Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

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

CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH

Facility

$118.67

Service Code	NDC 0378-0871-99
Hospital Charge Code	27505
Hospital Revenue Code	637
Min. Negotiated Rate	$74.76
Max. Negotiated Rate	$106.80
Rate for Payer: Aetna Commercial	$100.87
Rate for Payer: Aetna New Business (MI Preferred)	$77.14
Rate for Payer: Cash Price	$94.94
Rate for Payer: Cofinity Commercial	$102.06
Rate for Payer: Cofinity Commercial	$83.07
Rate for Payer: Healthscope Commercial	$106.80
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$100.87
Rate for Payer: PHP Commercial	$100.87
Rate for Payer: Priority Health Cigna Priority Health	$83.07
Rate for Payer: Priority Health SBD	$74.76

CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH

Facility

$29.67

Service Code	NDC 0378-0871-16
Hospital Charge Code	27505
Hospital Revenue Code	637
Min. Negotiated Rate	$18.69
Max. Negotiated Rate	$26.70
Rate for Payer: Aetna Commercial	$25.22
Rate for Payer: Aetna New Business (MI Preferred)	$19.29
Rate for Payer: Cash Price	$23.74
Rate for Payer: Cofinity Commercial	$20.77
Rate for Payer: Cofinity Commercial	$25.52
Rate for Payer: Healthscope Commercial	$26.70
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$25.22
Rate for Payer: PHP Commercial	$25.22
Rate for Payer: Priority Health Cigna Priority Health	$20.77
Rate for Payer: Priority Health SBD	$18.69

CLONIDINE 0.2 MG/24 HR WEEKLY TRANSDERMAL PATCH

Facility

$198.44

Service Code	NDC 0378-0872-99
Hospital Charge Code	27506
Hospital Revenue Code	637
Min. Negotiated Rate	$125.02
Max. Negotiated Rate	$178.60
Rate for Payer: Aetna Commercial	$168.67
Rate for Payer: Aetna New Business (MI Preferred)	$128.99
Rate for Payer: Cash Price	$158.75
Rate for Payer: Cofinity Commercial	$138.91
Rate for Payer: Cofinity Commercial	$170.66
Rate for Payer: Healthscope Commercial	$178.60
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$168.67
Rate for Payer: PHP Commercial	$168.67
Rate for Payer: Priority Health Cigna Priority Health	$138.91
Rate for Payer: Priority Health SBD	$125.02

CLONIDINE 0.2 MG/24 HR WEEKLY TRANSDERMAL PATCH

Facility

$49.61

Service Code	NDC 0378-0872-16
Hospital Charge Code	27506
Hospital Revenue Code	637
Min. Negotiated Rate	$31.25
Max. Negotiated Rate	$44.65
Rate for Payer: Aetna Commercial	$42.17
Rate for Payer: Aetna New Business (MI Preferred)	$32.25
Rate for Payer: Cash Price	$39.69
Rate for Payer: Cofinity Commercial	$34.73
Rate for Payer: Cofinity Commercial	$42.66
Rate for Payer: Healthscope Commercial	$44.65
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$42.17
Rate for Payer: PHP Commercial	$42.17
Rate for Payer: Priority Health Cigna Priority Health	$34.73
Rate for Payer: Priority Health SBD	$31.25

CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH

Facility

$63.66

Service Code	NDC 0378-0873-16
Hospital Charge Code	27507
Hospital Revenue Code	637
Min. Negotiated Rate	$40.11
Max. Negotiated Rate	$57.29
Rate for Payer: Aetna Commercial	$54.11
Rate for Payer: Aetna New Business (MI Preferred)	$41.38
Rate for Payer: Cash Price	$50.93
Rate for Payer: Cofinity Commercial	$54.75
Rate for Payer: Cofinity Commercial	$44.56
Rate for Payer: Healthscope Commercial	$57.29
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$54.11
Rate for Payer: PHP Commercial	$54.11
Rate for Payer: Priority Health Cigna Priority Health	$44.56
Rate for Payer: Priority Health SBD	$40.11

CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH

Facility

$254.64

Service Code	NDC 0378-0873-99
Hospital Charge Code	27507
Hospital Revenue Code	637
Min. Negotiated Rate	$160.42
Max. Negotiated Rate	$229.18
Rate for Payer: Aetna Commercial	$216.44
Rate for Payer: Aetna New Business (MI Preferred)	$165.52
Rate for Payer: Cash Price	$203.71
Rate for Payer: Cofinity Commercial	$178.25
Rate for Payer: Cofinity Commercial	$218.99
Rate for Payer: Healthscope Commercial	$229.18
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$216.44
Rate for Payer: PHP Commercial	$216.44
Rate for Payer: Priority Health Cigna Priority Health	$178.25
Rate for Payer: Priority Health SBD	$160.42

CLONIDINE HCL 0.1 MG TABLET

Facility

$2.55

Service Code	NDC 60687-113-11
Hospital Charge Code	1755
Hospital Revenue Code	637
Min. Negotiated Rate	$1.61
Max. Negotiated Rate	$2.30
Rate for Payer: Aetna Commercial	$2.17
Rate for Payer: Aetna New Business (MI Preferred)	$1.66
Rate for Payer: Cash Price	$2.04
Rate for Payer: Cofinity Commercial	$2.19
Rate for Payer: Cofinity Commercial	$1.78
Rate for Payer: Healthscope Commercial	$2.30
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2.17
Rate for Payer: PHP Commercial	$2.17
Rate for Payer: Priority Health Cigna Priority Health	$1.78
Rate for Payer: Priority Health SBD	$1.61

CLONIDINE HCL 0.1 MG TABLET

Facility

$79.90

Service Code	NDC 58657-647-01
Hospital Charge Code	1755
Hospital Revenue Code	637
Min. Negotiated Rate	$50.34
Max. Negotiated Rate	$71.91
Rate for Payer: Aetna Commercial	$67.92
Rate for Payer: Aetna New Business (MI Preferred)	$51.94
Rate for Payer: Cash Price	$63.92
Rate for Payer: Cofinity Commercial	$55.93
Rate for Payer: Cofinity Commercial	$68.71
Rate for Payer: Healthscope Commercial	$71.91
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$67.92
Rate for Payer: PHP Commercial	$67.92
Rate for Payer: Priority Health Cigna Priority Health	$55.93
Rate for Payer: Priority Health SBD	$50.34

CLONIDINE HCL 0.1 MG TABLET

Facility

$89.30

Service Code	NDC 0228-2127-10
Hospital Charge Code	1755
Hospital Revenue Code	637
Min. Negotiated Rate	$35.72
Max. Negotiated Rate	$80.37
Rate for Payer: Aetna Commercial	$75.90
Rate for Payer: Aetna New Business (MI Preferred)	$58.04
Rate for Payer: BCBS Complete	$35.72
Rate for Payer: Cash Price	$71.44
Rate for Payer: Cofinity Commercial	$62.51
Rate for Payer: Cofinity Commercial	$76.80
Rate for Payer: Healthscope Commercial	$80.37
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$75.90
Rate for Payer: PHP Commercial	$75.90
Rate for Payer: Priority Health Cigna Priority Health	$62.51
Rate for Payer: Priority Health SBD	$56.26

CLONIDINE HCL 0.1 MG TABLET

Facility

$254.60

Service Code	NDC 60687-113-01
Hospital Charge Code	1755
Hospital Revenue Code	637
Min. Negotiated Rate	$160.40
Max. Negotiated Rate	$229.14
Rate for Payer: Aetna Commercial	$216.41
Rate for Payer: Aetna New Business (MI Preferred)	$165.49
Rate for Payer: Cash Price	$203.68
Rate for Payer: Cofinity Commercial	$178.22
Rate for Payer: Cofinity Commercial	$218.96
Rate for Payer: Healthscope Commercial	$229.14
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$216.41
Rate for Payer: PHP Commercial	$216.41
Rate for Payer: Priority Health Cigna Priority Health	$178.22
Rate for Payer: Priority Health SBD	$160.40

CLONIDINE HCL 0.1 MG TABLET

Facility

$89.30

Service Code	NDC 0228-2127-10
Hospital Charge Code	1755
Hospital Revenue Code	637
Min. Negotiated Rate	$56.26
Max. Negotiated Rate	$80.37
Rate for Payer: Aetna Commercial	$75.90
Rate for Payer: Aetna New Business (MI Preferred)	$58.04
Rate for Payer: Cash Price	$71.44
Rate for Payer: Cofinity Commercial	$62.51
Rate for Payer: Cofinity Commercial	$76.80
Rate for Payer: Healthscope Commercial	$80.37
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$75.90
Rate for Payer: PHP Commercial	$75.90
Rate for Payer: Priority Health Cigna Priority Health	$62.51
Rate for Payer: Priority Health SBD	$56.26

CLONIDINE HCL 0.2 MG TABLET

Facility

$266.95

Service Code	NDC 60687-124-01
Hospital Charge Code	1756
Hospital Revenue Code	637
Min. Negotiated Rate	$168.18
Max. Negotiated Rate	$240.26
Rate for Payer: Aetna Commercial	$226.91
Rate for Payer: Aetna New Business (MI Preferred)	$173.52
Rate for Payer: Cash Price	$213.56
Rate for Payer: Cofinity Commercial	$186.86
Rate for Payer: Cofinity Commercial	$229.58
Rate for Payer: Healthscope Commercial	$240.26
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$226.91
Rate for Payer: PHP Commercial	$226.91
Rate for Payer: Priority Health Cigna Priority Health	$186.86
Rate for Payer: Priority Health SBD	$168.18

CLONIDINE HCL 0.2 MG TABLET

Facility

$126.90

Service Code	NDC 52817-181-10
Hospital Charge Code	1756
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

CLONIDINE HCL 0.2 MG TABLET

Facility

$2.67

Service Code	NDC 60687-124-11
Hospital Charge Code	1756
Hospital Revenue Code	637
Min. Negotiated Rate	$1.68
Max. Negotiated Rate	$2.40
Rate for Payer: Aetna Commercial	$2.27
Rate for Payer: Aetna New Business (MI Preferred)	$1.74
Rate for Payer: Cash Price	$2.14
Rate for Payer: Cofinity Commercial	$1.87
Rate for Payer: Cofinity Commercial	$2.30
Rate for Payer: Healthscope Commercial	$2.40
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2.27
Rate for Payer: PHP Commercial	$2.27
Rate for Payer: Priority Health Cigna Priority Health	$1.87
Rate for Payer: Priority Health SBD	$1.68

CLONIDINE HCL 0.2 MG TABLET

Facility

$126.90

Service Code	NDC 29300-136-01
Hospital Charge Code	1756
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

CLONIDINE HCL 0.3 MG TABLET

Facility

$131.60

Service Code	NDC 0228-2129-10
Hospital Charge Code	1757
Hospital Revenue Code	637
Min. Negotiated Rate	$82.91
Max. Negotiated Rate	$118.44
Rate for Payer: Aetna Commercial	$111.86
Rate for Payer: Aetna New Business (MI Preferred)	$85.54
Rate for Payer: Cash Price	$105.28
Rate for Payer: Cofinity Commercial	$113.18
Rate for Payer: Cofinity Commercial	$92.12
Rate for Payer: Healthscope Commercial	$118.44
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$111.86
Rate for Payer: PHP Commercial	$111.86
Rate for Payer: Priority Health Cigna Priority Health	$92.12
Rate for Payer: Priority Health SBD	$82.91

CLONIDINE HCL 0.3 MG TABLET

Facility

$223.25

Service Code	NDC 51079-301-20
Hospital Charge Code	1757
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

CLONIDINE HCL 0.3 MG TABLET

Facility

$2.24

Service Code	NDC 51079-301-01
Hospital Charge Code	1757
Hospital Revenue Code	637
Min. Negotiated Rate	$1.41
Max. Negotiated Rate	$2.02
Rate for Payer: Aetna Commercial	$1.90
Rate for Payer: Aetna New Business (MI Preferred)	$1.46
Rate for Payer: Cash Price	$1.79
Rate for Payer: Cofinity Commercial	$1.57
Rate for Payer: Cofinity Commercial	$1.93
Rate for Payer: Healthscope Commercial	$2.02
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1.90
Rate for Payer: PHP Commercial	$1.90
Rate for Payer: Priority Health Cigna Priority Health	$1.57
Rate for Payer: Priority Health SBD	$1.41

CLONIDINE HCL 0.3 MG TABLET

Facility

$3.20

Service Code	NDC 50268-194-11
Hospital Charge Code	1757
Hospital Revenue Code	637
Min. Negotiated Rate	$2.02
Max. Negotiated Rate	$2.88
Rate for Payer: Aetna Commercial	$2.72
Rate for Payer: Aetna New Business (MI Preferred)	$2.08
Rate for Payer: Cash Price	$2.56
Rate for Payer: Cofinity Commercial	$2.24
Rate for Payer: Cofinity Commercial	$2.75
Rate for Payer: Healthscope Commercial	$2.88
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2.72
Rate for Payer: PHP Commercial	$2.72
Rate for Payer: Priority Health Cigna Priority Health	$2.24
Rate for Payer: Priority Health SBD	$2.02

CLONIDINE HCL 0.3 MG TABLET

Facility

$244.40

Service Code	NDC 29300-137-01
Hospital Charge Code	1757
Hospital Revenue Code	637
Min. Negotiated Rate	$153.97
Max. Negotiated Rate	$219.96
Rate for Payer: Aetna Commercial	$207.74
Rate for Payer: Aetna New Business (MI Preferred)	$158.86
Rate for Payer: Cash Price	$195.52
Rate for Payer: Cofinity Commercial	$171.08
Rate for Payer: Cofinity Commercial	$210.18
Rate for Payer: Healthscope Commercial	$219.96
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$207.74
Rate for Payer: PHP Commercial	$207.74
Rate for Payer: Priority Health Cigna Priority Health	$171.08
Rate for Payer: Priority Health SBD	$153.97

CLONIDINE HCL 0.3 MG TABLET

Facility

$159.60

Service Code	NDC 50268-194-15
Hospital Charge Code	1757
Hospital Revenue Code	637
Min. Negotiated Rate	$100.55
Max. Negotiated Rate	$143.64
Rate for Payer: Aetna Commercial	$135.66
Rate for Payer: Aetna New Business (MI Preferred)	$103.74
Rate for Payer: Cash Price	$127.68
Rate for Payer: Cofinity Commercial	$111.72
Rate for Payer: Cofinity Commercial	$137.26
Rate for Payer: Healthscope Commercial	$143.64
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$135.66
Rate for Payer: PHP Commercial	$135.66
Rate for Payer: Priority Health Cigna Priority Health	$111.72
Rate for Payer: Priority Health SBD	$100.55

CLONIDINE HCL 0.3 MG TABLET

Facility

$162.15

Service Code	NDC 52817-182-10
Hospital Charge Code	1757
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

CLOPIDOGREL 75 MG TABLET

Facility

$420.65

Service Code	NDC 68084-536-01
Hospital Charge Code	22142
Hospital Revenue Code	637
Min. Negotiated Rate	$265.01
Max. Negotiated Rate	$378.58
Rate for Payer: Aetna Commercial	$357.55
Rate for Payer: Aetna New Business (MI Preferred)	$273.42
Rate for Payer: Cash Price	$336.52
Rate for Payer: Cofinity Commercial	$294.46
Rate for Payer: Cofinity Commercial	$361.76
Rate for Payer: Healthscope Commercial	$378.58
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$357.55
Rate for Payer: PHP Commercial	$357.55
Rate for Payer: Priority Health Cigna Priority Health	$294.46
Rate for Payer: Priority Health SBD	$265.01

CLOPIDOGREL 75 MG TABLET

Facility

$326.65

Service Code	NDC 0904-6294-61
Hospital Charge Code	22142
Hospital Revenue Code	637
Min. Negotiated Rate	$205.79
Max. Negotiated Rate	$293.98
Rate for Payer: Aetna Commercial	$277.65
Rate for Payer: Aetna New Business (MI Preferred)	$212.32
Rate for Payer: Cash Price	$261.32
Rate for Payer: Cofinity Commercial	$228.66
Rate for Payer: Cofinity Commercial	$280.92
Rate for Payer: Healthscope Commercial	$293.98
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$277.65
Rate for Payer: PHP Commercial	$277.65
Rate for Payer: Priority Health Cigna Priority Health	$228.66
Rate for Payer: Priority Health SBD	$205.79

Know your out-of-pocket cost for care.

All Charges