Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH

Facility

$63.25

Service Code	NDC 00378647016
Hospital Charge Code	27696
Hospital Revenue Code	637
Min. Negotiated Rate	$39.85
Max. Negotiated Rate	$56.92
Rate for Payer: Aetna Commercial	$53.76
Rate for Payer: Aetna New Business (MI Preferred)	$41.11
Rate for Payer: Cash Price	$50.60
Rate for Payer: Cofinity Commercial	$44.27
Rate for Payer: Cofinity Commercial	$54.40
Rate for Payer: Cofinity Medicare Advantage	$44.27
Rate for Payer: Encore Health Key Benefits Commercial	$50.60
Rate for Payer: Healthscope Commercial	$56.92
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$53.76
Rate for Payer: PHP Commercial	$53.76
Rate for Payer: Priority Health Cigna Priority Health	$41.11
Rate for Payer: Priority Health SBD	$39.85

SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH

Facility

$24.23

Service Code	NDC 50742050501
Hospital Charge Code	27696
Hospital Revenue Code	637
Min. Negotiated Rate	$9.69
Max. Negotiated Rate	$21.81
Rate for Payer: Aetna Commercial	$20.60
Rate for Payer: Aetna Medicare	$12.12
Rate for Payer: Aetna New Business (MI Preferred)	$15.75
Rate for Payer: BCBS Complete	$9.69
Rate for Payer: Cash Price	$19.38
Rate for Payer: Cofinity Commercial	$16.96
Rate for Payer: Cofinity Commercial	$20.84
Rate for Payer: Cofinity Medicare Advantage	$16.96
Rate for Payer: Encore Health Key Benefits Commercial	$19.38
Rate for Payer: Healthscope Commercial	$21.81
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$20.60
Rate for Payer: PHP Commercial	$20.60
Rate for Payer: Priority Health Cigna Priority Health	$15.75
Rate for Payer: Priority Health SBD	$15.26

SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH

Facility

$632.41

Service Code	NDC 00378647097
Hospital Charge Code	27696
Hospital Revenue Code	637
Min. Negotiated Rate	$398.42
Max. Negotiated Rate	$569.17
Rate for Payer: Aetna Commercial	$537.55
Rate for Payer: Aetna New Business (MI Preferred)	$411.07
Rate for Payer: Cash Price	$505.93
Rate for Payer: Cofinity Commercial	$442.69
Rate for Payer: Cofinity Commercial	$543.87
Rate for Payer: Cofinity Medicare Advantage	$442.69
Rate for Payer: Encore Health Key Benefits Commercial	$505.93
Rate for Payer: Healthscope Commercial	$569.17
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$537.55
Rate for Payer: PHP Commercial	$537.55
Rate for Payer: Priority Health Cigna Priority Health	$411.07
Rate for Payer: Priority Health SBD	$398.42

SCREENING OF A PATIENT

Professional

Both

$15.00

Service Code	HCPCS D0190
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$9.75
Rate for Payer: Aetna Medicare	$7.50
Rate for Payer: BCBS Complete	$6.00
Rate for Payer: Cash Price	$12.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$9.75
Rate for Payer: Priority Health Cigna Priority Health	$9.75

SCROTAL EXPLORATION

Facility

$9,468.51

Service Code	CPT 55110
Hospital Revenue Code	360
Min. Negotiated Rate	$1,802.95
Max. Negotiated Rate	$9,468.51
Rate for Payer: Aetna Medicare	$3,498.26
Rate for Payer: Allen County Amish Medical Aid Commercial	$4,204.64
Rate for Payer: Amish Plain Church Group Commercial	$4,204.64
Rate for Payer: BCBS Complete	$1,893.10
Rate for Payer: BCBS MAPPO	$3,363.71
Rate for Payer: BCN Medicare Advantage	$3,363.71
Rate for Payer: Health Alliance Plan Medicare Advantage	$3,363.71
Rate for Payer: Mclaren Medicaid	$1,802.95
Rate for Payer: Mclaren Medicare	$3,363.71
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$3,531.90
Rate for Payer: Meridian Medicaid	$1,893.10
Rate for Payer: MI Amish Medical Board Commercial	$3,868.27
Rate for Payer: PACE Medicare	$3,195.52
Rate for Payer: PACE SWMI	$3,363.71
Rate for Payer: PHP Medicare Advantage	$3,363.71
Rate for Payer: Priority Health Choice Medicaid	$1,802.95
Rate for Payer: Priority Health Medicare	$3,363.71
Rate for Payer: Railroad Medicare Medicare	$3,363.71
Rate for Payer: UHC All Payor (Choice/PPO)	$9,468.51
Rate for Payer: UHC Dual Complete DSNP	$3,363.71
Rate for Payer: UHC Medicare Advantage	$3,363.71
Rate for Payer: UHCCP Medicaid	$1,893.77
Rate for Payer: VA VA	$3,363.71

SCROTOPLASTY; SIMPLE

Facility

$9,468.51

Service Code	CPT 55175
Hospital Revenue Code	360
Min. Negotiated Rate	$1,802.95
Max. Negotiated Rate	$9,468.51
Rate for Payer: Aetna Medicare	$3,498.26
Rate for Payer: Allen County Amish Medical Aid Commercial	$4,204.64
Rate for Payer: Amish Plain Church Group Commercial	$4,204.64
Rate for Payer: BCBS Complete	$1,893.10
Rate for Payer: BCBS MAPPO	$3,363.71
Rate for Payer: BCN Medicare Advantage	$3,363.71
Rate for Payer: Health Alliance Plan Medicare Advantage	$3,363.71
Rate for Payer: Mclaren Medicaid	$1,802.95
Rate for Payer: Mclaren Medicare	$3,363.71
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$3,531.90
Rate for Payer: Meridian Medicaid	$1,893.10
Rate for Payer: MI Amish Medical Board Commercial	$3,868.27
Rate for Payer: PACE Medicare	$3,195.52
Rate for Payer: PACE SWMI	$3,363.71
Rate for Payer: PHP Medicare Advantage	$3,363.71
Rate for Payer: Priority Health Choice Medicaid	$1,802.95
Rate for Payer: Priority Health Medicare	$3,363.71
Rate for Payer: Railroad Medicare Medicare	$3,363.71
Rate for Payer: UHC All Payor (Choice/PPO)	$9,468.51
Rate for Payer: UHC Dual Complete DSNP	$3,363.71
Rate for Payer: UHC Medicare Advantage	$3,363.71
Rate for Payer: UHCCP Medicaid	$1,893.77
Rate for Payer: VA VA	$3,363.71

SECONDARY CLOSURE OF SURGICAL WOUND OR DEHISCENCE, EXTENSIVE OR COMPLICATED

Facility

$5,021.81

Service Code	CPT 13160
Hospital Revenue Code	360
Min. Negotiated Rate	$956.23
Max. Negotiated Rate	$5,021.81
Rate for Payer: Aetna Medicare	$1,855.37
Rate for Payer: Allen County Amish Medical Aid Commercial	$2,230.01
Rate for Payer: Amish Plain Church Group Commercial	$2,230.01
Rate for Payer: BCBS Complete	$1,004.04
Rate for Payer: BCBS MAPPO	$1,784.01
Rate for Payer: BCN Medicare Advantage	$1,784.01
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,784.01
Rate for Payer: Mclaren Medicaid	$956.23
Rate for Payer: Mclaren Medicare	$1,784.01
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$1,873.21
Rate for Payer: Meridian Medicaid	$1,004.04
Rate for Payer: MI Amish Medical Board Commercial	$2,051.61
Rate for Payer: PACE Medicare	$1,694.81
Rate for Payer: PACE SWMI	$1,784.01
Rate for Payer: PHP Medicare Advantage	$1,784.01
Rate for Payer: Priority Health Choice Medicaid	$956.23
Rate for Payer: Priority Health Medicare	$1,784.01
Rate for Payer: Railroad Medicare Medicare	$1,784.01
Rate for Payer: UHC All Payor (Choice/PPO)	$5,021.81
Rate for Payer: UHC Dual Complete DSNP	$1,784.01
Rate for Payer: UHC Medicare Advantage	$1,784.01
Rate for Payer: UHCCP Medicaid	$1,004.40
Rate for Payer: VA VA	$1,784.01

SELENIUM 60 MCG/ML INTRAVENOUS SOLUTION

Facility

$705.82

Service Code	NDC 00517656025
Hospital Charge Code	190643
Hospital Revenue Code	250
Min. Negotiated Rate	$444.67
Max. Negotiated Rate	$635.24
Rate for Payer: Aetna Commercial	$599.95
Rate for Payer: Aetna New Business (MI Preferred)	$458.78
Rate for Payer: Cash Price	$564.66
Rate for Payer: Cofinity Commercial	$494.07
Rate for Payer: Cofinity Commercial	$607.01
Rate for Payer: Cofinity Medicare Advantage	$494.07
Rate for Payer: Encore Health Key Benefits Commercial	$564.66
Rate for Payer: Healthscope Commercial	$635.24
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$599.95
Rate for Payer: PHP Commercial	$599.95
Rate for Payer: Priority Health Cigna Priority Health	$458.78
Rate for Payer: Priority Health SBD	$444.67

SELENIUM 60 MCG/ML INTRAVENOUS SOLUTION

Facility

$705.82

Service Code	NDC 00517656025
Hospital Charge Code	190643
Hospital Revenue Code	250
Min. Negotiated Rate	$282.33
Max. Negotiated Rate	$635.24
Rate for Payer: Aetna Commercial	$599.95
Rate for Payer: Aetna Medicare	$352.91
Rate for Payer: Aetna New Business (MI Preferred)	$458.78
Rate for Payer: BCBS Complete	$282.33
Rate for Payer: Cash Price	$564.66
Rate for Payer: Cofinity Commercial	$494.07
Rate for Payer: Cofinity Commercial	$607.01
Rate for Payer: Cofinity Medicare Advantage	$494.07
Rate for Payer: Encore Health Key Benefits Commercial	$564.66
Rate for Payer: Healthscope Commercial	$635.24
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$599.95
Rate for Payer: PHP Commercial	$599.95
Rate for Payer: Priority Health Cigna Priority Health	$458.78
Rate for Payer: Priority Health SBD	$444.67

SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET

Facility

$84.63

Service Code	NDC 67618011030
Hospital Charge Code	24216
Hospital Revenue Code	637
Min. Negotiated Rate	$33.85
Max. Negotiated Rate	$76.17
Rate for Payer: Aetna Commercial	$71.94
Rate for Payer: Aetna Medicare	$42.31
Rate for Payer: Aetna New Business (MI Preferred)	$55.01
Rate for Payer: BCBS Complete	$33.85
Rate for Payer: Cash Price	$67.70
Rate for Payer: Cofinity Commercial	$59.24
Rate for Payer: Cofinity Commercial	$72.78
Rate for Payer: Cofinity Medicare Advantage	$59.24
Rate for Payer: Encore Health Key Benefits Commercial	$67.70
Rate for Payer: Healthscope Commercial	$76.17
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$71.94
Rate for Payer: PHP Commercial	$71.94
Rate for Payer: Priority Health Cigna Priority Health	$55.01
Rate for Payer: Priority Health SBD	$53.32

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 Commercial	$111.65
Rate for Payer: Cofinity Commercial	$137.17
Rate for Payer: Cofinity Medicare Advantage	$111.65
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: PHP Commercial	$135.57
Rate for Payer: Priority Health Cigna Priority Health	$103.67
Rate for Payer: Priority Health SBD	$100.48

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	$63.80
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 Commercial	$111.65
Rate for Payer: Cofinity Commercial	$137.17
Rate for Payer: Cofinity Medicare Advantage	$111.65
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: PHP Commercial	$135.57
Rate for Payer: Priority Health Cigna Priority Health	$103.67
Rate for Payer: Priority Health SBD	$100.48

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	$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 Commercial	$31.16
Rate for Payer: Cofinity Commercial	$38.29
Rate for Payer: Cofinity Medicare Advantage	$31.16
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: PHP Commercial	$37.84
Rate for Payer: Priority Health Cigna Priority Health	$28.94
Rate for Payer: Priority Health SBD	$28.05

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	$17.81
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 Commercial	$31.16
Rate for Payer: Cofinity Commercial	$38.29
Rate for Payer: Cofinity Medicare Advantage	$31.16
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: PHP Commercial	$37.84
Rate for Payer: Priority Health Cigna Priority Health	$28.94
Rate for Payer: Priority Health SBD	$28.05

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	$40.48
Max. Negotiated Rate	$91.08
Rate for Payer: Aetna Commercial	$86.02
Rate for Payer: Aetna Medicare	$50.60
Rate for Payer: Aetna New Business (MI Preferred)	$65.78
Rate for Payer: BCBS Complete	$40.48
Rate for Payer: Cash Price	$80.96
Rate for Payer: Cofinity Commercial	$70.84
Rate for Payer: Cofinity Commercial	$87.03
Rate for Payer: Cofinity Medicare Advantage	$70.84
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: PHP Commercial	$86.02
Rate for Payer: Priority Health Cigna Priority Health	$65.78
Rate for Payer: Priority Health SBD	$63.76

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	$37.80
Max. Negotiated Rate	$85.05
Rate for Payer: Aetna Commercial	$80.33
Rate for Payer: Aetna Medicare	$47.25
Rate for Payer: Aetna New Business (MI Preferred)	$61.42
Rate for Payer: BCBS Complete	$37.80
Rate for Payer: Cash Price	$75.60
Rate for Payer: Cofinity Commercial	$66.15
Rate for Payer: Cofinity Commercial	$81.27
Rate for Payer: Cofinity Medicare Advantage	$66.15
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: PHP Commercial	$80.33
Rate for Payer: Priority Health Cigna Priority Health	$61.42
Rate for Payer: Priority Health SBD	$59.53

SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET

Facility

$103.62

Service Code	NDC 60258095106
Hospital Charge Code	24216
Hospital Revenue Code	637
Min. Negotiated Rate	$41.45
Max. Negotiated Rate	$93.26
Rate for Payer: Aetna Commercial	$88.08
Rate for Payer: Aetna Medicare	$51.81
Rate for Payer: Aetna New Business (MI Preferred)	$67.35
Rate for Payer: BCBS Complete	$41.45
Rate for Payer: Cash Price	$82.90
Rate for Payer: Cofinity Commercial	$72.53
Rate for Payer: Cofinity Commercial	$89.11
Rate for Payer: Cofinity Medicare Advantage	$72.53
Rate for Payer: Encore Health Key Benefits Commercial	$82.90
Rate for Payer: Healthscope Commercial	$93.26
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$88.08
Rate for Payer: PHP Commercial	$88.08
Rate for Payer: Priority Health Cigna Priority Health	$67.35
Rate for Payer: Priority Health SBD	$65.28

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	$0.64
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 Commercial	$1.12
Rate for Payer: Cofinity Commercial	$1.38
Rate for Payer: Cofinity Medicare Advantage	$1.12
Rate for Payer: Encore Health Key Benefits Commercial	$1.28
Rate for Payer: Healthscope Commercial	$1.44
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1.36
Rate for Payer: PHP Commercial	$1.36
Rate for Payer: Priority Health Cigna Priority Health	$1.04
Rate for Payer: Priority Health SBD	$1.01

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	$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 Commercial	$61.74
Rate for Payer: Cofinity Commercial	$75.85
Rate for Payer: Cofinity Medicare Advantage	$61.74
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: PHP Commercial	$74.97
Rate for Payer: Priority Health Cigna Priority Health	$57.33
Rate for Payer: Priority Health SBD	$55.57

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	$1.01
Max. Negotiated Rate	$1.44
Rate for Payer: Aetna Commercial	$1.36
Rate for Payer: Aetna New Business (MI Preferred)	$1.04
Rate for Payer: Cash Price	$1.28
Rate for Payer: Cofinity Commercial	$1.12
Rate for Payer: Cofinity Commercial	$1.38
Rate for Payer: Cofinity Medicare Advantage	$1.12
Rate for Payer: Encore Health Key Benefits Commercial	$1.28
Rate for Payer: Healthscope Commercial	$1.44
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1.36
Rate for Payer: PHP Commercial	$1.36
Rate for Payer: Priority Health Cigna Priority Health	$1.04
Rate for Payer: Priority Health SBD	$1.01

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 Commercial	$70.84
Rate for Payer: Cofinity Commercial	$87.03
Rate for Payer: Cofinity Medicare Advantage	$70.84
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: PHP Commercial	$86.02
Rate for Payer: Priority Health Cigna Priority Health	$65.78
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	$35.28
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 Commercial	$61.74
Rate for Payer: Cofinity Commercial	$75.85
Rate for Payer: Cofinity Medicare Advantage	$61.74
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: PHP Commercial	$74.97
Rate for Payer: Priority Health Cigna Priority Health	$57.33
Rate for Payer: Priority Health SBD	$55.57

SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET

Facility

$103.62

Service Code	NDC 60258095106
Hospital Charge Code	24216
Hospital Revenue Code	637
Min. Negotiated Rate	$65.28
Max. Negotiated Rate	$93.26
Rate for Payer: Aetna Commercial	$88.08
Rate for Payer: Aetna New Business (MI Preferred)	$67.35
Rate for Payer: Cash Price	$82.90
Rate for Payer: Cofinity Commercial	$72.53
Rate for Payer: Cofinity Commercial	$89.11
Rate for Payer: Cofinity Medicare Advantage	$72.53
Rate for Payer: Encore Health Key Benefits Commercial	$82.90
Rate for Payer: Healthscope Commercial	$93.26
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$88.08
Rate for Payer: PHP Commercial	$88.08
Rate for Payer: Priority Health Cigna Priority Health	$67.35
Rate for Payer: Priority Health SBD	$65.28

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 Commercial	$66.15
Rate for Payer: Cofinity Commercial	$81.27
Rate for Payer: Cofinity Medicare Advantage	$66.15
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: PHP Commercial	$80.33
Rate for Payer: Priority Health Cigna Priority Health	$61.42
Rate for Payer: Priority Health SBD	$59.53

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 Commercial	$133.77
Rate for Payer: Cofinity Commercial	$164.35
Rate for Payer: Cofinity Medicare Advantage	$133.77
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: PHP Commercial	$162.44
Rate for Payer: Priority Health Cigna Priority Health	$124.22
Rate for Payer: Priority Health SBD	$120.39

Know your out-of-pocket cost for care.

All Charges