Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

CITALOPRAM 10 MG TABLET

Facility

$122.20

Service Code	NDC 0904-6084-61
Hospital Charge Code	30264
Hospital Revenue Code	637
Min. Negotiated Rate	$76.99
Max. Negotiated Rate	$109.98
Rate for Payer: Aetna Commercial	$103.87
Rate for Payer: Aetna New Business (MI Preferred)	$79.43
Rate for Payer: Cash Price	$97.76
Rate for Payer: Cofinity Commercial	$85.54
Rate for Payer: Cofinity Commercial	$105.09
Rate for Payer: Healthscope Commercial	$109.98
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$103.87
Rate for Payer: PHP Commercial	$103.87
Rate for Payer: Priority Health Cigna Priority Health	$85.54
Rate for Payer: Priority Health SBD	$76.99

CITALOPRAM 20 MG TABLET

Facility

$13.16

Service Code	NDC 0904-6085-61
Hospital Charge Code	21062
Hospital Revenue Code	637
Min. Negotiated Rate	$8.29
Max. Negotiated Rate	$11.84
Rate for Payer: Aetna Commercial	$11.19
Rate for Payer: Aetna New Business (MI Preferred)	$8.55
Rate for Payer: Cash Price	$10.53
Rate for Payer: Cofinity Commercial	$11.32
Rate for Payer: Cofinity Commercial	$9.21
Rate for Payer: Healthscope Commercial	$11.84
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$11.19
Rate for Payer: PHP Commercial	$11.19
Rate for Payer: Priority Health Cigna Priority Health	$9.21
Rate for Payer: Priority Health SBD	$8.29

CITALOPRAM 20 MG TABLET

Facility

$752.00

Service Code	NDC 57664-508-18
Hospital Charge Code	21062
Hospital Revenue Code	637
Min. Negotiated Rate	$473.76
Max. Negotiated Rate	$676.80
Rate for Payer: Aetna Commercial	$639.20
Rate for Payer: Aetna New Business (MI Preferred)	$488.80
Rate for Payer: Cash Price	$601.60
Rate for Payer: Cofinity Commercial	$526.40
Rate for Payer: Cofinity Commercial	$646.72
Rate for Payer: Healthscope Commercial	$676.80
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$639.20
Rate for Payer: PHP Commercial	$639.20
Rate for Payer: Priority Health Cigna Priority Health	$526.40
Rate for Payer: Priority Health SBD	$473.76

CITALOPRAM 40 MG TABLET

Facility

$75.20

Service Code	NDC 0378-6233-01
Hospital Charge Code	23490
Hospital Revenue Code	637
Min. Negotiated Rate	$47.38
Max. Negotiated Rate	$67.68
Rate for Payer: Aetna Commercial	$63.92
Rate for Payer: Aetna New Business (MI Preferred)	$48.88
Rate for Payer: Cash Price	$60.16
Rate for Payer: Cofinity Commercial	$64.67
Rate for Payer: Cofinity Commercial	$52.64
Rate for Payer: Healthscope Commercial	$67.68
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$63.92
Rate for Payer: PHP Commercial	$63.92
Rate for Payer: Priority Health Cigna Priority Health	$52.64
Rate for Payer: Priority Health SBD	$47.38

CLADRIBINE 10 MG/10 ML INTRAVENOUS SOLUTION

Facility

$929.07

Service Code	HCPCS J9065
Hospital Charge Code	9615
Hospital Revenue Code	636
Min. Negotiated Rate	$585.31
Max. Negotiated Rate	$836.16
Rate for Payer: Aetna Commercial	$789.71
Rate for Payer: Aetna New Business (MI Preferred)	$603.90
Rate for Payer: Cash Price	$743.26
Rate for Payer: Cofinity Commercial	$799.00
Rate for Payer: Cofinity Commercial	$650.35
Rate for Payer: Healthscope Commercial	$836.16
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$789.71
Rate for Payer: PHP Commercial	$789.71
Rate for Payer: Priority Health Cigna Priority Health	$650.35
Rate for Payer: Priority Health SBD	$585.31

CLADRIBINE 10 MG/10 ML INTRAVENOUS SOLUTION

Facility

$929.07

Service Code	HCPCS J9065
Hospital Charge Code	9615
Hospital Revenue Code	636
Min. Negotiated Rate	$8.63
Max. Negotiated Rate	$836.16
Rate for Payer: Aetna Commercial	$789.71
Rate for Payer: Aetna Commercial	$613.15
Rate for Payer: Aetna Medicare	$16.40
Rate for Payer: Aetna Medicare	$16.40
Rate for Payer: Aetna New Business (MI Preferred)	$468.88
Rate for Payer: Aetna New Business (MI Preferred)	$603.90
Rate for Payer: Allen County Amish Medical Aid Commercial	$19.72
Rate for Payer: Allen County Amish Medical Aid Commercial	$19.72
Rate for Payer: Amish Plain Church Group Commercial	$19.72
Rate for Payer: Amish Plain Church Group Commercial	$19.72
Rate for Payer: BCBS Complete	$9.06
Rate for Payer: BCBS Complete	$9.06
Rate for Payer: BCBS MAPPO	$15.77
Rate for Payer: BCBS MAPPO	$15.77
Rate for Payer: BCBS Trust/PPO	$46.69
Rate for Payer: BCBS Trust/PPO	$46.69
Rate for Payer: BCN Medicare Advantage	$15.77
Rate for Payer: BCN Medicare Advantage	$15.77
Rate for Payer: Cash Price	$743.26
Rate for Payer: Cash Price	$577.08
Rate for Payer: Cash Price	$577.08
Rate for Payer: Cash Price	$743.26
Rate for Payer: Cofinity Commercial	$620.36
Rate for Payer: Cofinity Commercial	$799.00
Rate for Payer: Cofinity Commercial	$650.35
Rate for Payer: Cofinity Commercial	$504.94
Rate for Payer: Health Alliance Plan Medicare Advantage	$15.77
Rate for Payer: Health Alliance Plan Medicare Advantage	$15.77
Rate for Payer: Healthscope Commercial	$836.16
Rate for Payer: Healthscope Commercial	$649.22
Rate for Payer: Mclaren Medicaid	$8.63
Rate for Payer: Mclaren Medicaid	$8.63
Rate for Payer: Mclaren Medicare	$15.77
Rate for Payer: Mclaren Medicare	$15.77
Rate for Payer: Meridian Medicaid	$9.06
Rate for Payer: Meridian Medicaid	$9.06
Rate for Payer: Meridian Wellcare - Medicare Advantage	$16.56
Rate for Payer: Meridian Wellcare - Medicare Advantage	$16.56
Rate for Payer: MI Amish Medical Board Commercial	$18.14
Rate for Payer: MI Amish Medical Board Commercial	$18.14
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$789.71
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$613.15
Rate for Payer: PACE Medicare	$14.98
Rate for Payer: PACE Medicare	$14.98
Rate for Payer: PACE SWMI	$15.77
Rate for Payer: PACE SWMI	$15.77
Rate for Payer: PHP Commercial	$789.71
Rate for Payer: PHP Commercial	$613.15
Rate for Payer: PHP Medicare Advantage	$15.77
Rate for Payer: PHP Medicare Advantage	$15.77
Rate for Payer: Priority Health Choice Medicaid	$8.63
Rate for Payer: Priority Health Choice Medicaid	$8.63
Rate for Payer: Priority Health Cigna Priority Health	$650.35
Rate for Payer: Priority Health Cigna Priority Health	$504.94
Rate for Payer: Priority Health Medicare	$15.77
Rate for Payer: Priority Health Medicare	$15.77
Rate for Payer: Priority Health SBD	$454.45
Rate for Payer: Priority Health SBD	$585.31
Rate for Payer: Railroad Medicare Medicare	$15.77
Rate for Payer: Railroad Medicare Medicare	$15.77
Rate for Payer: UHC Dual Complete DSNP	$15.77
Rate for Payer: UHC Dual Complete DSNP	$15.77
Rate for Payer: UHC Medicare Advantage	$16.25
Rate for Payer: UHC Medicare Advantage	$16.25
Rate for Payer: VA VA	$15.77
Rate for Payer: VA VA	$15.77

CLARITHROMYCIN 500 MG TABLET

Facility

$17.24

Service Code	NDC 68084-651-95
Hospital Charge Code	9617
Hospital Revenue Code	637
Min. Negotiated Rate	$10.86
Max. Negotiated Rate	$15.52
Rate for Payer: Aetna Commercial	$14.65
Rate for Payer: Aetna New Business (MI Preferred)	$11.21
Rate for Payer: Cash Price	$13.79
Rate for Payer: Cofinity Commercial	$12.07
Rate for Payer: Cofinity Commercial	$14.83
Rate for Payer: Healthscope Commercial	$15.52
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$14.65
Rate for Payer: PHP Commercial	$14.65
Rate for Payer: Priority Health Cigna Priority Health	$12.07
Rate for Payer: Priority Health SBD	$10.86

CLARITHROMYCIN 500 MG TABLET

Facility

$284.84

Service Code	NDC 0904-6872-04
Hospital Charge Code	9617
Hospital Revenue Code	637
Min. Negotiated Rate	$179.45
Max. Negotiated Rate	$256.36
Rate for Payer: Aetna Commercial	$242.11
Rate for Payer: Aetna New Business (MI Preferred)	$185.15
Rate for Payer: Cash Price	$227.87
Rate for Payer: Cofinity Commercial	$199.39
Rate for Payer: Cofinity Commercial	$244.96
Rate for Payer: Healthscope Commercial	$256.36
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$242.11
Rate for Payer: PHP Commercial	$242.11
Rate for Payer: Priority Health Cigna Priority Health	$199.39
Rate for Payer: Priority Health SBD	$179.45

CLARITHROMYCIN 500 MG TABLET

Facility

$516.93

Service Code	NDC 68084-651-25
Hospital Charge Code	9617
Hospital Revenue Code	637
Min. Negotiated Rate	$325.67
Max. Negotiated Rate	$465.24
Rate for Payer: Aetna Commercial	$439.39
Rate for Payer: Aetna New Business (MI Preferred)	$336.00
Rate for Payer: Cash Price	$413.54
Rate for Payer: Cofinity Commercial	$361.85
Rate for Payer: Cofinity Commercial	$444.56
Rate for Payer: Healthscope Commercial	$465.24
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$439.39
Rate for Payer: PHP Commercial	$439.39
Rate for Payer: Priority Health Cigna Priority Health	$361.85
Rate for Payer: Priority Health SBD	$325.67

CLARITHROMYCIN 500 MG TABLET

Facility

$271.89

Service Code	NDC 0781-1962-60
Hospital Charge Code	9617
Hospital Revenue Code	637
Min. Negotiated Rate	$171.29
Max. Negotiated Rate	$244.70
Rate for Payer: Aetna Commercial	$231.11
Rate for Payer: Aetna New Business (MI Preferred)	$176.73
Rate for Payer: Cash Price	$217.51
Rate for Payer: Cofinity Commercial	$233.83
Rate for Payer: Cofinity Commercial	$190.32
Rate for Payer: Healthscope Commercial	$244.70
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$231.11
Rate for Payer: PHP Commercial	$231.11
Rate for Payer: Priority Health Cigna Priority Health	$190.32
Rate for Payer: Priority Health SBD	$171.29

CLAVICULECTOMY; PARTIAL

Facility

$8,925.64

Service Code	CPT 23120
Hospital Revenue Code	360
Min. Negotiated Rate	$589.40
Max. Negotiated Rate	$8,925.64
Rate for Payer: Aetna Medicare	$2,995.31
Rate for Payer: Allen County Amish Medical Aid Commercial	$3,600.14
Rate for Payer: Amish Plain Church Group Commercial	$3,600.14
Rate for Payer: BCBS Complete	$1,654.34
Rate for Payer: BCBS MAPPO	$2,880.11
Rate for Payer: BCBS Trust/PPO	$1,234.36
Rate for Payer: BCN Medicare Advantage	$2,880.11
Rate for Payer: Health Alliance Plan Medicare Advantage	$2,880.11
Rate for Payer: Mclaren Medicaid	$1,575.42
Rate for Payer: Mclaren Medicare	$2,880.11
Rate for Payer: Meridian Medicaid	$1,654.34
Rate for Payer: Meridian Wellcare - Medicare Advantage	$3,024.12
Rate for Payer: MI Amish Medical Board Commercial	$3,312.13
Rate for Payer: PACE Medicare	$2,736.10
Rate for Payer: PACE SWMI	$2,880.11
Rate for Payer: PHP Medicare Advantage	$2,880.11
Rate for Payer: Priority Health Choice Medicaid	$1,575.42
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$8,925.64
Rate for Payer: Priority Health Medicare	$2,880.11
Rate for Payer: Priority Health Narrow Network	$7,140.51
Rate for Payer: Railroad Medicare Medicare	$2,880.11
Rate for Payer: UHC All Payor (Choice/PPO)	$648.34
Rate for Payer: UHC Core	$5,427.00
Rate for Payer: UHC Dual Complete DSNP	$2,880.11
Rate for Payer: UHC Exchange	$589.40
Rate for Payer: UHC Medicare Advantage	$2,966.51
Rate for Payer: VA VA	$2,880.11

CLINDAMYCIN 150 MG/ML INJECTION SOLUTION

Facility

$23.40

Service Code	HCPCS J0736
Hospital Charge Code	1743
Hospital Revenue Code	636
Min. Negotiated Rate	$14.74
Max. Negotiated Rate	$21.06
Rate for Payer: Aetna Commercial	$19.89
Rate for Payer: Aetna New Business (MI Preferred)	$15.21
Rate for Payer: Cash Price	$18.72
Rate for Payer: Cofinity Commercial	$16.38
Rate for Payer: Cofinity Commercial	$20.12
Rate for Payer: Healthscope Commercial	$21.06
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$19.89
Rate for Payer: PHP Commercial	$19.89
Rate for Payer: Priority Health Cigna Priority Health	$16.38
Rate for Payer: Priority Health SBD	$14.74

CLINDAMYCIN 2 % VAGINAL CREAM

Facility

$216.44

Service Code	NDC 0168-0277-40
Hospital Charge Code	9624
Hospital Revenue Code	637
Min. Negotiated Rate	$136.36
Max. Negotiated Rate	$194.80
Rate for Payer: Aetna Commercial	$183.97
Rate for Payer: Aetna New Business (MI Preferred)	$140.69
Rate for Payer: Cash Price	$173.15
Rate for Payer: Cofinity Commercial	$151.51
Rate for Payer: Cofinity Commercial	$186.14
Rate for Payer: Healthscope Commercial	$194.80
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$183.97
Rate for Payer: PHP Commercial	$183.97
Rate for Payer: Priority Health Cigna Priority Health	$151.51
Rate for Payer: Priority Health SBD	$136.36

CLINDAMYCIN 600 MG/50 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK

Facility

$20.03

Service Code	HCPCS J0737
Hospital Charge Code	183289
Hospital Revenue Code	636
Min. Negotiated Rate	$12.62
Max. Negotiated Rate	$18.03
Rate for Payer: Aetna Commercial	$17.03
Rate for Payer: Aetna Commercial	$23.59
Rate for Payer: Aetna New Business (MI Preferred)	$18.04
Rate for Payer: Aetna New Business (MI Preferred)	$13.02
Rate for Payer: Cash Price	$22.20
Rate for Payer: Cash Price	$16.02
Rate for Payer: Cofinity Commercial	$17.23
Rate for Payer: Cofinity Commercial	$14.02
Rate for Payer: Cofinity Commercial	$23.86
Rate for Payer: Cofinity Commercial	$19.42
Rate for Payer: Healthscope Commercial	$24.98
Rate for Payer: Healthscope Commercial	$18.03
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$23.59
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$17.03
Rate for Payer: PHP Commercial	$17.03
Rate for Payer: PHP Commercial	$23.59
Rate for Payer: Priority Health Cigna Priority Health	$19.42
Rate for Payer: Priority Health Cigna Priority Health	$14.02
Rate for Payer: Priority Health SBD	$12.62
Rate for Payer: Priority Health SBD	$17.48

CLINDAMYCIN 600 MG/50 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK

Facility

$34.49

Service Code	HCPCS J0736
Hospital Charge Code	183289
Hospital Revenue Code	636
Min. Negotiated Rate	$21.73
Max. Negotiated Rate	$31.04
Rate for Payer: Aetna Commercial	$29.32
Rate for Payer: Aetna New Business (MI Preferred)	$22.42
Rate for Payer: Cash Price	$27.59
Rate for Payer: Cofinity Commercial	$24.14
Rate for Payer: Cofinity Commercial	$29.66
Rate for Payer: Healthscope Commercial	$31.04
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$29.32
Rate for Payer: PHP Commercial	$29.32
Rate for Payer: Priority Health Cigna Priority Health	$24.14
Rate for Payer: Priority Health SBD	$21.73

CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK

Facility

$535.53

Service Code	NDC 0781-3289-91
Hospital Charge Code	9626
Hospital Revenue Code	250
Min. Negotiated Rate	$337.38
Max. Negotiated Rate	$481.98
Rate for Payer: Aetna Commercial	$455.20
Rate for Payer: Aetna New Business (MI Preferred)	$348.09
Rate for Payer: Cash Price	$428.42
Rate for Payer: Cofinity Commercial	$374.87
Rate for Payer: Cofinity Commercial	$460.56
Rate for Payer: Healthscope Commercial	$481.98
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$455.20
Rate for Payer: PHP Commercial	$455.20
Rate for Payer: Priority Health Cigna Priority Health	$374.87
Rate for Payer: Priority Health SBD	$337.38

CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK

Facility

$362.78

Service Code	NDC 0781-9221-09
Hospital Charge Code	9626
Hospital Revenue Code	250
Min. Negotiated Rate	$228.55
Max. Negotiated Rate	$326.50
Rate for Payer: Aetna Commercial	$308.36
Rate for Payer: Aetna New Business (MI Preferred)	$235.81
Rate for Payer: Cash Price	$290.22
Rate for Payer: Cofinity Commercial	$253.95
Rate for Payer: Cofinity Commercial	$311.99
Rate for Payer: Healthscope Commercial	$326.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$308.36
Rate for Payer: PHP Commercial	$308.36
Rate for Payer: Priority Health Cigna Priority Health	$253.95
Rate for Payer: Priority Health SBD	$228.55

CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK

Facility

$535.53

Service Code	NDC 0781-3289-09
Hospital Charge Code	9626
Hospital Revenue Code	250
Min. Negotiated Rate	$337.38
Max. Negotiated Rate	$481.98
Rate for Payer: Aetna Commercial	$455.20
Rate for Payer: Aetna New Business (MI Preferred)	$348.09
Rate for Payer: Cash Price	$428.42
Rate for Payer: Cofinity Commercial	$374.87
Rate for Payer: Cofinity Commercial	$460.56
Rate for Payer: Healthscope Commercial	$481.98
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$455.20
Rate for Payer: PHP Commercial	$455.20
Rate for Payer: Priority Health Cigna Priority Health	$374.87
Rate for Payer: Priority Health SBD	$337.38

CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK

Facility

$362.78

Service Code	NDC 0781-9221-91
Hospital Charge Code	9626
Hospital Revenue Code	250
Min. Negotiated Rate	$228.55
Max. Negotiated Rate	$326.50
Rate for Payer: Aetna Commercial	$308.36
Rate for Payer: Aetna New Business (MI Preferred)	$235.81
Rate for Payer: Cash Price	$290.22
Rate for Payer: Cofinity Commercial	$253.95
Rate for Payer: Cofinity Commercial	$311.99
Rate for Payer: Healthscope Commercial	$326.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$308.36
Rate for Payer: PHP Commercial	$308.36
Rate for Payer: Priority Health Cigna Priority Health	$253.95
Rate for Payer: Priority Health SBD	$228.55

CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK

Facility

$259.13

Service Code	HCPCS J0737
Hospital Charge Code	9626
Hospital Revenue Code	250
Min. Negotiated Rate	$163.25
Max. Negotiated Rate	$233.22
Rate for Payer: Aetna Commercial	$220.26
Rate for Payer: Aetna New Business (MI Preferred)	$168.43
Rate for Payer: Cash Price	$207.30
Rate for Payer: Cofinity Commercial	$181.39
Rate for Payer: Cofinity Commercial	$222.85
Rate for Payer: Healthscope Commercial	$233.22
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$220.26
Rate for Payer: PHP Commercial	$220.26
Rate for Payer: Priority Health Cigna Priority Health	$181.39
Rate for Payer: Priority Health SBD	$163.25

CLINDAMYCIN 600 MG/50 ML IVPB IN D5W OR NS CUSTOM

Facility

$34.49

Service Code	NDC 0781-3289-91
Hospital Charge Code	300021
Hospital Revenue Code	250
Min. Negotiated Rate	$21.73
Max. Negotiated Rate	$31.04
Rate for Payer: Aetna Commercial	$29.32
Rate for Payer: Aetna New Business (MI Preferred)	$22.42
Rate for Payer: Cash Price	$27.59
Rate for Payer: Cofinity Commercial	$24.14
Rate for Payer: Cofinity Commercial	$29.66
Rate for Payer: Healthscope Commercial	$31.04
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$29.32
Rate for Payer: PHP Commercial	$29.32
Rate for Payer: Priority Health Cigna Priority Health	$24.14
Rate for Payer: Priority Health SBD	$21.73

CLINDAMYCIN 600 MG/50 ML IVPB IN D5W OR NS CUSTOM

Facility

$34.49

Service Code	NDC 0781-3289-09
Hospital Charge Code	300021
Hospital Revenue Code	250
Min. Negotiated Rate	$21.73
Max. Negotiated Rate	$31.04
Rate for Payer: Aetna Commercial	$29.32
Rate for Payer: Aetna New Business (MI Preferred)	$22.42
Rate for Payer: Cash Price	$27.59
Rate for Payer: Cofinity Commercial	$24.14
Rate for Payer: Cofinity Commercial	$29.66
Rate for Payer: Healthscope Commercial	$31.04
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$29.32
Rate for Payer: PHP Commercial	$29.32
Rate for Payer: Priority Health Cigna Priority Health	$24.14
Rate for Payer: Priority Health SBD	$21.73

CLINDAMYCIN 600 MG/50 ML IVPB IN D5W OR NS CUSTOM

Facility

$27.75

Service Code	HCPCS J0737
Hospital Charge Code	300021
Hospital Revenue Code	250
Min. Negotiated Rate	$17.48
Max. Negotiated Rate	$24.98
Rate for Payer: Aetna Commercial	$23.59
Rate for Payer: Aetna New Business (MI Preferred)	$18.04
Rate for Payer: Cash Price	$22.20
Rate for Payer: Cofinity Commercial	$19.42
Rate for Payer: Cofinity Commercial	$23.86
Rate for Payer: Healthscope Commercial	$24.98
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$23.59
Rate for Payer: PHP Commercial	$23.59
Rate for Payer: Priority Health Cigna Priority Health	$19.42
Rate for Payer: Priority Health SBD	$17.48

CLINDAMYCIN 600 MG/50 ML IVPB IN D5W OR NS CUSTOM

Facility

$21.03

Service Code	NDC 9900-0001-57
Hospital Charge Code	300021
Hospital Revenue Code	250
Min. Negotiated Rate	$13.25
Max. Negotiated Rate	$18.93
Rate for Payer: Aetna Commercial	$17.88
Rate for Payer: Aetna New Business (MI Preferred)	$13.67
Rate for Payer: Cash Price	$16.82
Rate for Payer: Cofinity Commercial	$18.09
Rate for Payer: Cofinity Commercial	$14.72
Rate for Payer: Healthscope Commercial	$18.93
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$17.88
Rate for Payer: PHP Commercial	$17.88
Rate for Payer: Priority Health Cigna Priority Health	$14.72
Rate for Payer: Priority Health SBD	$13.25

CLINDAMYCIN 600 MG/50 ML IVPB IN D5W OR NS CUSTOM

Facility

$23.37

Service Code	NDC 0781-9221-09
Hospital Charge Code	300021
Hospital Revenue Code	250
Min. Negotiated Rate	$14.72
Max. Negotiated Rate	$21.03
Rate for Payer: Aetna Commercial	$19.86
Rate for Payer: Aetna New Business (MI Preferred)	$15.19
Rate for Payer: Cash Price	$18.70
Rate for Payer: Cofinity Commercial	$16.36
Rate for Payer: Cofinity Commercial	$20.10
Rate for Payer: Healthscope Commercial	$21.03
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$19.86
Rate for Payer: PHP Commercial	$19.86
Rate for Payer: Priority Health Cigna Priority Health	$16.36
Rate for Payer: Priority Health SBD	$14.72

Know your out-of-pocket cost for care.

All Charges