Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

ASPIRIN 25 MG-DIPYRIDAMOLE 200 MG CAPSULE,EXT.RELEASE 12 HR MULTIPHASE

Facility

$215.14

Service Code	NDC 68462-405-60
Hospital Charge Code	27644
Hospital Revenue Code	637
Min. Negotiated Rate	$135.54
Max. Negotiated Rate	$193.63
Rate for Payer: Aetna Commercial	$182.87
Rate for Payer: Aetna New Business (MI Preferred)	$139.84
Rate for Payer: Cash Price	$172.11
Rate for Payer: Cofinity Commercial	$150.60
Rate for Payer: Cofinity Commercial	$185.02
Rate for Payer: Healthscope Commercial	$193.63
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$182.87
Rate for Payer: PHP Commercial	$182.87
Rate for Payer: Priority Health Cigna Priority Health	$150.60
Rate for Payer: Priority Health SBD	$135.54

ASPIRIN 300 MG RECTAL SUPPOSITORY

Facility

$36.43

Service Code	NDC 0574-7034-12
Hospital Charge Code	693
Hospital Revenue Code	637
Min. Negotiated Rate	$22.95
Max. Negotiated Rate	$32.79
Rate for Payer: Aetna Commercial	$30.97
Rate for Payer: Aetna New Business (MI Preferred)	$23.68
Rate for Payer: Cash Price	$29.14
Rate for Payer: Cofinity Commercial	$25.50
Rate for Payer: Cofinity Commercial	$31.33
Rate for Payer: Healthscope Commercial	$32.79
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$30.97
Rate for Payer: PHP Commercial	$30.97
Rate for Payer: Priority Health Cigna Priority Health	$25.50
Rate for Payer: Priority Health SBD	$22.95

ASPIRIN 325 MG TABLET

Facility

$511.50

Service Code	NDC 66553-001-01
Hospital Charge Code	681
Hospital Revenue Code	637
Min. Negotiated Rate	$322.24
Max. Negotiated Rate	$460.35
Rate for Payer: Aetna Commercial	$434.78
Rate for Payer: Aetna New Business (MI Preferred)	$332.48
Rate for Payer: Cash Price	$409.20
Rate for Payer: Cofinity Commercial	$358.05
Rate for Payer: Cofinity Commercial	$439.89
Rate for Payer: Healthscope Commercial	$460.35
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$434.78
Rate for Payer: PHP Commercial	$434.78
Rate for Payer: Priority Health Cigna Priority Health	$358.05
Rate for Payer: Priority Health SBD	$322.24

ASPIRIN 81 MG CHEWABLE TABLET

Facility

$441.00

Service Code	NDC 0904-6794-80
Hospital Charge Code	679
Hospital Revenue Code	637
Min. Negotiated Rate	$277.83
Max. Negotiated Rate	$396.90
Rate for Payer: Aetna Commercial	$374.85
Rate for Payer: Aetna New Business (MI Preferred)	$286.65
Rate for Payer: Cash Price	$352.80
Rate for Payer: Cofinity Commercial	$308.70
Rate for Payer: Cofinity Commercial	$379.26
Rate for Payer: Healthscope Commercial	$396.90
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$374.85
Rate for Payer: PHP Commercial	$374.85
Rate for Payer: Priority Health Cigna Priority Health	$308.70
Rate for Payer: Priority Health SBD	$277.83

ASPIRIN 81 MG CHEWABLE TABLET

Facility

$58.97

Service Code	NDC 0536-1008-36
Hospital Charge Code	679
Hospital Revenue Code	637
Min. Negotiated Rate	$37.15
Max. Negotiated Rate	$53.07
Rate for Payer: Aetna Commercial	$50.12
Rate for Payer: Aetna New Business (MI Preferred)	$38.33
Rate for Payer: Cash Price	$47.18
Rate for Payer: Cofinity Commercial	$41.28
Rate for Payer: Cofinity Commercial	$50.71
Rate for Payer: Healthscope Commercial	$53.07
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$50.12
Rate for Payer: PHP Commercial	$50.12
Rate for Payer: Priority Health Cigna Priority Health	$41.28
Rate for Payer: Priority Health SBD	$37.15

ASPIRIN 81 MG CHEWABLE TABLET

Facility

$744.00

Service Code	NDC 63739-434-02
Hospital Charge Code	679
Hospital Revenue Code	637
Min. Negotiated Rate	$468.72
Max. Negotiated Rate	$669.60
Rate for Payer: Aetna Commercial	$632.40
Rate for Payer: Aetna New Business (MI Preferred)	$483.60
Rate for Payer: Cash Price	$595.20
Rate for Payer: Cofinity Commercial	$520.80
Rate for Payer: Cofinity Commercial	$639.84
Rate for Payer: Healthscope Commercial	$669.60
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$632.40
Rate for Payer: PHP Commercial	$632.40
Rate for Payer: Priority Health Cigna Priority Health	$520.80
Rate for Payer: Priority Health SBD	$468.72

ASPIRIN 81 MG CHEWABLE TABLET

Facility

$1,134.00

Service Code	NDC 63739-434-01
Hospital Charge Code	679
Hospital Revenue Code	637
Min. Negotiated Rate	$714.42
Max. Negotiated Rate	$1,020.60
Rate for Payer: Aetna Commercial	$963.90
Rate for Payer: Aetna New Business (MI Preferred)	$737.10
Rate for Payer: Cash Price	$907.20
Rate for Payer: Cofinity Commercial	$793.80
Rate for Payer: Cofinity Commercial	$975.24
Rate for Payer: Healthscope Commercial	$1,020.60
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$963.90
Rate for Payer: PHP Commercial	$963.90
Rate for Payer: Priority Health Cigna Priority Health	$793.80
Rate for Payer: Priority Health SBD	$714.42

ASPIRIN 81 MG CHEWABLE TABLET

Facility

$672.00

Service Code	NDC 0904-6794-30
Hospital Charge Code	679
Hospital Revenue Code	637
Min. Negotiated Rate	$423.36
Max. Negotiated Rate	$604.80
Rate for Payer: Aetna Commercial	$571.20
Rate for Payer: Aetna New Business (MI Preferred)	$436.80
Rate for Payer: Cash Price	$537.60
Rate for Payer: Cofinity Commercial	$470.40
Rate for Payer: Cofinity Commercial	$577.92
Rate for Payer: Healthscope Commercial	$604.80
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$571.20
Rate for Payer: PHP Commercial	$571.20
Rate for Payer: Priority Health Cigna Priority Health	$470.40
Rate for Payer: Priority Health SBD	$423.36

ASPIRIN 81 MG CHEWABLE TABLET

Facility

$252.00

Service Code	NDC 16103-366-11
Hospital Charge Code	679
Hospital Revenue Code	637
Min. Negotiated Rate	$158.76
Max. Negotiated Rate	$226.80
Rate for Payer: Aetna Commercial	$214.20
Rate for Payer: Aetna New Business (MI Preferred)	$163.80
Rate for Payer: Cash Price	$201.60
Rate for Payer: Cofinity Commercial	$176.40
Rate for Payer: Cofinity Commercial	$216.72
Rate for Payer: Healthscope Commercial	$226.80
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$214.20
Rate for Payer: PHP Commercial	$214.20
Rate for Payer: Priority Health Cigna Priority Health	$176.40
Rate for Payer: Priority Health SBD	$158.76

ASPIRIN 81 MG CHEWABLE TABLET

Facility

$47.63

Service Code	NDC 57896-911-36
Hospital Charge Code	679
Hospital Revenue Code	637
Min. Negotiated Rate	$30.01
Max. Negotiated Rate	$42.87
Rate for Payer: Aetna Commercial	$40.49
Rate for Payer: Aetna New Business (MI Preferred)	$30.96
Rate for Payer: Cash Price	$38.10
Rate for Payer: Cofinity Commercial	$33.34
Rate for Payer: Cofinity Commercial	$40.96
Rate for Payer: Healthscope Commercial	$42.87
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$40.49
Rate for Payer: PHP Commercial	$40.49
Rate for Payer: Priority Health Cigna Priority Health	$33.34
Rate for Payer: Priority Health SBD	$30.01

ASPIRIN 81 MG CHEWABLE TABLET

Facility

$544.50

Service Code	NDC 66553-002-01
Hospital Charge Code	679
Hospital Revenue Code	637
Min. Negotiated Rate	$343.04
Max. Negotiated Rate	$490.05
Rate for Payer: Aetna Commercial	$462.82
Rate for Payer: Aetna New Business (MI Preferred)	$353.92
Rate for Payer: Cash Price	$435.60
Rate for Payer: Cofinity Commercial	$381.15
Rate for Payer: Cofinity Commercial	$468.27
Rate for Payer: Healthscope Commercial	$490.05
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$462.82
Rate for Payer: PHP Commercial	$462.82
Rate for Payer: Priority Health Cigna Priority Health	$381.15
Rate for Payer: Priority Health SBD	$343.04

ASPIRIN-ACETAMINOPHEN-CAFFEINE 250 MG-250 MG-65 MG TABLET

Facility

$46.82

Service Code	NDC 9629512960
Hospital Charge Code	9158
Hospital Revenue Code	637
Min. Negotiated Rate	$29.50
Max. Negotiated Rate	$42.14
Rate for Payer: Aetna Commercial	$39.80
Rate for Payer: Aetna New Business (MI Preferred)	$30.43
Rate for Payer: Cash Price	$37.46
Rate for Payer: Cofinity Commercial	$32.77
Rate for Payer: Cofinity Commercial	$40.27
Rate for Payer: Healthscope Commercial	$42.14
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$39.80
Rate for Payer: PHP Commercial	$39.80
Rate for Payer: Priority Health Cigna Priority Health	$32.77
Rate for Payer: Priority Health SBD	$29.50

ASPIRIN-ACETAMINOPHEN-CAFFEINE 250 MG-250 MG-65 MG TABLET

Facility

$58.75

Service Code	NDC 0536-1326-01
Hospital Charge Code	9158
Hospital Revenue Code	637
Min. Negotiated Rate	$37.01
Max. Negotiated Rate	$52.88
Rate for Payer: Aetna Commercial	$49.94
Rate for Payer: Aetna New Business (MI Preferred)	$38.19
Rate for Payer: Cash Price	$47.00
Rate for Payer: Cofinity Commercial	$41.12
Rate for Payer: Cofinity Commercial	$50.52
Rate for Payer: Healthscope Commercial	$52.88
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$49.94
Rate for Payer: PHP Commercial	$49.94
Rate for Payer: Priority Health Cigna Priority Health	$41.12
Rate for Payer: Priority Health SBD	$37.01

ASPIRIN-ACETAMINOPHEN-CAFFEINE 250 MG-250 MG-65 MG TABLET

Facility

$46.82

Service Code	NDC 70000-0146-1
Hospital Charge Code	9158
Hospital Revenue Code	637
Min. Negotiated Rate	$29.50
Max. Negotiated Rate	$42.14
Rate for Payer: Aetna Commercial	$39.80
Rate for Payer: Aetna New Business (MI Preferred)	$30.43
Rate for Payer: Cash Price	$37.46
Rate for Payer: Cofinity Commercial	$32.77
Rate for Payer: Cofinity Commercial	$40.27
Rate for Payer: Healthscope Commercial	$42.14
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$39.80
Rate for Payer: PHP Commercial	$39.80
Rate for Payer: Priority Health Cigna Priority Health	$32.77
Rate for Payer: Priority Health SBD	$29.50

ASPIRIN-ACETAMINOPHEN-CAFFEINE 250 MG-250 MG-65 MG TABLET

Facility

$4.85

Service Code	NDC 47682-228-64
Hospital Charge Code	9158
Hospital Revenue Code	637
Min. Negotiated Rate	$3.06
Max. Negotiated Rate	$4.36
Rate for Payer: Aetna Commercial	$4.12
Rate for Payer: Aetna New Business (MI Preferred)	$3.15
Rate for Payer: Cash Price	$3.88
Rate for Payer: Cofinity Commercial	$3.40
Rate for Payer: Cofinity Commercial	$4.17
Rate for Payer: Healthscope Commercial	$4.36
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$4.12
Rate for Payer: PHP Commercial	$4.12
Rate for Payer: Priority Health Cigna Priority Health	$3.40
Rate for Payer: Priority Health SBD	$3.06

ASPIRIN-ACETAMINOPHEN-CAFFEINE 250 MG-250 MG-65 MG TABLET

Facility

$44.65

Service Code	NDC 0904-5135-59
Hospital Charge Code	9158
Hospital Revenue Code	637
Min. Negotiated Rate	$28.13
Max. Negotiated Rate	$40.18
Rate for Payer: Aetna Commercial	$37.95
Rate for Payer: Aetna New Business (MI Preferred)	$29.02
Rate for Payer: Cash Price	$35.72
Rate for Payer: Cofinity Commercial	$38.40
Rate for Payer: Cofinity Commercial	$31.26
Rate for Payer: Healthscope Commercial	$40.18
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$37.95
Rate for Payer: PHP Commercial	$37.95
Rate for Payer: Priority Health Cigna Priority Health	$31.26
Rate for Payer: Priority Health SBD	$28.13

ATENOLOL 25 MG TABLET

Facility

$705.00

Service Code	NDC 0093-0787-10
Hospital Charge Code	717
Hospital Revenue Code	637
Min. Negotiated Rate	$444.15
Max. Negotiated Rate	$634.50
Rate for Payer: Aetna Commercial	$599.25
Rate for Payer: Aetna New Business (MI Preferred)	$458.25
Rate for Payer: Cash Price	$564.00
Rate for Payer: Cofinity Commercial	$493.50
Rate for Payer: Cofinity Commercial	$606.30
Rate for Payer: Healthscope Commercial	$634.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$599.25
Rate for Payer: PHP Commercial	$599.25
Rate for Payer: Priority Health Cigna Priority Health	$493.50
Rate for Payer: Priority Health SBD	$444.15

ATENOLOL 25 MG TABLET

Facility

$3.81

Service Code	NDC 51079-759-01
Hospital Charge Code	717
Hospital Revenue Code	637
Min. Negotiated Rate	$2.40
Max. Negotiated Rate	$3.43
Rate for Payer: Aetna Commercial	$3.24
Rate for Payer: Aetna New Business (MI Preferred)	$2.48
Rate for Payer: Cash Price	$3.05
Rate for Payer: Cofinity Commercial	$2.67
Rate for Payer: Cofinity Commercial	$3.28
Rate for Payer: Healthscope Commercial	$3.43
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3.24
Rate for Payer: PHP Commercial	$3.24
Rate for Payer: Priority Health Cigna Priority Health	$2.67
Rate for Payer: Priority Health SBD	$2.40

ATENOLOL 25 MG TABLET

Facility

$380.70

Service Code	NDC 51079-759-20
Hospital Charge Code	717
Hospital Revenue Code	637
Min. Negotiated Rate	$239.84
Max. Negotiated Rate	$342.63
Rate for Payer: Aetna Commercial	$323.60
Rate for Payer: Aetna New Business (MI Preferred)	$247.46
Rate for Payer: Cash Price	$304.56
Rate for Payer: Cofinity Commercial	$266.49
Rate for Payer: Cofinity Commercial	$327.40
Rate for Payer: Healthscope Commercial	$342.63
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$323.60
Rate for Payer: PHP Commercial	$323.60
Rate for Payer: Priority Health Cigna Priority Health	$266.49
Rate for Payer: Priority Health SBD	$239.84

ATENOLOL 25 MG TABLET

Facility

$3.81

Service Code	NDC 51079-759-01
Hospital Charge Code	717
Hospital Revenue Code	637
Min. Negotiated Rate	$1.52
Max. Negotiated Rate	$3.43
Rate for Payer: Aetna Commercial	$3.24
Rate for Payer: Aetna New Business (MI Preferred)	$2.48
Rate for Payer: BCBS Complete	$1.52
Rate for Payer: Cash Price	$3.05
Rate for Payer: Cofinity Commercial	$2.67
Rate for Payer: Cofinity Commercial	$3.28
Rate for Payer: Healthscope Commercial	$3.43
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3.24
Rate for Payer: PHP Commercial	$3.24
Rate for Payer: Priority Health Cigna Priority Health	$2.67
Rate for Payer: Priority Health SBD	$2.40

ATENOLOL 25 MG TABLET

Facility

$75.20

Service Code	NDC 0093-0787-01
Hospital Charge Code	717
Hospital Revenue Code	637
Min. Negotiated Rate	$47.38
Max. Negotiated Rate	$67.68
Rate for Payer: Aetna Commercial	$63.92
Rate for Payer: Aetna New Business (MI Preferred)	$48.88
Rate for Payer: Cash Price	$60.16
Rate for Payer: Cofinity Commercial	$52.64
Rate for Payer: Cofinity Commercial	$64.67
Rate for Payer: Healthscope Commercial	$67.68
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$63.92
Rate for Payer: PHP Commercial	$63.92
Rate for Payer: Priority Health Cigna Priority Health	$52.64
Rate for Payer: Priority Health SBD	$47.38

ATENOLOL 25 MG TABLET

Facility

$380.70

Service Code	NDC 51079-759-20
Hospital Charge Code	717
Hospital Revenue Code	637
Min. Negotiated Rate	$152.28
Max. Negotiated Rate	$342.63
Rate for Payer: Aetna Commercial	$323.60
Rate for Payer: Aetna New Business (MI Preferred)	$247.46
Rate for Payer: BCBS Complete	$152.28
Rate for Payer: Cash Price	$304.56
Rate for Payer: Cofinity Commercial	$266.49
Rate for Payer: Cofinity Commercial	$327.40
Rate for Payer: Healthscope Commercial	$342.63
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$323.60
Rate for Payer: PHP Commercial	$323.60
Rate for Payer: Priority Health Cigna Priority Health	$266.49
Rate for Payer: Priority Health SBD	$239.84

ATENOLOL 50 MG TABLET

Facility

$2.00

Service Code	NDC 51079-684-01
Hospital Charge Code	718
Hospital Revenue Code	637
Min. Negotiated Rate	$1.26
Max. Negotiated Rate	$1.80
Rate for Payer: Aetna Commercial	$1.70
Rate for Payer: Aetna New Business (MI Preferred)	$1.30
Rate for Payer: Cash Price	$1.60
Rate for Payer: Cofinity Commercial	$1.40
Rate for Payer: Cofinity Commercial	$1.72
Rate for Payer: Healthscope Commercial	$1.80
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1.70
Rate for Payer: PHP Commercial	$1.70
Rate for Payer: Priority Health Cigna Priority Health	$1.40
Rate for Payer: Priority Health SBD	$1.26

ATENOLOL 50 MG TABLET

Facility

$155.10

Service Code	NDC 0378-0231-01
Hospital Charge Code	718
Hospital Revenue Code	637
Min. Negotiated Rate	$97.71
Max. Negotiated Rate	$139.59
Rate for Payer: Aetna Commercial	$131.84
Rate for Payer: Aetna New Business (MI Preferred)	$100.82
Rate for Payer: Cash Price	$124.08
Rate for Payer: Cofinity Commercial	$108.57
Rate for Payer: Cofinity Commercial	$133.39
Rate for Payer: Healthscope Commercial	$139.59
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$131.84
Rate for Payer: PHP Commercial	$131.84
Rate for Payer: Priority Health Cigna Priority Health	$108.57
Rate for Payer: Priority Health SBD	$97.71

ATENOLOL 50 MG TABLET

Facility

$75.20

Service Code	NDC 0093-0752-01
Hospital Charge Code	718
Hospital Revenue Code	637
Min. Negotiated Rate	$47.38
Max. Negotiated Rate	$67.68
Rate for Payer: Aetna Commercial	$63.92
Rate for Payer: Aetna New Business (MI Preferred)	$48.88
Rate for Payer: Cash Price	$60.16
Rate for Payer: Cofinity Commercial	$52.64
Rate for Payer: Cofinity Commercial	$64.67
Rate for Payer: Healthscope Commercial	$67.68
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$63.92
Rate for Payer: PHP Commercial	$63.92
Rate for Payer: Priority Health Cigna Priority Health	$52.64
Rate for Payer: Priority Health SBD	$47.38

Know your out-of-pocket cost for care.

All Charges