Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

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

CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION

Facility

$365.75

Service Code	NDC 59762-0016-1
Hospital Charge Code	37642
Hospital Revenue Code	637
Min. Negotiated Rate	$230.42
Max. Negotiated Rate	$329.18
Rate for Payer: Aetna Commercial	$310.89
Rate for Payer: Aetna New Business (MI Preferred)	$237.74
Rate for Payer: Cash Price	$292.60
Rate for Payer: Cofinity Commercial	$256.02
Rate for Payer: Cofinity Commercial	$314.54
Rate for Payer: Healthscope Commercial	$329.18
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$310.89
Rate for Payer: PHP Commercial	$310.89
Rate for Payer: Priority Health Cigna Priority Health	$256.02
Rate for Payer: Priority Health SBD	$230.42

CLINDAMYCIN 900 MG/50 ML IVPB IN D5W OR NS CUSTOM

Facility

$23.81

Service Code	HCPCS J0737
Hospital Charge Code	300022
Hospital Revenue Code	250
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$21.43
Rate for Payer: Aetna Commercial	$20.24
Rate for Payer: Aetna Commercial	$46.15
Rate for Payer: Aetna New Business (MI Preferred)	$35.29
Rate for Payer: Aetna New Business (MI Preferred)	$15.48
Rate for Payer: Cash Price	$19.05
Rate for Payer: Cash Price	$43.43
Rate for Payer: Cofinity Commercial	$38.00
Rate for Payer: Cofinity Commercial	$16.67
Rate for Payer: Cofinity Commercial	$20.48
Rate for Payer: Cofinity Commercial	$46.69
Rate for Payer: Healthscope Commercial	$21.43
Rate for Payer: Healthscope Commercial	$48.86
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$46.15
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$20.24
Rate for Payer: PHP Commercial	$20.24
Rate for Payer: PHP Commercial	$46.15
Rate for Payer: Priority Health Cigna Priority Health	$16.67
Rate for Payer: Priority Health Cigna Priority Health	$38.00
Rate for Payer: Priority Health SBD	$34.20
Rate for Payer: Priority Health SBD	$15.00

CLINDAMYCIN 900 MG/50 ML IVPB IN D5W OR NS CUSTOM

Facility

$16.28

Service Code	NDC 9900-0001-58
Hospital Charge Code	300022
Hospital Revenue Code	250
Min. Negotiated Rate	$10.26
Max. Negotiated Rate	$14.65
Rate for Payer: Aetna Commercial	$13.84
Rate for Payer: Aetna New Business (MI Preferred)	$10.58
Rate for Payer: Cash Price	$13.02
Rate for Payer: Cofinity Commercial	$11.40
Rate for Payer: Cofinity Commercial	$14.00
Rate for Payer: Healthscope Commercial	$14.65
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$13.84
Rate for Payer: PHP Commercial	$13.84
Rate for Payer: Priority Health Cigna Priority Health	$11.40
Rate for Payer: Priority Health SBD	$10.26

CLINDAMYCIN HCL 150 MG CAPSULE

Facility

$2.08

Service Code	NDC 68084-243-11
Hospital Charge Code	1740
Hospital Revenue Code	637
Min. Negotiated Rate	$1.31
Max. Negotiated Rate	$1.87
Rate for Payer: Aetna Commercial	$1.77
Rate for Payer: Aetna New Business (MI Preferred)	$1.35
Rate for Payer: Cash Price	$1.66
Rate for Payer: Cofinity Commercial	$1.46
Rate for Payer: Cofinity Commercial	$1.79
Rate for Payer: Healthscope Commercial	$1.87
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1.77
Rate for Payer: PHP Commercial	$1.77
Rate for Payer: Priority Health Cigna Priority Health	$1.46
Rate for Payer: Priority Health SBD	$1.31

CLINDAMYCIN HCL 150 MG CAPSULE

Facility

$336.05

Service Code	NDC 0904-5959-61
Hospital Charge Code	1740
Hospital Revenue Code	637
Min. Negotiated Rate	$211.71
Max. Negotiated Rate	$302.44
Rate for Payer: Aetna Commercial	$285.64
Rate for Payer: Aetna New Business (MI Preferred)	$218.43
Rate for Payer: Cash Price	$268.84
Rate for Payer: Cofinity Commercial	$235.24
Rate for Payer: Cofinity Commercial	$289.00
Rate for Payer: Healthscope Commercial	$302.44
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$285.64
Rate for Payer: PHP Commercial	$285.64
Rate for Payer: Priority Health Cigna Priority Health	$235.24
Rate for Payer: Priority Health SBD	$211.71

CLINDAMYCIN HCL 150 MG CAPSULE

Facility

$223.25

Service Code	NDC 63304-692-01
Hospital Charge Code	1740
Hospital Revenue Code	637
Min. Negotiated Rate	$140.65
Max. Negotiated Rate	$200.92
Rate for Payer: Aetna Commercial	$189.76
Rate for Payer: Aetna New Business (MI Preferred)	$145.11
Rate for Payer: Cash Price	$178.60
Rate for Payer: Cofinity Commercial	$156.28
Rate for Payer: Cofinity Commercial	$192.00
Rate for Payer: Healthscope Commercial	$200.92
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$189.76
Rate for Payer: PHP Commercial	$189.76
Rate for Payer: Priority Health Cigna Priority Health	$156.28
Rate for Payer: Priority Health SBD	$140.65

CLINDAMYCIN HCL 150 MG CAPSULE

Facility

$4.54

Service Code	NDC 42292-018-01
Hospital Charge Code	1740
Hospital Revenue Code	637
Min. Negotiated Rate	$2.86
Max. Negotiated Rate	$4.09
Rate for Payer: Aetna Commercial	$3.86
Rate for Payer: Aetna New Business (MI Preferred)	$2.95
Rate for Payer: Cash Price	$3.63
Rate for Payer: Cofinity Commercial	$3.18
Rate for Payer: Cofinity Commercial	$3.90
Rate for Payer: Healthscope Commercial	$4.09
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3.86
Rate for Payer: PHP Commercial	$3.86
Rate for Payer: Priority Health Cigna Priority Health	$3.18
Rate for Payer: Priority Health SBD	$2.86

CLINDAMYCIN HCL 150 MG CAPSULE

Facility

$441.80

Service Code	NDC 63739-059-10
Hospital Charge Code	1740
Hospital Revenue Code	637
Min. Negotiated Rate	$278.33
Max. Negotiated Rate	$397.62
Rate for Payer: Aetna Commercial	$375.53
Rate for Payer: Aetna New Business (MI Preferred)	$287.17
Rate for Payer: Cash Price	$353.44
Rate for Payer: Cofinity Commercial	$309.26
Rate for Payer: Cofinity Commercial	$379.95
Rate for Payer: Healthscope Commercial	$397.62
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$375.53
Rate for Payer: PHP Commercial	$375.53
Rate for Payer: Priority Health Cigna Priority Health	$309.26
Rate for Payer: Priority Health SBD	$278.33

CLINDAMYCIN HCL 150 MG CAPSULE

Facility

$207.10

Service Code	NDC 68084-243-01
Hospital Charge Code	1740
Hospital Revenue Code	637
Min. Negotiated Rate	$130.47
Max. Negotiated Rate	$186.39
Rate for Payer: Aetna Commercial	$176.04
Rate for Payer: Aetna New Business (MI Preferred)	$134.62
Rate for Payer: Cash Price	$165.68
Rate for Payer: Cofinity Commercial	$144.97
Rate for Payer: Cofinity Commercial	$178.11
Rate for Payer: Healthscope Commercial	$186.39
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$176.04
Rate for Payer: PHP Commercial	$176.04
Rate for Payer: Priority Health Cigna Priority Health	$144.97
Rate for Payer: Priority Health SBD	$130.47

CLINDAMYCIN HCL 150 MG CAPSULE

Facility

$453.55

Service Code	NDC 42292-018-20
Hospital Charge Code	1740
Hospital Revenue Code	637
Min. Negotiated Rate	$285.74
Max. Negotiated Rate	$408.20
Rate for Payer: Aetna Commercial	$385.52
Rate for Payer: Aetna New Business (MI Preferred)	$294.81
Rate for Payer: Cash Price	$362.84
Rate for Payer: Cofinity Commercial	$317.48
Rate for Payer: Cofinity Commercial	$390.05
Rate for Payer: Healthscope Commercial	$408.20
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$385.52
Rate for Payer: PHP Commercial	$385.52
Rate for Payer: Priority Health Cigna Priority Health	$317.48
Rate for Payer: Priority Health SBD	$285.74

CLOBAZAM 10 MG TABLET

Facility

$9,150.57

Service Code	NDC 67386-314-01
Hospital Charge Code	150910
Hospital Revenue Code	637
Min. Negotiated Rate	$5,764.86
Max. Negotiated Rate	$8,235.51
Rate for Payer: Aetna Commercial	$7,777.98
Rate for Payer: Aetna New Business (MI Preferred)	$5,947.87
Rate for Payer: Cash Price	$7,320.46
Rate for Payer: Cofinity Commercial	$6,405.40
Rate for Payer: Cofinity Commercial	$7,869.49
Rate for Payer: Healthscope Commercial	$8,235.51
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$7,777.98
Rate for Payer: PHP Commercial	$7,777.98
Rate for Payer: Priority Health Cigna Priority Health	$6,405.40
Rate for Payer: Priority Health SBD	$5,764.86

CLOBETASOL 0.05 % TOPICAL CREAM

Facility

$130.20

Service Code	NDC 51672-1258-3
Hospital Charge Code	9630
Hospital Revenue Code	637
Min. Negotiated Rate	$82.03
Max. Negotiated Rate	$117.18
Rate for Payer: Aetna Commercial	$110.67
Rate for Payer: Aetna New Business (MI Preferred)	$84.63
Rate for Payer: Cash Price	$104.16
Rate for Payer: Cofinity Commercial	$111.97
Rate for Payer: Cofinity Commercial	$91.14
Rate for Payer: Healthscope Commercial	$117.18
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$110.67
Rate for Payer: PHP Commercial	$110.67
Rate for Payer: Priority Health Cigna Priority Health	$91.14
Rate for Payer: Priority Health SBD	$82.03

CLOBETASOL 0.05 % TOPICAL CREAM

Facility

$18.84

Service Code	NDC 69238-1532-5
Hospital Charge Code	9630
Hospital Revenue Code	637
Min. Negotiated Rate	$11.87
Max. Negotiated Rate	$16.96
Rate for Payer: Aetna Commercial	$16.01
Rate for Payer: Aetna New Business (MI Preferred)	$12.25
Rate for Payer: Cash Price	$15.07
Rate for Payer: Cofinity Commercial	$13.19
Rate for Payer: Cofinity Commercial	$16.20
Rate for Payer: Healthscope Commercial	$16.96
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$16.01
Rate for Payer: PHP Commercial	$16.01
Rate for Payer: Priority Health Cigna Priority Health	$13.19
Rate for Payer: Priority Health SBD	$11.87

CLOBETASOL 0.05 % TOPICAL CREAM

Facility

$32.55

Service Code	NDC 51672-1258-1
Hospital Charge Code	9630
Hospital Revenue Code	637
Min. Negotiated Rate	$20.51
Max. Negotiated Rate	$29.30
Rate for Payer: Aetna Commercial	$27.67
Rate for Payer: Aetna New Business (MI Preferred)	$21.16
Rate for Payer: Cash Price	$26.04
Rate for Payer: Cofinity Commercial	$22.78
Rate for Payer: Cofinity Commercial	$27.99
Rate for Payer: Healthscope Commercial	$29.30
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$27.67
Rate for Payer: PHP Commercial	$27.67
Rate for Payer: Priority Health Cigna Priority Health	$22.78
Rate for Payer: Priority Health SBD	$20.51

CLOBETASOL 0.05 % TOPICAL CREAM

Facility

$52.61

Service Code	NDC 0168-0163-15
Hospital Charge Code	9630
Hospital Revenue Code	637
Min. Negotiated Rate	$33.14
Max. Negotiated Rate	$47.35
Rate for Payer: Aetna Commercial	$44.72
Rate for Payer: Aetna New Business (MI Preferred)	$34.20
Rate for Payer: Cash Price	$42.09
Rate for Payer: Cofinity Commercial	$36.83
Rate for Payer: Cofinity Commercial	$45.24
Rate for Payer: Healthscope Commercial	$47.35
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$44.72
Rate for Payer: PHP Commercial	$44.72
Rate for Payer: Priority Health Cigna Priority Health	$36.83
Rate for Payer: Priority Health SBD	$33.14

CLONAZEPAM 0.5 MG TABLET

Facility

$64.75

Service Code	NDC 43547-406-10
Hospital Charge Code	9637
Hospital Revenue Code	637
Min. Negotiated Rate	$40.79
Max. Negotiated Rate	$58.28
Rate for Payer: Aetna Commercial	$55.04
Rate for Payer: Aetna New Business (MI Preferred)	$42.09
Rate for Payer: Cash Price	$51.80
Rate for Payer: Cofinity Commercial	$45.32
Rate for Payer: Cofinity Commercial	$55.68
Rate for Payer: Healthscope Commercial	$58.28
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$55.04
Rate for Payer: PHP Commercial	$55.04
Rate for Payer: Priority Health Cigna Priority Health	$45.32
Rate for Payer: Priority Health SBD	$40.79

CLONAZEPAM 0.5 MG TABLET

Facility

$82.25

Service Code	NDC 63739-263-10
Hospital Charge Code	9637
Hospital Revenue Code	637
Min. Negotiated Rate	$51.82
Max. Negotiated Rate	$74.02
Rate for Payer: Aetna Commercial	$69.91
Rate for Payer: Aetna New Business (MI Preferred)	$53.46
Rate for Payer: Cash Price	$65.80
Rate for Payer: Cofinity Commercial	$57.58
Rate for Payer: Cofinity Commercial	$70.74
Rate for Payer: Healthscope Commercial	$74.02
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$69.91
Rate for Payer: PHP Commercial	$69.91
Rate for Payer: Priority Health Cigna Priority Health	$57.58
Rate for Payer: Priority Health SBD	$51.82

CLONAZEPAM 1 MG TABLET

Facility

$1,058.85

Service Code	NDC 0004-0058-01
Hospital Charge Code	9638
Hospital Revenue Code	637
Min. Negotiated Rate	$667.08
Max. Negotiated Rate	$952.96
Rate for Payer: Aetna Commercial	$900.02
Rate for Payer: Aetna New Business (MI Preferred)	$688.25
Rate for Payer: Cash Price	$847.08
Rate for Payer: Cofinity Commercial	$741.20
Rate for Payer: Cofinity Commercial	$910.61
Rate for Payer: Healthscope Commercial	$952.96
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$900.02
Rate for Payer: PHP Commercial	$900.02
Rate for Payer: Priority Health Cigna Priority Health	$741.20
Rate for Payer: Priority Health SBD	$667.08

CLONAZEPAM 1 MG TABLET

Facility

$147.00

Service Code	NDC 0781-5567-01
Hospital Charge Code	9638
Hospital Revenue Code	637
Min. Negotiated Rate	$92.61
Max. Negotiated Rate	$132.30
Rate for Payer: Aetna Commercial	$124.95
Rate for Payer: Aetna New Business (MI Preferred)	$95.55
Rate for Payer: Cash Price	$117.60
Rate for Payer: Cofinity Commercial	$102.90
Rate for Payer: Cofinity Commercial	$126.42
Rate for Payer: Healthscope Commercial	$132.30
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$124.95
Rate for Payer: PHP Commercial	$124.95
Rate for Payer: Priority Health Cigna Priority Health	$102.90
Rate for Payer: Priority Health SBD	$92.61

CLONAZEPAM 1 MG TABLET

Facility

$84.00

Service Code	NDC 43547-407-10
Hospital Charge Code	9638
Hospital Revenue Code	637
Min. Negotiated Rate	$52.92
Max. Negotiated Rate	$75.60
Rate for Payer: Aetna Commercial	$71.40
Rate for Payer: Aetna New Business (MI Preferred)	$54.60
Rate for Payer: Cash Price	$67.20
Rate for Payer: Cofinity Commercial	$58.80
Rate for Payer: Cofinity Commercial	$72.24
Rate for Payer: Healthscope Commercial	$75.60
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$71.40
Rate for Payer: PHP Commercial	$71.40
Rate for Payer: Priority Health Cigna Priority Health	$58.80
Rate for Payer: Priority Health SBD	$52.92

CLONAZEPAM 1 MG TABLET

Facility

$1.47

Service Code	NDC 51079-882-01
Hospital Charge Code	9638
Hospital Revenue Code	637
Min. Negotiated Rate	$0.93
Max. Negotiated Rate	$1.32
Rate for Payer: Aetna Commercial	$1.25
Rate for Payer: Aetna New Business (MI Preferred)	$0.96
Rate for Payer: Cash Price	$1.18
Rate for Payer: Cofinity Commercial	$1.03
Rate for Payer: Cofinity Commercial	$1.26
Rate for Payer: Healthscope Commercial	$1.32
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1.25
Rate for Payer: PHP Commercial	$1.25
Rate for Payer: Priority Health Cigna Priority Health	$1.03
Rate for Payer: Priority Health SBD	$0.93

CLONAZEPAM 1 MG TABLET

Facility

$147.00

Service Code	NDC 51079-882-20
Hospital Charge Code	9638
Hospital Revenue Code	637
Min. Negotiated Rate	$92.61
Max. Negotiated Rate	$132.30
Rate for Payer: Aetna Commercial	$124.95
Rate for Payer: Aetna New Business (MI Preferred)	$95.55
Rate for Payer: Cash Price	$117.60
Rate for Payer: Cofinity Commercial	$102.90
Rate for Payer: Cofinity Commercial	$126.42
Rate for Payer: Healthscope Commercial	$132.30
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$124.95
Rate for Payer: PHP Commercial	$124.95
Rate for Payer: Priority Health Cigna Priority Health	$102.90
Rate for Payer: Priority Health SBD	$92.61

CLONAZEPAM 2 MG TABLET

Facility

$1.47

Service Code	NDC 51079-883-01
Hospital Charge Code	9639
Hospital Revenue Code	637
Min. Negotiated Rate	$0.93
Max. Negotiated Rate	$1.32
Rate for Payer: Aetna Commercial	$1.25
Rate for Payer: Aetna New Business (MI Preferred)	$0.96
Rate for Payer: Cash Price	$1.18
Rate for Payer: Cofinity Commercial	$1.03
Rate for Payer: Cofinity Commercial	$1.26
Rate for Payer: Healthscope Commercial	$1.32
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1.25
Rate for Payer: PHP Commercial	$1.25
Rate for Payer: Priority Health Cigna Priority Health	$1.03
Rate for Payer: Priority Health SBD	$0.93

CLONAZEPAM 2 MG TABLET

Facility

$147.00

Service Code	NDC 51079-883-20
Hospital Charge Code	9639
Hospital Revenue Code	637
Min. Negotiated Rate	$92.61
Max. Negotiated Rate	$132.30
Rate for Payer: Aetna Commercial	$124.95
Rate for Payer: Aetna New Business (MI Preferred)	$95.55
Rate for Payer: Cash Price	$117.60
Rate for Payer: Cofinity Commercial	$102.90
Rate for Payer: Cofinity Commercial	$126.42
Rate for Payer: Healthscope Commercial	$132.30
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$124.95
Rate for Payer: PHP Commercial	$124.95
Rate for Payer: Priority Health Cigna Priority Health	$102.90
Rate for Payer: Priority Health SBD	$92.61

Know your out-of-pocket cost for care.

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