Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

METHACHOLINE CHLORIDE 100 MG SOLUTION FOR INHALATION

Facility

$285.61

Service Code	HCPCS J7674
Hospital Charge Code	27032
Hospital Revenue Code	636
Min. Negotiated Rate	$179.93
Max. Negotiated Rate	$257.05
Rate for Payer: Aetna Commercial	$242.77
Rate for Payer: Aetna New Business (MI Preferred)	$185.65
Rate for Payer: Cash Price	$228.49
Rate for Payer: Cofinity Commercial	$199.93
Rate for Payer: Cofinity Commercial	$245.62
Rate for Payer: Healthscope Commercial	$257.05
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$242.77
Rate for Payer: PHP Commercial	$242.77
Rate for Payer: Priority Health Cigna Priority Health	$199.93
Rate for Payer: Priority Health SBD	$179.93

METHADONE 10 MG/ML ORAL CONCENTRATE

Facility

$132.09

Service Code	NDC 0054-3553-44
Hospital Charge Code	15996
Hospital Revenue Code	637
Min. Negotiated Rate	$83.22
Max. Negotiated Rate	$118.88
Rate for Payer: Aetna Commercial	$112.28
Rate for Payer: Aetna New Business (MI Preferred)	$85.86
Rate for Payer: Cash Price	$105.67
Rate for Payer: Cofinity Commercial	$113.60
Rate for Payer: Cofinity Commercial	$92.46
Rate for Payer: Healthscope Commercial	$118.88
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$112.28
Rate for Payer: PHP Commercial	$112.28
Rate for Payer: Priority Health Cigna Priority Health	$92.46
Rate for Payer: Priority Health SBD	$83.22

METHADONE 10 MG TABLET

Facility

$4.13

Service Code	NDC 0406-5771-23
Hospital Charge Code	4953
Hospital Revenue Code	637
Min. Negotiated Rate	$2.60
Max. Negotiated Rate	$3.72
Rate for Payer: Aetna Commercial	$3.51
Rate for Payer: Aetna New Business (MI Preferred)	$2.68
Rate for Payer: Cash Price	$3.30
Rate for Payer: Cofinity Commercial	$2.89
Rate for Payer: Cofinity Commercial	$3.55
Rate for Payer: Healthscope Commercial	$3.72
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3.51
Rate for Payer: PHP Commercial	$3.51
Rate for Payer: Priority Health Cigna Priority Health	$2.89
Rate for Payer: Priority Health SBD	$2.60

METHADONE 10 MG TABLET

Facility

$413.00

Service Code	NDC 0406-5771-62
Hospital Charge Code	4953
Hospital Revenue Code	637
Min. Negotiated Rate	$260.19
Max. Negotiated Rate	$371.70
Rate for Payer: Aetna Commercial	$351.05
Rate for Payer: Aetna New Business (MI Preferred)	$268.45
Rate for Payer: Cash Price	$330.40
Rate for Payer: Cofinity Commercial	$289.10
Rate for Payer: Cofinity Commercial	$355.18
Rate for Payer: Healthscope Commercial	$371.70
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$351.05
Rate for Payer: PHP Commercial	$351.05
Rate for Payer: Priority Health Cigna Priority Health	$289.10
Rate for Payer: Priority Health SBD	$260.19

METHADONE 5 MG TABLET

Facility

$430.50

Service Code	NDC 0406-5755-62
Hospital Charge Code	4954
Hospital Revenue Code	637
Min. Negotiated Rate	$271.22
Max. Negotiated Rate	$387.45
Rate for Payer: Aetna Commercial	$365.92
Rate for Payer: Aetna New Business (MI Preferred)	$279.82
Rate for Payer: Cash Price	$344.40
Rate for Payer: Cofinity Commercial	$301.35
Rate for Payer: Cofinity Commercial	$370.23
Rate for Payer: Healthscope Commercial	$387.45
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$365.92
Rate for Payer: PHP Commercial	$365.92
Rate for Payer: Priority Health Cigna Priority Health	$301.35
Rate for Payer: Priority Health SBD	$271.22

METHADONE 5 MG TABLET

Facility

$4.31

Service Code	NDC 0406-5755-23
Hospital Charge Code	4954
Hospital Revenue Code	637
Min. Negotiated Rate	$2.72
Max. Negotiated Rate	$3.88
Rate for Payer: Aetna Commercial	$3.66
Rate for Payer: Aetna New Business (MI Preferred)	$2.80
Rate for Payer: Cash Price	$3.45
Rate for Payer: Cofinity Commercial	$3.02
Rate for Payer: Cofinity Commercial	$3.71
Rate for Payer: Healthscope Commercial	$3.88
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3.66
Rate for Payer: PHP Commercial	$3.66
Rate for Payer: Priority Health Cigna Priority Health	$3.02
Rate for Payer: Priority Health SBD	$2.72

METHIMAZOLE 10 MG TABLET

Facility

$323.00

Service Code	NDC 68084-276-01
Hospital Charge Code	10552
Hospital Revenue Code	637
Min. Negotiated Rate	$203.49
Max. Negotiated Rate	$290.70
Rate for Payer: Aetna Commercial	$274.55
Rate for Payer: Aetna New Business (MI Preferred)	$209.95
Rate for Payer: Cash Price	$258.40
Rate for Payer: Cofinity Commercial	$226.10
Rate for Payer: Cofinity Commercial	$277.78
Rate for Payer: Healthscope Commercial	$290.70
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$274.55
Rate for Payer: PHP Commercial	$274.55
Rate for Payer: Priority Health Cigna Priority Health	$226.10
Rate for Payer: Priority Health SBD	$203.49

METHIMAZOLE 10 MG TABLET

Facility

$251.04

Service Code	NDC 60687-370-01
Hospital Charge Code	10552
Hospital Revenue Code	637
Min. Negotiated Rate	$158.16
Max. Negotiated Rate	$225.94
Rate for Payer: Aetna Commercial	$213.38
Rate for Payer: Aetna New Business (MI Preferred)	$163.18
Rate for Payer: Cash Price	$200.83
Rate for Payer: Cofinity Commercial	$175.73
Rate for Payer: Cofinity Commercial	$215.89
Rate for Payer: Healthscope Commercial	$225.94
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$213.38
Rate for Payer: PHP Commercial	$213.38
Rate for Payer: Priority Health Cigna Priority Health	$175.73
Rate for Payer: Priority Health SBD	$158.16

METHIMAZOLE 10 MG TABLET

Facility

$3.34

Service Code	NDC 60687-680-11
Hospital Charge Code	10552
Hospital Revenue Code	637
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$3.01
Rate for Payer: Aetna Commercial	$2.84
Rate for Payer: Aetna New Business (MI Preferred)	$2.17
Rate for Payer: Cash Price	$2.67
Rate for Payer: Cofinity Commercial	$2.34
Rate for Payer: Cofinity Commercial	$2.87
Rate for Payer: Healthscope Commercial	$3.01
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2.84
Rate for Payer: PHP Commercial	$2.84
Rate for Payer: Priority Health Cigna Priority Health	$2.34
Rate for Payer: Priority Health SBD	$2.10

METHIMAZOLE 10 MG TABLET

Facility

$333.60

Service Code	NDC 60687-680-01
Hospital Charge Code	10552
Hospital Revenue Code	637
Min. Negotiated Rate	$210.17
Max. Negotiated Rate	$300.24
Rate for Payer: Aetna Commercial	$283.56
Rate for Payer: Aetna New Business (MI Preferred)	$216.84
Rate for Payer: Cash Price	$266.88
Rate for Payer: Cofinity Commercial	$233.52
Rate for Payer: Cofinity Commercial	$286.90
Rate for Payer: Healthscope Commercial	$300.24
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$283.56
Rate for Payer: PHP Commercial	$283.56
Rate for Payer: Priority Health Cigna Priority Health	$233.52
Rate for Payer: Priority Health SBD	$210.17

METHIMAZOLE 10 MG TABLET

Facility

$298.45

Service Code	NDC 23155-071-01
Hospital Charge Code	10552
Hospital Revenue Code	637
Min. Negotiated Rate	$188.02
Max. Negotiated Rate	$268.60
Rate for Payer: Aetna Commercial	$253.68
Rate for Payer: Aetna New Business (MI Preferred)	$193.99
Rate for Payer: Cash Price	$238.76
Rate for Payer: Cofinity Commercial	$208.92
Rate for Payer: Cofinity Commercial	$256.67
Rate for Payer: Healthscope Commercial	$268.60
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$253.68
Rate for Payer: PHP Commercial	$253.68
Rate for Payer: Priority Health Cigna Priority Health	$208.92
Rate for Payer: Priority Health SBD	$188.02

METHIMAZOLE 10 MG TABLET

Facility

$2.52

Service Code	NDC 60687-370-11
Hospital Charge Code	10552
Hospital Revenue Code	637
Min. Negotiated Rate	$1.59
Max. Negotiated Rate	$2.27
Rate for Payer: Aetna Commercial	$2.14
Rate for Payer: Aetna New Business (MI Preferred)	$1.64
Rate for Payer: Cash Price	$2.02
Rate for Payer: Cofinity Commercial	$1.76
Rate for Payer: Cofinity Commercial	$2.17
Rate for Payer: Healthscope Commercial	$2.27
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2.14
Rate for Payer: PHP Commercial	$2.14
Rate for Payer: Priority Health Cigna Priority Health	$1.76
Rate for Payer: Priority Health SBD	$1.59

METHOCARBAMOL 500 MG TABLET

Facility

$467.65

Service Code	NDC 63739-991-10
Hospital Charge Code	4971
Hospital Revenue Code	637
Min. Negotiated Rate	$294.62
Max. Negotiated Rate	$420.88
Rate for Payer: Aetna Commercial	$397.50
Rate for Payer: Aetna New Business (MI Preferred)	$303.97
Rate for Payer: Cash Price	$374.12
Rate for Payer: Cofinity Commercial	$327.36
Rate for Payer: Cofinity Commercial	$402.18
Rate for Payer: Healthscope Commercial	$420.88
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$397.50
Rate for Payer: PHP Commercial	$397.50
Rate for Payer: Priority Health Cigna Priority Health	$327.36
Rate for Payer: Priority Health SBD	$294.62

METHOCARBAMOL 750 MG TABLET

Facility

$224.20

Service Code	NDC 0904-7058-61
Hospital Charge Code	4972
Hospital Revenue Code	637
Min. Negotiated Rate	$141.25
Max. Negotiated Rate	$201.78
Rate for Payer: Aetna Commercial	$190.57
Rate for Payer: Aetna New Business (MI Preferred)	$145.73
Rate for Payer: Cash Price	$179.36
Rate for Payer: Cofinity Commercial	$156.94
Rate for Payer: Cofinity Commercial	$192.81
Rate for Payer: Healthscope Commercial	$201.78
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$190.57
Rate for Payer: PHP Commercial	$190.57
Rate for Payer: Priority Health Cigna Priority Health	$156.94
Rate for Payer: Priority Health SBD	$141.25

METHOTREXATE SODIUM 25 MG/ML INJECTION SOLUTION

Facility

$125.00

Service Code	HCPCS J9250
Hospital Charge Code	4974
Hospital Revenue Code	636
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$106.25
Rate for Payer: Aetna New Business (MI Preferred)	$81.25
Rate for Payer: BCBS Complete	$50.00
Rate for Payer: BCBS Trust/PPO	$0.90
Rate for Payer: Cash Price	$100.00
Rate for Payer: Cash Price	$100.00
Rate for Payer: Cofinity Commercial	$87.50
Rate for Payer: Cofinity Commercial	$107.50
Rate for Payer: Healthscope Commercial	$112.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$106.25
Rate for Payer: PHP Commercial	$106.25
Rate for Payer: Priority Health Cigna Priority Health	$87.50
Rate for Payer: Priority Health SBD	$78.75

METHOTREXATE SODIUM 2.5 MG TABLET

Facility

$182.86

Service Code	HCPCS J8610
Hospital Charge Code	4973
Hospital Revenue Code	636
Min. Negotiated Rate	$115.20
Max. Negotiated Rate	$164.57
Rate for Payer: Aetna Commercial	$155.43
Rate for Payer: Aetna Commercial	$3.53
Rate for Payer: Aetna Commercial	$176.26
Rate for Payer: Aetna Commercial	$7.78
Rate for Payer: Aetna New Business (MI Preferred)	$5.95
Rate for Payer: Aetna New Business (MI Preferred)	$118.86
Rate for Payer: Aetna New Business (MI Preferred)	$134.78
Rate for Payer: Aetna New Business (MI Preferred)	$2.70
Rate for Payer: Cash Price	$7.32
Rate for Payer: Cash Price	$165.89
Rate for Payer: Cash Price	$3.32
Rate for Payer: Cash Price	$146.29
Rate for Payer: Cofinity Commercial	$157.26
Rate for Payer: Cofinity Commercial	$128.00
Rate for Payer: Cofinity Commercial	$178.33
Rate for Payer: Cofinity Commercial	$145.15
Rate for Payer: Cofinity Commercial	$7.87
Rate for Payer: Cofinity Commercial	$6.40
Rate for Payer: Cofinity Commercial	$3.57
Rate for Payer: Cofinity Commercial	$2.90
Rate for Payer: Healthscope Commercial	$8.24
Rate for Payer: Healthscope Commercial	$186.62
Rate for Payer: Healthscope Commercial	$3.74
Rate for Payer: Healthscope Commercial	$164.57
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3.53
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$176.26
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$155.43
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$7.78
Rate for Payer: PHP Commercial	$155.43
Rate for Payer: PHP Commercial	$3.53
Rate for Payer: PHP Commercial	$7.78
Rate for Payer: PHP Commercial	$176.26
Rate for Payer: Priority Health Cigna Priority Health	$145.15
Rate for Payer: Priority Health Cigna Priority Health	$128.00
Rate for Payer: Priority Health Cigna Priority Health	$2.90
Rate for Payer: Priority Health Cigna Priority Health	$6.40
Rate for Payer: Priority Health SBD	$130.64
Rate for Payer: Priority Health SBD	$115.20
Rate for Payer: Priority Health SBD	$5.76
Rate for Payer: Priority Health SBD	$2.61

METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION

Facility

$85.85

Service Code	HCPCS J9260
Hospital Charge Code	96981
Hospital Revenue Code	636
Min. Negotiated Rate	$8.98
Max. Negotiated Rate	$77.26
Rate for Payer: Aetna Commercial	$72.97
Rate for Payer: Aetna New Business (MI Preferred)	$55.80
Rate for Payer: BCBS Complete	$34.34
Rate for Payer: BCBS Trust/PPO	$8.98
Rate for Payer: Cash Price	$68.68
Rate for Payer: Cash Price	$68.68
Rate for Payer: Cofinity Commercial	$60.10
Rate for Payer: Cofinity Commercial	$73.83
Rate for Payer: Healthscope Commercial	$77.26
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$72.97
Rate for Payer: PHP Commercial	$72.97
Rate for Payer: Priority Health Cigna Priority Health	$60.10
Rate for Payer: Priority Health SBD	$54.09

METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION

Facility

$74.08

Service Code	NDC 17478-504-01
Hospital Charge Code	4985
Hospital Revenue Code	250
Min. Negotiated Rate	$46.67
Max. Negotiated Rate	$66.67
Rate for Payer: Aetna Commercial	$62.97
Rate for Payer: Aetna New Business (MI Preferred)	$48.15
Rate for Payer: Cash Price	$59.26
Rate for Payer: Cofinity Commercial	$51.86
Rate for Payer: Cofinity Commercial	$63.71
Rate for Payer: Healthscope Commercial	$66.67
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$62.97
Rate for Payer: PHP Commercial	$62.97
Rate for Payer: Priority Health Cigna Priority Health	$51.86
Rate for Payer: Priority Health SBD	$46.67

METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION

Facility

$590.90

Service Code	NDC 17478-504-10
Hospital Charge Code	4985
Hospital Revenue Code	250
Min. Negotiated Rate	$372.27
Max. Negotiated Rate	$531.81
Rate for Payer: Aetna Commercial	$502.26
Rate for Payer: Aetna New Business (MI Preferred)	$384.08
Rate for Payer: Cash Price	$472.72
Rate for Payer: Cofinity Commercial	$413.63
Rate for Payer: Cofinity Commercial	$508.17
Rate for Payer: Healthscope Commercial	$531.81
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$502.26
Rate for Payer: PHP Commercial	$502.26
Rate for Payer: Priority Health Cigna Priority Health	$413.63
Rate for Payer: Priority Health SBD	$372.27

METHYLENE BLUE (ANTIDOTE) 5 MG/ML INTRAVENOUS SOLUTION

Facility

$662.29

Service Code	NDC 0517-0374-05
Hospital Charge Code	180747
Hospital Revenue Code	250
Min. Negotiated Rate	$417.24
Max. Negotiated Rate	$596.06
Rate for Payer: Aetna Commercial	$562.95
Rate for Payer: Aetna New Business (MI Preferred)	$430.49
Rate for Payer: Cash Price	$529.83
Rate for Payer: Cofinity Commercial	$463.60
Rate for Payer: Cofinity Commercial	$569.57
Rate for Payer: Healthscope Commercial	$596.06
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$562.95
Rate for Payer: PHP Commercial	$562.95
Rate for Payer: Priority Health Cigna Priority Health	$463.60
Rate for Payer: Priority Health SBD	$417.24

METHYLENE BLUE (ANTIDOTE) 5 MG/ML INTRAVENOUS SOLUTION

Facility

$662.29

Service Code	NDC 0517-0374-01
Hospital Charge Code	180747
Hospital Revenue Code	250
Min. Negotiated Rate	$417.24
Max. Negotiated Rate	$596.06
Rate for Payer: Aetna Commercial	$562.95
Rate for Payer: Aetna New Business (MI Preferred)	$430.49
Rate for Payer: Cash Price	$529.83
Rate for Payer: Cofinity Commercial	$463.60
Rate for Payer: Cofinity Commercial	$569.57
Rate for Payer: Healthscope Commercial	$596.06
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$562.95
Rate for Payer: PHP Commercial	$562.95
Rate for Payer: Priority Health Cigna Priority Health	$463.60
Rate for Payer: Priority Health SBD	$417.24

METHYLERGONOVINE 0.2 MG/ML (1 ML) INJECTION SOLUTION

Facility

$88.43

Service Code	HCPCS J2210
Hospital Charge Code	10571
Hospital Revenue Code	636
Min. Negotiated Rate	$55.71
Max. Negotiated Rate	$79.59
Rate for Payer: Aetna Commercial	$75.17
Rate for Payer: Aetna New Business (MI Preferred)	$57.48
Rate for Payer: Cash Price	$70.74
Rate for Payer: Cofinity Commercial	$61.90
Rate for Payer: Cofinity Commercial	$76.05
Rate for Payer: Healthscope Commercial	$79.59
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$75.17
Rate for Payer: PHP Commercial	$75.17
Rate for Payer: Priority Health Cigna Priority Health	$61.90
Rate for Payer: Priority Health SBD	$55.71

METHYLERGONOVINE 0.2 MG TABLET

Facility

$2,561.04

Service Code	NDC 27437-050-57
Hospital Charge Code	10572
Hospital Revenue Code	637
Min. Negotiated Rate	$1,613.46
Max. Negotiated Rate	$2,304.94
Rate for Payer: Aetna Commercial	$2,176.88
Rate for Payer: Aetna New Business (MI Preferred)	$1,664.68
Rate for Payer: Cash Price	$2,048.83
Rate for Payer: Cofinity Commercial	$1,792.73
Rate for Payer: Cofinity Commercial	$2,202.49
Rate for Payer: Healthscope Commercial	$2,304.94
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,176.88
Rate for Payer: PHP Commercial	$2,176.88
Rate for Payer: Priority Health Cigna Priority Health	$1,792.73
Rate for Payer: Priority Health SBD	$1,613.46

METHYLERGONOVINE 0.2 MG TABLET

Facility

$3,559.48

Service Code	NDC 60687-410-94
Hospital Charge Code	10572
Hospital Revenue Code	637
Min. Negotiated Rate	$2,242.47
Max. Negotiated Rate	$3,203.53
Rate for Payer: Aetna Commercial	$3,025.56
Rate for Payer: Aetna New Business (MI Preferred)	$2,313.66
Rate for Payer: Cash Price	$2,847.58
Rate for Payer: Cofinity Commercial	$2,491.64
Rate for Payer: Cofinity Commercial	$3,061.15
Rate for Payer: Healthscope Commercial	$3,203.53
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3,025.56
Rate for Payer: PHP Commercial	$3,025.56
Rate for Payer: Priority Health Cigna Priority Health	$2,491.64
Rate for Payer: Priority Health SBD	$2,242.47

METHYLERGONOVINE 0.2 MG TABLET

Facility

$681.32

Service Code	NDC 69238-1605-2
Hospital Charge Code	10572
Hospital Revenue Code	637
Min. Negotiated Rate	$429.23
Max. Negotiated Rate	$613.19
Rate for Payer: Aetna Commercial	$579.12
Rate for Payer: Aetna New Business (MI Preferred)	$442.86
Rate for Payer: Cash Price	$545.06
Rate for Payer: Cofinity Commercial	$476.92
Rate for Payer: Cofinity Commercial	$585.94
Rate for Payer: Healthscope Commercial	$613.19
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$579.12
Rate for Payer: PHP Commercial	$579.12
Rate for Payer: Priority Health Cigna Priority Health	$476.92
Rate for Payer: Priority Health SBD	$429.23

Know your out-of-pocket cost for care.

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