Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

FLECAINIDE 50 MG TABLET

Facility

$258.50

Service Code	NDC 53746064101
Hospital Charge Code	10043
Hospital Revenue Code	637
Min. Negotiated Rate	$103.40
Max. Negotiated Rate	$232.65
Rate for Payer: Aetna Commercial	$219.72
Rate for Payer: Aetna Medicare	$129.25
Rate for Payer: Aetna New Business (MI Preferred)	$168.02
Rate for Payer: BCBS Complete	$103.40
Rate for Payer: Cash Price	$206.80
Rate for Payer: Cofinity Commercial	$180.95
Rate for Payer: Cofinity Commercial	$222.31
Rate for Payer: Cofinity Medicare Advantage	$180.95
Rate for Payer: Encore Health Key Benefits Commercial	$206.80
Rate for Payer: Healthscope Commercial	$232.65
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$219.72
Rate for Payer: PHP Commercial	$219.72
Rate for Payer: Priority Health Cigna Priority Health	$168.02
Rate for Payer: Priority Health SBD	$162.86

FLECAINIDE 50 MG TABLET

Facility

$153.80

Service Code	NDC 00054001021
Hospital Charge Code	10043
Hospital Revenue Code	637
Min. Negotiated Rate	$61.52
Max. Negotiated Rate	$138.42
Rate for Payer: Aetna Commercial	$130.73
Rate for Payer: Aetna Medicare	$76.90
Rate for Payer: Aetna New Business (MI Preferred)	$99.97
Rate for Payer: BCBS Complete	$61.52
Rate for Payer: Cash Price	$123.04
Rate for Payer: Cofinity Commercial	$107.66
Rate for Payer: Cofinity Commercial	$132.27
Rate for Payer: Cofinity Medicare Advantage	$107.66
Rate for Payer: Encore Health Key Benefits Commercial	$123.04
Rate for Payer: Healthscope Commercial	$138.42
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$130.73
Rate for Payer: PHP Commercial	$130.73
Rate for Payer: Priority Health Cigna Priority Health	$99.97
Rate for Payer: Priority Health SBD	$96.89

FLECAINIDE 50 MG TABLET

Facility

$253.92

Service Code	NDC 00054001020
Hospital Charge Code	10043
Hospital Revenue Code	637
Min. Negotiated Rate	$159.97
Max. Negotiated Rate	$228.53
Rate for Payer: Aetna Commercial	$215.83
Rate for Payer: Aetna New Business (MI Preferred)	$165.05
Rate for Payer: Cash Price	$203.14
Rate for Payer: Cofinity Commercial	$177.74
Rate for Payer: Cofinity Commercial	$218.37
Rate for Payer: Cofinity Medicare Advantage	$177.74
Rate for Payer: Encore Health Key Benefits Commercial	$203.14
Rate for Payer: Healthscope Commercial	$228.53
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$215.83
Rate for Payer: PHP Commercial	$215.83
Rate for Payer: Priority Health Cigna Priority Health	$165.05
Rate for Payer: Priority Health SBD	$159.97

FLUCONAZOLE 100 MG TABLET

Facility

$117.42

Service Code	NDC 68462010230
Hospital Charge Code	10044
Hospital Revenue Code	637
Min. Negotiated Rate	$73.97
Max. Negotiated Rate	$105.68
Rate for Payer: Aetna Commercial	$99.81
Rate for Payer: Aetna New Business (MI Preferred)	$76.32
Rate for Payer: Cash Price	$93.94
Rate for Payer: Cofinity Commercial	$100.98
Rate for Payer: Cofinity Commercial	$82.19
Rate for Payer: Cofinity Medicare Advantage	$82.19
Rate for Payer: Encore Health Key Benefits Commercial	$93.94
Rate for Payer: Healthscope Commercial	$105.68
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$99.81
Rate for Payer: PHP Commercial	$99.81
Rate for Payer: Priority Health Cigna Priority Health	$76.32
Rate for Payer: Priority Health SBD	$73.97

FLUCONAZOLE 100 MG TABLET

Facility

$554.40

Service Code	NDC 00904650061
Hospital Charge Code	10044
Hospital Revenue Code	637
Min. Negotiated Rate	$349.27
Max. Negotiated Rate	$498.96
Rate for Payer: Aetna Commercial	$471.24
Rate for Payer: Aetna New Business (MI Preferred)	$360.36
Rate for Payer: Cash Price	$443.52
Rate for Payer: Cofinity Commercial	$388.08
Rate for Payer: Cofinity Commercial	$476.78
Rate for Payer: Cofinity Medicare Advantage	$388.08
Rate for Payer: Encore Health Key Benefits Commercial	$443.52
Rate for Payer: Healthscope Commercial	$498.96
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$471.24
Rate for Payer: PHP Commercial	$471.24
Rate for Payer: Priority Health Cigna Priority Health	$360.36
Rate for Payer: Priority Health SBD	$349.27

FLUCONAZOLE 100 MG TABLET

Facility

$554.40

Service Code	NDC 00904650061
Hospital Charge Code	10044
Hospital Revenue Code	637
Min. Negotiated Rate	$221.76
Max. Negotiated Rate	$498.96
Rate for Payer: Aetna Commercial	$471.24
Rate for Payer: Aetna Medicare	$277.20
Rate for Payer: Aetna New Business (MI Preferred)	$360.36
Rate for Payer: BCBS Complete	$221.76
Rate for Payer: Cash Price	$443.52
Rate for Payer: Cofinity Commercial	$388.08
Rate for Payer: Cofinity Commercial	$476.78
Rate for Payer: Cofinity Medicare Advantage	$388.08
Rate for Payer: Encore Health Key Benefits Commercial	$443.52
Rate for Payer: Healthscope Commercial	$498.96
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$471.24
Rate for Payer: PHP Commercial	$471.24
Rate for Payer: Priority Health Cigna Priority Health	$360.36
Rate for Payer: Priority Health SBD	$349.27

FLUCONAZOLE 100 MG TABLET

Facility

$117.42

Service Code	NDC 68462010230
Hospital Charge Code	10044
Hospital Revenue Code	637
Min. Negotiated Rate	$46.97
Max. Negotiated Rate	$105.68
Rate for Payer: Aetna Commercial	$99.81
Rate for Payer: Aetna Medicare	$58.71
Rate for Payer: Aetna New Business (MI Preferred)	$76.32
Rate for Payer: BCBS Complete	$46.97
Rate for Payer: Cash Price	$93.94
Rate for Payer: Cofinity Commercial	$100.98
Rate for Payer: Cofinity Commercial	$82.19
Rate for Payer: Cofinity Medicare Advantage	$82.19
Rate for Payer: Encore Health Key Benefits Commercial	$93.94
Rate for Payer: Healthscope Commercial	$105.68
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$99.81
Rate for Payer: PHP Commercial	$99.81
Rate for Payer: Priority Health Cigna Priority Health	$76.32
Rate for Payer: Priority Health SBD	$73.97

FLUCONAZOLE 150 MG TABLET

Facility

$60.20

Service Code	NDC 57237000511
Hospital Charge Code	13577
Hospital Revenue Code	637
Min. Negotiated Rate	$24.08
Max. Negotiated Rate	$54.18
Rate for Payer: Aetna Commercial	$51.17
Rate for Payer: Aetna Medicare	$30.10
Rate for Payer: Aetna New Business (MI Preferred)	$39.13
Rate for Payer: BCBS Complete	$24.08
Rate for Payer: Cash Price	$48.16
Rate for Payer: Cofinity Commercial	$42.14
Rate for Payer: Cofinity Commercial	$51.77
Rate for Payer: Cofinity Medicare Advantage	$42.14
Rate for Payer: Encore Health Key Benefits Commercial	$48.16
Rate for Payer: Healthscope Commercial	$54.18
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$51.17
Rate for Payer: PHP Commercial	$51.17
Rate for Payer: Priority Health Cigna Priority Health	$39.13
Rate for Payer: Priority Health SBD	$37.93

FLUCONAZOLE 150 MG TABLET

Facility

$60.20

Service Code	NDC 57237000511
Hospital Charge Code	13577
Hospital Revenue Code	637
Min. Negotiated Rate	$37.93
Max. Negotiated Rate	$54.18
Rate for Payer: Aetna Commercial	$51.17
Rate for Payer: Aetna New Business (MI Preferred)	$39.13
Rate for Payer: Cash Price	$48.16
Rate for Payer: Cofinity Commercial	$42.14
Rate for Payer: Cofinity Commercial	$51.77
Rate for Payer: Cofinity Medicare Advantage	$42.14
Rate for Payer: Encore Health Key Benefits Commercial	$48.16
Rate for Payer: Healthscope Commercial	$54.18
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$51.17
Rate for Payer: PHP Commercial	$51.17
Rate for Payer: Priority Health Cigna Priority Health	$39.13
Rate for Payer: Priority Health SBD	$37.93

FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK

Facility

$59.02

Service Code	HCPCS J1450
Hospital Charge Code	10049
Hospital Revenue Code	636
Min. Negotiated Rate	$37.18
Max. Negotiated Rate	$53.12
Rate for Payer: Aetna Commercial	$50.17
Rate for Payer: Aetna Commercial	$89.48
Rate for Payer: Aetna Commercial	$75.92
Rate for Payer: Aetna New Business (MI Preferred)	$38.36
Rate for Payer: Aetna New Business (MI Preferred)	$68.43
Rate for Payer: Aetna New Business (MI Preferred)	$58.06
Rate for Payer: Cash Price	$84.22
Rate for Payer: Cash Price	$71.46
Rate for Payer: Cash Price	$47.22
Rate for Payer: Cofinity Commercial	$73.69
Rate for Payer: Cofinity Commercial	$90.53
Rate for Payer: Cofinity Commercial	$41.31
Rate for Payer: Cofinity Commercial	$50.76
Rate for Payer: Cofinity Commercial	$62.52
Rate for Payer: Cofinity Commercial	$76.82
Rate for Payer: Cofinity Medicare Advantage	$73.69
Rate for Payer: Cofinity Medicare Advantage	$62.52
Rate for Payer: Cofinity Medicare Advantage	$41.31
Rate for Payer: Encore Health Key Benefits Commercial	$84.22
Rate for Payer: Encore Health Key Benefits Commercial	$47.22
Rate for Payer: Encore Health Key Benefits Commercial	$71.46
Rate for Payer: Healthscope Commercial	$94.74
Rate for Payer: Healthscope Commercial	$53.12
Rate for Payer: Healthscope Commercial	$80.39
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$89.48
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$50.17
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$75.92
Rate for Payer: PHP Commercial	$50.17
Rate for Payer: PHP Commercial	$75.92
Rate for Payer: PHP Commercial	$89.48
Rate for Payer: Priority Health Cigna Priority Health	$58.06
Rate for Payer: Priority Health Cigna Priority Health	$38.36
Rate for Payer: Priority Health Cigna Priority Health	$68.43
Rate for Payer: Priority Health SBD	$56.27
Rate for Payer: Priority Health SBD	$37.18
Rate for Payer: Priority Health SBD	$66.32

FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK

Facility

$89.32

Service Code	HCPCS J1450
Hospital Charge Code	10049
Hospital Revenue Code	636
Min. Negotiated Rate	$7.37
Max. Negotiated Rate	$80.39
Rate for Payer: Aetna Commercial	$75.92
Rate for Payer: Aetna Commercial	$89.48
Rate for Payer: Aetna Commercial	$50.17
Rate for Payer: Aetna Medicare	$52.64
Rate for Payer: Aetna Medicare	$29.51
Rate for Payer: Aetna Medicare	$44.66
Rate for Payer: Aetna New Business (MI Preferred)	$38.36
Rate for Payer: Aetna New Business (MI Preferred)	$68.43
Rate for Payer: Aetna New Business (MI Preferred)	$58.06
Rate for Payer: BCBS Complete	$23.61
Rate for Payer: BCBS Complete	$42.11
Rate for Payer: BCBS Complete	$35.73
Rate for Payer: BCBS Trust/PPO	$7.37
Rate for Payer: BCBS Trust/PPO	$7.37
Rate for Payer: BCBS Trust/PPO	$7.37
Rate for Payer: BCN Commercial	$7.37
Rate for Payer: BCN Commercial	$7.37
Rate for Payer: BCN Commercial	$7.37
Rate for Payer: Cash Price	$47.22
Rate for Payer: Cash Price	$84.22
Rate for Payer: Cash Price	$71.46
Rate for Payer: Cash Price	$47.22
Rate for Payer: Cash Price	$84.22
Rate for Payer: Cash Price	$71.46
Rate for Payer: Cofinity Commercial	$41.31
Rate for Payer: Cofinity Commercial	$73.69
Rate for Payer: Cofinity Commercial	$90.53
Rate for Payer: Cofinity Commercial	$50.76
Rate for Payer: Cofinity Commercial	$62.52
Rate for Payer: Cofinity Commercial	$76.82
Rate for Payer: Cofinity Medicare Advantage	$62.52
Rate for Payer: Cofinity Medicare Advantage	$41.31
Rate for Payer: Cofinity Medicare Advantage	$73.69
Rate for Payer: Encore Health Key Benefits Commercial	$84.22
Rate for Payer: Encore Health Key Benefits Commercial	$47.22
Rate for Payer: Encore Health Key Benefits Commercial	$71.46
Rate for Payer: Healthscope Commercial	$53.12
Rate for Payer: Healthscope Commercial	$94.74
Rate for Payer: Healthscope Commercial	$80.39
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$50.17
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$89.48
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$75.92
Rate for Payer: PHP Commercial	$50.17
Rate for Payer: PHP Commercial	$75.92
Rate for Payer: PHP Commercial	$89.48
Rate for Payer: Priority Health Cigna Priority Health	$38.36
Rate for Payer: Priority Health Cigna Priority Health	$58.06
Rate for Payer: Priority Health Cigna Priority Health	$68.43
Rate for Payer: Priority Health SBD	$66.32
Rate for Payer: Priority Health SBD	$56.27
Rate for Payer: Priority Health SBD	$37.18

FLUCONAZOLE 200 MG TABLET

Facility

$280.08

Service Code	NDC 00904650106
Hospital Charge Code	10045
Hospital Revenue Code	637
Min. Negotiated Rate	$176.45
Max. Negotiated Rate	$252.07
Rate for Payer: Aetna Commercial	$238.07
Rate for Payer: Aetna New Business (MI Preferred)	$182.05
Rate for Payer: Cash Price	$224.06
Rate for Payer: Cofinity Commercial	$196.06
Rate for Payer: Cofinity Commercial	$240.87
Rate for Payer: Cofinity Medicare Advantage	$196.06
Rate for Payer: Encore Health Key Benefits Commercial	$224.06
Rate for Payer: Healthscope Commercial	$252.07
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$238.07
Rate for Payer: PHP Commercial	$238.07
Rate for Payer: Priority Health Cigna Priority Health	$182.05
Rate for Payer: Priority Health SBD	$176.45

FLUCONAZOLE 200 MG TABLET

Facility

$8.14

Service Code	NDC 68084073511
Hospital Charge Code	10045
Hospital Revenue Code	637
Min. Negotiated Rate	$3.26
Max. Negotiated Rate	$7.33
Rate for Payer: Aetna Commercial	$6.92
Rate for Payer: Aetna Medicare	$4.07
Rate for Payer: Aetna New Business (MI Preferred)	$5.29
Rate for Payer: BCBS Complete	$3.26
Rate for Payer: Cash Price	$6.51
Rate for Payer: Cofinity Commercial	$5.70
Rate for Payer: Cofinity Commercial	$7.00
Rate for Payer: Cofinity Medicare Advantage	$5.70
Rate for Payer: Encore Health Key Benefits Commercial	$6.51
Rate for Payer: Healthscope Commercial	$7.33
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$6.92
Rate for Payer: PHP Commercial	$6.92
Rate for Payer: Priority Health Cigna Priority Health	$5.29
Rate for Payer: Priority Health SBD	$5.13

FLUCONAZOLE 200 MG TABLET

Facility

$6.17

Service Code	NDC 50268033911
Hospital Charge Code	10045
Hospital Revenue Code	637
Min. Negotiated Rate	$2.47
Max. Negotiated Rate	$5.55
Rate for Payer: Aetna Commercial	$5.24
Rate for Payer: Aetna Medicare	$3.08
Rate for Payer: Aetna New Business (MI Preferred)	$4.01
Rate for Payer: BCBS Complete	$2.47
Rate for Payer: Cash Price	$4.94
Rate for Payer: Cofinity Commercial	$4.32
Rate for Payer: Cofinity Commercial	$5.31
Rate for Payer: Cofinity Medicare Advantage	$4.32
Rate for Payer: Encore Health Key Benefits Commercial	$4.94
Rate for Payer: Healthscope Commercial	$5.55
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$5.24
Rate for Payer: PHP Commercial	$5.24
Rate for Payer: Priority Health Cigna Priority Health	$4.01
Rate for Payer: Priority Health SBD	$3.89

FLUCONAZOLE 200 MG TABLET

Facility

$991.23

Service Code	NDC 55111014601
Hospital Charge Code	10045
Hospital Revenue Code	637
Min. Negotiated Rate	$396.49
Max. Negotiated Rate	$892.11
Rate for Payer: Aetna Commercial	$842.55
Rate for Payer: Aetna Medicare	$495.62
Rate for Payer: Aetna New Business (MI Preferred)	$644.30
Rate for Payer: BCBS Complete	$396.49
Rate for Payer: Cash Price	$792.98
Rate for Payer: Cofinity Commercial	$693.86
Rate for Payer: Cofinity Commercial	$852.46
Rate for Payer: Cofinity Medicare Advantage	$693.86
Rate for Payer: Encore Health Key Benefits Commercial	$792.98
Rate for Payer: Healthscope Commercial	$892.11
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$842.55
Rate for Payer: PHP Commercial	$842.55
Rate for Payer: Priority Health Cigna Priority Health	$644.30
Rate for Payer: Priority Health SBD	$624.47

FLUCONAZOLE 200 MG TABLET

Facility

$8.14

Service Code	NDC 68084073511
Hospital Charge Code	10045
Hospital Revenue Code	637
Min. Negotiated Rate	$5.13
Max. Negotiated Rate	$7.33
Rate for Payer: Aetna Commercial	$6.92
Rate for Payer: Aetna New Business (MI Preferred)	$5.29
Rate for Payer: Cash Price	$6.51
Rate for Payer: Cofinity Commercial	$5.70
Rate for Payer: Cofinity Commercial	$7.00
Rate for Payer: Cofinity Medicare Advantage	$5.70
Rate for Payer: Encore Health Key Benefits Commercial	$6.51
Rate for Payer: Healthscope Commercial	$7.33
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$6.92
Rate for Payer: PHP Commercial	$6.92
Rate for Payer: Priority Health Cigna Priority Health	$5.29
Rate for Payer: Priority Health SBD	$5.13

FLUCONAZOLE 200 MG TABLET

Facility

$813.12

Service Code	NDC 68084073501
Hospital Charge Code	10045
Hospital Revenue Code	637
Min. Negotiated Rate	$325.25
Max. Negotiated Rate	$731.81
Rate for Payer: Aetna Commercial	$691.15
Rate for Payer: Aetna Medicare	$406.56
Rate for Payer: Aetna New Business (MI Preferred)	$528.53
Rate for Payer: BCBS Complete	$325.25
Rate for Payer: Cash Price	$650.50
Rate for Payer: Cofinity Commercial	$569.18
Rate for Payer: Cofinity Commercial	$699.28
Rate for Payer: Cofinity Medicare Advantage	$569.18
Rate for Payer: Encore Health Key Benefits Commercial	$650.50
Rate for Payer: Healthscope Commercial	$731.81
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$691.15
Rate for Payer: PHP Commercial	$691.15
Rate for Payer: Priority Health Cigna Priority Health	$528.53
Rate for Payer: Priority Health SBD	$512.27

FLUCONAZOLE 200 MG TABLET

Facility

$991.23

Service Code	NDC 55111014601
Hospital Charge Code	10045
Hospital Revenue Code	637
Min. Negotiated Rate	$624.47
Max. Negotiated Rate	$892.11
Rate for Payer: Aetna Commercial	$842.55
Rate for Payer: Aetna New Business (MI Preferred)	$644.30
Rate for Payer: Cash Price	$792.98
Rate for Payer: Cofinity Commercial	$693.86
Rate for Payer: Cofinity Commercial	$852.46
Rate for Payer: Cofinity Medicare Advantage	$693.86
Rate for Payer: Encore Health Key Benefits Commercial	$792.98
Rate for Payer: Healthscope Commercial	$892.11
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$842.55
Rate for Payer: PHP Commercial	$842.55
Rate for Payer: Priority Health Cigna Priority Health	$644.30
Rate for Payer: Priority Health SBD	$624.47

FLUCONAZOLE 200 MG TABLET

Facility

$6.17

Service Code	NDC 50268033911
Hospital Charge Code	10045
Hospital Revenue Code	637
Min. Negotiated Rate	$3.89
Max. Negotiated Rate	$5.55
Rate for Payer: Aetna Commercial	$5.24
Rate for Payer: Aetna New Business (MI Preferred)	$4.01
Rate for Payer: Cash Price	$4.94
Rate for Payer: Cofinity Commercial	$4.32
Rate for Payer: Cofinity Commercial	$5.31
Rate for Payer: Cofinity Medicare Advantage	$4.32
Rate for Payer: Encore Health Key Benefits Commercial	$4.94
Rate for Payer: Healthscope Commercial	$5.55
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$5.24
Rate for Payer: PHP Commercial	$5.24
Rate for Payer: Priority Health Cigna Priority Health	$4.01
Rate for Payer: Priority Health SBD	$3.89

FLUCONAZOLE 200 MG TABLET

Facility

$813.12

Service Code	NDC 68084073501
Hospital Charge Code	10045
Hospital Revenue Code	637
Min. Negotiated Rate	$512.27
Max. Negotiated Rate	$731.81
Rate for Payer: Aetna Commercial	$691.15
Rate for Payer: Aetna New Business (MI Preferred)	$528.53
Rate for Payer: Cash Price	$650.50
Rate for Payer: Cofinity Commercial	$569.18
Rate for Payer: Cofinity Commercial	$699.28
Rate for Payer: Cofinity Medicare Advantage	$569.18
Rate for Payer: Encore Health Key Benefits Commercial	$650.50
Rate for Payer: Healthscope Commercial	$731.81
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$691.15
Rate for Payer: PHP Commercial	$691.15
Rate for Payer: Priority Health Cigna Priority Health	$528.53
Rate for Payer: Priority Health SBD	$512.27

FLUCONAZOLE 200 MG TABLET

Facility

$308.16

Service Code	NDC 50268033915
Hospital Charge Code	10045
Hospital Revenue Code	637
Min. Negotiated Rate	$123.26
Max. Negotiated Rate	$277.34
Rate for Payer: Aetna Commercial	$261.94
Rate for Payer: Aetna Medicare	$154.08
Rate for Payer: Aetna New Business (MI Preferred)	$200.30
Rate for Payer: BCBS Complete	$123.26
Rate for Payer: Cash Price	$246.53
Rate for Payer: Cofinity Commercial	$215.71
Rate for Payer: Cofinity Commercial	$265.02
Rate for Payer: Cofinity Medicare Advantage	$215.71
Rate for Payer: Encore Health Key Benefits Commercial	$246.53
Rate for Payer: Healthscope Commercial	$277.34
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$261.94
Rate for Payer: PHP Commercial	$261.94
Rate for Payer: Priority Health Cigna Priority Health	$200.30
Rate for Payer: Priority Health SBD	$194.14

FLUCONAZOLE 200 MG TABLET

Facility

$280.08

Service Code	NDC 00904650106
Hospital Charge Code	10045
Hospital Revenue Code	637
Min. Negotiated Rate	$112.03
Max. Negotiated Rate	$252.07
Rate for Payer: Aetna Commercial	$238.07
Rate for Payer: Aetna Medicare	$140.04
Rate for Payer: Aetna New Business (MI Preferred)	$182.05
Rate for Payer: BCBS Complete	$112.03
Rate for Payer: Cash Price	$224.06
Rate for Payer: Cofinity Commercial	$196.06
Rate for Payer: Cofinity Commercial	$240.87
Rate for Payer: Cofinity Medicare Advantage	$196.06
Rate for Payer: Encore Health Key Benefits Commercial	$224.06
Rate for Payer: Healthscope Commercial	$252.07
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$238.07
Rate for Payer: PHP Commercial	$238.07
Rate for Payer: Priority Health Cigna Priority Health	$182.05
Rate for Payer: Priority Health SBD	$176.45

FLUCONAZOLE 200 MG TABLET

Facility

$308.16

Service Code	NDC 50268033915
Hospital Charge Code	10045
Hospital Revenue Code	637
Min. Negotiated Rate	$194.14
Max. Negotiated Rate	$277.34
Rate for Payer: Aetna Commercial	$261.94
Rate for Payer: Aetna New Business (MI Preferred)	$200.30
Rate for Payer: Cash Price	$246.53
Rate for Payer: Cofinity Commercial	$215.71
Rate for Payer: Cofinity Commercial	$265.02
Rate for Payer: Cofinity Medicare Advantage	$215.71
Rate for Payer: Encore Health Key Benefits Commercial	$246.53
Rate for Payer: Healthscope Commercial	$277.34
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$261.94
Rate for Payer: PHP Commercial	$261.94
Rate for Payer: Priority Health Cigna Priority Health	$200.30
Rate for Payer: Priority Health SBD	$194.14

FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK

Facility

$102.08

Service Code	HCPCS J1450
Hospital Charge Code	10050
Hospital Revenue Code	636
Min. Negotiated Rate	$64.31
Max. Negotiated Rate	$91.87
Rate for Payer: Aetna Commercial	$86.77
Rate for Payer: Aetna Commercial	$54.23
Rate for Payer: Aetna New Business (MI Preferred)	$66.35
Rate for Payer: Aetna New Business (MI Preferred)	$41.47
Rate for Payer: Cash Price	$81.66
Rate for Payer: Cash Price	$51.04
Rate for Payer: Cofinity Commercial	$71.46
Rate for Payer: Cofinity Commercial	$44.66
Rate for Payer: Cofinity Commercial	$54.87
Rate for Payer: Cofinity Commercial	$87.79
Rate for Payer: Cofinity Medicare Advantage	$44.66
Rate for Payer: Cofinity Medicare Advantage	$71.46
Rate for Payer: Encore Health Key Benefits Commercial	$81.66
Rate for Payer: Encore Health Key Benefits Commercial	$51.04
Rate for Payer: Healthscope Commercial	$91.87
Rate for Payer: Healthscope Commercial	$57.42
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$86.77
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$54.23
Rate for Payer: PHP Commercial	$86.77
Rate for Payer: PHP Commercial	$54.23
Rate for Payer: Priority Health Cigna Priority Health	$41.47
Rate for Payer: Priority Health Cigna Priority Health	$66.35
Rate for Payer: Priority Health SBD	$40.19
Rate for Payer: Priority Health SBD	$64.31

FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK

Facility

$102.08

Service Code	HCPCS J1450
Hospital Charge Code	10050
Hospital Revenue Code	636
Min. Negotiated Rate	$7.37
Max. Negotiated Rate	$91.87
Rate for Payer: Aetna Commercial	$86.77
Rate for Payer: Aetna Commercial	$54.23
Rate for Payer: Aetna Medicare	$31.90
Rate for Payer: Aetna Medicare	$51.04
Rate for Payer: Aetna New Business (MI Preferred)	$66.35
Rate for Payer: Aetna New Business (MI Preferred)	$41.47
Rate for Payer: BCBS Complete	$25.52
Rate for Payer: BCBS Complete	$40.83
Rate for Payer: BCBS Trust/PPO	$7.37
Rate for Payer: BCBS Trust/PPO	$7.37
Rate for Payer: BCN Commercial	$7.37
Rate for Payer: BCN Commercial	$7.37
Rate for Payer: Cash Price	$51.04
Rate for Payer: Cash Price	$51.04
Rate for Payer: Cash Price	$81.66
Rate for Payer: Cash Price	$81.66
Rate for Payer: Cofinity Commercial	$71.46
Rate for Payer: Cofinity Commercial	$54.87
Rate for Payer: Cofinity Commercial	$44.66
Rate for Payer: Cofinity Commercial	$87.79
Rate for Payer: Cofinity Medicare Advantage	$44.66
Rate for Payer: Cofinity Medicare Advantage	$71.46
Rate for Payer: Encore Health Key Benefits Commercial	$81.66
Rate for Payer: Encore Health Key Benefits Commercial	$51.04
Rate for Payer: Healthscope Commercial	$91.87
Rate for Payer: Healthscope Commercial	$57.42
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$54.23
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$86.77
Rate for Payer: PHP Commercial	$54.23
Rate for Payer: PHP Commercial	$86.77
Rate for Payer: Priority Health Cigna Priority Health	$66.35
Rate for Payer: Priority Health Cigna Priority Health	$41.47
Rate for Payer: Priority Health SBD	$40.19
Rate for Payer: Priority Health SBD	$64.31

Know your out-of-pocket cost for care.

All Charges