Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION

Facility

$15.45

Service Code	NDC 66689-023-01
Hospital Charge Code	37848
Hospital Revenue Code	637
Min. Negotiated Rate	$9.73
Max. Negotiated Rate	$13.90
Rate for Payer: Aetna Commercial	$13.13
Rate for Payer: Aetna New Business (MI Preferred)	$10.04
Rate for Payer: Cash Price	$12.36
Rate for Payer: Cofinity Commercial	$10.82
Rate for Payer: Cofinity Commercial	$13.29
Rate for Payer: Healthscope Commercial	$13.90
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$13.13
Rate for Payer: PHP Commercial	$13.13
Rate for Payer: Priority Health Cigna Priority Health	$10.82
Rate for Payer: Priority Health SBD	$9.73

HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION

Facility

$25.93

Service Code	NDC 0121-4772-05
Hospital Charge Code	37848
Hospital Revenue Code	637
Min. Negotiated Rate	$16.34
Max. Negotiated Rate	$23.34
Rate for Payer: Aetna Commercial	$22.04
Rate for Payer: Aetna New Business (MI Preferred)	$16.85
Rate for Payer: Cash Price	$20.74
Rate for Payer: Cofinity Commercial	$18.15
Rate for Payer: Cofinity Commercial	$22.30
Rate for Payer: Healthscope Commercial	$23.34
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$22.04
Rate for Payer: PHP Commercial	$22.04
Rate for Payer: Priority Health Cigna Priority Health	$18.15
Rate for Payer: Priority Health SBD	$16.34

HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION

Facility

$16.91

Service Code	NDC 0121-2316-15
Hospital Charge Code	37848
Hospital Revenue Code	637
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$15.22
Rate for Payer: Aetna Commercial	$14.37
Rate for Payer: Aetna New Business (MI Preferred)	$10.99
Rate for Payer: Cash Price	$13.53
Rate for Payer: Cofinity Commercial	$11.84
Rate for Payer: Cofinity Commercial	$14.54
Rate for Payer: Healthscope Commercial	$15.22
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$14.37
Rate for Payer: PHP Commercial	$14.37
Rate for Payer: Priority Health Cigna Priority Health	$11.84
Rate for Payer: Priority Health SBD	$10.65

HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION

Facility

$15.45

Service Code	NDC 66689-023-50
Hospital Charge Code	37848
Hospital Revenue Code	637
Min. Negotiated Rate	$9.73
Max. Negotiated Rate	$13.90
Rate for Payer: Aetna Commercial	$13.13
Rate for Payer: Aetna New Business (MI Preferred)	$10.04
Rate for Payer: Cash Price	$12.36
Rate for Payer: Cofinity Commercial	$10.82
Rate for Payer: Cofinity Commercial	$13.29
Rate for Payer: Healthscope Commercial	$13.90
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$13.13
Rate for Payer: PHP Commercial	$13.13
Rate for Payer: Priority Health Cigna Priority Health	$10.82
Rate for Payer: Priority Health SBD	$9.73

HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION

Facility

$15.45

Service Code	NDC 66689-023-50
Hospital Charge Code	37848
Hospital Revenue Code	637
Min. Negotiated Rate	$6.18
Max. Negotiated Rate	$13.90
Rate for Payer: Aetna Commercial	$13.13
Rate for Payer: Aetna New Business (MI Preferred)	$10.04
Rate for Payer: BCBS Complete	$6.18
Rate for Payer: Cash Price	$12.36
Rate for Payer: Cofinity Commercial	$10.82
Rate for Payer: Cofinity Commercial	$13.29
Rate for Payer: Healthscope Commercial	$13.90
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$13.13
Rate for Payer: PHP Commercial	$13.13
Rate for Payer: Priority Health Cigna Priority Health	$10.82
Rate for Payer: Priority Health SBD	$9.73

HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG TABLET

Facility

$285.25

Service Code	NDC 50268-400-15
Hospital Charge Code	34544
Hospital Revenue Code	637
Min. Negotiated Rate	$179.71
Max. Negotiated Rate	$256.72
Rate for Payer: Aetna Commercial	$242.46
Rate for Payer: Aetna New Business (MI Preferred)	$185.41
Rate for Payer: Cash Price	$228.20
Rate for Payer: Cofinity Commercial	$199.68
Rate for Payer: Cofinity Commercial	$245.32
Rate for Payer: Healthscope Commercial	$256.72
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$242.46
Rate for Payer: PHP Commercial	$242.46
Rate for Payer: Priority Health Cigna Priority Health	$199.68
Rate for Payer: Priority Health SBD	$179.71

HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG TABLET

Facility

$822.50

Service Code	NDC 0406-0124-62
Hospital Charge Code	34544
Hospital Revenue Code	637
Min. Negotiated Rate	$518.18
Max. Negotiated Rate	$740.25
Rate for Payer: Aetna Commercial	$699.12
Rate for Payer: Aetna New Business (MI Preferred)	$534.62
Rate for Payer: Cash Price	$658.00
Rate for Payer: Cofinity Commercial	$575.75
Rate for Payer: Cofinity Commercial	$707.35
Rate for Payer: Healthscope Commercial	$740.25
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$699.12
Rate for Payer: PHP Commercial	$699.12
Rate for Payer: Priority Health Cigna Priority Health	$575.75
Rate for Payer: Priority Health SBD	$518.18

HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG TABLET

Facility

$5.71

Service Code	NDC 50268-400-11
Hospital Charge Code	34544
Hospital Revenue Code	637
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$5.14
Rate for Payer: Aetna Commercial	$4.85
Rate for Payer: Aetna New Business (MI Preferred)	$3.71
Rate for Payer: Cash Price	$4.57
Rate for Payer: Cofinity Commercial	$4.00
Rate for Payer: Cofinity Commercial	$4.91
Rate for Payer: Healthscope Commercial	$5.14
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$4.85
Rate for Payer: PHP Commercial	$4.85
Rate for Payer: Priority Health Cigna Priority Health	$4.00
Rate for Payer: Priority Health SBD	$3.60

HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG TABLET

Facility

$175.00

Service Code	NDC 13107-020-01
Hospital Charge Code	34544
Hospital Revenue Code	637
Min. Negotiated Rate	$110.25
Max. Negotiated Rate	$157.50
Rate for Payer: Aetna Commercial	$148.75
Rate for Payer: Aetna New Business (MI Preferred)	$113.75
Rate for Payer: Cash Price	$140.00
Rate for Payer: Cofinity Commercial	$122.50
Rate for Payer: Cofinity Commercial	$150.50
Rate for Payer: Healthscope Commercial	$157.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$148.75
Rate for Payer: PHP Commercial	$148.75
Rate for Payer: Priority Health Cigna Priority Health	$122.50
Rate for Payer: Priority Health SBD	$110.25

HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG TABLET

Facility

$530.25

Service Code	NDC 0904-6826-61
Hospital Charge Code	34544
Hospital Revenue Code	637
Min. Negotiated Rate	$212.10
Max. Negotiated Rate	$477.22
Rate for Payer: Aetna Commercial	$450.71
Rate for Payer: Aetna New Business (MI Preferred)	$344.66
Rate for Payer: BCBS Complete	$212.10
Rate for Payer: Cash Price	$424.20
Rate for Payer: Cofinity Commercial	$371.18
Rate for Payer: Cofinity Commercial	$456.02
Rate for Payer: Healthscope Commercial	$477.22
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$450.71
Rate for Payer: PHP Commercial	$450.71
Rate for Payer: Priority Health Cigna Priority Health	$371.18
Rate for Payer: Priority Health SBD	$334.06

HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG TABLET

Facility

$530.25

Service Code	NDC 0904-6826-61
Hospital Charge Code	34544
Hospital Revenue Code	637
Min. Negotiated Rate	$334.06
Max. Negotiated Rate	$477.22
Rate for Payer: Aetna Commercial	$450.71
Rate for Payer: Aetna New Business (MI Preferred)	$344.66
Rate for Payer: Cash Price	$424.20
Rate for Payer: Cofinity Commercial	$371.18
Rate for Payer: Cofinity Commercial	$456.02
Rate for Payer: Healthscope Commercial	$477.22
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$450.71
Rate for Payer: PHP Commercial	$450.71
Rate for Payer: Priority Health Cigna Priority Health	$371.18
Rate for Payer: Priority Health SBD	$334.06

HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG TABLET

Facility

$8.23

Service Code	NDC 0406-0124-23
Hospital Charge Code	34544
Hospital Revenue Code	637
Min. Negotiated Rate	$5.18
Max. Negotiated Rate	$7.41
Rate for Payer: Aetna Commercial	$7.00
Rate for Payer: Aetna New Business (MI Preferred)	$5.35
Rate for Payer: Cash Price	$6.58
Rate for Payer: Cofinity Commercial	$5.76
Rate for Payer: Cofinity Commercial	$7.08
Rate for Payer: Healthscope Commercial	$7.41
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$7.00
Rate for Payer: PHP Commercial	$7.00
Rate for Payer: Priority Health Cigna Priority Health	$5.76
Rate for Payer: Priority Health SBD	$5.18

HYDROCOLLOID DRESSING 5 1/2" X 5 1/2"

Facility

$103.38

Service Code	NDC 6845510723
Hospital Charge Code	111353
Hospital Revenue Code	637
Min. Negotiated Rate	$65.13
Max. Negotiated Rate	$93.04
Rate for Payer: Aetna Commercial	$87.87
Rate for Payer: Aetna New Business (MI Preferred)	$67.20
Rate for Payer: Cash Price	$82.70
Rate for Payer: Cofinity Commercial	$72.37
Rate for Payer: Cofinity Commercial	$88.91
Rate for Payer: Healthscope Commercial	$93.04
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$87.87
Rate for Payer: PHP Commercial	$87.87
Rate for Payer: Priority Health Cigna Priority Health	$72.37
Rate for Payer: Priority Health SBD	$65.13

HYDROCOLLOID DRESSING 6" X 6"

Facility

$108.04

Service Code	NDC 6845510692
Hospital Charge Code	111013
Hospital Revenue Code	637
Min. Negotiated Rate	$68.07
Max. Negotiated Rate	$97.24
Rate for Payer: Aetna Commercial	$91.83
Rate for Payer: Aetna New Business (MI Preferred)	$70.23
Rate for Payer: Cash Price	$86.43
Rate for Payer: Cofinity Commercial	$75.63
Rate for Payer: Cofinity Commercial	$92.91
Rate for Payer: Healthscope Commercial	$97.24
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$91.83
Rate for Payer: PHP Commercial	$91.83
Rate for Payer: Priority Health Cigna Priority Health	$75.63
Rate for Payer: Priority Health SBD	$68.07

HYDROCORTISONE 0.5 % TOPICAL CREAM

Facility

$21.60

Service Code	NDC 51672-2010-2
Hospital Charge Code	3725
Hospital Revenue Code	637
Min. Negotiated Rate	$13.61
Max. Negotiated Rate	$19.44
Rate for Payer: Aetna Commercial	$18.36
Rate for Payer: Aetna New Business (MI Preferred)	$14.04
Rate for Payer: Cash Price	$17.28
Rate for Payer: Cofinity Commercial	$15.12
Rate for Payer: Cofinity Commercial	$18.58
Rate for Payer: Healthscope Commercial	$19.44
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$18.36
Rate for Payer: PHP Commercial	$18.36
Rate for Payer: Priority Health Cigna Priority Health	$15.12
Rate for Payer: Priority Health SBD	$13.61

HYDROCORTISONE 10 MG TABLET

Facility

$757.92

Service Code	NDC 0009-0031-01
Hospital Charge Code	3733
Hospital Revenue Code	637
Min. Negotiated Rate	$477.49
Max. Negotiated Rate	$682.13
Rate for Payer: Aetna Commercial	$644.23
Rate for Payer: Aetna New Business (MI Preferred)	$492.65
Rate for Payer: Cash Price	$606.34
Rate for Payer: Cofinity Commercial	$530.54
Rate for Payer: Cofinity Commercial	$651.81
Rate for Payer: Healthscope Commercial	$682.13
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$644.23
Rate for Payer: PHP Commercial	$644.23
Rate for Payer: Priority Health Cigna Priority Health	$530.54
Rate for Payer: Priority Health SBD	$477.49

HYDROCORTISONE 10 MG TABLET

Facility

$252.70

Service Code	NDC 59762-0074-1
Hospital Charge Code	3733
Hospital Revenue Code	637
Min. Negotiated Rate	$159.20
Max. Negotiated Rate	$227.43
Rate for Payer: Aetna Commercial	$214.80
Rate for Payer: Aetna New Business (MI Preferred)	$164.26
Rate for Payer: Cash Price	$202.16
Rate for Payer: Cofinity Commercial	$176.89
Rate for Payer: Cofinity Commercial	$217.32
Rate for Payer: Healthscope Commercial	$227.43
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$214.80
Rate for Payer: PHP Commercial	$214.80
Rate for Payer: Priority Health Cigna Priority Health	$176.89
Rate for Payer: Priority Health SBD	$159.20

HYDROCORTISONE 10 MG TABLET

Facility

$7.13

Service Code	NDC 60687-582-11
Hospital Charge Code	3733
Hospital Revenue Code	637
Min. Negotiated Rate	$4.49
Max. Negotiated Rate	$6.42
Rate for Payer: Aetna Commercial	$6.06
Rate for Payer: Aetna New Business (MI Preferred)	$4.63
Rate for Payer: Cash Price	$5.70
Rate for Payer: Cofinity Commercial	$4.99
Rate for Payer: Cofinity Commercial	$6.13
Rate for Payer: Healthscope Commercial	$6.42
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$6.06
Rate for Payer: PHP Commercial	$6.06
Rate for Payer: Priority Health Cigna Priority Health	$4.99
Rate for Payer: Priority Health SBD	$4.49

HYDROCORTISONE 10 MG TABLET

Facility

$712.32

Service Code	NDC 60687-582-01
Hospital Charge Code	3733
Hospital Revenue Code	637
Min. Negotiated Rate	$448.76
Max. Negotiated Rate	$641.09
Rate for Payer: Aetna Commercial	$605.47
Rate for Payer: Aetna New Business (MI Preferred)	$463.01
Rate for Payer: Cash Price	$569.86
Rate for Payer: Cofinity Commercial	$498.62
Rate for Payer: Cofinity Commercial	$612.60
Rate for Payer: Healthscope Commercial	$641.09
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$605.47
Rate for Payer: PHP Commercial	$605.47
Rate for Payer: Priority Health Cigna Priority Health	$498.62
Rate for Payer: Priority Health SBD	$448.76

HYDROCORTISONE 1 %-PRAMOXINE 1 % RECTAL FOAM

Facility

$539.42

Service Code	NDC 0037-6822-10
Hospital Charge Code	28849
Hospital Revenue Code	637
Min. Negotiated Rate	$339.83
Max. Negotiated Rate	$485.48
Rate for Payer: Aetna Commercial	$458.51
Rate for Payer: Aetna New Business (MI Preferred)	$350.62
Rate for Payer: Cash Price	$431.54
Rate for Payer: Cofinity Commercial	$377.59
Rate for Payer: Cofinity Commercial	$463.90
Rate for Payer: Healthscope Commercial	$485.48
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$458.51
Rate for Payer: PHP Commercial	$458.51
Rate for Payer: Priority Health Cigna Priority Health	$377.59
Rate for Payer: Priority Health SBD	$339.83

HYDROCORTISONE 1 % TOPICAL CREAM

Facility

$9.45

Service Code	NDC 45802-438-03
Hospital Charge Code	3726
Hospital Revenue Code	637
Min. Negotiated Rate	$5.95
Max. Negotiated Rate	$8.50
Rate for Payer: Aetna Commercial	$8.03
Rate for Payer: Aetna New Business (MI Preferred)	$6.14
Rate for Payer: Cash Price	$7.56
Rate for Payer: Cofinity Commercial	$6.62
Rate for Payer: Cofinity Commercial	$8.13
Rate for Payer: Healthscope Commercial	$8.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$8.03
Rate for Payer: PHP Commercial	$8.03
Rate for Payer: Priority Health Cigna Priority Health	$6.62
Rate for Payer: Priority Health SBD	$5.95

HYDROCORTISONE 1 % TOPICAL CREAM

Facility

$7.73

Service Code	NDC 0904-7623-31
Hospital Charge Code	3726
Hospital Revenue Code	637
Min. Negotiated Rate	$4.87
Max. Negotiated Rate	$6.96
Rate for Payer: Aetna Commercial	$6.57
Rate for Payer: Aetna New Business (MI Preferred)	$5.02
Rate for Payer: Cash Price	$6.18
Rate for Payer: Cofinity Commercial	$5.41
Rate for Payer: Cofinity Commercial	$6.65
Rate for Payer: Healthscope Commercial	$6.96
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$6.57
Rate for Payer: PHP Commercial	$6.57
Rate for Payer: Priority Health Cigna Priority Health	$5.41
Rate for Payer: Priority Health SBD	$4.87

HYDROCORTISONE 1 % TOPICAL CREAM

Facility

$10.08

Service Code	NDC 61269-343-56
Hospital Charge Code	3726
Hospital Revenue Code	637
Min. Negotiated Rate	$6.35
Max. Negotiated Rate	$9.07
Rate for Payer: Aetna Commercial	$8.57
Rate for Payer: Aetna New Business (MI Preferred)	$6.55
Rate for Payer: Cash Price	$8.06
Rate for Payer: Cofinity Commercial	$7.06
Rate for Payer: Cofinity Commercial	$8.67
Rate for Payer: Healthscope Commercial	$9.07
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$8.57
Rate for Payer: PHP Commercial	$8.57
Rate for Payer: Priority Health Cigna Priority Health	$7.06
Rate for Payer: Priority Health SBD	$6.35

HYDROCORTISONE 1 % TOPICAL CREAM

Facility

$10.74

Service Code	NDC 9629513687
Hospital Charge Code	3726
Hospital Revenue Code	637
Min. Negotiated Rate	$6.77
Max. Negotiated Rate	$9.67
Rate for Payer: Aetna Commercial	$9.13
Rate for Payer: Aetna New Business (MI Preferred)	$6.98
Rate for Payer: Cash Price	$8.59
Rate for Payer: Cofinity Commercial	$7.52
Rate for Payer: Cofinity Commercial	$9.24
Rate for Payer: Healthscope Commercial	$9.67
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$9.13
Rate for Payer: PHP Commercial	$9.13
Rate for Payer: Priority Health Cigna Priority Health	$7.52
Rate for Payer: Priority Health SBD	$6.77

HYDROCORTISONE 1 % TOPICAL OINTMENT

Facility

$11.09

Service Code	NDC 45802-276-03
Hospital Charge Code	3731
Hospital Revenue Code	637
Min. Negotiated Rate	$6.99
Max. Negotiated Rate	$9.98
Rate for Payer: Aetna Commercial	$9.43
Rate for Payer: Aetna New Business (MI Preferred)	$7.21
Rate for Payer: Cash Price	$8.87
Rate for Payer: Cofinity Commercial	$7.76
Rate for Payer: Cofinity Commercial	$9.54
Rate for Payer: Healthscope Commercial	$9.98
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$9.43
Rate for Payer: PHP Commercial	$9.43
Rate for Payer: Priority Health Cigna Priority Health	$7.76
Rate for Payer: Priority Health SBD	$6.99

Know your out-of-pocket cost for care.

All Charges