Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION

Facility

$365.75

Service Code	NDC 59762001601
Hospital Charge Code	37642
Hospital Revenue Code	637
Min. Negotiated Rate	$146.30
Max. Negotiated Rate	$329.18
Rate for Payer: Aetna Commercial	$310.89
Rate for Payer: Aetna Medicare	$182.88
Rate for Payer: Aetna New Business (MI Preferred)	$237.74
Rate for Payer: BCBS Complete	$146.30
Rate for Payer: Cash Price	$292.60
Rate for Payer: Cofinity Commercial	$256.02
Rate for Payer: Cofinity Commercial	$314.54
Rate for Payer: Cofinity Medicare Advantage	$256.02
Rate for Payer: Encore Health Key Benefits Commercial	$292.60
Rate for Payer: Healthscope Commercial	$329.18
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$310.89
Rate for Payer: PHP Commercial	$310.89
Rate for Payer: Priority Health Cigna Priority Health	$237.74
Rate for Payer: Priority Health SBD	$230.42

CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION

Facility

$365.75

Service Code	NDC 59762001601
Hospital Charge Code	37642
Hospital Revenue Code	637
Min. Negotiated Rate	$230.42
Max. Negotiated Rate	$329.18
Rate for Payer: Aetna Commercial	$310.89
Rate for Payer: Aetna New Business (MI Preferred)	$237.74
Rate for Payer: Cash Price	$292.60
Rate for Payer: Cofinity Commercial	$256.02
Rate for Payer: Cofinity Commercial	$314.54
Rate for Payer: Cofinity Medicare Advantage	$256.02
Rate for Payer: Encore Health Key Benefits Commercial	$292.60
Rate for Payer: Healthscope Commercial	$329.18
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$310.89
Rate for Payer: PHP Commercial	$310.89
Rate for Payer: Priority Health Cigna Priority Health	$237.74
Rate for Payer: Priority Health SBD	$230.42

CLINDAMYCIN 900 MG/50 ML IVPB IN D5W OR NS CUSTOM

Facility

$26.48

Service Code	HCPCS J0737
Hospital Charge Code	300022
Hospital Revenue Code	250
Min. Negotiated Rate	$16.68
Max. Negotiated Rate	$23.83
Rate for Payer: Aetna Commercial	$22.51
Rate for Payer: Aetna New Business (MI Preferred)	$17.21
Rate for Payer: Cash Price	$21.18
Rate for Payer: Cofinity Commercial	$18.54
Rate for Payer: Cofinity Commercial	$22.77
Rate for Payer: Cofinity Medicare Advantage	$18.54
Rate for Payer: Encore Health Key Benefits Commercial	$21.18
Rate for Payer: Healthscope Commercial	$23.83
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$22.51
Rate for Payer: PHP Commercial	$22.51
Rate for Payer: Priority Health Cigna Priority Health	$17.21
Rate for Payer: Priority Health SBD	$16.68

CLINDAMYCIN 900 MG/50 ML IVPB IN D5W OR NS CUSTOM

Facility

$16.28

Service Code	HCPCS J0736
Hospital Charge Code	300022
Hospital Revenue Code	250
Min. Negotiated Rate	$6.51
Max. Negotiated Rate	$14.65
Rate for Payer: Aetna Commercial	$13.84
Rate for Payer: Aetna Commercial	$46.15
Rate for Payer: Aetna Medicare	$27.14
Rate for Payer: Aetna Medicare	$8.14
Rate for Payer: Aetna New Business (MI Preferred)	$10.58
Rate for Payer: Aetna New Business (MI Preferred)	$35.29
Rate for Payer: BCBS Complete	$21.72
Rate for Payer: BCBS Complete	$6.51
Rate for Payer: BCBS Trust/PPO	$6.96
Rate for Payer: BCBS Trust/PPO	$6.96
Rate for Payer: BCN Commercial	$6.96
Rate for Payer: BCN Commercial	$6.96
Rate for Payer: Cash Price	$43.43
Rate for Payer: Cash Price	$13.02
Rate for Payer: Cash Price	$13.02
Rate for Payer: Cash Price	$43.43
Rate for Payer: Cofinity Commercial	$14.00
Rate for Payer: Cofinity Commercial	$11.40
Rate for Payer: Cofinity Commercial	$38.00
Rate for Payer: Cofinity Commercial	$46.69
Rate for Payer: Cofinity Medicare Advantage	$11.40
Rate for Payer: Cofinity Medicare Advantage	$38.00
Rate for Payer: Encore Health Key Benefits Commercial	$13.02
Rate for Payer: Encore Health Key Benefits Commercial	$43.43
Rate for Payer: Healthscope Commercial	$48.86
Rate for Payer: Healthscope Commercial	$14.65
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$46.15
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$13.84
Rate for Payer: PHP Commercial	$46.15
Rate for Payer: PHP Commercial	$13.84
Rate for Payer: Priority Health Cigna Priority Health	$35.29
Rate for Payer: Priority Health Cigna Priority Health	$10.58
Rate for Payer: Priority Health SBD	$34.20
Rate for Payer: Priority Health SBD	$10.26

CLINDAMYCIN 900 MG/50 ML IVPB IN D5W OR NS CUSTOM

Facility

$26.48

Service Code	HCPCS J0737
Hospital Charge Code	300022
Hospital Revenue Code	250
Min. Negotiated Rate	$7.93
Max. Negotiated Rate	$23.83
Rate for Payer: Aetna Commercial	$22.51
Rate for Payer: Aetna Medicare	$13.24
Rate for Payer: Aetna New Business (MI Preferred)	$17.21
Rate for Payer: BCBS Complete	$10.59
Rate for Payer: BCBS Trust/PPO	$7.93
Rate for Payer: BCN Commercial	$7.93
Rate for Payer: Cash Price	$21.18
Rate for Payer: Cash Price	$21.18
Rate for Payer: Cofinity Commercial	$18.54
Rate for Payer: Cofinity Commercial	$22.77
Rate for Payer: Cofinity Medicare Advantage	$18.54
Rate for Payer: Encore Health Key Benefits Commercial	$21.18
Rate for Payer: Healthscope Commercial	$23.83
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$22.51
Rate for Payer: PHP Commercial	$22.51
Rate for Payer: Priority Health Cigna Priority Health	$17.21
Rate for Payer: Priority Health SBD	$16.68

CLINDAMYCIN 900 MG/50 ML IVPB IN D5W OR NS CUSTOM

Facility

$54.29

Service Code	HCPCS J0736
Hospital Charge Code	300022
Hospital Revenue Code	250
Min. Negotiated Rate	$34.20
Max. Negotiated Rate	$48.86
Rate for Payer: Aetna Commercial	$46.15
Rate for Payer: Aetna Commercial	$13.84
Rate for Payer: Aetna New Business (MI Preferred)	$10.58
Rate for Payer: Aetna New Business (MI Preferred)	$35.29
Rate for Payer: Cash Price	$13.02
Rate for Payer: Cash Price	$43.43
Rate for Payer: Cofinity Commercial	$46.69
Rate for Payer: Cofinity Commercial	$38.00
Rate for Payer: Cofinity Commercial	$11.40
Rate for Payer: Cofinity Commercial	$14.00
Rate for Payer: Cofinity Medicare Advantage	$11.40
Rate for Payer: Cofinity Medicare Advantage	$38.00
Rate for Payer: Encore Health Key Benefits Commercial	$13.02
Rate for Payer: Encore Health Key Benefits Commercial	$43.43
Rate for Payer: Healthscope Commercial	$48.86
Rate for Payer: Healthscope Commercial	$14.65
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$13.84
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$46.15
Rate for Payer: PHP Commercial	$46.15
Rate for Payer: PHP Commercial	$13.84
Rate for Payer: Priority Health Cigna Priority Health	$10.58
Rate for Payer: Priority Health Cigna Priority Health	$35.29
Rate for Payer: Priority Health SBD	$10.26
Rate for Payer: Priority Health SBD	$34.20

CLINDAMYCIN HCL 150 MG CAPSULE

Facility

$2.08

Service Code	NDC 68084024311
Hospital Charge Code	1740
Hospital Revenue Code	637
Min. Negotiated Rate	$1.31
Max. Negotiated Rate	$1.87
Rate for Payer: Aetna Commercial	$1.77
Rate for Payer: Aetna New Business (MI Preferred)	$1.35
Rate for Payer: Cash Price	$1.66
Rate for Payer: Cofinity Commercial	$1.46
Rate for Payer: Cofinity Commercial	$1.79
Rate for Payer: Cofinity Medicare Advantage	$1.46
Rate for Payer: Encore Health Key Benefits Commercial	$1.66
Rate for Payer: Healthscope Commercial	$1.87
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1.77
Rate for Payer: PHP Commercial	$1.77
Rate for Payer: Priority Health Cigna Priority Health	$1.35
Rate for Payer: Priority Health SBD	$1.31

CLINDAMYCIN HCL 150 MG CAPSULE

Facility

$270.25

Service Code	NDC 63304069201
Hospital Charge Code	1740
Hospital Revenue Code	637
Min. Negotiated Rate	$108.10
Max. Negotiated Rate	$243.22
Rate for Payer: Aetna Commercial	$229.71
Rate for Payer: Aetna Medicare	$135.12
Rate for Payer: Aetna New Business (MI Preferred)	$175.66
Rate for Payer: BCBS Complete	$108.10
Rate for Payer: Cash Price	$216.20
Rate for Payer: Cofinity Commercial	$189.18
Rate for Payer: Cofinity Commercial	$232.42
Rate for Payer: Cofinity Medicare Advantage	$189.18
Rate for Payer: Encore Health Key Benefits Commercial	$216.20
Rate for Payer: Healthscope Commercial	$243.22
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$229.71
Rate for Payer: PHP Commercial	$229.71
Rate for Payer: Priority Health Cigna Priority Health	$175.66
Rate for Payer: Priority Health SBD	$170.26

CLINDAMYCIN HCL 150 MG CAPSULE

Facility

$4.54

Service Code	NDC 42292001801
Hospital Charge Code	1740
Hospital Revenue Code	637
Min. Negotiated Rate	$1.82
Max. Negotiated Rate	$4.09
Rate for Payer: Aetna Commercial	$3.86
Rate for Payer: Aetna Medicare	$2.27
Rate for Payer: Aetna New Business (MI Preferred)	$2.95
Rate for Payer: BCBS Complete	$1.82
Rate for Payer: Cash Price	$3.63
Rate for Payer: Cofinity Commercial	$3.18
Rate for Payer: Cofinity Commercial	$3.90
Rate for Payer: Cofinity Medicare Advantage	$3.18
Rate for Payer: Encore Health Key Benefits Commercial	$3.63
Rate for Payer: Healthscope Commercial	$4.09
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3.86
Rate for Payer: PHP Commercial	$3.86
Rate for Payer: Priority Health Cigna Priority Health	$2.95
Rate for Payer: Priority Health SBD	$2.86

CLINDAMYCIN HCL 150 MG CAPSULE

Facility

$2.08

Service Code	NDC 68084024311
Hospital Charge Code	1740
Hospital Revenue Code	637
Min. Negotiated Rate	$0.83
Max. Negotiated Rate	$1.87
Rate for Payer: Aetna Commercial	$1.77
Rate for Payer: Aetna Medicare	$1.04
Rate for Payer: Aetna New Business (MI Preferred)	$1.35
Rate for Payer: BCBS Complete	$0.83
Rate for Payer: Cash Price	$1.66
Rate for Payer: Cofinity Commercial	$1.46
Rate for Payer: Cofinity Commercial	$1.79
Rate for Payer: Cofinity Medicare Advantage	$1.46
Rate for Payer: Encore Health Key Benefits Commercial	$1.66
Rate for Payer: Healthscope Commercial	$1.87
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1.77
Rate for Payer: PHP Commercial	$1.77
Rate for Payer: Priority Health Cigna Priority Health	$1.35
Rate for Payer: Priority Health SBD	$1.31

CLINDAMYCIN HCL 150 MG CAPSULE

Facility

$4.54

Service Code	NDC 42292001801
Hospital Charge Code	1740
Hospital Revenue Code	637
Min. Negotiated Rate	$2.86
Max. Negotiated Rate	$4.09
Rate for Payer: Aetna Commercial	$3.86
Rate for Payer: Aetna New Business (MI Preferred)	$2.95
Rate for Payer: Cash Price	$3.63
Rate for Payer: Cofinity Commercial	$3.18
Rate for Payer: Cofinity Commercial	$3.90
Rate for Payer: Cofinity Medicare Advantage	$3.18
Rate for Payer: Encore Health Key Benefits Commercial	$3.63
Rate for Payer: Healthscope Commercial	$4.09
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3.86
Rate for Payer: PHP Commercial	$3.86
Rate for Payer: Priority Health Cigna Priority Health	$2.95
Rate for Payer: Priority Health SBD	$2.86

CLINDAMYCIN HCL 150 MG CAPSULE

Facility

$340.75

Service Code	NDC 00904595961
Hospital Charge Code	1740
Hospital Revenue Code	637
Min. Negotiated Rate	$214.67
Max. Negotiated Rate	$306.68
Rate for Payer: Aetna Commercial	$289.64
Rate for Payer: Aetna New Business (MI Preferred)	$221.49
Rate for Payer: Cash Price	$272.60
Rate for Payer: Cofinity Commercial	$238.52
Rate for Payer: Cofinity Commercial	$293.04
Rate for Payer: Cofinity Medicare Advantage	$238.52
Rate for Payer: Encore Health Key Benefits Commercial	$272.60
Rate for Payer: Healthscope Commercial	$306.68
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$289.64
Rate for Payer: PHP Commercial	$289.64
Rate for Payer: Priority Health Cigna Priority Health	$221.49
Rate for Payer: Priority Health SBD	$214.67

CLINDAMYCIN HCL 150 MG CAPSULE

Facility

$207.10

Service Code	NDC 68084024301
Hospital Charge Code	1740
Hospital Revenue Code	637
Min. Negotiated Rate	$130.47
Max. Negotiated Rate	$186.39
Rate for Payer: Aetna Commercial	$176.04
Rate for Payer: Aetna New Business (MI Preferred)	$134.62
Rate for Payer: Cash Price	$165.68
Rate for Payer: Cofinity Commercial	$144.97
Rate for Payer: Cofinity Commercial	$178.11
Rate for Payer: Cofinity Medicare Advantage	$144.97
Rate for Payer: Encore Health Key Benefits Commercial	$165.68
Rate for Payer: Healthscope Commercial	$186.39
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$176.04
Rate for Payer: PHP Commercial	$176.04
Rate for Payer: Priority Health Cigna Priority Health	$134.62
Rate for Payer: Priority Health SBD	$130.47

CLINDAMYCIN HCL 150 MG CAPSULE

Facility

$207.10

Service Code	NDC 68084024301
Hospital Charge Code	1740
Hospital Revenue Code	637
Min. Negotiated Rate	$82.84
Max. Negotiated Rate	$186.39
Rate for Payer: Aetna Commercial	$176.04
Rate for Payer: Aetna Medicare	$103.55
Rate for Payer: Aetna New Business (MI Preferred)	$134.62
Rate for Payer: BCBS Complete	$82.84
Rate for Payer: Cash Price	$165.68
Rate for Payer: Cofinity Commercial	$144.97
Rate for Payer: Cofinity Commercial	$178.11
Rate for Payer: Cofinity Medicare Advantage	$144.97
Rate for Payer: Encore Health Key Benefits Commercial	$165.68
Rate for Payer: Healthscope Commercial	$186.39
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$176.04
Rate for Payer: PHP Commercial	$176.04
Rate for Payer: Priority Health Cigna Priority Health	$134.62
Rate for Payer: Priority Health SBD	$130.47

CLINDAMYCIN HCL 150 MG CAPSULE

Facility

$453.55

Service Code	NDC 42292001820
Hospital Charge Code	1740
Hospital Revenue Code	637
Min. Negotiated Rate	$181.42
Max. Negotiated Rate	$408.20
Rate for Payer: Aetna Commercial	$385.52
Rate for Payer: Aetna Medicare	$226.78
Rate for Payer: Aetna New Business (MI Preferred)	$294.81
Rate for Payer: BCBS Complete	$181.42
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

CLINDAMYCIN HCL 150 MG CAPSULE

Facility

$270.25

Service Code	NDC 63304069201
Hospital Charge Code	1740
Hospital Revenue Code	637
Min. Negotiated Rate	$170.26
Max. Negotiated Rate	$243.22
Rate for Payer: Aetna Commercial	$229.71
Rate for Payer: Aetna New Business (MI Preferred)	$175.66
Rate for Payer: Cash Price	$216.20
Rate for Payer: Cofinity Commercial	$189.18
Rate for Payer: Cofinity Commercial	$232.42
Rate for Payer: Cofinity Medicare Advantage	$189.18
Rate for Payer: Encore Health Key Benefits Commercial	$216.20
Rate for Payer: Healthscope Commercial	$243.22
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$229.71
Rate for Payer: PHP Commercial	$229.71
Rate for Payer: Priority Health Cigna Priority Health	$175.66
Rate for Payer: Priority Health SBD	$170.26

CLINDAMYCIN HCL 150 MG CAPSULE

Facility

$340.75

Service Code	NDC 00904595961
Hospital Charge Code	1740
Hospital Revenue Code	637
Min. Negotiated Rate	$136.30
Max. Negotiated Rate	$306.68
Rate for Payer: Aetna Commercial	$289.64
Rate for Payer: Aetna Medicare	$170.38
Rate for Payer: Aetna New Business (MI Preferred)	$221.49
Rate for Payer: BCBS Complete	$136.30
Rate for Payer: Cash Price	$272.60
Rate for Payer: Cofinity Commercial	$238.52
Rate for Payer: Cofinity Commercial	$293.04
Rate for Payer: Cofinity Medicare Advantage	$238.52
Rate for Payer: Encore Health Key Benefits Commercial	$272.60
Rate for Payer: Healthscope Commercial	$306.68
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$289.64
Rate for Payer: PHP Commercial	$289.64
Rate for Payer: Priority Health Cigna Priority Health	$221.49
Rate for Payer: Priority Health SBD	$214.67

CLINDAMYCIN HCL 150 MG CAPSULE

Facility

$453.55

Service Code	NDC 42292001820
Hospital Charge Code	1740
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

CLOBAZAM 10 MG TABLET

Facility

$9,607.95

Service Code	NDC 67386031401
Hospital Charge Code	150910
Hospital Revenue Code	637
Min. Negotiated Rate	$3,843.18
Max. Negotiated Rate	$8,647.16
Rate for Payer: Aetna Commercial	$8,166.76
Rate for Payer: Aetna Medicare	$4,803.98
Rate for Payer: Aetna New Business (MI Preferred)	$6,245.17
Rate for Payer: BCBS Complete	$3,843.18
Rate for Payer: Cash Price	$7,686.36
Rate for Payer: Cofinity Commercial	$6,725.56
Rate for Payer: Cofinity Commercial	$8,262.84
Rate for Payer: Cofinity Medicare Advantage	$6,725.56
Rate for Payer: Encore Health Key Benefits Commercial	$7,686.36
Rate for Payer: Healthscope Commercial	$8,647.16
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$8,166.76
Rate for Payer: PHP Commercial	$8,166.76
Rate for Payer: Priority Health Cigna Priority Health	$6,245.17
Rate for Payer: Priority Health SBD	$6,053.01

CLOBAZAM 10 MG TABLET

Facility

$9,607.95

Service Code	NDC 67386031401
Hospital Charge Code	150910
Hospital Revenue Code	637
Min. Negotiated Rate	$6,053.01
Max. Negotiated Rate	$8,647.16
Rate for Payer: Aetna Commercial	$8,166.76
Rate for Payer: Aetna New Business (MI Preferred)	$6,245.17
Rate for Payer: Cash Price	$7,686.36
Rate for Payer: Cofinity Commercial	$6,725.56
Rate for Payer: Cofinity Commercial	$8,262.84
Rate for Payer: Cofinity Medicare Advantage	$6,725.56
Rate for Payer: Encore Health Key Benefits Commercial	$7,686.36
Rate for Payer: Healthscope Commercial	$8,647.16
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$8,166.76
Rate for Payer: PHP Commercial	$8,166.76
Rate for Payer: Priority Health Cigna Priority Health	$6,245.17
Rate for Payer: Priority Health SBD	$6,053.01

CLOBETASOL 0.05 % TOPICAL CREAM

Facility

$18.84

Service Code	NDC 69238153205
Hospital Charge Code	9630
Hospital Revenue Code	637
Min. Negotiated Rate	$7.54
Max. Negotiated Rate	$16.96
Rate for Payer: Aetna Commercial	$16.01
Rate for Payer: Aetna Medicare	$9.42
Rate for Payer: Aetna New Business (MI Preferred)	$12.25
Rate for Payer: BCBS Complete	$7.54
Rate for Payer: Cash Price	$15.07
Rate for Payer: Cofinity Commercial	$13.19
Rate for Payer: Cofinity Commercial	$16.20
Rate for Payer: Cofinity Medicare Advantage	$13.19
Rate for Payer: Encore Health Key Benefits Commercial	$15.07
Rate for Payer: Healthscope Commercial	$16.96
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$16.01
Rate for Payer: PHP Commercial	$16.01
Rate for Payer: Priority Health Cigna Priority Health	$12.25
Rate for Payer: Priority Health SBD	$11.87

CLOBETASOL 0.05 % TOPICAL CREAM

Facility

$32.55

Service Code	NDC 51672125801
Hospital Charge Code	9630
Hospital Revenue Code	637
Min. Negotiated Rate	$20.51
Max. Negotiated Rate	$29.30
Rate for Payer: Aetna Commercial	$27.67
Rate for Payer: Aetna New Business (MI Preferred)	$21.16
Rate for Payer: Cash Price	$26.04
Rate for Payer: Cofinity Commercial	$22.78
Rate for Payer: Cofinity Commercial	$27.99
Rate for Payer: Cofinity Medicare Advantage	$22.78
Rate for Payer: Encore Health Key Benefits Commercial	$26.04
Rate for Payer: Healthscope Commercial	$29.30
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$27.67
Rate for Payer: PHP Commercial	$27.67
Rate for Payer: Priority Health Cigna Priority Health	$21.16
Rate for Payer: Priority Health SBD	$20.51

CLOBETASOL 0.05 % TOPICAL CREAM

Facility

$130.20

Service Code	NDC 51672125803
Hospital Charge Code	9630
Hospital Revenue Code	637
Min. Negotiated Rate	$52.08
Max. Negotiated Rate	$117.18
Rate for Payer: Aetna Commercial	$110.67
Rate for Payer: Aetna Medicare	$65.10
Rate for Payer: Aetna New Business (MI Preferred)	$84.63
Rate for Payer: BCBS Complete	$52.08
Rate for Payer: Cash Price	$104.16
Rate for Payer: Cofinity Commercial	$111.97
Rate for Payer: Cofinity Commercial	$91.14
Rate for Payer: Cofinity Medicare Advantage	$91.14
Rate for Payer: Encore Health Key Benefits Commercial	$104.16
Rate for Payer: Healthscope Commercial	$117.18
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$110.67
Rate for Payer: PHP Commercial	$110.67
Rate for Payer: Priority Health Cigna Priority Health	$84.63
Rate for Payer: Priority Health SBD	$82.03

CLOBETASOL 0.05 % TOPICAL CREAM

Facility

$52.61

Service Code	NDC 00168016315
Hospital Charge Code	9630
Hospital Revenue Code	637
Min. Negotiated Rate	$21.04
Max. Negotiated Rate	$47.35
Rate for Payer: Aetna Commercial	$44.72
Rate for Payer: Aetna Medicare	$26.30
Rate for Payer: Aetna New Business (MI Preferred)	$34.20
Rate for Payer: BCBS Complete	$21.04
Rate for Payer: Cash Price	$42.09
Rate for Payer: Cofinity Commercial	$36.83
Rate for Payer: Cofinity Commercial	$45.24
Rate for Payer: Cofinity Medicare Advantage	$36.83
Rate for Payer: Encore Health Key Benefits Commercial	$42.09
Rate for Payer: Healthscope Commercial	$47.35
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$44.72
Rate for Payer: PHP Commercial	$44.72
Rate for Payer: Priority Health Cigna Priority Health	$34.20
Rate for Payer: Priority Health SBD	$33.14

CLOBETASOL 0.05 % TOPICAL CREAM

Facility

$52.61

Service Code	NDC 00168016315
Hospital Charge Code	9630
Hospital Revenue Code	637
Min. Negotiated Rate	$33.14
Max. Negotiated Rate	$47.35
Rate for Payer: Aetna Commercial	$44.72
Rate for Payer: Aetna New Business (MI Preferred)	$34.20
Rate for Payer: Cash Price	$42.09
Rate for Payer: Cofinity Commercial	$36.83
Rate for Payer: Cofinity Commercial	$45.24
Rate for Payer: Cofinity Medicare Advantage	$36.83
Rate for Payer: Encore Health Key Benefits Commercial	$42.09
Rate for Payer: Healthscope Commercial	$47.35
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$44.72
Rate for Payer: PHP Commercial	$44.72
Rate for Payer: Priority Health Cigna Priority Health	$34.20
Rate for Payer: Priority Health SBD	$33.14

Know your out-of-pocket cost for care.

All Charges