Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

METOCLOPRAMIDE 10 MG TABLET

Facility

$3.27

Service Code	NDC 51079-888-01
Hospital Charge Code	5005
Hospital Revenue Code	637
Min. Negotiated Rate	$2.06
Max. Negotiated Rate	$2.94
Rate for Payer: Aetna Commercial	$2.78
Rate for Payer: Aetna New Business (MI Preferred)	$2.13
Rate for Payer: Cash Price	$2.62
Rate for Payer: Cofinity Commercial	$2.29
Rate for Payer: Cofinity Commercial	$2.81
Rate for Payer: Healthscope Commercial	$2.94
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2.78
Rate for Payer: PHP Commercial	$2.78
Rate for Payer: Priority Health Cigna Priority Health	$2.29
Rate for Payer: Priority Health SBD	$2.06

METOCLOPRAMIDE 10 MG TABLET

Facility

$75.20

Service Code	NDC 0093-2203-01
Hospital Charge Code	5005
Hospital Revenue Code	637
Min. Negotiated Rate	$47.38
Max. Negotiated Rate	$67.68
Rate for Payer: Aetna Commercial	$63.92
Rate for Payer: Aetna New Business (MI Preferred)	$48.88
Rate for Payer: Cash Price	$60.16
Rate for Payer: Cofinity Commercial	$52.64
Rate for Payer: Cofinity Commercial	$64.67
Rate for Payer: Healthscope Commercial	$67.68
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$63.92
Rate for Payer: PHP Commercial	$63.92
Rate for Payer: Priority Health Cigna Priority Health	$52.64
Rate for Payer: Priority Health SBD	$47.38

METOCLOPRAMIDE 10 MG TABLET

Facility

$326.40

Service Code	NDC 51079-888-20
Hospital Charge Code	5005
Hospital Revenue Code	637
Min. Negotiated Rate	$205.63
Max. Negotiated Rate	$293.76
Rate for Payer: Aetna Commercial	$277.44
Rate for Payer: Aetna New Business (MI Preferred)	$212.16
Rate for Payer: Cash Price	$261.12
Rate for Payer: Cofinity Commercial	$228.48
Rate for Payer: Cofinity Commercial	$280.70
Rate for Payer: Healthscope Commercial	$293.76
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$277.44
Rate for Payer: PHP Commercial	$277.44
Rate for Payer: Priority Health Cigna Priority Health	$228.48
Rate for Payer: Priority Health SBD	$205.63

METOCLOPRAMIDE 10 MG TABLET

Facility

$2.57

Service Code	NDC 60687-631-11
Hospital Charge Code	5005
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

METOCLOPRAMIDE 10 MG TABLET

Facility

$256.32

Service Code	NDC 60687-631-01
Hospital Charge Code	5005
Hospital Revenue Code	637
Min. Negotiated Rate	$161.48
Max. Negotiated Rate	$230.69
Rate for Payer: Aetna Commercial	$217.87
Rate for Payer: Aetna New Business (MI Preferred)	$166.61
Rate for Payer: Cash Price	$205.06
Rate for Payer: Cofinity Commercial	$179.42
Rate for Payer: Cofinity Commercial	$220.44
Rate for Payer: Healthscope Commercial	$230.69
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$217.87
Rate for Payer: PHP Commercial	$217.87
Rate for Payer: Priority Health Cigna Priority Health	$179.42
Rate for Payer: Priority Health SBD	$161.48

METOCLOPRAMIDE 10 MG TABLET

Facility

$188.00

Service Code	NDC 63739-293-10
Hospital Charge Code	5005
Hospital Revenue Code	637
Min. Negotiated Rate	$118.44
Max. Negotiated Rate	$169.20
Rate for Payer: Aetna Commercial	$159.80
Rate for Payer: Aetna New Business (MI Preferred)	$122.20
Rate for Payer: Cash Price	$150.40
Rate for Payer: Cofinity Commercial	$131.60
Rate for Payer: Cofinity Commercial	$161.68
Rate for Payer: Healthscope Commercial	$169.20
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$159.80
Rate for Payer: PHP Commercial	$159.80
Rate for Payer: Priority Health Cigna Priority Health	$131.60
Rate for Payer: Priority Health SBD	$118.44

METOCLOPRAMIDE 5 MG/5 ML ORAL SOLUTION

Facility

$30.50

Service Code	NDC 0121-1576-10
Hospital Charge Code	77725
Hospital Revenue Code	637
Min. Negotiated Rate	$19.22
Max. Negotiated Rate	$27.45
Rate for Payer: Aetna Commercial	$25.92
Rate for Payer: Aetna New Business (MI Preferred)	$19.82
Rate for Payer: Cash Price	$24.40
Rate for Payer: Cofinity Commercial	$21.35
Rate for Payer: Cofinity Commercial	$26.23
Rate for Payer: Healthscope Commercial	$27.45
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$25.92
Rate for Payer: PHP Commercial	$25.92
Rate for Payer: Priority Health Cigna Priority Health	$21.35
Rate for Payer: Priority Health SBD	$19.22

METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION

Facility

$10.79

Service Code	HCPCS J2765
Hospital Charge Code	5002
Hospital Revenue Code	636
Min. Negotiated Rate	$6.80
Max. Negotiated Rate	$9.71
Rate for Payer: Aetna Commercial	$9.17
Rate for Payer: Aetna Commercial	$12.16
Rate for Payer: Aetna New Business (MI Preferred)	$7.01
Rate for Payer: Aetna New Business (MI Preferred)	$9.30
Rate for Payer: Cash Price	$8.63
Rate for Payer: Cash Price	$11.44
Rate for Payer: Cofinity Commercial	$9.28
Rate for Payer: Cofinity Commercial	$7.55
Rate for Payer: Cofinity Commercial	$12.30
Rate for Payer: Cofinity Commercial	$10.01
Rate for Payer: Healthscope Commercial	$12.87
Rate for Payer: Healthscope Commercial	$9.71
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$9.17
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$12.16
Rate for Payer: PHP Commercial	$12.16
Rate for Payer: PHP Commercial	$9.17
Rate for Payer: Priority Health Cigna Priority Health	$7.55
Rate for Payer: Priority Health Cigna Priority Health	$10.01
Rate for Payer: Priority Health SBD	$9.01
Rate for Payer: Priority Health SBD	$6.80

METOCLOPRAMIDE 5 MG TABLET

Facility

$2.56

Service Code	NDC 60687-620-11
Hospital Charge Code	5006
Hospital Revenue Code	637
Min. Negotiated Rate	$1.61
Max. Negotiated Rate	$2.30
Rate for Payer: Aetna Commercial	$2.18
Rate for Payer: Aetna New Business (MI Preferred)	$1.66
Rate for Payer: Cash Price	$2.05
Rate for Payer: Cofinity Commercial	$1.79
Rate for Payer: Cofinity Commercial	$2.20
Rate for Payer: Healthscope Commercial	$2.30
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	$1.79
Rate for Payer: Priority Health SBD	$1.61

METOCLOPRAMIDE 5 MG TABLET

Facility

$255.84

Service Code	NDC 60687-620-01
Hospital Charge Code	5006
Hospital Revenue Code	637
Min. Negotiated Rate	$161.18
Max. Negotiated Rate	$230.26
Rate for Payer: Aetna Commercial	$217.46
Rate for Payer: Aetna New Business (MI Preferred)	$166.30
Rate for Payer: Cash Price	$204.67
Rate for Payer: Cofinity Commercial	$179.09
Rate for Payer: Cofinity Commercial	$220.02
Rate for Payer: Healthscope Commercial	$230.26
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$217.46
Rate for Payer: PHP Commercial	$217.46
Rate for Payer: Priority Health Cigna Priority Health	$179.09
Rate for Payer: Priority Health SBD	$161.18

METOLAZONE 2.5 MG TABLET

Facility

$934.99

Service Code	NDC 51079-023-20
Hospital Charge Code	10587
Hospital Revenue Code	637
Min. Negotiated Rate	$589.04
Max. Negotiated Rate	$841.49
Rate for Payer: Aetna Commercial	$794.74
Rate for Payer: Aetna New Business (MI Preferred)	$607.74
Rate for Payer: Cash Price	$747.99
Rate for Payer: Cofinity Commercial	$654.49
Rate for Payer: Cofinity Commercial	$804.09
Rate for Payer: Healthscope Commercial	$841.49
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$794.74
Rate for Payer: PHP Commercial	$794.74
Rate for Payer: Priority Health Cigna Priority Health	$654.49
Rate for Payer: Priority Health SBD	$589.04

METOLAZONE 2.5 MG TABLET

Facility

$257.28

Service Code	NDC 0185-5050-01
Hospital Charge Code	10587
Hospital Revenue Code	637
Min. Negotiated Rate	$162.09
Max. Negotiated Rate	$231.55
Rate for Payer: Aetna Commercial	$218.69
Rate for Payer: Aetna New Business (MI Preferred)	$167.23
Rate for Payer: Cash Price	$205.82
Rate for Payer: Cofinity Commercial	$180.10
Rate for Payer: Cofinity Commercial	$221.26
Rate for Payer: Healthscope Commercial	$231.55
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$218.69
Rate for Payer: PHP Commercial	$218.69
Rate for Payer: Priority Health Cigna Priority Health	$180.10
Rate for Payer: Priority Health SBD	$162.09

METOLAZONE 2.5 MG TABLET

Facility

$805.44

Service Code	NDC 0378-6172-01
Hospital Charge Code	10587
Hospital Revenue Code	637
Min. Negotiated Rate	$507.43
Max. Negotiated Rate	$724.90
Rate for Payer: Aetna Commercial	$684.62
Rate for Payer: Aetna New Business (MI Preferred)	$523.54
Rate for Payer: Cash Price	$644.35
Rate for Payer: Cofinity Commercial	$563.81
Rate for Payer: Cofinity Commercial	$692.68
Rate for Payer: Healthscope Commercial	$724.90
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$684.62
Rate for Payer: PHP Commercial	$684.62
Rate for Payer: Priority Health Cigna Priority Health	$563.81
Rate for Payer: Priority Health SBD	$507.43

METOLAZONE 2.5 MG TABLET

Facility

$9.35

Service Code	NDC 51079-023-01
Hospital Charge Code	10587
Hospital Revenue Code	637
Min. Negotiated Rate	$5.89
Max. Negotiated Rate	$8.42
Rate for Payer: Aetna Commercial	$7.95
Rate for Payer: Aetna New Business (MI Preferred)	$6.08
Rate for Payer: Cash Price	$7.48
Rate for Payer: Cofinity Commercial	$8.04
Rate for Payer: Cofinity Commercial	$6.54
Rate for Payer: Healthscope Commercial	$8.42
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$7.95
Rate for Payer: PHP Commercial	$7.95
Rate for Payer: Priority Health Cigna Priority Health	$6.54
Rate for Payer: Priority Health SBD	$5.89

METOLAZONE 2.5 MG TABLET

Facility

$752.21

Service Code	NDC 0904-6916-61
Hospital Charge Code	10587
Hospital Revenue Code	637
Min. Negotiated Rate	$473.89
Max. Negotiated Rate	$676.99
Rate for Payer: Aetna Commercial	$639.38
Rate for Payer: Aetna New Business (MI Preferred)	$488.94
Rate for Payer: Cash Price	$601.77
Rate for Payer: Cofinity Commercial	$526.55
Rate for Payer: Cofinity Commercial	$646.90
Rate for Payer: Healthscope Commercial	$676.99
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$639.38
Rate for Payer: PHP Commercial	$639.38
Rate for Payer: Priority Health Cigna Priority Health	$526.55
Rate for Payer: Priority Health SBD	$473.89

METOLAZONE 5 MG TABLET

Facility

$10.71

Service Code	NDC 51079-024-01
Hospital Charge Code	10588
Hospital Revenue Code	637
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$9.64
Rate for Payer: Aetna Commercial	$9.10
Rate for Payer: Aetna New Business (MI Preferred)	$6.96
Rate for Payer: Cash Price	$8.57
Rate for Payer: Cofinity Commercial	$9.21
Rate for Payer: Cofinity Commercial	$7.50
Rate for Payer: Healthscope Commercial	$9.64
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$9.10
Rate for Payer: PHP Commercial	$9.10
Rate for Payer: Priority Health Cigna Priority Health	$7.50
Rate for Payer: Priority Health SBD	$6.75

METOLAZONE 5 MG TABLET

Facility

$967.55

Service Code	NDC 0904-7329-61
Hospital Charge Code	10588
Hospital Revenue Code	637
Min. Negotiated Rate	$609.56
Max. Negotiated Rate	$870.80
Rate for Payer: Aetna Commercial	$822.42
Rate for Payer: Aetna New Business (MI Preferred)	$628.91
Rate for Payer: Cash Price	$774.04
Rate for Payer: Cofinity Commercial	$832.09
Rate for Payer: Cofinity Commercial	$677.28
Rate for Payer: Healthscope Commercial	$870.80
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$822.42
Rate for Payer: PHP Commercial	$822.42
Rate for Payer: Priority Health Cigna Priority Health	$677.28
Rate for Payer: Priority Health SBD	$609.56

METOLAZONE 5 MG TABLET

Facility

$895.40

Service Code	NDC 0904-7139-61
Hospital Charge Code	10588
Hospital Revenue Code	637
Min. Negotiated Rate	$564.10
Max. Negotiated Rate	$805.86
Rate for Payer: Aetna Commercial	$761.09
Rate for Payer: Aetna New Business (MI Preferred)	$582.01
Rate for Payer: Cash Price	$716.32
Rate for Payer: Cofinity Commercial	$626.78
Rate for Payer: Cofinity Commercial	$770.04
Rate for Payer: Healthscope Commercial	$805.86
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$761.09
Rate for Payer: PHP Commercial	$761.09
Rate for Payer: Priority Health Cigna Priority Health	$626.78
Rate for Payer: Priority Health SBD	$564.10

METOLAZONE 5 MG TABLET

Facility

$1,070.41

Service Code	NDC 51079-024-20
Hospital Charge Code	10588
Hospital Revenue Code	637
Min. Negotiated Rate	$674.36
Max. Negotiated Rate	$963.37
Rate for Payer: Aetna Commercial	$909.85
Rate for Payer: Aetna New Business (MI Preferred)	$695.77
Rate for Payer: Cash Price	$856.33
Rate for Payer: Cofinity Commercial	$920.55
Rate for Payer: Cofinity Commercial	$749.29
Rate for Payer: Healthscope Commercial	$963.37
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$909.85
Rate for Payer: PHP Commercial	$909.85
Rate for Payer: Priority Health Cigna Priority Health	$749.29
Rate for Payer: Priority Health SBD	$674.36

METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR

Facility

$311.52

Service Code	NDC 0904-6324-61
Hospital Charge Code	30071
Hospital Revenue Code	637
Min. Negotiated Rate	$196.26
Max. Negotiated Rate	$280.37
Rate for Payer: Aetna Commercial	$264.79
Rate for Payer: Aetna New Business (MI Preferred)	$202.49
Rate for Payer: Cash Price	$249.22
Rate for Payer: Cofinity Commercial	$218.06
Rate for Payer: Cofinity Commercial	$267.91
Rate for Payer: Healthscope Commercial	$280.37
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$264.79
Rate for Payer: PHP Commercial	$264.79
Rate for Payer: Priority Health Cigna Priority Health	$218.06
Rate for Payer: Priority Health SBD	$196.26

METOPROLOL SUCCINATE ER 12.5 MG CUSTOM TAB

Facility

$245.28

Service Code	NDC 9999-0015-01
Hospital Charge Code	150704
Hospital Revenue Code	637
Min. Negotiated Rate	$154.53
Max. Negotiated Rate	$220.75
Rate for Payer: Aetna Commercial	$208.49
Rate for Payer: Aetna New Business (MI Preferred)	$159.43
Rate for Payer: Cash Price	$196.22
Rate for Payer: Cofinity Commercial	$171.70
Rate for Payer: Cofinity Commercial	$210.94
Rate for Payer: Healthscope Commercial	$220.75
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$208.49
Rate for Payer: PHP Commercial	$208.49
Rate for Payer: Priority Health Cigna Priority Health	$171.70
Rate for Payer: Priority Health SBD	$154.53

METOPROLOL SUCCINATE ER 12.5 MG CUSTOM TAB

Facility

$240.48

Service Code	NDC 9900-0000-13
Hospital Charge Code	150704
Hospital Revenue Code	637
Min. Negotiated Rate	$151.50
Max. Negotiated Rate	$216.43
Rate for Payer: Aetna Commercial	$204.41
Rate for Payer: Aetna New Business (MI Preferred)	$156.31
Rate for Payer: Cash Price	$192.38
Rate for Payer: Cofinity Commercial	$168.34
Rate for Payer: Cofinity Commercial	$206.81
Rate for Payer: Healthscope Commercial	$216.43
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$204.41
Rate for Payer: PHP Commercial	$204.41
Rate for Payer: Priority Health Cigna Priority Health	$168.34
Rate for Payer: Priority Health SBD	$151.50

METOPROLOL SUCCINATE ER 25 MG TABLET,EXTENDED RELEASE 24 HR

Facility

$239.70

Service Code	NDC 50742-615-01
Hospital Charge Code	29858
Hospital Revenue Code	637
Min. Negotiated Rate	$151.01
Max. Negotiated Rate	$215.73
Rate for Payer: Aetna Commercial	$203.74
Rate for Payer: Aetna New Business (MI Preferred)	$155.80
Rate for Payer: Cash Price	$191.76
Rate for Payer: Cofinity Commercial	$167.79
Rate for Payer: Cofinity Commercial	$206.14
Rate for Payer: Healthscope Commercial	$215.73
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$203.74
Rate for Payer: PHP Commercial	$203.74
Rate for Payer: Priority Health Cigna Priority Health	$167.79
Rate for Payer: Priority Health SBD	$151.01

METOPROLOL SUCCINATE ER 25 MG TABLET,EXTENDED RELEASE 24 HR

Facility

$152.75

Service Code	NDC 70436-202-01
Hospital Charge Code	29858
Hospital Revenue Code	637
Min. Negotiated Rate	$96.23
Max. Negotiated Rate	$137.48
Rate for Payer: Aetna Commercial	$129.84
Rate for Payer: Aetna New Business (MI Preferred)	$99.29
Rate for Payer: Cash Price	$122.20
Rate for Payer: Cofinity Commercial	$106.92
Rate for Payer: Cofinity Commercial	$131.36
Rate for Payer: Healthscope Commercial	$137.48
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$129.84
Rate for Payer: PHP Commercial	$129.84
Rate for Payer: Priority Health Cigna Priority Health	$106.92
Rate for Payer: Priority Health SBD	$96.23

METOPROLOL SUCCINATE ER 25 MG TABLET,EXTENDED RELEASE 24 HR

Facility

$367.65

Service Code	NDC 0904-6322-61
Hospital Charge Code	29858
Hospital Revenue Code	637
Min. Negotiated Rate	$231.62
Max. Negotiated Rate	$330.88
Rate for Payer: Aetna Commercial	$312.50
Rate for Payer: Aetna New Business (MI Preferred)	$238.97
Rate for Payer: Cash Price	$294.12
Rate for Payer: Cofinity Commercial	$316.18
Rate for Payer: Cofinity Commercial	$257.36
Rate for Payer: Healthscope Commercial	$330.88
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$312.50
Rate for Payer: PHP Commercial	$312.50
Rate for Payer: Priority Health Cigna Priority Health	$257.36
Rate for Payer: Priority Health SBD	$231.62

Know your out-of-pocket cost for care.

All Charges