Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

DIVALPROEX 125 MG TABLET,DELAYED RELEASE

Facility

$138.65

Service Code	NDC 62756079688
Hospital Charge Code	2551
Hospital Revenue Code	637
Min. Negotiated Rate	$55.46
Max. Negotiated Rate	$124.78
Rate for Payer: Aetna Commercial	$117.85
Rate for Payer: Aetna Medicare	$69.32
Rate for Payer: Aetna New Business (MI Preferred)	$90.12
Rate for Payer: BCBS Complete	$55.46
Rate for Payer: Cash Price	$110.92
Rate for Payer: Cofinity Commercial	$119.24
Rate for Payer: Cofinity Commercial	$97.06
Rate for Payer: Cofinity Medicare Advantage	$97.06
Rate for Payer: Encore Health Key Benefits Commercial	$110.92
Rate for Payer: Healthscope Commercial	$124.78
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$117.85
Rate for Payer: PHP Commercial	$117.85
Rate for Payer: Priority Health Cigna Priority Health	$90.12
Rate for Payer: Priority Health SBD	$87.35

DIVALPROEX 250 MG TABLET,DELAYED RELEASE

Facility

$373.65

Service Code	NDC 68084077601
Hospital Charge Code	2552
Hospital Revenue Code	637
Min. Negotiated Rate	$149.46
Max. Negotiated Rate	$336.28
Rate for Payer: Aetna Commercial	$317.60
Rate for Payer: Aetna Medicare	$186.82
Rate for Payer: Aetna New Business (MI Preferred)	$242.87
Rate for Payer: BCBS Complete	$149.46
Rate for Payer: Cash Price	$298.92
Rate for Payer: Cofinity Commercial	$261.56
Rate for Payer: Cofinity Commercial	$321.34
Rate for Payer: Cofinity Medicare Advantage	$261.56
Rate for Payer: Encore Health Key Benefits Commercial	$298.92
Rate for Payer: Healthscope Commercial	$336.28
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$317.60
Rate for Payer: PHP Commercial	$317.60
Rate for Payer: Priority Health Cigna Priority Health	$242.87
Rate for Payer: Priority Health SBD	$235.40

DIVALPROEX 250 MG TABLET,DELAYED RELEASE

Facility

$3.74

Service Code	NDC 00832712389
Hospital Charge Code	2552
Hospital Revenue Code	637
Min. Negotiated Rate	$2.36
Max. Negotiated Rate	$3.37
Rate for Payer: Aetna Commercial	$3.18
Rate for Payer: Aetna New Business (MI Preferred)	$2.43
Rate for Payer: Cash Price	$2.99
Rate for Payer: Cofinity Commercial	$2.62
Rate for Payer: Cofinity Commercial	$3.22
Rate for Payer: Cofinity Medicare Advantage	$2.62
Rate for Payer: Encore Health Key Benefits Commercial	$2.99
Rate for Payer: Healthscope Commercial	$3.37
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3.18
Rate for Payer: PHP Commercial	$3.18
Rate for Payer: Priority Health Cigna Priority Health	$2.43
Rate for Payer: Priority Health SBD	$2.36

DIVALPROEX 250 MG TABLET,DELAYED RELEASE

Facility

$1,316.00

Service Code	NDC 62756079713
Hospital Charge Code	2552
Hospital Revenue Code	637
Min. Negotiated Rate	$526.40
Max. Negotiated Rate	$1,184.40
Rate for Payer: Aetna Commercial	$1,118.60
Rate for Payer: Aetna Medicare	$658.00
Rate for Payer: Aetna New Business (MI Preferred)	$855.40
Rate for Payer: BCBS Complete	$526.40
Rate for Payer: Cash Price	$1,052.80
Rate for Payer: Cofinity Commercial	$1,131.76
Rate for Payer: Cofinity Commercial	$921.20
Rate for Payer: Cofinity Medicare Advantage	$921.20
Rate for Payer: Encore Health Key Benefits Commercial	$1,052.80
Rate for Payer: Healthscope Commercial	$1,184.40
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,118.60
Rate for Payer: PHP Commercial	$1,118.60
Rate for Payer: Priority Health Cigna Priority Health	$855.40
Rate for Payer: Priority Health SBD	$829.08

DIVALPROEX 250 MG TABLET,DELAYED RELEASE

Facility

$3.74

Service Code	NDC 68084077611
Hospital Charge Code	2552
Hospital Revenue Code	637
Min. Negotiated Rate	$2.36
Max. Negotiated Rate	$3.37
Rate for Payer: Aetna Commercial	$3.18
Rate for Payer: Aetna New Business (MI Preferred)	$2.43
Rate for Payer: Cash Price	$2.99
Rate for Payer: Cofinity Commercial	$2.62
Rate for Payer: Cofinity Commercial	$3.22
Rate for Payer: Cofinity Medicare Advantage	$2.62
Rate for Payer: Encore Health Key Benefits Commercial	$2.99
Rate for Payer: Healthscope Commercial	$3.37
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3.18
Rate for Payer: PHP Commercial	$3.18
Rate for Payer: Priority Health Cigna Priority Health	$2.43
Rate for Payer: Priority Health SBD	$2.36

DIVALPROEX 250 MG TABLET,DELAYED RELEASE

Facility

$373.65

Service Code	NDC 00832712301
Hospital Charge Code	2552
Hospital Revenue Code	637
Min. Negotiated Rate	$149.46
Max. Negotiated Rate	$336.28
Rate for Payer: Aetna Commercial	$317.60
Rate for Payer: Aetna Medicare	$186.82
Rate for Payer: Aetna New Business (MI Preferred)	$242.87
Rate for Payer: BCBS Complete	$149.46
Rate for Payer: Cash Price	$298.92
Rate for Payer: Cofinity Commercial	$261.56
Rate for Payer: Cofinity Commercial	$321.34
Rate for Payer: Cofinity Medicare Advantage	$261.56
Rate for Payer: Encore Health Key Benefits Commercial	$298.92
Rate for Payer: Healthscope Commercial	$336.28
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$317.60
Rate for Payer: PHP Commercial	$317.60
Rate for Payer: Priority Health Cigna Priority Health	$242.87
Rate for Payer: Priority Health SBD	$235.40

DIVALPROEX 250 MG TABLET,DELAYED RELEASE

Facility

$3.74

Service Code	NDC 68084077611
Hospital Charge Code	2552
Hospital Revenue Code	637
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$3.37
Rate for Payer: Aetna Commercial	$3.18
Rate for Payer: Aetna Medicare	$1.87
Rate for Payer: Aetna New Business (MI Preferred)	$2.43
Rate for Payer: BCBS Complete	$1.50
Rate for Payer: Cash Price	$2.99
Rate for Payer: Cofinity Commercial	$2.62
Rate for Payer: Cofinity Commercial	$3.22
Rate for Payer: Cofinity Medicare Advantage	$2.62
Rate for Payer: Encore Health Key Benefits Commercial	$2.99
Rate for Payer: Healthscope Commercial	$3.37
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3.18
Rate for Payer: PHP Commercial	$3.18
Rate for Payer: Priority Health Cigna Priority Health	$2.43
Rate for Payer: Priority Health SBD	$2.36

DIVALPROEX 250 MG TABLET,DELAYED RELEASE

Facility

$373.65

Service Code	NDC 68084077601
Hospital Charge Code	2552
Hospital Revenue Code	637
Min. Negotiated Rate	$235.40
Max. Negotiated Rate	$336.28
Rate for Payer: Aetna Commercial	$317.60
Rate for Payer: Aetna New Business (MI Preferred)	$242.87
Rate for Payer: Cash Price	$298.92
Rate for Payer: Cofinity Commercial	$261.56
Rate for Payer: Cofinity Commercial	$321.34
Rate for Payer: Cofinity Medicare Advantage	$261.56
Rate for Payer: Encore Health Key Benefits Commercial	$298.92
Rate for Payer: Healthscope Commercial	$336.28
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$317.60
Rate for Payer: PHP Commercial	$317.60
Rate for Payer: Priority Health Cigna Priority Health	$242.87
Rate for Payer: Priority Health SBD	$235.40

DIVALPROEX 250 MG TABLET,DELAYED RELEASE

Facility

$373.65

Service Code	NDC 00832712301
Hospital Charge Code	2552
Hospital Revenue Code	637
Min. Negotiated Rate	$235.40
Max. Negotiated Rate	$336.28
Rate for Payer: Aetna Commercial	$317.60
Rate for Payer: Aetna New Business (MI Preferred)	$242.87
Rate for Payer: Cash Price	$298.92
Rate for Payer: Cofinity Commercial	$261.56
Rate for Payer: Cofinity Commercial	$321.34
Rate for Payer: Cofinity Medicare Advantage	$261.56
Rate for Payer: Encore Health Key Benefits Commercial	$298.92
Rate for Payer: Healthscope Commercial	$336.28
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$317.60
Rate for Payer: PHP Commercial	$317.60
Rate for Payer: Priority Health Cigna Priority Health	$242.87
Rate for Payer: Priority Health SBD	$235.40

DIVALPROEX 250 MG TABLET,DELAYED RELEASE

Facility

$3.74

Service Code	NDC 00832712389
Hospital Charge Code	2552
Hospital Revenue Code	637
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$3.37
Rate for Payer: Aetna Commercial	$3.18
Rate for Payer: Aetna Medicare	$1.87
Rate for Payer: Aetna New Business (MI Preferred)	$2.43
Rate for Payer: BCBS Complete	$1.50
Rate for Payer: Cash Price	$2.99
Rate for Payer: Cofinity Commercial	$2.62
Rate for Payer: Cofinity Commercial	$3.22
Rate for Payer: Cofinity Medicare Advantage	$2.62
Rate for Payer: Encore Health Key Benefits Commercial	$2.99
Rate for Payer: Healthscope Commercial	$3.37
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3.18
Rate for Payer: PHP Commercial	$3.18
Rate for Payer: Priority Health Cigna Priority Health	$2.43
Rate for Payer: Priority Health SBD	$2.36

DIVALPROEX 250 MG TABLET,DELAYED RELEASE

Facility

$1,316.00

Service Code	NDC 62756079713
Hospital Charge Code	2552
Hospital Revenue Code	637
Min. Negotiated Rate	$829.08
Max. Negotiated Rate	$1,184.40
Rate for Payer: Aetna Commercial	$1,118.60
Rate for Payer: Aetna New Business (MI Preferred)	$855.40
Rate for Payer: Cash Price	$1,052.80
Rate for Payer: Cofinity Commercial	$1,131.76
Rate for Payer: Cofinity Commercial	$921.20
Rate for Payer: Cofinity Medicare Advantage	$921.20
Rate for Payer: Encore Health Key Benefits Commercial	$1,052.80
Rate for Payer: Healthscope Commercial	$1,184.40
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,118.60
Rate for Payer: PHP Commercial	$1,118.60
Rate for Payer: Priority Health Cigna Priority Health	$855.40
Rate for Payer: Priority Health SBD	$829.08

DIVALPROEX 500 MG TABLET,DELAYED RELEASE

Facility

$221.35

Service Code	NDC 62756079888
Hospital Charge Code	2553
Hospital Revenue Code	637
Min. Negotiated Rate	$88.54
Max. Negotiated Rate	$199.22
Rate for Payer: Aetna Commercial	$188.15
Rate for Payer: Aetna Medicare	$110.68
Rate for Payer: Aetna New Business (MI Preferred)	$143.88
Rate for Payer: BCBS Complete	$88.54
Rate for Payer: Cash Price	$177.08
Rate for Payer: Cofinity Commercial	$154.94
Rate for Payer: Cofinity Commercial	$190.36
Rate for Payer: Cofinity Medicare Advantage	$154.94
Rate for Payer: Encore Health Key Benefits Commercial	$177.08
Rate for Payer: Healthscope Commercial	$199.22
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$188.15
Rate for Payer: PHP Commercial	$188.15
Rate for Payer: Priority Health Cigna Priority Health	$143.88
Rate for Payer: Priority Health SBD	$139.45

DIVALPROEX 500 MG TABLET,DELAYED RELEASE

Facility

$236.84

Service Code	NDC 68084078261
Hospital Charge Code	2553
Hospital Revenue Code	637
Min. Negotiated Rate	$149.21
Max. Negotiated Rate	$213.16
Rate for Payer: Aetna Commercial	$201.31
Rate for Payer: Aetna New Business (MI Preferred)	$153.95
Rate for Payer: Cash Price	$189.47
Rate for Payer: Cofinity Commercial	$165.79
Rate for Payer: Cofinity Commercial	$203.68
Rate for Payer: Cofinity Medicare Advantage	$165.79
Rate for Payer: Encore Health Key Benefits Commercial	$189.47
Rate for Payer: Healthscope Commercial	$213.16
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$201.31
Rate for Payer: PHP Commercial	$201.31
Rate for Payer: Priority Health Cigna Priority Health	$153.95
Rate for Payer: Priority Health SBD	$149.21

DIVALPROEX 500 MG TABLET,DELAYED RELEASE

Facility

$303.15

Service Code	NDC 57237004801
Hospital Charge Code	2553
Hospital Revenue Code	637
Min. Negotiated Rate	$121.26
Max. Negotiated Rate	$272.84
Rate for Payer: Aetna Commercial	$257.68
Rate for Payer: Aetna Medicare	$151.58
Rate for Payer: Aetna New Business (MI Preferred)	$197.05
Rate for Payer: BCBS Complete	$121.26
Rate for Payer: Cash Price	$242.52
Rate for Payer: Cofinity Commercial	$212.20
Rate for Payer: Cofinity Commercial	$260.71
Rate for Payer: Cofinity Medicare Advantage	$212.20
Rate for Payer: Encore Health Key Benefits Commercial	$242.52
Rate for Payer: Healthscope Commercial	$272.84
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$257.68
Rate for Payer: PHP Commercial	$257.68
Rate for Payer: Priority Health Cigna Priority Health	$197.05
Rate for Payer: Priority Health SBD	$190.98

DIVALPROEX 500 MG TABLET,DELAYED RELEASE

Facility

$303.15

Service Code	NDC 57237004801
Hospital Charge Code	2553
Hospital Revenue Code	637
Min. Negotiated Rate	$190.98
Max. Negotiated Rate	$272.84
Rate for Payer: Aetna Commercial	$257.68
Rate for Payer: Aetna New Business (MI Preferred)	$197.05
Rate for Payer: Cash Price	$242.52
Rate for Payer: Cofinity Commercial	$212.20
Rate for Payer: Cofinity Commercial	$260.71
Rate for Payer: Cofinity Medicare Advantage	$212.20
Rate for Payer: Encore Health Key Benefits Commercial	$242.52
Rate for Payer: Healthscope Commercial	$272.84
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$257.68
Rate for Payer: PHP Commercial	$257.68
Rate for Payer: Priority Health Cigna Priority Health	$197.05
Rate for Payer: Priority Health SBD	$190.98

DIVALPROEX 500 MG TABLET,DELAYED RELEASE

Facility

$221.35

Service Code	NDC 62756079888
Hospital Charge Code	2553
Hospital Revenue Code	637
Min. Negotiated Rate	$139.45
Max. Negotiated Rate	$199.22
Rate for Payer: Aetna Commercial	$188.15
Rate for Payer: Aetna New Business (MI Preferred)	$143.88
Rate for Payer: Cash Price	$177.08
Rate for Payer: Cofinity Commercial	$154.94
Rate for Payer: Cofinity Commercial	$190.36
Rate for Payer: Cofinity Medicare Advantage	$154.94
Rate for Payer: Encore Health Key Benefits Commercial	$177.08
Rate for Payer: Healthscope Commercial	$199.22
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$188.15
Rate for Payer: PHP Commercial	$188.15
Rate for Payer: Priority Health Cigna Priority Health	$143.88
Rate for Payer: Priority Health SBD	$139.45

DIVALPROEX 500 MG TABLET,DELAYED RELEASE

Facility

$236.84

Service Code	NDC 68084078261
Hospital Charge Code	2553
Hospital Revenue Code	637
Min. Negotiated Rate	$94.74
Max. Negotiated Rate	$213.16
Rate for Payer: Aetna Commercial	$201.31
Rate for Payer: Aetna Medicare	$118.42
Rate for Payer: Aetna New Business (MI Preferred)	$153.95
Rate for Payer: BCBS Complete	$94.74
Rate for Payer: Cash Price	$189.47
Rate for Payer: Cofinity Commercial	$165.79
Rate for Payer: Cofinity Commercial	$203.68
Rate for Payer: Cofinity Medicare Advantage	$165.79
Rate for Payer: Encore Health Key Benefits Commercial	$189.47
Rate for Payer: Healthscope Commercial	$213.16
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$201.31
Rate for Payer: PHP Commercial	$201.31
Rate for Payer: Priority Health Cigna Priority Health	$153.95
Rate for Payer: Priority Health SBD	$149.21

DIVALPROEX ER 250 MG TABLET,EXTENDED RELEASE 24 HR

Facility

$435.84

Service Code	NDC 68084031001
Hospital Charge Code	34418
Hospital Revenue Code	637
Min. Negotiated Rate	$174.34
Max. Negotiated Rate	$392.26
Rate for Payer: Aetna Commercial	$370.46
Rate for Payer: Aetna Medicare	$217.92
Rate for Payer: Aetna New Business (MI Preferred)	$283.30
Rate for Payer: BCBS Complete	$174.34
Rate for Payer: Cash Price	$348.67
Rate for Payer: Cofinity Commercial	$305.09
Rate for Payer: Cofinity Commercial	$374.82
Rate for Payer: Cofinity Medicare Advantage	$305.09
Rate for Payer: Encore Health Key Benefits Commercial	$348.67
Rate for Payer: Healthscope Commercial	$392.26
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$370.46
Rate for Payer: PHP Commercial	$370.46
Rate for Payer: Priority Health Cigna Priority Health	$283.30
Rate for Payer: Priority Health SBD	$274.58

DIVALPROEX ER 250 MG TABLET,EXTENDED RELEASE 24 HR

Facility

$396.48

Service Code	NDC 00904636361
Hospital Charge Code	34418
Hospital Revenue Code	637
Min. Negotiated Rate	$158.59
Max. Negotiated Rate	$356.83
Rate for Payer: Aetna Commercial	$337.01
Rate for Payer: Aetna Medicare	$198.24
Rate for Payer: Aetna New Business (MI Preferred)	$257.71
Rate for Payer: BCBS Complete	$158.59
Rate for Payer: Cash Price	$317.18
Rate for Payer: Cofinity Commercial	$277.54
Rate for Payer: Cofinity Commercial	$340.97
Rate for Payer: Cofinity Medicare Advantage	$277.54
Rate for Payer: Encore Health Key Benefits Commercial	$317.18
Rate for Payer: Healthscope Commercial	$356.83
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$337.01
Rate for Payer: PHP Commercial	$337.01
Rate for Payer: Priority Health Cigna Priority Health	$257.71
Rate for Payer: Priority Health SBD	$249.78

DIVALPROEX ER 250 MG TABLET,EXTENDED RELEASE 24 HR

Facility

$435.84

Service Code	NDC 68084031001
Hospital Charge Code	34418
Hospital Revenue Code	637
Min. Negotiated Rate	$274.58
Max. Negotiated Rate	$392.26
Rate for Payer: Aetna Commercial	$370.46
Rate for Payer: Aetna New Business (MI Preferred)	$283.30
Rate for Payer: Cash Price	$348.67
Rate for Payer: Cofinity Commercial	$305.09
Rate for Payer: Cofinity Commercial	$374.82
Rate for Payer: Cofinity Medicare Advantage	$305.09
Rate for Payer: Encore Health Key Benefits Commercial	$348.67
Rate for Payer: Healthscope Commercial	$392.26
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$370.46
Rate for Payer: PHP Commercial	$370.46
Rate for Payer: Priority Health Cigna Priority Health	$283.30
Rate for Payer: Priority Health SBD	$274.58

DIVALPROEX ER 250 MG TABLET,EXTENDED RELEASE 24 HR

Facility

$4.36

Service Code	NDC 68084031011
Hospital Charge Code	34418
Hospital Revenue Code	637
Min. Negotiated Rate	$1.74
Max. Negotiated Rate	$3.92
Rate for Payer: Aetna Commercial	$3.71
Rate for Payer: Aetna Medicare	$2.18
Rate for Payer: Aetna New Business (MI Preferred)	$2.83
Rate for Payer: BCBS Complete	$1.74
Rate for Payer: Cash Price	$3.49
Rate for Payer: Cofinity Commercial	$3.05
Rate for Payer: Cofinity Commercial	$3.75
Rate for Payer: Cofinity Medicare Advantage	$3.05
Rate for Payer: Encore Health Key Benefits Commercial	$3.49
Rate for Payer: Healthscope Commercial	$3.92
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3.71
Rate for Payer: PHP Commercial	$3.71
Rate for Payer: Priority Health Cigna Priority Health	$2.83
Rate for Payer: Priority Health SBD	$2.75

DIVALPROEX ER 250 MG TABLET,EXTENDED RELEASE 24 HR

Facility

$4.36

Service Code	NDC 68084031011
Hospital Charge Code	34418
Hospital Revenue Code	637
Min. Negotiated Rate	$2.75
Max. Negotiated Rate	$3.92
Rate for Payer: Aetna Commercial	$3.71
Rate for Payer: Aetna New Business (MI Preferred)	$2.83
Rate for Payer: Cash Price	$3.49
Rate for Payer: Cofinity Commercial	$3.05
Rate for Payer: Cofinity Commercial	$3.75
Rate for Payer: Cofinity Medicare Advantage	$3.05
Rate for Payer: Encore Health Key Benefits Commercial	$3.49
Rate for Payer: Healthscope Commercial	$3.92
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3.71
Rate for Payer: PHP Commercial	$3.71
Rate for Payer: Priority Health Cigna Priority Health	$2.83
Rate for Payer: Priority Health SBD	$2.75

DIVALPROEX ER 250 MG TABLET,EXTENDED RELEASE 24 HR

Facility

$396.48

Service Code	NDC 00904636361
Hospital Charge Code	34418
Hospital Revenue Code	637
Min. Negotiated Rate	$249.78
Max. Negotiated Rate	$356.83
Rate for Payer: Aetna Commercial	$337.01
Rate for Payer: Aetna New Business (MI Preferred)	$257.71
Rate for Payer: Cash Price	$317.18
Rate for Payer: Cofinity Commercial	$277.54
Rate for Payer: Cofinity Commercial	$340.97
Rate for Payer: Cofinity Medicare Advantage	$277.54
Rate for Payer: Encore Health Key Benefits Commercial	$317.18
Rate for Payer: Healthscope Commercial	$356.83
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$337.01
Rate for Payer: PHP Commercial	$337.01
Rate for Payer: Priority Health Cigna Priority Health	$257.71
Rate for Payer: Priority Health SBD	$249.78

DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR

Facility

$7.86

Service Code	NDC 68084041511
Hospital Charge Code	81426
Hospital Revenue Code	637
Min. Negotiated Rate	$3.14
Max. Negotiated Rate	$7.07
Rate for Payer: Aetna Commercial	$6.68
Rate for Payer: Aetna Medicare	$3.93
Rate for Payer: Aetna New Business (MI Preferred)	$5.11
Rate for Payer: BCBS Complete	$3.14
Rate for Payer: Cash Price	$6.29
Rate for Payer: Cofinity Commercial	$5.50
Rate for Payer: Cofinity Commercial	$6.76
Rate for Payer: Cofinity Medicare Advantage	$5.50
Rate for Payer: Encore Health Key Benefits Commercial	$6.29
Rate for Payer: Healthscope Commercial	$7.07
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$6.68
Rate for Payer: PHP Commercial	$6.68
Rate for Payer: Priority Health Cigna Priority Health	$5.11
Rate for Payer: Priority Health SBD	$4.95

DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR

Facility

$2,007.25

Service Code	NDC 00074712611
Hospital Charge Code	81426
Hospital Revenue Code	637
Min. Negotiated Rate	$802.90
Max. Negotiated Rate	$1,806.52
Rate for Payer: Aetna Commercial	$1,706.16
Rate for Payer: Aetna Medicare	$1,003.62
Rate for Payer: Aetna New Business (MI Preferred)	$1,304.71
Rate for Payer: BCBS Complete	$802.90
Rate for Payer: Cash Price	$1,605.80
Rate for Payer: Cofinity Commercial	$1,405.08
Rate for Payer: Cofinity Commercial	$1,726.24
Rate for Payer: Cofinity Medicare Advantage	$1,405.08
Rate for Payer: Encore Health Key Benefits Commercial	$1,605.80
Rate for Payer: Healthscope Commercial	$1,806.52
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,706.16
Rate for Payer: PHP Commercial	$1,706.16
Rate for Payer: Priority Health Cigna Priority Health	$1,304.71
Rate for Payer: Priority Health SBD	$1,264.57

Know your out-of-pocket cost for care.

All Charges