Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

IBUPROFEN 100 MG/5 ML ORAL SUSPENSION

Facility

$2.35

Service Code	NDC 9900-0019-41
Hospital Charge Code	10246
Hospital Revenue Code	637
Min. Negotiated Rate	$1.48
Max. Negotiated Rate	$2.12
Rate for Payer: Aetna Commercial	$2.00
Rate for Payer: Aetna New Business (MI Preferred)	$1.53
Rate for Payer: Cash Price	$1.88
Rate for Payer: Cofinity Commercial	$1.64
Rate for Payer: Cofinity Commercial	$2.02
Rate for Payer: Healthscope Commercial	$2.12
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2.00
Rate for Payer: PHP Commercial	$2.00
Rate for Payer: Priority Health Cigna Priority Health	$1.64
Rate for Payer: Priority Health SBD	$1.48

IBUPROFEN 100 MG/5 ML ORAL SUSPENSION

Facility

$4.66

Service Code	NDC 0121-0914-05
Hospital Charge Code	10246
Hospital Revenue Code	637
Min. Negotiated Rate	$2.94
Max. Negotiated Rate	$4.19
Rate for Payer: Aetna Commercial	$3.96
Rate for Payer: Aetna New Business (MI Preferred)	$3.03
Rate for Payer: Cash Price	$3.73
Rate for Payer: Cofinity Commercial	$3.26
Rate for Payer: Cofinity Commercial	$4.01
Rate for Payer: Healthscope Commercial	$4.19
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3.96
Rate for Payer: PHP Commercial	$3.96
Rate for Payer: Priority Health Cigna Priority Health	$3.26
Rate for Payer: Priority Health SBD	$2.94

IBUPROFEN 200 MG TABLET

Facility

$35.52

Service Code	NDC 0904-6747-24
Hospital Charge Code	3841
Hospital Revenue Code	637
Min. Negotiated Rate	$22.38
Max. Negotiated Rate	$31.97
Rate for Payer: Aetna Commercial	$30.19
Rate for Payer: Aetna New Business (MI Preferred)	$23.09
Rate for Payer: Cash Price	$28.42
Rate for Payer: Cofinity Commercial	$24.86
Rate for Payer: Cofinity Commercial	$30.55
Rate for Payer: Healthscope Commercial	$31.97
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$30.19
Rate for Payer: PHP Commercial	$30.19
Rate for Payer: Priority Health Cigna Priority Health	$24.86
Rate for Payer: Priority Health SBD	$22.38

IBUPROFEN 200 MG TABLET

Facility

$19.60

Service Code	NDC 0904-7914-61
Hospital Charge Code	3841
Hospital Revenue Code	637
Min. Negotiated Rate	$12.35
Max. Negotiated Rate	$17.64
Rate for Payer: Aetna Commercial	$16.66
Rate for Payer: Aetna New Business (MI Preferred)	$12.74
Rate for Payer: Cash Price	$15.68
Rate for Payer: Cofinity Commercial	$13.72
Rate for Payer: Cofinity Commercial	$16.86
Rate for Payer: Healthscope Commercial	$17.64
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$16.66
Rate for Payer: PHP Commercial	$16.66
Rate for Payer: Priority Health Cigna Priority Health	$13.72
Rate for Payer: Priority Health SBD	$12.35

IBUPROFEN 400 MG TABLET

Facility

$126.90

Service Code	NDC 63739-672-10
Hospital Charge Code	3843
Hospital Revenue Code	637
Min. Negotiated Rate	$50.76
Max. Negotiated Rate	$114.21
Rate for Payer: Aetna Commercial	$107.86
Rate for Payer: Aetna New Business (MI Preferred)	$82.48
Rate for Payer: BCBS Complete	$50.76
Rate for Payer: Cash Price	$101.52
Rate for Payer: Cofinity Commercial	$109.13
Rate for Payer: Cofinity Commercial	$88.83
Rate for Payer: Healthscope Commercial	$114.21
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$107.86
Rate for Payer: PHP Commercial	$107.86
Rate for Payer: Priority Health Cigna Priority Health	$88.83
Rate for Payer: Priority Health SBD	$79.95

IBUPROFEN 400 MG TABLET

Facility

$117.50

Service Code	NDC 67877-319-01
Hospital Charge Code	3843
Hospital Revenue Code	637
Min. Negotiated Rate	$74.02
Max. Negotiated Rate	$105.75
Rate for Payer: Aetna Commercial	$99.88
Rate for Payer: Aetna New Business (MI Preferred)	$76.38
Rate for Payer: Cash Price	$94.00
Rate for Payer: Cofinity Commercial	$101.05
Rate for Payer: Cofinity Commercial	$82.25
Rate for Payer: Healthscope Commercial	$105.75
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$99.88
Rate for Payer: PHP Commercial	$99.88
Rate for Payer: Priority Health Cigna Priority Health	$82.25
Rate for Payer: Priority Health SBD	$74.02

IBUPROFEN 400 MG TABLET

Facility

$265.55

Service Code	NDC 68084-658-01
Hospital Charge Code	3843
Hospital Revenue Code	637
Min. Negotiated Rate	$167.30
Max. Negotiated Rate	$239.00
Rate for Payer: Aetna Commercial	$225.72
Rate for Payer: Aetna New Business (MI Preferred)	$172.61
Rate for Payer: Cash Price	$212.44
Rate for Payer: Cofinity Commercial	$185.88
Rate for Payer: Cofinity Commercial	$228.37
Rate for Payer: Healthscope Commercial	$239.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$225.72
Rate for Payer: PHP Commercial	$225.72
Rate for Payer: Priority Health Cigna Priority Health	$185.88
Rate for Payer: Priority Health SBD	$167.30

IBUPROFEN 400 MG TABLET

Facility

$423.00

Service Code	NDC 67877-319-05
Hospital Charge Code	3843
Hospital Revenue Code	637
Min. Negotiated Rate	$266.49
Max. Negotiated Rate	$380.70
Rate for Payer: Aetna Commercial	$359.55
Rate for Payer: Aetna New Business (MI Preferred)	$274.95
Rate for Payer: Cash Price	$338.40
Rate for Payer: Cofinity Commercial	$296.10
Rate for Payer: Cofinity Commercial	$363.78
Rate for Payer: Healthscope Commercial	$380.70
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$359.55
Rate for Payer: PHP Commercial	$359.55
Rate for Payer: Priority Health Cigna Priority Health	$296.10
Rate for Payer: Priority Health SBD	$266.49

IBUPROFEN 400 MG TABLET

Facility

$150.40

Service Code	NDC 0904-5853-61
Hospital Charge Code	3843
Hospital Revenue Code	637
Min. Negotiated Rate	$94.75
Max. Negotiated Rate	$135.36
Rate for Payer: Aetna Commercial	$127.84
Rate for Payer: Aetna New Business (MI Preferred)	$97.76
Rate for Payer: Cash Price	$120.32
Rate for Payer: Cofinity Commercial	$129.34
Rate for Payer: Cofinity Commercial	$105.28
Rate for Payer: Healthscope Commercial	$135.36
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$127.84
Rate for Payer: PHP Commercial	$127.84
Rate for Payer: Priority Health Cigna Priority Health	$105.28
Rate for Payer: Priority Health SBD	$94.75

IBUPROFEN 400 MG TABLET

Facility

$2.66

Service Code	NDC 68084-658-11
Hospital Charge Code	3843
Hospital Revenue Code	637
Min. Negotiated Rate	$1.68
Max. Negotiated Rate	$2.39
Rate for Payer: Aetna Commercial	$2.26
Rate for Payer: Aetna New Business (MI Preferred)	$1.73
Rate for Payer: Cash Price	$2.13
Rate for Payer: Cofinity Commercial	$1.86
Rate for Payer: Cofinity Commercial	$2.29
Rate for Payer: Healthscope Commercial	$2.39
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2.26
Rate for Payer: PHP Commercial	$2.26
Rate for Payer: Priority Health Cigna Priority Health	$1.86
Rate for Payer: Priority Health SBD	$1.68

IBUPROFEN 400 MG TABLET

Facility

$126.90

Service Code	NDC 63739-672-10
Hospital Charge Code	3843
Hospital Revenue Code	637
Min. Negotiated Rate	$79.95
Max. Negotiated Rate	$114.21
Rate for Payer: Aetna Commercial	$107.86
Rate for Payer: Aetna New Business (MI Preferred)	$82.48
Rate for Payer: Cash Price	$101.52
Rate for Payer: Cofinity Commercial	$109.13
Rate for Payer: Cofinity Commercial	$88.83
Rate for Payer: Healthscope Commercial	$114.21
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$107.86
Rate for Payer: PHP Commercial	$107.86
Rate for Payer: Priority Health Cigna Priority Health	$88.83
Rate for Payer: Priority Health SBD	$79.95

IBUPROFEN 600 MG TABLET

Facility

$404.20

Service Code	NDC 60687-457-01
Hospital Charge Code	3844
Hospital Revenue Code	637
Min. Negotiated Rate	$254.65
Max. Negotiated Rate	$363.78
Rate for Payer: Aetna Commercial	$343.57
Rate for Payer: Aetna New Business (MI Preferred)	$262.73
Rate for Payer: Cash Price	$323.36
Rate for Payer: Cofinity Commercial	$282.94
Rate for Payer: Cofinity Commercial	$347.61
Rate for Payer: Healthscope Commercial	$363.78
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$343.57
Rate for Payer: PHP Commercial	$343.57
Rate for Payer: Priority Health Cigna Priority Health	$282.94
Rate for Payer: Priority Health SBD	$254.65

IBUPROFEN 600 MG TABLET

Facility

$164.50

Service Code	NDC 63739-684-10
Hospital Charge Code	3844
Hospital Revenue Code	637
Min. Negotiated Rate	$103.64
Max. Negotiated Rate	$148.05
Rate for Payer: Aetna Commercial	$139.82
Rate for Payer: Aetna New Business (MI Preferred)	$106.92
Rate for Payer: Cash Price	$131.60
Rate for Payer: Cofinity Commercial	$115.15
Rate for Payer: Cofinity Commercial	$141.47
Rate for Payer: Healthscope Commercial	$148.05
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$139.82
Rate for Payer: PHP Commercial	$139.82
Rate for Payer: Priority Health Cigna Priority Health	$115.15
Rate for Payer: Priority Health SBD	$103.64

IBUPROFEN 600 MG TABLET

Facility

$185.65

Service Code	NDC 0904-5854-61
Hospital Charge Code	3844
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

IBUPROFEN 600 MG TABLET

Facility

$162.15

Service Code	NDC 67877-320-01
Hospital Charge Code	3844
Hospital Revenue Code	637
Min. Negotiated Rate	$102.15
Max. Negotiated Rate	$145.94
Rate for Payer: Aetna Commercial	$137.83
Rate for Payer: Aetna New Business (MI Preferred)	$105.40
Rate for Payer: Cash Price	$129.72
Rate for Payer: Cofinity Commercial	$113.50
Rate for Payer: Cofinity Commercial	$139.45
Rate for Payer: Healthscope Commercial	$145.94
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$137.83
Rate for Payer: PHP Commercial	$137.83
Rate for Payer: Priority Health Cigna Priority Health	$113.50
Rate for Payer: Priority Health SBD	$102.15

IBUPROFEN 600 MG TABLET

Facility

$4.05

Service Code	NDC 60687-457-11
Hospital Charge Code	3844
Hospital Revenue Code	637
Min. Negotiated Rate	$2.55
Max. Negotiated Rate	$3.64
Rate for Payer: Aetna Commercial	$3.44
Rate for Payer: Aetna New Business (MI Preferred)	$2.63
Rate for Payer: Cash Price	$3.24
Rate for Payer: Cofinity Commercial	$2.84
Rate for Payer: Cofinity Commercial	$3.48
Rate for Payer: Healthscope Commercial	$3.64
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3.44
Rate for Payer: PHP Commercial	$3.44
Rate for Payer: Priority Health Cigna Priority Health	$2.84
Rate for Payer: Priority Health SBD	$2.55

IBUPROFEN 600 MG TABLET

Facility

$611.00

Service Code	NDC 67877-320-05
Hospital Charge Code	3844
Hospital Revenue Code	637
Min. Negotiated Rate	$384.93
Max. Negotiated Rate	$549.90
Rate for Payer: Aetna Commercial	$519.35
Rate for Payer: Aetna New Business (MI Preferred)	$397.15
Rate for Payer: Cash Price	$488.80
Rate for Payer: Cofinity Commercial	$427.70
Rate for Payer: Cofinity Commercial	$525.46
Rate for Payer: Healthscope Commercial	$549.90
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$519.35
Rate for Payer: PHP Commercial	$519.35
Rate for Payer: Priority Health Cigna Priority Health	$427.70
Rate for Payer: Priority Health SBD	$384.93

IBUPROFEN 800 MG TABLET

Facility

$16.22

Service Code	NDC 0904-5855-61
Hospital Charge Code	3845
Hospital Revenue Code	637
Min. Negotiated Rate	$10.22
Max. Negotiated Rate	$14.60
Rate for Payer: Aetna Commercial	$13.79
Rate for Payer: Aetna New Business (MI Preferred)	$10.54
Rate for Payer: Cash Price	$12.98
Rate for Payer: Cofinity Commercial	$11.35
Rate for Payer: Cofinity Commercial	$13.95
Rate for Payer: Healthscope Commercial	$14.60
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$13.79
Rate for Payer: PHP Commercial	$13.79
Rate for Payer: Priority Health Cigna Priority Health	$11.35
Rate for Payer: Priority Health SBD	$10.22

IBUPROFEN 800 MG TABLET

Facility

$267.90

Service Code	NDC 0904-5855-60
Hospital Charge Code	3845
Hospital Revenue Code	637
Min. Negotiated Rate	$168.78
Max. Negotiated Rate	$241.11
Rate for Payer: Aetna Commercial	$227.72
Rate for Payer: Aetna New Business (MI Preferred)	$174.14
Rate for Payer: Cash Price	$214.32
Rate for Payer: Cofinity Commercial	$230.39
Rate for Payer: Cofinity Commercial	$187.53
Rate for Payer: Healthscope Commercial	$241.11
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$227.72
Rate for Payer: PHP Commercial	$227.72
Rate for Payer: Priority Health Cigna Priority Health	$187.53
Rate for Payer: Priority Health SBD	$168.78

IBUPROFEN 800 MG TABLET

Facility

$4.12

Service Code	NDC 60687-468-11
Hospital Charge Code	3845
Hospital Revenue Code	637
Min. Negotiated Rate	$2.60
Max. Negotiated Rate	$3.71
Rate for Payer: Aetna Commercial	$3.50
Rate for Payer: Aetna New Business (MI Preferred)	$2.68
Rate for Payer: Cash Price	$3.30
Rate for Payer: Cofinity Commercial	$2.88
Rate for Payer: Cofinity Commercial	$3.54
Rate for Payer: Healthscope Commercial	$3.71
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3.50
Rate for Payer: PHP Commercial	$3.50
Rate for Payer: Priority Health Cigna Priority Health	$2.88
Rate for Payer: Priority Health SBD	$2.60

IBUPROFEN 800 MG TABLET

Facility

$46.53

Service Code	NDC 68645-563-54
Hospital Charge Code	3845
Hospital Revenue Code	637
Min. Negotiated Rate	$29.31
Max. Negotiated Rate	$41.88
Rate for Payer: Aetna Commercial	$39.55
Rate for Payer: Aetna New Business (MI Preferred)	$30.24
Rate for Payer: Cash Price	$37.22
Rate for Payer: Cofinity Commercial	$32.57
Rate for Payer: Cofinity Commercial	$40.02
Rate for Payer: Healthscope Commercial	$41.88
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$39.55
Rate for Payer: PHP Commercial	$39.55
Rate for Payer: Priority Health Cigna Priority Health	$32.57
Rate for Payer: Priority Health SBD	$29.31

IBUPROFEN 800 MG TABLET

Facility

$185.65

Service Code	NDC 63739-691-10
Hospital Charge Code	3845
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

IBUPROFEN 800 MG TABLET

Facility

$411.25

Service Code	NDC 60687-468-01
Hospital Charge Code	3845
Hospital Revenue Code	637
Min. Negotiated Rate	$259.09
Max. Negotiated Rate	$370.12
Rate for Payer: Aetna Commercial	$349.56
Rate for Payer: Aetna New Business (MI Preferred)	$267.31
Rate for Payer: Cash Price	$329.00
Rate for Payer: Cofinity Commercial	$287.88
Rate for Payer: Cofinity Commercial	$353.68
Rate for Payer: Healthscope Commercial	$370.12
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$349.56
Rate for Payer: PHP Commercial	$349.56
Rate for Payer: Priority Health Cigna Priority Health	$287.88
Rate for Payer: Priority Health SBD	$259.09

IBUPROFEN 800 MG TABLET

Facility

$881.25

Service Code	NDC 63739-691-01
Hospital Charge Code	3845
Hospital Revenue Code	637
Min. Negotiated Rate	$555.19
Max. Negotiated Rate	$793.12
Rate for Payer: Aetna Commercial	$749.06
Rate for Payer: Aetna New Business (MI Preferred)	$572.81
Rate for Payer: Cash Price	$705.00
Rate for Payer: Cofinity Commercial	$616.88
Rate for Payer: Cofinity Commercial	$757.88
Rate for Payer: Healthscope Commercial	$793.12
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$749.06
Rate for Payer: PHP Commercial	$749.06
Rate for Payer: Priority Health Cigna Priority Health	$616.88
Rate for Payer: Priority Health SBD	$555.19

IMATINIB 100 MG TABLET

Facility

$487.30

Service Code	HCPCS J8999
Hospital Charge Code	32979
Hospital Revenue Code	636
Min. Negotiated Rate	$307.00
Max. Negotiated Rate	$438.57
Rate for Payer: Aetna Commercial	$414.20
Rate for Payer: Aetna New Business (MI Preferred)	$316.74
Rate for Payer: Cash Price	$389.84
Rate for Payer: Cofinity Commercial	$341.11
Rate for Payer: Cofinity Commercial	$419.08
Rate for Payer: Healthscope Commercial	$438.57
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$414.20
Rate for Payer: PHP Commercial	$414.20
Rate for Payer: Priority Health Cigna Priority Health	$341.11
Rate for Payer: Priority Health SBD	$307.00

Know your out-of-pocket cost for care.

All Charges