Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR

Facility

$269.80

Service Code	NDC 63824000815
Hospital Charge Code	170771
Hospital Revenue Code	637
Min. Negotiated Rate	$107.92
Max. Negotiated Rate	$242.82
Rate for Payer: Aetna Commercial	$229.33
Rate for Payer: Aetna Medicare	$134.90
Rate for Payer: Aetna New Business (MI Preferred)	$175.37
Rate for Payer: BCBS Complete	$107.92
Rate for Payer: Cash Price	$215.84
Rate for Payer: Cofinity Commercial	$188.86
Rate for Payer: Cofinity Commercial	$232.03
Rate for Payer: Cofinity Medicare Advantage	$188.86
Rate for Payer: Encore Health Key Benefits Commercial	$215.84
Rate for Payer: Healthscope Commercial	$242.82
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$229.33
Rate for Payer: PHP Commercial	$229.33
Rate for Payer: Priority Health Cigna Priority Health	$175.37
Rate for Payer: Priority Health SBD	$169.97

GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR

Facility

$363.36

Service Code	NDC 68084057201
Hospital Charge Code	170771
Hospital Revenue Code	637
Min. Negotiated Rate	$145.34
Max. Negotiated Rate	$327.02
Rate for Payer: Aetna Commercial	$308.86
Rate for Payer: Aetna Medicare	$181.68
Rate for Payer: Aetna New Business (MI Preferred)	$236.18
Rate for Payer: BCBS Complete	$145.34
Rate for Payer: Cash Price	$290.69
Rate for Payer: Cofinity Commercial	$254.35
Rate for Payer: Cofinity Commercial	$312.49
Rate for Payer: Cofinity Medicare Advantage	$254.35
Rate for Payer: Encore Health Key Benefits Commercial	$290.69
Rate for Payer: Healthscope Commercial	$327.02
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$308.86
Rate for Payer: PHP Commercial	$308.86
Rate for Payer: Priority Health Cigna Priority Health	$236.18
Rate for Payer: Priority Health SBD	$228.92

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	$736.16
Max. Negotiated Rate	$1,051.65
Rate for Payer: Aetna Commercial	$993.22
Rate for Payer: Aetna New Business (MI Preferred)	$759.52
Rate for Payer: Cash Price	$934.80
Rate for Payer: Cofinity Commercial	$1,004.91
Rate for Payer: Cofinity Commercial	$817.95
Rate for Payer: Cofinity Medicare Advantage	$817.95
Rate for Payer: Encore Health Key Benefits Commercial	$934.80
Rate for Payer: Healthscope Commercial	$1,051.65
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$993.22
Rate for Payer: PHP Commercial	$993.22
Rate for Payer: Priority Health Cigna Priority Health	$759.52
Rate for Payer: Priority Health SBD	$736.16

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	$467.40
Max. Negotiated Rate	$1,051.65
Rate for Payer: Aetna Commercial	$993.22
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 Commercial	$1,004.91
Rate for Payer: Cofinity Commercial	$817.95
Rate for Payer: Cofinity Medicare Advantage	$817.95
Rate for Payer: Encore Health Key Benefits Commercial	$934.80
Rate for Payer: Healthscope Commercial	$1,051.65
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$993.22
Rate for Payer: PHP Commercial	$993.22
Rate for Payer: Priority Health Cigna Priority Health	$759.52
Rate for Payer: Priority Health SBD	$736.16

GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR

Facility

$126.20

Service Code	NDC 96295012390
Hospital Charge Code	170771
Hospital Revenue Code	637
Min. Negotiated Rate	$50.48
Max. Negotiated Rate	$113.58
Rate for Payer: Aetna Commercial	$107.27
Rate for Payer: Aetna Medicare	$63.10
Rate for Payer: Aetna New Business (MI Preferred)	$82.03
Rate for Payer: BCBS Complete	$50.48
Rate for Payer: Cash Price	$100.96
Rate for Payer: Cofinity Commercial	$108.53
Rate for Payer: Cofinity Commercial	$88.34
Rate for Payer: Cofinity Medicare Advantage	$88.34
Rate for Payer: Encore Health Key Benefits Commercial	$100.96
Rate for Payer: Healthscope Commercial	$113.58
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$107.27
Rate for Payer: PHP Commercial	$107.27
Rate for Payer: Priority Health Cigna Priority Health	$82.03
Rate for Payer: Priority Health SBD	$79.51

GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR

Facility

$3.64

Service Code	NDC 68084057211
Hospital Charge Code	170771
Hospital Revenue Code	637
Min. Negotiated Rate	$2.29
Max. Negotiated Rate	$3.28
Rate for Payer: Aetna Commercial	$3.09
Rate for Payer: Aetna New Business (MI Preferred)	$2.37
Rate for Payer: Cash Price	$2.91
Rate for Payer: Cofinity Commercial	$2.55
Rate for Payer: Cofinity Commercial	$3.13
Rate for Payer: Cofinity Medicare Advantage	$2.55
Rate for Payer: Encore Health Key Benefits Commercial	$2.91
Rate for Payer: Healthscope Commercial	$3.28
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3.09
Rate for Payer: PHP Commercial	$3.09
Rate for Payer: Priority Health Cigna Priority Health	$2.37
Rate for Payer: Priority Health SBD	$2.29

GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR

Facility

$115.90

Service Code	NDC 63824000834
Hospital Charge Code	170771
Hospital Revenue Code	637
Min. Negotiated Rate	$73.02
Max. Negotiated Rate	$104.31
Rate for Payer: Aetna Commercial	$98.52
Rate for Payer: Aetna New Business (MI Preferred)	$75.34
Rate for Payer: Cash Price	$92.72
Rate for Payer: Cofinity Commercial	$81.13
Rate for Payer: Cofinity Commercial	$99.67
Rate for Payer: Cofinity Medicare Advantage	$81.13
Rate for Payer: Encore Health Key Benefits Commercial	$92.72
Rate for Payer: Healthscope Commercial	$104.31
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$98.52
Rate for Payer: PHP Commercial	$98.52
Rate for Payer: Priority Health Cigna Priority Health	$75.34
Rate for Payer: Priority Health SBD	$73.02

GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR

Facility

$269.80

Service Code	NDC 63824000815
Hospital Charge Code	170771
Hospital Revenue Code	637
Min. Negotiated Rate	$169.97
Max. Negotiated Rate	$242.82
Rate for Payer: Aetna Commercial	$229.33
Rate for Payer: Aetna New Business (MI Preferred)	$175.37
Rate for Payer: Cash Price	$215.84
Rate for Payer: Cofinity Commercial	$188.86
Rate for Payer: Cofinity Commercial	$232.03
Rate for Payer: Cofinity Medicare Advantage	$188.86
Rate for Payer: Encore Health Key Benefits Commercial	$215.84
Rate for Payer: Healthscope Commercial	$242.82
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$229.33
Rate for Payer: PHP Commercial	$229.33
Rate for Payer: Priority Health Cigna Priority Health	$175.37
Rate for Payer: Priority Health SBD	$169.97

GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR

Facility

$3.64

Service Code	NDC 68084057211
Hospital Charge Code	170771
Hospital Revenue Code	637
Min. Negotiated Rate	$1.46
Max. Negotiated Rate	$3.28
Rate for Payer: Aetna Commercial	$3.09
Rate for Payer: Aetna Medicare	$1.82
Rate for Payer: Aetna New Business (MI Preferred)	$2.37
Rate for Payer: BCBS Complete	$1.46
Rate for Payer: Cash Price	$2.91
Rate for Payer: Cofinity Commercial	$2.55
Rate for Payer: Cofinity Commercial	$3.13
Rate for Payer: Cofinity Medicare Advantage	$2.55
Rate for Payer: Encore Health Key Benefits Commercial	$2.91
Rate for Payer: Healthscope Commercial	$3.28
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3.09
Rate for Payer: PHP Commercial	$3.09
Rate for Payer: Priority Health Cigna Priority Health	$2.37
Rate for Payer: Priority Health SBD	$2.29

GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR

Facility

$363.36

Service Code	NDC 68084057201
Hospital Charge Code	170771
Hospital Revenue Code	637
Min. Negotiated Rate	$228.92
Max. Negotiated Rate	$327.02
Rate for Payer: Aetna Commercial	$308.86
Rate for Payer: Aetna New Business (MI Preferred)	$236.18
Rate for Payer: Cash Price	$290.69
Rate for Payer: Cofinity Commercial	$254.35
Rate for Payer: Cofinity Commercial	$312.49
Rate for Payer: Cofinity Medicare Advantage	$254.35
Rate for Payer: Encore Health Key Benefits Commercial	$290.69
Rate for Payer: Healthscope Commercial	$327.02
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$308.86
Rate for Payer: PHP Commercial	$308.86
Rate for Payer: Priority Health Cigna Priority Health	$236.18
Rate for Payer: Priority Health SBD	$228.92

GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR

Facility

$115.90

Service Code	NDC 63824000834
Hospital Charge Code	170771
Hospital Revenue Code	637
Min. Negotiated Rate	$46.36
Max. Negotiated Rate	$104.31
Rate for Payer: Aetna Commercial	$98.52
Rate for Payer: Aetna Medicare	$57.95
Rate for Payer: Aetna New Business (MI Preferred)	$75.34
Rate for Payer: BCBS Complete	$46.36
Rate for Payer: Cash Price	$92.72
Rate for Payer: Cofinity Commercial	$81.13
Rate for Payer: Cofinity Commercial	$99.67
Rate for Payer: Cofinity Medicare Advantage	$81.13
Rate for Payer: Encore Health Key Benefits Commercial	$92.72
Rate for Payer: Healthscope Commercial	$104.31
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$98.52
Rate for Payer: PHP Commercial	$98.52
Rate for Payer: Priority Health Cigna Priority Health	$75.34
Rate for Payer: Priority Health SBD	$73.02

GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR

Facility

$126.20

Service Code	NDC 96295012390
Hospital Charge Code	170771
Hospital Revenue Code	637
Min. Negotiated Rate	$79.51
Max. Negotiated Rate	$113.58
Rate for Payer: Aetna Commercial	$107.27
Rate for Payer: Aetna New Business (MI Preferred)	$82.03
Rate for Payer: Cash Price	$100.96
Rate for Payer: Cofinity Commercial	$108.53
Rate for Payer: Cofinity Commercial	$88.34
Rate for Payer: Cofinity Medicare Advantage	$88.34
Rate for Payer: Encore Health Key Benefits Commercial	$100.96
Rate for Payer: Healthscope Commercial	$113.58
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$107.27
Rate for Payer: PHP Commercial	$107.27
Rate for Payer: Priority Health Cigna Priority Health	$82.03
Rate for Payer: Priority Health SBD	$79.51

GUANFACINE 1 MG TABLET

Facility

$6.33

Service Code	NDC 68094001959
Hospital Charge Code	10149
Hospital Revenue Code	637
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$5.70
Rate for Payer: Aetna Commercial	$5.38
Rate for Payer: Aetna Medicare	$3.16
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 Commercial	$4.43
Rate for Payer: Cofinity Commercial	$5.44
Rate for Payer: Cofinity Medicare Advantage	$4.43
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: PHP Commercial	$5.38
Rate for Payer: Priority Health Cigna Priority Health	$4.11
Rate for Payer: Priority Health SBD	$3.99

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 Commercial	$4.43
Rate for Payer: Cofinity Commercial	$5.44
Rate for Payer: Cofinity Medicare Advantage	$4.43
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: PHP Commercial	$5.38
Rate for Payer: Priority Health Cigna Priority Health	$4.11
Rate for Payer: Priority Health SBD	$3.99

GUANFACINE 1 MG TABLET

Facility

$6.37

Service Code	NDC 68084074895
Hospital Charge Code	10149
Hospital Revenue Code	637
Min. Negotiated Rate	$2.55
Max. Negotiated Rate	$5.73
Rate for Payer: Aetna Commercial	$5.41
Rate for Payer: Aetna Medicare	$3.18
Rate for Payer: Aetna New Business (MI Preferred)	$4.14
Rate for Payer: BCBS Complete	$2.55
Rate for Payer: Cash Price	$5.10
Rate for Payer: Cofinity Commercial	$4.46
Rate for Payer: Cofinity Commercial	$5.48
Rate for Payer: Cofinity Medicare Advantage	$4.46
Rate for Payer: Encore Health Key Benefits Commercial	$5.10
Rate for Payer: Healthscope Commercial	$5.73
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$5.41
Rate for Payer: PHP Commercial	$5.41
Rate for Payer: Priority Health Cigna Priority Health	$4.14
Rate for Payer: Priority Health SBD	$4.01

GUANFACINE 1 MG TABLET

Facility

$8.71

Service Code	NDC 60687071011
Hospital Charge Code	10149
Hospital Revenue Code	637
Min. Negotiated Rate	$3.48
Max. Negotiated Rate	$7.84
Rate for Payer: Aetna Commercial	$7.40
Rate for Payer: Aetna Medicare	$4.36
Rate for Payer: Aetna New Business (MI Preferred)	$5.66
Rate for Payer: BCBS Complete	$3.48
Rate for Payer: Cash Price	$6.97
Rate for Payer: Cofinity Commercial	$6.10
Rate for Payer: Cofinity Commercial	$7.49
Rate for Payer: Cofinity Medicare Advantage	$6.10
Rate for Payer: Encore Health Key Benefits Commercial	$6.97
Rate for Payer: Healthscope Commercial	$7.84
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$7.40
Rate for Payer: PHP Commercial	$7.40
Rate for Payer: Priority Health Cigna Priority Health	$5.66
Rate for Payer: Priority Health SBD	$5.49

GUANFACINE 1 MG TABLET

Facility

$190.95

Service Code	NDC 68084074825
Hospital Charge Code	10149
Hospital Revenue Code	637
Min. Negotiated Rate	$76.38
Max. Negotiated Rate	$171.86
Rate for Payer: Aetna Commercial	$162.31
Rate for Payer: Aetna Medicare	$95.48
Rate for Payer: Aetna New Business (MI Preferred)	$124.12
Rate for Payer: BCBS Complete	$76.38
Rate for Payer: Cash Price	$152.76
Rate for Payer: Cofinity Commercial	$133.66
Rate for Payer: Cofinity Commercial	$164.22
Rate for Payer: Cofinity Medicare Advantage	$133.66
Rate for Payer: Encore Health Key Benefits Commercial	$152.76
Rate for Payer: Healthscope Commercial	$171.86
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$162.31
Rate for Payer: PHP Commercial	$162.31
Rate for Payer: Priority Health Cigna Priority Health	$124.12
Rate for Payer: Priority Health SBD	$120.30

GUANFACINE 1 MG TABLET

Facility

$261.08

Service Code	NDC 60687071021
Hospital Charge Code	10149
Hospital Revenue Code	637
Min. Negotiated Rate	$164.48
Max. Negotiated Rate	$234.97
Rate for Payer: Aetna Commercial	$221.92
Rate for Payer: Aetna New Business (MI Preferred)	$169.70
Rate for Payer: Cash Price	$208.86
Rate for Payer: Cofinity Commercial	$182.76
Rate for Payer: Cofinity Commercial	$224.53
Rate for Payer: Cofinity Medicare Advantage	$182.76
Rate for Payer: Encore Health Key Benefits Commercial	$208.86
Rate for Payer: Healthscope Commercial	$234.97
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$221.92
Rate for Payer: PHP Commercial	$221.92
Rate for Payer: Priority Health Cigna Priority Health	$169.70
Rate for Payer: Priority Health SBD	$164.48

GUANFACINE 1 MG TABLET

Facility

$215.28

Service Code	NDC 00904714004
Hospital Charge Code	10149
Hospital Revenue Code	637
Min. Negotiated Rate	$86.11
Max. Negotiated Rate	$193.75
Rate for Payer: Aetna Commercial	$182.99
Rate for Payer: Aetna Medicare	$107.64
Rate for Payer: Aetna New Business (MI Preferred)	$139.93
Rate for Payer: BCBS Complete	$86.11
Rate for Payer: Cash Price	$172.22
Rate for Payer: Cofinity Commercial	$150.70
Rate for Payer: Cofinity Commercial	$185.14
Rate for Payer: Cofinity Medicare Advantage	$150.70
Rate for Payer: Encore Health Key Benefits Commercial	$172.22
Rate for Payer: Healthscope Commercial	$193.75
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$182.99
Rate for Payer: PHP Commercial	$182.99
Rate for Payer: Priority Health Cigna Priority Health	$139.93
Rate for Payer: Priority Health SBD	$135.63

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	$170.68
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 Commercial	$132.76
Rate for Payer: Cofinity Commercial	$163.10
Rate for Payer: Cofinity Medicare Advantage	$132.76
Rate for Payer: Encore Health Key Benefits Commercial	$151.72
Rate for Payer: Healthscope Commercial	$170.68
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$161.20
Rate for Payer: PHP Commercial	$161.20
Rate for Payer: Priority Health Cigna Priority Health	$123.27
Rate for Payer: Priority Health SBD	$119.48

GUANFACINE 1 MG TABLET

Facility

$190.95

Service Code	NDC 68084074825
Hospital Charge Code	10149
Hospital Revenue Code	637
Min. Negotiated Rate	$120.30
Max. Negotiated Rate	$171.86
Rate for Payer: Aetna Commercial	$162.31
Rate for Payer: Aetna New Business (MI Preferred)	$124.12
Rate for Payer: Cash Price	$152.76
Rate for Payer: Cofinity Commercial	$133.66
Rate for Payer: Cofinity Commercial	$164.22
Rate for Payer: Cofinity Medicare Advantage	$133.66
Rate for Payer: Encore Health Key Benefits Commercial	$152.76
Rate for Payer: Healthscope Commercial	$171.86
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$162.31
Rate for Payer: PHP Commercial	$162.31
Rate for Payer: Priority Health Cigna Priority Health	$124.12
Rate for Payer: Priority Health SBD	$120.30

GUANFACINE 1 MG TABLET

Facility

$8.71

Service Code	NDC 60687071011
Hospital Charge Code	10149
Hospital Revenue Code	637
Min. Negotiated Rate	$5.49
Max. Negotiated Rate	$7.84
Rate for Payer: Aetna Commercial	$7.40
Rate for Payer: Aetna New Business (MI Preferred)	$5.66
Rate for Payer: Cash Price	$6.97
Rate for Payer: Cofinity Commercial	$6.10
Rate for Payer: Cofinity Commercial	$7.49
Rate for Payer: Cofinity Medicare Advantage	$6.10
Rate for Payer: Encore Health Key Benefits Commercial	$6.97
Rate for Payer: Healthscope Commercial	$7.84
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$7.40
Rate for Payer: PHP Commercial	$7.40
Rate for Payer: Priority Health Cigna Priority Health	$5.66
Rate for Payer: Priority Health SBD	$5.49

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)	$290.22
Rate for Payer: Cash Price	$357.20
Rate for Payer: Cofinity Commercial	$312.55
Rate for Payer: Cofinity Commercial	$383.99
Rate for Payer: Cofinity Medicare Advantage	$312.55
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: PHP Commercial	$379.52
Rate for Payer: Priority Health Cigna Priority Health	$290.22
Rate for Payer: Priority Health SBD	$281.30

GUANFACINE 1 MG TABLET

Facility

$189.65

Service Code	NDC 68094001962
Hospital Charge Code	10149
Hospital Revenue Code	637
Min. Negotiated Rate	$75.86
Max. Negotiated Rate	$170.68
Rate for Payer: Aetna Commercial	$161.20
Rate for Payer: Aetna Medicare	$94.82
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 Commercial	$132.76
Rate for Payer: Cofinity Commercial	$163.10
Rate for Payer: Cofinity Medicare Advantage	$132.76
Rate for Payer: Encore Health Key Benefits Commercial	$151.72
Rate for Payer: Healthscope Commercial	$170.68
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$161.20
Rate for Payer: PHP Commercial	$161.20
Rate for Payer: Priority Health Cigna Priority Health	$123.27
Rate for Payer: Priority Health SBD	$119.48

GUANFACINE 1 MG TABLET

Facility

$261.08

Service Code	NDC 60687071021
Hospital Charge Code	10149
Hospital Revenue Code	637
Min. Negotiated Rate	$104.43
Max. Negotiated Rate	$234.97
Rate for Payer: Aetna Commercial	$221.92
Rate for Payer: Aetna Medicare	$130.54
Rate for Payer: Aetna New Business (MI Preferred)	$169.70
Rate for Payer: BCBS Complete	$104.43
Rate for Payer: Cash Price	$208.86
Rate for Payer: Cofinity Commercial	$182.76
Rate for Payer: Cofinity Commercial	$224.53
Rate for Payer: Cofinity Medicare Advantage	$182.76
Rate for Payer: Encore Health Key Benefits Commercial	$208.86
Rate for Payer: Healthscope Commercial	$234.97
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$221.92
Rate for Payer: PHP Commercial	$221.92
Rate for Payer: Priority Health Cigna Priority Health	$169.70
Rate for Payer: Priority Health SBD	$164.48

Know your out-of-pocket cost for care.

All Charges