for Payer: Aetna Medicare	$5.41
Rate for Payer: Aetna New Business (MI Preferred)	$7.03
Rate for Payer: BCBS Complete	$4.33
Rate for Payer: Cash Price	$8.66
Rate for Payer: Cofinity Commercial	$7.57
Rate for Payer: Cofinity Commercial	$9.31
Rate for Payer: Cofinity Medicare Advantage	$7.57
Rate for Payer: Encore Health Key Benefits Commercial	$8.66
Rate for Payer: Healthscope Commercial	$9.74
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$9.20
Rate for Payer: PHP Commercial	$9.20
Rate for Payer: Priority Health Cigna Priority Health	$7.03
Rate for Payer: Priority Health SBD	$6.82

RIFAMPIN 150 MG CAPSULE

Facility

$324.35

Service Code	NDC 60687057521
Hospital Charge Code	11292
Hospital Revenue Code	637
Min. Negotiated Rate	$204.34
Max. Negotiated Rate	$291.92
Rate for Payer: Aetna Commercial	$275.70
Rate for Payer: Aetna New Business (MI Preferred)	$210.83
Rate for Payer: Cash Price	$259.48
Rate for Payer: Cofinity Commercial	$227.04
Rate for Payer: Cofinity Commercial	$278.94
Rate for Payer: Cofinity Medicare Advantage	$227.04
Rate for Payer: Encore Health Key Benefits Commercial	$259.48
Rate for Payer: Healthscope Commercial	$291.92
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$275.70
Rate for Payer: PHP Commercial	$275.70
Rate for Payer: Priority Health Cigna Priority Health	$210.83
Rate for Payer: Priority Health SBD	$204.34

RIFAMPIN 150 MG CAPSULE

Facility

$324.35

Service Code	NDC 60687057521
Hospital Charge Code	11292
Hospital Revenue Code	637
Min. Negotiated Rate	$129.74
Max. Negotiated Rate	$291.92
Rate for Payer: Aetna Commercial	$275.70
Rate for Payer: Aetna Medicare	$162.18
Rate for Payer: Aetna New Business (MI Preferred)	$210.83
Rate for Payer: BCBS Complete	$129.74
Rate for Payer: Cash Price	$259.48
Rate for Payer: Cofinity Commercial	$227.04
Rate for Payer: Cofinity Commercial	$278.94
Rate for Payer: Cofinity Medicare Advantage	$227.04
Rate for Payer: Encore Health Key Benefits Commercial	$259.48
Rate for Payer: Healthscope Commercial	$291.92
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$275.70
Rate for Payer: PHP Commercial	$275.70
Rate for Payer: Priority Health Cigna Priority Health	$210.83
Rate for Payer: Priority Health SBD	$204.34

RIFAMPIN 150 MG CAPSULE

Facility

$10.82

Service Code	NDC 60687057511
Hospital Charge Code	11292
Hospital Revenue Code	637
Min. Negotiated Rate	$6.82
Max. Negotiated Rate	$9.74
Rate for Payer: Aetna Commercial	$9.20
Rate for Payer: Aetna New Business (MI Preferred)	$7.03
Rate for Payer: Cash Price	$8.66
Rate for Payer: Cofinity Commercial	$7.57
Rate for Payer: Cofinity Commercial	$9.31
Rate for Payer: Cofinity Medicare Advantage	$7.57
Rate for Payer: Encore Health Key Benefits Commercial	$8.66
Rate for Payer: Healthscope Commercial	$9.74
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$9.20
Rate for Payer: PHP Commercial	$9.20
Rate for Payer: Priority Health Cigna Priority Health	$7.03
Rate for Payer: Priority Health SBD	$6.82

RIFAMPIN 600 MG INTRAVENOUS SOLUTION

Facility

$589.52

Service Code	NDC 00068059701
Hospital Charge Code	11291
Hospital Revenue Code	250
Min. Negotiated Rate	$371.40
Max. Negotiated Rate	$530.57
Rate for Payer: Aetna Commercial	$501.09
Rate for Payer: Aetna New Business (MI Preferred)	$383.19
Rate for Payer: Cash Price	$471.62
Rate for Payer: Cofinity Commercial	$412.66
Rate for Payer: Cofinity Commercial	$506.99
Rate for Payer: Cofinity Medicare Advantage	$412.66
Rate for Payer: Encore Health Key Benefits Commercial	$471.62
Rate for Payer: Healthscope Commercial	$530.57
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$501.09
Rate for Payer: PHP Commercial	$501.09
Rate for Payer: Priority Health Cigna Priority Health	$383.19
Rate for Payer: Priority Health SBD	$371.40

RIFAMPIN 600 MG INTRAVENOUS SOLUTION

Facility

$589.52

Service Code	NDC 00068059701
Hospital Charge Code	11291
Hospital Revenue Code	250
Min. Negotiated Rate	$235.81
Max. Negotiated Rate	$530.57
Rate for Payer: Aetna Commercial	$501.09
Rate for Payer: Aetna Medicare	$294.76
Rate for Payer: Aetna New Business (MI Preferred)	$383.19
Rate for Payer: BCBS Complete	$235.81
Rate for Payer: Cash Price	$471.62
Rate for Payer: Cofinity Commercial	$412.66
Rate for Payer: Cofinity Commercial	$506.99
Rate for Payer: Cofinity Medicare Advantage	$412.66
Rate for Payer: Encore Health Key Benefits Commercial	$471.62
Rate for Payer: Healthscope Commercial	$530.57
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$501.09
Rate for Payer: PHP Commercial	$501.09
Rate for Payer: Priority Health Cigna Priority Health	$383.19
Rate for Payer: Priority Health SBD	$371.40

RIFAXIMIN 550 MG TABLET

Facility

$11,242.53

Service Code	NDC 65649030302
Hospital Charge Code	104604
Hospital Revenue Code	637
Min. Negotiated Rate	$4,497.01
Max. Negotiated Rate	$10,118.28
Rate for Payer: Aetna Commercial	$9,556.15
Rate for Payer: Aetna Medicare	$5,621.26
Rate for Payer: Aetna New Business (MI Preferred)	$7,307.64
Rate for Payer: BCBS Complete	$4,497.01
Rate for Payer: Cash Price	$8,994.02
Rate for Payer: Cofinity Commercial	$7,869.77
Rate for Payer: Cofinity Commercial	$9,668.58
Rate for Payer: Cofinity Medicare Advantage	$7,869.77
Rate for Payer: Encore Health Key Benefits Commercial	$8,994.02
Rate for Payer: Healthscope Commercial	$10,118.28
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$9,556.15
Rate for Payer: PHP Commercial	$9,556.15
Rate for Payer: Priority Health Cigna Priority Health	$7,307.64
Rate for Payer: Priority Health SBD	$7,082.79

RIFAXIMIN 550 MG TABLET

Facility

$11,242.53

Service Code	NDC 65649030303
Hospital Charge Code	104604
Hospital Revenue Code	637
Min. Negotiated Rate	$7,082.79
Max. Negotiated Rate	$10,118.28
Rate for Payer: Aetna Commercial	$9,556.15
Rate for Payer: Aetna New Business (MI Preferred)	$7,307.64
Rate for Payer: Cash Price	$8,994.02
Rate for Payer: Cofinity Commercial	$7,869.77
Rate for Payer: Cofinity Commercial	$9,668.58
Rate for Payer: Cofinity Medicare Advantage	$7,869.77
Rate for Payer: Encore Health Key Benefits Commercial	$8,994.02
Rate for Payer: Healthscope Commercial	$10,118.28
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$9,556.15
Rate for Payer: PHP Commercial	$9,556.15
Rate for Payer: Priority Health Cigna Priority Health	$7,307.64
Rate for Payer: Priority Health SBD	$7,082.79

RIFAXIMIN 550 MG TABLET

Facility

$11,242.53

Service Code	NDC 65649030302
Hospital Charge Code	104604
Hospital Revenue Code	637
Min. Negotiated Rate	$7,082.79
Max. Negotiated Rate	$10,118.28
Rate for Payer: Aetna Commercial	$9,556.15
Rate for Payer: Aetna New Business (MI Preferred)	$7,307.64
Rate for Payer: Cash Price	$8,994.02
Rate for Payer: Cofinity Commercial	$7,869.77
Rate for Payer: Cofinity Commercial	$9,668.58
Rate for Payer: Cofinity Medicare Advantage	$7,869.77
Rate for Payer: Encore Health Key Benefits Commercial	$8,994.02
Rate for Payer: Healthscope Commercial	$10,118.28
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$9,556.15
Rate for Payer: PHP Commercial	$9,556.15
Rate for Payer: Priority Health Cigna Priority Health	$7,307.64
Rate for Payer: Priority Health SBD	$7,082.79

RIFAXIMIN 550 MG TABLET

Facility

$11,242.53

Service Code	NDC 65649030303
Hospital Charge Code	104604
Hospital Revenue Code	637
Min. Negotiated Rate	$4,497.01
Max. Negotiated Rate	$10,118.28
Rate for Payer: Aetna Commercial	$9,556.15
Rate for Payer: Aetna Medicare	$5,621.26
Rate for Payer: Aetna New Business (MI Preferred)	$7,307.64
Rate for Payer: BCBS Complete	$4,497.01
Rate for Payer: Cash Price	$8,994.02
Rate for Payer: Cofinity Commercial	$7,869.77
Rate for Payer: Cofinity Commercial	$9,668.58
Rate for Payer: Cofinity Medicare Advantage	$7,869.77
Rate for Payer: Encore Health Key Benefits Commercial	$8,994.02
Rate for Payer: Healthscope Commercial	$10,118.28
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$9,556.15
Rate for Payer: PHP Commercial	$9,556.15
Rate for Payer: Priority Health Cigna Priority Health	$7,307.64
Rate for Payer: Priority Health SBD	$7,082.79

RINGERS LACTATE INFUSION, UP TO 1000 CC

Facility

$6.82

Service Code	CPT J7120
Hospital Revenue Code	360
Min. Negotiated Rate	$6.82
Max. Negotiated Rate	$6.82
Rate for Payer: BCBS Trust/PPO	$6.82
Rate for Payer: BCN Commercial	$6.82

RISANKIZUMAB-RZAA 60 MG/ML INTRAVENOUS SOLUTION

Facility

$26,969.02

Service Code	HCPCS J2327
Hospital Charge Code	200582
Hospital Revenue Code	636
Min. Negotiated Rate	$8.08
Max. Negotiated Rate	$24,272.12
Rate for Payer: Aetna Commercial	$22,923.67
Rate for Payer: Aetna Medicare	$15.68
Rate for Payer: Aetna New Business (MI Preferred)	$17,529.86
Rate for Payer: Allen County Amish Medical Aid Commercial	$18.85
Rate for Payer: Amish Plain Church Group Commercial	$18.85
Rate for Payer: BCBS Complete	$8.49
Rate for Payer: BCBS MAPPO	$15.08
Rate for Payer: BCBS Trust/PPO	$42.59
Rate for Payer: BCN Commercial	$42.59
Rate for Payer: BCN Medicare Advantage	$15.08
Rate for Payer: Cash Price	$21,575.22
Rate for Payer: Cash Price	$21,575.22
Rate for Payer: Cofinity Commercial	$23,193.36
Rate for Payer: Cofinity Commercial	$18,878.31
Rate for Payer: Cofinity Medicare Advantage	$18,878.31
Rate for Payer: Encore Health Key Benefits Commercial	$21,575.22
Rate for Payer: Health Alliance Plan Medicare Advantage	$15.08
Rate for Payer: Healthscope Commercial	$24,272.12
Rate for Payer: Mclaren Medicaid	$8.08
Rate for Payer: Mclaren Medicare	$15.08
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$15.83
Rate for Payer: Meridian Medicaid	$8.49
Rate for Payer: MI Amish Medical Board Commercial	$17.34
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$22,923.67
Rate for Payer: Nomi Health Commercial	$45.24
Rate for Payer: PACE Medicare	$14.33
Rate for Payer: PACE SWMI	$15.08
Rate for Payer: PHP Commercial	$22,923.67
Rate for Payer: PHP Medicare Advantage	$15.08
Rate for Payer: Priority Health Choice Medicaid	$8.08
Rate for Payer: Priority Health Cigna Priority Health	$17,529.86
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$42.11
Rate for Payer: Priority Health Medicare	$15.08
Rate for Payer: Priority Health Narrow Network	$33.69
Rate for Payer: Priority Health SBD	$16,990.48
Rate for Payer: Railroad Medicare Medicare	$15.08
Rate for Payer: UHC All Payor (Choice/PPO)	$42.45
Rate for Payer: UHC Dual Complete DSNP	$15.08
Rate for Payer: UHC Medicare Advantage	$15.08
Rate for Payer: UHCCP Medicaid	$8.49
Rate for Payer: VA VA	$15.08

RISANKIZUMAB-RZAA 60 MG/ML INTRAVENOUS SOLUTION

Facility

$26,969.02

Service Code	HCPCS J2327
Hospital Charge Code	200582
Hospital Revenue Code	636
Min. Negotiated Rate	$16,990.48
Max. Negotiated Rate	$24,272.12
Rate for Payer: Aetna Commercial	$22,923.67
Rate for Payer: Aetna New Business (MI Preferred)	$17,529.86
Rate for Payer: Cash Price	$21,575.22
Rate for Payer: Cofinity Commercial	$18,878.31
Rate for Payer: Cofinity Commercial	$23,193.36
Rate for Payer: Cofinity Medicare Advantage	$18,878.31
Rate for Payer: Encore Health Key Benefits Commercial	$21,575.22
Rate for Payer: Healthscope Commercial	$24,272.12
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$22,923.67
Rate for Payer: PHP Commercial	$22,923.67
Rate for Payer: Priority Health Cigna Priority Health	$17,529.86
Rate for Payer: Priority Health SBD	$16,990.48

RISPERIDONE 0.25 MG TABLET

Facility

$249.85

Service Code	NDC 51079046020
Hospital Charge Code	25519
Hospital Revenue Code	637
Min. Negotiated Rate	$157.41
Max. Negotiated Rate	$224.86
Rate for Payer: Aetna Commercial	$212.37
Rate for Payer: Aetna New Business (MI Preferred)	$162.40
Rate for Payer: Cash Price	$199.88
Rate for Payer: Cofinity Commercial	$174.90
Rate for Payer: Cofinity Commercial	$214.87
Rate for Payer: Cofinity Medicare Advantage	$174.90
Rate for Payer: Encore Health Key Benefits Commercial	$199.88
Rate for Payer: Healthscope Commercial	$224.86
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$212.37
Rate for Payer: PHP Commercial	$212.37
Rate for Payer: Priority Health Cigna Priority Health	$162.40
Rate for Payer: Priority Health SBD	$157.41

RISPERIDONE 0.25 MG TABLET

Facility

$198.55

Service Code	NDC 68084027001
Hospital Charge Code	25519
Hospital Revenue Code	637
Min. Negotiated Rate	$79.42
Max. Negotiated Rate	$178.70
Rate for Payer: Aetna Commercial	$168.77
Rate for Payer: Aetna Medicare	$99.28
Rate for Payer: Aetna New Business (MI Preferred)	$129.06
Rate for Payer: BCBS Complete	$79.42
Rate for Payer: Cash Price	$158.84
Rate for Payer: Cofinity Commercial	$138.98
Rate for Payer: Cofinity Commercial	$170.75
Rate for Payer: Cofinity Medicare Advantage	$138.98
Rate for Payer: Encore Health Key Benefits Commercial	$158.84
Rate for Payer: Healthscope Commercial	$178.70
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$168.77
Rate for Payer: PHP Commercial	$168.77
Rate for Payer: Priority Health Cigna Priority Health	$129.06
Rate for Payer: Priority Health SBD	$125.09

RISPERIDONE 0.25 MG TABLET

Facility

$1.99

Service Code	NDC 68084027011
Hospital Charge Code	25519
Hospital Revenue Code	637
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$1.79
Rate for Payer: Aetna Commercial	$1.69
Rate for Payer: Aetna New Business (MI Preferred)	$1.29
Rate for Payer: Cash Price	$1.59
Rate for Payer: Cofinity Commercial	$1.39
Rate for Payer: Cofinity Commercial	$1.71
Rate for Payer: Cofinity Medicare Advantage	$1.39
Rate for Payer: Encore Health Key Benefits Commercial	$1.59
Rate for Payer: Healthscope Commercial	$1.79
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1.69
Rate for Payer: PHP Commercial	$1.69
Rate for Payer: Priority Health Cigna Priority Health	$1.29
Rate for Payer: Priority Health SBD	$1.25

RISPERIDONE 0.25 MG TABLET

Facility

$310.20

Service Code	NDC 00904635761
Hospital Charge Code	25519
Hospital Revenue Code	637
Min. Negotiated Rate	$195.43
Max. Negotiated Rate	$279.18
Rate for Payer: Aetna Commercial	$263.67
Rate for Payer: Aetna New Business (MI Preferred)	$201.63
Rate for Payer: Cash Price	$248.16
Rate for Payer: Cofinity Commercial	$217.14
Rate for Payer: Cofinity Commercial	$266.77
Rate for Payer: Cofinity Medicare Advantage	$217.14
Rate for Payer: Encore Health Key Benefits Commercial	$248.16
Rate for Payer: Healthscope Commercial	$279.18
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$263.67
Rate for Payer: PHP Commercial	$263.67
Rate for Payer: Priority Health Cigna Priority Health	$201.63
Rate for Payer: Priority Health SBD	$195.43

RISPERIDONE 0.25 MG TABLET

Facility

$310.20

Service Code	NDC 00904635761
Hospital Charge Code	25519
Hospital Revenue Code	637
Min. Negotiated Rate	$124.08
Max. Negotiated Rate	$279.18
Rate for Payer: Aetna Commercial	$263.67
Rate for Payer: Aetna Medicare	$155.10
Rate for Payer: Aetna New Business (MI Preferred)	$201.63
Rate for Payer: BCBS Complete	$124.08
Rate for Payer: Cash Price	$248.16
Rate for Payer: Cofinity Commercial	$217.14
Rate for Payer: Cofinity Commercial	$266.77
Rate for Payer: Cofinity Medicare Advantage	$217.14
Rate for Payer: Encore Health Key Benefits Commercial	$248.16
Rate for Payer: Healthscope Commercial	$279.18
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$263.67
Rate for Payer: PHP Commercial	$263.67
Rate for Payer: Priority Health Cigna Priority Health	$201.63
Rate for Payer: Priority Health SBD	$195.43

RISPERIDONE 0.25 MG TABLET

Facility

$198.55

Service Code	NDC 68084027001
Hospital Charge Code	25519
Hospital Revenue Code	637
Min. Negotiated Rate	$125.09
Max. Negotiated Rate	$178.70
Rate for Payer: Aetna Commercial	$168.77
Rate for Payer: Aetna New Business (MI Preferred)	$129.06
Rate for Payer: Cash Price	$158.84
Rate for Payer: Cofinity Commercial	$138.98
Rate for Payer: Cofinity Commercial	$170.75
Rate for Payer: Cofinity Medicare Advantage	$138.98
Rate for Payer: Encore Health Key Benefits Commercial	$158.84
Rate for Payer: Healthscope Commercial	$178.70
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$168.77
Rate for Payer: PHP Commercial	$168.77
Rate for Payer: Priority Health Cigna Priority Health	$129.06
Rate for Payer: Priority Health SBD	$125.09

RISPERIDONE 0.25 MG TABLET

Facility

$1.99

Service Code	NDC 68084027011
Hospital Charge Code	25519
Hospital Revenue Code	637
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$1.79
Rate for Payer: Aetna Commercial	$1.69
Rate for Payer: Aetna Medicare	$1.00
Rate for Payer: Aetna New Business (MI Preferred)	$1.29
Rate for Payer: BCBS Complete	$0.80
Rate for Payer: Cash Price	$1.59
Rate for Payer: Cofinity Commercial	$1.39
Rate for Payer: Cofinity Commercial	$1.71
Rate for Payer: Cofinity Medicare Advantage	$1.39
Rate for Payer: Encore Health Key Benefits Commercial	$1.59
Rate for Payer: Healthscope Commercial	$1.79
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1.69
Rate for Payer: PHP Commercial	$1.69
Rate for Payer: Priority Health Cigna Priority Health	$1.29
Rate for Payer: Priority Health SBD	$1.25

RISPERIDONE 0.25 MG TABLET

Facility

$249.85

Service Code	NDC 51079046020
Hospital Charge Code	25519
Hospital Revenue Code	637
Min. Negotiated Rate	$99.94
Max. Negotiated Rate	$224.86
Rate for Payer: Aetna Commercial	$212.37
Rate for Payer: Aetna Medicare	$124.92
Rate for Payer: Aetna New Business (MI Preferred)	$162.40
Rate for Payer: BCBS Complete	$99.94
Rate for Payer: Cash Price	$199.88
Rate for Payer: Cofinity Commercial	$174.90
Rate for Payer: Cofinity Commercial	$214.87
Rate for Payer: Cofinity Medicare Advantage	$174.90
Rate for Payer: Encore Health Key Benefits Commercial	$199.88
Rate for Payer: Healthscope Commercial	$224.86
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$212.37
Rate for Payer: PHP Commercial	$212.37
Rate for Payer: Priority Health Cigna Priority Health	$162.40
Rate for Payer: Priority Health SBD	$157.41

RISPERIDONE 0.5 MG TABLET

Facility

$453.55

Service Code	NDC 68084027101
Hospital Charge Code	25520
Hospital Revenue Code	637
Min. Negotiated Rate	$285.74
Max. Negotiated Rate	$408.20
Rate for Payer: Aetna Commercial	$385.52
Rate for Payer: Aetna New Business (MI Preferred)	$294.81
Rate for Payer: Cash Price	$362.84
Rate for Payer: Cofinity Commercial	$317.48
Rate for Payer: Cofinity Commercial	$390.05
Rate for Payer: Cofinity Medicare Advantage	$317.48
Rate for Payer: Encore Health Key Benefits Commercial	$362.84
Rate for Payer: Healthscope Commercial	$408.20
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$385.52
Rate for Payer: PHP Commercial	$385.52
Rate for Payer: Priority Health Cigna Priority Health	$294.81
Rate for Payer: Priority Health SBD	$285.74

Know your out-of-pocket cost for care.

All Charges