Bronson Battle Creek

All Charges

Charge

Type

Price

ALLOPURINOL 100 MG TABLET

Facility IP

$277.40

Service Code	NDC 0591-5543-01
Hospital Charge Code	310
Hospital Revenue Code	637
Min. Negotiated Rate	$174.76
Max. Negotiated Rate	$249.66
Rate for Payer: Aetna Commercial	$235.79
Rate for Payer: Aetna New Business (MI Preferred)	$180.31
Rate for Payer: Cash Price	$221.92
Rate for Payer: Cofinity Commercial	$194.18
Rate for Payer: Cofinity Commercial	$238.56
Rate for Payer: Healthscope Commercial	$249.66
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$235.79
Rate for Payer: PHP Commercial	$235.79
Rate for Payer: Priority Health Cigna Priority Health	$194.18
Rate for Payer: Priority Health SBD	$174.76

ALLOPURINOL 100 MG TABLET

Facility IP

$171.55

Service Code	NDC 55111-729-01
Hospital Charge Code	310
Hospital Revenue Code	637
Min. Negotiated Rate	$108.08
Max. Negotiated Rate	$154.40
Rate for Payer: Aetna Commercial	$145.82
Rate for Payer: Aetna New Business (MI Preferred)	$111.51
Rate for Payer: Cash Price	$137.24
Rate for Payer: Cofinity Commercial	$120.08
Rate for Payer: Cofinity Commercial	$147.53
Rate for Payer: Healthscope Commercial	$154.40
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$145.82
Rate for Payer: PHP Commercial	$145.82
Rate for Payer: Priority Health Cigna Priority Health	$120.08
Rate for Payer: Priority Health SBD	$108.08

ALLOPURINOL 300 MG TABLET

Facility IP

$458.25

Service Code	NDC 70710-1210-1
Hospital Charge Code	311
Hospital Revenue Code	637
Min. Negotiated Rate	$288.70
Max. Negotiated Rate	$412.42
Rate for Payer: Aetna Commercial	$389.51
Rate for Payer: Aetna New Business (MI Preferred)	$297.86
Rate for Payer: Cash Price	$366.60
Rate for Payer: Cofinity Commercial	$320.78
Rate for Payer: Cofinity Commercial	$394.10
Rate for Payer: Healthscope Commercial	$412.42
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$389.51
Rate for Payer: PHP Commercial	$389.51
Rate for Payer: Priority Health Cigna Priority Health	$320.78
Rate for Payer: Priority Health SBD	$288.70

ALLOPURINOL 300 MG TABLET

Facility IP

$325.85

Service Code	NDC 0904-6572-61
Hospital Charge Code	311
Hospital Revenue Code	637
Min. Negotiated Rate	$205.29
Max. Negotiated Rate	$293.26
Rate for Payer: Aetna Commercial	$276.97
Rate for Payer: Aetna New Business (MI Preferred)	$211.80
Rate for Payer: Cash Price	$260.68
Rate for Payer: Cofinity Commercial	$228.10
Rate for Payer: Cofinity Commercial	$280.23
Rate for Payer: Healthscope Commercial	$293.26
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$276.97
Rate for Payer: PHP Commercial	$276.97
Rate for Payer: Priority Health Cigna Priority Health	$228.10
Rate for Payer: Priority Health SBD	$205.29

ALLOPURINOL 300 MG TABLET

Facility IP

$240.96

Service Code	NDC 62584-713-01
Hospital Charge Code	311
Hospital Revenue Code	637
Min. Negotiated Rate	$151.80
Max. Negotiated Rate	$216.86
Rate for Payer: Aetna Commercial	$204.82
Rate for Payer: Aetna New Business (MI Preferred)	$156.62
Rate for Payer: Cash Price	$192.77
Rate for Payer: Cofinity Commercial	$168.67
Rate for Payer: Cofinity Commercial	$207.23
Rate for Payer: Healthscope Commercial	$216.86
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$204.82
Rate for Payer: PHP Commercial	$204.82
Rate for Payer: Priority Health Cigna Priority Health	$168.67
Rate for Payer: Priority Health SBD	$151.80

ALLOPURINOL 300 MG TABLET

Facility IP

$2.41

Service Code	NDC 62584-713-11
Hospital Charge Code	311
Hospital Revenue Code	637
Min. Negotiated Rate	$1.52
Max. Negotiated Rate	$2.17
Rate for Payer: Aetna Commercial	$2.05
Rate for Payer: Aetna New Business (MI Preferred)	$1.57
Rate for Payer: Cash Price	$1.93
Rate for Payer: Cofinity Commercial	$1.69
Rate for Payer: Cofinity Commercial	$2.07
Rate for Payer: Healthscope Commercial	$2.17
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2.05
Rate for Payer: PHP Commercial	$2.05
Rate for Payer: Priority Health Cigna Priority Health	$1.69
Rate for Payer: Priority Health SBD	$1.52

ALLOPURINOL 300 MG TABLET

Facility IP

$273.60

Service Code	NDC 0603-2116-21
Hospital Charge Code	311
Hospital Revenue Code	637
Min. Negotiated Rate	$172.37
Max. Negotiated Rate	$246.24
Rate for Payer: Aetna Commercial	$232.56
Rate for Payer: Aetna New Business (MI Preferred)	$177.84
Rate for Payer: Cash Price	$218.88
Rate for Payer: Cofinity Commercial	$191.52
Rate for Payer: Cofinity Commercial	$235.30
Rate for Payer: Healthscope Commercial	$246.24
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$232.56
Rate for Payer: PHP Commercial	$232.56
Rate for Payer: Priority Health Cigna Priority Health	$191.52
Rate for Payer: Priority Health SBD	$172.37

ALOE VERA-COLLAGEN TOPICAL FOAM

Facility IP

$28.09

Service Code	NDC 6845510841
Hospital Charge Code	108259
Hospital Revenue Code	637
Min. Negotiated Rate	$17.70
Max. Negotiated Rate	$25.28
Rate for Payer: Aetna Commercial	$23.88
Rate for Payer: Aetna New Business (MI Preferred)	$18.26
Rate for Payer: Cash Price	$22.47
Rate for Payer: Cofinity Commercial	$19.66
Rate for Payer: Cofinity Commercial	$24.16
Rate for Payer: Healthscope Commercial	$25.28
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$23.88
Rate for Payer: PHP Commercial	$23.88
Rate for Payer: Priority Health Cigna Priority Health	$19.66
Rate for Payer: Priority Health SBD	$17.70

ALOE VERA-SOAP

Facility IP

$9.21

Service Code	NDC 6845510835
Hospital Charge Code	114141
Hospital Revenue Code	637
Min. Negotiated Rate	$5.80
Max. Negotiated Rate	$8.29
Rate for Payer: Aetna Commercial	$7.83
Rate for Payer: Aetna New Business (MI Preferred)	$5.99
Rate for Payer: Cash Price	$7.37
Rate for Payer: Cofinity Commercial	$6.45
Rate for Payer: Cofinity Commercial	$7.92
Rate for Payer: Healthscope Commercial	$8.29
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$7.83
Rate for Payer: PHP Commercial	$7.83
Rate for Payer: Priority Health Cigna Priority Health	$6.45
Rate for Payer: Priority Health SBD	$5.80

ALPHA-1-PROTEINASE INHIBITOR (HUMAN) 1,000 MG (+/-)/20 ML IV SOLUTION

Facility IP

$1.48

Service Code	HCPCS J0256
Hospital Charge Code	185673
Hospital Revenue Code	636
Min. Negotiated Rate	$0.93
Max. Negotiated Rate	$1.33
Rate for Payer: Aetna Commercial	$1.26
Rate for Payer: Aetna New Business (MI Preferred)	$0.96
Rate for Payer: Cash Price	$1.18
Rate for Payer: Cofinity Commercial	$1.04
Rate for Payer: Cofinity Commercial	$1.27
Rate for Payer: Healthscope Commercial	$1.33
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1.26
Rate for Payer: PHP Commercial	$1.26
Rate for Payer: Priority Health Cigna Priority Health	$1.04
Rate for Payer: Priority Health SBD	$0.93

ALPRAZOLAM 0.25 MG TABLET

Facility IP

$105.00

Service Code	NDC 51079-788-20
Hospital Charge Code	324
Hospital Revenue Code	637
Min. Negotiated Rate	$66.15
Max. Negotiated Rate	$94.50
Rate for Payer: Aetna Commercial	$89.25
Rate for Payer: Aetna New Business (MI Preferred)	$68.25
Rate for Payer: Cash Price	$84.00
Rate for Payer: Cofinity Commercial	$73.50
Rate for Payer: Cofinity Commercial	$90.30
Rate for Payer: Healthscope Commercial	$94.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$89.25
Rate for Payer: PHP Commercial	$89.25
Rate for Payer: Priority Health Cigna Priority Health	$73.50
Rate for Payer: Priority Health SBD	$66.15

ALPRAZOLAM 0.25 MG TABLET

Facility OP

$57.75

Service Code	NDC 59762-3719-1
Hospital Charge Code	324
Hospital Revenue Code	637
Min. Negotiated Rate	$23.10
Max. Negotiated Rate	$51.98
Rate for Payer: Aetna Commercial	$49.09
Rate for Payer: Aetna New Business (MI Preferred)	$37.54
Rate for Payer: BCBS Complete	$23.10
Rate for Payer: Cash Price	$46.20
Rate for Payer: Cofinity Commercial	$40.42
Rate for Payer: Cofinity Commercial	$49.66
Rate for Payer: Healthscope Commercial	$51.98
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$49.09
Rate for Payer: PHP Commercial	$49.09
Rate for Payer: Priority Health Cigna Priority Health	$40.42
Rate for Payer: Priority Health SBD	$36.38

ALPRAZOLAM 0.25 MG TABLET

Facility IP

$64.75

Service Code	NDC 65862-676-01
Hospital Charge Code	324
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

ALPRAZOLAM 0.25 MG TABLET

Facility IP

$1.05

Service Code	NDC 51079-788-01
Hospital Charge Code	324
Hospital Revenue Code	637
Min. Negotiated Rate	$0.66
Max. Negotiated Rate	$0.95
Rate for Payer: Aetna Commercial	$0.89
Rate for Payer: Aetna New Business (MI Preferred)	$0.68
Rate for Payer: Cash Price	$0.84
Rate for Payer: Cofinity Commercial	$0.74
Rate for Payer: Cofinity Commercial	$0.90
Rate for Payer: Healthscope Commercial	$0.95
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$0.89
Rate for Payer: PHP Commercial	$0.89
Rate for Payer: Priority Health Cigna Priority Health	$0.74
Rate for Payer: Priority Health SBD	$0.66

ALPRAZOLAM 0.25 MG TABLET

Facility IP

$57.75

Service Code	NDC 59762-3719-1
Hospital Charge Code	324
Hospital Revenue Code	637
Min. Negotiated Rate	$36.38
Max. Negotiated Rate	$51.98
Rate for Payer: Aetna Commercial	$49.09
Rate for Payer: Aetna New Business (MI Preferred)	$37.54
Rate for Payer: Cash Price	$46.20
Rate for Payer: Cofinity Commercial	$40.42
Rate for Payer: Cofinity Commercial	$49.66
Rate for Payer: Healthscope Commercial	$51.98
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$49.09
Rate for Payer: PHP Commercial	$49.09
Rate for Payer: Priority Health Cigna Priority Health	$40.42
Rate for Payer: Priority Health SBD	$36.38

ALPRAZOLAM 0.25 MG TABLET

Facility IP

$47.25

Service Code	NDC 0781-1061-01
Hospital Charge Code	324
Hospital Revenue Code	637
Min. Negotiated Rate	$29.77
Max. Negotiated Rate	$42.52
Rate for Payer: Aetna Commercial	$40.16
Rate for Payer: Aetna New Business (MI Preferred)	$30.71
Rate for Payer: Cash Price	$37.80
Rate for Payer: Cofinity Commercial	$33.08
Rate for Payer: Cofinity Commercial	$40.64
Rate for Payer: Healthscope Commercial	$42.52
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$40.16
Rate for Payer: PHP Commercial	$40.16
Rate for Payer: Priority Health Cigna Priority Health	$33.08
Rate for Payer: Priority Health SBD	$29.77

ALPRAZOLAM 0.25 MG TABLET

Facility IP

$80.50

Service Code	NDC 0228-2027-10
Hospital Charge Code	324
Hospital Revenue Code	637
Min. Negotiated Rate	$50.72
Max. Negotiated Rate	$72.45
Rate for Payer: Aetna Commercial	$68.42
Rate for Payer: Aetna New Business (MI Preferred)	$52.32
Rate for Payer: Cash Price	$64.40
Rate for Payer: Cofinity Commercial	$56.35
Rate for Payer: Cofinity Commercial	$69.23
Rate for Payer: Healthscope Commercial	$72.45
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$68.42
Rate for Payer: PHP Commercial	$68.42
Rate for Payer: Priority Health Cigna Priority Health	$56.35
Rate for Payer: Priority Health SBD	$50.72

ALPRAZOLAM 0.25 MG TABLET

Facility IP

$54.25

Service Code	NDC 51991-704-01
Hospital Charge Code	324
Hospital Revenue Code	637
Min. Negotiated Rate	$34.18
Max. Negotiated Rate	$48.82
Rate for Payer: Aetna Commercial	$46.11
Rate for Payer: Aetna New Business (MI Preferred)	$35.26
Rate for Payer: Cash Price	$43.40
Rate for Payer: Cofinity Commercial	$37.98
Rate for Payer: Cofinity Commercial	$46.66
Rate for Payer: Healthscope Commercial	$48.82
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$46.11
Rate for Payer: PHP Commercial	$46.11
Rate for Payer: Priority Health Cigna Priority Health	$37.98
Rate for Payer: Priority Health SBD	$34.18

ALPRAZOLAM 0.5 MG TABLET

Facility IP

$92.75

Service Code	NDC 51079-789-20
Hospital Charge Code	325
Hospital Revenue Code	637
Min. Negotiated Rate	$58.43
Max. Negotiated Rate	$83.48
Rate for Payer: Aetna Commercial	$78.84
Rate for Payer: Aetna New Business (MI Preferred)	$60.29
Rate for Payer: Cash Price	$74.20
Rate for Payer: Cofinity Commercial	$64.92
Rate for Payer: Cofinity Commercial	$79.76
Rate for Payer: Healthscope Commercial	$83.48
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$78.84
Rate for Payer: PHP Commercial	$78.84
Rate for Payer: Priority Health Cigna Priority Health	$64.92
Rate for Payer: Priority Health SBD	$58.43

ALPRAZOLAM 0.5 MG TABLET

Facility IP

$56.00

Service Code	NDC 0781-1077-01
Hospital Charge Code	325
Hospital Revenue Code	637
Min. Negotiated Rate	$35.28
Max. Negotiated Rate	$50.40
Rate for Payer: Aetna Commercial	$47.60
Rate for Payer: Aetna New Business (MI Preferred)	$36.40
Rate for Payer: Cash Price	$44.80
Rate for Payer: Cofinity Commercial	$39.20
Rate for Payer: Cofinity Commercial	$48.16
Rate for Payer: Healthscope Commercial	$50.40
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$47.60
Rate for Payer: PHP Commercial	$47.60
Rate for Payer: Priority Health Cigna Priority Health	$39.20
Rate for Payer: Priority Health SBD	$35.28

ALPRAZOLAM 0.5 MG TABLET

Facility IP

$0.93

Service Code	NDC 51079-789-01
Hospital Charge Code	325
Hospital Revenue Code	637
Min. Negotiated Rate	$0.59
Max. Negotiated Rate	$0.84
Rate for Payer: Aetna Commercial	$0.79
Rate for Payer: Aetna New Business (MI Preferred)	$0.60
Rate for Payer: Cash Price	$0.74
Rate for Payer: Cofinity Commercial	$0.80
Rate for Payer: Cofinity Commercial	$0.65
Rate for Payer: Healthscope Commercial	$0.84
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$0.79
Rate for Payer: PHP Commercial	$0.79
Rate for Payer: Priority Health Cigna Priority Health	$0.65
Rate for Payer: Priority Health SBD	$0.59

ALPRAZOLAM 0.5 MG TABLET

Facility IP

$68.25

Service Code	NDC 51991-705-01
Hospital Charge Code	325
Hospital Revenue Code	637
Min. Negotiated Rate	$43.00
Max. Negotiated Rate	$61.42
Rate for Payer: Aetna Commercial	$58.01
Rate for Payer: Aetna New Business (MI Preferred)	$44.36
Rate for Payer: Cash Price	$54.60
Rate for Payer: Cofinity Commercial	$47.78
Rate for Payer: Cofinity Commercial	$58.70
Rate for Payer: Healthscope Commercial	$61.42
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$58.01
Rate for Payer: PHP Commercial	$58.01
Rate for Payer: Priority Health Cigna Priority Health	$47.78
Rate for Payer: Priority Health SBD	$43.00

ALPRAZOLAM 1 MG TABLET

Facility IP

$136.30

Service Code	NDC 51079-790-20
Hospital Charge Code	326
Hospital Revenue Code	637
Min. Negotiated Rate	$85.87
Max. Negotiated Rate	$122.67
Rate for Payer: Aetna Commercial	$115.86
Rate for Payer: Aetna New Business (MI Preferred)	$88.60
Rate for Payer: Cash Price	$109.04
Rate for Payer: Cofinity Commercial	$117.22
Rate for Payer: Cofinity Commercial	$95.41
Rate for Payer: Healthscope Commercial	$122.67
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$115.86
Rate for Payer: PHP Commercial	$115.86
Rate for Payer: Priority Health Cigna Priority Health	$95.41
Rate for Payer: Priority Health SBD	$85.87

ALPRAZOLAM 1 MG TABLET

Facility IP

$1.37

Service Code	NDC 51079-790-01
Hospital Charge Code	326
Hospital Revenue Code	637
Min. Negotiated Rate	$0.86
Max. Negotiated Rate	$1.23
Rate for Payer: Aetna Commercial	$1.16
Rate for Payer: Aetna New Business (MI Preferred)	$0.89
Rate for Payer: Cash Price	$1.10
Rate for Payer: Cofinity Commercial	$0.96
Rate for Payer: Cofinity Commercial	$1.18
Rate for Payer: Healthscope Commercial	$1.23
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1.16
Rate for Payer: PHP Commercial	$1.16
Rate for Payer: Priority Health Cigna Priority Health	$0.96
Rate for Payer: Priority Health SBD	$0.86

ALTEPLASE 100 MG INTRAVENOUS SOLUTION

Facility IP

$28,836.00

Service Code	HCPCS J2997
Hospital Charge Code	9002
Hospital Revenue Code	636
Min. Negotiated Rate	$18,166.68
Max. Negotiated Rate	$25,952.40
Rate for Payer: Aetna Commercial	$24,510.60
Rate for Payer: Aetna New Business (MI Preferred)	$18,743.40
Rate for Payer: Cash Price	$23,068.80
Rate for Payer: Cofinity Commercial	$20,185.20
Rate for Payer: Cofinity Commercial	$24,798.96
Rate for Payer: Healthscope Commercial	$25,952.40
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$24,510.60
Rate for Payer: PHP Commercial	$24,510.60
Rate for Payer: Priority Health Cigna Priority Health	$20,185.20
Rate for Payer: Priority Health SBD	$18,166.68

Price Transparency.

All Charges