Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE

Facility

$1,419.47

Service Code	NDC 68382-711-19
Hospital Charge Code	78310
Hospital Revenue Code	637
Min. Negotiated Rate	$894.27
Max. Negotiated Rate	$1,277.52
Rate for Payer: Aetna Commercial	$1,206.55
Rate for Payer: Aetna New Business (MI Preferred)	$922.66
Rate for Payer: Cash Price	$1,135.58
Rate for Payer: Cofinity Commercial	$993.63
Rate for Payer: Cofinity Commercial	$1,220.74
Rate for Payer: Healthscope Commercial	$1,277.52
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,206.55
Rate for Payer: PHP Commercial	$1,206.55
Rate for Payer: Priority Health Cigna Priority Health	$993.63
Rate for Payer: Priority Health SBD	$894.27

MESALAMINE 4 GRAM/60 ML ENEMA

Facility

$38.19

Service Code	NDC 45802-098-46
Hospital Charge Code	10535
Hospital Revenue Code	637
Min. Negotiated Rate	$24.06
Max. Negotiated Rate	$34.37
Rate for Payer: Aetna Commercial	$32.46
Rate for Payer: Aetna New Business (MI Preferred)	$24.82
Rate for Payer: Cash Price	$30.55
Rate for Payer: Cofinity Commercial	$26.73
Rate for Payer: Cofinity Commercial	$32.84
Rate for Payer: Healthscope Commercial	$34.37
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$32.46
Rate for Payer: PHP Commercial	$32.46
Rate for Payer: Priority Health Cigna Priority Health	$26.73
Rate for Payer: Priority Health SBD	$24.06

MESALAMINE 800 MG TABLET,DELAYED RELEASE

Facility

$1,403.49

Service Code	NDC 60687-408-25
Hospital Charge Code	96949
Hospital Revenue Code	637
Min. Negotiated Rate	$884.20
Max. Negotiated Rate	$1,263.14
Rate for Payer: Aetna Commercial	$1,192.97
Rate for Payer: Aetna New Business (MI Preferred)	$912.27
Rate for Payer: Cash Price	$1,122.79
Rate for Payer: Cofinity Commercial	$1,207.00
Rate for Payer: Cofinity Commercial	$982.44
Rate for Payer: Healthscope Commercial	$1,263.14
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,192.97
Rate for Payer: PHP Commercial	$1,192.97
Rate for Payer: Priority Health Cigna Priority Health	$982.44
Rate for Payer: Priority Health SBD	$884.20

MESALAMINE 800 MG TABLET,DELAYED RELEASE

Facility

$3,993.34

Service Code	NDC 68382-435-28
Hospital Charge Code	96949
Hospital Revenue Code	637
Min. Negotiated Rate	$2,515.80
Max. Negotiated Rate	$3,594.01
Rate for Payer: Aetna Commercial	$3,394.34
Rate for Payer: Aetna New Business (MI Preferred)	$2,595.67
Rate for Payer: Cash Price	$3,194.67
Rate for Payer: Cofinity Commercial	$2,795.34
Rate for Payer: Cofinity Commercial	$3,434.27
Rate for Payer: Healthscope Commercial	$3,594.01
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3,394.34
Rate for Payer: PHP Commercial	$3,394.34
Rate for Payer: Priority Health Cigna Priority Health	$2,795.34
Rate for Payer: Priority Health SBD	$2,515.80

MESALAMINE 800 MG TABLET,DELAYED RELEASE

Facility

$46.79

Service Code	NDC 60687-408-95
Hospital Charge Code	96949
Hospital Revenue Code	637
Min. Negotiated Rate	$29.48
Max. Negotiated Rate	$42.11
Rate for Payer: Aetna Commercial	$39.77
Rate for Payer: Aetna New Business (MI Preferred)	$30.41
Rate for Payer: Cash Price	$37.43
Rate for Payer: Cofinity Commercial	$32.75
Rate for Payer: Cofinity Commercial	$40.24
Rate for Payer: Healthscope Commercial	$42.11
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$39.77
Rate for Payer: PHP Commercial	$39.77
Rate for Payer: Priority Health Cigna Priority Health	$32.75
Rate for Payer: Priority Health SBD	$29.48

MESALAMINE ER 250 MG CAPSULE,EXTENDED RELEASE

Facility

$2,507.72

Service Code	NDC 54092-189-81
Hospital Charge Code	10533
Hospital Revenue Code	637
Min. Negotiated Rate	$1,579.86
Max. Negotiated Rate	$2,256.95
Rate for Payer: Aetna Commercial	$2,131.56
Rate for Payer: Aetna New Business (MI Preferred)	$1,630.02
Rate for Payer: Cash Price	$2,006.18
Rate for Payer: Cofinity Commercial	$1,755.40
Rate for Payer: Cofinity Commercial	$2,156.64
Rate for Payer: Healthscope Commercial	$2,256.95
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,131.56
Rate for Payer: PHP Commercial	$2,131.56
Rate for Payer: Priority Health Cigna Priority Health	$1,755.40
Rate for Payer: Priority Health SBD	$1,579.86

MESALAMINE RECTAL SUSP ENEMA WITH CLEANSING WIPES 4 GRAM/60 ML KIT

Facility

$456.40

Service Code	NDC 45802-923-41
Hospital Charge Code	92860
Hospital Revenue Code	637
Min. Negotiated Rate	$287.53
Max. Negotiated Rate	$410.76
Rate for Payer: Aetna Commercial	$387.94
Rate for Payer: Aetna New Business (MI Preferred)	$296.66
Rate for Payer: Cash Price	$365.12
Rate for Payer: Cofinity Commercial	$319.48
Rate for Payer: Cofinity Commercial	$392.50
Rate for Payer: Healthscope Commercial	$410.76
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$387.94
Rate for Payer: PHP Commercial	$387.94
Rate for Payer: Priority Health Cigna Priority Health	$319.48
Rate for Payer: Priority Health SBD	$287.53

MESNA 100 MG/ML INTRAVENOUS SOLUTION

Facility

$196.64

Service Code	HCPCS J9209
Hospital Charge Code	10537
Hospital Revenue Code	636
Min. Negotiated Rate	$123.88
Max. Negotiated Rate	$176.98
Rate for Payer: Aetna Commercial	$167.14
Rate for Payer: Aetna New Business (MI Preferred)	$127.82
Rate for Payer: Cash Price	$157.31
Rate for Payer: Cofinity Commercial	$137.65
Rate for Payer: Cofinity Commercial	$169.11
Rate for Payer: Healthscope Commercial	$176.98
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$167.14
Rate for Payer: PHP Commercial	$167.14
Rate for Payer: Priority Health Cigna Priority Health	$137.65
Rate for Payer: Priority Health SBD	$123.88

MESNA 100 MG/ML INTRAVENOUS SOLUTION

Facility

$196.64

Service Code	HCPCS J9209
Hospital Charge Code	10537
Hospital Revenue Code	636
Min. Negotiated Rate	$4.04
Max. Negotiated Rate	$176.98
Rate for Payer: Aetna Commercial	$167.14
Rate for Payer: Aetna New Business (MI Preferred)	$127.82
Rate for Payer: BCBS Complete	$78.66
Rate for Payer: BCBS Trust/PPO	$4.04
Rate for Payer: Cash Price	$157.31
Rate for Payer: Cash Price	$157.31
Rate for Payer: Cofinity Commercial	$137.65
Rate for Payer: Cofinity Commercial	$169.11
Rate for Payer: Healthscope Commercial	$176.98
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$167.14
Rate for Payer: PHP Commercial	$167.14
Rate for Payer: Priority Health Cigna Priority Health	$137.65
Rate for Payer: Priority Health SBD	$123.88

METATARSECTOMY

Facility

$4,155.00

Service Code	CPT 28140
Hospital Revenue Code	360
Min. Negotiated Rate	$420.44
Max. Negotiated Rate	$4,155.00
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	$1,058.03
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 Medicare	$2,880.11
Rate for Payer: Railroad Medicare Medicare	$2,880.11
Rate for Payer: UHC All Payor (Choice/PPO)	$462.48
Rate for Payer: UHC Core	$4,155.00
Rate for Payer: UHC Dual Complete DSNP	$2,880.11
Rate for Payer: UHC Exchange	$420.44
Rate for Payer: UHC Medicare Advantage	$2,966.51
Rate for Payer: VA VA	$2,880.11

METFORMIN 1,000 MG TABLET

Facility

$211.50

Service Code	NDC 0904-7164-61
Hospital Charge Code	24398
Hospital Revenue Code	637
Min. Negotiated Rate	$133.24
Max. Negotiated Rate	$190.35
Rate for Payer: Aetna Commercial	$179.78
Rate for Payer: Aetna New Business (MI Preferred)	$137.48
Rate for Payer: Cash Price	$169.20
Rate for Payer: Cofinity Commercial	$148.05
Rate for Payer: Cofinity Commercial	$181.89
Rate for Payer: Healthscope Commercial	$190.35
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$179.78
Rate for Payer: PHP Commercial	$179.78
Rate for Payer: Priority Health Cigna Priority Health	$148.05
Rate for Payer: Priority Health SBD	$133.24

METFORMIN 500 MG TABLET

Facility

$138.65

Service Code	NDC 0904-7162-61
Hospital Charge Code	10544
Hospital Revenue Code	637
Min. Negotiated Rate	$87.35
Max. Negotiated Rate	$124.78
Rate for Payer: Aetna Commercial	$117.85
Rate for Payer: Aetna New Business (MI Preferred)	$90.12
Rate for Payer: Cash Price	$110.92
Rate for Payer: Cofinity Commercial	$119.24
Rate for Payer: Cofinity Commercial	$97.06
Rate for Payer: Healthscope Commercial	$124.78
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$117.85
Rate for Payer: PHP Commercial	$117.85
Rate for Payer: Priority Health Cigna Priority Health	$97.06
Rate for Payer: Priority Health SBD	$87.35

METFORMIN 500 MG TABLET

Facility

$136.30

Service Code	NDC 51079-172-20
Hospital Charge Code	10544
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

METFORMIN 500 MG TABLET

Facility

$42.30

Service Code	NDC 70010-063-01
Hospital Charge Code	10544
Hospital Revenue Code	637
Min. Negotiated Rate	$26.65
Max. Negotiated Rate	$38.07
Rate for Payer: Aetna Commercial	$35.96
Rate for Payer: Aetna New Business (MI Preferred)	$27.50
Rate for Payer: Cash Price	$33.84
Rate for Payer: Cofinity Commercial	$29.61
Rate for Payer: Cofinity Commercial	$36.38
Rate for Payer: Healthscope Commercial	$38.07
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$35.96
Rate for Payer: PHP Commercial	$35.96
Rate for Payer: Priority Health Cigna Priority Health	$29.61
Rate for Payer: Priority Health SBD	$26.65

METFORMIN 500 MG TABLET

Facility

$256.15

Service Code	NDC 60687-155-01
Hospital Charge Code	10544
Hospital Revenue Code	637
Min. Negotiated Rate	$161.37
Max. Negotiated Rate	$230.54
Rate for Payer: Aetna Commercial	$217.73
Rate for Payer: Aetna New Business (MI Preferred)	$166.50
Rate for Payer: Cash Price	$204.92
Rate for Payer: Cofinity Commercial	$179.30
Rate for Payer: Cofinity Commercial	$220.29
Rate for Payer: Healthscope Commercial	$230.54
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$217.73
Rate for Payer: PHP Commercial	$217.73
Rate for Payer: Priority Health Cigna Priority Health	$179.30
Rate for Payer: Priority Health SBD	$161.37

METFORMIN 500 MG TABLET

Facility

$2.57

Service Code	NDC 60687-155-11
Hospital Charge Code	10544
Hospital Revenue Code	637
Min. Negotiated Rate	$1.62
Max. Negotiated Rate	$2.31
Rate for Payer: Aetna Commercial	$2.18
Rate for Payer: Aetna New Business (MI Preferred)	$1.67
Rate for Payer: Cash Price	$2.06
Rate for Payer: Cofinity Commercial	$1.80
Rate for Payer: Cofinity Commercial	$2.21
Rate for Payer: Healthscope Commercial	$2.31
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2.18
Rate for Payer: PHP Commercial	$2.18
Rate for Payer: Priority Health Cigna Priority Health	$1.80
Rate for Payer: Priority Health SBD	$1.62

METFORMIN 500 MG TABLET

Facility

$86.95

Service Code	NDC 23155-102-01
Hospital Charge Code	10544
Hospital Revenue Code	637
Min. Negotiated Rate	$54.78
Max. Negotiated Rate	$78.26
Rate for Payer: Aetna Commercial	$73.91
Rate for Payer: Aetna New Business (MI Preferred)	$56.52
Rate for Payer: Cash Price	$69.56
Rate for Payer: Cofinity Commercial	$60.86
Rate for Payer: Cofinity Commercial	$74.78
Rate for Payer: Healthscope Commercial	$78.26
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$73.91
Rate for Payer: PHP Commercial	$73.91
Rate for Payer: Priority Health Cigna Priority Health	$60.86
Rate for Payer: Priority Health SBD	$54.78

METFORMIN 500 MG TABLET

Facility

$117.50

Service Code	NDC 0904-6689-61
Hospital Charge Code	10544
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

METFORMIN 500 MG TABLET

Facility

$108.10

Service Code	NDC 71093-132-04
Hospital Charge Code	10544
Hospital Revenue Code	637
Min. Negotiated Rate	$68.10
Max. Negotiated Rate	$97.29
Rate for Payer: Aetna Commercial	$91.88
Rate for Payer: Aetna New Business (MI Preferred)	$70.26
Rate for Payer: Cash Price	$86.48
Rate for Payer: Cofinity Commercial	$75.67
Rate for Payer: Cofinity Commercial	$92.97
Rate for Payer: Healthscope Commercial	$97.29
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$91.88
Rate for Payer: PHP Commercial	$91.88
Rate for Payer: Priority Health Cigna Priority Health	$75.67
Rate for Payer: Priority Health SBD	$68.10

METFORMIN 500 MG TABLET

Facility

$282.00

Service Code	NDC 70010-063-10
Hospital Charge Code	10544
Hospital Revenue Code	637
Min. Negotiated Rate	$177.66
Max. Negotiated Rate	$253.80
Rate for Payer: Aetna Commercial	$239.70
Rate for Payer: Aetna New Business (MI Preferred)	$183.30
Rate for Payer: Cash Price	$225.60
Rate for Payer: Cofinity Commercial	$197.40
Rate for Payer: Cofinity Commercial	$242.52
Rate for Payer: Healthscope Commercial	$253.80
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$239.70
Rate for Payer: PHP Commercial	$239.70
Rate for Payer: Priority Health Cigna Priority Health	$197.40
Rate for Payer: Priority Health SBD	$177.66

METFORMIN 500 MG TABLET

Facility

$119.85

Service Code	NDC 63739-640-10
Hospital Charge Code	10544
Hospital Revenue Code	637
Min. Negotiated Rate	$75.51
Max. Negotiated Rate	$107.86
Rate for Payer: Aetna Commercial	$101.87
Rate for Payer: Aetna New Business (MI Preferred)	$77.90
Rate for Payer: Cash Price	$95.88
Rate for Payer: Cofinity Commercial	$103.07
Rate for Payer: Cofinity Commercial	$83.90
Rate for Payer: Healthscope Commercial	$107.86
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$101.87
Rate for Payer: PHP Commercial	$101.87
Rate for Payer: Priority Health Cigna Priority Health	$83.90
Rate for Payer: Priority Health SBD	$75.51

METFORMIN 500 MG TABLET

Facility

$1.37

Service Code	NDC 51079-172-01
Hospital Charge Code	10544
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

METFORMIN 850 MG TABLET

Facility

$4.23

Service Code	NDC 60687-143-11
Hospital Charge Code	14719
Hospital Revenue Code	637
Min. Negotiated Rate	$2.66
Max. Negotiated Rate	$3.81
Rate for Payer: Aetna Commercial	$3.60
Rate for Payer: Aetna New Business (MI Preferred)	$2.75
Rate for Payer: Cash Price	$3.38
Rate for Payer: Cofinity Commercial	$2.96
Rate for Payer: Cofinity Commercial	$3.64
Rate for Payer: Healthscope Commercial	$3.81
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3.60
Rate for Payer: PHP Commercial	$3.60
Rate for Payer: Priority Health Cigna Priority Health	$2.96
Rate for Payer: Priority Health SBD	$2.66

METFORMIN 850 MG TABLET

Facility

$423.00

Service Code	NDC 60687-143-01
Hospital Charge Code	14719
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

METHACHOLINE 0.0625 MG/ML (VIAL E) SOLUTION FOR INHALATION

Facility

$170.20

Service Code	HCPCS J7674
Hospital Charge Code	180308
Hospital Revenue Code	636
Min. Negotiated Rate	$107.23
Max. Negotiated Rate	$153.18
Rate for Payer: Aetna Commercial	$144.67
Rate for Payer: Aetna New Business (MI Preferred)	$110.63
Rate for Payer: Cash Price	$136.16
Rate for Payer: Cofinity Commercial	$119.14
Rate for Payer: Cofinity Commercial	$146.37
Rate for Payer: Healthscope Commercial	$153.18
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$144.67
Rate for Payer: PHP Commercial	$144.67
Rate for Payer: Priority Health Cigna Priority Health	$119.14
Rate for Payer: Priority Health SBD	$107.23

Know your out-of-pocket cost for care.

All Charges