Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION

Facility

$19.10

Service Code	NDC 00013111421
Hospital Charge Code	155937
Hospital Revenue Code	250
Min. Negotiated Rate	$12.03
Max. Negotiated Rate	$17.19
Rate for Payer: Aetna Commercial	$16.23
Rate for Payer: Aetna New Business (MI Preferred)	$12.41
Rate for Payer: Cash Price	$15.28
Rate for Payer: Cofinity Commercial	$13.37
Rate for Payer: Cofinity Commercial	$16.43
Rate for Payer: Cofinity Medicare Advantage	$13.37
Rate for Payer: Encore Health Key Benefits Commercial	$15.28
Rate for Payer: Healthscope Commercial	$17.19
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$16.23
Rate for Payer: PHP Commercial	$16.23
Rate for Payer: Priority Health Cigna Priority Health	$12.41
Rate for Payer: Priority Health SBD	$12.03

TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION

Facility

$31.07

Service Code	NDC 00517096001
Hospital Charge Code	155937
Hospital Revenue Code	250
Min. Negotiated Rate	$12.43
Max. Negotiated Rate	$27.96
Rate for Payer: Aetna Commercial	$26.41
Rate for Payer: Aetna Medicare	$15.54
Rate for Payer: Aetna New Business (MI Preferred)	$20.20
Rate for Payer: BCBS Complete	$12.43
Rate for Payer: Cash Price	$24.86
Rate for Payer: Cofinity Commercial	$21.75
Rate for Payer: Cofinity Commercial	$26.72
Rate for Payer: Cofinity Medicare Advantage	$21.75
Rate for Payer: Encore Health Key Benefits Commercial	$24.86
Rate for Payer: Healthscope Commercial	$27.96
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$26.41
Rate for Payer: PHP Commercial	$26.41
Rate for Payer: Priority Health Cigna Priority Health	$20.20
Rate for Payer: Priority Health SBD	$19.57

TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION

Facility

$31.07

Service Code	NDC 00517096010
Hospital Charge Code	155937
Hospital Revenue Code	250
Min. Negotiated Rate	$12.43
Max. Negotiated Rate	$27.96
Rate for Payer: Aetna Commercial	$26.41
Rate for Payer: Aetna Medicare	$15.54
Rate for Payer: Aetna New Business (MI Preferred)	$20.20
Rate for Payer: BCBS Complete	$12.43
Rate for Payer: Cash Price	$24.86
Rate for Payer: Cofinity Commercial	$21.75
Rate for Payer: Cofinity Commercial	$26.72
Rate for Payer: Cofinity Medicare Advantage	$21.75
Rate for Payer: Encore Health Key Benefits Commercial	$24.86
Rate for Payer: Healthscope Commercial	$27.96
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$26.41
Rate for Payer: PHP Commercial	$26.41
Rate for Payer: Priority Health Cigna Priority Health	$20.20
Rate for Payer: Priority Health SBD	$19.57

TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION

Facility

$18.43

Service Code	NDC 60505616900
Hospital Charge Code	155937
Hospital Revenue Code	250
Min. Negotiated Rate	$7.37
Max. Negotiated Rate	$16.59
Rate for Payer: Aetna Commercial	$15.67
Rate for Payer: Aetna Medicare	$9.21
Rate for Payer: Aetna New Business (MI Preferred)	$11.98
Rate for Payer: BCBS Complete	$7.37
Rate for Payer: Cash Price	$14.74
Rate for Payer: Cofinity Commercial	$12.90
Rate for Payer: Cofinity Commercial	$15.85
Rate for Payer: Cofinity Medicare Advantage	$12.90
Rate for Payer: Encore Health Key Benefits Commercial	$14.74
Rate for Payer: Healthscope Commercial	$16.59
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$15.67
Rate for Payer: PHP Commercial	$15.67
Rate for Payer: Priority Health Cigna Priority Health	$11.98
Rate for Payer: Priority Health SBD	$11.61

TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION

Facility

$24.05

Service Code	NDC 72485010701
Hospital Charge Code	155937
Hospital Revenue Code	250
Min. Negotiated Rate	$15.15
Max. Negotiated Rate	$21.64
Rate for Payer: Aetna Commercial	$20.44
Rate for Payer: Aetna New Business (MI Preferred)	$15.63
Rate for Payer: Cash Price	$19.24
Rate for Payer: Cofinity Commercial	$16.84
Rate for Payer: Cofinity Commercial	$20.68
Rate for Payer: Cofinity Medicare Advantage	$16.84
Rate for Payer: Encore Health Key Benefits Commercial	$19.24
Rate for Payer: Healthscope Commercial	$21.64
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$20.44
Rate for Payer: PHP Commercial	$20.44
Rate for Payer: Priority Health Cigna Priority Health	$15.63
Rate for Payer: Priority Health SBD	$15.15

TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION

Facility

$38.59

Service Code	NDC 63323056310
Hospital Charge Code	155937
Hospital Revenue Code	250
Min. Negotiated Rate	$24.31
Max. Negotiated Rate	$34.73
Rate for Payer: Aetna Commercial	$32.80
Rate for Payer: Aetna New Business (MI Preferred)	$25.08
Rate for Payer: Cash Price	$30.87
Rate for Payer: Cofinity Commercial	$27.01
Rate for Payer: Cofinity Commercial	$33.19
Rate for Payer: Cofinity Medicare Advantage	$27.01
Rate for Payer: Encore Health Key Benefits Commercial	$30.87
Rate for Payer: Healthscope Commercial	$34.73
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$32.80
Rate for Payer: PHP Commercial	$32.80
Rate for Payer: Priority Health Cigna Priority Health	$25.08
Rate for Payer: Priority Health SBD	$24.31

TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION

Facility

$24.05

Service Code	NDC 72485010701
Hospital Charge Code	155937
Hospital Revenue Code	250
Min. Negotiated Rate	$9.62
Max. Negotiated Rate	$21.64
Rate for Payer: Aetna Commercial	$20.44
Rate for Payer: Aetna Medicare	$12.03
Rate for Payer: Aetna New Business (MI Preferred)	$15.63
Rate for Payer: BCBS Complete	$9.62
Rate for Payer: Cash Price	$19.24
Rate for Payer: Cofinity Commercial	$16.84
Rate for Payer: Cofinity Commercial	$20.68
Rate for Payer: Cofinity Medicare Advantage	$16.84
Rate for Payer: Encore Health Key Benefits Commercial	$19.24
Rate for Payer: Healthscope Commercial	$21.64
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$20.44
Rate for Payer: PHP Commercial	$20.44
Rate for Payer: Priority Health Cigna Priority Health	$15.63
Rate for Payer: Priority Health SBD	$15.15

TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION

Facility

$19.10

Service Code	NDC 00013111420
Hospital Charge Code	155937
Hospital Revenue Code	250
Min. Negotiated Rate	$7.64
Max. Negotiated Rate	$17.19
Rate for Payer: Aetna Commercial	$16.23
Rate for Payer: Aetna Medicare	$9.55
Rate for Payer: Aetna New Business (MI Preferred)	$12.41
Rate for Payer: BCBS Complete	$7.64
Rate for Payer: Cash Price	$15.28
Rate for Payer: Cofinity Commercial	$13.37
Rate for Payer: Cofinity Commercial	$16.43
Rate for Payer: Cofinity Medicare Advantage	$13.37
Rate for Payer: Encore Health Key Benefits Commercial	$15.28
Rate for Payer: Healthscope Commercial	$17.19
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$16.23
Rate for Payer: PHP Commercial	$16.23
Rate for Payer: Priority Health Cigna Priority Health	$12.41
Rate for Payer: Priority Health SBD	$12.03

TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION

Facility

$19.10

Service Code	NDC 00013111421
Hospital Charge Code	155937
Hospital Revenue Code	250
Min. Negotiated Rate	$7.64
Max. Negotiated Rate	$17.19
Rate for Payer: Aetna Commercial	$16.23
Rate for Payer: Aetna Medicare	$9.55
Rate for Payer: Aetna New Business (MI Preferred)	$12.41
Rate for Payer: BCBS Complete	$7.64
Rate for Payer: Cash Price	$15.28
Rate for Payer: Cofinity Commercial	$13.37
Rate for Payer: Cofinity Commercial	$16.43
Rate for Payer: Cofinity Medicare Advantage	$13.37
Rate for Payer: Encore Health Key Benefits Commercial	$15.28
Rate for Payer: Healthscope Commercial	$17.19
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$16.23
Rate for Payer: PHP Commercial	$16.23
Rate for Payer: Priority Health Cigna Priority Health	$12.41
Rate for Payer: Priority Health SBD	$12.03

TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION

Facility

$24.05

Service Code	NDC 72485010710
Hospital Charge Code	155937
Hospital Revenue Code	250
Min. Negotiated Rate	$15.15
Max. Negotiated Rate	$21.64
Rate for Payer: Aetna Commercial	$20.44
Rate for Payer: Aetna New Business (MI Preferred)	$15.63
Rate for Payer: Cash Price	$19.24
Rate for Payer: Cofinity Commercial	$16.84
Rate for Payer: Cofinity Commercial	$20.68
Rate for Payer: Cofinity Medicare Advantage	$16.84
Rate for Payer: Encore Health Key Benefits Commercial	$19.24
Rate for Payer: Healthscope Commercial	$21.64
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$20.44
Rate for Payer: PHP Commercial	$20.44
Rate for Payer: Priority Health Cigna Priority Health	$15.63
Rate for Payer: Priority Health SBD	$15.15

TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION

Facility

$38.59

Service Code	NDC 63323056301
Hospital Charge Code	155937
Hospital Revenue Code	250
Min. Negotiated Rate	$15.44
Max. Negotiated Rate	$34.73
Rate for Payer: Aetna Commercial	$32.80
Rate for Payer: Aetna Medicare	$19.30
Rate for Payer: Aetna New Business (MI Preferred)	$25.08
Rate for Payer: BCBS Complete	$15.44
Rate for Payer: Cash Price	$30.87
Rate for Payer: Cofinity Commercial	$27.01
Rate for Payer: Cofinity Commercial	$33.19
Rate for Payer: Cofinity Medicare Advantage	$27.01
Rate for Payer: Encore Health Key Benefits Commercial	$30.87
Rate for Payer: Healthscope Commercial	$34.73
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$32.80
Rate for Payer: PHP Commercial	$32.80
Rate for Payer: Priority Health Cigna Priority Health	$25.08
Rate for Payer: Priority Health SBD	$24.31

TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION

Facility

$38.59

Service Code	NDC 63323056301
Hospital Charge Code	155937
Hospital Revenue Code	250
Min. Negotiated Rate	$24.31
Max. Negotiated Rate	$34.73
Rate for Payer: Aetna Commercial	$32.80
Rate for Payer: Aetna New Business (MI Preferred)	$25.08
Rate for Payer: Cash Price	$30.87
Rate for Payer: Cofinity Commercial	$27.01
Rate for Payer: Cofinity Commercial	$33.19
Rate for Payer: Cofinity Medicare Advantage	$27.01
Rate for Payer: Encore Health Key Benefits Commercial	$30.87
Rate for Payer: Healthscope Commercial	$34.73
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$32.80
Rate for Payer: PHP Commercial	$32.80
Rate for Payer: Priority Health Cigna Priority Health	$25.08
Rate for Payer: Priority Health SBD	$24.31

TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION

Facility

$31.07

Service Code	NDC 00517096001
Hospital Charge Code	155937
Hospital Revenue Code	250
Min. Negotiated Rate	$19.57
Max. Negotiated Rate	$27.96
Rate for Payer: Aetna Commercial	$26.41
Rate for Payer: Aetna New Business (MI Preferred)	$20.20
Rate for Payer: Cash Price	$24.86
Rate for Payer: Cofinity Commercial	$21.75
Rate for Payer: Cofinity Commercial	$26.72
Rate for Payer: Cofinity Medicare Advantage	$21.75
Rate for Payer: Encore Health Key Benefits Commercial	$24.86
Rate for Payer: Healthscope Commercial	$27.96
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$26.41
Rate for Payer: PHP Commercial	$26.41
Rate for Payer: Priority Health Cigna Priority Health	$20.20
Rate for Payer: Priority Health SBD	$19.57

TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION

Facility

$18.43

Service Code	NDC 60505616901
Hospital Charge Code	155937
Hospital Revenue Code	250
Min. Negotiated Rate	$7.37
Max. Negotiated Rate	$16.59
Rate for Payer: Aetna Commercial	$15.67
Rate for Payer: Aetna Medicare	$9.21
Rate for Payer: Aetna New Business (MI Preferred)	$11.98
Rate for Payer: BCBS Complete	$7.37
Rate for Payer: Cash Price	$14.74
Rate for Payer: Cofinity Commercial	$12.90
Rate for Payer: Cofinity Commercial	$15.85
Rate for Payer: Cofinity Medicare Advantage	$12.90
Rate for Payer: Encore Health Key Benefits Commercial	$14.74
Rate for Payer: Healthscope Commercial	$16.59
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$15.67
Rate for Payer: PHP Commercial	$15.67
Rate for Payer: Priority Health Cigna Priority Health	$11.98
Rate for Payer: Priority Health SBD	$11.61

TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION

Facility

$15.91

Service Code	NDC 55150018810
Hospital Charge Code	155937
Hospital Revenue Code	250
Min. Negotiated Rate	$10.02
Max. Negotiated Rate	$14.32
Rate for Payer: Aetna Commercial	$13.52
Rate for Payer: Aetna New Business (MI Preferred)	$10.34
Rate for Payer: Cash Price	$12.73
Rate for Payer: Cofinity Commercial	$11.14
Rate for Payer: Cofinity Commercial	$13.68
Rate for Payer: Cofinity Medicare Advantage	$11.14
Rate for Payer: Encore Health Key Benefits Commercial	$12.73
Rate for Payer: Healthscope Commercial	$14.32
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$13.52
Rate for Payer: PHP Commercial	$13.52
Rate for Payer: Priority Health Cigna Priority Health	$10.34
Rate for Payer: Priority Health SBD	$10.02

TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION

Facility

$15.91

Service Code	NDC 55150018810
Hospital Charge Code	155937
Hospital Revenue Code	250
Min. Negotiated Rate	$6.36
Max. Negotiated Rate	$14.32
Rate for Payer: Aetna Commercial	$13.52
Rate for Payer: Aetna Medicare	$7.96
Rate for Payer: Aetna New Business (MI Preferred)	$10.34
Rate for Payer: BCBS Complete	$6.36
Rate for Payer: Cash Price	$12.73
Rate for Payer: Cofinity Commercial	$11.14
Rate for Payer: Cofinity Commercial	$13.68
Rate for Payer: Cofinity Medicare Advantage	$11.14
Rate for Payer: Encore Health Key Benefits Commercial	$12.73
Rate for Payer: Healthscope Commercial	$14.32
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$13.52
Rate for Payer: PHP Commercial	$13.52
Rate for Payer: Priority Health Cigna Priority Health	$10.34
Rate for Payer: Priority Health SBD	$10.02

TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION

Facility

$23.46

Service Code	NDC 00013111401
Hospital Charge Code	155937
Hospital Revenue Code	250
Min. Negotiated Rate	$14.78
Max. Negotiated Rate	$21.11
Rate for Payer: Aetna Commercial	$19.94
Rate for Payer: Aetna New Business (MI Preferred)	$15.25
Rate for Payer: Cash Price	$18.77
Rate for Payer: Cofinity Commercial	$16.42
Rate for Payer: Cofinity Commercial	$20.18
Rate for Payer: Cofinity Medicare Advantage	$16.42
Rate for Payer: Encore Health Key Benefits Commercial	$18.77
Rate for Payer: Healthscope Commercial	$21.11
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$19.94
Rate for Payer: PHP Commercial	$19.94
Rate for Payer: Priority Health Cigna Priority Health	$15.25
Rate for Payer: Priority Health SBD	$14.78

TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION

Facility

$38.59

Service Code	NDC 63323056310
Hospital Charge Code	155937
Hospital Revenue Code	250
Min. Negotiated Rate	$15.44
Max. Negotiated Rate	$34.73
Rate for Payer: Aetna Commercial	$32.80
Rate for Payer: Aetna Medicare	$19.30
Rate for Payer: Aetna New Business (MI Preferred)	$25.08
Rate for Payer: BCBS Complete	$15.44
Rate for Payer: Cash Price	$30.87
Rate for Payer: Cofinity Commercial	$27.01
Rate for Payer: Cofinity Commercial	$33.19
Rate for Payer: Cofinity Medicare Advantage	$27.01
Rate for Payer: Encore Health Key Benefits Commercial	$30.87
Rate for Payer: Healthscope Commercial	$34.73
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$32.80
Rate for Payer: PHP Commercial	$32.80
Rate for Payer: Priority Health Cigna Priority Health	$25.08
Rate for Payer: Priority Health SBD	$24.31

TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION

Facility

$23.99

Service Code	NDC 39822100001
Hospital Charge Code	155937
Hospital Revenue Code	250
Min. Negotiated Rate	$9.60
Max. Negotiated Rate	$21.59
Rate for Payer: Aetna Commercial	$20.39
Rate for Payer: Aetna Medicare	$11.99
Rate for Payer: Aetna New Business (MI Preferred)	$15.59
Rate for Payer: BCBS Complete	$9.60
Rate for Payer: Cash Price	$19.19
Rate for Payer: Cofinity Commercial	$16.79
Rate for Payer: Cofinity Commercial	$20.63
Rate for Payer: Cofinity Medicare Advantage	$16.79
Rate for Payer: Encore Health Key Benefits Commercial	$19.19
Rate for Payer: Healthscope Commercial	$21.59
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$20.39
Rate for Payer: PHP Commercial	$20.39
Rate for Payer: Priority Health Cigna Priority Health	$15.59
Rate for Payer: Priority Health SBD	$15.11

TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION

Facility

$18.43

Service Code	NDC 60505616900
Hospital Charge Code	155937
Hospital Revenue Code	250
Min. Negotiated Rate	$11.61
Max. Negotiated Rate	$16.59
Rate for Payer: Aetna Commercial	$15.67
Rate for Payer: Aetna New Business (MI Preferred)	$11.98
Rate for Payer: Cash Price	$14.74
Rate for Payer: Cofinity Commercial	$12.90
Rate for Payer: Cofinity Commercial	$15.85
Rate for Payer: Cofinity Medicare Advantage	$12.90
Rate for Payer: Encore Health Key Benefits Commercial	$14.74
Rate for Payer: Healthscope Commercial	$16.59
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$15.67
Rate for Payer: PHP Commercial	$15.67
Rate for Payer: Priority Health Cigna Priority Health	$11.98
Rate for Payer: Priority Health SBD	$11.61

TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION

Facility

$18.43

Service Code	NDC 60505616901
Hospital Charge Code	155937
Hospital Revenue Code	250
Min. Negotiated Rate	$11.61
Max. Negotiated Rate	$16.59
Rate for Payer: Aetna Commercial	$15.67
Rate for Payer: Aetna New Business (MI Preferred)	$11.98
Rate for Payer: Cash Price	$14.74
Rate for Payer: Cofinity Commercial	$12.90
Rate for Payer: Cofinity Commercial	$15.85
Rate for Payer: Cofinity Medicare Advantage	$12.90
Rate for Payer: Encore Health Key Benefits Commercial	$14.74
Rate for Payer: Healthscope Commercial	$16.59
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$15.67
Rate for Payer: PHP Commercial	$15.67
Rate for Payer: Priority Health Cigna Priority Health	$11.98
Rate for Payer: Priority Health SBD	$11.61

TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION

Facility

$19.10

Service Code	NDC 00013111420
Hospital Charge Code	155937
Hospital Revenue Code	250
Min. Negotiated Rate	$12.03
Max. Negotiated Rate	$17.19
Rate for Payer: Aetna Commercial	$16.23
Rate for Payer: Aetna New Business (MI Preferred)	$12.41
Rate for Payer: Cash Price	$15.28
Rate for Payer: Cofinity Commercial	$13.37
Rate for Payer: Cofinity Commercial	$16.43
Rate for Payer: Cofinity Medicare Advantage	$13.37
Rate for Payer: Encore Health Key Benefits Commercial	$15.28
Rate for Payer: Healthscope Commercial	$17.19
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$16.23
Rate for Payer: PHP Commercial	$16.23
Rate for Payer: Priority Health Cigna Priority Health	$12.41
Rate for Payer: Priority Health SBD	$12.03

TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION

Facility

$31.07

Service Code	NDC 00517096010
Hospital Charge Code	155937
Hospital Revenue Code	250
Min. Negotiated Rate	$19.57
Max. Negotiated Rate	$27.96
Rate for Payer: Aetna Commercial	$26.41
Rate for Payer: Aetna New Business (MI Preferred)	$20.20
Rate for Payer: Cash Price	$24.86
Rate for Payer: Cofinity Commercial	$21.75
Rate for Payer: Cofinity Commercial	$26.72
Rate for Payer: Cofinity Medicare Advantage	$21.75
Rate for Payer: Encore Health Key Benefits Commercial	$24.86
Rate for Payer: Healthscope Commercial	$27.96
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$26.41
Rate for Payer: PHP Commercial	$26.41
Rate for Payer: Priority Health Cigna Priority Health	$20.20
Rate for Payer: Priority Health SBD	$19.57

TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION

Facility

$24.05

Service Code	NDC 72485010710
Hospital Charge Code	155937
Hospital Revenue Code	250
Min. Negotiated Rate	$9.62
Max. Negotiated Rate	$21.64
Rate for Payer: Aetna Commercial	$20.44
Rate for Payer: Aetna Medicare	$12.03
Rate for Payer: Aetna New Business (MI Preferred)	$15.63
Rate for Payer: BCBS Complete	$9.62
Rate for Payer: Cash Price	$19.24
Rate for Payer: Cofinity Commercial	$16.84
Rate for Payer: Cofinity Commercial	$20.68
Rate for Payer: Cofinity Medicare Advantage	$16.84
Rate for Payer: Encore Health Key Benefits Commercial	$19.24
Rate for Payer: Healthscope Commercial	$21.64
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$20.44
Rate for Payer: PHP Commercial	$20.44
Rate for Payer: Priority Health Cigna Priority Health	$15.63
Rate for Payer: Priority Health SBD	$15.15

TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION

Facility

$23.46

Service Code	NDC 00013111401
Hospital Charge Code	155937
Hospital Revenue Code	250
Min. Negotiated Rate	$9.38
Max. Negotiated Rate	$21.11
Rate for Payer: Aetna Commercial	$19.94
Rate for Payer: Aetna Medicare	$11.73
Rate for Payer: Aetna New Business (MI Preferred)	$15.25
Rate for Payer: BCBS Complete	$9.38
Rate for Payer: Cash Price	$18.77
Rate for Payer: Cofinity Commercial	$16.42
Rate for Payer: Cofinity Commercial	$20.18
Rate for Payer: Cofinity Medicare Advantage	$16.42
Rate for Payer: Encore Health Key Benefits Commercial	$18.77
Rate for Payer: Healthscope Commercial	$21.11
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$19.94
Rate for Payer: PHP Commercial	$19.94
Rate for Payer: Priority Health Cigna Priority Health	$15.25
Rate for Payer: Priority Health SBD	$14.78

Know your out-of-pocket cost for care.

All Charges