Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE

Facility

$131.84

Service Code	NDC 68180-320-06
Hospital Charge Code	36776
Hospital Revenue Code	637
Min. Negotiated Rate	$83.06
Max. Negotiated Rate	$118.66
Rate for Payer: Aetna Commercial	$112.06
Rate for Payer: Aetna New Business (MI Preferred)	$85.70
Rate for Payer: Cash Price	$105.47
Rate for Payer: Cofinity Commercial	$113.38
Rate for Payer: Cofinity Commercial	$92.29
Rate for Payer: Healthscope Commercial	$118.66
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$112.06
Rate for Payer: PHP Commercial	$112.06
Rate for Payer: Priority Health Cigna Priority Health	$92.29
Rate for Payer: Priority Health SBD	$83.06

BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE

Facility

$410.31

Service Code	NDC 68180-320-09
Hospital Charge Code	36776
Hospital Revenue Code	637
Min. Negotiated Rate	$258.50
Max. Negotiated Rate	$369.28
Rate for Payer: Aetna Commercial	$348.76
Rate for Payer: Aetna New Business (MI Preferred)	$266.70
Rate for Payer: Cash Price	$328.25
Rate for Payer: Cofinity Commercial	$287.22
Rate for Payer: Cofinity Commercial	$352.87
Rate for Payer: Healthscope Commercial	$369.28
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$348.76
Rate for Payer: PHP Commercial	$348.76
Rate for Payer: Priority Health Cigna Priority Health	$287.22
Rate for Payer: Priority Health SBD	$258.50

BUSPIRONE 10 MG TABLET

Facility

$96.35

Service Code	NDC 16729-202-01
Hospital Charge Code	9323
Hospital Revenue Code	637
Min. Negotiated Rate	$60.70
Max. Negotiated Rate	$86.72
Rate for Payer: Aetna Commercial	$81.90
Rate for Payer: Aetna New Business (MI Preferred)	$62.63
Rate for Payer: Cash Price	$77.08
Rate for Payer: Cofinity Commercial	$67.44
Rate for Payer: Cofinity Commercial	$82.86
Rate for Payer: Healthscope Commercial	$86.72
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$81.90
Rate for Payer: PHP Commercial	$81.90
Rate for Payer: Priority Health Cigna Priority Health	$67.44
Rate for Payer: Priority Health SBD	$60.70

BUSPIRONE 10 MG TABLET

Facility

$77.55

Service Code	NDC 23155-024-01
Hospital Charge Code	9323
Hospital Revenue Code	637
Min. Negotiated Rate	$48.86
Max. Negotiated Rate	$69.80
Rate for Payer: Aetna Commercial	$65.92
Rate for Payer: Aetna New Business (MI Preferred)	$50.41
Rate for Payer: Cash Price	$62.04
Rate for Payer: Cofinity Commercial	$54.28
Rate for Payer: Cofinity Commercial	$66.69
Rate for Payer: Healthscope Commercial	$69.80
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$65.92
Rate for Payer: PHP Commercial	$65.92
Rate for Payer: Priority Health Cigna Priority Health	$54.28
Rate for Payer: Priority Health SBD	$48.86

BUSPIRONE 10 MG TABLET

Facility

$185.65

Service Code	NDC 24689-907-01
Hospital Charge Code	9323
Hospital Revenue Code	637
Min. Negotiated Rate	$116.96
Max. Negotiated Rate	$167.08
Rate for Payer: Aetna Commercial	$157.80
Rate for Payer: Aetna New Business (MI Preferred)	$120.67
Rate for Payer: Cash Price	$148.52
Rate for Payer: Cofinity Commercial	$129.96
Rate for Payer: Cofinity Commercial	$159.66
Rate for Payer: Healthscope Commercial	$167.08
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$157.80
Rate for Payer: PHP Commercial	$157.80
Rate for Payer: Priority Health Cigna Priority Health	$129.96
Rate for Payer: Priority Health SBD	$116.96

BUSPIRONE 10 MG TABLET

Facility

$300.80

Service Code	NDC 51079-986-20
Hospital Charge Code	9323
Hospital Revenue Code	637
Min. Negotiated Rate	$189.50
Max. Negotiated Rate	$270.72
Rate for Payer: Aetna Commercial	$255.68
Rate for Payer: Aetna New Business (MI Preferred)	$195.52
Rate for Payer: Cash Price	$240.64
Rate for Payer: Cofinity Commercial	$210.56
Rate for Payer: Cofinity Commercial	$258.69
Rate for Payer: Healthscope Commercial	$270.72
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$255.68
Rate for Payer: PHP Commercial	$255.68
Rate for Payer: Priority Health Cigna Priority Health	$210.56
Rate for Payer: Priority Health SBD	$189.50

BUSPIRONE 15 MG TABLET

Facility

$4.56

Service Code	NDC 51079-960-01
Hospital Charge Code	17464
Hospital Revenue Code	637
Min. Negotiated Rate	$2.87
Max. Negotiated Rate	$4.10
Rate for Payer: Aetna Commercial	$3.88
Rate for Payer: Aetna New Business (MI Preferred)	$2.96
Rate for Payer: Cash Price	$3.65
Rate for Payer: Cofinity Commercial	$3.19
Rate for Payer: Cofinity Commercial	$3.92
Rate for Payer: Healthscope Commercial	$4.10
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3.88
Rate for Payer: PHP Commercial	$3.88
Rate for Payer: Priority Health Cigna Priority Health	$3.19
Rate for Payer: Priority Health SBD	$2.87

BUSPIRONE 15 MG TABLET

Facility

$455.05

Service Code	NDC 51079-960-20
Hospital Charge Code	17464
Hospital Revenue Code	637
Min. Negotiated Rate	$286.68
Max. Negotiated Rate	$409.54
Rate for Payer: Aetna Commercial	$386.79
Rate for Payer: Aetna New Business (MI Preferred)	$295.78
Rate for Payer: Cash Price	$364.04
Rate for Payer: Cofinity Commercial	$318.54
Rate for Payer: Cofinity Commercial	$391.34
Rate for Payer: Healthscope Commercial	$409.54
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$386.79
Rate for Payer: PHP Commercial	$386.79
Rate for Payer: Priority Health Cigna Priority Health	$318.54
Rate for Payer: Priority Health SBD	$286.68

BUSPIRONE 5 MG TABLET

Facility

$220.90

Service Code	NDC 51079-985-20
Hospital Charge Code	9324
Hospital Revenue Code	637
Min. Negotiated Rate	$139.17
Max. Negotiated Rate	$198.81
Rate for Payer: Aetna Commercial	$187.76
Rate for Payer: Aetna New Business (MI Preferred)	$143.58
Rate for Payer: Cash Price	$176.72
Rate for Payer: Cofinity Commercial	$154.63
Rate for Payer: Cofinity Commercial	$189.97
Rate for Payer: Healthscope Commercial	$198.81
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$187.76
Rate for Payer: PHP Commercial	$187.76
Rate for Payer: Priority Health Cigna Priority Health	$154.63
Rate for Payer: Priority Health SBD	$139.17

BUSPIRONE 5 MG TABLET

Facility

$112.80

Service Code	NDC 24689-781-01
Hospital Charge Code	9324
Hospital Revenue Code	637
Min. Negotiated Rate	$71.06
Max. Negotiated Rate	$101.52
Rate for Payer: Aetna Commercial	$95.88
Rate for Payer: Aetna New Business (MI Preferred)	$73.32
Rate for Payer: Cash Price	$90.24
Rate for Payer: Cofinity Commercial	$78.96
Rate for Payer: Cofinity Commercial	$97.01
Rate for Payer: Healthscope Commercial	$101.52
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$95.88
Rate for Payer: PHP Commercial	$95.88
Rate for Payer: Priority Health Cigna Priority Health	$78.96
Rate for Payer: Priority Health SBD	$71.06

BUSPIRONE 5 MG TABLET

Facility

$105.75

Service Code	NDC 68382-180-01
Hospital Charge Code	9324
Hospital Revenue Code	637
Min. Negotiated Rate	$66.62
Max. Negotiated Rate	$95.18
Rate for Payer: Aetna Commercial	$89.89
Rate for Payer: Aetna New Business (MI Preferred)	$68.74
Rate for Payer: Cash Price	$84.60
Rate for Payer: Cofinity Commercial	$74.02
Rate for Payer: Cofinity Commercial	$90.94
Rate for Payer: Healthscope Commercial	$95.18
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$89.89
Rate for Payer: PHP Commercial	$89.89
Rate for Payer: Priority Health Cigna Priority Health	$74.02
Rate for Payer: Priority Health SBD	$66.62

BUSPIRONE 5 MG TABLET

Facility

$105.75

Service Code	NDC 64380-741-06
Hospital Charge Code	9324
Hospital Revenue Code	637
Min. Negotiated Rate	$66.62
Max. Negotiated Rate	$95.18
Rate for Payer: Aetna Commercial	$89.89
Rate for Payer: Aetna New Business (MI Preferred)	$68.74
Rate for Payer: Cash Price	$84.60
Rate for Payer: Cofinity Commercial	$74.02
Rate for Payer: Cofinity Commercial	$90.94
Rate for Payer: Healthscope Commercial	$95.18
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$89.89
Rate for Payer: PHP Commercial	$89.89
Rate for Payer: Priority Health Cigna Priority Health	$74.02
Rate for Payer: Priority Health SBD	$66.62

BUSPIRONE 5 MG TABLET

Facility

$65.80

Service Code	NDC 16729-200-01
Hospital Charge Code	9324
Hospital Revenue Code	637
Min. Negotiated Rate	$41.45
Max. Negotiated Rate	$59.22
Rate for Payer: Aetna Commercial	$55.93
Rate for Payer: Aetna New Business (MI Preferred)	$42.77
Rate for Payer: Cash Price	$52.64
Rate for Payer: Cofinity Commercial	$46.06
Rate for Payer: Cofinity Commercial	$56.59
Rate for Payer: Healthscope Commercial	$59.22
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$55.93
Rate for Payer: PHP Commercial	$55.93
Rate for Payer: Priority Health Cigna Priority Health	$46.06
Rate for Payer: Priority Health SBD	$41.45

BUSPIRONE 5 MG TABLET

Facility

$329.00

Service Code	NDC 16729-200-16
Hospital Charge Code	9324
Hospital Revenue Code	637
Min. Negotiated Rate	$207.27
Max. Negotiated Rate	$296.10
Rate for Payer: Aetna Commercial	$279.65
Rate for Payer: Aetna New Business (MI Preferred)	$213.85
Rate for Payer: Cash Price	$263.20
Rate for Payer: Cofinity Commercial	$230.30
Rate for Payer: Cofinity Commercial	$282.94
Rate for Payer: Healthscope Commercial	$296.10
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$279.65
Rate for Payer: PHP Commercial	$279.65
Rate for Payer: Priority Health Cigna Priority Health	$230.30
Rate for Payer: Priority Health SBD	$207.27

BUSPIRONE 5 MG TABLET

Facility

$564.00

Service Code	NDC 0093-0053-05
Hospital Charge Code	9324
Hospital Revenue Code	637
Min. Negotiated Rate	$355.32
Max. Negotiated Rate	$507.60
Rate for Payer: Aetna Commercial	$479.40
Rate for Payer: Aetna New Business (MI Preferred)	$366.60
Rate for Payer: Cash Price	$451.20
Rate for Payer: Cofinity Commercial	$394.80
Rate for Payer: Cofinity Commercial	$485.04
Rate for Payer: Healthscope Commercial	$507.60
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$479.40
Rate for Payer: PHP Commercial	$479.40
Rate for Payer: Priority Health Cigna Priority Health	$394.80
Rate for Payer: Priority Health SBD	$355.32

BUSPIRONE 5 MG TABLET

Facility

$220.90

Service Code	NDC 0904-7122-61
Hospital Charge Code	9324
Hospital Revenue Code	637
Min. Negotiated Rate	$139.17
Max. Negotiated Rate	$198.81
Rate for Payer: Aetna Commercial	$187.76
Rate for Payer: Aetna New Business (MI Preferred)	$143.58
Rate for Payer: Cash Price	$176.72
Rate for Payer: Cofinity Commercial	$154.63
Rate for Payer: Cofinity Commercial	$189.97
Rate for Payer: Healthscope Commercial	$198.81
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$187.76
Rate for Payer: PHP Commercial	$187.76
Rate for Payer: Priority Health Cigna Priority Health	$154.63
Rate for Payer: Priority Health SBD	$139.17

BUSPIRONE 5 MG TABLET

Facility

$91.65

Service Code	NDC 23155-023-01
Hospital Charge Code	9324
Hospital Revenue Code	637
Min. Negotiated Rate	$57.74
Max. Negotiated Rate	$82.48
Rate for Payer: Aetna Commercial	$77.90
Rate for Payer: Aetna New Business (MI Preferred)	$59.57
Rate for Payer: Cash Price	$73.32
Rate for Payer: Cofinity Commercial	$64.16
Rate for Payer: Cofinity Commercial	$78.82
Rate for Payer: Healthscope Commercial	$82.48
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$77.90
Rate for Payer: PHP Commercial	$77.90
Rate for Payer: Priority Health Cigna Priority Health	$64.16
Rate for Payer: Priority Health SBD	$57.74

BUSPIRONE 5 MG TABLET

Facility

$2.21

Service Code	NDC 51079-985-01
Hospital Charge Code	9324
Hospital Revenue Code	637
Min. Negotiated Rate	$1.39
Max. Negotiated Rate	$1.99
Rate for Payer: Aetna Commercial	$1.88
Rate for Payer: Aetna New Business (MI Preferred)	$1.44
Rate for Payer: Cash Price	$1.77
Rate for Payer: Cofinity Commercial	$1.55
Rate for Payer: Cofinity Commercial	$1.90
Rate for Payer: Healthscope Commercial	$1.99
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1.88
Rate for Payer: PHP Commercial	$1.88
Rate for Payer: Priority Health Cigna Priority Health	$1.55
Rate for Payer: Priority Health SBD	$1.39

BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET

Facility

$8.57

Service Code	NDC 60687-672-11
Hospital Charge Code	8958
Hospital Revenue Code	637
Min. Negotiated Rate	$5.40
Max. Negotiated Rate	$7.71
Rate for Payer: Aetna Commercial	$7.28
Rate for Payer: Aetna New Business (MI Preferred)	$5.57
Rate for Payer: Cash Price	$6.86
Rate for Payer: Cofinity Commercial	$6.00
Rate for Payer: Cofinity Commercial	$7.37
Rate for Payer: Healthscope Commercial	$7.71
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$7.28
Rate for Payer: PHP Commercial	$7.28
Rate for Payer: Priority Health Cigna Priority Health	$6.00
Rate for Payer: Priority Health SBD	$5.40

BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET

Facility

$532.35

Service Code	NDC 68084-396-65
Hospital Charge Code	8958
Hospital Revenue Code	637
Min. Negotiated Rate	$335.38
Max. Negotiated Rate	$479.12
Rate for Payer: Aetna Commercial	$452.50
Rate for Payer: Aetna New Business (MI Preferred)	$346.03
Rate for Payer: Cash Price	$425.88
Rate for Payer: Cofinity Commercial	$372.64
Rate for Payer: Cofinity Commercial	$457.82
Rate for Payer: Healthscope Commercial	$479.12
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$452.50
Rate for Payer: PHP Commercial	$452.50
Rate for Payer: Priority Health Cigna Priority Health	$372.64
Rate for Payer: Priority Health SBD	$335.38

BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET

Facility

$428.05

Service Code	NDC 60687-672-65
Hospital Charge Code	8958
Hospital Revenue Code	637
Min. Negotiated Rate	$269.67
Max. Negotiated Rate	$385.24
Rate for Payer: Aetna Commercial	$363.84
Rate for Payer: Aetna New Business (MI Preferred)	$278.23
Rate for Payer: Cash Price	$342.44
Rate for Payer: Cofinity Commercial	$299.64
Rate for Payer: Cofinity Commercial	$368.12
Rate for Payer: Healthscope Commercial	$385.24
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$363.84
Rate for Payer: PHP Commercial	$363.84
Rate for Payer: Priority Health Cigna Priority Health	$299.64
Rate for Payer: Priority Health SBD	$269.67

BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET

Facility

$365.40

Service Code	NDC 0904-6938-06
Hospital Charge Code	8958
Hospital Revenue Code	637
Min. Negotiated Rate	$230.20
Max. Negotiated Rate	$328.86
Rate for Payer: Aetna Commercial	$310.59
Rate for Payer: Aetna New Business (MI Preferred)	$237.51
Rate for Payer: Cash Price	$292.32
Rate for Payer: Cofinity Commercial	$255.78
Rate for Payer: Cofinity Commercial	$314.24
Rate for Payer: Healthscope Commercial	$328.86
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$310.59
Rate for Payer: PHP Commercial	$310.59
Rate for Payer: Priority Health Cigna Priority Health	$255.78
Rate for Payer: Priority Health SBD	$230.20

BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET

Facility

$10.65

Service Code	NDC 68084-396-11
Hospital Charge Code	8958
Hospital Revenue Code	637
Min. Negotiated Rate	$6.71
Max. Negotiated Rate	$9.58
Rate for Payer: Aetna Commercial	$9.05
Rate for Payer: Aetna New Business (MI Preferred)	$6.92
Rate for Payer: Cash Price	$8.52
Rate for Payer: Cofinity Commercial	$7.46
Rate for Payer: Cofinity Commercial	$9.16
Rate for Payer: Healthscope Commercial	$9.58
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$9.05
Rate for Payer: PHP Commercial	$9.05
Rate for Payer: Priority Health Cigna Priority Health	$7.46
Rate for Payer: Priority Health SBD	$6.71

BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET

Facility

$735.70

Service Code	NDC 0603-2544-21
Hospital Charge Code	8958
Hospital Revenue Code	637
Min. Negotiated Rate	$463.49
Max. Negotiated Rate	$662.13
Rate for Payer: Aetna Commercial	$625.34
Rate for Payer: Aetna New Business (MI Preferred)	$478.20
Rate for Payer: Cash Price	$588.56
Rate for Payer: Cofinity Commercial	$514.99
Rate for Payer: Cofinity Commercial	$632.70
Rate for Payer: Healthscope Commercial	$662.13
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$625.34
Rate for Payer: PHP Commercial	$625.34
Rate for Payer: Priority Health Cigna Priority Health	$514.99
Rate for Payer: Priority Health SBD	$463.49

BUTORPHANOL 2 MG/ML INJECTION SOLUTION

Facility

$35.90

Service Code	HCPCS J0595
Hospital Charge Code	9334
Hospital Revenue Code	636
Min. Negotiated Rate	$22.62
Max. Negotiated Rate	$32.31
Rate for Payer: Aetna Commercial	$30.52
Rate for Payer: Aetna New Business (MI Preferred)	$23.34
Rate for Payer: Cash Price	$28.72
Rate for Payer: Cofinity Commercial	$25.13
Rate for Payer: Cofinity Commercial	$30.87
Rate for Payer: Healthscope Commercial	$32.31
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$30.52
Rate for Payer: PHP Commercial	$30.52
Rate for Payer: Priority Health Cigna Priority Health	$25.13
Rate for Payer: Priority Health SBD	$22.62

Know your out-of-pocket cost for care.

All Charges