Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

MESALAMINE 4 GRAM/60 ML ENEMA

Facility

$39.08

Service Code	NDC 45802009846
Hospital Charge Code	10535
Hospital Revenue Code	637
Min. Negotiated Rate	$15.63
Max. Negotiated Rate	$35.17
Rate for Payer: Aetna Commercial	$33.22
Rate for Payer: Aetna Medicare	$19.54
Rate for Payer: Aetna New Business (MI Preferred)	$25.40
Rate for Payer: BCBS Complete	$15.63
Rate for Payer: Cash Price	$31.26
Rate for Payer: Cofinity Commercial	$27.36
Rate for Payer: Cofinity Commercial	$33.61
Rate for Payer: Cofinity Medicare Advantage	$27.36
Rate for Payer: Encore Health Key Benefits Commercial	$31.26
Rate for Payer: Healthscope Commercial	$35.17
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$33.22
Rate for Payer: PHP Commercial	$33.22
Rate for Payer: Priority Health Cigna Priority Health	$25.40
Rate for Payer: Priority Health SBD	$24.62

MESALAMINE 4 GRAM/60 ML ENEMA

Facility

$39.08

Service Code	NDC 45802009846
Hospital Charge Code	10535
Hospital Revenue Code	637
Min. Negotiated Rate	$24.62
Max. Negotiated Rate	$35.17
Rate for Payer: Aetna Commercial	$33.22
Rate for Payer: Aetna New Business (MI Preferred)	$25.40
Rate for Payer: Cash Price	$31.26
Rate for Payer: Cofinity Commercial	$27.36
Rate for Payer: Cofinity Commercial	$33.61
Rate for Payer: Cofinity Medicare Advantage	$27.36
Rate for Payer: Encore Health Key Benefits Commercial	$31.26
Rate for Payer: Healthscope Commercial	$35.17
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$33.22
Rate for Payer: PHP Commercial	$33.22
Rate for Payer: Priority Health Cigna Priority Health	$25.40
Rate for Payer: Priority Health SBD	$24.62

MESALAMINE 800 MG TABLET,DELAYED RELEASE

Facility

$47.03

Service Code	NDC 60687040895
Hospital Charge Code	96949
Hospital Revenue Code	637
Min. Negotiated Rate	$29.63
Max. Negotiated Rate	$42.33
Rate for Payer: Aetna Commercial	$39.98
Rate for Payer: Aetna New Business (MI Preferred)	$30.57
Rate for Payer: Cash Price	$37.62
Rate for Payer: Cofinity Commercial	$32.92
Rate for Payer: Cofinity Commercial	$40.45
Rate for Payer: Cofinity Medicare Advantage	$32.92
Rate for Payer: Encore Health Key Benefits Commercial	$37.62
Rate for Payer: Healthscope Commercial	$42.33
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$39.98
Rate for Payer: PHP Commercial	$39.98
Rate for Payer: Priority Health Cigna Priority Health	$30.57
Rate for Payer: Priority Health SBD	$29.63

MESALAMINE 800 MG TABLET,DELAYED RELEASE

Facility

$47.03

Service Code	NDC 60687040895
Hospital Charge Code	96949
Hospital Revenue Code	637
Min. Negotiated Rate	$18.81
Max. Negotiated Rate	$42.33
Rate for Payer: Aetna Commercial	$39.98
Rate for Payer: Aetna Medicare	$23.52
Rate for Payer: Aetna New Business (MI Preferred)	$30.57
Rate for Payer: BCBS Complete	$18.81
Rate for Payer: Cash Price	$37.62
Rate for Payer: Cofinity Commercial	$32.92
Rate for Payer: Cofinity Commercial	$40.45
Rate for Payer: Cofinity Medicare Advantage	$32.92
Rate for Payer: Encore Health Key Benefits Commercial	$37.62
Rate for Payer: Healthscope Commercial	$42.33
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$39.98
Rate for Payer: PHP Commercial	$39.98
Rate for Payer: Priority Health Cigna Priority Health	$30.57
Rate for Payer: Priority Health SBD	$29.63

MESALAMINE 800 MG TABLET,DELAYED RELEASE

Facility

$4,595.40

Service Code	NDC 68382043528
Hospital Charge Code	96949
Hospital Revenue Code	637
Min. Negotiated Rate	$2,895.10
Max. Negotiated Rate	$4,135.86
Rate for Payer: Aetna Commercial	$3,906.09
Rate for Payer: Aetna New Business (MI Preferred)	$2,987.01
Rate for Payer: Cash Price	$3,676.32
Rate for Payer: Cofinity Commercial	$3,216.78
Rate for Payer: Cofinity Commercial	$3,952.04
Rate for Payer: Cofinity Medicare Advantage	$3,216.78
Rate for Payer: Encore Health Key Benefits Commercial	$3,676.32
Rate for Payer: Healthscope Commercial	$4,135.86
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3,906.09
Rate for Payer: PHP Commercial	$3,906.09
Rate for Payer: Priority Health Cigna Priority Health	$2,987.01
Rate for Payer: Priority Health SBD	$2,895.10

MESALAMINE 800 MG TABLET,DELAYED RELEASE

Facility

$1,410.81

Service Code	NDC 60687040825
Hospital Charge Code	96949
Hospital Revenue Code	637
Min. Negotiated Rate	$888.81
Max. Negotiated Rate	$1,269.73
Rate for Payer: Aetna Commercial	$1,199.19
Rate for Payer: Aetna New Business (MI Preferred)	$917.03
Rate for Payer: Cash Price	$1,128.65
Rate for Payer: Cofinity Commercial	$1,213.30
Rate for Payer: Cofinity Commercial	$987.57
Rate for Payer: Cofinity Medicare Advantage	$987.57
Rate for Payer: Encore Health Key Benefits Commercial	$1,128.65
Rate for Payer: Healthscope Commercial	$1,269.73
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,199.19
Rate for Payer: PHP Commercial	$1,199.19
Rate for Payer: Priority Health Cigna Priority Health	$917.03
Rate for Payer: Priority Health SBD	$888.81

MESALAMINE 800 MG TABLET,DELAYED RELEASE

Facility

$1,410.81

Service Code	NDC 60687040825
Hospital Charge Code	96949
Hospital Revenue Code	637
Min. Negotiated Rate	$564.32
Max. Negotiated Rate	$1,269.73
Rate for Payer: Aetna Commercial	$1,199.19
Rate for Payer: Aetna Medicare	$705.40
Rate for Payer: Aetna New Business (MI Preferred)	$917.03
Rate for Payer: BCBS Complete	$564.32
Rate for Payer: Cash Price	$1,128.65
Rate for Payer: Cofinity Commercial	$1,213.30
Rate for Payer: Cofinity Commercial	$987.57
Rate for Payer: Cofinity Medicare Advantage	$987.57
Rate for Payer: Encore Health Key Benefits Commercial	$1,128.65
Rate for Payer: Healthscope Commercial	$1,269.73
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,199.19
Rate for Payer: PHP Commercial	$1,199.19
Rate for Payer: Priority Health Cigna Priority Health	$917.03
Rate for Payer: Priority Health SBD	$888.81

MESALAMINE 800 MG TABLET,DELAYED RELEASE

Facility

$4,595.40

Service Code	NDC 68382043528
Hospital Charge Code	96949
Hospital Revenue Code	637
Min. Negotiated Rate	$1,838.16
Max. Negotiated Rate	$4,135.86
Rate for Payer: Aetna Commercial	$3,906.09
Rate for Payer: Aetna Medicare	$2,297.70
Rate for Payer: Aetna New Business (MI Preferred)	$2,987.01
Rate for Payer: BCBS Complete	$1,838.16
Rate for Payer: Cash Price	$3,676.32
Rate for Payer: Cofinity Commercial	$3,216.78
Rate for Payer: Cofinity Commercial	$3,952.04
Rate for Payer: Cofinity Medicare Advantage	$3,216.78
Rate for Payer: Encore Health Key Benefits Commercial	$3,676.32
Rate for Payer: Healthscope Commercial	$4,135.86
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3,906.09
Rate for Payer: PHP Commercial	$3,906.09
Rate for Payer: Priority Health Cigna Priority Health	$2,987.01
Rate for Payer: Priority Health SBD	$2,895.10

MESALAMINE ER 250 MG CAPSULE,EXTENDED RELEASE

Facility

$2,507.72

Service Code	NDC 54092018981
Hospital Charge Code	10533
Hospital Revenue Code	637
Min. Negotiated Rate	$1,003.09
Max. Negotiated Rate	$2,256.95
Rate for Payer: Aetna Commercial	$2,131.56
Rate for Payer: Aetna Medicare	$1,253.86
Rate for Payer: Aetna New Business (MI Preferred)	$1,630.02
Rate for Payer: BCBS Complete	$1,003.09
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: Cofinity Medicare Advantage	$1,755.40
Rate for Payer: Encore Health Key Benefits Commercial	$2,006.18
Rate for Payer: Healthscope Commercial	$2,256.95
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2,131.56
Rate for Payer: PHP Commercial	$2,131.56
Rate for Payer: Priority Health Cigna Priority Health	$1,630.02
Rate for Payer: Priority Health SBD	$1,579.86

MESALAMINE ER 250 MG CAPSULE,EXTENDED RELEASE

Facility

$2,507.72

Service Code	NDC 54092018981
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: Cofinity Medicare Advantage	$1,755.40
Rate for Payer: Encore Health Key Benefits Commercial	$2,006.18
Rate for Payer: Healthscope Commercial	$2,256.95
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2,131.56
Rate for Payer: PHP Commercial	$2,131.56
Rate for Payer: Priority Health Cigna Priority Health	$1,630.02
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 45802092341
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: Cofinity Medicare Advantage	$319.48
Rate for Payer: Encore Health Key Benefits Commercial	$365.12
Rate for Payer: Healthscope Commercial	$410.76
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$387.94
Rate for Payer: PHP Commercial	$387.94
Rate for Payer: Priority Health Cigna Priority Health	$296.66
Rate for Payer: Priority Health SBD	$287.53

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

Facility

$456.40

Service Code	NDC 45802092341
Hospital Charge Code	92860
Hospital Revenue Code	637
Min. Negotiated Rate	$182.56
Max. Negotiated Rate	$410.76
Rate for Payer: Aetna Commercial	$387.94
Rate for Payer: Aetna Medicare	$228.20
Rate for Payer: Aetna New Business (MI Preferred)	$296.66
Rate for Payer: BCBS Complete	$182.56
Rate for Payer: Cash Price	$365.12
Rate for Payer: Cofinity Commercial	$319.48
Rate for Payer: Cofinity Commercial	$392.50
Rate for Payer: Cofinity Medicare Advantage	$319.48
Rate for Payer: Encore Health Key Benefits Commercial	$365.12
Rate for Payer: Healthscope Commercial	$410.76
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$387.94
Rate for Payer: PHP Commercial	$387.94
Rate for Payer: Priority Health Cigna Priority Health	$296.66
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	$78.66
Max. Negotiated Rate	$176.98
Rate for Payer: Aetna Commercial	$167.14
Rate for Payer: Aetna Medicare	$98.32
Rate for Payer: Aetna New Business (MI Preferred)	$127.82
Rate for Payer: BCBS Complete	$78.66
Rate for Payer: Cash Price	$157.31
Rate for Payer: Cofinity Commercial	$137.65
Rate for Payer: Cofinity Commercial	$169.11
Rate for Payer: Cofinity Medicare Advantage	$137.65
Rate for Payer: Encore Health Key Benefits Commercial	$157.31
Rate for Payer: Healthscope Commercial	$176.98
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$167.14
Rate for Payer: PHP Commercial	$167.14
Rate for Payer: Priority Health Cigna Priority Health	$127.82
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	$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: Cofinity Medicare Advantage	$137.65
Rate for Payer: Encore Health Key Benefits Commercial	$157.31
Rate for Payer: Healthscope Commercial	$176.98
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$167.14
Rate for Payer: PHP Commercial	$167.14
Rate for Payer: Priority Health Cigna Priority Health	$127.82
Rate for Payer: Priority Health SBD	$123.88

METATARSECTOMY

Facility

$8,907.47

Service Code	CPT 28140
Hospital Revenue Code	360
Min. Negotiated Rate	$1,696.12
Max. Negotiated Rate	$8,907.47
Rate for Payer: Aetna Medicare	$3,290.98
Rate for Payer: Allen County Amish Medical Aid Commercial	$3,955.50
Rate for Payer: Amish Plain Church Group Commercial	$3,955.50
Rate for Payer: BCBS Complete	$1,780.92
Rate for Payer: BCBS MAPPO	$3,164.40
Rate for Payer: BCN Medicare Advantage	$3,164.40
Rate for Payer: Health Alliance Plan Medicare Advantage	$3,164.40
Rate for Payer: Mclaren Medicaid	$1,696.12
Rate for Payer: Mclaren Medicare	$3,164.40
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$3,322.62
Rate for Payer: Meridian Medicaid	$1,780.92
Rate for Payer: MI Amish Medical Board Commercial	$3,639.06
Rate for Payer: PACE Medicare	$3,006.18
Rate for Payer: PACE SWMI	$3,164.40
Rate for Payer: PHP Medicare Advantage	$3,164.40
Rate for Payer: Priority Health Choice Medicaid	$1,696.12
Rate for Payer: Priority Health Medicare	$3,164.40
Rate for Payer: Railroad Medicare Medicare	$3,164.40
Rate for Payer: UHC All Payor (Choice/PPO)	$8,907.47
Rate for Payer: UHC Dual Complete DSNP	$3,164.40
Rate for Payer: UHC Medicare Advantage	$3,164.40
Rate for Payer: UHCCP Medicaid	$1,781.56
Rate for Payer: VA VA	$3,164.40

METFORMIN 1,000 MG TABLET

Facility

$220.90

Service Code	NDC 00904716461
Hospital Charge Code	24398
Hospital Revenue Code	637
Min. Negotiated Rate	$88.36
Max. Negotiated Rate	$198.81
Rate for Payer: Aetna Commercial	$187.76
Rate for Payer: Aetna Medicare	$110.45
Rate for Payer: Aetna New Business (MI Preferred)	$143.59
Rate for Payer: BCBS Complete	$88.36
Rate for Payer: Cash Price	$176.72
Rate for Payer: Cofinity Commercial	$154.63
Rate for Payer: Cofinity Commercial	$189.97
Rate for Payer: Cofinity Medicare Advantage	$154.63
Rate for Payer: Encore Health Key Benefits Commercial	$176.72
Rate for Payer: Healthscope Commercial	$198.81
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$187.76
Rate for Payer: PHP Commercial	$187.76
Rate for Payer: Priority Health Cigna Priority Health	$143.59
Rate for Payer: Priority Health SBD	$139.17

METFORMIN 1,000 MG TABLET

Facility

$359.55

Service Code	NDC 60687016201
Hospital Charge Code	24398
Hospital Revenue Code	637
Min. Negotiated Rate	$226.52
Max. Negotiated Rate	$323.60
Rate for Payer: Aetna Commercial	$305.62
Rate for Payer: Aetna New Business (MI Preferred)	$233.71
Rate for Payer: Cash Price	$287.64
Rate for Payer: Cofinity Commercial	$251.69
Rate for Payer: Cofinity Commercial	$309.21
Rate for Payer: Cofinity Medicare Advantage	$251.69
Rate for Payer: Encore Health Key Benefits Commercial	$287.64
Rate for Payer: Healthscope Commercial	$323.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$305.62
Rate for Payer: PHP Commercial	$305.62
Rate for Payer: Priority Health Cigna Priority Health	$233.71
Rate for Payer: Priority Health SBD	$226.52

METFORMIN 1,000 MG TABLET

Facility

$359.55

Service Code	NDC 60687016201
Hospital Charge Code	24398
Hospital Revenue Code	637
Min. Negotiated Rate	$143.82
Max. Negotiated Rate	$323.60
Rate for Payer: Aetna Commercial	$305.62
Rate for Payer: Aetna Medicare	$179.78
Rate for Payer: Aetna New Business (MI Preferred)	$233.71
Rate for Payer: BCBS Complete	$143.82
Rate for Payer: Cash Price	$287.64
Rate for Payer: Cofinity Commercial	$251.69
Rate for Payer: Cofinity Commercial	$309.21
Rate for Payer: Cofinity Medicare Advantage	$251.69
Rate for Payer: Encore Health Key Benefits Commercial	$287.64
Rate for Payer: Healthscope Commercial	$323.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$305.62
Rate for Payer: PHP Commercial	$305.62
Rate for Payer: Priority Health Cigna Priority Health	$233.71
Rate for Payer: Priority Health SBD	$226.52

METFORMIN 1,000 MG TABLET

Facility

$220.90

Service Code	NDC 00904716461
Hospital Charge Code	24398
Hospital Revenue Code	637
Min. Negotiated Rate	$139.17
Max. Negotiated Rate	$198.81
Rate for Payer: Aetna Commercial	$187.76
Rate for Payer: Aetna New Business (MI Preferred)	$143.59
Rate for Payer: Cash Price	$176.72
Rate for Payer: Cofinity Commercial	$154.63
Rate for Payer: Cofinity Commercial	$189.97
Rate for Payer: Cofinity Medicare Advantage	$154.63
Rate for Payer: Encore Health Key Benefits Commercial	$176.72
Rate for Payer: Healthscope Commercial	$198.81
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$187.76
Rate for Payer: PHP Commercial	$187.76
Rate for Payer: Priority Health Cigna Priority Health	$143.59
Rate for Payer: Priority Health SBD	$139.17

METFORMIN 1,000 MG TABLET

Facility

$3.60

Service Code	NDC 60687016211
Hospital Charge Code	24398
Hospital Revenue Code	637
Min. Negotiated Rate	$2.27
Max. Negotiated Rate	$3.24
Rate for Payer: Aetna Commercial	$3.06
Rate for Payer: Aetna New Business (MI Preferred)	$2.34
Rate for Payer: Cash Price	$2.88
Rate for Payer: Cofinity Commercial	$2.52
Rate for Payer: Cofinity Commercial	$3.10
Rate for Payer: Cofinity Medicare Advantage	$2.52
Rate for Payer: Encore Health Key Benefits Commercial	$2.88
Rate for Payer: Healthscope Commercial	$3.24
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3.06
Rate for Payer: PHP Commercial	$3.06
Rate for Payer: Priority Health Cigna Priority Health	$2.34
Rate for Payer: Priority Health SBD	$2.27

METFORMIN 1,000 MG TABLET

Facility

$3.60

Service Code	NDC 60687016211
Hospital Charge Code	24398
Hospital Revenue Code	637
Min. Negotiated Rate	$1.44
Max. Negotiated Rate	$3.24
Rate for Payer: Aetna Commercial	$3.06
Rate for Payer: Aetna Medicare	$1.80
Rate for Payer: Aetna New Business (MI Preferred)	$2.34
Rate for Payer: BCBS Complete	$1.44
Rate for Payer: Cash Price	$2.88
Rate for Payer: Cofinity Commercial	$2.52
Rate for Payer: Cofinity Commercial	$3.10
Rate for Payer: Cofinity Medicare Advantage	$2.52
Rate for Payer: Encore Health Key Benefits Commercial	$2.88
Rate for Payer: Healthscope Commercial	$3.24
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3.06
Rate for Payer: PHP Commercial	$3.06
Rate for Payer: Priority Health Cigna Priority Health	$2.34
Rate for Payer: Priority Health SBD	$2.27

METFORMIN 500 MG TABLET

Facility

$2.47

Service Code	NDC 60687015511
Hospital Charge Code	10544
Hospital Revenue Code	637
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$2.22
Rate for Payer: Aetna Commercial	$2.10
Rate for Payer: Aetna New Business (MI Preferred)	$1.61
Rate for Payer: Cash Price	$1.98
Rate for Payer: Cofinity Commercial	$1.73
Rate for Payer: Cofinity Commercial	$2.12
Rate for Payer: Cofinity Medicare Advantage	$1.73
Rate for Payer: Encore Health Key Benefits Commercial	$1.98
Rate for Payer: Healthscope Commercial	$2.22
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2.10
Rate for Payer: PHP Commercial	$2.10
Rate for Payer: Priority Health Cigna Priority Health	$1.61
Rate for Payer: Priority Health SBD	$1.56

METFORMIN 500 MG TABLET

Facility

$246.75

Service Code	NDC 60687015501
Hospital Charge Code	10544
Hospital Revenue Code	637
Min. Negotiated Rate	$98.70
Max. Negotiated Rate	$222.07
Rate for Payer: Aetna Commercial	$209.74
Rate for Payer: Aetna Medicare	$123.38
Rate for Payer: Aetna New Business (MI Preferred)	$160.39
Rate for Payer: BCBS Complete	$98.70
Rate for Payer: Cash Price	$197.40
Rate for Payer: Cofinity Commercial	$172.72
Rate for Payer: Cofinity Commercial	$212.21
Rate for Payer: Cofinity Medicare Advantage	$172.72
Rate for Payer: Encore Health Key Benefits Commercial	$197.40
Rate for Payer: Healthscope Commercial	$222.07
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$209.74
Rate for Payer: PHP Commercial	$209.74
Rate for Payer: Priority Health Cigna Priority Health	$160.39
Rate for Payer: Priority Health SBD	$155.45

METFORMIN 500 MG TABLET

Facility

$42.30

Service Code	NDC 70010006301
Hospital Charge Code	10544
Hospital Revenue Code	637
Min. Negotiated Rate	$16.92
Max. Negotiated Rate	$38.07
Rate for Payer: Aetna Commercial	$35.95
Rate for Payer: Aetna Medicare	$21.15
Rate for Payer: Aetna New Business (MI Preferred)	$27.50
Rate for Payer: BCBS Complete	$16.92
Rate for Payer: Cash Price	$33.84
Rate for Payer: Cofinity Commercial	$29.61
Rate for Payer: Cofinity Commercial	$36.38
Rate for Payer: Cofinity Medicare Advantage	$29.61
Rate for Payer: Encore Health Key Benefits Commercial	$33.84
Rate for Payer: Healthscope Commercial	$38.07
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$35.95
Rate for Payer: PHP Commercial	$35.95
Rate for Payer: Priority Health Cigna Priority Health	$27.50
Rate for Payer: Priority Health SBD	$26.65

METFORMIN 500 MG TABLET

Facility

$282.00

Service Code	NDC 70010006310
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: Cofinity Medicare Advantage	$197.40
Rate for Payer: Encore Health Key Benefits Commercial	$225.60
Rate for Payer: Healthscope Commercial	$253.80
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$239.70
Rate for Payer: PHP Commercial	$239.70
Rate for Payer: Priority Health Cigna Priority Health	$183.30
Rate for Payer: Priority Health SBD	$177.66

Know your out-of-pocket cost for care.

All Charges