Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

IBUPROFEN 600 MG TABLET

Facility

$634.50

Service Code	NDC 67877032005
Hospital Charge Code	3844
Hospital Revenue Code	637
Min. Negotiated Rate	$399.74
Max. Negotiated Rate	$571.05
Rate for Payer: Aetna Commercial	$539.33
Rate for Payer: Aetna New Business (MI Preferred)	$412.43
Rate for Payer: Cash Price	$507.60
Rate for Payer: Cofinity Advantage	$444.15
Rate for Payer: Cofinity Commercial	$545.67
Rate for Payer: Encore Health Key Benefits Commercial	$507.60
Rate for Payer: Healthscope Commercial	$571.05
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$539.33
Rate for Payer: Opus (Opus Packaging Group) HMA	$475.88
Rate for Payer: PHP Commercial	$539.33
Rate for Payer: Priority Health SBD	$399.74

IBUPROFEN 600 MG TABLET

Facility

$705.00

Service Code	NDC 64380080807
Hospital Charge Code	3844
Hospital Revenue Code	637
Min. Negotiated Rate	$444.15
Max. Negotiated Rate	$634.50
Rate for Payer: Aetna Commercial	$599.25
Rate for Payer: Aetna New Business (MI Preferred)	$458.25
Rate for Payer: Cash Price	$564.00
Rate for Payer: Cofinity Advantage	$493.50
Rate for Payer: Cofinity Commercial	$606.30
Rate for Payer: Encore Health Key Benefits Commercial	$564.00
Rate for Payer: Healthscope Commercial	$634.50
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$599.25
Rate for Payer: Opus (Opus Packaging Group) HMA	$528.75
Rate for Payer: PHP Commercial	$599.25
Rate for Payer: Priority Health SBD	$444.15

IBUPROFEN 600 MG TABLET

Facility

$705.00

Service Code	NDC 64380080807
Hospital Charge Code	3844
Hospital Revenue Code	637
Min. Negotiated Rate	$277.06
Max. Negotiated Rate	$634.50
Rate for Payer: Aetna Commercial	$599.25
Rate for Payer: Aetna Medicare	$352.50
Rate for Payer: Aetna New Business (MI Preferred)	$458.25
Rate for Payer: BCBS Complete	$282.00
Rate for Payer: Cash Price	$564.00
Rate for Payer: Cofinity Advantage	$493.50
Rate for Payer: Cofinity Commercial	$606.30
Rate for Payer: Encore Health Key Benefits Commercial	$564.00
Rate for Payer: Healthscope Commercial	$634.50
Rate for Payer: MI Amish Medical Board Commercial	$564.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$599.25
Rate for Payer: Opus (Opus Packaging Group) HMA	$528.75
Rate for Payer: PHP Commercial	$599.25
Rate for Payer: Priority Health SBD	$444.15
Rate for Payer: UHC All Payor (Choice/PPO)	$458.25
Rate for Payer: UHC Core	$367.31
Rate for Payer: UHC Exchange	$277.06

IBUPROFEN 600 MG TABLET

Facility

$406.55

Service Code	NDC 60687045701
Hospital Charge Code	3844
Hospital Revenue Code	637
Min. Negotiated Rate	$159.77
Max. Negotiated Rate	$365.89
Rate for Payer: Aetna Commercial	$345.57
Rate for Payer: Aetna Medicare	$203.28
Rate for Payer: Aetna New Business (MI Preferred)	$264.26
Rate for Payer: BCBS Complete	$162.62
Rate for Payer: Cash Price	$325.24
Rate for Payer: Cofinity Advantage	$284.58
Rate for Payer: Cofinity Commercial	$349.63
Rate for Payer: Encore Health Key Benefits Commercial	$325.24
Rate for Payer: Healthscope Commercial	$365.89
Rate for Payer: MI Amish Medical Board Commercial	$325.24
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$345.57
Rate for Payer: Opus (Opus Packaging Group) HMA	$304.91
Rate for Payer: PHP Commercial	$345.57
Rate for Payer: Priority Health SBD	$256.13
Rate for Payer: UHC All Payor (Choice/PPO)	$264.26
Rate for Payer: UHC Core	$211.81
Rate for Payer: UHC Exchange	$159.77

IBUPROFEN 600 MG TABLET

Facility

$4.07

Service Code	NDC 60687045711
Hospital Charge Code	3844
Hospital Revenue Code	637
Min. Negotiated Rate	$2.56
Max. Negotiated Rate	$3.66
Rate for Payer: Aetna Commercial	$3.46
Rate for Payer: Aetna New Business (MI Preferred)	$2.65
Rate for Payer: Cash Price	$3.26
Rate for Payer: Cofinity Advantage	$2.85
Rate for Payer: Cofinity Commercial	$3.50
Rate for Payer: Encore Health Key Benefits Commercial	$3.26
Rate for Payer: Healthscope Commercial	$3.66
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3.46
Rate for Payer: Opus (Opus Packaging Group) HMA	$3.05
Rate for Payer: PHP Commercial	$3.46
Rate for Payer: Priority Health SBD	$2.56

IBUPROFEN 600 MG TABLET

Facility

$4.07

Service Code	NDC 60687045711
Hospital Charge Code	3844
Hospital Revenue Code	637
Min. Negotiated Rate	$1.60
Max. Negotiated Rate	$3.66
Rate for Payer: Aetna Commercial	$3.46
Rate for Payer: Aetna Medicare	$2.04
Rate for Payer: Aetna New Business (MI Preferred)	$2.65
Rate for Payer: BCBS Complete	$1.63
Rate for Payer: Cash Price	$3.26
Rate for Payer: Cofinity Advantage	$2.85
Rate for Payer: Cofinity Commercial	$3.50
Rate for Payer: Encore Health Key Benefits Commercial	$3.26
Rate for Payer: Healthscope Commercial	$3.66
Rate for Payer: MI Amish Medical Board Commercial	$3.26
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3.46
Rate for Payer: Opus (Opus Packaging Group) HMA	$3.05
Rate for Payer: PHP Commercial	$3.46
Rate for Payer: Priority Health SBD	$2.56
Rate for Payer: UHC All Payor (Choice/PPO)	$2.65
Rate for Payer: UHC Core	$2.12
Rate for Payer: UHC Exchange	$1.60

IBUPROFEN 600 MG TABLET

Facility

$634.50

Service Code	NDC 67877032005
Hospital Charge Code	3844
Hospital Revenue Code	637
Min. Negotiated Rate	$249.36
Max. Negotiated Rate	$571.05
Rate for Payer: Aetna Commercial	$539.33
Rate for Payer: Aetna Medicare	$317.25
Rate for Payer: Aetna New Business (MI Preferred)	$412.43
Rate for Payer: BCBS Complete	$253.80
Rate for Payer: Cash Price	$507.60
Rate for Payer: Cofinity Advantage	$444.15
Rate for Payer: Cofinity Commercial	$545.67
Rate for Payer: Encore Health Key Benefits Commercial	$507.60
Rate for Payer: Healthscope Commercial	$571.05
Rate for Payer: MI Amish Medical Board Commercial	$507.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$539.33
Rate for Payer: Opus (Opus Packaging Group) HMA	$475.88
Rate for Payer: PHP Commercial	$539.33
Rate for Payer: Priority Health SBD	$399.74
Rate for Payer: UHC All Payor (Choice/PPO)	$412.43
Rate for Payer: UHC Core	$330.57
Rate for Payer: UHC Exchange	$249.36

IBUPROFEN 600 MG TABLET

Facility

$185.65

Service Code	NDC 00904585461
Hospital Charge Code	3844
Hospital Revenue Code	637
Min. Negotiated Rate	$116.96
Max. Negotiated Rate	$167.09
Rate for Payer: Aetna Commercial	$157.80
Rate for Payer: Aetna New Business (MI Preferred)	$120.67
Rate for Payer: Cash Price	$148.52
Rate for Payer: Cofinity Advantage	$129.96
Rate for Payer: Cofinity Commercial	$159.66
Rate for Payer: Encore Health Key Benefits Commercial	$148.52
Rate for Payer: Healthscope Commercial	$167.09
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$157.80
Rate for Payer: Opus (Opus Packaging Group) HMA	$139.24
Rate for Payer: PHP Commercial	$157.80
Rate for Payer: Priority Health SBD	$116.96

IBUPROFEN 600 MG TABLET

Facility

$406.55

Service Code	NDC 60687045701
Hospital Charge Code	3844
Hospital Revenue Code	637
Min. Negotiated Rate	$256.13
Max. Negotiated Rate	$365.89
Rate for Payer: Aetna Commercial	$345.57
Rate for Payer: Aetna New Business (MI Preferred)	$264.26
Rate for Payer: Cash Price	$325.24
Rate for Payer: Cofinity Advantage	$284.58
Rate for Payer: Cofinity Commercial	$349.63
Rate for Payer: Encore Health Key Benefits Commercial	$325.24
Rate for Payer: Healthscope Commercial	$365.89
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$345.57
Rate for Payer: Opus (Opus Packaging Group) HMA	$304.91
Rate for Payer: PHP Commercial	$345.57
Rate for Payer: Priority Health SBD	$256.13

IBUPROFEN 600 MG TABLET

Facility

$166.85

Service Code	NDC 67877032001
Hospital Charge Code	3844
Hospital Revenue Code	637
Min. Negotiated Rate	$65.57
Max. Negotiated Rate	$150.16
Rate for Payer: Aetna Commercial	$141.82
Rate for Payer: Aetna Medicare	$83.42
Rate for Payer: Aetna New Business (MI Preferred)	$108.45
Rate for Payer: BCBS Complete	$66.74
Rate for Payer: Cash Price	$133.48
Rate for Payer: Cofinity Advantage	$116.80
Rate for Payer: Cofinity Commercial	$143.49
Rate for Payer: Encore Health Key Benefits Commercial	$133.48
Rate for Payer: Healthscope Commercial	$150.16
Rate for Payer: MI Amish Medical Board Commercial	$133.48
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$141.82
Rate for Payer: Opus (Opus Packaging Group) HMA	$125.14
Rate for Payer: PHP Commercial	$141.82
Rate for Payer: Priority Health SBD	$105.12
Rate for Payer: UHC All Payor (Choice/PPO)	$108.45
Rate for Payer: UHC Core	$86.93
Rate for Payer: UHC Exchange	$65.57

IBUPROFEN 600 MG TABLET

Facility

$152.75

Service Code	NDC 64380080806
Hospital Charge Code	3844
Hospital Revenue Code	637
Min. Negotiated Rate	$96.23
Max. Negotiated Rate	$137.47
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 Advantage	$106.92
Rate for Payer: Cofinity Commercial	$131.37
Rate for Payer: Encore Health Key Benefits Commercial	$122.20
Rate for Payer: Healthscope Commercial	$137.47
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$129.84
Rate for Payer: Opus (Opus Packaging Group) HMA	$114.56
Rate for Payer: PHP Commercial	$129.84
Rate for Payer: Priority Health SBD	$96.23

IBUPROFEN 600 MG TABLET

Facility

$166.85

Service Code	NDC 67877032001
Hospital Charge Code	3844
Hospital Revenue Code	637
Min. Negotiated Rate	$105.12
Max. Negotiated Rate	$150.16
Rate for Payer: Aetna Commercial	$141.82
Rate for Payer: Aetna New Business (MI Preferred)	$108.45
Rate for Payer: Cash Price	$133.48
Rate for Payer: Cofinity Advantage	$116.80
Rate for Payer: Cofinity Commercial	$143.49
Rate for Payer: Encore Health Key Benefits Commercial	$133.48
Rate for Payer: Healthscope Commercial	$150.16
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$141.82
Rate for Payer: Opus (Opus Packaging Group) HMA	$125.14
Rate for Payer: PHP Commercial	$141.82
Rate for Payer: Priority Health SBD	$105.12

IBUPROFEN 600 MG TABLET

Facility

$152.75

Service Code	NDC 64380080806
Hospital Charge Code	3844
Hospital Revenue Code	637
Min. Negotiated Rate	$60.03
Max. Negotiated Rate	$137.47
Rate for Payer: Aetna Commercial	$129.84
Rate for Payer: Aetna Medicare	$76.38
Rate for Payer: Aetna New Business (MI Preferred)	$99.29
Rate for Payer: BCBS Complete	$61.10
Rate for Payer: Cash Price	$122.20
Rate for Payer: Cofinity Advantage	$106.92
Rate for Payer: Cofinity Commercial	$131.37
Rate for Payer: Encore Health Key Benefits Commercial	$122.20
Rate for Payer: Healthscope Commercial	$137.47
Rate for Payer: MI Amish Medical Board Commercial	$122.20
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$129.84
Rate for Payer: Opus (Opus Packaging Group) HMA	$114.56
Rate for Payer: PHP Commercial	$129.84
Rate for Payer: Priority Health SBD	$96.23
Rate for Payer: UHC All Payor (Choice/PPO)	$99.29
Rate for Payer: UHC Core	$79.58
Rate for Payer: UHC Exchange	$60.03

IBUPROFEN 600 MG TABLET

Facility

$157.45

Service Code	NDC 49483060301
Hospital Charge Code	3844
Hospital Revenue Code	637
Min. Negotiated Rate	$99.19
Max. Negotiated Rate	$141.71
Rate for Payer: Aetna Commercial	$133.83
Rate for Payer: Aetna New Business (MI Preferred)	$102.34
Rate for Payer: Cash Price	$125.96
Rate for Payer: Cofinity Advantage	$110.22
Rate for Payer: Cofinity Commercial	$135.41
Rate for Payer: Encore Health Key Benefits Commercial	$125.96
Rate for Payer: Healthscope Commercial	$141.71
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$133.83
Rate for Payer: Opus (Opus Packaging Group) HMA	$118.09
Rate for Payer: PHP Commercial	$133.83
Rate for Payer: Priority Health SBD	$99.19

IBUPROFEN 600 MG TABLET

Facility

$157.45

Service Code	NDC 49483060301
Hospital Charge Code	3844
Hospital Revenue Code	637
Min. Negotiated Rate	$61.88
Max. Negotiated Rate	$141.71
Rate for Payer: Aetna Commercial	$133.83
Rate for Payer: Aetna Medicare	$78.72
Rate for Payer: Aetna New Business (MI Preferred)	$102.34
Rate for Payer: BCBS Complete	$62.98
Rate for Payer: Cash Price	$125.96
Rate for Payer: Cofinity Advantage	$110.22
Rate for Payer: Cofinity Commercial	$135.41
Rate for Payer: Encore Health Key Benefits Commercial	$125.96
Rate for Payer: Healthscope Commercial	$141.71
Rate for Payer: MI Amish Medical Board Commercial	$125.96
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$133.83
Rate for Payer: Opus (Opus Packaging Group) HMA	$118.09
Rate for Payer: PHP Commercial	$133.83
Rate for Payer: Priority Health SBD	$99.19
Rate for Payer: UHC All Payor (Choice/PPO)	$102.34
Rate for Payer: UHC Core	$82.03
Rate for Payer: UHC Exchange	$61.88

IBUPROFEN 800 MG TABLET

Facility

$267.90

Service Code	NDC 00904585560
Hospital Charge Code	3845
Hospital Revenue Code	637
Min. Negotiated Rate	$168.78
Max. Negotiated Rate	$241.11
Rate for Payer: Aetna Commercial	$227.72
Rate for Payer: Aetna New Business (MI Preferred)	$174.13
Rate for Payer: Cash Price	$214.32
Rate for Payer: Cofinity Advantage	$187.53
Rate for Payer: Cofinity Commercial	$230.39
Rate for Payer: Encore Health Key Benefits Commercial	$214.32
Rate for Payer: Healthscope Commercial	$241.11
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$227.72
Rate for Payer: Opus (Opus Packaging Group) HMA	$200.93
Rate for Payer: PHP Commercial	$227.72
Rate for Payer: Priority Health SBD	$168.78

IBUPROFEN 800 MG TABLET

Facility

$157.45

Service Code	NDC 67877032101
Hospital Charge Code	3845
Hospital Revenue Code	637
Min. Negotiated Rate	$99.19
Max. Negotiated Rate	$141.71
Rate for Payer: Aetna Commercial	$133.83
Rate for Payer: Aetna New Business (MI Preferred)	$102.34
Rate for Payer: Cash Price	$125.96
Rate for Payer: Cofinity Advantage	$110.22
Rate for Payer: Cofinity Commercial	$135.41
Rate for Payer: Encore Health Key Benefits Commercial	$125.96
Rate for Payer: Healthscope Commercial	$141.71
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$133.83
Rate for Payer: Opus (Opus Packaging Group) HMA	$118.09
Rate for Payer: PHP Commercial	$133.83
Rate for Payer: Priority Health SBD	$99.19

IBUPROFEN 800 MG TABLET

Facility

$46.53

Service Code	NDC 68645056354
Hospital Charge Code	3845
Hospital Revenue Code	637
Min. Negotiated Rate	$18.29
Max. Negotiated Rate	$41.88
Rate for Payer: Aetna Commercial	$39.55
Rate for Payer: Aetna Medicare	$23.27
Rate for Payer: Aetna New Business (MI Preferred)	$30.24
Rate for Payer: BCBS Complete	$18.61
Rate for Payer: Cash Price	$37.22
Rate for Payer: Cofinity Advantage	$32.57
Rate for Payer: Cofinity Commercial	$40.02
Rate for Payer: Encore Health Key Benefits Commercial	$37.22
Rate for Payer: Healthscope Commercial	$41.88
Rate for Payer: MI Amish Medical Board Commercial	$37.22
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$39.55
Rate for Payer: Opus (Opus Packaging Group) HMA	$34.90
Rate for Payer: PHP Commercial	$39.55
Rate for Payer: Priority Health SBD	$29.31
Rate for Payer: UHC All Payor (Choice/PPO)	$30.24
Rate for Payer: UHC Core	$24.24
Rate for Payer: UHC Exchange	$18.29

IBUPROFEN 800 MG TABLET

Facility

$267.90

Service Code	NDC 00904585560
Hospital Charge Code	3845
Hospital Revenue Code	637
Min. Negotiated Rate	$105.28
Max. Negotiated Rate	$241.11
Rate for Payer: Aetna Commercial	$227.72
Rate for Payer: Aetna Medicare	$133.95
Rate for Payer: Aetna New Business (MI Preferred)	$174.13
Rate for Payer: BCBS Complete	$107.16
Rate for Payer: Cash Price	$214.32
Rate for Payer: Cofinity Advantage	$187.53
Rate for Payer: Cofinity Commercial	$230.39
Rate for Payer: Encore Health Key Benefits Commercial	$214.32
Rate for Payer: Healthscope Commercial	$241.11
Rate for Payer: MI Amish Medical Board Commercial	$214.32
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$227.72
Rate for Payer: Opus (Opus Packaging Group) HMA	$200.93
Rate for Payer: PHP Commercial	$227.72
Rate for Payer: Priority Health SBD	$168.78
Rate for Payer: UHC All Payor (Choice/PPO)	$174.13
Rate for Payer: UHC Core	$139.58
Rate for Payer: UHC Exchange	$105.28

IBUPROFEN 800 MG TABLET

Facility

$157.45

Service Code	NDC 67877032101
Hospital Charge Code	3845
Hospital Revenue Code	637
Min. Negotiated Rate	$61.88
Max. Negotiated Rate	$141.71
Rate for Payer: Aetna Commercial	$133.83
Rate for Payer: Aetna Medicare	$78.72
Rate for Payer: Aetna New Business (MI Preferred)	$102.34
Rate for Payer: BCBS Complete	$62.98
Rate for Payer: Cash Price	$125.96
Rate for Payer: Cofinity Advantage	$110.22
Rate for Payer: Cofinity Commercial	$135.41
Rate for Payer: Encore Health Key Benefits Commercial	$125.96
Rate for Payer: Healthscope Commercial	$141.71
Rate for Payer: MI Amish Medical Board Commercial	$125.96
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$133.83
Rate for Payer: Opus (Opus Packaging Group) HMA	$118.09
Rate for Payer: PHP Commercial	$133.83
Rate for Payer: Priority Health SBD	$99.19
Rate for Payer: UHC All Payor (Choice/PPO)	$102.34
Rate for Payer: UHC Core	$82.03
Rate for Payer: UHC Exchange	$61.88

IBUPROFEN 800 MG TABLET

Facility

$383.05

Service Code	NDC 60687046801
Hospital Charge Code	3845
Hospital Revenue Code	637
Min. Negotiated Rate	$150.54
Max. Negotiated Rate	$344.75
Rate for Payer: Aetna Commercial	$325.59
Rate for Payer: Aetna Medicare	$191.53
Rate for Payer: Aetna New Business (MI Preferred)	$248.98
Rate for Payer: BCBS Complete	$153.22
Rate for Payer: Cash Price	$306.44
Rate for Payer: Cofinity Advantage	$268.13
Rate for Payer: Cofinity Commercial	$329.42
Rate for Payer: Encore Health Key Benefits Commercial	$306.44
Rate for Payer: Healthscope Commercial	$344.75
Rate for Payer: MI Amish Medical Board Commercial	$306.44
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$325.59
Rate for Payer: Opus (Opus Packaging Group) HMA	$287.29
Rate for Payer: PHP Commercial	$325.59
Rate for Payer: Priority Health SBD	$241.32
Rate for Payer: UHC All Payor (Choice/PPO)	$248.98
Rate for Payer: UHC Core	$199.57
Rate for Payer: UHC Exchange	$150.54

IBUPROFEN 800 MG TABLET

Facility

$3.84

Service Code	NDC 60687046811
Hospital Charge Code	3845
Hospital Revenue Code	637
Min. Negotiated Rate	$2.42
Max. Negotiated Rate	$3.46
Rate for Payer: Aetna Commercial	$3.26
Rate for Payer: Aetna New Business (MI Preferred)	$2.50
Rate for Payer: Cash Price	$3.07
Rate for Payer: Cofinity Advantage	$2.69
Rate for Payer: Cofinity Commercial	$3.30
Rate for Payer: Encore Health Key Benefits Commercial	$3.07
Rate for Payer: Healthscope Commercial	$3.46
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3.26
Rate for Payer: Opus (Opus Packaging Group) HMA	$2.88
Rate for Payer: PHP Commercial	$3.26
Rate for Payer: Priority Health SBD	$2.42

IBUPROFEN 800 MG TABLET

Facility

$3.84

Service Code	NDC 60687046811
Hospital Charge Code	3845
Hospital Revenue Code	637
Min. Negotiated Rate	$1.51
Max. Negotiated Rate	$3.46
Rate for Payer: Aetna Commercial	$3.26
Rate for Payer: Aetna Medicare	$1.92
Rate for Payer: Aetna New Business (MI Preferred)	$2.50
Rate for Payer: BCBS Complete	$1.54
Rate for Payer: Cash Price	$3.07
Rate for Payer: Cofinity Advantage	$2.69
Rate for Payer: Cofinity Commercial	$3.30
Rate for Payer: Encore Health Key Benefits Commercial	$3.07
Rate for Payer: Healthscope Commercial	$3.46
Rate for Payer: MI Amish Medical Board Commercial	$3.07
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3.26
Rate for Payer: Opus (Opus Packaging Group) HMA	$2.88
Rate for Payer: PHP Commercial	$3.26
Rate for Payer: Priority Health SBD	$2.42
Rate for Payer: UHC All Payor (Choice/PPO)	$2.50
Rate for Payer: UHC Core	$2.00
Rate for Payer: UHC Exchange	$1.51

IBUPROFEN 800 MG TABLET

Facility

$18.80

Service Code	NDC 00904585561
Hospital Charge Code	3845
Hospital Revenue Code	637
Min. Negotiated Rate	$11.84
Max. Negotiated Rate	$16.92
Rate for Payer: Aetna Commercial	$15.98
Rate for Payer: Aetna New Business (MI Preferred)	$12.22
Rate for Payer: Cash Price	$15.04
Rate for Payer: Cofinity Advantage	$13.16
Rate for Payer: Cofinity Commercial	$16.17
Rate for Payer: Encore Health Key Benefits Commercial	$15.04
Rate for Payer: Healthscope Commercial	$16.92
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$15.98
Rate for Payer: Opus (Opus Packaging Group) HMA	$14.10
Rate for Payer: PHP Commercial	$15.98
Rate for Payer: Priority Health SBD	$11.84

IBUPROFEN 800 MG TABLET

Facility

$46.53

Service Code	NDC 68645056354
Hospital Charge Code	3845
Hospital Revenue Code	637
Min. Negotiated Rate	$29.31
Max. Negotiated Rate	$41.88
Rate for Payer: Aetna Commercial	$39.55
Rate for Payer: Aetna New Business (MI Preferred)	$30.24
Rate for Payer: Cash Price	$37.22
Rate for Payer: Cofinity Advantage	$32.57
Rate for Payer: Cofinity Commercial	$40.02
Rate for Payer: Encore Health Key Benefits Commercial	$37.22
Rate for Payer: Healthscope Commercial	$41.88
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$39.55
Rate for Payer: Opus (Opus Packaging Group) HMA	$34.90
Rate for Payer: PHP Commercial	$39.55
Rate for Payer: Priority Health SBD	$29.31

Know your out-of-pocket cost for care.

All Charges