Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

CALCIUM ACETATE(PHOSPHATE BINDERS) 667 MG CAPSULE

Facility

$570.00

Service Code	NDC 0781-2081-02
Hospital Charge Code	30961
Hospital Revenue Code	637
Min. Negotiated Rate	$359.10
Max. Negotiated Rate	$513.00
Rate for Payer: Aetna Commercial	$484.50
Rate for Payer: Aetna New Business (MI Preferred)	$370.50
Rate for Payer: Cash Price	$456.00
Rate for Payer: Cofinity Commercial	$399.00
Rate for Payer: Cofinity Commercial	$490.20
Rate for Payer: Healthscope Commercial	$513.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$484.50
Rate for Payer: PHP Commercial	$484.50
Rate for Payer: Priority Health Cigna Priority Health	$399.00
Rate for Payer: Priority Health SBD	$359.10

CALCIUM ACETATE(PHOSPHATE BINDERS) 667 MG CAPSULE

Facility

$442.70

Service Code	NDC 23155-531-02
Hospital Charge Code	30961
Hospital Revenue Code	637
Min. Negotiated Rate	$278.90
Max. Negotiated Rate	$398.43
Rate for Payer: Aetna Commercial	$376.30
Rate for Payer: Aetna New Business (MI Preferred)	$287.76
Rate for Payer: Cash Price	$354.16
Rate for Payer: Cofinity Commercial	$309.89
Rate for Payer: Cofinity Commercial	$380.72
Rate for Payer: Healthscope Commercial	$398.43
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$376.30
Rate for Payer: PHP Commercial	$376.30
Rate for Payer: Priority Health Cigna Priority Health	$309.89
Rate for Payer: Priority Health SBD	$278.90

CALCIUM ACETATE(PHOSPHATE BINDERS) 667 MG CAPSULE

Facility

$626.88

Service Code	NDC 62135-191-22
Hospital Charge Code	30961
Hospital Revenue Code	637
Min. Negotiated Rate	$394.93
Max. Negotiated Rate	$564.19
Rate for Payer: Aetna Commercial	$532.85
Rate for Payer: Aetna New Business (MI Preferred)	$407.47
Rate for Payer: Cash Price	$501.50
Rate for Payer: Cofinity Commercial	$438.82
Rate for Payer: Cofinity Commercial	$539.12
Rate for Payer: Healthscope Commercial	$564.19
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$532.85
Rate for Payer: PHP Commercial	$532.85
Rate for Payer: Priority Health Cigna Priority Health	$438.82
Rate for Payer: Priority Health SBD	$394.93

CALCIUM CARBONATE 200 MG CALCIUM (500 MG) CHEWABLE TABLET

Facility

$189.00

Service Code	NDC 57896-763-15
Hospital Charge Code	9385
Hospital Revenue Code	637
Min. Negotiated Rate	$119.07
Max. Negotiated Rate	$170.10
Rate for Payer: Aetna Commercial	$160.65
Rate for Payer: Aetna New Business (MI Preferred)	$122.85
Rate for Payer: Cash Price	$151.20
Rate for Payer: Cofinity Commercial	$132.30
Rate for Payer: Cofinity Commercial	$162.54
Rate for Payer: Healthscope Commercial	$170.10
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$160.65
Rate for Payer: PHP Commercial	$160.65
Rate for Payer: Priority Health Cigna Priority Health	$132.30
Rate for Payer: Priority Health SBD	$119.07

CALCIUM CARBONATE 200 MG CALCIUM (500 MG) CHEWABLE TABLET

Facility

$577.50

Service Code	NDC 66553-004-01
Hospital Charge Code	9385
Hospital Revenue Code	637
Min. Negotiated Rate	$363.82
Max. Negotiated Rate	$519.75
Rate for Payer: Aetna Commercial	$490.88
Rate for Payer: Aetna New Business (MI Preferred)	$375.38
Rate for Payer: Cash Price	$462.00
Rate for Payer: Cofinity Commercial	$404.25
Rate for Payer: Cofinity Commercial	$496.65
Rate for Payer: Healthscope Commercial	$519.75
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$490.88
Rate for Payer: PHP Commercial	$490.88
Rate for Payer: Priority Health Cigna Priority Health	$404.25
Rate for Payer: Priority Health SBD	$363.82

CALCIUM CARBONATE 200 MG CALCIUM (500 MG) CHEWABLE TABLET

Facility

$141.75

Service Code	NDC 0536-1007-15
Hospital Charge Code	9385
Hospital Revenue Code	637
Min. Negotiated Rate	$89.30
Max. Negotiated Rate	$127.58
Rate for Payer: Aetna Commercial	$120.49
Rate for Payer: Aetna New Business (MI Preferred)	$92.14
Rate for Payer: Cash Price	$113.40
Rate for Payer: Cofinity Commercial	$121.90
Rate for Payer: Cofinity Commercial	$99.22
Rate for Payer: Healthscope Commercial	$127.58
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$120.49
Rate for Payer: PHP Commercial	$120.49
Rate for Payer: Priority Health Cigna Priority Health	$99.22
Rate for Payer: Priority Health SBD	$89.30

CALCIUM CARBONATE 500 MG-VITAMIN D3 5 MCG (200 UNIT) TABLET

Facility

$172.00

Service Code	NDC 1000670038
Hospital Charge Code	19483
Hospital Revenue Code	637
Min. Negotiated Rate	$108.36
Max. Negotiated Rate	$154.80
Rate for Payer: Aetna Commercial	$146.20
Rate for Payer: Aetna New Business (MI Preferred)	$111.80
Rate for Payer: Cash Price	$137.60
Rate for Payer: Cofinity Commercial	$120.40
Rate for Payer: Cofinity Commercial	$147.92
Rate for Payer: Healthscope Commercial	$154.80
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$146.20
Rate for Payer: PHP Commercial	$146.20
Rate for Payer: Priority Health Cigna Priority Health	$120.40
Rate for Payer: Priority Health SBD	$108.36

CALCIUM CARBONATE 500 MG-VITAMIN D3 5 MCG (200 UNIT) TABLET

Facility

$1,200.00

Service Code	NDC 6373929101
Hospital Charge Code	19483
Hospital Revenue Code	637
Min. Negotiated Rate	$756.00
Max. Negotiated Rate	$1,080.00
Rate for Payer: Aetna Commercial	$1,020.00
Rate for Payer: Aetna New Business (MI Preferred)	$780.00
Rate for Payer: Cash Price	$960.00
Rate for Payer: Cofinity Commercial	$1,032.00
Rate for Payer: Cofinity Commercial	$840.00
Rate for Payer: Healthscope Commercial	$1,080.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,020.00
Rate for Payer: PHP Commercial	$1,020.00
Rate for Payer: Priority Health Cigna Priority Health	$840.00
Rate for Payer: Priority Health SBD	$756.00

CALCIUM CARBONATE 500 MG-VITAMIN D3 5 MCG (200 UNIT) TABLET

Facility

$321.30

Service Code	NDC 904546072
Hospital Charge Code	19483
Hospital Revenue Code	637
Min. Negotiated Rate	$202.42
Max. Negotiated Rate	$289.17
Rate for Payer: Aetna Commercial	$273.10
Rate for Payer: Aetna New Business (MI Preferred)	$208.84
Rate for Payer: Cash Price	$257.04
Rate for Payer: Cofinity Commercial	$224.91
Rate for Payer: Cofinity Commercial	$276.32
Rate for Payer: Healthscope Commercial	$289.17
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$273.10
Rate for Payer: PHP Commercial	$273.10
Rate for Payer: Priority Health Cigna Priority Health	$224.91
Rate for Payer: Priority Health SBD	$202.42

CALCIUM CARBONATE 500 MG-VITAMIN D3 5 MCG (200 UNIT) TABLET

Facility

$189.00

Service Code	NDC 904546092
Hospital Charge Code	19483
Hospital Revenue Code	637
Min. Negotiated Rate	$119.07
Max. Negotiated Rate	$170.10
Rate for Payer: Aetna Commercial	$160.65
Rate for Payer: Aetna New Business (MI Preferred)	$122.85
Rate for Payer: Cash Price	$151.20
Rate for Payer: Cofinity Commercial	$132.30
Rate for Payer: Cofinity Commercial	$162.54
Rate for Payer: Healthscope Commercial	$170.10
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$160.65
Rate for Payer: PHP Commercial	$160.65
Rate for Payer: Priority Health Cigna Priority Health	$132.30
Rate for Payer: Priority Health SBD	$119.07

CALCIUM CARBONATE 500 MG-VITAMIN D3 5 MCG (200 UNIT) TABLET

Facility

$83.16

Service Code	NDC 536781708
Hospital Charge Code	19483
Hospital Revenue Code	637
Min. Negotiated Rate	$52.39
Max. Negotiated Rate	$74.84
Rate for Payer: Aetna Commercial	$70.69
Rate for Payer: Aetna New Business (MI Preferred)	$54.05
Rate for Payer: Cash Price	$66.53
Rate for Payer: Cofinity Commercial	$58.21
Rate for Payer: Cofinity Commercial	$71.52
Rate for Payer: Healthscope Commercial	$74.84
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$70.69
Rate for Payer: PHP Commercial	$70.69
Rate for Payer: Priority Health Cigna Priority Health	$58.21
Rate for Payer: Priority Health SBD	$52.39

CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SOLUTION

Facility

$33.65

Service Code	NDC 0517-6710-10
Hospital Charge Code	108968
Hospital Revenue Code	250
Min. Negotiated Rate	$21.20
Max. Negotiated Rate	$30.28
Rate for Payer: Aetna Commercial	$28.60
Rate for Payer: Aetna New Business (MI Preferred)	$21.87
Rate for Payer: Cash Price	$26.92
Rate for Payer: Cofinity Commercial	$23.56
Rate for Payer: Cofinity Commercial	$28.94
Rate for Payer: Healthscope Commercial	$30.28
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$28.60
Rate for Payer: PHP Commercial	$28.60
Rate for Payer: Priority Health Cigna Priority Health	$23.56
Rate for Payer: Priority Health SBD	$21.20

CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SOLUTION

Facility

$33.65

Service Code	NDC 0517-6710-01
Hospital Charge Code	108968
Hospital Revenue Code	250
Min. Negotiated Rate	$21.20
Max. Negotiated Rate	$30.28
Rate for Payer: Aetna Commercial	$28.60
Rate for Payer: Aetna New Business (MI Preferred)	$21.87
Rate for Payer: Cash Price	$26.92
Rate for Payer: Cofinity Commercial	$23.56
Rate for Payer: Cofinity Commercial	$28.94
Rate for Payer: Healthscope Commercial	$30.28
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$28.60
Rate for Payer: PHP Commercial	$28.60
Rate for Payer: Priority Health Cigna Priority Health	$23.56
Rate for Payer: Priority Health SBD	$21.20

CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE

Facility

$39.39

Service Code	NDC 76329-3304-1
Hospital Charge Code	1306
Hospital Revenue Code	250
Min. Negotiated Rate	$15.76
Max. Negotiated Rate	$35.45
Rate for Payer: Aetna Commercial	$33.48
Rate for Payer: Aetna New Business (MI Preferred)	$25.60
Rate for Payer: BCBS Complete	$15.76
Rate for Payer: Cash Price	$31.51
Rate for Payer: Cofinity Commercial	$27.57
Rate for Payer: Cofinity Commercial	$33.88
Rate for Payer: Healthscope Commercial	$35.45
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$33.48
Rate for Payer: PHP Commercial	$33.48
Rate for Payer: Priority Health Cigna Priority Health	$27.57
Rate for Payer: Priority Health SBD	$24.82

CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE

Facility

$33.11

Service Code	NDC 64253-900-30
Hospital Charge Code	1306
Hospital Revenue Code	250
Min. Negotiated Rate	$20.86
Max. Negotiated Rate	$29.80
Rate for Payer: Aetna Commercial	$28.14
Rate for Payer: Aetna New Business (MI Preferred)	$21.52
Rate for Payer: Cash Price	$26.49
Rate for Payer: Cofinity Commercial	$23.18
Rate for Payer: Cofinity Commercial	$28.47
Rate for Payer: Healthscope Commercial	$29.80
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$28.14
Rate for Payer: PHP Commercial	$28.14
Rate for Payer: Priority Health Cigna Priority Health	$23.18
Rate for Payer: Priority Health SBD	$20.86

CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE

Facility

$36.23

Service Code	NDC 64253-900-91
Hospital Charge Code	1306
Hospital Revenue Code	250
Min. Negotiated Rate	$22.82
Max. Negotiated Rate	$32.61
Rate for Payer: Aetna Commercial	$30.80
Rate for Payer: Aetna New Business (MI Preferred)	$23.55
Rate for Payer: Cash Price	$28.98
Rate for Payer: Cofinity Commercial	$25.36
Rate for Payer: Cofinity Commercial	$31.16
Rate for Payer: Healthscope Commercial	$32.61
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$30.80
Rate for Payer: PHP Commercial	$30.80
Rate for Payer: Priority Health Cigna Priority Health	$25.36
Rate for Payer: Priority Health SBD	$22.82

CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE

Facility

$39.39

Service Code	NDC 76329-3304-1
Hospital Charge Code	1306
Hospital Revenue Code	250
Min. Negotiated Rate	$24.82
Max. Negotiated Rate	$35.45
Rate for Payer: Aetna Commercial	$33.48
Rate for Payer: Aetna New Business (MI Preferred)	$25.60
Rate for Payer: Cash Price	$31.51
Rate for Payer: Cofinity Commercial	$27.57
Rate for Payer: Cofinity Commercial	$33.88
Rate for Payer: Healthscope Commercial	$35.45
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$33.48
Rate for Payer: PHP Commercial	$33.48
Rate for Payer: Priority Health Cigna Priority Health	$27.57
Rate for Payer: Priority Health SBD	$24.82

CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE

Facility

$60.08

Service Code	NDC 0409-4928-34
Hospital Charge Code	1306
Hospital Revenue Code	250
Min. Negotiated Rate	$37.85
Max. Negotiated Rate	$54.07
Rate for Payer: Aetna Commercial	$51.07
Rate for Payer: Aetna New Business (MI Preferred)	$39.05
Rate for Payer: Cash Price	$48.06
Rate for Payer: Cofinity Commercial	$42.06
Rate for Payer: Cofinity Commercial	$51.67
Rate for Payer: Healthscope Commercial	$54.07
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$51.07
Rate for Payer: PHP Commercial	$51.07
Rate for Payer: Priority Health Cigna Priority Health	$42.06
Rate for Payer: Priority Health SBD	$37.85

CALCIUM CHLORIDE 100 MG/ML (10 %) IV SYRINGE (CODE)

Facility

$39.39

Service Code	NDC 76329-3304-1
Hospital Charge Code	163711
Hospital Revenue Code	250
Min. Negotiated Rate	$24.82
Max. Negotiated Rate	$35.45
Rate for Payer: Aetna Commercial	$33.48
Rate for Payer: Aetna New Business (MI Preferred)	$25.60
Rate for Payer: Cash Price	$31.51
Rate for Payer: Cofinity Commercial	$27.57
Rate for Payer: Cofinity Commercial	$33.88
Rate for Payer: Healthscope Commercial	$35.45
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$33.48
Rate for Payer: PHP Commercial	$33.48
Rate for Payer: Priority Health Cigna Priority Health	$27.57
Rate for Payer: Priority Health SBD	$24.82

CALCIUM CHLORIDE 100 MG/ML (10 %) IV SYRINGE (CODE)

Facility

$60.08

Service Code	NDC 0409-4928-34
Hospital Charge Code	163711
Hospital Revenue Code	250
Min. Negotiated Rate	$37.85
Max. Negotiated Rate	$54.07
Rate for Payer: Aetna Commercial	$51.07
Rate for Payer: Aetna New Business (MI Preferred)	$39.05
Rate for Payer: Cash Price	$48.06
Rate for Payer: Cofinity Commercial	$42.06
Rate for Payer: Cofinity Commercial	$51.67
Rate for Payer: Healthscope Commercial	$54.07
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$51.07
Rate for Payer: PHP Commercial	$51.07
Rate for Payer: Priority Health Cigna Priority Health	$42.06
Rate for Payer: Priority Health SBD	$37.85

CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION

Facility

$39.34

Service Code	HCPCS J0612
Hospital Charge Code	1312
Hospital Revenue Code	636
Min. Negotiated Rate	$24.78
Max. Negotiated Rate	$35.41
Rate for Payer: Aetna Commercial	$33.44
Rate for Payer: Aetna New Business (MI Preferred)	$25.57
Rate for Payer: Cash Price	$31.47
Rate for Payer: Cofinity Commercial	$27.54
Rate for Payer: Cofinity Commercial	$33.83
Rate for Payer: Healthscope Commercial	$35.41
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$33.44
Rate for Payer: PHP Commercial	$33.44
Rate for Payer: Priority Health Cigna Priority Health	$27.54
Rate for Payer: Priority Health SBD	$24.78

CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION

Facility

$39.34

Service Code	HCPCS J0612
Hospital Charge Code	1312
Hospital Revenue Code	636
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$35.41
Rate for Payer: Aetna Commercial	$33.44
Rate for Payer: Aetna Medicare	$0.05
Rate for Payer: Aetna New Business (MI Preferred)	$25.57
Rate for Payer: Allen County Amish Medical Aid Commercial	$0.06
Rate for Payer: Amish Plain Church Group Commercial	$0.06
Rate for Payer: BCBS Complete	$0.03
Rate for Payer: BCBS MAPPO	$0.05
Rate for Payer: BCBS Trust/PPO	$0.15
Rate for Payer: BCN Medicare Advantage	$0.05
Rate for Payer: Cash Price	$31.47
Rate for Payer: Cash Price	$31.47
Rate for Payer: Cofinity Commercial	$33.83
Rate for Payer: Cofinity Commercial	$27.54
Rate for Payer: Health Alliance Plan Medicare Advantage	$0.05
Rate for Payer: Healthscope Commercial	$35.41
Rate for Payer: Mclaren Medicaid	$0.03
Rate for Payer: Mclaren Medicare	$0.05
Rate for Payer: Meridian Medicaid	$0.03
Rate for Payer: Meridian Wellcare - Medicare Advantage	$0.05
Rate for Payer: MI Amish Medical Board Commercial	$0.06
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$33.44
Rate for Payer: PACE Medicare	$0.05
Rate for Payer: PACE SWMI	$0.05
Rate for Payer: PHP Commercial	$33.44
Rate for Payer: PHP Medicare Advantage	$0.05
Rate for Payer: Priority Health Choice Medicaid	$0.03
Rate for Payer: Priority Health Cigna Priority Health	$27.54
Rate for Payer: Priority Health Medicare	$0.05
Rate for Payer: Priority Health SBD	$24.78
Rate for Payer: Railroad Medicare Medicare	$0.05
Rate for Payer: UHC Dual Complete DSNP	$0.05
Rate for Payer: UHC Medicare Advantage	$0.05
Rate for Payer: VA VA	$0.05

CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS (TPN COMPONENT)

Facility

$167.77

Service Code	HCPCS J0612
Hospital Charge Code	180903
Hospital Revenue Code	636
Min. Negotiated Rate	$105.70
Max. Negotiated Rate	$150.99
Rate for Payer: Aetna Commercial	$142.60
Rate for Payer: Aetna New Business (MI Preferred)	$109.05
Rate for Payer: Cash Price	$134.22
Rate for Payer: Cofinity Commercial	$117.44
Rate for Payer: Cofinity Commercial	$144.28
Rate for Payer: Healthscope Commercial	$150.99
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$142.60
Rate for Payer: PHP Commercial	$142.60
Rate for Payer: Priority Health Cigna Priority Health	$117.44
Rate for Payer: Priority Health SBD	$105.70

CALCIUM GLUCONATE 1 GRAM/50 ML IN SODIUM CHLORIDE, ISO-OSM IV SOLUTION

Facility

$35.38

Service Code	HCPCS J0613
Hospital Charge Code	189461
Hospital Revenue Code	636
Min. Negotiated Rate	$22.29
Max. Negotiated Rate	$31.84
Rate for Payer: Aetna Commercial	$30.07
Rate for Payer: Aetna New Business (MI Preferred)	$23.00
Rate for Payer: Cash Price	$28.30
Rate for Payer: Cofinity Commercial	$24.77
Rate for Payer: Cofinity Commercial	$30.43
Rate for Payer: Healthscope Commercial	$31.84
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$30.07
Rate for Payer: PHP Commercial	$30.07
Rate for Payer: Priority Health Cigna Priority Health	$24.77
Rate for Payer: Priority Health SBD	$22.29

CALCIUM GLUCONATE 2 GRAM/100 ML IN SODIUM CHLORIDE,ISO-OSM IV SOLUTION

Facility

$74.32

Service Code	HCPCS J0613
Hospital Charge Code	190608
Hospital Revenue Code	636
Min. Negotiated Rate	$46.82
Max. Negotiated Rate	$66.89
Rate for Payer: Aetna Commercial	$63.17
Rate for Payer: Aetna New Business (MI Preferred)	$48.31
Rate for Payer: Cash Price	$59.46
Rate for Payer: Cofinity Commercial	$52.02
Rate for Payer: Cofinity Commercial	$63.92
Rate for Payer: Healthscope Commercial	$66.89
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$63.17
Rate for Payer: PHP Commercial	$63.17
Rate for Payer: Priority Health Cigna Priority Health	$52.02
Rate for Payer: Priority Health SBD	$46.82

Know your out-of-pocket cost for care.

All Charges