Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

RIVAROXABAN 2.5 MG TABLET

Facility

$23.50

Service Code	NDC 50458057710
Hospital Charge Code	188575
Hospital Revenue Code	637
Min. Negotiated Rate	$9.40
Max. Negotiated Rate	$21.15
Rate for Payer: Aetna Commercial	$19.98
Rate for Payer: Aetna Medicare	$11.75
Rate for Payer: Aetna New Business (MI Preferred)	$15.28
Rate for Payer: BCBS Complete	$9.40
Rate for Payer: Cash Price	$18.80
Rate for Payer: Cofinity Commercial	$16.45
Rate for Payer: Cofinity Commercial	$20.21
Rate for Payer: Cofinity Medicare Advantage	$16.45
Rate for Payer: Encore Health Key Benefits Commercial	$18.80
Rate for Payer: Healthscope Commercial	$21.15
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$19.98
Rate for Payer: PHP Commercial	$19.98
Rate for Payer: Priority Health Cigna Priority Health	$15.28
Rate for Payer: Priority Health SBD	$14.80

RIVASTIGMINE 13.3 MG/24 HOUR TRANSDERMAL PATCH

Facility

$256.61

Service Code	NDC 65162074934
Hospital Charge Code	162142
Hospital Revenue Code	637
Min. Negotiated Rate	$161.66
Max. Negotiated Rate	$230.95
Rate for Payer: Aetna Commercial	$218.12
Rate for Payer: Aetna New Business (MI Preferred)	$166.80
Rate for Payer: Cash Price	$205.29
Rate for Payer: Cofinity Commercial	$179.63
Rate for Payer: Cofinity Commercial	$220.68
Rate for Payer: Cofinity Medicare Advantage	$179.63
Rate for Payer: Encore Health Key Benefits Commercial	$205.29
Rate for Payer: Healthscope Commercial	$230.95
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$218.12
Rate for Payer: PHP Commercial	$218.12
Rate for Payer: Priority Health Cigna Priority Health	$166.80
Rate for Payer: Priority Health SBD	$161.66

RIVASTIGMINE 13.3 MG/24 HOUR TRANSDERMAL PATCH

Facility

$2,360.53

Service Code	NDC 00078050315
Hospital Charge Code	162142
Hospital Revenue Code	637
Min. Negotiated Rate	$1,487.13
Max. Negotiated Rate	$2,124.48
Rate for Payer: Aetna Commercial	$2,006.45
Rate for Payer: Aetna New Business (MI Preferred)	$1,534.34
Rate for Payer: Cash Price	$1,888.42
Rate for Payer: Cofinity Commercial	$1,652.37
Rate for Payer: Cofinity Commercial	$2,030.06
Rate for Payer: Cofinity Medicare Advantage	$1,652.37
Rate for Payer: Encore Health Key Benefits Commercial	$1,888.42
Rate for Payer: Healthscope Commercial	$2,124.48
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2,006.45
Rate for Payer: PHP Commercial	$2,006.45
Rate for Payer: Priority Health Cigna Priority Health	$1,534.34
Rate for Payer: Priority Health SBD	$1,487.13

RIVASTIGMINE 13.3 MG/24 HOUR TRANSDERMAL PATCH

Facility

$78.69

Service Code	NDC 00078050361
Hospital Charge Code	162142
Hospital Revenue Code	637
Min. Negotiated Rate	$31.48
Max. Negotiated Rate	$70.82
Rate for Payer: Aetna Commercial	$66.89
Rate for Payer: Aetna Medicare	$39.34
Rate for Payer: Aetna New Business (MI Preferred)	$51.15
Rate for Payer: BCBS Complete	$31.48
Rate for Payer: Cash Price	$62.95
Rate for Payer: Cofinity Commercial	$55.08
Rate for Payer: Cofinity Commercial	$67.67
Rate for Payer: Cofinity Medicare Advantage	$55.08
Rate for Payer: Encore Health Key Benefits Commercial	$62.95
Rate for Payer: Healthscope Commercial	$70.82
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$66.89
Rate for Payer: PHP Commercial	$66.89
Rate for Payer: Priority Health Cigna Priority Health	$51.15
Rate for Payer: Priority Health SBD	$49.57

RIVASTIGMINE 13.3 MG/24 HOUR TRANSDERMAL PATCH

Facility

$256.61

Service Code	NDC 65162074934
Hospital Charge Code	162142
Hospital Revenue Code	637
Min. Negotiated Rate	$102.64
Max. Negotiated Rate	$230.95
Rate for Payer: Aetna Commercial	$218.12
Rate for Payer: Aetna Medicare	$128.31
Rate for Payer: Aetna New Business (MI Preferred)	$166.80
Rate for Payer: BCBS Complete	$102.64
Rate for Payer: Cash Price	$205.29
Rate for Payer: Cofinity Commercial	$179.63
Rate for Payer: Cofinity Commercial	$220.68
Rate for Payer: Cofinity Medicare Advantage	$179.63
Rate for Payer: Encore Health Key Benefits Commercial	$205.29
Rate for Payer: Healthscope Commercial	$230.95
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$218.12
Rate for Payer: PHP Commercial	$218.12
Rate for Payer: Priority Health Cigna Priority Health	$166.80
Rate for Payer: Priority Health SBD	$161.66

RIVASTIGMINE 13.3 MG/24 HOUR TRANSDERMAL PATCH

Facility

$2,360.53

Service Code	NDC 00078050315
Hospital Charge Code	162142
Hospital Revenue Code	637
Min. Negotiated Rate	$944.21
Max. Negotiated Rate	$2,124.48
Rate for Payer: Aetna Commercial	$2,006.45
Rate for Payer: Aetna Medicare	$1,180.27
Rate for Payer: Aetna New Business (MI Preferred)	$1,534.34
Rate for Payer: BCBS Complete	$944.21
Rate for Payer: Cash Price	$1,888.42
Rate for Payer: Cofinity Commercial	$1,652.37
Rate for Payer: Cofinity Commercial	$2,030.06
Rate for Payer: Cofinity Medicare Advantage	$1,652.37
Rate for Payer: Encore Health Key Benefits Commercial	$1,888.42
Rate for Payer: Healthscope Commercial	$2,124.48
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2,006.45
Rate for Payer: PHP Commercial	$2,006.45
Rate for Payer: Priority Health Cigna Priority Health	$1,534.34
Rate for Payer: Priority Health SBD	$1,487.13

RIVASTIGMINE 13.3 MG/24 HOUR TRANSDERMAL PATCH

Facility

$78.69

Service Code	NDC 00078050361
Hospital Charge Code	162142
Hospital Revenue Code	637
Min. Negotiated Rate	$49.57
Max. Negotiated Rate	$70.82
Rate for Payer: Aetna Commercial	$66.89
Rate for Payer: Aetna New Business (MI Preferred)	$51.15
Rate for Payer: Cash Price	$62.95
Rate for Payer: Cofinity Commercial	$55.08
Rate for Payer: Cofinity Commercial	$67.67
Rate for Payer: Cofinity Medicare Advantage	$55.08
Rate for Payer: Encore Health Key Benefits Commercial	$62.95
Rate for Payer: Healthscope Commercial	$70.82
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$66.89
Rate for Payer: PHP Commercial	$66.89
Rate for Payer: Priority Health Cigna Priority Health	$51.15
Rate for Payer: Priority Health SBD	$49.57

RIVASTIGMINE 1.5 MG CAPSULE

Facility

$159.56

Service Code	NDC 55111035260
Hospital Charge Code	28278
Hospital Revenue Code	637
Min. Negotiated Rate	$100.52
Max. Negotiated Rate	$143.60
Rate for Payer: Aetna Commercial	$135.63
Rate for Payer: Aetna New Business (MI Preferred)	$103.71
Rate for Payer: Cash Price	$127.65
Rate for Payer: Cofinity Commercial	$111.69
Rate for Payer: Cofinity Commercial	$137.22
Rate for Payer: Cofinity Medicare Advantage	$111.69
Rate for Payer: Encore Health Key Benefits Commercial	$127.65
Rate for Payer: Healthscope Commercial	$143.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$135.63
Rate for Payer: PHP Commercial	$135.63
Rate for Payer: Priority Health Cigna Priority Health	$103.71
Rate for Payer: Priority Health SBD	$100.52

RIVASTIGMINE 1.5 MG CAPSULE

Facility

$959.04

Service Code	NDC 00904710761
Hospital Charge Code	28278
Hospital Revenue Code	637
Min. Negotiated Rate	$604.20
Max. Negotiated Rate	$863.14
Rate for Payer: Aetna Commercial	$815.18
Rate for Payer: Aetna New Business (MI Preferred)	$623.38
Rate for Payer: Cash Price	$767.23
Rate for Payer: Cofinity Commercial	$671.33
Rate for Payer: Cofinity Commercial	$824.77
Rate for Payer: Cofinity Medicare Advantage	$671.33
Rate for Payer: Encore Health Key Benefits Commercial	$767.23
Rate for Payer: Healthscope Commercial	$863.14
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$815.18
Rate for Payer: PHP Commercial	$815.18
Rate for Payer: Priority Health Cigna Priority Health	$623.38
Rate for Payer: Priority Health SBD	$604.20

RIVASTIGMINE 1.5 MG CAPSULE

Facility

$159.56

Service Code	NDC 55111035260
Hospital Charge Code	28278
Hospital Revenue Code	637
Min. Negotiated Rate	$63.82
Max. Negotiated Rate	$143.60
Rate for Payer: Aetna Commercial	$135.63
Rate for Payer: Aetna Medicare	$79.78
Rate for Payer: Aetna New Business (MI Preferred)	$103.71
Rate for Payer: BCBS Complete	$63.82
Rate for Payer: Cash Price	$127.65
Rate for Payer: Cofinity Commercial	$111.69
Rate for Payer: Cofinity Commercial	$137.22
Rate for Payer: Cofinity Medicare Advantage	$111.69
Rate for Payer: Encore Health Key Benefits Commercial	$127.65
Rate for Payer: Healthscope Commercial	$143.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$135.63
Rate for Payer: PHP Commercial	$135.63
Rate for Payer: Priority Health Cigna Priority Health	$103.71
Rate for Payer: Priority Health SBD	$100.52

RIVASTIGMINE 1.5 MG CAPSULE

Facility

$959.04

Service Code	NDC 00904710761
Hospital Charge Code	28278
Hospital Revenue Code	637
Min. Negotiated Rate	$383.62
Max. Negotiated Rate	$863.14
Rate for Payer: Aetna Commercial	$815.18
Rate for Payer: Aetna Medicare	$479.52
Rate for Payer: Aetna New Business (MI Preferred)	$623.38
Rate for Payer: BCBS Complete	$383.62
Rate for Payer: Cash Price	$767.23
Rate for Payer: Cofinity Commercial	$671.33
Rate for Payer: Cofinity Commercial	$824.77
Rate for Payer: Cofinity Medicare Advantage	$671.33
Rate for Payer: Encore Health Key Benefits Commercial	$767.23
Rate for Payer: Healthscope Commercial	$863.14
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$815.18
Rate for Payer: PHP Commercial	$815.18
Rate for Payer: Priority Health Cigna Priority Health	$623.38
Rate for Payer: Priority Health SBD	$604.20

RIVASTIGMINE 4.6 MG/24 HOUR TRANSDERMAL PATCH

Facility

$2,360.53

Service Code	NDC 00078050115
Hospital Charge Code	82504
Hospital Revenue Code	637
Min. Negotiated Rate	$1,487.13
Max. Negotiated Rate	$2,124.48
Rate for Payer: Aetna Commercial	$2,006.45
Rate for Payer: Aetna New Business (MI Preferred)	$1,534.34
Rate for Payer: Cash Price	$1,888.42
Rate for Payer: Cofinity Commercial	$1,652.37
Rate for Payer: Cofinity Commercial	$2,030.06
Rate for Payer: Cofinity Medicare Advantage	$1,652.37
Rate for Payer: Encore Health Key Benefits Commercial	$1,888.42
Rate for Payer: Healthscope Commercial	$2,124.48
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2,006.45
Rate for Payer: PHP Commercial	$2,006.45
Rate for Payer: Priority Health Cigna Priority Health	$1,534.34
Rate for Payer: Priority Health SBD	$1,487.13

RIVASTIGMINE 4.6 MG/24 HOUR TRANSDERMAL PATCH

Facility

$39.03

Service Code	NDC 47781030411
Hospital Charge Code	82504
Hospital Revenue Code	637
Min. Negotiated Rate	$24.59
Max. Negotiated Rate	$35.13
Rate for Payer: Aetna Commercial	$33.18
Rate for Payer: Aetna New Business (MI Preferred)	$25.37
Rate for Payer: Cash Price	$31.22
Rate for Payer: Cofinity Commercial	$27.32
Rate for Payer: Cofinity Commercial	$33.57
Rate for Payer: Cofinity Medicare Advantage	$27.32
Rate for Payer: Encore Health Key Benefits Commercial	$31.22
Rate for Payer: Healthscope Commercial	$35.13
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$33.18
Rate for Payer: PHP Commercial	$33.18
Rate for Payer: Priority Health Cigna Priority Health	$25.37
Rate for Payer: Priority Health SBD	$24.59

RIVASTIGMINE 4.6 MG/24 HOUR TRANSDERMAL PATCH

Facility

$1,170.83

Service Code	NDC 47781030403
Hospital Charge Code	82504
Hospital Revenue Code	637
Min. Negotiated Rate	$737.62
Max. Negotiated Rate	$1,053.75
Rate for Payer: Aetna Commercial	$995.21
Rate for Payer: Aetna New Business (MI Preferred)	$761.04
Rate for Payer: Cash Price	$936.66
Rate for Payer: Cofinity Commercial	$1,006.91
Rate for Payer: Cofinity Commercial	$819.58
Rate for Payer: Cofinity Medicare Advantage	$819.58
Rate for Payer: Encore Health Key Benefits Commercial	$936.66
Rate for Payer: Healthscope Commercial	$1,053.75
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$995.21
Rate for Payer: PHP Commercial	$995.21
Rate for Payer: Priority Health Cigna Priority Health	$761.04
Rate for Payer: Priority Health SBD	$737.62

RIVASTIGMINE 4.6 MG/24 HOUR TRANSDERMAL PATCH

Facility

$39.03

Service Code	NDC 47781030411
Hospital Charge Code	82504
Hospital Revenue Code	637
Min. Negotiated Rate	$15.61
Max. Negotiated Rate	$35.13
Rate for Payer: Aetna Commercial	$33.18
Rate for Payer: Aetna Medicare	$19.52
Rate for Payer: Aetna New Business (MI Preferred)	$25.37
Rate for Payer: BCBS Complete	$15.61
Rate for Payer: Cash Price	$31.22
Rate for Payer: Cofinity Commercial	$27.32
Rate for Payer: Cofinity Commercial	$33.57
Rate for Payer: Cofinity Medicare Advantage	$27.32
Rate for Payer: Encore Health Key Benefits Commercial	$31.22
Rate for Payer: Healthscope Commercial	$35.13
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$33.18
Rate for Payer: PHP Commercial	$33.18
Rate for Payer: Priority Health Cigna Priority Health	$25.37
Rate for Payer: Priority Health SBD	$24.59

RIVASTIGMINE 4.6 MG/24 HOUR TRANSDERMAL PATCH

Facility

$2,360.53

Service Code	NDC 00078050115
Hospital Charge Code	82504
Hospital Revenue Code	637
Min. Negotiated Rate	$944.21
Max. Negotiated Rate	$2,124.48
Rate for Payer: Aetna Commercial	$2,006.45
Rate for Payer: Aetna Medicare	$1,180.27
Rate for Payer: Aetna New Business (MI Preferred)	$1,534.34
Rate for Payer: BCBS Complete	$944.21
Rate for Payer: Cash Price	$1,888.42
Rate for Payer: Cofinity Commercial	$1,652.37
Rate for Payer: Cofinity Commercial	$2,030.06
Rate for Payer: Cofinity Medicare Advantage	$1,652.37
Rate for Payer: Encore Health Key Benefits Commercial	$1,888.42
Rate for Payer: Healthscope Commercial	$2,124.48
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2,006.45
Rate for Payer: PHP Commercial	$2,006.45
Rate for Payer: Priority Health Cigna Priority Health	$1,534.34
Rate for Payer: Priority Health SBD	$1,487.13

RIVASTIGMINE 4.6 MG/24 HOUR TRANSDERMAL PATCH

Facility

$1,170.83

Service Code	NDC 47781030403
Hospital Charge Code	82504
Hospital Revenue Code	637
Min. Negotiated Rate	$468.33
Max. Negotiated Rate	$1,053.75
Rate for Payer: Aetna Commercial	$995.21
Rate for Payer: Aetna Medicare	$585.41
Rate for Payer: Aetna New Business (MI Preferred)	$761.04
Rate for Payer: BCBS Complete	$468.33
Rate for Payer: Cash Price	$936.66
Rate for Payer: Cofinity Commercial	$1,006.91
Rate for Payer: Cofinity Commercial	$819.58
Rate for Payer: Cofinity Medicare Advantage	$819.58
Rate for Payer: Encore Health Key Benefits Commercial	$936.66
Rate for Payer: Healthscope Commercial	$1,053.75
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$995.21
Rate for Payer: PHP Commercial	$995.21
Rate for Payer: Priority Health Cigna Priority Health	$761.04
Rate for Payer: Priority Health SBD	$737.62

RIVASTIGMINE 9.5 MG/24 HOUR TRANSDERMAL PATCH

Facility

$78.69

Service Code	NDC 00078050261
Hospital Charge Code	82505
Hospital Revenue Code	637
Min. Negotiated Rate	$31.48
Max. Negotiated Rate	$70.82
Rate for Payer: Aetna Commercial	$66.89
Rate for Payer: Aetna Medicare	$39.34
Rate for Payer: Aetna New Business (MI Preferred)	$51.15
Rate for Payer: BCBS Complete	$31.48
Rate for Payer: Cash Price	$62.95
Rate for Payer: Cofinity Commercial	$55.08
Rate for Payer: Cofinity Commercial	$67.67
Rate for Payer: Cofinity Medicare Advantage	$55.08
Rate for Payer: Encore Health Key Benefits Commercial	$62.95
Rate for Payer: Healthscope Commercial	$70.82
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$66.89
Rate for Payer: PHP Commercial	$66.89
Rate for Payer: Priority Health Cigna Priority Health	$51.15
Rate for Payer: Priority Health SBD	$49.57

RIVASTIGMINE 9.5 MG/24 HOUR TRANSDERMAL PATCH

Facility

$46.52

Service Code	NDC 00781730958
Hospital Charge Code	82505
Hospital Revenue Code	637
Min. Negotiated Rate	$18.61
Max. Negotiated Rate	$41.87
Rate for Payer: Aetna Commercial	$39.54
Rate for Payer: Aetna Medicare	$23.26
Rate for Payer: Aetna New Business (MI Preferred)	$30.24
Rate for Payer: BCBS Complete	$18.61
Rate for Payer: Cash Price	$37.22
Rate for Payer: Cofinity Commercial	$32.56
Rate for Payer: Cofinity Commercial	$40.01
Rate for Payer: Cofinity Medicare Advantage	$32.56
Rate for Payer: Encore Health Key Benefits Commercial	$37.22
Rate for Payer: Healthscope Commercial	$41.87
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$39.54
Rate for Payer: PHP Commercial	$39.54
Rate for Payer: Priority Health Cigna Priority Health	$30.24
Rate for Payer: Priority Health SBD	$29.31

RIVASTIGMINE 9.5 MG/24 HOUR TRANSDERMAL PATCH

Facility

$46.52

Service Code	NDC 00781730958
Hospital Charge Code	82505
Hospital Revenue Code	637
Min. Negotiated Rate	$29.31
Max. Negotiated Rate	$41.87
Rate for Payer: Aetna Commercial	$39.54
Rate for Payer: Aetna New Business (MI Preferred)	$30.24
Rate for Payer: Cash Price	$37.22
Rate for Payer: Cofinity Commercial	$32.56
Rate for Payer: Cofinity Commercial	$40.01
Rate for Payer: Cofinity Medicare Advantage	$32.56
Rate for Payer: Encore Health Key Benefits Commercial	$37.22
Rate for Payer: Healthscope Commercial	$41.87
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$39.54
Rate for Payer: PHP Commercial	$39.54
Rate for Payer: Priority Health Cigna Priority Health	$30.24
Rate for Payer: Priority Health SBD	$29.31

RIVASTIGMINE 9.5 MG/24 HOUR TRANSDERMAL PATCH

Facility

$1,395.39

Service Code	NDC 00781730931
Hospital Charge Code	82505
Hospital Revenue Code	637
Min. Negotiated Rate	$558.16
Max. Negotiated Rate	$1,255.85
Rate for Payer: Aetna Commercial	$1,186.08
Rate for Payer: Aetna Medicare	$697.70
Rate for Payer: Aetna New Business (MI Preferred)	$907.00
Rate for Payer: BCBS Complete	$558.16
Rate for Payer: Cash Price	$1,116.31
Rate for Payer: Cofinity Commercial	$1,200.04
Rate for Payer: Cofinity Commercial	$976.77
Rate for Payer: Cofinity Medicare Advantage	$976.77
Rate for Payer: Encore Health Key Benefits Commercial	$1,116.31
Rate for Payer: Healthscope Commercial	$1,255.85
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,186.08
Rate for Payer: PHP Commercial	$1,186.08
Rate for Payer: Priority Health Cigna Priority Health	$907.00
Rate for Payer: Priority Health SBD	$879.10

RIVASTIGMINE 9.5 MG/24 HOUR TRANSDERMAL PATCH

Facility

$78.69

Service Code	NDC 00078050261
Hospital Charge Code	82505
Hospital Revenue Code	637
Min. Negotiated Rate	$49.57
Max. Negotiated Rate	$70.82
Rate for Payer: Aetna Commercial	$66.89
Rate for Payer: Aetna New Business (MI Preferred)	$51.15
Rate for Payer: Cash Price	$62.95
Rate for Payer: Cofinity Commercial	$55.08
Rate for Payer: Cofinity Commercial	$67.67
Rate for Payer: Cofinity Medicare Advantage	$55.08
Rate for Payer: Encore Health Key Benefits Commercial	$62.95
Rate for Payer: Healthscope Commercial	$70.82
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$66.89
Rate for Payer: PHP Commercial	$66.89
Rate for Payer: Priority Health Cigna Priority Health	$51.15
Rate for Payer: Priority Health SBD	$49.57

RIVASTIGMINE 9.5 MG/24 HOUR TRANSDERMAL PATCH

Facility

$1,395.39

Service Code	NDC 00781730931
Hospital Charge Code	82505
Hospital Revenue Code	637
Min. Negotiated Rate	$879.10
Max. Negotiated Rate	$1,255.85
Rate for Payer: Aetna Commercial	$1,186.08
Rate for Payer: Aetna New Business (MI Preferred)	$907.00
Rate for Payer: Cash Price	$1,116.31
Rate for Payer: Cofinity Commercial	$1,200.04
Rate for Payer: Cofinity Commercial	$976.77
Rate for Payer: Cofinity Medicare Advantage	$976.77
Rate for Payer: Encore Health Key Benefits Commercial	$1,116.31
Rate for Payer: Healthscope Commercial	$1,255.85
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,186.08
Rate for Payer: PHP Commercial	$1,186.08
Rate for Payer: Priority Health Cigna Priority Health	$907.00
Rate for Payer: Priority Health SBD	$879.10

RIVASTIGMINE 9.5 MG/24 HOUR TRANSDERMAL PATCH

Facility

$2,360.53

Service Code	NDC 00078050215
Hospital Charge Code	82505
Hospital Revenue Code	637
Min. Negotiated Rate	$1,487.13
Max. Negotiated Rate	$2,124.48
Rate for Payer: Aetna Commercial	$2,006.45
Rate for Payer: Aetna New Business (MI Preferred)	$1,534.34
Rate for Payer: Cash Price	$1,888.42
Rate for Payer: Cofinity Commercial	$1,652.37
Rate for Payer: Cofinity Commercial	$2,030.06
Rate for Payer: Cofinity Medicare Advantage	$1,652.37
Rate for Payer: Encore Health Key Benefits Commercial	$1,888.42
Rate for Payer: Healthscope Commercial	$2,124.48
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2,006.45
Rate for Payer: PHP Commercial	$2,006.45
Rate for Payer: Priority Health Cigna Priority Health	$1,534.34
Rate for Payer: Priority Health SBD	$1,487.13

RIVASTIGMINE 9.5 MG/24 HOUR TRANSDERMAL PATCH

Facility

$2,360.53

Service Code	NDC 00078050215
Hospital Charge Code	82505
Hospital Revenue Code	637
Min. Negotiated Rate	$944.21
Max. Negotiated Rate	$2,124.48
Rate for Payer: Aetna Commercial	$2,006.45
Rate for Payer: Aetna Medicare	$1,180.27
Rate for Payer: Aetna New Business (MI Preferred)	$1,534.34
Rate for Payer: BCBS Complete	$944.21
Rate for Payer: Cash Price	$1,888.42
Rate for Payer: Cofinity Commercial	$1,652.37
Rate for Payer: Cofinity Commercial	$2,030.06
Rate for Payer: Cofinity Medicare Advantage	$1,652.37
Rate for Payer: Encore Health Key Benefits Commercial	$1,888.42
Rate for Payer: Healthscope Commercial	$2,124.48
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2,006.45
Rate for Payer: PHP Commercial	$2,006.45
Rate for Payer: Priority Health Cigna Priority Health	$1,534.34
Rate for Payer: Priority Health SBD	$1,487.13

Know your out-of-pocket cost for care.

All Charges