Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION

Facility

$274.95

Service Code	NDC 67877054588
Hospital Charge Code	9502
Hospital Revenue Code	637
Min. Negotiated Rate	$109.98
Max. Negotiated Rate	$247.46
Rate for Payer: Aetna Commercial	$233.71
Rate for Payer: Aetna Medicare	$137.48
Rate for Payer: Aetna New Business (MI Preferred)	$178.72
Rate for Payer: BCBS Complete	$109.98
Rate for Payer: Cash Price	$219.96
Rate for Payer: Cofinity Commercial	$192.46
Rate for Payer: Cofinity Commercial	$236.46
Rate for Payer: Cofinity Medicare Advantage	$192.46
Rate for Payer: Encore Health Key Benefits Commercial	$219.96
Rate for Payer: Healthscope Commercial	$247.46
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$233.71
Rate for Payer: PHP Commercial	$233.71
Rate for Payer: Priority Health Cigna Priority Health	$178.72
Rate for Payer: Priority Health SBD	$173.22

CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION

Facility

$201.40

Service Code	NDC 68180044101
Hospital Charge Code	9502
Hospital Revenue Code	637
Min. Negotiated Rate	$80.56
Max. Negotiated Rate	$181.26
Rate for Payer: Aetna Commercial	$171.19
Rate for Payer: Aetna Medicare	$100.70
Rate for Payer: Aetna New Business (MI Preferred)	$130.91
Rate for Payer: BCBS Complete	$80.56
Rate for Payer: Cash Price	$161.12
Rate for Payer: Cofinity Commercial	$140.98
Rate for Payer: Cofinity Commercial	$173.20
Rate for Payer: Cofinity Medicare Advantage	$140.98
Rate for Payer: Encore Health Key Benefits Commercial	$161.12
Rate for Payer: Healthscope Commercial	$181.26
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$171.19
Rate for Payer: PHP Commercial	$171.19
Rate for Payer: Priority Health Cigna Priority Health	$130.91
Rate for Payer: Priority Health SBD	$126.88

CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION

Facility

$274.95

Service Code	NDC 67877054588
Hospital Charge Code	9502
Hospital Revenue Code	637
Min. Negotiated Rate	$173.22
Max. Negotiated Rate	$247.46
Rate for Payer: Aetna Commercial	$233.71
Rate for Payer: Aetna New Business (MI Preferred)	$178.72
Rate for Payer: Cash Price	$219.96
Rate for Payer: Cofinity Commercial	$192.46
Rate for Payer: Cofinity Commercial	$236.46
Rate for Payer: Cofinity Medicare Advantage	$192.46
Rate for Payer: Encore Health Key Benefits Commercial	$219.96
Rate for Payer: Healthscope Commercial	$247.46
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$233.71
Rate for Payer: PHP Commercial	$233.71
Rate for Payer: Priority Health Cigna Priority Health	$178.72
Rate for Payer: Priority Health SBD	$173.22

CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION

Facility

$201.40

Service Code	NDC 68180044101
Hospital Charge Code	9502
Hospital Revenue Code	637
Min. Negotiated Rate	$126.88
Max. Negotiated Rate	$181.26
Rate for Payer: Aetna Commercial	$171.19
Rate for Payer: Aetna New Business (MI Preferred)	$130.91
Rate for Payer: Cash Price	$161.12
Rate for Payer: Cofinity Commercial	$140.98
Rate for Payer: Cofinity Commercial	$173.20
Rate for Payer: Cofinity Medicare Advantage	$140.98
Rate for Payer: Encore Health Key Benefits Commercial	$161.12
Rate for Payer: Healthscope Commercial	$181.26
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$171.19
Rate for Payer: PHP Commercial	$171.19
Rate for Payer: Priority Health Cigna Priority Health	$130.91
Rate for Payer: Priority Health SBD	$126.88

CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION

Facility

$203.30

Service Code	NDC 00093417773
Hospital Charge Code	9502
Hospital Revenue Code	637
Min. Negotiated Rate	$81.32
Max. Negotiated Rate	$182.97
Rate for Payer: Aetna Commercial	$172.80
Rate for Payer: Aetna Medicare	$101.65
Rate for Payer: Aetna New Business (MI Preferred)	$132.14
Rate for Payer: BCBS Complete	$81.32
Rate for Payer: Cash Price	$162.64
Rate for Payer: Cofinity Commercial	$142.31
Rate for Payer: Cofinity Commercial	$174.84
Rate for Payer: Cofinity Medicare Advantage	$142.31
Rate for Payer: Encore Health Key Benefits Commercial	$162.64
Rate for Payer: Healthscope Commercial	$182.97
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$172.80
Rate for Payer: PHP Commercial	$172.80
Rate for Payer: Priority Health Cigna Priority Health	$132.14
Rate for Payer: Priority Health SBD	$128.08

CEPHALEXIN 250 MG CAPSULE

Facility

$258.40

Service Code	NDC 00904733661
Hospital Charge Code	9499
Hospital Revenue Code	637
Min. Negotiated Rate	$162.79
Max. Negotiated Rate	$232.56
Rate for Payer: Aetna Commercial	$219.64
Rate for Payer: Aetna New Business (MI Preferred)	$167.96
Rate for Payer: Cash Price	$206.72
Rate for Payer: Cofinity Commercial	$180.88
Rate for Payer: Cofinity Commercial	$222.22
Rate for Payer: Cofinity Medicare Advantage	$180.88
Rate for Payer: Encore Health Key Benefits Commercial	$206.72
Rate for Payer: Healthscope Commercial	$232.56
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$219.64
Rate for Payer: PHP Commercial	$219.64
Rate for Payer: Priority Health Cigna Priority Health	$167.96
Rate for Payer: Priority Health SBD	$162.79

CEPHALEXIN 250 MG CAPSULE

Facility

$284.05

Service Code	NDC 60687015201
Hospital Charge Code	9499
Hospital Revenue Code	637
Min. Negotiated Rate	$178.95
Max. Negotiated Rate	$255.64
Rate for Payer: Aetna Commercial	$241.44
Rate for Payer: Aetna New Business (MI Preferred)	$184.63
Rate for Payer: Cash Price	$227.24
Rate for Payer: Cofinity Commercial	$198.84
Rate for Payer: Cofinity Commercial	$244.28
Rate for Payer: Cofinity Medicare Advantage	$198.84
Rate for Payer: Encore Health Key Benefits Commercial	$227.24
Rate for Payer: Healthscope Commercial	$255.64
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$241.44
Rate for Payer: PHP Commercial	$241.44
Rate for Payer: Priority Health Cigna Priority Health	$184.63
Rate for Payer: Priority Health SBD	$178.95

CEPHALEXIN 250 MG CAPSULE

Facility

$289.05

Service Code	NDC 00093314501
Hospital Charge Code	9499
Hospital Revenue Code	637
Min. Negotiated Rate	$115.62
Max. Negotiated Rate	$260.14
Rate for Payer: Aetna Commercial	$245.69
Rate for Payer: Aetna Medicare	$144.52
Rate for Payer: Aetna New Business (MI Preferred)	$187.88
Rate for Payer: BCBS Complete	$115.62
Rate for Payer: Cash Price	$231.24
Rate for Payer: Cofinity Commercial	$202.34
Rate for Payer: Cofinity Commercial	$248.58
Rate for Payer: Cofinity Medicare Advantage	$202.34
Rate for Payer: Encore Health Key Benefits Commercial	$231.24
Rate for Payer: Healthscope Commercial	$260.14
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$245.69
Rate for Payer: PHP Commercial	$245.69
Rate for Payer: Priority Health Cigna Priority Health	$187.88
Rate for Payer: Priority Health SBD	$182.10

CEPHALEXIN 250 MG CAPSULE

Facility

$284.05

Service Code	NDC 60687015201
Hospital Charge Code	9499
Hospital Revenue Code	637
Min. Negotiated Rate	$113.62
Max. Negotiated Rate	$255.64
Rate for Payer: Aetna Commercial	$241.44
Rate for Payer: Aetna Medicare	$142.02
Rate for Payer: Aetna New Business (MI Preferred)	$184.63
Rate for Payer: BCBS Complete	$113.62
Rate for Payer: Cash Price	$227.24
Rate for Payer: Cofinity Commercial	$198.84
Rate for Payer: Cofinity Commercial	$244.28
Rate for Payer: Cofinity Medicare Advantage	$198.84
Rate for Payer: Encore Health Key Benefits Commercial	$227.24
Rate for Payer: Healthscope Commercial	$255.64
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$241.44
Rate for Payer: PHP Commercial	$241.44
Rate for Payer: Priority Health Cigna Priority Health	$184.63
Rate for Payer: Priority Health SBD	$178.95

CEPHALEXIN 250 MG CAPSULE

Facility

$258.40

Service Code	NDC 00904733661
Hospital Charge Code	9499
Hospital Revenue Code	637
Min. Negotiated Rate	$103.36
Max. Negotiated Rate	$232.56
Rate for Payer: Aetna Commercial	$219.64
Rate for Payer: Aetna Medicare	$129.20
Rate for Payer: Aetna New Business (MI Preferred)	$167.96
Rate for Payer: BCBS Complete	$103.36
Rate for Payer: Cash Price	$206.72
Rate for Payer: Cofinity Commercial	$180.88
Rate for Payer: Cofinity Commercial	$222.22
Rate for Payer: Cofinity Medicare Advantage	$180.88
Rate for Payer: Encore Health Key Benefits Commercial	$206.72
Rate for Payer: Healthscope Commercial	$232.56
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$219.64
Rate for Payer: PHP Commercial	$219.64
Rate for Payer: Priority Health Cigna Priority Health	$167.96
Rate for Payer: Priority Health SBD	$162.79

CEPHALEXIN 250 MG CAPSULE

Facility

$289.05

Service Code	NDC 00093314501
Hospital Charge Code	9499
Hospital Revenue Code	637
Min. Negotiated Rate	$182.10
Max. Negotiated Rate	$260.14
Rate for Payer: Aetna Commercial	$245.69
Rate for Payer: Aetna New Business (MI Preferred)	$187.88
Rate for Payer: Cash Price	$231.24
Rate for Payer: Cofinity Commercial	$202.34
Rate for Payer: Cofinity Commercial	$248.58
Rate for Payer: Cofinity Medicare Advantage	$202.34
Rate for Payer: Encore Health Key Benefits Commercial	$231.24
Rate for Payer: Healthscope Commercial	$260.14
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$245.69
Rate for Payer: PHP Commercial	$245.69
Rate for Payer: Priority Health Cigna Priority Health	$187.88
Rate for Payer: Priority Health SBD	$182.10

CEPHALEXIN 500 MG CAPSULE

Facility

$128.25

Service Code	NDC 50268015215
Hospital Charge Code	9500
Hospital Revenue Code	637
Min. Negotiated Rate	$80.80
Max. Negotiated Rate	$115.42
Rate for Payer: Aetna Commercial	$109.01
Rate for Payer: Aetna New Business (MI Preferred)	$83.36
Rate for Payer: Cash Price	$102.60
Rate for Payer: Cofinity Commercial	$110.30
Rate for Payer: Cofinity Commercial	$89.78
Rate for Payer: Cofinity Medicare Advantage	$89.78
Rate for Payer: Encore Health Key Benefits Commercial	$102.60
Rate for Payer: Healthscope Commercial	$115.42
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$109.01
Rate for Payer: PHP Commercial	$109.01
Rate for Payer: Priority Health Cigna Priority Health	$83.36
Rate for Payer: Priority Health SBD	$80.80

CEPHALEXIN 500 MG CAPSULE

Facility

$3.16

Service Code	NDC 60687016311
Hospital Charge Code	9500
Hospital Revenue Code	637
Min. Negotiated Rate	$1.99
Max. Negotiated Rate	$2.84
Rate for Payer: Aetna Commercial	$2.69
Rate for Payer: Aetna New Business (MI Preferred)	$2.05
Rate for Payer: Cash Price	$2.53
Rate for Payer: Cofinity Commercial	$2.21
Rate for Payer: Cofinity Commercial	$2.72
Rate for Payer: Cofinity Medicare Advantage	$2.21
Rate for Payer: Encore Health Key Benefits Commercial	$2.53
Rate for Payer: Healthscope Commercial	$2.84
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2.69
Rate for Payer: PHP Commercial	$2.69
Rate for Payer: Priority Health Cigna Priority Health	$2.05
Rate for Payer: Priority Health SBD	$1.99

CEPHALEXIN 500 MG CAPSULE

Facility

$2.57

Service Code	NDC 50268015211
Hospital Charge Code	9500
Hospital Revenue Code	637
Min. Negotiated Rate	$1.62
Max. Negotiated Rate	$2.31
Rate for Payer: Aetna Commercial	$2.18
Rate for Payer: Aetna New Business (MI Preferred)	$1.67
Rate for Payer: Cash Price	$2.06
Rate for Payer: Cofinity Commercial	$1.80
Rate for Payer: Cofinity Commercial	$2.21
Rate for Payer: Cofinity Medicare Advantage	$1.80
Rate for Payer: Encore Health Key Benefits Commercial	$2.06
Rate for Payer: Healthscope Commercial	$2.31
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2.18
Rate for Payer: PHP Commercial	$2.18
Rate for Payer: Priority Health Cigna Priority Health	$1.67
Rate for Payer: Priority Health SBD	$1.62

CEPHALEXIN 500 MG CAPSULE

Facility

$286.90

Service Code	NDC 00904733761
Hospital Charge Code	9500
Hospital Revenue Code	637
Min. Negotiated Rate	$114.76
Max. Negotiated Rate	$258.21
Rate for Payer: Aetna Commercial	$243.86
Rate for Payer: Aetna Medicare	$143.45
Rate for Payer: Aetna New Business (MI Preferred)	$186.48
Rate for Payer: BCBS Complete	$114.76
Rate for Payer: Cash Price	$229.52
Rate for Payer: Cofinity Commercial	$200.83
Rate for Payer: Cofinity Commercial	$246.73
Rate for Payer: Cofinity Medicare Advantage	$200.83
Rate for Payer: Encore Health Key Benefits Commercial	$229.52
Rate for Payer: Healthscope Commercial	$258.21
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$243.86
Rate for Payer: PHP Commercial	$243.86
Rate for Payer: Priority Health Cigna Priority Health	$186.48
Rate for Payer: Priority Health SBD	$180.75

CEPHALEXIN 500 MG CAPSULE

Facility

$315.40

Service Code	NDC 60687016301
Hospital Charge Code	9500
Hospital Revenue Code	637
Min. Negotiated Rate	$126.16
Max. Negotiated Rate	$283.86
Rate for Payer: Aetna Commercial	$268.09
Rate for Payer: Aetna Medicare	$157.70
Rate for Payer: Aetna New Business (MI Preferred)	$205.01
Rate for Payer: BCBS Complete	$126.16
Rate for Payer: Cash Price	$252.32
Rate for Payer: Cofinity Commercial	$220.78
Rate for Payer: Cofinity Commercial	$271.24
Rate for Payer: Cofinity Medicare Advantage	$220.78
Rate for Payer: Encore Health Key Benefits Commercial	$252.32
Rate for Payer: Healthscope Commercial	$283.86
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$268.09
Rate for Payer: PHP Commercial	$268.09
Rate for Payer: Priority Health Cigna Priority Health	$205.01
Rate for Payer: Priority Health SBD	$198.70

CEPHALEXIN 500 MG CAPSULE

Facility

$315.40

Service Code	NDC 60687016301
Hospital Charge Code	9500
Hospital Revenue Code	637
Min. Negotiated Rate	$198.70
Max. Negotiated Rate	$283.86
Rate for Payer: Aetna Commercial	$268.09
Rate for Payer: Aetna New Business (MI Preferred)	$205.01
Rate for Payer: Cash Price	$252.32
Rate for Payer: Cofinity Commercial	$220.78
Rate for Payer: Cofinity Commercial	$271.24
Rate for Payer: Cofinity Medicare Advantage	$220.78
Rate for Payer: Encore Health Key Benefits Commercial	$252.32
Rate for Payer: Healthscope Commercial	$283.86
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$268.09
Rate for Payer: PHP Commercial	$268.09
Rate for Payer: Priority Health Cigna Priority Health	$205.01
Rate for Payer: Priority Health SBD	$198.70

CEPHALEXIN 500 MG CAPSULE

Facility

$324.30

Service Code	NDC 67877021901
Hospital Charge Code	9500
Hospital Revenue Code	637
Min. Negotiated Rate	$129.72
Max. Negotiated Rate	$291.87
Rate for Payer: Aetna Commercial	$275.66
Rate for Payer: Aetna Medicare	$162.15
Rate for Payer: Aetna New Business (MI Preferred)	$210.80
Rate for Payer: BCBS Complete	$129.72
Rate for Payer: Cash Price	$259.44
Rate for Payer: Cofinity Commercial	$227.01
Rate for Payer: Cofinity Commercial	$278.90
Rate for Payer: Cofinity Medicare Advantage	$227.01
Rate for Payer: Encore Health Key Benefits Commercial	$259.44
Rate for Payer: Healthscope Commercial	$291.87
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$275.66
Rate for Payer: PHP Commercial	$275.66
Rate for Payer: Priority Health Cigna Priority Health	$210.80
Rate for Payer: Priority Health SBD	$204.31

CEPHALEXIN 500 MG CAPSULE

Facility

$324.30

Service Code	NDC 67877021901
Hospital Charge Code	9500
Hospital Revenue Code	637
Min. Negotiated Rate	$204.31
Max. Negotiated Rate	$291.87
Rate for Payer: Aetna Commercial	$275.66
Rate for Payer: Aetna New Business (MI Preferred)	$210.80
Rate for Payer: Cash Price	$259.44
Rate for Payer: Cofinity Commercial	$227.01
Rate for Payer: Cofinity Commercial	$278.90
Rate for Payer: Cofinity Medicare Advantage	$227.01
Rate for Payer: Encore Health Key Benefits Commercial	$259.44
Rate for Payer: Healthscope Commercial	$291.87
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$275.66
Rate for Payer: PHP Commercial	$275.66
Rate for Payer: Priority Health Cigna Priority Health	$210.80
Rate for Payer: Priority Health SBD	$204.31

CEPHALEXIN 500 MG CAPSULE

Facility

$192.85

Service Code	NDC 00093314701
Hospital Charge Code	9500
Hospital Revenue Code	637
Min. Negotiated Rate	$77.14
Max. Negotiated Rate	$173.56
Rate for Payer: Aetna Commercial	$163.92
Rate for Payer: Aetna Medicare	$96.42
Rate for Payer: Aetna New Business (MI Preferred)	$125.35
Rate for Payer: BCBS Complete	$77.14
Rate for Payer: Cash Price	$154.28
Rate for Payer: Cofinity Commercial	$135.00
Rate for Payer: Cofinity Commercial	$165.85
Rate for Payer: Cofinity Medicare Advantage	$135.00
Rate for Payer: Encore Health Key Benefits Commercial	$154.28
Rate for Payer: Healthscope Commercial	$173.56
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$163.92
Rate for Payer: PHP Commercial	$163.92
Rate for Payer: Priority Health Cigna Priority Health	$125.35
Rate for Payer: Priority Health SBD	$121.50

CEPHALEXIN 500 MG CAPSULE

Facility

$3.16

Service Code	NDC 60687016311
Hospital Charge Code	9500
Hospital Revenue Code	637
Min. Negotiated Rate	$1.26
Max. Negotiated Rate	$2.84
Rate for Payer: Aetna Commercial	$2.69
Rate for Payer: Aetna Medicare	$1.58
Rate for Payer: Aetna New Business (MI Preferred)	$2.05
Rate for Payer: BCBS Complete	$1.26
Rate for Payer: Cash Price	$2.53
Rate for Payer: Cofinity Commercial	$2.21
Rate for Payer: Cofinity Commercial	$2.72
Rate for Payer: Cofinity Medicare Advantage	$2.21
Rate for Payer: Encore Health Key Benefits Commercial	$2.53
Rate for Payer: Healthscope Commercial	$2.84
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2.69
Rate for Payer: PHP Commercial	$2.69
Rate for Payer: Priority Health Cigna Priority Health	$2.05
Rate for Payer: Priority Health SBD	$1.99

CEPHALEXIN 500 MG CAPSULE

Facility

$2.57

Service Code	NDC 50268015211
Hospital Charge Code	9500
Hospital Revenue Code	637
Min. Negotiated Rate	$1.03
Max. Negotiated Rate	$2.31
Rate for Payer: Aetna Commercial	$2.18
Rate for Payer: Aetna Medicare	$1.28
Rate for Payer: Aetna New Business (MI Preferred)	$1.67
Rate for Payer: BCBS Complete	$1.03
Rate for Payer: Cash Price	$2.06
Rate for Payer: Cofinity Commercial	$1.80
Rate for Payer: Cofinity Commercial	$2.21
Rate for Payer: Cofinity Medicare Advantage	$1.80
Rate for Payer: Encore Health Key Benefits Commercial	$2.06
Rate for Payer: Healthscope Commercial	$2.31
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2.18
Rate for Payer: PHP Commercial	$2.18
Rate for Payer: Priority Health Cigna Priority Health	$1.67
Rate for Payer: Priority Health SBD	$1.62

CEPHALEXIN 500 MG CAPSULE

Facility

$128.25

Service Code	NDC 50268015215
Hospital Charge Code	9500
Hospital Revenue Code	637
Min. Negotiated Rate	$51.30
Max. Negotiated Rate	$115.42
Rate for Payer: Aetna Commercial	$109.01
Rate for Payer: Aetna Medicare	$64.12
Rate for Payer: Aetna New Business (MI Preferred)	$83.36
Rate for Payer: BCBS Complete	$51.30
Rate for Payer: Cash Price	$102.60
Rate for Payer: Cofinity Commercial	$110.30
Rate for Payer: Cofinity Commercial	$89.78
Rate for Payer: Cofinity Medicare Advantage	$89.78
Rate for Payer: Encore Health Key Benefits Commercial	$102.60
Rate for Payer: Healthscope Commercial	$115.42
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$109.01
Rate for Payer: PHP Commercial	$109.01
Rate for Payer: Priority Health Cigna Priority Health	$83.36
Rate for Payer: Priority Health SBD	$80.80

CEPHALEXIN 500 MG CAPSULE

Facility

$192.85

Service Code	NDC 00093314701
Hospital Charge Code	9500
Hospital Revenue Code	637
Min. Negotiated Rate	$121.50
Max. Negotiated Rate	$173.56
Rate for Payer: Aetna Commercial	$163.92
Rate for Payer: Aetna New Business (MI Preferred)	$125.35
Rate for Payer: Cash Price	$154.28
Rate for Payer: Cofinity Commercial	$135.00
Rate for Payer: Cofinity Commercial	$165.85
Rate for Payer: Cofinity Medicare Advantage	$135.00
Rate for Payer: Encore Health Key Benefits Commercial	$154.28
Rate for Payer: Healthscope Commercial	$173.56
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$163.92
Rate for Payer: PHP Commercial	$163.92
Rate for Payer: Priority Health Cigna Priority Health	$125.35
Rate for Payer: Priority Health SBD	$121.50

CEPHALEXIN 500 MG CAPSULE

Facility

$286.90

Service Code	NDC 00904733761
Hospital Charge Code	9500
Hospital Revenue Code	637
Min. Negotiated Rate	$180.75
Max. Negotiated Rate	$258.21
Rate for Payer: Aetna Commercial	$243.86
Rate for Payer: Aetna New Business (MI Preferred)	$186.48
Rate for Payer: Cash Price	$229.52
Rate for Payer: Cofinity Commercial	$200.83
Rate for Payer: Cofinity Commercial	$246.73
Rate for Payer: Cofinity Medicare Advantage	$200.83
Rate for Payer: Encore Health Key Benefits Commercial	$229.52
Rate for Payer: Healthscope Commercial	$258.21
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$243.86
Rate for Payer: PHP Commercial	$243.86
Rate for Payer: Priority Health Cigna Priority Health	$186.48
Rate for Payer: Priority Health SBD	$180.75

Know your out-of-pocket cost for care.

All Charges