Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

FENOFIBRATE NANOCRYSTALLIZED 48 MG TABLET

Facility

$121.68

Service Code	NDC 60687061821
Hospital Charge Code	40009
Hospital Revenue Code	637
Min. Negotiated Rate	$48.67
Max. Negotiated Rate	$109.51
Rate for Payer: Aetna Commercial	$103.43
Rate for Payer: Aetna Medicare	$60.84
Rate for Payer: Aetna New Business (MI Preferred)	$79.09
Rate for Payer: BCBS Complete	$48.67
Rate for Payer: Cash Price	$97.34
Rate for Payer: Cofinity Commercial	$104.64
Rate for Payer: Cofinity Commercial	$85.18
Rate for Payer: Cofinity Medicare Advantage	$85.18
Rate for Payer: Encore Health Key Benefits Commercial	$97.34
Rate for Payer: Healthscope Commercial	$109.51
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$103.43
Rate for Payer: PHP Commercial	$103.43
Rate for Payer: Priority Health Cigna Priority Health	$79.09
Rate for Payer: Priority Health SBD	$76.66

FENOFIBRATE NANOCRYSTALLIZED 48 MG TABLET

Facility

$4.06

Service Code	NDC 60687061811
Hospital Charge Code	40009
Hospital Revenue Code	637
Min. Negotiated Rate	$1.62
Max. Negotiated Rate	$3.65
Rate for Payer: Aetna Commercial	$3.45
Rate for Payer: Aetna Medicare	$2.03
Rate for Payer: Aetna New Business (MI Preferred)	$2.64
Rate for Payer: BCBS Complete	$1.62
Rate for Payer: Cash Price	$3.25
Rate for Payer: Cofinity Commercial	$2.84
Rate for Payer: Cofinity Commercial	$3.49
Rate for Payer: Cofinity Medicare Advantage	$2.84
Rate for Payer: Encore Health Key Benefits Commercial	$3.25
Rate for Payer: Healthscope Commercial	$3.65
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3.45
Rate for Payer: PHP Commercial	$3.45
Rate for Payer: Priority Health Cigna Priority Health	$2.64
Rate for Payer: Priority Health SBD	$2.56

FENOFIBRATE NANOCRYSTALLIZED 48 MG TABLET

Facility

$121.68

Service Code	NDC 60687061821
Hospital Charge Code	40009
Hospital Revenue Code	637
Min. Negotiated Rate	$76.66
Max. Negotiated Rate	$109.51
Rate for Payer: Aetna Commercial	$103.43
Rate for Payer: Aetna New Business (MI Preferred)	$79.09
Rate for Payer: Cash Price	$97.34
Rate for Payer: Cofinity Commercial	$104.64
Rate for Payer: Cofinity Commercial	$85.18
Rate for Payer: Cofinity Medicare Advantage	$85.18
Rate for Payer: Encore Health Key Benefits Commercial	$97.34
Rate for Payer: Healthscope Commercial	$109.51
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$103.43
Rate for Payer: PHP Commercial	$103.43
Rate for Payer: Priority Health Cigna Priority Health	$79.09
Rate for Payer: Priority Health SBD	$76.66

FENOFIBRATE NANOCRYSTALLIZED 48 MG TABLET

Facility

$4.06

Service Code	NDC 60687061811
Hospital Charge Code	40009
Hospital Revenue Code	637
Min. Negotiated Rate	$2.56
Max. Negotiated Rate	$3.65
Rate for Payer: Aetna Commercial	$3.45
Rate for Payer: Aetna New Business (MI Preferred)	$2.64
Rate for Payer: Cash Price	$3.25
Rate for Payer: Cofinity Commercial	$2.84
Rate for Payer: Cofinity Commercial	$3.49
Rate for Payer: Cofinity Medicare Advantage	$2.84
Rate for Payer: Encore Health Key Benefits Commercial	$3.25
Rate for Payer: Healthscope Commercial	$3.65
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3.45
Rate for Payer: PHP Commercial	$3.45
Rate for Payer: Priority Health Cigna Priority Health	$2.64
Rate for Payer: Priority Health SBD	$2.56

FENTANYL 100 MCG/HR TRANSDERMAL PATCH

Facility

$59.54

Service Code	NDC 60505708400
Hospital Charge Code	27908
Hospital Revenue Code	637
Min. Negotiated Rate	$23.82
Max. Negotiated Rate	$53.59
Rate for Payer: Aetna Commercial	$50.61
Rate for Payer: Aetna Medicare	$29.77
Rate for Payer: Aetna New Business (MI Preferred)	$38.70
Rate for Payer: BCBS Complete	$23.82
Rate for Payer: Cash Price	$47.63
Rate for Payer: Cofinity Commercial	$41.68
Rate for Payer: Cofinity Commercial	$51.20
Rate for Payer: Cofinity Medicare Advantage	$41.68
Rate for Payer: Encore Health Key Benefits Commercial	$47.63
Rate for Payer: Healthscope Commercial	$53.59
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$50.61
Rate for Payer: PHP Commercial	$50.61
Rate for Payer: Priority Health Cigna Priority Health	$38.70
Rate for Payer: Priority Health SBD	$37.51

FENTANYL 100 MCG/HR TRANSDERMAL PATCH

Facility

$28.66

Service Code	NDC 60505700900
Hospital Charge Code	27908
Hospital Revenue Code	637
Min. Negotiated Rate	$11.46
Max. Negotiated Rate	$25.79
Rate for Payer: Aetna Commercial	$24.36
Rate for Payer: Aetna Medicare	$14.33
Rate for Payer: Aetna New Business (MI Preferred)	$18.63
Rate for Payer: BCBS Complete	$11.46
Rate for Payer: Cash Price	$22.93
Rate for Payer: Cofinity Commercial	$20.06
Rate for Payer: Cofinity Commercial	$24.65
Rate for Payer: Cofinity Medicare Advantage	$20.06
Rate for Payer: Encore Health Key Benefits Commercial	$22.93
Rate for Payer: Healthscope Commercial	$25.79
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$24.36
Rate for Payer: PHP Commercial	$24.36
Rate for Payer: Priority Health Cigna Priority Health	$18.63
Rate for Payer: Priority Health SBD	$18.06

FENTANYL 100 MCG/HR TRANSDERMAL PATCH

Facility

$297.70

Service Code	NDC 60505708402
Hospital Charge Code	27908
Hospital Revenue Code	637
Min. Negotiated Rate	$119.08
Max. Negotiated Rate	$267.93
Rate for Payer: Aetna Commercial	$253.04
Rate for Payer: Aetna Medicare	$148.85
Rate for Payer: Aetna New Business (MI Preferred)	$193.50
Rate for Payer: BCBS Complete	$119.08
Rate for Payer: Cash Price	$238.16
Rate for Payer: Cofinity Commercial	$208.39
Rate for Payer: Cofinity Commercial	$256.02
Rate for Payer: Cofinity Medicare Advantage	$208.39
Rate for Payer: Encore Health Key Benefits Commercial	$238.16
Rate for Payer: Healthscope Commercial	$267.93
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$253.04
Rate for Payer: PHP Commercial	$253.04
Rate for Payer: Priority Health Cigna Priority Health	$193.50
Rate for Payer: Priority Health SBD	$187.55

FENTANYL 100 MCG/HR TRANSDERMAL PATCH

Facility

$297.70

Service Code	NDC 60505708402
Hospital Charge Code	27908
Hospital Revenue Code	637
Min. Negotiated Rate	$187.55
Max. Negotiated Rate	$267.93
Rate for Payer: Aetna Commercial	$253.04
Rate for Payer: Aetna New Business (MI Preferred)	$193.50
Rate for Payer: Cash Price	$238.16
Rate for Payer: Cofinity Commercial	$208.39
Rate for Payer: Cofinity Commercial	$256.02
Rate for Payer: Cofinity Medicare Advantage	$208.39
Rate for Payer: Encore Health Key Benefits Commercial	$238.16
Rate for Payer: Healthscope Commercial	$267.93
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$253.04
Rate for Payer: PHP Commercial	$253.04
Rate for Payer: Priority Health Cigna Priority Health	$193.50
Rate for Payer: Priority Health SBD	$187.55

FENTANYL 100 MCG/HR TRANSDERMAL PATCH

Facility

$143.29

Service Code	NDC 60505700902
Hospital Charge Code	27908
Hospital Revenue Code	637
Min. Negotiated Rate	$57.32
Max. Negotiated Rate	$128.96
Rate for Payer: Aetna Commercial	$121.80
Rate for Payer: Aetna Medicare	$71.64
Rate for Payer: Aetna New Business (MI Preferred)	$93.14
Rate for Payer: BCBS Complete	$57.32
Rate for Payer: Cash Price	$114.63
Rate for Payer: Cofinity Commercial	$100.30
Rate for Payer: Cofinity Commercial	$123.23
Rate for Payer: Cofinity Medicare Advantage	$100.30
Rate for Payer: Encore Health Key Benefits Commercial	$114.63
Rate for Payer: Healthscope Commercial	$128.96
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$121.80
Rate for Payer: PHP Commercial	$121.80
Rate for Payer: Priority Health Cigna Priority Health	$93.14
Rate for Payer: Priority Health SBD	$90.27

FENTANYL 100 MCG/HR TRANSDERMAL PATCH

Facility

$28.66

Service Code	NDC 60505700900
Hospital Charge Code	27908
Hospital Revenue Code	637
Min. Negotiated Rate	$18.06
Max. Negotiated Rate	$25.79
Rate for Payer: Aetna Commercial	$24.36
Rate for Payer: Aetna New Business (MI Preferred)	$18.63
Rate for Payer: Cash Price	$22.93
Rate for Payer: Cofinity Commercial	$20.06
Rate for Payer: Cofinity Commercial	$24.65
Rate for Payer: Cofinity Medicare Advantage	$20.06
Rate for Payer: Encore Health Key Benefits Commercial	$22.93
Rate for Payer: Healthscope Commercial	$25.79
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$24.36
Rate for Payer: PHP Commercial	$24.36
Rate for Payer: Priority Health Cigna Priority Health	$18.63
Rate for Payer: Priority Health SBD	$18.06

FENTANYL 100 MCG/HR TRANSDERMAL PATCH

Facility

$59.54

Service Code	NDC 60505708400
Hospital Charge Code	27908
Hospital Revenue Code	637
Min. Negotiated Rate	$37.51
Max. Negotiated Rate	$53.59
Rate for Payer: Aetna Commercial	$50.61
Rate for Payer: Aetna New Business (MI Preferred)	$38.70
Rate for Payer: Cash Price	$47.63
Rate for Payer: Cofinity Commercial	$41.68
Rate for Payer: Cofinity Commercial	$51.20
Rate for Payer: Cofinity Medicare Advantage	$41.68
Rate for Payer: Encore Health Key Benefits Commercial	$47.63
Rate for Payer: Healthscope Commercial	$53.59
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$50.61
Rate for Payer: PHP Commercial	$50.61
Rate for Payer: Priority Health Cigna Priority Health	$38.70
Rate for Payer: Priority Health SBD	$37.51

FENTANYL 100 MCG/HR TRANSDERMAL PATCH

Facility

$143.29

Service Code	NDC 60505700902
Hospital Charge Code	27908
Hospital Revenue Code	637
Min. Negotiated Rate	$90.27
Max. Negotiated Rate	$128.96
Rate for Payer: Aetna Commercial	$121.80
Rate for Payer: Aetna New Business (MI Preferred)	$93.14
Rate for Payer: Cash Price	$114.63
Rate for Payer: Cofinity Commercial	$100.30
Rate for Payer: Cofinity Commercial	$123.23
Rate for Payer: Cofinity Medicare Advantage	$100.30
Rate for Payer: Encore Health Key Benefits Commercial	$114.63
Rate for Payer: Healthscope Commercial	$128.96
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$121.80
Rate for Payer: PHP Commercial	$121.80
Rate for Payer: Priority Health Cigna Priority Health	$93.14
Rate for Payer: Priority Health SBD	$90.27

FENTANYL 12 MCG/HR TRANSDERMAL PATCH

Facility

$262.19

Service Code	NDC 00378911998
Hospital Charge Code	41382
Hospital Revenue Code	637
Min. Negotiated Rate	$104.88
Max. Negotiated Rate	$235.97
Rate for Payer: Aetna Commercial	$222.86
Rate for Payer: Aetna Medicare	$131.10
Rate for Payer: Aetna New Business (MI Preferred)	$170.42
Rate for Payer: BCBS Complete	$104.88
Rate for Payer: Cash Price	$209.75
Rate for Payer: Cofinity Commercial	$183.53
Rate for Payer: Cofinity Commercial	$225.48
Rate for Payer: Cofinity Medicare Advantage	$183.53
Rate for Payer: Encore Health Key Benefits Commercial	$209.75
Rate for Payer: Healthscope Commercial	$235.97
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$222.86
Rate for Payer: PHP Commercial	$222.86
Rate for Payer: Priority Health Cigna Priority Health	$170.42
Rate for Payer: Priority Health SBD	$165.18

FENTANYL 12 MCG/HR TRANSDERMAL PATCH

Facility

$262.19

Service Code	NDC 00378911998
Hospital Charge Code	41382
Hospital Revenue Code	637
Min. Negotiated Rate	$165.18
Max. Negotiated Rate	$235.97
Rate for Payer: Aetna Commercial	$222.86
Rate for Payer: Aetna New Business (MI Preferred)	$170.42
Rate for Payer: Cash Price	$209.75
Rate for Payer: Cofinity Commercial	$183.53
Rate for Payer: Cofinity Commercial	$225.48
Rate for Payer: Cofinity Medicare Advantage	$183.53
Rate for Payer: Encore Health Key Benefits Commercial	$209.75
Rate for Payer: Healthscope Commercial	$235.97
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$222.86
Rate for Payer: PHP Commercial	$222.86
Rate for Payer: Priority Health Cigna Priority Health	$170.42
Rate for Payer: Priority Health SBD	$165.18

FENTANYL 25 MCG/HR TRANSDERMAL PATCH

Facility

$109.40

Service Code	NDC 47781042447
Hospital Charge Code	27905
Hospital Revenue Code	637
Min. Negotiated Rate	$68.92
Max. Negotiated Rate	$98.46
Rate for Payer: Aetna Commercial	$92.99
Rate for Payer: Aetna New Business (MI Preferred)	$71.11
Rate for Payer: Cash Price	$87.52
Rate for Payer: Cofinity Commercial	$76.58
Rate for Payer: Cofinity Commercial	$94.08
Rate for Payer: Cofinity Medicare Advantage	$76.58
Rate for Payer: Encore Health Key Benefits Commercial	$87.52
Rate for Payer: Healthscope Commercial	$98.46
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$92.99
Rate for Payer: PHP Commercial	$92.99
Rate for Payer: Priority Health Cigna Priority Health	$71.11
Rate for Payer: Priority Health SBD	$68.92

FENTANYL 25 MCG/HR TRANSDERMAL PATCH

Facility

$21.88

Service Code	NDC 47781042411
Hospital Charge Code	27905
Hospital Revenue Code	637
Min. Negotiated Rate	$8.75
Max. Negotiated Rate	$19.69
Rate for Payer: Aetna Commercial	$18.60
Rate for Payer: Aetna Medicare	$10.94
Rate for Payer: Aetna New Business (MI Preferred)	$14.22
Rate for Payer: BCBS Complete	$8.75
Rate for Payer: Cash Price	$17.50
Rate for Payer: Cofinity Commercial	$15.32
Rate for Payer: Cofinity Commercial	$18.82
Rate for Payer: Cofinity Medicare Advantage	$15.32
Rate for Payer: Encore Health Key Benefits Commercial	$17.50
Rate for Payer: Healthscope Commercial	$19.69
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$18.60
Rate for Payer: PHP Commercial	$18.60
Rate for Payer: Priority Health Cigna Priority Health	$14.22
Rate for Payer: Priority Health SBD	$13.78

FENTANYL 25 MCG/HR TRANSDERMAL PATCH

Facility

$109.40

Service Code	NDC 47781042447
Hospital Charge Code	27905
Hospital Revenue Code	637
Min. Negotiated Rate	$43.76
Max. Negotiated Rate	$98.46
Rate for Payer: Aetna Commercial	$92.99
Rate for Payer: Aetna Medicare	$54.70
Rate for Payer: Aetna New Business (MI Preferred)	$71.11
Rate for Payer: BCBS Complete	$43.76
Rate for Payer: Cash Price	$87.52
Rate for Payer: Cofinity Commercial	$76.58
Rate for Payer: Cofinity Commercial	$94.08
Rate for Payer: Cofinity Medicare Advantage	$76.58
Rate for Payer: Encore Health Key Benefits Commercial	$87.52
Rate for Payer: Healthscope Commercial	$98.46
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$92.99
Rate for Payer: PHP Commercial	$92.99
Rate for Payer: Priority Health Cigna Priority Health	$71.11
Rate for Payer: Priority Health SBD	$68.92

FENTANYL 25 MCG/HR TRANSDERMAL PATCH

Facility

$21.88

Service Code	NDC 47781042411
Hospital Charge Code	27905
Hospital Revenue Code	637
Min. Negotiated Rate	$13.78
Max. Negotiated Rate	$19.69
Rate for Payer: Aetna Commercial	$18.60
Rate for Payer: Aetna New Business (MI Preferred)	$14.22
Rate for Payer: Cash Price	$17.50
Rate for Payer: Cofinity Commercial	$15.32
Rate for Payer: Cofinity Commercial	$18.82
Rate for Payer: Cofinity Medicare Advantage	$15.32
Rate for Payer: Encore Health Key Benefits Commercial	$17.50
Rate for Payer: Healthscope Commercial	$19.69
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$18.60
Rate for Payer: PHP Commercial	$18.60
Rate for Payer: Priority Health Cigna Priority Health	$14.22
Rate for Payer: Priority Health SBD	$13.78

FENTANYL 50 MCG/HR TRANSDERMAL PATCH

Facility

$30.08

Service Code	NDC 60505708200
Hospital Charge Code	27906
Hospital Revenue Code	637
Min. Negotiated Rate	$18.95
Max. Negotiated Rate	$27.07
Rate for Payer: Aetna Commercial	$25.57
Rate for Payer: Aetna New Business (MI Preferred)	$19.55
Rate for Payer: Cash Price	$24.06
Rate for Payer: Cofinity Commercial	$21.06
Rate for Payer: Cofinity Commercial	$25.87
Rate for Payer: Cofinity Medicare Advantage	$21.06
Rate for Payer: Encore Health Key Benefits Commercial	$24.06
Rate for Payer: Healthscope Commercial	$27.07
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$25.57
Rate for Payer: PHP Commercial	$25.57
Rate for Payer: Priority Health Cigna Priority Health	$19.55
Rate for Payer: Priority Health SBD	$18.95

FENTANYL 50 MCG/HR TRANSDERMAL PATCH

Facility

$150.39

Service Code	NDC 60505708202
Hospital Charge Code	27906
Hospital Revenue Code	637
Min. Negotiated Rate	$60.16
Max. Negotiated Rate	$135.35
Rate for Payer: Aetna Commercial	$127.83
Rate for Payer: Aetna Medicare	$75.20
Rate for Payer: Aetna New Business (MI Preferred)	$97.75
Rate for Payer: BCBS Complete	$60.16
Rate for Payer: Cash Price	$120.31
Rate for Payer: Cofinity Commercial	$105.27
Rate for Payer: Cofinity Commercial	$129.34
Rate for Payer: Cofinity Medicare Advantage	$105.27
Rate for Payer: Encore Health Key Benefits Commercial	$120.31
Rate for Payer: Healthscope Commercial	$135.35
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$127.83
Rate for Payer: PHP Commercial	$127.83
Rate for Payer: Priority Health Cigna Priority Health	$97.75
Rate for Payer: Priority Health SBD	$94.75

FENTANYL 50 MCG/HR TRANSDERMAL PATCH

Facility

$30.08

Service Code	NDC 60505708200
Hospital Charge Code	27906
Hospital Revenue Code	637
Min. Negotiated Rate	$12.03
Max. Negotiated Rate	$27.07
Rate for Payer: Aetna Commercial	$25.57
Rate for Payer: Aetna Medicare	$15.04
Rate for Payer: Aetna New Business (MI Preferred)	$19.55
Rate for Payer: BCBS Complete	$12.03
Rate for Payer: Cash Price	$24.06
Rate for Payer: Cofinity Commercial	$21.06
Rate for Payer: Cofinity Commercial	$25.87
Rate for Payer: Cofinity Medicare Advantage	$21.06
Rate for Payer: Encore Health Key Benefits Commercial	$24.06
Rate for Payer: Healthscope Commercial	$27.07
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$25.57
Rate for Payer: PHP Commercial	$25.57
Rate for Payer: Priority Health Cigna Priority Health	$19.55
Rate for Payer: Priority Health SBD	$18.95

FENTANYL 50 MCG/HR TRANSDERMAL PATCH

Facility

$150.39

Service Code	NDC 60505708202
Hospital Charge Code	27906
Hospital Revenue Code	637
Min. Negotiated Rate	$94.75
Max. Negotiated Rate	$135.35
Rate for Payer: Aetna Commercial	$127.83
Rate for Payer: Aetna New Business (MI Preferred)	$97.75
Rate for Payer: Cash Price	$120.31
Rate for Payer: Cofinity Commercial	$105.27
Rate for Payer: Cofinity Commercial	$129.34
Rate for Payer: Cofinity Medicare Advantage	$105.27
Rate for Payer: Encore Health Key Benefits Commercial	$120.31
Rate for Payer: Healthscope Commercial	$135.35
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$127.83
Rate for Payer: PHP Commercial	$127.83
Rate for Payer: Priority Health Cigna Priority Health	$97.75
Rate for Payer: Priority Health SBD	$94.75

FENTANYL 50 MCG/ML INHALATION

Facility

$14.39

Service Code	HCPCS J3010
Hospital Charge Code	300141
Hospital Revenue Code	636
Min. Negotiated Rate	$9.07
Max. Negotiated Rate	$12.95
Rate for Payer: Aetna Commercial	$12.23
Rate for Payer: Aetna Commercial	$14.93
Rate for Payer: Aetna Commercial	$17.83
Rate for Payer: Aetna New Business (MI Preferred)	$11.41
Rate for Payer: Aetna New Business (MI Preferred)	$9.35
Rate for Payer: Aetna New Business (MI Preferred)	$13.64
Rate for Payer: Cash Price	$11.51
Rate for Payer: Cash Price	$14.05
Rate for Payer: Cash Price	$16.78
Rate for Payer: Cofinity Commercial	$14.69
Rate for Payer: Cofinity Commercial	$10.07
Rate for Payer: Cofinity Commercial	$12.38
Rate for Payer: Cofinity Commercial	$18.04
Rate for Payer: Cofinity Commercial	$12.29
Rate for Payer: Cofinity Commercial	$15.10
Rate for Payer: Cofinity Medicare Advantage	$12.29
Rate for Payer: Cofinity Medicare Advantage	$14.69
Rate for Payer: Cofinity Medicare Advantage	$10.07
Rate for Payer: Encore Health Key Benefits Commercial	$14.05
Rate for Payer: Encore Health Key Benefits Commercial	$11.51
Rate for Payer: Encore Health Key Benefits Commercial	$16.78
Rate for Payer: Healthscope Commercial	$15.80
Rate for Payer: Healthscope Commercial	$18.88
Rate for Payer: Healthscope Commercial	$12.95
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$14.93
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$12.23
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$17.83
Rate for Payer: PHP Commercial	$17.83
Rate for Payer: PHP Commercial	$12.23
Rate for Payer: PHP Commercial	$14.93
Rate for Payer: Priority Health Cigna Priority Health	$9.35
Rate for Payer: Priority Health Cigna Priority Health	$13.64
Rate for Payer: Priority Health Cigna Priority Health	$11.41
Rate for Payer: Priority Health SBD	$13.22
Rate for Payer: Priority Health SBD	$9.07
Rate for Payer: Priority Health SBD	$11.06

FENTANYL 50 MCG/ML INHALATION

Facility

$20.98

Service Code	HCPCS J3010
Hospital Charge Code	300141
Hospital Revenue Code	636
Min. Negotiated Rate	$2.55
Max. Negotiated Rate	$18.88
Rate for Payer: Aetna Commercial	$17.83
Rate for Payer: Aetna Commercial	$12.23
Rate for Payer: Aetna Commercial	$14.93
Rate for Payer: Aetna Medicare	$7.20
Rate for Payer: Aetna Medicare	$8.78
Rate for Payer: Aetna Medicare	$10.49
Rate for Payer: Aetna New Business (MI Preferred)	$11.41
Rate for Payer: Aetna New Business (MI Preferred)	$9.35
Rate for Payer: Aetna New Business (MI Preferred)	$13.64
Rate for Payer: BCBS Complete	$7.02
Rate for Payer: BCBS Complete	$5.76
Rate for Payer: BCBS Complete	$8.39
Rate for Payer: BCBS Trust/PPO	$2.55
Rate for Payer: BCBS Trust/PPO	$2.55
Rate for Payer: BCBS Trust/PPO	$2.55
Rate for Payer: BCN Commercial	$2.55
Rate for Payer: BCN Commercial	$2.55
Rate for Payer: BCN Commercial	$2.55
Rate for Payer: Cash Price	$14.05
Rate for Payer: Cash Price	$11.51
Rate for Payer: Cash Price	$16.78
Rate for Payer: Cash Price	$14.05
Rate for Payer: Cash Price	$11.51
Rate for Payer: Cash Price	$16.78
Rate for Payer: Cofinity Commercial	$12.29
Rate for Payer: Cofinity Commercial	$10.07
Rate for Payer: Cofinity Commercial	$12.38
Rate for Payer: Cofinity Commercial	$15.10
Rate for Payer: Cofinity Commercial	$14.69
Rate for Payer: Cofinity Commercial	$18.04
Rate for Payer: Cofinity Medicare Advantage	$14.69
Rate for Payer: Cofinity Medicare Advantage	$12.29
Rate for Payer: Cofinity Medicare Advantage	$10.07
Rate for Payer: Encore Health Key Benefits Commercial	$11.51
Rate for Payer: Encore Health Key Benefits Commercial	$14.05
Rate for Payer: Encore Health Key Benefits Commercial	$16.78
Rate for Payer: Healthscope Commercial	$15.80
Rate for Payer: Healthscope Commercial	$12.95
Rate for Payer: Healthscope Commercial	$18.88
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$14.93
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$12.23
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$17.83
Rate for Payer: PHP Commercial	$14.93
Rate for Payer: PHP Commercial	$17.83
Rate for Payer: PHP Commercial	$12.23
Rate for Payer: Priority Health Cigna Priority Health	$11.41
Rate for Payer: Priority Health Cigna Priority Health	$13.64
Rate for Payer: Priority Health Cigna Priority Health	$9.35
Rate for Payer: Priority Health SBD	$9.07
Rate for Payer: Priority Health SBD	$13.22
Rate for Payer: Priority Health SBD	$11.06

FENTANYL BOLUS FROM BAG 10 MCG/ML

Facility

$2.55

Service Code	HCPCS J3010
Hospital Charge Code	500621
Hospital Revenue Code	636
Min. Negotiated Rate	$2.55
Max. Negotiated Rate	$2.55
Rate for Payer: BCBS Trust/PPO	$2.55
Rate for Payer: BCN Commercial	$2.55

Know your out-of-pocket cost for care.

All Charges