Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

METFORMIN 1,000 MG TABLET

Facility

$256.15

Service Code	NDC 00904716461
Hospital Charge Code	24398
Hospital Revenue Code	637
Min. Negotiated Rate	$100.67
Max. Negotiated Rate	$230.53
Rate for Payer: Aetna Commercial	$217.73
Rate for Payer: Aetna Medicare	$128.07
Rate for Payer: Aetna New Business (MI Preferred)	$166.50
Rate for Payer: BCBS Complete	$102.46
Rate for Payer: Cash Price	$204.92
Rate for Payer: Cofinity Advantage	$179.31
Rate for Payer: Cofinity Commercial	$220.29
Rate for Payer: Encore Health Key Benefits Commercial	$204.92
Rate for Payer: Healthscope Commercial	$230.53
Rate for Payer: MI Amish Medical Board Commercial	$204.92
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$217.73
Rate for Payer: Opus (Opus Packaging Group) HMA	$192.11
Rate for Payer: PHP Commercial	$217.73
Rate for Payer: Priority Health SBD	$161.37
Rate for Payer: UHC All Payor (Choice/PPO)	$166.50
Rate for Payer: UHC Core	$133.45
Rate for Payer: UHC Exchange	$100.67

METFORMIN 1,000 MG TABLET

Facility

$3.39

Service Code	NDC 60687016211
Hospital Charge Code	24398
Hospital Revenue Code	637
Min. Negotiated Rate	$2.14
Max. Negotiated Rate	$3.05
Rate for Payer: Aetna Commercial	$2.88
Rate for Payer: Aetna New Business (MI Preferred)	$2.20
Rate for Payer: Cash Price	$2.71
Rate for Payer: Cofinity Advantage	$2.37
Rate for Payer: Cofinity Commercial	$2.92
Rate for Payer: Encore Health Key Benefits Commercial	$2.71
Rate for Payer: Healthscope Commercial	$3.05
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2.88
Rate for Payer: Opus (Opus Packaging Group) HMA	$2.54
Rate for Payer: PHP Commercial	$2.88
Rate for Payer: Priority Health SBD	$2.14

METFORMIN 500 MG TABLET

Facility

$162.15

Service Code	NDC 00904716261
Hospital Charge Code	10544
Hospital Revenue Code	637
Min. Negotiated Rate	$102.15
Max. Negotiated Rate	$145.94
Rate for Payer: Aetna Commercial	$137.83
Rate for Payer: Aetna New Business (MI Preferred)	$105.40
Rate for Payer: Cash Price	$129.72
Rate for Payer: Cofinity Advantage	$113.50
Rate for Payer: Cofinity Commercial	$139.45
Rate for Payer: Encore Health Key Benefits Commercial	$129.72
Rate for Payer: Healthscope Commercial	$145.94
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$137.83
Rate for Payer: Opus (Opus Packaging Group) HMA	$121.61
Rate for Payer: PHP Commercial	$137.83
Rate for Payer: Priority Health SBD	$102.15

METFORMIN 500 MG TABLET

Facility

$230.30

Service Code	NDC 60687015501
Hospital Charge Code	10544
Hospital Revenue Code	637
Min. Negotiated Rate	$145.09
Max. Negotiated Rate	$207.27
Rate for Payer: Aetna Commercial	$195.75
Rate for Payer: Aetna New Business (MI Preferred)	$149.69
Rate for Payer: Cash Price	$184.24
Rate for Payer: Cofinity Advantage	$161.21
Rate for Payer: Cofinity Commercial	$198.06
Rate for Payer: Encore Health Key Benefits Commercial	$184.24
Rate for Payer: Healthscope Commercial	$207.27
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$195.75
Rate for Payer: Opus (Opus Packaging Group) HMA	$172.72
Rate for Payer: PHP Commercial	$195.75
Rate for Payer: Priority Health SBD	$145.09

METFORMIN 500 MG TABLET

Facility

$86.95

Service Code	NDC 23155010201
Hospital Charge Code	10544
Hospital Revenue Code	637
Min. Negotiated Rate	$54.78
Max. Negotiated Rate	$78.25
Rate for Payer: Aetna Commercial	$73.91
Rate for Payer: Aetna New Business (MI Preferred)	$56.52
Rate for Payer: Cash Price	$69.56
Rate for Payer: Cofinity Advantage	$60.87
Rate for Payer: Cofinity Commercial	$74.78
Rate for Payer: Encore Health Key Benefits Commercial	$69.56
Rate for Payer: Healthscope Commercial	$78.25
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$73.91
Rate for Payer: Opus (Opus Packaging Group) HMA	$65.21
Rate for Payer: PHP Commercial	$73.91
Rate for Payer: Priority Health SBD	$54.78

METFORMIN 500 MG TABLET

Facility

$108.10

Service Code	NDC 71093013204
Hospital Charge Code	10544
Hospital Revenue Code	637
Min. Negotiated Rate	$68.10
Max. Negotiated Rate	$97.29
Rate for Payer: Aetna Commercial	$91.89
Rate for Payer: Aetna New Business (MI Preferred)	$70.27
Rate for Payer: Cash Price	$86.48
Rate for Payer: Cofinity Advantage	$75.67
Rate for Payer: Cofinity Commercial	$92.97
Rate for Payer: Encore Health Key Benefits Commercial	$86.48
Rate for Payer: Healthscope Commercial	$97.29
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$91.89
Rate for Payer: Opus (Opus Packaging Group) HMA	$81.08
Rate for Payer: PHP Commercial	$91.89
Rate for Payer: Priority Health SBD	$68.10

METFORMIN 500 MG TABLET

Facility

$51.70

Service Code	NDC 70010006301
Hospital Charge Code	10544
Hospital Revenue Code	637
Min. Negotiated Rate	$32.57
Max. Negotiated Rate	$46.53
Rate for Payer: Aetna Commercial	$43.95
Rate for Payer: Aetna New Business (MI Preferred)	$33.60
Rate for Payer: Cash Price	$41.36
Rate for Payer: Cofinity Advantage	$36.19
Rate for Payer: Cofinity Commercial	$44.46
Rate for Payer: Encore Health Key Benefits Commercial	$41.36
Rate for Payer: Healthscope Commercial	$46.53
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$43.95
Rate for Payer: Opus (Opus Packaging Group) HMA	$38.77
Rate for Payer: PHP Commercial	$43.95
Rate for Payer: Priority Health SBD	$32.57

METFORMIN 500 MG TABLET

Facility

$352.50

Service Code	NDC 70010006310
Hospital Charge Code	10544
Hospital Revenue Code	637
Min. Negotiated Rate	$138.53
Max. Negotiated Rate	$317.25
Rate for Payer: Aetna Commercial	$299.62
Rate for Payer: Aetna Medicare	$176.25
Rate for Payer: Aetna New Business (MI Preferred)	$229.12
Rate for Payer: BCBS Complete	$141.00
Rate for Payer: Cash Price	$282.00
Rate for Payer: Cofinity Advantage	$246.75
Rate for Payer: Cofinity Commercial	$303.15
Rate for Payer: Encore Health Key Benefits Commercial	$282.00
Rate for Payer: Healthscope Commercial	$317.25
Rate for Payer: MI Amish Medical Board Commercial	$282.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$299.62
Rate for Payer: Opus (Opus Packaging Group) HMA	$264.38
Rate for Payer: PHP Commercial	$299.62
Rate for Payer: Priority Health SBD	$222.07
Rate for Payer: UHC All Payor (Choice/PPO)	$229.12
Rate for Payer: UHC Core	$183.65
Rate for Payer: UHC Exchange	$138.53

METFORMIN 500 MG TABLET

Facility

$2.31

Service Code	NDC 60687015511
Hospital Charge Code	10544
Hospital Revenue Code	637
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$2.08
Rate for Payer: Aetna Commercial	$1.96
Rate for Payer: Aetna Medicare	$1.16
Rate for Payer: Aetna New Business (MI Preferred)	$1.50
Rate for Payer: BCBS Complete	$0.92
Rate for Payer: Cash Price	$1.85
Rate for Payer: Cofinity Advantage	$1.62
Rate for Payer: Cofinity Commercial	$1.99
Rate for Payer: Encore Health Key Benefits Commercial	$1.85
Rate for Payer: Healthscope Commercial	$2.08
Rate for Payer: MI Amish Medical Board Commercial	$1.85
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1.96
Rate for Payer: Opus (Opus Packaging Group) HMA	$1.73
Rate for Payer: PHP Commercial	$1.96
Rate for Payer: Priority Health SBD	$1.46
Rate for Payer: UHC All Payor (Choice/PPO)	$1.50
Rate for Payer: UHC Core	$1.20
Rate for Payer: UHC Exchange	$0.91

METFORMIN 500 MG TABLET

Facility

$230.30

Service Code	NDC 60687015501
Hospital Charge Code	10544
Hospital Revenue Code	637
Min. Negotiated Rate	$90.51
Max. Negotiated Rate	$207.27
Rate for Payer: Aetna Commercial	$195.75
Rate for Payer: Aetna Medicare	$115.15
Rate for Payer: Aetna New Business (MI Preferred)	$149.69
Rate for Payer: BCBS Complete	$92.12
Rate for Payer: Cash Price	$184.24
Rate for Payer: Cofinity Advantage	$161.21
Rate for Payer: Cofinity Commercial	$198.06
Rate for Payer: Encore Health Key Benefits Commercial	$184.24
Rate for Payer: Healthscope Commercial	$207.27
Rate for Payer: MI Amish Medical Board Commercial	$184.24
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$195.75
Rate for Payer: Opus (Opus Packaging Group) HMA	$172.72
Rate for Payer: PHP Commercial	$195.75
Rate for Payer: Priority Health SBD	$145.09
Rate for Payer: UHC All Payor (Choice/PPO)	$149.69
Rate for Payer: UHC Core	$119.99
Rate for Payer: UHC Exchange	$90.51

METFORMIN 500 MG TABLET

Facility

$2.31

Service Code	NDC 60687015511
Hospital Charge Code	10544
Hospital Revenue Code	637
Min. Negotiated Rate	$1.46
Max. Negotiated Rate	$2.08
Rate for Payer: Aetna Commercial	$1.96
Rate for Payer: Aetna New Business (MI Preferred)	$1.50
Rate for Payer: Cash Price	$1.85
Rate for Payer: Cofinity Advantage	$1.62
Rate for Payer: Cofinity Commercial	$1.99
Rate for Payer: Encore Health Key Benefits Commercial	$1.85
Rate for Payer: Healthscope Commercial	$2.08
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1.96
Rate for Payer: Opus (Opus Packaging Group) HMA	$1.73
Rate for Payer: PHP Commercial	$1.96
Rate for Payer: Priority Health SBD	$1.46

METFORMIN 500 MG TABLET

Facility

$108.10

Service Code	NDC 71093013204
Hospital Charge Code	10544
Hospital Revenue Code	637
Min. Negotiated Rate	$42.48
Max. Negotiated Rate	$97.29
Rate for Payer: Aetna Commercial	$91.89
Rate for Payer: Aetna Medicare	$54.05
Rate for Payer: Aetna New Business (MI Preferred)	$70.27
Rate for Payer: BCBS Complete	$43.24
Rate for Payer: Cash Price	$86.48
Rate for Payer: Cofinity Advantage	$75.67
Rate for Payer: Cofinity Commercial	$92.97
Rate for Payer: Encore Health Key Benefits Commercial	$86.48
Rate for Payer: Healthscope Commercial	$97.29
Rate for Payer: MI Amish Medical Board Commercial	$86.48
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$91.89
Rate for Payer: Opus (Opus Packaging Group) HMA	$81.08
Rate for Payer: PHP Commercial	$91.89
Rate for Payer: Priority Health SBD	$68.10
Rate for Payer: UHC All Payor (Choice/PPO)	$70.27
Rate for Payer: UHC Core	$56.32
Rate for Payer: UHC Exchange	$42.48

METFORMIN 500 MG TABLET

Facility

$352.50

Service Code	NDC 70010006310
Hospital Charge Code	10544
Hospital Revenue Code	637
Min. Negotiated Rate	$222.07
Max. Negotiated Rate	$317.25
Rate for Payer: Aetna Commercial	$299.62
Rate for Payer: Aetna New Business (MI Preferred)	$229.12
Rate for Payer: Cash Price	$282.00
Rate for Payer: Cofinity Advantage	$246.75
Rate for Payer: Cofinity Commercial	$303.15
Rate for Payer: Encore Health Key Benefits Commercial	$282.00
Rate for Payer: Healthscope Commercial	$317.25
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$299.62
Rate for Payer: Opus (Opus Packaging Group) HMA	$264.38
Rate for Payer: PHP Commercial	$299.62
Rate for Payer: Priority Health SBD	$222.07

METFORMIN 500 MG TABLET

Facility

$51.70

Service Code	NDC 70010006301
Hospital Charge Code	10544
Hospital Revenue Code	637
Min. Negotiated Rate	$20.32
Max. Negotiated Rate	$46.53
Rate for Payer: Aetna Commercial	$43.95
Rate for Payer: Aetna Medicare	$25.85
Rate for Payer: Aetna New Business (MI Preferred)	$33.60
Rate for Payer: BCBS Complete	$20.68
Rate for Payer: Cash Price	$41.36
Rate for Payer: Cofinity Advantage	$36.19
Rate for Payer: Cofinity Commercial	$44.46
Rate for Payer: Encore Health Key Benefits Commercial	$41.36
Rate for Payer: Healthscope Commercial	$46.53
Rate for Payer: MI Amish Medical Board Commercial	$41.36
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$43.95
Rate for Payer: Opus (Opus Packaging Group) HMA	$38.77
Rate for Payer: PHP Commercial	$43.95
Rate for Payer: Priority Health SBD	$32.57
Rate for Payer: UHC All Payor (Choice/PPO)	$33.60
Rate for Payer: UHC Core	$26.94
Rate for Payer: UHC Exchange	$20.32

METFORMIN 500 MG TABLET

Facility

$162.15

Service Code	NDC 00904716261
Hospital Charge Code	10544
Hospital Revenue Code	637
Min. Negotiated Rate	$63.72
Max. Negotiated Rate	$145.94
Rate for Payer: Aetna Commercial	$137.83
Rate for Payer: Aetna Medicare	$81.08
Rate for Payer: Aetna New Business (MI Preferred)	$105.40
Rate for Payer: BCBS Complete	$64.86
Rate for Payer: Cash Price	$129.72
Rate for Payer: Cofinity Advantage	$113.50
Rate for Payer: Cofinity Commercial	$139.45
Rate for Payer: Encore Health Key Benefits Commercial	$129.72
Rate for Payer: Healthscope Commercial	$145.94
Rate for Payer: MI Amish Medical Board Commercial	$129.72
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$137.83
Rate for Payer: Opus (Opus Packaging Group) HMA	$121.61
Rate for Payer: PHP Commercial	$137.83
Rate for Payer: Priority Health SBD	$102.15
Rate for Payer: UHC All Payor (Choice/PPO)	$105.40
Rate for Payer: UHC Core	$84.48
Rate for Payer: UHC Exchange	$63.72

METFORMIN 500 MG TABLET

Facility

$86.95

Service Code	NDC 23155010201
Hospital Charge Code	10544
Hospital Revenue Code	637
Min. Negotiated Rate	$34.17
Max. Negotiated Rate	$78.25
Rate for Payer: Aetna Commercial	$73.91
Rate for Payer: Aetna Medicare	$43.48
Rate for Payer: Aetna New Business (MI Preferred)	$56.52
Rate for Payer: BCBS Complete	$34.78
Rate for Payer: Cash Price	$69.56
Rate for Payer: Cofinity Advantage	$60.87
Rate for Payer: Cofinity Commercial	$74.78
Rate for Payer: Encore Health Key Benefits Commercial	$69.56
Rate for Payer: Healthscope Commercial	$78.25
Rate for Payer: MI Amish Medical Board Commercial	$69.56
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$73.91
Rate for Payer: Opus (Opus Packaging Group) HMA	$65.21
Rate for Payer: PHP Commercial	$73.91
Rate for Payer: Priority Health SBD	$54.78
Rate for Payer: UHC All Payor (Choice/PPO)	$56.52
Rate for Payer: UHC Core	$45.30
Rate for Payer: UHC Exchange	$34.17

METFORMIN 850 MG TABLET

Facility

$1.92

Service Code	NDC 60687014311
Hospital Charge Code	14719
Hospital Revenue Code	637
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$1.73
Rate for Payer: Aetna Commercial	$1.63
Rate for Payer: Aetna New Business (MI Preferred)	$1.25
Rate for Payer: Cash Price	$1.54
Rate for Payer: Cofinity Advantage	$1.34
Rate for Payer: Cofinity Commercial	$1.65
Rate for Payer: Encore Health Key Benefits Commercial	$1.54
Rate for Payer: Healthscope Commercial	$1.73
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1.63
Rate for Payer: Opus (Opus Packaging Group) HMA	$1.44
Rate for Payer: PHP Commercial	$1.63
Rate for Payer: Priority Health SBD	$1.21

METFORMIN 850 MG TABLET

Facility

$191.90

Service Code	NDC 60687014301
Hospital Charge Code	14719
Hospital Revenue Code	637
Min. Negotiated Rate	$75.42
Max. Negotiated Rate	$172.71
Rate for Payer: Aetna Commercial	$163.12
Rate for Payer: Aetna Medicare	$95.95
Rate for Payer: Aetna New Business (MI Preferred)	$124.73
Rate for Payer: BCBS Complete	$76.76
Rate for Payer: Cash Price	$153.52
Rate for Payer: Cofinity Advantage	$134.33
Rate for Payer: Cofinity Commercial	$165.03
Rate for Payer: Encore Health Key Benefits Commercial	$153.52
Rate for Payer: Healthscope Commercial	$172.71
Rate for Payer: MI Amish Medical Board Commercial	$153.52
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$163.12
Rate for Payer: Opus (Opus Packaging Group) HMA	$143.93
Rate for Payer: PHP Commercial	$163.12
Rate for Payer: Priority Health SBD	$120.90
Rate for Payer: UHC All Payor (Choice/PPO)	$124.73
Rate for Payer: UHC Core	$99.98
Rate for Payer: UHC Exchange	$75.42

METFORMIN 850 MG TABLET

Facility

$191.90

Service Code	NDC 60687014301
Hospital Charge Code	14719
Hospital Revenue Code	637
Min. Negotiated Rate	$120.90
Max. Negotiated Rate	$172.71
Rate for Payer: Aetna Commercial	$163.12
Rate for Payer: Aetna New Business (MI Preferred)	$124.73
Rate for Payer: Cash Price	$153.52
Rate for Payer: Cofinity Advantage	$134.33
Rate for Payer: Cofinity Commercial	$165.03
Rate for Payer: Encore Health Key Benefits Commercial	$153.52
Rate for Payer: Healthscope Commercial	$172.71
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$163.12
Rate for Payer: Opus (Opus Packaging Group) HMA	$143.93
Rate for Payer: PHP Commercial	$163.12
Rate for Payer: Priority Health SBD	$120.90

METFORMIN 850 MG TABLET

Facility

$1.92

Service Code	NDC 60687014311
Hospital Charge Code	14719
Hospital Revenue Code	637
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$1.73
Rate for Payer: Aetna Commercial	$1.63
Rate for Payer: Aetna Medicare	$0.96
Rate for Payer: Aetna New Business (MI Preferred)	$1.25
Rate for Payer: BCBS Complete	$0.77
Rate for Payer: Cash Price	$1.54
Rate for Payer: Cofinity Advantage	$1.34
Rate for Payer: Cofinity Commercial	$1.65
Rate for Payer: Encore Health Key Benefits Commercial	$1.54
Rate for Payer: Healthscope Commercial	$1.73
Rate for Payer: MI Amish Medical Board Commercial	$1.54
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1.63
Rate for Payer: Opus (Opus Packaging Group) HMA	$1.44
Rate for Payer: PHP Commercial	$1.63
Rate for Payer: Priority Health SBD	$1.21
Rate for Payer: UHC All Payor (Choice/PPO)	$1.25
Rate for Payer: UHC Core	$1.00
Rate for Payer: UHC Exchange	$0.75

METFORMIN ER 500 MG 24 HR TABLET,EXTENDED RELEASE (GASTRIC RETENTION)

Facility

$334.56

Service Code	NDC 68462052001
Hospital Charge Code	77856
Hospital Revenue Code	637
Min. Negotiated Rate	$131.48
Max. Negotiated Rate	$301.10
Rate for Payer: Aetna Commercial	$284.38
Rate for Payer: Aetna Medicare	$167.28
Rate for Payer: Aetna New Business (MI Preferred)	$217.46
Rate for Payer: BCBS Complete	$133.82
Rate for Payer: Cash Price	$267.65
Rate for Payer: Cofinity Advantage	$234.19
Rate for Payer: Cofinity Commercial	$287.72
Rate for Payer: Encore Health Key Benefits Commercial	$267.65
Rate for Payer: Healthscope Commercial	$301.10
Rate for Payer: MI Amish Medical Board Commercial	$267.65
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$284.38
Rate for Payer: Opus (Opus Packaging Group) HMA	$250.92
Rate for Payer: PHP Commercial	$284.38
Rate for Payer: Priority Health SBD	$210.77
Rate for Payer: UHC All Payor (Choice/PPO)	$217.46
Rate for Payer: UHC Core	$174.31
Rate for Payer: UHC Exchange	$131.48

METFORMIN ER 500 MG 24 HR TABLET,EXTENDED RELEASE (GASTRIC RETENTION)

Facility

$334.56

Service Code	NDC 68462052001
Hospital Charge Code	77856
Hospital Revenue Code	637
Min. Negotiated Rate	$210.77
Max. Negotiated Rate	$301.10
Rate for Payer: Aetna Commercial	$284.38
Rate for Payer: Aetna New Business (MI Preferred)	$217.46
Rate for Payer: Cash Price	$267.65
Rate for Payer: Cofinity Advantage	$234.19
Rate for Payer: Cofinity Commercial	$287.72
Rate for Payer: Encore Health Key Benefits Commercial	$267.65
Rate for Payer: Healthscope Commercial	$301.10
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$284.38
Rate for Payer: Opus (Opus Packaging Group) HMA	$250.92
Rate for Payer: PHP Commercial	$284.38
Rate for Payer: Priority Health SBD	$210.77

METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR

Facility

$208.05

Service Code	NDC 50268055015
Hospital Charge Code	28995
Hospital Revenue Code	637
Min. Negotiated Rate	$81.76
Max. Negotiated Rate	$187.25
Rate for Payer: Aetna Commercial	$176.84
Rate for Payer: Aetna Medicare	$104.03
Rate for Payer: Aetna New Business (MI Preferred)	$135.23
Rate for Payer: BCBS Complete	$83.22
Rate for Payer: Cash Price	$166.44
Rate for Payer: Cofinity Advantage	$145.63
Rate for Payer: Cofinity Commercial	$178.92
Rate for Payer: Encore Health Key Benefits Commercial	$166.44
Rate for Payer: Healthscope Commercial	$187.25
Rate for Payer: MI Amish Medical Board Commercial	$166.44
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$176.84
Rate for Payer: Opus (Opus Packaging Group) HMA	$156.04
Rate for Payer: PHP Commercial	$176.84
Rate for Payer: Priority Health SBD	$131.07
Rate for Payer: UHC All Payor (Choice/PPO)	$135.23
Rate for Payer: UHC Core	$108.39
Rate for Payer: UHC Exchange	$81.76

METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR

Facility

$4.17

Service Code	NDC 50268055011
Hospital Charge Code	28995
Hospital Revenue Code	637
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$3.75
Rate for Payer: Aetna Commercial	$3.54
Rate for Payer: Aetna Medicare	$2.08
Rate for Payer: Aetna New Business (MI Preferred)	$2.71
Rate for Payer: BCBS Complete	$1.67
Rate for Payer: Cash Price	$3.34
Rate for Payer: Cofinity Advantage	$2.92
Rate for Payer: Cofinity Commercial	$3.59
Rate for Payer: Encore Health Key Benefits Commercial	$3.34
Rate for Payer: Healthscope Commercial	$3.75
Rate for Payer: MI Amish Medical Board Commercial	$3.34
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3.54
Rate for Payer: Opus (Opus Packaging Group) HMA	$3.13
Rate for Payer: PHP Commercial	$3.54
Rate for Payer: Priority Health SBD	$2.63
Rate for Payer: UHC All Payor (Choice/PPO)	$2.71
Rate for Payer: UHC Core	$2.17
Rate for Payer: UHC Exchange	$1.64

METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR

Facility

$208.05

Service Code	NDC 50268055015
Hospital Charge Code	28995
Hospital Revenue Code	637
Min. Negotiated Rate	$131.07
Max. Negotiated Rate	$187.25
Rate for Payer: Aetna Commercial	$176.84
Rate for Payer: Aetna New Business (MI Preferred)	$135.23
Rate for Payer: Cash Price	$166.44
Rate for Payer: Cofinity Advantage	$145.63
Rate for Payer: Cofinity Commercial	$178.92
Rate for Payer: Encore Health Key Benefits Commercial	$166.44
Rate for Payer: Healthscope Commercial	$187.25
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$176.84
Rate for Payer: Opus (Opus Packaging Group) HMA	$156.04
Rate for Payer: PHP Commercial	$176.84
Rate for Payer: Priority Health SBD	$131.07

Know your out-of-pocket cost for care.

All Charges