Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR

Facility

$5.81

Service Code	NDC 68084057211
Hospital Charge Code	170771
Hospital Revenue Code	637
Min. Negotiated Rate	$3.66
Max. Negotiated Rate	$5.23
Rate for Payer: Aetna Commercial	$4.94
Rate for Payer: Aetna New Business (MI Preferred)	$3.78
Rate for Payer: Cash Price	$4.65
Rate for Payer: Cofinity Advantage	$4.07
Rate for Payer: Cofinity Commercial	$5.00
Rate for Payer: Encore Health Key Benefits Commercial	$4.65
Rate for Payer: Healthscope Commercial	$5.23
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4.94
Rate for Payer: Opus (Opus Packaging Group) HMA	$4.36
Rate for Payer: PHP Commercial	$4.94
Rate for Payer: Priority Health SBD	$3.66

GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR

Facility

$1,168.50

Service Code	NDC 00904698640
Hospital Charge Code	170771
Hospital Revenue Code	637
Min. Negotiated Rate	$459.22
Max. Negotiated Rate	$1,051.65
Rate for Payer: Aetna Commercial	$993.23
Rate for Payer: Aetna Medicare	$584.25
Rate for Payer: Aetna New Business (MI Preferred)	$759.52
Rate for Payer: BCBS Complete	$467.40
Rate for Payer: Cash Price	$934.80
Rate for Payer: Cofinity Advantage	$817.95
Rate for Payer: Cofinity Commercial	$1,004.91
Rate for Payer: Encore Health Key Benefits Commercial	$934.80
Rate for Payer: Healthscope Commercial	$1,051.65
Rate for Payer: MI Amish Medical Board Commercial	$934.80
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$993.23
Rate for Payer: Opus (Opus Packaging Group) HMA	$876.38
Rate for Payer: PHP Commercial	$993.23
Rate for Payer: Priority Health SBD	$736.15
Rate for Payer: UHC All Payor (Choice/PPO)	$759.52
Rate for Payer: UHC Core	$608.79
Rate for Payer: UHC Exchange	$459.22

GUANFACINE 1 MG TABLET

Facility

$8.16

Service Code	NDC 60687071011
Hospital Charge Code	10149
Hospital Revenue Code	637
Min. Negotiated Rate	$5.14
Max. Negotiated Rate	$7.34
Rate for Payer: Aetna Commercial	$6.94
Rate for Payer: Aetna New Business (MI Preferred)	$5.30
Rate for Payer: Cash Price	$6.53
Rate for Payer: Cofinity Advantage	$5.71
Rate for Payer: Cofinity Commercial	$7.02
Rate for Payer: Encore Health Key Benefits Commercial	$6.53
Rate for Payer: Healthscope Commercial	$7.34
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$6.94
Rate for Payer: Opus (Opus Packaging Group) HMA	$6.12
Rate for Payer: PHP Commercial	$6.94
Rate for Payer: Priority Health SBD	$5.14

GUANFACINE 1 MG TABLET

Facility

$9.00

Service Code	NDC 68094006559
Hospital Charge Code	10149
Hospital Revenue Code	637
Min. Negotiated Rate	$5.67
Max. Negotiated Rate	$8.10
Rate for Payer: Aetna Commercial	$7.65
Rate for Payer: Aetna New Business (MI Preferred)	$5.85
Rate for Payer: Cash Price	$7.20
Rate for Payer: Cofinity Advantage	$6.30
Rate for Payer: Cofinity Commercial	$7.74
Rate for Payer: Encore Health Key Benefits Commercial	$7.20
Rate for Payer: Healthscope Commercial	$8.10
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$7.65
Rate for Payer: Opus (Opus Packaging Group) HMA	$6.75
Rate for Payer: PHP Commercial	$7.65
Rate for Payer: Priority Health SBD	$5.67

GUANFACINE 1 MG TABLET

Facility

$244.54

Service Code	NDC 60687071021
Hospital Charge Code	10149
Hospital Revenue Code	637
Min. Negotiated Rate	$96.10
Max. Negotiated Rate	$220.09
Rate for Payer: Aetna Commercial	$207.86
Rate for Payer: Aetna Medicare	$122.27
Rate for Payer: Aetna New Business (MI Preferred)	$158.95
Rate for Payer: BCBS Complete	$97.82
Rate for Payer: Cash Price	$195.63
Rate for Payer: Cofinity Advantage	$171.18
Rate for Payer: Cofinity Commercial	$210.30
Rate for Payer: Encore Health Key Benefits Commercial	$195.63
Rate for Payer: Healthscope Commercial	$220.09
Rate for Payer: MI Amish Medical Board Commercial	$195.63
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$207.86
Rate for Payer: Opus (Opus Packaging Group) HMA	$183.41
Rate for Payer: PHP Commercial	$207.86
Rate for Payer: Priority Health SBD	$154.06
Rate for Payer: UHC All Payor (Choice/PPO)	$158.95
Rate for Payer: UHC Core	$127.41
Rate for Payer: UHC Exchange	$96.10

GUANFACINE 1 MG TABLET

Facility

$210.96

Service Code	NDC 00904714004
Hospital Charge Code	10149
Hospital Revenue Code	637
Min. Negotiated Rate	$132.90
Max. Negotiated Rate	$189.86
Rate for Payer: Aetna Commercial	$179.32
Rate for Payer: Aetna New Business (MI Preferred)	$137.12
Rate for Payer: Cash Price	$168.77
Rate for Payer: Cofinity Advantage	$147.67
Rate for Payer: Cofinity Commercial	$181.43
Rate for Payer: Encore Health Key Benefits Commercial	$168.77
Rate for Payer: Healthscope Commercial	$189.86
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$179.32
Rate for Payer: Opus (Opus Packaging Group) HMA	$158.22
Rate for Payer: PHP Commercial	$179.32
Rate for Payer: Priority Health SBD	$132.90

GUANFACINE 1 MG TABLET

Facility

$8.16

Service Code	NDC 60687071011
Hospital Charge Code	10149
Hospital Revenue Code	637
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$7.34
Rate for Payer: Aetna Commercial	$6.94
Rate for Payer: Aetna Medicare	$4.08
Rate for Payer: Aetna New Business (MI Preferred)	$5.30
Rate for Payer: BCBS Complete	$3.26
Rate for Payer: Cash Price	$6.53
Rate for Payer: Cofinity Advantage	$5.71
Rate for Payer: Cofinity Commercial	$7.02
Rate for Payer: Encore Health Key Benefits Commercial	$6.53
Rate for Payer: Healthscope Commercial	$7.34
Rate for Payer: MI Amish Medical Board Commercial	$6.53
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$6.94
Rate for Payer: Opus (Opus Packaging Group) HMA	$6.12
Rate for Payer: PHP Commercial	$6.94
Rate for Payer: Priority Health SBD	$5.14
Rate for Payer: UHC All Payor (Choice/PPO)	$5.30
Rate for Payer: UHC Core	$4.25
Rate for Payer: UHC Exchange	$3.21

GUANFACINE 1 MG TABLET

Facility

$244.54

Service Code	NDC 60687071021
Hospital Charge Code	10149
Hospital Revenue Code	637
Min. Negotiated Rate	$154.06
Max. Negotiated Rate	$220.09
Rate for Payer: Aetna Commercial	$207.86
Rate for Payer: Aetna New Business (MI Preferred)	$158.95
Rate for Payer: Cash Price	$195.63
Rate for Payer: Cofinity Advantage	$171.18
Rate for Payer: Cofinity Commercial	$210.30
Rate for Payer: Encore Health Key Benefits Commercial	$195.63
Rate for Payer: Healthscope Commercial	$220.09
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$207.86
Rate for Payer: Opus (Opus Packaging Group) HMA	$183.41
Rate for Payer: PHP Commercial	$207.86
Rate for Payer: Priority Health SBD	$154.06

GUANFACINE 1 MG TABLET

Facility

$6.33

Service Code	NDC 68094001959
Hospital Charge Code	10149
Hospital Revenue Code	637
Min. Negotiated Rate	$3.99
Max. Negotiated Rate	$5.70
Rate for Payer: Aetna Commercial	$5.38
Rate for Payer: Aetna New Business (MI Preferred)	$4.11
Rate for Payer: Cash Price	$5.06
Rate for Payer: Cofinity Advantage	$4.43
Rate for Payer: Cofinity Commercial	$5.44
Rate for Payer: Encore Health Key Benefits Commercial	$5.06
Rate for Payer: Healthscope Commercial	$5.70
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$5.38
Rate for Payer: Opus (Opus Packaging Group) HMA	$4.75
Rate for Payer: PHP Commercial	$5.38
Rate for Payer: Priority Health SBD	$3.99

GUANFACINE 1 MG TABLET

Facility

$189.65

Service Code	NDC 68094001962
Hospital Charge Code	10149
Hospital Revenue Code	637
Min. Negotiated Rate	$74.53
Max. Negotiated Rate	$170.69
Rate for Payer: Aetna Commercial	$161.20
Rate for Payer: Aetna Medicare	$94.83
Rate for Payer: Aetna New Business (MI Preferred)	$123.27
Rate for Payer: BCBS Complete	$75.86
Rate for Payer: Cash Price	$151.72
Rate for Payer: Cofinity Advantage	$132.75
Rate for Payer: Cofinity Commercial	$163.10
Rate for Payer: Encore Health Key Benefits Commercial	$151.72
Rate for Payer: Healthscope Commercial	$170.69
Rate for Payer: MI Amish Medical Board Commercial	$151.72
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$161.20
Rate for Payer: Opus (Opus Packaging Group) HMA	$142.24
Rate for Payer: PHP Commercial	$161.20
Rate for Payer: Priority Health SBD	$119.48
Rate for Payer: UHC All Payor (Choice/PPO)	$123.27
Rate for Payer: UHC Core	$98.81
Rate for Payer: UHC Exchange	$74.53

GUANFACINE 1 MG TABLET

Facility

$446.50

Service Code	NDC 00591044401
Hospital Charge Code	10149
Hospital Revenue Code	637
Min. Negotiated Rate	$281.30
Max. Negotiated Rate	$401.85
Rate for Payer: Aetna Commercial	$379.52
Rate for Payer: Aetna New Business (MI Preferred)	$290.23
Rate for Payer: Cash Price	$357.20
Rate for Payer: Cofinity Advantage	$312.55
Rate for Payer: Cofinity Commercial	$383.99
Rate for Payer: Encore Health Key Benefits Commercial	$357.20
Rate for Payer: Healthscope Commercial	$401.85
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$379.52
Rate for Payer: Opus (Opus Packaging Group) HMA	$334.88
Rate for Payer: PHP Commercial	$379.52
Rate for Payer: Priority Health SBD	$281.30

GUANFACINE 1 MG TABLET

Facility

$446.50

Service Code	NDC 00591044401
Hospital Charge Code	10149
Hospital Revenue Code	637
Min. Negotiated Rate	$175.47
Max. Negotiated Rate	$401.85
Rate for Payer: Aetna Commercial	$379.52
Rate for Payer: Aetna Medicare	$223.25
Rate for Payer: Aetna New Business (MI Preferred)	$290.23
Rate for Payer: BCBS Complete	$178.60
Rate for Payer: Cash Price	$357.20
Rate for Payer: Cofinity Advantage	$312.55
Rate for Payer: Cofinity Commercial	$383.99
Rate for Payer: Encore Health Key Benefits Commercial	$357.20
Rate for Payer: Healthscope Commercial	$401.85
Rate for Payer: MI Amish Medical Board Commercial	$357.20
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$379.52
Rate for Payer: Opus (Opus Packaging Group) HMA	$334.88
Rate for Payer: PHP Commercial	$379.52
Rate for Payer: Priority Health SBD	$281.30
Rate for Payer: UHC All Payor (Choice/PPO)	$290.23
Rate for Payer: UHC Core	$232.63
Rate for Payer: UHC Exchange	$175.47

GUANFACINE 1 MG TABLET

Facility

$6.33

Service Code	NDC 68094001959
Hospital Charge Code	10149
Hospital Revenue Code	637
Min. Negotiated Rate	$2.49
Max. Negotiated Rate	$5.70
Rate for Payer: Aetna Commercial	$5.38
Rate for Payer: Aetna Medicare	$3.17
Rate for Payer: Aetna New Business (MI Preferred)	$4.11
Rate for Payer: BCBS Complete	$2.53
Rate for Payer: Cash Price	$5.06
Rate for Payer: Cofinity Advantage	$4.43
Rate for Payer: Cofinity Commercial	$5.44
Rate for Payer: Encore Health Key Benefits Commercial	$5.06
Rate for Payer: Healthscope Commercial	$5.70
Rate for Payer: MI Amish Medical Board Commercial	$5.06
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$5.38
Rate for Payer: Opus (Opus Packaging Group) HMA	$4.75
Rate for Payer: PHP Commercial	$5.38
Rate for Payer: Priority Health SBD	$3.99
Rate for Payer: UHC All Payor (Choice/PPO)	$4.11
Rate for Payer: UHC Core	$3.30
Rate for Payer: UHC Exchange	$2.49

GUANFACINE 1 MG TABLET

Facility

$269.96

Service Code	NDC 68094006562
Hospital Charge Code	10149
Hospital Revenue Code	637
Min. Negotiated Rate	$106.09
Max. Negotiated Rate	$242.96
Rate for Payer: Aetna Commercial	$229.47
Rate for Payer: Aetna Medicare	$134.98
Rate for Payer: Aetna New Business (MI Preferred)	$175.47
Rate for Payer: BCBS Complete	$107.98
Rate for Payer: Cash Price	$215.97
Rate for Payer: Cofinity Advantage	$188.97
Rate for Payer: Cofinity Commercial	$232.17
Rate for Payer: Encore Health Key Benefits Commercial	$215.97
Rate for Payer: Healthscope Commercial	$242.96
Rate for Payer: MI Amish Medical Board Commercial	$215.97
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$229.47
Rate for Payer: Opus (Opus Packaging Group) HMA	$202.47
Rate for Payer: PHP Commercial	$229.47
Rate for Payer: Priority Health SBD	$170.07
Rate for Payer: UHC All Payor (Choice/PPO)	$175.47
Rate for Payer: UHC Core	$140.65
Rate for Payer: UHC Exchange	$106.09

GUANFACINE 1 MG TABLET

Facility

$9.00

Service Code	NDC 68094006559
Hospital Charge Code	10149
Hospital Revenue Code	637
Min. Negotiated Rate	$3.54
Max. Negotiated Rate	$8.10
Rate for Payer: Aetna Commercial	$7.65
Rate for Payer: Aetna Medicare	$4.50
Rate for Payer: Aetna New Business (MI Preferred)	$5.85
Rate for Payer: BCBS Complete	$3.60
Rate for Payer: Cash Price	$7.20
Rate for Payer: Cofinity Advantage	$6.30
Rate for Payer: Cofinity Commercial	$7.74
Rate for Payer: Encore Health Key Benefits Commercial	$7.20
Rate for Payer: Healthscope Commercial	$8.10
Rate for Payer: MI Amish Medical Board Commercial	$7.20
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$7.65
Rate for Payer: Opus (Opus Packaging Group) HMA	$6.75
Rate for Payer: PHP Commercial	$7.65
Rate for Payer: Priority Health SBD	$5.67
Rate for Payer: UHC All Payor (Choice/PPO)	$5.85
Rate for Payer: UHC Core	$4.69
Rate for Payer: UHC Exchange	$3.54

GUANFACINE 1 MG TABLET

Facility

$269.96

Service Code	NDC 68094006562
Hospital Charge Code	10149
Hospital Revenue Code	637
Min. Negotiated Rate	$170.07
Max. Negotiated Rate	$242.96
Rate for Payer: Aetna Commercial	$229.47
Rate for Payer: Aetna New Business (MI Preferred)	$175.47
Rate for Payer: Cash Price	$215.97
Rate for Payer: Cofinity Advantage	$188.97
Rate for Payer: Cofinity Commercial	$232.17
Rate for Payer: Encore Health Key Benefits Commercial	$215.97
Rate for Payer: Healthscope Commercial	$242.96
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$229.47
Rate for Payer: Opus (Opus Packaging Group) HMA	$202.47
Rate for Payer: PHP Commercial	$229.47
Rate for Payer: Priority Health SBD	$170.07

GUANFACINE 1 MG TABLET

Facility

$189.65

Service Code	NDC 68094001962
Hospital Charge Code	10149
Hospital Revenue Code	637
Min. Negotiated Rate	$119.48
Max. Negotiated Rate	$170.69
Rate for Payer: Aetna Commercial	$161.20
Rate for Payer: Aetna New Business (MI Preferred)	$123.27
Rate for Payer: Cash Price	$151.72
Rate for Payer: Cofinity Advantage	$132.75
Rate for Payer: Cofinity Commercial	$163.10
Rate for Payer: Encore Health Key Benefits Commercial	$151.72
Rate for Payer: Healthscope Commercial	$170.69
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$161.20
Rate for Payer: Opus (Opus Packaging Group) HMA	$142.24
Rate for Payer: PHP Commercial	$161.20
Rate for Payer: Priority Health SBD	$119.48

GUANFACINE 1 MG TABLET

Facility

$210.96

Service Code	NDC 00904714004
Hospital Charge Code	10149
Hospital Revenue Code	637
Min. Negotiated Rate	$82.91
Max. Negotiated Rate	$189.86
Rate for Payer: Aetna Commercial	$179.32
Rate for Payer: Aetna Medicare	$105.48
Rate for Payer: Aetna New Business (MI Preferred)	$137.12
Rate for Payer: BCBS Complete	$84.38
Rate for Payer: Cash Price	$168.77
Rate for Payer: Cofinity Advantage	$147.67
Rate for Payer: Cofinity Commercial	$181.43
Rate for Payer: Encore Health Key Benefits Commercial	$168.77
Rate for Payer: Healthscope Commercial	$189.86
Rate for Payer: MI Amish Medical Board Commercial	$168.77
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$179.32
Rate for Payer: Opus (Opus Packaging Group) HMA	$158.22
Rate for Payer: PHP Commercial	$179.32
Rate for Payer: Priority Health SBD	$132.90
Rate for Payer: UHC All Payor (Choice/PPO)	$137.12
Rate for Payer: UHC Core	$109.91
Rate for Payer: UHC Exchange	$82.91

GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR

Facility

$228.00

Service Code	NDC 62332074531
Hospital Charge Code	99835
Hospital Revenue Code	637
Min. Negotiated Rate	$143.64
Max. Negotiated Rate	$205.20
Rate for Payer: Aetna Commercial	$193.80
Rate for Payer: Aetna New Business (MI Preferred)	$148.20
Rate for Payer: Cash Price	$182.40
Rate for Payer: Cofinity Advantage	$159.60
Rate for Payer: Cofinity Commercial	$196.08
Rate for Payer: Encore Health Key Benefits Commercial	$182.40
Rate for Payer: Healthscope Commercial	$205.20
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$193.80
Rate for Payer: Opus (Opus Packaging Group) HMA	$171.00
Rate for Payer: PHP Commercial	$193.80
Rate for Payer: Priority Health SBD	$143.64

GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR

Facility

$228.00

Service Code	NDC 62332074531
Hospital Charge Code	99835
Hospital Revenue Code	637
Min. Negotiated Rate	$89.60
Max. Negotiated Rate	$205.20
Rate for Payer: Aetna Commercial	$193.80
Rate for Payer: Aetna Medicare	$114.00
Rate for Payer: Aetna New Business (MI Preferred)	$148.20
Rate for Payer: BCBS Complete	$91.20
Rate for Payer: Cash Price	$182.40
Rate for Payer: Cofinity Advantage	$159.60
Rate for Payer: Cofinity Commercial	$196.08
Rate for Payer: Encore Health Key Benefits Commercial	$182.40
Rate for Payer: Healthscope Commercial	$205.20
Rate for Payer: MI Amish Medical Board Commercial	$182.40
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$193.80
Rate for Payer: Opus (Opus Packaging Group) HMA	$171.00
Rate for Payer: PHP Commercial	$193.80
Rate for Payer: Priority Health SBD	$143.64
Rate for Payer: UHC All Payor (Choice/PPO)	$148.20
Rate for Payer: UHC Core	$118.79
Rate for Payer: UHC Exchange	$89.60

GUAR GUM ORAL POWDER PACKET

Facility

$160.95

Service Code	NDC 43900097648
Hospital Charge Code	30538
Hospital Revenue Code	637
Min. Negotiated Rate	$101.40
Max. Negotiated Rate	$144.85
Rate for Payer: Aetna Commercial	$136.81
Rate for Payer: Aetna New Business (MI Preferred)	$104.62
Rate for Payer: Cash Price	$128.76
Rate for Payer: Cofinity Advantage	$112.67
Rate for Payer: Cofinity Commercial	$138.42
Rate for Payer: Encore Health Key Benefits Commercial	$128.76
Rate for Payer: Healthscope Commercial	$144.85
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$136.81
Rate for Payer: Opus (Opus Packaging Group) HMA	$120.71
Rate for Payer: PHP Commercial	$136.81
Rate for Payer: Priority Health SBD	$101.40

GUAR GUM ORAL POWDER PACKET

Facility

$160.95

Service Code	NDC 43900097648
Hospital Charge Code	30538
Hospital Revenue Code	637
Min. Negotiated Rate	$63.25
Max. Negotiated Rate	$144.85
Rate for Payer: Aetna Commercial	$136.81
Rate for Payer: Aetna Medicare	$80.47
Rate for Payer: Aetna New Business (MI Preferred)	$104.62
Rate for Payer: BCBS Complete	$64.38
Rate for Payer: Cash Price	$128.76
Rate for Payer: Cofinity Advantage	$112.67
Rate for Payer: Cofinity Commercial	$138.42
Rate for Payer: Encore Health Key Benefits Commercial	$128.76
Rate for Payer: Healthscope Commercial	$144.85
Rate for Payer: MI Amish Medical Board Commercial	$128.76
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$136.81
Rate for Payer: Opus (Opus Packaging Group) HMA	$120.71
Rate for Payer: PHP Commercial	$136.81
Rate for Payer: Priority Health SBD	$101.40
Rate for Payer: UHC All Payor (Choice/PPO)	$104.62
Rate for Payer: UHC Core	$83.85
Rate for Payer: UHC Exchange	$63.25

GUAR GUM ORAL POWDER PACKET

Facility

$2.79

Service Code	NDC 43900097647
Hospital Charge Code	30538
Hospital Revenue Code	637
Min. Negotiated Rate	$1.10
Max. Negotiated Rate	$2.51
Rate for Payer: Aetna Commercial	$2.37
Rate for Payer: Aetna Medicare	$1.40
Rate for Payer: Aetna New Business (MI Preferred)	$1.81
Rate for Payer: BCBS Complete	$1.12
Rate for Payer: Cash Price	$2.23
Rate for Payer: Cofinity Advantage	$1.95
Rate for Payer: Cofinity Commercial	$2.40
Rate for Payer: Encore Health Key Benefits Commercial	$2.23
Rate for Payer: Healthscope Commercial	$2.51
Rate for Payer: MI Amish Medical Board Commercial	$2.23
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2.37
Rate for Payer: Opus (Opus Packaging Group) HMA	$2.09
Rate for Payer: PHP Commercial	$2.37
Rate for Payer: Priority Health SBD	$1.76
Rate for Payer: UHC All Payor (Choice/PPO)	$1.81
Rate for Payer: UHC Core	$1.45
Rate for Payer: UHC Exchange	$1.10

GUAR GUM ORAL POWDER PACKET

Facility

$2.79

Service Code	NDC 43900097647
Hospital Charge Code	30538
Hospital Revenue Code	637
Min. Negotiated Rate	$1.76
Max. Negotiated Rate	$2.51
Rate for Payer: Aetna Commercial	$2.37
Rate for Payer: Aetna New Business (MI Preferred)	$1.81
Rate for Payer: Cash Price	$2.23
Rate for Payer: Cofinity Advantage	$1.95
Rate for Payer: Cofinity Commercial	$2.40
Rate for Payer: Encore Health Key Benefits Commercial	$2.23
Rate for Payer: Healthscope Commercial	$2.51
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2.37
Rate for Payer: Opus (Opus Packaging Group) HMA	$2.09
Rate for Payer: PHP Commercial	$2.37
Rate for Payer: Priority Health SBD	$1.76

GYNECOLOGIC PROCEDURES FOR LEIOMYOMA

Facility

$22,535.85

Service Code	APR-DRG 5194
Min. Negotiated Rate	$21,462.71
Max. Negotiated Rate	$22,535.85
Rate for Payer: BCBS Complete	$22,535.85
Rate for Payer: Mclaren Medicaid	$21,462.71
Rate for Payer: Meridian Medicaid	$22,535.85
Rate for Payer: Priority Health Choice Medicaid	$21,462.71
Rate for Payer: UHC Medicaid	$21,462.71
Rate for Payer: UHCCP Medicaid	$21,462.71

Know your out-of-pocket cost for care.

All Charges