Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

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

METHYLNALTREXONE 12 MG/0.6 ML SUBCUTANEOUS SOLUTION

Facility

$507.90

Service Code	HCPCS J2212
Hospital Charge Code	91651
Hospital Revenue Code	636
Min. Negotiated Rate	$319.98
Max. Negotiated Rate	$457.11
Rate for Payer: Aetna Commercial	$431.72
Rate for Payer: Aetna New Business (MI Preferred)	$330.14
Rate for Payer: Cash Price	$406.32
Rate for Payer: Cofinity Commercial	$355.53
Rate for Payer: Cofinity Commercial	$436.79
Rate for Payer: Healthscope Commercial	$457.11
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$431.72
Rate for Payer: PHP Commercial	$431.72
Rate for Payer: Priority Health Cigna Priority Health	$355.53
Rate for Payer: Priority Health SBD	$319.98

METHYLPHENIDATE 10 MG TABLET

Facility

$467.25

Service Code	NDC 31722-174-01
Hospital Charge Code	4986
Hospital Revenue Code	637
Min. Negotiated Rate	$294.37
Max. Negotiated Rate	$420.52
Rate for Payer: Aetna Commercial	$397.16
Rate for Payer: Aetna New Business (MI Preferred)	$303.71
Rate for Payer: Cash Price	$373.80
Rate for Payer: Cofinity Commercial	$327.08
Rate for Payer: Cofinity Commercial	$401.84
Rate for Payer: Healthscope Commercial	$420.52
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$397.16
Rate for Payer: PHP Commercial	$397.16
Rate for Payer: Priority Health Cigna Priority Health	$327.08
Rate for Payer: Priority Health SBD	$294.37

METHYLPHENIDATE 10 MG TABLET

Facility

$512.40

Service Code	NDC 43386-574-01
Hospital Charge Code	4986
Hospital Revenue Code	637
Min. Negotiated Rate	$322.81
Max. Negotiated Rate	$461.16
Rate for Payer: Aetna Commercial	$435.54
Rate for Payer: Aetna New Business (MI Preferred)	$333.06
Rate for Payer: Cash Price	$409.92
Rate for Payer: Cofinity Commercial	$358.68
Rate for Payer: Cofinity Commercial	$440.66
Rate for Payer: Healthscope Commercial	$461.16
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$435.54
Rate for Payer: PHP Commercial	$435.54
Rate for Payer: Priority Health Cigna Priority Health	$358.68
Rate for Payer: Priority Health SBD	$322.81

METHYLPHENIDATE 10 MG TABLET

Facility

$218.75

Service Code	NDC 16729-479-01
Hospital Charge Code	4986
Hospital Revenue Code	637
Min. Negotiated Rate	$137.81
Max. Negotiated Rate	$196.88
Rate for Payer: Aetna Commercial	$185.94
Rate for Payer: Aetna New Business (MI Preferred)	$142.19
Rate for Payer: Cash Price	$175.00
Rate for Payer: Cofinity Commercial	$153.12
Rate for Payer: Cofinity Commercial	$188.12
Rate for Payer: Healthscope Commercial	$196.88
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$185.94
Rate for Payer: PHP Commercial	$185.94
Rate for Payer: Priority Health Cigna Priority Health	$153.12
Rate for Payer: Priority Health SBD	$137.81

METHYLPHENIDATE 10 MG TABLET

Facility

$456.75

Service Code	NDC 0406-1144-01
Hospital Charge Code	4986
Hospital Revenue Code	637
Min. Negotiated Rate	$287.75
Max. Negotiated Rate	$411.08
Rate for Payer: Aetna Commercial	$388.24
Rate for Payer: Aetna New Business (MI Preferred)	$296.89
Rate for Payer: Cash Price	$365.40
Rate for Payer: Cofinity Commercial	$319.72
Rate for Payer: Cofinity Commercial	$392.80
Rate for Payer: Healthscope Commercial	$411.08
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$388.24
Rate for Payer: PHP Commercial	$388.24
Rate for Payer: Priority Health Cigna Priority Health	$319.72
Rate for Payer: Priority Health SBD	$287.75

METHYLPHENIDATE 5 MG TABLET

Facility

$357.63

Service Code	NDC 68084-805-21
Hospital Charge Code	4988
Hospital Revenue Code	637
Min. Negotiated Rate	$225.31
Max. Negotiated Rate	$321.87
Rate for Payer: Aetna Commercial	$303.99
Rate for Payer: Aetna New Business (MI Preferred)	$232.46
Rate for Payer: Cash Price	$286.10
Rate for Payer: Cofinity Commercial	$250.34
Rate for Payer: Cofinity Commercial	$307.56
Rate for Payer: Healthscope Commercial	$321.87
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$303.99
Rate for Payer: PHP Commercial	$303.99
Rate for Payer: Priority Health Cigna Priority Health	$250.34
Rate for Payer: Priority Health SBD	$225.31

METHYLPHENIDATE 5 MG TABLET

Facility

$320.25

Service Code	NDC 0406-1142-01
Hospital Charge Code	4988
Hospital Revenue Code	637
Min. Negotiated Rate	$201.76
Max. Negotiated Rate	$288.22
Rate for Payer: Aetna Commercial	$272.21
Rate for Payer: Aetna New Business (MI Preferred)	$208.16
Rate for Payer: Cash Price	$256.20
Rate for Payer: Cofinity Commercial	$224.18
Rate for Payer: Cofinity Commercial	$275.42
Rate for Payer: Healthscope Commercial	$288.22
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$272.21
Rate for Payer: PHP Commercial	$272.21
Rate for Payer: Priority Health Cigna Priority Health	$224.18
Rate for Payer: Priority Health SBD	$201.76

METHYLPHENIDATE 5 MG TABLET

Facility

$11.93

Service Code	NDC 68084-805-11
Hospital Charge Code	4988
Hospital Revenue Code	637
Min. Negotiated Rate	$7.52
Max. Negotiated Rate	$10.74
Rate for Payer: Aetna Commercial	$10.14
Rate for Payer: Aetna New Business (MI Preferred)	$7.75
Rate for Payer: Cash Price	$9.54
Rate for Payer: Cofinity Commercial	$10.26
Rate for Payer: Cofinity Commercial	$8.35
Rate for Payer: Healthscope Commercial	$10.74
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$10.14
Rate for Payer: PHP Commercial	$10.14
Rate for Payer: Priority Health Cigna Priority Health	$8.35
Rate for Payer: Priority Health SBD	$7.52

METHYLPHENIDATE 5 MG TABLET

Facility

$162.75

Service Code	NDC 10702-100-01
Hospital Charge Code	4988
Hospital Revenue Code	637
Min. Negotiated Rate	$102.53
Max. Negotiated Rate	$146.48
Rate for Payer: Aetna Commercial	$138.34
Rate for Payer: Aetna New Business (MI Preferred)	$105.79
Rate for Payer: Cash Price	$130.20
Rate for Payer: Cofinity Commercial	$113.92
Rate for Payer: Cofinity Commercial	$139.96
Rate for Payer: Healthscope Commercial	$146.48
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$138.34
Rate for Payer: PHP Commercial	$138.34
Rate for Payer: Priority Health Cigna Priority Health	$113.92
Rate for Payer: Priority Health SBD	$102.53

METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR

Facility

$470.40

Service Code	NDC 13811-706-10
Hospital Charge Code	28750
Hospital Revenue Code	637
Min. Negotiated Rate	$296.35
Max. Negotiated Rate	$423.36
Rate for Payer: Aetna Commercial	$399.84
Rate for Payer: Aetna New Business (MI Preferred)	$305.76
Rate for Payer: Cash Price	$376.32
Rate for Payer: Cofinity Commercial	$329.28
Rate for Payer: Cofinity Commercial	$404.54
Rate for Payer: Healthscope Commercial	$423.36
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$399.84
Rate for Payer: PHP Commercial	$399.84
Rate for Payer: Priority Health Cigna Priority Health	$329.28
Rate for Payer: Priority Health SBD	$296.35

METHYLPHENIDATE ER 36 MG TABLET,EXTENDED RELEASE 24 HR

Facility

$506.80

Service Code	NDC 13811-708-10
Hospital Charge Code	28751
Hospital Revenue Code	637
Min. Negotiated Rate	$319.28
Max. Negotiated Rate	$456.12
Rate for Payer: Aetna Commercial	$430.78
Rate for Payer: Aetna New Business (MI Preferred)	$329.42
Rate for Payer: Cash Price	$405.44
Rate for Payer: Cofinity Commercial	$354.76
Rate for Payer: Cofinity Commercial	$435.85
Rate for Payer: Healthscope Commercial	$456.12
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$430.78
Rate for Payer: PHP Commercial	$430.78
Rate for Payer: Priority Health Cigna Priority Health	$354.76
Rate for Payer: Priority Health SBD	$319.28

METHYLPREDNISOLONE 32 MG TABLET

Facility

$286.20

Service Code	HCPCS J7509
Hospital Charge Code	10575
Hospital Revenue Code	636
Min. Negotiated Rate	$180.31
Max. Negotiated Rate	$257.58
Rate for Payer: Aetna Commercial	$243.27
Rate for Payer: Aetna New Business (MI Preferred)	$186.03
Rate for Payer: Cash Price	$228.96
Rate for Payer: Cofinity Commercial	$200.34
Rate for Payer: Cofinity Commercial	$246.13
Rate for Payer: Healthscope Commercial	$257.58
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$243.27
Rate for Payer: PHP Commercial	$243.27
Rate for Payer: Priority Health Cigna Priority Health	$200.34
Rate for Payer: Priority Health SBD	$180.31

METHYLPREDNISOLONE 4 MG TABLET

Facility

$647.52

Service Code	HCPCS J7509
Hospital Charge Code	4993
Hospital Revenue Code	636
Min. Negotiated Rate	$407.94
Max. Negotiated Rate	$582.77
Rate for Payer: Aetna Commercial	$550.39
Rate for Payer: Aetna Commercial	$433.70
Rate for Payer: Aetna Commercial	$5.51
Rate for Payer: Aetna Commercial	$213.18
Rate for Payer: Aetna New Business (MI Preferred)	$331.66
Rate for Payer: Aetna New Business (MI Preferred)	$4.21
Rate for Payer: Aetna New Business (MI Preferred)	$163.02
Rate for Payer: Aetna New Business (MI Preferred)	$420.89
Rate for Payer: Cash Price	$518.02
Rate for Payer: Cash Price	$5.18
Rate for Payer: Cash Price	$408.19
Rate for Payer: Cash Price	$200.64
Rate for Payer: Cofinity Commercial	$175.56
Rate for Payer: Cofinity Commercial	$5.57
Rate for Payer: Cofinity Commercial	$4.54
Rate for Payer: Cofinity Commercial	$453.26
Rate for Payer: Cofinity Commercial	$357.17
Rate for Payer: Cofinity Commercial	$438.81
Rate for Payer: Cofinity Commercial	$556.87
Rate for Payer: Cofinity Commercial	$215.69
Rate for Payer: Healthscope Commercial	$582.77
Rate for Payer: Healthscope Commercial	$225.72
Rate for Payer: Healthscope Commercial	$459.22
Rate for Payer: Healthscope Commercial	$5.83
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$550.39
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$213.18
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$433.70
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$5.51
Rate for Payer: PHP Commercial	$433.70
Rate for Payer: PHP Commercial	$213.18
Rate for Payer: PHP Commercial	$5.51
Rate for Payer: PHP Commercial	$550.39
Rate for Payer: Priority Health Cigna Priority Health	$357.17
Rate for Payer: Priority Health Cigna Priority Health	$453.26
Rate for Payer: Priority Health Cigna Priority Health	$175.56
Rate for Payer: Priority Health Cigna Priority Health	$4.54
Rate for Payer: Priority Health SBD	$4.08
Rate for Payer: Priority Health SBD	$158.00
Rate for Payer: Priority Health SBD	$407.94
Rate for Payer: Priority Health SBD	$321.45

METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION

Facility

$25.76

Service Code	HCPCS J1030
Hospital Charge Code	4995
Hospital Revenue Code	636
Min. Negotiated Rate	$16.23
Max. Negotiated Rate	$23.18
Rate for Payer: Aetna Commercial	$21.90
Rate for Payer: Aetna Commercial	$30.61
Rate for Payer: Aetna Commercial	$26.04
Rate for Payer: Aetna Commercial	$15.48
Rate for Payer: Aetna Commercial	$26.03
Rate for Payer: Aetna New Business (MI Preferred)	$16.74
Rate for Payer: Aetna New Business (MI Preferred)	$11.84
Rate for Payer: Aetna New Business (MI Preferred)	$23.41
Rate for Payer: Aetna New Business (MI Preferred)	$19.91
Rate for Payer: Aetna New Business (MI Preferred)	$19.90
Rate for Payer: Cash Price	$14.57
Rate for Payer: Cash Price	$20.61
Rate for Payer: Cash Price	$24.50
Rate for Payer: Cash Price	$24.50
Rate for Payer: Cash Price	$28.81
Rate for Payer: Cofinity Commercial	$12.75
Rate for Payer: Cofinity Commercial	$18.03
Rate for Payer: Cofinity Commercial	$30.97
Rate for Payer: Cofinity Commercial	$25.21
Rate for Payer: Cofinity Commercial	$15.66
Rate for Payer: Cofinity Commercial	$26.34
Rate for Payer: Cofinity Commercial	$21.44
Rate for Payer: Cofinity Commercial	$22.15
Rate for Payer: Cofinity Commercial	$21.43
Rate for Payer: Cofinity Commercial	$26.33
Rate for Payer: Healthscope Commercial	$32.41
Rate for Payer: Healthscope Commercial	$27.56
Rate for Payer: Healthscope Commercial	$16.39
Rate for Payer: Healthscope Commercial	$27.57
Rate for Payer: Healthscope Commercial	$23.18
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$30.61
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$26.03
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$21.90
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$26.04
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$15.48
Rate for Payer: PHP Commercial	$26.03
Rate for Payer: PHP Commercial	$26.04
Rate for Payer: PHP Commercial	$21.90
Rate for Payer: PHP Commercial	$15.48
Rate for Payer: PHP Commercial	$30.61
Rate for Payer: Priority Health Cigna Priority Health	$12.75
Rate for Payer: Priority Health Cigna Priority Health	$18.03
Rate for Payer: Priority Health Cigna Priority Health	$21.43
Rate for Payer: Priority Health Cigna Priority Health	$21.44
Rate for Payer: Priority Health Cigna Priority Health	$25.21
Rate for Payer: Priority Health SBD	$19.30
Rate for Payer: Priority Health SBD	$19.29
Rate for Payer: Priority Health SBD	$22.69
Rate for Payer: Priority Health SBD	$16.23
Rate for Payer: Priority Health SBD	$11.47

METHYLPREDNISOLONE ACETATE 80 MG/ML SUSPENSION FOR INJECTION

Facility

$35.18

Service Code	HCPCS J1040
Hospital Charge Code	4996
Hospital Revenue Code	636
Min. Negotiated Rate	$22.16
Max. Negotiated Rate	$31.66
Rate for Payer: Aetna Commercial	$29.90
Rate for Payer: Aetna Commercial	$22.02
Rate for Payer: Aetna New Business (MI Preferred)	$22.87
Rate for Payer: Aetna New Business (MI Preferred)	$16.84
Rate for Payer: Cash Price	$28.14
Rate for Payer: Cash Price	$20.72
Rate for Payer: Cofinity Commercial	$30.25
Rate for Payer: Cofinity Commercial	$18.13
Rate for Payer: Cofinity Commercial	$22.27
Rate for Payer: Cofinity Commercial	$24.63
Rate for Payer: Healthscope Commercial	$31.66
Rate for Payer: Healthscope Commercial	$23.31
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$22.02
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$29.90
Rate for Payer: PHP Commercial	$22.02
Rate for Payer: PHP Commercial	$29.90
Rate for Payer: Priority Health Cigna Priority Health	$24.63
Rate for Payer: Priority Health Cigna Priority Health	$18.13
Rate for Payer: Priority Health SBD	$16.32
Rate for Payer: Priority Health SBD	$22.16

METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION

Facility

$141.60

Service Code	HCPCS J2930
Hospital Charge Code	10577
Hospital Revenue Code	636
Min. Negotiated Rate	$89.21
Max. Negotiated Rate	$127.44
Rate for Payer: Aetna Commercial	$120.36
Rate for Payer: Aetna Commercial	$29.32
Rate for Payer: Aetna Commercial	$46.08
Rate for Payer: Aetna Commercial	$154.52
Rate for Payer: Aetna New Business (MI Preferred)	$22.42
Rate for Payer: Aetna New Business (MI Preferred)	$92.04
Rate for Payer: Aetna New Business (MI Preferred)	$118.16
Rate for Payer: Aetna New Business (MI Preferred)	$35.24
Rate for Payer: Cash Price	$113.28
Rate for Payer: Cash Price	$27.59
Rate for Payer: Cash Price	$43.37
Rate for Payer: Cash Price	$145.43
Rate for Payer: Cofinity Commercial	$46.62
Rate for Payer: Cofinity Commercial	$29.66
Rate for Payer: Cofinity Commercial	$24.14
Rate for Payer: Cofinity Commercial	$99.12
Rate for Payer: Cofinity Commercial	$37.95
Rate for Payer: Cofinity Commercial	$121.78
Rate for Payer: Cofinity Commercial	$127.25
Rate for Payer: Cofinity Commercial	$156.34
Rate for Payer: Healthscope Commercial	$48.79
Rate for Payer: Healthscope Commercial	$163.61
Rate for Payer: Healthscope Commercial	$127.44
Rate for Payer: Healthscope Commercial	$31.04
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$120.36
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$154.52
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$29.32
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$46.08
Rate for Payer: PHP Commercial	$154.52
Rate for Payer: PHP Commercial	$29.32
Rate for Payer: PHP Commercial	$120.36
Rate for Payer: PHP Commercial	$46.08
Rate for Payer: Priority Health Cigna Priority Health	$127.25
Rate for Payer: Priority Health Cigna Priority Health	$37.95
Rate for Payer: Priority Health Cigna Priority Health	$99.12
Rate for Payer: Priority Health Cigna Priority Health	$24.14
Rate for Payer: Priority Health SBD	$21.73
Rate for Payer: Priority Health SBD	$89.21
Rate for Payer: Priority Health SBD	$114.53
Rate for Payer: Priority Health SBD	$34.15

METHYLPREDNISOLONE SODIUM SUCCINATE 125 MG SOLUTION FOR INJECTION

Facility

$26.70

Service Code	HCPCS J2930
Hospital Charge Code	10578
Hospital Revenue Code	636
Min. Negotiated Rate	$16.82
Max. Negotiated Rate	$24.03
Rate for Payer: Aetna Commercial	$22.70
Rate for Payer: Aetna New Business (MI Preferred)	$17.36
Rate for Payer: Cash Price	$21.36
Rate for Payer: Cofinity Commercial	$18.69
Rate for Payer: Cofinity Commercial	$22.96
Rate for Payer: Healthscope Commercial	$24.03
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$22.70
Rate for Payer: PHP Commercial	$22.70
Rate for Payer: Priority Health Cigna Priority Health	$18.69
Rate for Payer: Priority Health SBD	$16.82

METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION

Facility

$100.26

Service Code	HCPCS J2930
Hospital Charge Code	10581
Hospital Revenue Code	636
Min. Negotiated Rate	$63.16
Max. Negotiated Rate	$90.23
Rate for Payer: Aetna Commercial	$85.22
Rate for Payer: Aetna New Business (MI Preferred)	$65.17
Rate for Payer: Cash Price	$80.21
Rate for Payer: Cofinity Commercial	$70.18
Rate for Payer: Cofinity Commercial	$86.22
Rate for Payer: Healthscope Commercial	$90.23
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$85.22
Rate for Payer: PHP Commercial	$85.22
Rate for Payer: Priority Health Cigna Priority Health	$70.18
Rate for Payer: Priority Health SBD	$63.16

METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOL (CODE)

Facility

$31.75

Service Code	HCPCS J2930
Hospital Charge Code	163731
Hospital Revenue Code	636
Min. Negotiated Rate	$20.00
Max. Negotiated Rate	$28.58
Rate for Payer: Aetna Commercial	$26.99
Rate for Payer: Aetna New Business (MI Preferred)	$20.64
Rate for Payer: Cash Price	$25.40
Rate for Payer: Cofinity Commercial	$22.22
Rate for Payer: Cofinity Commercial	$27.30
Rate for Payer: Healthscope Commercial	$28.58
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$26.99
Rate for Payer: PHP Commercial	$26.99
Rate for Payer: Priority Health Cigna Priority Health	$22.22
Rate for Payer: Priority Health SBD	$20.00

METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION

Facility

$31.75

Service Code	HCPCS J2930
Hospital Charge Code	119451
Hospital Revenue Code	636
Min. Negotiated Rate	$12.70
Max. Negotiated Rate	$28.58
Rate for Payer: Aetna Commercial	$26.99
Rate for Payer: Aetna New Business (MI Preferred)	$20.64
Rate for Payer: BCBS Complete	$12.70
Rate for Payer: BCBS Trust/PPO	$17.41
Rate for Payer: Cash Price	$25.40
Rate for Payer: Cash Price	$25.40
Rate for Payer: Cofinity Commercial	$27.30
Rate for Payer: Cofinity Commercial	$22.22
Rate for Payer: Healthscope Commercial	$28.58
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$26.99
Rate for Payer: PHP Commercial	$26.99
Rate for Payer: Priority Health Cigna Priority Health	$22.22
Rate for Payer: Priority Health SBD	$20.00

METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION

Facility

$31.75

Service Code	HCPCS J2930
Hospital Charge Code	119451
Hospital Revenue Code	636
Min. Negotiated Rate	$20.00
Max. Negotiated Rate	$28.58
Rate for Payer: Aetna Commercial	$26.99
Rate for Payer: Aetna New Business (MI Preferred)	$20.64
Rate for Payer: Cash Price	$25.40
Rate for Payer: Cofinity Commercial	$22.22
Rate for Payer: Cofinity Commercial	$27.30
Rate for Payer: Healthscope Commercial	$28.58
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$26.99
Rate for Payer: PHP Commercial	$26.99
Rate for Payer: Priority Health Cigna Priority Health	$22.22
Rate for Payer: Priority Health SBD	$20.00

METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION

Facility

$19.95

Service Code	HCPCS J2920
Hospital Charge Code	119450
Hospital Revenue Code	636
Min. Negotiated Rate	$7.98
Max. Negotiated Rate	$17.96
Rate for Payer: Aetna Commercial	$16.96
Rate for Payer: Aetna New Business (MI Preferred)	$12.97
Rate for Payer: BCBS Complete	$7.98
Rate for Payer: BCBS Trust/PPO	$12.38
Rate for Payer: Cash Price	$15.96
Rate for Payer: Cash Price	$15.96
Rate for Payer: Cofinity Commercial	$17.16
Rate for Payer: Cofinity Commercial	$13.96
Rate for Payer: Healthscope Commercial	$17.96
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$16.96
Rate for Payer: PHP Commercial	$16.96
Rate for Payer: Priority Health Cigna Priority Health	$13.96
Rate for Payer: Priority Health SBD	$12.57

METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION

Facility

$19.95

Service Code	HCPCS J2920
Hospital Charge Code	119450
Hospital Revenue Code	636
Min. Negotiated Rate	$12.57
Max. Negotiated Rate	$17.96
Rate for Payer: Cash Price	$15.96
Rate for Payer: Cofinity Commercial	$13.96
Rate for Payer: Cofinity Commercial	$17.16
Rate for Payer: Healthscope Commercial	$17.96
Rate for Payer: Aetna Commercial	$16.96
Rate for Payer: Aetna New Business (MI Preferred)	$12.97
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$16.96
Rate for Payer: PHP Commercial	$16.96
Rate for Payer: Priority Health Cigna Priority Health	$13.96
Rate for Payer: Priority Health SBD	$12.57

METHYL SALICYLATE 15 %-MENTHOL 10 % TOPICAL CREAM

Facility

$12.24

Service Code	NDC 45802-174-53
Hospital Charge Code	76971
Hospital Revenue Code	637
Min. Negotiated Rate	$7.71
Max. Negotiated Rate	$11.02
Rate for Payer: Aetna Commercial	$10.40
Rate for Payer: Aetna New Business (MI Preferred)	$7.96
Rate for Payer: Cash Price	$9.79
Rate for Payer: Cofinity Commercial	$10.53
Rate for Payer: Cofinity Commercial	$8.57
Rate for Payer: Healthscope Commercial	$11.02
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$10.40
Rate for Payer: PHP Commercial	$10.40
Rate for Payer: Priority Health Cigna Priority Health	$8.57
Rate for Payer: Priority Health SBD	$7.71

Know your out-of-pocket cost for care.

All Charges