Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

CLONIDINE 0.2 MG/24 HR WEEKLY TRANSDERMAL PATCH

Facility

$153.52

Service Code	NDC 00378087216
Hospital Charge Code	27506
Hospital Revenue Code	637
Min. Negotiated Rate	$61.41
Max. Negotiated Rate	$138.17
Rate for Payer: Aetna Commercial	$130.49
Rate for Payer: Aetna Medicare	$76.76
Rate for Payer: Aetna New Business (MI Preferred)	$99.79
Rate for Payer: BCBS Complete	$61.41
Rate for Payer: Cash Price	$122.82
Rate for Payer: Cofinity Commercial	$107.46
Rate for Payer: Cofinity Commercial	$132.03
Rate for Payer: Cofinity Medicare Advantage	$107.46
Rate for Payer: Encore Health Key Benefits Commercial	$122.82
Rate for Payer: Healthscope Commercial	$138.17
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$130.49
Rate for Payer: PHP Commercial	$130.49
Rate for Payer: Priority Health Cigna Priority Health	$99.79
Rate for Payer: Priority Health SBD	$96.72

CLONIDINE 0.2 MG/24 HR WEEKLY TRANSDERMAL PATCH

Facility

$614.06

Service Code	NDC 00378087299
Hospital Charge Code	27506
Hospital Revenue Code	637
Min. Negotiated Rate	$245.62
Max. Negotiated Rate	$552.65
Rate for Payer: Aetna Commercial	$521.95
Rate for Payer: Aetna Medicare	$307.03
Rate for Payer: Aetna New Business (MI Preferred)	$399.14
Rate for Payer: BCBS Complete	$245.62
Rate for Payer: Cash Price	$491.25
Rate for Payer: Cofinity Commercial	$429.84
Rate for Payer: Cofinity Commercial	$528.09
Rate for Payer: Cofinity Medicare Advantage	$429.84
Rate for Payer: Encore Health Key Benefits Commercial	$491.25
Rate for Payer: Healthscope Commercial	$552.65
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$521.95
Rate for Payer: PHP Commercial	$521.95
Rate for Payer: Priority Health Cigna Priority Health	$399.14
Rate for Payer: Priority Health SBD	$386.86

CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH

Facility

$212.97

Service Code	NDC 00378087316
Hospital Charge Code	27507
Hospital Revenue Code	637
Min. Negotiated Rate	$85.19
Max. Negotiated Rate	$191.67
Rate for Payer: Aetna Commercial	$181.02
Rate for Payer: Aetna Medicare	$106.48
Rate for Payer: Aetna New Business (MI Preferred)	$138.43
Rate for Payer: BCBS Complete	$85.19
Rate for Payer: Cash Price	$170.38
Rate for Payer: Cofinity Commercial	$149.08
Rate for Payer: Cofinity Commercial	$183.15
Rate for Payer: Cofinity Medicare Advantage	$149.08
Rate for Payer: Encore Health Key Benefits Commercial	$170.38
Rate for Payer: Healthscope Commercial	$191.67
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$181.02
Rate for Payer: PHP Commercial	$181.02
Rate for Payer: Priority Health Cigna Priority Health	$138.43
Rate for Payer: Priority Health SBD	$134.17

CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH

Facility

$851.86

Service Code	NDC 00378087399
Hospital Charge Code	27507
Hospital Revenue Code	637
Min. Negotiated Rate	$340.74
Max. Negotiated Rate	$766.67
Rate for Payer: Aetna Commercial	$724.08
Rate for Payer: Aetna Medicare	$425.93
Rate for Payer: Aetna New Business (MI Preferred)	$553.71
Rate for Payer: BCBS Complete	$340.74
Rate for Payer: Cash Price	$681.49
Rate for Payer: Cofinity Commercial	$596.30
Rate for Payer: Cofinity Commercial	$732.60
Rate for Payer: Cofinity Medicare Advantage	$596.30
Rate for Payer: Encore Health Key Benefits Commercial	$681.49
Rate for Payer: Healthscope Commercial	$766.67
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$724.08
Rate for Payer: PHP Commercial	$724.08
Rate for Payer: Priority Health Cigna Priority Health	$553.71
Rate for Payer: Priority Health SBD	$536.67

CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH

Facility

$851.86

Service Code	NDC 00378087399
Hospital Charge Code	27507
Hospital Revenue Code	637
Min. Negotiated Rate	$536.67
Max. Negotiated Rate	$766.67
Rate for Payer: Aetna Commercial	$724.08
Rate for Payer: Aetna New Business (MI Preferred)	$553.71
Rate for Payer: Cash Price	$681.49
Rate for Payer: Cofinity Commercial	$596.30
Rate for Payer: Cofinity Commercial	$732.60
Rate for Payer: Cofinity Medicare Advantage	$596.30
Rate for Payer: Encore Health Key Benefits Commercial	$681.49
Rate for Payer: Healthscope Commercial	$766.67
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$724.08
Rate for Payer: PHP Commercial	$724.08
Rate for Payer: Priority Health Cigna Priority Health	$553.71
Rate for Payer: Priority Health SBD	$536.67

CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH

Facility

$212.97

Service Code	NDC 00378087316
Hospital Charge Code	27507
Hospital Revenue Code	637
Min. Negotiated Rate	$134.17
Max. Negotiated Rate	$191.67
Rate for Payer: Aetna Commercial	$181.02
Rate for Payer: Aetna New Business (MI Preferred)	$138.43
Rate for Payer: Cash Price	$170.38
Rate for Payer: Cofinity Commercial	$149.08
Rate for Payer: Cofinity Commercial	$183.15
Rate for Payer: Cofinity Medicare Advantage	$149.08
Rate for Payer: Encore Health Key Benefits Commercial	$170.38
Rate for Payer: Healthscope Commercial	$191.67
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$181.02
Rate for Payer: PHP Commercial	$181.02
Rate for Payer: Priority Health Cigna Priority Health	$138.43
Rate for Payer: Priority Health SBD	$134.17

CLONIDINE HCL 0.1 MG TABLET

Facility

$285.95

Service Code	NDC 60687011301
Hospital Charge Code	1755
Hospital Revenue Code	637
Min. Negotiated Rate	$114.38
Max. Negotiated Rate	$257.36
Rate for Payer: Aetna Commercial	$243.06
Rate for Payer: Aetna Medicare	$142.98
Rate for Payer: Aetna New Business (MI Preferred)	$185.87
Rate for Payer: BCBS Complete	$114.38
Rate for Payer: Cash Price	$228.76
Rate for Payer: Cofinity Commercial	$200.16
Rate for Payer: Cofinity Commercial	$245.92
Rate for Payer: Cofinity Medicare Advantage	$200.16
Rate for Payer: Encore Health Key Benefits Commercial	$228.76
Rate for Payer: Healthscope Commercial	$257.36
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$243.06
Rate for Payer: PHP Commercial	$243.06
Rate for Payer: Priority Health Cigna Priority Health	$185.87
Rate for Payer: Priority Health SBD	$180.15

CLONIDINE HCL 0.1 MG TABLET

Facility

$2.86

Service Code	NDC 60687011311
Hospital Charge Code	1755
Hospital Revenue Code	637
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$2.57
Rate for Payer: Aetna Commercial	$2.43
Rate for Payer: Aetna New Business (MI Preferred)	$1.86
Rate for Payer: Cash Price	$2.29
Rate for Payer: Cofinity Commercial	$2.00
Rate for Payer: Cofinity Commercial	$2.46
Rate for Payer: Cofinity Medicare Advantage	$2.00
Rate for Payer: Encore Health Key Benefits Commercial	$2.29
Rate for Payer: Healthscope Commercial	$2.57
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2.43
Rate for Payer: PHP Commercial	$2.43
Rate for Payer: Priority Health Cigna Priority Health	$1.86
Rate for Payer: Priority Health SBD	$1.80

CLONIDINE HCL 0.1 MG TABLET

Facility

$285.95

Service Code	NDC 60687011301
Hospital Charge Code	1755
Hospital Revenue Code	637
Min. Negotiated Rate	$180.15
Max. Negotiated Rate	$257.36
Rate for Payer: Aetna Commercial	$243.06
Rate for Payer: Aetna New Business (MI Preferred)	$185.87
Rate for Payer: Cash Price	$228.76
Rate for Payer: Cofinity Commercial	$200.16
Rate for Payer: Cofinity Commercial	$245.92
Rate for Payer: Cofinity Medicare Advantage	$200.16
Rate for Payer: Encore Health Key Benefits Commercial	$228.76
Rate for Payer: Healthscope Commercial	$257.36
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$243.06
Rate for Payer: PHP Commercial	$243.06
Rate for Payer: Priority Health Cigna Priority Health	$185.87
Rate for Payer: Priority Health SBD	$180.15

CLONIDINE HCL 0.1 MG TABLET

Facility

$84.60

Service Code	NDC 58657064701
Hospital Charge Code	1755
Hospital Revenue Code	637
Min. Negotiated Rate	$53.30
Max. Negotiated Rate	$76.14
Rate for Payer: Aetna Commercial	$71.91
Rate for Payer: Aetna New Business (MI Preferred)	$54.99
Rate for Payer: Cash Price	$67.68
Rate for Payer: Cofinity Commercial	$59.22
Rate for Payer: Cofinity Commercial	$72.76
Rate for Payer: Cofinity Medicare Advantage	$59.22
Rate for Payer: Encore Health Key Benefits Commercial	$67.68
Rate for Payer: Healthscope Commercial	$76.14
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$71.91
Rate for Payer: PHP Commercial	$71.91
Rate for Payer: Priority Health Cigna Priority Health	$54.99
Rate for Payer: Priority Health SBD	$53.30

CLONIDINE HCL 0.1 MG TABLET

Facility

$91.65

Service Code	NDC 00228212710
Hospital Charge Code	1755
Hospital Revenue Code	637
Min. Negotiated Rate	$57.74
Max. Negotiated Rate	$82.48
Rate for Payer: Aetna Commercial	$77.90
Rate for Payer: Aetna New Business (MI Preferred)	$59.57
Rate for Payer: Cash Price	$73.32
Rate for Payer: Cofinity Commercial	$64.16
Rate for Payer: Cofinity Commercial	$78.82
Rate for Payer: Cofinity Medicare Advantage	$64.16
Rate for Payer: Encore Health Key Benefits Commercial	$73.32
Rate for Payer: Healthscope Commercial	$82.48
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$77.90
Rate for Payer: PHP Commercial	$77.90
Rate for Payer: Priority Health Cigna Priority Health	$59.57
Rate for Payer: Priority Health SBD	$57.74

CLONIDINE HCL 0.1 MG TABLET

Facility

$91.65

Service Code	NDC 00228212710
Hospital Charge Code	1755
Hospital Revenue Code	637
Min. Negotiated Rate	$36.66
Max. Negotiated Rate	$82.48
Rate for Payer: Aetna Commercial	$77.90
Rate for Payer: Aetna Medicare	$45.82
Rate for Payer: Aetna New Business (MI Preferred)	$59.57
Rate for Payer: BCBS Complete	$36.66
Rate for Payer: Cash Price	$73.32
Rate for Payer: Cofinity Commercial	$64.16
Rate for Payer: Cofinity Commercial	$78.82
Rate for Payer: Cofinity Medicare Advantage	$64.16
Rate for Payer: Encore Health Key Benefits Commercial	$73.32
Rate for Payer: Healthscope Commercial	$82.48
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$77.90
Rate for Payer: PHP Commercial	$77.90
Rate for Payer: Priority Health Cigna Priority Health	$59.57
Rate for Payer: Priority Health SBD	$57.74

CLONIDINE HCL 0.1 MG TABLET

Facility

$2.86

Service Code	NDC 60687011311
Hospital Charge Code	1755
Hospital Revenue Code	637
Min. Negotiated Rate	$1.14
Max. Negotiated Rate	$2.57
Rate for Payer: Aetna Commercial	$2.43
Rate for Payer: Aetna Medicare	$1.43
Rate for Payer: Aetna New Business (MI Preferred)	$1.86
Rate for Payer: BCBS Complete	$1.14
Rate for Payer: Cash Price	$2.29
Rate for Payer: Cofinity Commercial	$2.00
Rate for Payer: Cofinity Commercial	$2.46
Rate for Payer: Cofinity Medicare Advantage	$2.00
Rate for Payer: Encore Health Key Benefits Commercial	$2.29
Rate for Payer: Healthscope Commercial	$2.57
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2.43
Rate for Payer: PHP Commercial	$2.43
Rate for Payer: Priority Health Cigna Priority Health	$1.86
Rate for Payer: Priority Health SBD	$1.80

CLONIDINE HCL 0.1 MG TABLET

Facility

$84.60

Service Code	NDC 58657064701
Hospital Charge Code	1755
Hospital Revenue Code	637
Min. Negotiated Rate	$33.84
Max. Negotiated Rate	$76.14
Rate for Payer: Aetna Commercial	$71.91
Rate for Payer: Aetna Medicare	$42.30
Rate for Payer: Aetna New Business (MI Preferred)	$54.99
Rate for Payer: BCBS Complete	$33.84
Rate for Payer: Cash Price	$67.68
Rate for Payer: Cofinity Commercial	$59.22
Rate for Payer: Cofinity Commercial	$72.76
Rate for Payer: Cofinity Medicare Advantage	$59.22
Rate for Payer: Encore Health Key Benefits Commercial	$67.68
Rate for Payer: Healthscope Commercial	$76.14
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$71.91
Rate for Payer: PHP Commercial	$71.91
Rate for Payer: Priority Health Cigna Priority Health	$54.99
Rate for Payer: Priority Health SBD	$53.30

CLONIDINE HCL 0.2 MG TABLET

Facility

$126.90

Service Code	NDC 29300013601
Hospital Charge Code	1756
Hospital Revenue Code	637
Min. Negotiated Rate	$79.95
Max. Negotiated Rate	$114.21
Rate for Payer: Aetna Commercial	$107.86
Rate for Payer: Aetna New Business (MI Preferred)	$82.48
Rate for Payer: Cash Price	$101.52
Rate for Payer: Cofinity Commercial	$109.13
Rate for Payer: Cofinity Commercial	$88.83
Rate for Payer: Cofinity Medicare Advantage	$88.83
Rate for Payer: Encore Health Key Benefits Commercial	$101.52
Rate for Payer: Healthscope Commercial	$114.21
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$107.86
Rate for Payer: PHP Commercial	$107.86
Rate for Payer: Priority Health Cigna Priority Health	$82.48
Rate for Payer: Priority Health SBD	$79.95

CLONIDINE HCL 0.2 MG TABLET

Facility

$126.90

Service Code	NDC 52817018110
Hospital Charge Code	1756
Hospital Revenue Code	637
Min. Negotiated Rate	$50.76
Max. Negotiated Rate	$114.21
Rate for Payer: Aetna Commercial	$107.86
Rate for Payer: Aetna Medicare	$63.45
Rate for Payer: Aetna New Business (MI Preferred)	$82.48
Rate for Payer: BCBS Complete	$50.76
Rate for Payer: Cash Price	$101.52
Rate for Payer: Cofinity Commercial	$109.13
Rate for Payer: Cofinity Commercial	$88.83
Rate for Payer: Cofinity Medicare Advantage	$88.83
Rate for Payer: Encore Health Key Benefits Commercial	$101.52
Rate for Payer: Healthscope Commercial	$114.21
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$107.86
Rate for Payer: PHP Commercial	$107.86
Rate for Payer: Priority Health Cigna Priority Health	$82.48
Rate for Payer: Priority Health SBD	$79.95

CLONIDINE HCL 0.2 MG TABLET

Facility

$2.69

Service Code	NDC 60687012411
Hospital Charge Code	1756
Hospital Revenue Code	637
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$2.42
Rate for Payer: Aetna Commercial	$2.29
Rate for Payer: Aetna New Business (MI Preferred)	$1.75
Rate for Payer: Cash Price	$2.15
Rate for Payer: Cofinity Commercial	$1.88
Rate for Payer: Cofinity Commercial	$2.31
Rate for Payer: Cofinity Medicare Advantage	$1.88
Rate for Payer: Encore Health Key Benefits Commercial	$2.15
Rate for Payer: Healthscope Commercial	$2.42
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2.29
Rate for Payer: PHP Commercial	$2.29
Rate for Payer: Priority Health Cigna Priority Health	$1.75
Rate for Payer: Priority Health SBD	$1.69

CLONIDINE HCL 0.2 MG TABLET

Facility

$126.90

Service Code	NDC 52817018110
Hospital Charge Code	1756
Hospital Revenue Code	637
Min. Negotiated Rate	$79.95
Max. Negotiated Rate	$114.21
Rate for Payer: Aetna Commercial	$107.86
Rate for Payer: Aetna New Business (MI Preferred)	$82.48
Rate for Payer: Cash Price	$101.52
Rate for Payer: Cofinity Commercial	$109.13
Rate for Payer: Cofinity Commercial	$88.83
Rate for Payer: Cofinity Medicare Advantage	$88.83
Rate for Payer: Encore Health Key Benefits Commercial	$101.52
Rate for Payer: Healthscope Commercial	$114.21
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$107.86
Rate for Payer: PHP Commercial	$107.86
Rate for Payer: Priority Health Cigna Priority Health	$82.48
Rate for Payer: Priority Health SBD	$79.95

CLONIDINE HCL 0.2 MG TABLET

Facility

$268.85

Service Code	NDC 60687012401
Hospital Charge Code	1756
Hospital Revenue Code	637
Min. Negotiated Rate	$169.38
Max. Negotiated Rate	$241.96
Rate for Payer: Aetna Commercial	$228.52
Rate for Payer: Aetna New Business (MI Preferred)	$174.75
Rate for Payer: Cash Price	$215.08
Rate for Payer: Cofinity Commercial	$188.20
Rate for Payer: Cofinity Commercial	$231.21
Rate for Payer: Cofinity Medicare Advantage	$188.20
Rate for Payer: Encore Health Key Benefits Commercial	$215.08
Rate for Payer: Healthscope Commercial	$241.96
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$228.52
Rate for Payer: PHP Commercial	$228.52
Rate for Payer: Priority Health Cigna Priority Health	$174.75
Rate for Payer: Priority Health SBD	$169.38

CLONIDINE HCL 0.2 MG TABLET

Facility

$268.85

Service Code	NDC 60687012401
Hospital Charge Code	1756
Hospital Revenue Code	637
Min. Negotiated Rate	$107.54
Max. Negotiated Rate	$241.96
Rate for Payer: Aetna Commercial	$228.52
Rate for Payer: Aetna Medicare	$134.42
Rate for Payer: Aetna New Business (MI Preferred)	$174.75
Rate for Payer: BCBS Complete	$107.54
Rate for Payer: Cash Price	$215.08
Rate for Payer: Cofinity Commercial	$188.20
Rate for Payer: Cofinity Commercial	$231.21
Rate for Payer: Cofinity Medicare Advantage	$188.20
Rate for Payer: Encore Health Key Benefits Commercial	$215.08
Rate for Payer: Healthscope Commercial	$241.96
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$228.52
Rate for Payer: PHP Commercial	$228.52
Rate for Payer: Priority Health Cigna Priority Health	$174.75
Rate for Payer: Priority Health SBD	$169.38

CLONIDINE HCL 0.2 MG TABLET

Facility

$126.90

Service Code	NDC 29300013601
Hospital Charge Code	1756
Hospital Revenue Code	637
Min. Negotiated Rate	$50.76
Max. Negotiated Rate	$114.21
Rate for Payer: Aetna Commercial	$107.86
Rate for Payer: Aetna Medicare	$63.45
Rate for Payer: Aetna New Business (MI Preferred)	$82.48
Rate for Payer: BCBS Complete	$50.76
Rate for Payer: Cash Price	$101.52
Rate for Payer: Cofinity Commercial	$109.13
Rate for Payer: Cofinity Commercial	$88.83
Rate for Payer: Cofinity Medicare Advantage	$88.83
Rate for Payer: Encore Health Key Benefits Commercial	$101.52
Rate for Payer: Healthscope Commercial	$114.21
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$107.86
Rate for Payer: PHP Commercial	$107.86
Rate for Payer: Priority Health Cigna Priority Health	$82.48
Rate for Payer: Priority Health SBD	$79.95

CLONIDINE HCL 0.2 MG TABLET

Facility

$2.69

Service Code	NDC 60687012411
Hospital Charge Code	1756
Hospital Revenue Code	637
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$2.42
Rate for Payer: Aetna Commercial	$2.29
Rate for Payer: Aetna Medicare	$1.34
Rate for Payer: Aetna New Business (MI Preferred)	$1.75
Rate for Payer: BCBS Complete	$1.08
Rate for Payer: Cash Price	$2.15
Rate for Payer: Cofinity Commercial	$1.88
Rate for Payer: Cofinity Commercial	$2.31
Rate for Payer: Cofinity Medicare Advantage	$1.88
Rate for Payer: Encore Health Key Benefits Commercial	$2.15
Rate for Payer: Healthscope Commercial	$2.42
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2.29
Rate for Payer: PHP Commercial	$2.29
Rate for Payer: Priority Health Cigna Priority Health	$1.75
Rate for Payer: Priority Health SBD	$1.69

CLONIDINE HCL 0.3 MG TABLET

Facility

$162.15

Service Code	NDC 52817018210
Hospital Charge Code	1757
Hospital Revenue Code	637
Min. Negotiated Rate	$64.86
Max. Negotiated Rate	$145.94
Rate for Payer: Aetna Commercial	$137.83
Rate for Payer: Aetna Medicare	$81.08
Rate for Payer: Aetna New Business (MI Preferred)	$105.40
Rate for Payer: BCBS Complete	$64.86
Rate for Payer: Cash Price	$129.72
Rate for Payer: Cofinity Commercial	$113.50
Rate for Payer: Cofinity Commercial	$139.45
Rate for Payer: Cofinity Medicare Advantage	$113.50
Rate for Payer: Encore Health Key Benefits Commercial	$129.72
Rate for Payer: Healthscope Commercial	$145.94
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$137.83
Rate for Payer: PHP Commercial	$137.83
Rate for Payer: Priority Health Cigna Priority Health	$105.40
Rate for Payer: Priority Health SBD	$102.15

CLONIDINE HCL 0.3 MG TABLET

Facility

$2.24

Service Code	NDC 51079030101
Hospital Charge Code	1757
Hospital Revenue Code	637
Min. Negotiated Rate	$1.41
Max. Negotiated Rate	$2.02
Rate for Payer: Aetna Commercial	$1.90
Rate for Payer: Aetna New Business (MI Preferred)	$1.46
Rate for Payer: Cash Price	$1.79
Rate for Payer: Cofinity Commercial	$1.57
Rate for Payer: Cofinity Commercial	$1.93
Rate for Payer: Cofinity Medicare Advantage	$1.57
Rate for Payer: Encore Health Key Benefits Commercial	$1.79
Rate for Payer: Healthscope Commercial	$2.02
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1.90
Rate for Payer: PHP Commercial	$1.90
Rate for Payer: Priority Health Cigna Priority Health	$1.46
Rate for Payer: Priority Health SBD	$1.41

CLONIDINE HCL 0.3 MG TABLET

Facility

$159.60

Service Code	NDC 50268019415
Hospital Charge Code	1757
Hospital Revenue Code	637
Min. Negotiated Rate	$63.84
Max. Negotiated Rate	$143.64
Rate for Payer: Aetna Commercial	$135.66
Rate for Payer: Aetna Medicare	$79.80
Rate for Payer: Aetna New Business (MI Preferred)	$103.74
Rate for Payer: BCBS Complete	$63.84
Rate for Payer: Cash Price	$127.68
Rate for Payer: Cofinity Commercial	$111.72
Rate for Payer: Cofinity Commercial	$137.26
Rate for Payer: Cofinity Medicare Advantage	$111.72
Rate for Payer: Encore Health Key Benefits Commercial	$127.68
Rate for Payer: Healthscope Commercial	$143.64
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$135.66
Rate for Payer: PHP Commercial	$135.66
Rate for Payer: Priority Health Cigna Priority Health	$103.74
Rate for Payer: Priority Health SBD	$100.55

Know your out-of-pocket cost for care.

All Charges